The health of people with coeliac disease in New Zealand

Researchers:

• Dr Kirsten Coppell
• Miss Kiri Sharp
• Associate Professor Michael Schultz

Prevalence of coeliac disease

Approximately 10% of people with type 1 diabetes also have coeliac disease (CD). Like type 1 diabetes, the prevalence of coeliac disease is also increasing worldwide. The prevalence of CD is about 1% in New Zealand.

Coeliac disease is a multisystem autoimmune condition for which the only treatment currently is a gluten free diet. Complete elimination of dietary gluten will, in most cases, allow a full recovery. However, maintaining a gluten free (GF) diet is challenging.

The challenge of a gluten free diet

The restrictions of a GF diet have potentially far reaching effects beyond the choice of foods. Whether GF food is available, hidden sources of gluten and gluten contamination can restrict the lifestyle of a person with CD.

In New Zealand, little is known about the health and dietary treatment of patients with CD, and the impact of such treatment. The aim of the NZ Coeliac survey was to describe the health and dietary treatment of people with CD in New Zealand.

Members of Coeliac New Zealand were invited to participate in the survey. Most (88%) described their diet as being strictly GF, yet many had incomplete recovery from symptoms. Following a GF diet was very difficult or moderately difficult for more than one-third (36%).
Coeliac New Zealand

Food quality and labeling common problems

Common problems included finding good quality GF foods and identifying whether foods were GF or not from the label.  More than one-third (36%) avoided travelling at least some of the time because of CD, and more than one-quarter (26%) never or rarely ate at restaurants.

Food preparation practices poor

A concurrent study examined GF food preparation practices at food outlets in central Dunedin. This study confirmed why people with CD are reluctant to eat at restaurants. A survey of 90 chefs at Dunedin restaurants during summer 2012/13 demonstrated that it was not safe for people with CD to dine out at more than 75% of restaurants offering GF food in Dunedin.

Publications

• Sharp K, Walker H, Coppell KJ Coeliac Disease and the Gluten Free Diet in New Zealand: the New Zealand Coeliac Health Survey. Nutrition and Dietetics (published online 24 Feb 2014)
• Schultz M, Shin S, Coppell KJ. Awareness of coeliac disease among chefs and cooks depends on the level and place of training.Asia Pac J Clin Nutr. 2017;26(4):719-724.

Presentations

Diabetes and Coeliac Disease – a dietary challenge. Coppell K, Sharp K, Walker H. Presented at the NZ Society for the Study of Diabetes Annual Scientific Meeting, Napier 2013.

The New Zealand Coeliac Survey. Sharp K and Coppell K. Presented at the Gut Health Network Public Research Forum, Dunedin, February 2013.

Awareness of Coeliac Disease: A survey amongst chefs in Dunedin. Shin S, Schultz M, Coppell K. Presented at the Gut Health Network Public Research Forum, Dunedin, February 2013.