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Research Article: Cross-Cultural Participation in Food-Related Activities and Quality of Life among Children with Celiac Disease

Date Published: 2023-07-28

Abstract:
Children with celiac disease may face challenges in managing a gluten-free diet during their daily interactions and activities. The objective of this study was to compare how children with celiac disease manage their gluten-free diet and participate in food-related activities in Italy and Israel and to assess their quality of life. The previously validated Children’s Activities Report (CD-Chart) and the Disease-specific Health-Related Quality of Life Questionnaire for Children with Celiac Disease (CDDUX) were administered in Italy to children aged 8–16 diagnosed with CD (n = 39). The results were compared to data that had been previously gathered from Israeli children with CD (n = 106). The CD-Chart demonstrated satisfactory internal reliability within each cultural group (Italy: ? = 0.82; Israel: ? = 0.76). Mann–Whitney U-tests indicated significant differences between the two groups. The Italian children exhibited a significantly higher preference for participating in the activities compared to the Israelis (U = 3283.50, p < 0.001). Nonetheless, the Italian children displayed a notable decrease in their level of involvement in the preparation required before engaging in different activities (U = 760.50, p < 0.001). Moreover, they exhibited significantly lower self-determination in this preparatory process compared to the Israeli children (U = 726.00, p < 0.001). Significant group differences were found between the CDDUX children’s self-reports and parents’ proxy reports in the Israeli group but not in the Italian group. The CD-Chart revealed both shared and distinct participation characteristics in daily food-related activities across different cultural contexts. By incorporating the CD-Chart and the CDDUX, healthcare professionals can emphasize crucial aspects of day-to-day health management and guide them in establishing suitable intervention objectives to enhance effective health self-management.

Introduction:
Celiac disease (CD) is a common autoimmune disorder characterized by chronic inflammation of the small bowel. The condition is triggered by a permanent intolerance to gluten and primarily affects individuals with a genetic predisposition [1,2]. Gluten is a protein present in various grains (wheat, rye, and barley). In fact, the daily intake of gluten in the Mediterranean diet is about 10–20 g/day. Gluten’s main role is not primarily nutritional, as it lacks essential amino acids. However, it is critical in…

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