Oral Presentation International Celiac Disease Symposium 2026

Global Preparedness of Celiac disease from the lens of dietitians: Are we ready for the future? (146902)

Suyasha Gupta 1 , Nick Trott 2 , Cristian Costas Batlle 3 , Maria Paz Temprano 4 , Chris Mak 5 , Vineet Ahuja 1 , Govind Makharia 1 , Anne R Lee 6
  1. All India Institute of Medical Sciences, New Delhi, Ansari Nagar, All India Institute Of Medical Sciences, DELHI 110029, India
  2. Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, , Sheffield,, UK
  3. Nutrition and Dietetics, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
  4. Hospital Dr. Carlos B. Udaondo. Ciudad Autónoma de Buenos Aires, Argentina, Buenos Aires, Argentina
  5. Dutch Celiac Association, Netherlands
  6. Celiac Center, Columbia University, New York, United States of America

Introduction
While celiac disease (CeD) is well established in Europe, North America and Australia, it is emerging in Asia, South America and Africa. Treatment of CeD is not pharmacological but strict lifelong gluten restriction. Hence, dietitians are at the centre of care. Preparedness for care and associated barriers varies across continents. We assessed global preparedness for CeD from the perspective of dietitians with expertise in CeD.

Methods
We conducted a cross-sectional online survey of celiac specialist dietitians, identified through purposive and snowball sampling using committee lists, gastroenterology networks and researchers. The Qualtrics survey was administered in English over twelve weeks (June to August 2026) with three reminders. The questionnaire covered quality, cost, affordability, accessibility of gluten-free food, labelling and regulations, dietetic workforce, and education and training in caring for CeD. Data analysis was based on country income level.

Results
Of 87 approached, 70 (80.4%) from 25 countries responded. Approximately two-thirds (65.2%) were satisfied with GF food quality; however, 62.3%, 53.6% and 49.3% were dissatisfied with high sugar, low fibre and high fat content. Most (92.8%) perceived GF foods as more expensive. Dietitian availability was greater in HICs than LICs and declined from metropolitan to remote areas, where dietitians were never available. Dietitians were available in private practices (82.9%), university hospitals (77.1%), and regional clinics (64.3%), with limited availability in rural clinics (10.0%). CeD was included in over half of undergraduate (59.1%) and postgraduate (68.2%) coursework; 59.1% received gastroenterology nutrition training, but only 37.9% received CeD management training. Just over one-third reported CeD centres of excellence (36.4%), predominantly in HICs.

Conclusion:
Global preparedness for CeD is sub-optimal in many regions. Focused efforts are needed for equitable availability and affordability of quality GF foods, alongside dietitian training and accessibility, particularly where CeD is emerging.