The relationship between diet quality, social participation, quality of life, and occupational balance in adolescents with Celiac disease.

BACKGROUND: Adolescents diagnosed with Celiac Disease are at risk of experiencing physical, psychological and social difficulties that affect their quality of life. Dietary restrictions also create stress related to social difficulties in daily life.This study aimed to examine the associations between diet quality, social participation, quality of life, and occupational balance among adolescents diagnosed with Celiac Disease, and to evaluate the interrelationships among these variables. METHODS: The study sample consisted of 52 adolescents diagnosed with Celiac Disease (aged 12-18 years) and 55 age-matched healthy controls. Data were collected on participants' body composition, anthropometric measurements, adherence to the Mediterranean diet (assessed via the KIDMED index), social participation (Child and Adolescent Scale of Participation, CASP), Quality of Life (Pediatric Quality of Life Inventory, PedsQL), and occupational balance (Adolescent Occupational Balance Scale, A-OBS). Spearman's rank-order correlation analysis was conducted to examine the associations among the study variables. RESULTS: The mean KIDMED score was significantly higher in adolescents with Celiac Disease compared to healthy controls (24.09 ± 1.65 vs. 22.96 ± 2.45; p = 0.006). Additionally, the Celiac Disease group demonstrated significantly higher scores in total PedsQL, physical functioning, and school functioning domains (p < 0.05). Scores for the Adolescent Occupational Balance Scale (A-OBS), including total score, temporality, and rest and sleep subdomains, were also significantly elevated in the Celiac group (p < 0.05). The correlation analysis revealed no significant associations between the total KIDMED score and other measured parameters, except for a weak but statistically significant negative correlation with the CASP Home and Community Living Activities subscale (rho = - 0.292, p = 0.036). Furthermore, total PedsQL score was positively correlated with A-OBS total, temporality, and rest and sleep scores. CONCLUSIONS: This study demonstrated that adolescents with Celiac Disease exhibit higher diet quality compared to their healthy counterparts; however, this improved dietary adherence may be negatively associated with social participation. These findings underscore the importance of a holistic approach in the clinical management of Celiac Disease, taking into account not only nutritional adequacy but also psychosocial well-being.