Introduction: The gluten-free diet (GFD) is currently the only treatment for celiac disease (CeD), but diet-related burden is not fully understood.
Methods: This study examined diet-related burdens associated with a CeD diagnosis through an online survey open May to July 2026. Eligible respondents were US adults with CeD (patients) and US adults without a gluten-related disorder who did not have a child or household member with a gluten-related disorder (controls). These cohorts responded to items about daily living over the past 60 days, including questions on food spending, time spent cooking, and financial stress frequency.
Results: 817 patients and 110 controls responded to the survey. Average age was 52.8 years (SD =16.9), with patients on average 5.7 years older than controls (p =.00155, d =0.339). Compared to controls, patients were more likely to follow the GFD (97.5% vs. 2.7%) (p <.00001, d =0.892). Patients reported spending more time on daily food preparation (p <.00001, d =0.519) and weekly meal planning (p <.00001, V =.213). Patients also spent more time on social coordination and advocacy for their food (p <.00001, V =.322). Compared to controls, patients more often visited multiple grocery stores to get everything they needed (p <.00001, V = .287). Patients reported more frequent difficulty being spontaneous due to health issues than controls (p <.00001, d =1.30). Patients had a lower food away-from-home share of total food spending per person compared to controls (p =.0128, d =0.342). Patients felt their life was restricted more often (p <.00001, d =1.00) and felt financially stressed more often compared to controls (p =.00199, d =0.293). With GFD adherence constant, CeD remained an independent predictor of each food advocacy, spontaneity, restricted life, and financial stress (p <.05 for all).
Conclusion: Future studies should focus on methods to reduce these burdens.