Celiac Disease and the Gluten-free Diet: Registered Dietitian Nutritionists’ Self-reported Knowledge Varies

Joan Geiger¹, Yeong Rhee¹, Sherri N. Stastny^1, , Ardith Brunt¹ and Elizabeth Blodgett Salafia²

¹Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, United States of America

²Human Development and Family Science, North Dakota State University, Fargo, United States of America

Cite this paper:
Joan Geiger, Yeong Rhee, Sherri N. Stastny, Ardith Brunt and Elizabeth Blodgett Salafia. Celiac Disease and the Gluten-free Diet: Registered Dietitian Nutritionists’ Self-reported Knowledge Varies. International Journal of Celiac Disease. 2017; 5(2):56-61. doi: 10.12691/ijcd-5-2-1

Abstract

Background: Adherence to the gluten-free diet is the only treatment for celiac disease (CD) and some patients report lack of expertise among registered dietitian nutritionists (RDNs). Objective: To measure RDN self-reported celiac disease (CD) knowledge and preferences for resources for self-education and patient education. Methods: A cross-sectional research design was used to recruit RDNs from participating state affiliates Alaska, Colorado, Connecticut, Delaware, Montana, Nebraska, and North Dakota in 2013. A 35 item internet-based survey was distributed via Survey Monkey and included Likert scale questions based on a previous RDN allergy survey. Demographic and gluten-free diet and CD multiple-choice questions were also included. Results: Four-hundred and five registered dietitians (RDNs) who volunteered from the seven participating affiliates responded to the survey. Chi-squares were used to determine frequencies and differences in responses per variable. Pearson correlation analyses were performed to determine the correlation of age, education level, years of practice, or number of CD patients seen per week and CD self-reported knowledge. RDNs reported either moderate or high levels of knowledge for all seven self-reported knowledge topics. Over 85% of RDNs selected correct answers for five CD knowledge questions. Professional and academic publications were the most commonly used resources by RDNs for self-education whereas handouts were the most commonly used resource by RDNs for patient education. Conclusion: RDNs may need more reinforcement on identification and treatment of nutritional deficiencies of CD management.

Keywords:
Celiac Disease Registered Dietitian Nutritionist Celiac Disease Knowledge gluten free diet gluten free diet knowledge

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References:

[1]	Autodore JR, Verma RM, Gupta KB. Celiac disease and its treatment. Top Clin Nutr. 2012; 27(3):270-276.
[2]	Niewinski M. Advances in celiac disease and gluten-free diet. J Am Diet Assoc. 2008; 108(4):661-672.
[3]	Lähdeaho M, Mäki M, Laurila K, Huhtala H, Kaukinen K. Small- bowel mucosal changes and antibody responses after low- and moderate-dose gluten challenge in celiac disease. BMC Gastroenterol. 2011; 11:129.
[4]	Hall N, Rubin G, Charnock A. Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease. Aliment Pharmacol Ther. 2009; 30(4):315-330.
[5]	National Institute of Health (2004). Consensus Development Conference Statement. Paper presented at the NIH Consensus Development Conference on Celiac Disease. 2004. http://consensus.nih.gov/2004/2004CeliacDisease118html.html. Accessed May 31, 2016.
[6]	Case S. The gluten-free diet: how to provide effective education and resources. Gastroenterology. 2005; 128 (4 Suppl. 1):128-134.
[7]	McNally S, Donohue M, Newton K, Ogletree S, Conner K, Ingegneri S, Kagnoff M. Can consumers trust web-based information about celiac disease? Accuracy, comprehensiveness, transparency, and readability of information on the internet. Interact J Med Res. 2012; 1(1).
[8]	Crandall, J. (2012). Gluten-free app reviews. http://www.eatrightpro.org/resources/media/trends-and-reviews/app-reviews. Accessed August 2, 2016.
[9]	Tidwell D, Bomba A. Attitudes of people with celiac disease towards dietitians and medical nutrition therapy. J Am Diet Assoc. 2001; 101(95):29.
[10]	Groetch M, Christie L, Vargas P, Jones S, Sicherer S. Food allergy educational needs of pediatric dietitians: a survey by the Consortium of Food Allergy Research. J Nutr Educ Behav. 2010; 42(4):259-264.
[11]	Commission on Dietetic Registered dietitian demographics. https://certifications/registered-dietitians-demographics. Updated December 1, 2013. Accessed December 30, 2016.
[12]	Mahadev S, Simpson S, Lebwohl B, Lewis S, Tennyson C, Green P. Is dietitian use associated with celiac disease outcomes? Nutrients. 2013; 5(5):1585-1594.
[13]	Meyer K, Fasshauer M, Nebel I, Paschke R. Comparative analysis of conventional training and a computer-based interactive training program for celiac disease patients. Patient Educ Couns. 2003; 54(3):353-360.
[14]	Boyce, B. Nutrition apps: opportunities to guide patients and grow your career. J Academy Nutr Diet. 2014; 114(1):13-15.
[15]	Celiac Disease Foundation. http://celiac.org. Accessed July 26, 2016.
[16]	Celiac disease. http://www.digestive.niddk.nih.gov/ddiseases/pubs/celiac. Accessed July 26, 2016.
[17]	United States Census Bureau. Table 1159159. Internet activities of adults by community type: 2011. https://www.census.gov/library/publications/2011/compendia/statab/131ed/information-communications.html. Accessed May 23, 2016.
[18]	Norman G, Zabinski M, Adams MA, Rosenberg D, Yaroch A, Atienza A. A review of eHealth interventions for physical activity and dietary behavior change. Am J Prevent Med. 2007; 33:336-345.
[19]	Nyquist H, Rhee Y, Brunt A, Garden-Robinson J. Promoting health eating and exercise through online messages: a pilot study. J Extension. 2011; 49(6):6FEA6.
[20]	Aungst TD, Clauson KA, Misra S, Lewis TL, Husain I. How to identify, assess and utilise mobile medical applications in clinical practice. Int J Clin Pract. 2014; 68(2):155-162.
[21]	Simpson S, Thompson T. Nutrition assessment in celiac disease. Gastrointest Endosc Clin N Am. 2012; 22(4):797-809.