Assessment of a standard dietitian evaluation in pediatric patients with celiac disease

Nutrition. 2026 Feb 14;147:113169. doi: 10.1016/j.nut.2026.113169. Online ahead of print.

ABSTRACT

OBJECTIVE: Evaluate the validity of a standard dietitian evaluation (SDE) assessment of gluten-free dietary (GFD) adherence for pediatric patients with celiac disease (CeD).

METHODS: Exploratory and confirmatory factor analyses were conducted in this cross-sectional, retrospective study to evaluate the factor structure of a clinical SDE. Construct validity analyses were performed to establish if the SDE was associated with the primary outcome measure of a biological measure of adherence (autoantibody serology). Retrospective data were gathered from 367 pediatric patients from a large pediatric tertiary care center. Patients identified had a documented diagnosis of CeD and at least one SDE completed by a gastroenterology dietitian between January 2014 and March 2020.

RESULTS: The results of the exploratory and confirmatory factor analyses supported a single SDE factor. Greater reduction in autoantibody serology since diagnosis was correlated with better SDE score (partial Spearman ρ = 0.22 (95% CI: 0.01, 0.41; P = 0.04).

CONCLUSIONS AND PRACTICE IMPLICATIONS: This study is the first to evaluate the structural integrity of an SDE for GFD adherence in pediatric CeD. Findings support the SDE’s structural integrity and construct validity with serology, highlighting its potential as a reliable clinical tool for evaluating dietary adherence in pediatric CeD.

PMID:41832847 | DOI:10.1016/j.nut.2026.113169