European Journal of Pediatrics

, Volume 177, Issue 6, pp 859–866 | Cite as

Obesogenic habits among children and their families in response to initiation of gluten-free diet

  • Neriya Levran
  • Michael Wilschanski
  • Jessica Livovsky
  • Edna Shachar
  • Moti Moskovitz
  • Lama Assaf-Jabrin
  • Eyal Shteyer
Original Article


Initiation of a lifelong, gluten-free diet (GFD) in children with celiac disease (CD) influences the child’s life in many ways. The aim of this study was to assess the influence of GFD on the child and his/her family’s eating habits and lifestyle behaviors. To study this, we asked children and their parents completed the Family Eating and Activity Habits Questionnaire (FEAHQ) at the time of diagnosis of CD and at least 6 months after initiation of GFD and a questionnaires assessing symptoms related to CD and adherence to the GFD diet. We analyzed questionnaires from 40 children with CD and their families. There were 21 females, ranging in age from 4 to 15.7 years (median age 7.4 years±2.8 years). The control group comprised 15 healthy children. After initiation of GFD the family ate more junk food including snacks and candies (p = 0.05), with the significant change reported by children and fathers (p = 0.001 and 0.03 respectively). All family members in the control group had significantly less snacks. Parents and children reported a significant increase in obesogenic eating styles, such as eating from the cooking pot and eating while doing other activities (mothers, p = 0.001; fathers, 0.02; and children, 0.02 respectively).

Conclusions: Our study shows that initiation of GFD in children with CD leads to changes in eating habits and staple food eating that may lead to a more obesogenic environment. Care givers, pediatricians, gastroenterologists, and dieticians alike should be aware of these implications and educate families towards a healthier lifestyle and diet beyond the GFD itself.

What’s Known:

Gluten-free diet has been shown to affect various psychosocial aspects of children with celiac disease.

Obesity and celiac are associated.

What is New:

Initiation of gluten-free diet led to increased eating of junk food both in the patient and his/her family.

After initiation of GFD pro-obesogenic eating habits is increased.


Celiac disease Gluten free diet Obesity Family Eating habits 



Gluten-Free Diet


Celiac Disease


Family Eating and Activity Habits Questionnaire


Gluten-Free Food


Body Mass Index


Authors’ Contributions

NL: nutritional guidance for the patients, recruiting and assessing the patients and writing the manuscript.

MW: recruiting and assessing the patients and writing the manuscript.

JL: nutritional guidance for the patients.

MM: recruiting and assessing the control group.

LAJ: recruiting and assessing the control group.

ES: recruiting and assessing the patients and writing the manuscript.


No external funding for this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have they have no conflict of interest.

Financial disclosure

All authors have indicated they have no financial relationships relevant to this article to disclose.

Informed consent

The study protocol was approved by the institutional review board (IRB) human ethics Committee of Hadassah (application 0290-12, 7/2012). Informed consent was obtained from all the parents or legal guardians of the participating children.

Supplementary material

431_2018_3128_MOESM1_ESM.doc (670 kb)
ESM 1 (DOC 670 kb)
431_2018_3128_MOESM2_ESM.docx (21 kb)
ESM 2 (DOCX 21 kb)
431_2018_3128_MOESM3_ESM.docx (20 kb)
ESM 3 (DOCX 19 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pediatric Gastroenterology UnitHebrew University-Hadassah Medical CenterJerusalemIsrael
  2. 2.Department of Pediatric Dentistry, Hebrew UniversityHadassah School of Dental MedicineJerusalemIsrael
  3. 3.The Juliet Keidan Institute of Pediatric Gastroenterology, Pediatric Gastroenterology InstituteShaare Zedek Medical CenterJerusalemIsrael

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