Memo to patients with (CD) and their doctors: Avoiding gluten is im簫portant ��� but so is maintaining quality of life.

So finds a study led by TC���s , As簫sociate Professor of, published last spring in Digestive Diseases & Sciences.

���There are potential negative consequences of hypervigilance to a strict gluten-free diet,��� write Wolf and co-authors (including faculty and TC students Jennifer Cadenhead and Chelsea Amengual). ���Clinicians must consider the importance of concurrently promoting both dietary adherence and social and emotional well-being for individuals with CD.���

An accompanying editorial said the study ���highlights the need for finding balance between adherence to a gluten-free diet and maintaining a high quality of life��� and called for further studies to determine that balance.

���Clinicians must consider the importance of concurrently promoting both dietary adherence and social and emotional well-being for individuals with CD.���

��� Randi Wolf

With celiac disease, a genetically acquired autoimmune disorder, the intestine becomes in簫flamed after the ingestion of gluten, a protein found in wheat, barley and rye. Some people have no symptoms; others expe簫rience abdominal pain, infertility and anemia. Continued gluten ingestion can cause intestinal damage and increase risk for osteoporosis and certain cancers. The condition affects one in 133 people ��� a five-fold increase since the 1950s.

Randi Wolf

Randi Wolf, As簫sociate Professor of Human Nutrition

Wolf���s team surveyed adults and teens with biopsy-confirmed celiac disease. Some patients, classified as ���hypervigilant,��� carefully monitored their diets to avoid intentional and unintentional gluten exposure, dined in gluten-free restau簫rants, prepared food for non-household consumption and closely attended to food labeling. A second group was less meticulous in monitor簫ing food intake inside and outside the home.

The hypervigilant participants reported lower energy and greater anxiety and stress, including constant worries about cross-contamination and dismissive or uninformed wait staff.