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. 2021 Jan 27;13(2):396.
doi: 10.3390/nu13020396.

Prevalence of Wheat/Gluten-Related Disorders and Gluten-Free Diet in Paraguay: An Online Survey-Based Study

Noé Ontiveros  1 , Raúl Emilio Real-Delor  2 , José Antonio Mora-Melgem  3 , Carlos Eduardo Beltrán-Cárdenas  3 , Oscar Gerardo Figueroa-Salcido  4 , Marcela de Jesús Vergara-Jiménez  3 , Feliznando Isidro Cárdenas-Torres  3 , Lilian Karem Flores-Mendoza  1 , Jesús Gilberto Arámburo-Gálvez  3   4 , Francisco Cabrera-Chávez  3
Affiliations

Prevalence of Wheat/Gluten-Related Disorders and Gluten-Free Diet in Paraguay: An Online Survey-Based Study

Noé Ontiveros et al. Nutrients. .

Abstract

Gluten-related disorders (GRDs) are increasing around the world, but their magnitude and relevance remain unknown in most Latin American countries. Thus, an online survey was conducted to estimate the prevalence of GRDs as well as adherence to a gluten-free diet (GFD) in Paraguayan adult population. There were 1058 individuals surveyed using a validated questionnaire (response rate of 93.9%). The self-reported prevalence rates were as follows (95% CI): gluten sensitivity (GS), 10.30% (8.53-12.29); non-celiac GS (NCGS), 5.19% (3.94-6.71); physician-diagnosed celiac disease (PD-CD), 3.11% (2.15-4.35); wheat allergy (WA), 2.07% (1.30-3.13); and adherence to GFD, 15.69% (13.55-18.02). Excluding CD, more women than men met the criteria for GRDs, adverse food reactions, and GFD (p < 0.05). Eight respondents reported the coexistence of NCGS with PD-CD and/or WA. Most cases on a GFD indicated medical/dietitian advice for following the diet (68.07%). Non-self-reported GS individuals indicated weight control (46.4%) and the notion that the GFD is healthier (20.2%) as the main motivations for following the diet. GRDs are not uncommon in Paraguayan adult population. It seems that there is awareness about GRDs and the GFD, but training about the diagnosis of GRDs is desirable because of the informed overlapping diagnoses of CD or WA with NCGS. Future studies involving face-to-face interviews are necessary.

Keywords: celiac disease; gluten-free diet; gluten-related disorders; non-celiac gluten sensitivity; wheat allergy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Algorithm and criteria to classify respondents. SR-GS—self-reported gluten-sensitivity; GFD—gluten-free diet; SR-PD—self-reported physician-diagnosed; GRDs—gluten-related disorders; CD—celiac disease; NCGS—non-celiac gluten-sensitivity; WA—wheat allergy.
Figure 2
Figure 2
Self-reported (A) gastrointestinal and (B) extra-intestinal symptoms in SR-GS individuals (n = 109).
Figure 3
Figure 3
Prevalence of adherence to a GFD and wheat/gluten avoiders stratified by age. (A) Characteristics of individuals following a GFD. (B) GFD adherence and avoidance of wheat/gluten according to age. * One subject reported that a physician diagnosed her/him both CD and WA and was on a GFD. *** p < 0.001.
Figure 4
Figure 4
Motivations for following a GFD among SR-GS and non-SR-GS cases, or for avoiding wheat/gluten from the diet among wheat/gluten avoiders. GFD—gluten-free diet; CD—celiac disease.
See this image and copyright information in PMC

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