the relation of gluten-free diet and quality of life in children with celiac disease: a cross-sectional study

Background: the present study aimed to determine the relationship between a gluten-free diet (gfd) and quality of life (qol) in children with celiac disease (cd) and to evaluate the impact of additional factors that may affect both. methods: this cross-sectional study was conducted in 2021 using a census sampling method. a total of 409 children aged ≤ 10 years with cd were recruited from referral clinics in zahedan. data were collected through a structured questionnaire. statistical analyses were performed using independent t-tests, analysis of variance (anova), chi-square tests, and pearson’s correlation coefficient in spss version 23.0. results: the gender distribution revealed a predominance of females (61.4%). the children had a mean age of 6.81 ± 2.46 years and a median disease duration of 3 years. the most common symptoms included abdominal pain (75.6%), weight loss (64.1%), and diarrhea (44.7%), while aggression (17.1%) and depression (11.5%) were the most frequently reported comorbidities. poorer qol was significantly associated with older age, longer disease duration, more comorbidities, and lower adherence to a gfd (all p < 0.01). financial difficulties were also linked to reduced dietary adherence and worse qol (p < 0.01).conclusions: this study highlights that, while many children with cd maintain a relatively good qol, several factors — particularly older age, longer disease duration, comorbid conditions, and financial hardship — negatively impact both dietary adherence and qol.