Meal frequency and snacking patterns among adolescents and young adults without any food restrictions or with celiac disease and following a gluten-free diet

Abstract Purpose People with celiac disease (CeD) may face challenges in maintaining healthy eating habits while following a gluten-free diet (GFD), but data are scarce. We compared meal and snacking patterns between individuals with celiac disease and controls. Methods A survey on health-related issues and diet was distributed to 16-30-year-old members of Celiac Society and similar age students from university of applied sciences and vocational school. Results Of all respondents, 80% were women and 64% students. CeD patients ( n = 210) reported more frequent meal patterns (mean 3.4 vs. 3.0 meals/day, p = 0.003) while snacking frequency or replacing main meals with snacks was similar to controls ( n = 143). Patients reported challenges with a GFD in school or workplace cafeterias, and consumed lunch there less often (18% vs. 38%, p < 0.001). They also consumed more frequently ice cream (0.9 vs. 0.3 times/week, p = 0.010), low-fiber bread (1.6 vs. 0.8, p = 0.005) and plant oil-based margarine/fat spreads (2.4 vs. 1.2, p = 0.008). They used less frequently sugar-sweetened beverages (0.6 vs. 1.2, p = 0.045), whole grain noodles (0.0 vs. 0.4, p = 0.033) and butter and other margarines (2.0 vs. 2.8, p = 0.038) as a snack, as well as alcohol and tobacco. Key factors affecting snack purchases were taste, ease of transport and price. Conclusions CeD group had more frequent meal patterns and consumed less alcohol and tobacco. However, their choices also reflected dietary limitations, including low‑fiber, added‑sugar snacks and reduced use of school or workplace cafeteria. As a novel finding, these well-known limitations of GFD were also evident in snack choices, which may have implications for overall diet quality.