Dietary adherence is not dependent on the mode of diagnosis in children with coeliac disease.

Aim: To compare the adherence to gluten‐free diet between children with serology‐based and biopsy‐proven coeliac disease. Methods: Medical records were retrospectively reviewed in 257 Swedish children diagnosed with coeliac disease between 2012 and 2019 at a tertiary hospital. Adherence to a gluten‐free diet was systematically assessed by trained dietitians at follow‐up. Mixed models were used to analyse the dietary adherence by mode of diagnosis (serology‐based vs. biopsy‐proven). Results: After mean 6.3 (SD 2.4) years, there was neither a difference in the dietary adherence over time depending on the mode of diagnosis (OR 0.64 [95% confidence interval (CI) 0.26, 1.60], p = 0.342), nor if coeliac disease was detected in screening studies (OR 0.74 [95% CI 0.25, 2.17], p = 0.584) or in risk‐groups (OR 1.01 [95% CI 0.26, 3.91], p = 0.991) compared to clinically detected diagnosis. Non‐adherence to a gluten‐free diet increased with age (OR 1.19 [95% CI 1.06, 1.33], p = 0.003). There was no difference in the proportion of patients improving their dietary adherence from non‐adherent to adherent over time (p = 0.322). Conclusion: Mode of diagnosis did not influence the dietary adherence in Swedish children with coeliac disease, although adherence to a gluten‐free diet was inversely associated with increasing age. [ABSTRACT FROM AUTHOR]