Researchers studied 397 adults with celiac disease to understand how struggling to afford food affects their health. They found that about 1 in 6 people with celiac disease had trouble getting enough food. Those who struggled to afford food reported worse stomach problems like bloating, constipation, and diarrhea. They also found it harder to stick to their gluten-free diet and had more problems with restrictive eating habits. This research shows that money troubles aren’t just about hunger—they can make celiac disease symptoms worse and make it harder for people to manage their condition.
The Quick Take
- What they studied: Whether people with celiac disease who struggle to afford food have worse stomach symptoms and more trouble following a gluten-free diet
- Who participated: 397 adults with celiac disease who visited a celiac disease clinic in the southeastern United States. About 1 in 6 (15.6%) reported struggling to afford enough food
- Key finding: People who struggled to afford food reported significantly worse stomach symptoms including bloating, constipation, and diarrhea compared to those who could afford food. They also found it harder to stick to their gluten-free diet
- What it means for you: If you have celiac disease and struggle with food costs, your worse symptoms may be partly due to difficulty affording gluten-free foods and managing your diet. Talking to your doctor about food assistance programs might help. However, this study shows a connection, not necessarily that one causes the other
The Research Details
This was a cross-sectional study, which means researchers looked at a group of people at one point in time rather than following them over months or years. All 397 participants filled out questionnaires at a celiac disease clinic that asked about their food security (whether they could afford enough food), stomach symptoms, how hard it was to follow a gluten-free diet, eating habits, and mental health.
The researchers used a simple two-question screening tool called the Hunger Vital Signs to identify people struggling with food costs. They then compared people who had enough food with those who didn’t, looking at differences in stomach symptoms, diet difficulty, eating patterns, anxiety, and depression.
When some people didn’t answer all questions, researchers used a statistical technique called multiple imputation to fill in missing information fairly, rather than just ignoring those people.
This approach is important because it captures real-world experiences of people managing celiac disease in a clinic setting. By looking at multiple health areas at once—stomach symptoms, diet adherence, eating behaviors, and mental health—the study gives a complete picture of how food struggles affect people with celiac disease. This helps doctors understand all the ways that affording gluten-free food matters for their patients’ health.
This study has several strengths: it included a decent-sized group (397 people), used validated questionnaires that other researchers trust, and looked at multiple health outcomes. However, because it’s a snapshot in time rather than following people over time, we can’t say for certain that food struggles cause worse symptoms—only that they go together. The study was done at one clinic in one region, so results might be different in other parts of the country. Also, all information came from people’s answers on questionnaires rather than medical tests, which can be less precise.
What the Results Show
About 1 in 6 people with celiac disease (15.6%) screened positive for food insecurity, meaning they struggled to afford enough food. This is higher than the general U.S. population, suggesting people with celiac disease face special challenges because gluten-free foods cost more.
People struggling with food costs reported significantly worse stomach symptoms compared to those with enough food. Specifically, they reported more bloating, constipation, diarrhea, and overall stomach discomfort. These aren’t just minor differences—they were statistically significant, meaning they’re unlikely to be due to chance.
People with food struggles also reported that following a gluten-free diet felt much harder and more burdensome. This makes sense because gluten-free foods are often more expensive and harder to find, so when money is tight, sticking to the diet becomes even more challenging.
Interestingly, people with food struggles also showed more signs of restrictive eating patterns and were more focused on body shape and weight, though the study didn’t find clear differences in anxiety or depression between the two groups.
The study found that people struggling with food costs showed higher levels of avoidant and restrictive eating symptoms. This means they were more likely to avoid certain foods or eat very limited diets, which could make their celiac disease harder to manage. The study also found that people with food struggles were more focused on their body shape and weight, which could indicate disordered eating patterns. However, surprisingly, anxiety and depression scores were similar between the two groups, suggesting that the main impact of food struggles is on physical symptoms and eating behaviors rather than mood.
Previous research has shown that food insecurity is linked to worse health in general populations, but this study is important because it focuses specifically on people with celiac disease. Celiac disease is unique because people must follow a strict gluten-free diet for life, and gluten-free foods are significantly more expensive than regular foods. This study confirms that the general pattern of food insecurity causing health problems applies to celiac disease, but adds new information about how it specifically affects stomach symptoms and diet adherence in this population.
This study has several important limitations to keep in mind. First, it’s a snapshot—researchers looked at people at one moment in time, so we can’t prove that food struggles cause worse symptoms; we only know they happen together. Second, the study only included people at one clinic in the southeastern United States, so results might be different in other regions or in people who don’t go to specialty clinics. Third, all information came from people’s answers on questionnaires rather than medical tests or doctor observations, which can be less accurate. Fourth, the study didn’t look at other factors that might explain the connection, like stress or other health conditions. Finally, the study was published in 2026, so it’s very recent research that other scientists haven’t had much time to review or repeat yet.
The Bottom Line
If you have celiac disease and struggle to afford food, talk to your doctor or a dietitian about food assistance programs in your area, such as SNAP (food stamps) or local food banks that carry gluten-free options. Consider connecting with celiac disease support groups that may have resources for affordable gluten-free foods. While this study doesn’t prove that food struggles cause worse symptoms, it shows they’re connected, so getting help with food costs may help improve your symptoms and make managing your diet easier. Confidence level: Moderate—this is good evidence, but more research is needed.
This research matters most for people with celiac disease who struggle to afford food, their family members, and their doctors. It’s also important for policy makers and organizations that work on food assistance programs, as it shows that people with celiac disease may need special support because gluten-free foods are expensive. If you have celiac disease and can easily afford food, this research is less directly relevant to you, though it’s still good to understand the challenges others face.
If you get help with food costs, you might notice improvements in stomach symptoms within a few weeks to a few months as you’re able to better stick to your gluten-free diet. However, this study doesn’t tell us exactly how long it takes to see improvements, so talk to your doctor about what to expect.
Want to Apply This Research?
- Track your weekly food budget and gluten-free food purchases alongside your daily stomach symptoms (bloating, constipation, diarrhea severity on a 1-10 scale) to see if improving food access helps reduce symptoms over time
- Use the app to log local food resources and gluten-free options available at different price points, set reminders to apply for food assistance programs, and track which affordable gluten-free foods work best for your symptoms
- Create a monthly report comparing your food security status (using simple yes/no questions about affording food), overall stomach symptom burden, and diet adherence to identify patterns and celebrate improvements as your food situation stabilizes
This research shows a connection between food struggles and worse celiac disease symptoms, but doesn’t prove one causes the other. If you have celiac disease and are struggling to afford food, please talk to your doctor or a registered dietitian for personalized advice. This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a healthcare provider before making changes to your diet or treatment plan. If you’re experiencing food insecurity, contact your local food bank or call 211 to find assistance programs in your area.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.