A170 CANADIANS WITH CELIAC DISEASE MISINTERPRET PRODUCT LABEL INFORMATION WHICH MAY LEAD TO UNSAFE FOOD CHOICES DESPITE ALLERGEN LABELLING LAWS

Patients with celiac disease (CD) often report challenges reading labels as well as inadvertent gluten exposures and the most common cause of non-responsive CD is gluten exposure. To assess whether patients with CD can proficiently assess product labelling to determine if a product is gluten-free. The Manitoba Celiac Disease Cohort includes newly diagnosed adults with elevated TTG and/or EMA antibodies and Marsh III histology. At each follow-up visit (6, 12 and 24 months), participants were presented with 25 grocery items purchased at a local supermarket (different items at each time point) and asked to determine whether each was gluten-free based upon labeling information. The Celiac Diet Assessment Tool (CDAT) and Gluten-Free Eating Assessment Tool (GF-EAT) were used to assess GFD adherence. There were 78 participants (62% female, mean age 40 years) who completed the 24 month study visit, of whom 70 also completed the 6 month assessment and 62 the 12 month assessment. Participants generally reported good gluten-free diet adherence (median CDAT score < 13 at each time point, which is associated with adequate adherence); however, at 24 months 73% reported rare gluten exposure less than once per month on the GF-EAT. Grocery Quiz scores were [median (IQR)]: 6 months, 22/25 correct (21–23); 12 months, 21 (20–22); 24 months, 18 (18–19). Participants were more likely to make errors with gluten-containing items and least likely to make errors with gluten-free products with explicit “gluten-free” labelling claims. There were no significant correlations between quiz scores and either TTG antibody levels or standardized gluten-free diet adherence assessment tools. Patients who are trying to follow a gluten-free diet may not be able to consistently choose appropriate gluten-free foods based upon product labeling information. The ability to correctly read food labels does not appear to improve with time. Further studies are needed to evaluate whether insufficient label reading skills are associated with persistent villous atrophy. CAG, CIHRNational Institutes of Health (United States)

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