Gluten-free diet shapes snack choices of young people with celiac disease

Young people with celiac disease eat more regular meals than their peers without dietary restrictions, but their snack choices reveal the well-known nutritional limitations of a gluten-free diet, according to a survey-based study published in BMC Nutrition.

The study compared meal and snacking patterns between adolescents and young adults with celiac disease who follow a gluten-free diet and controls of the same age without any food restrictions. A survey on health-related issues and diet was distributed to 16 to 30-year-old members of the Celiac Society and to students of similar age from a university of applied sciences and a vocational school.

The respondents with celiac disease numbered 210, while the control group comprised 143 participants.

Participants with celiac disease reported more frequent meal patterns than controls, averaging 3.4 meals per day compared with 3.0 meals per day, a difference that was statistically significant. In contrast, snacking frequency and the tendency to replace main meals with snacks were similar between the two groups.

The findings also pointed to practical challenges of maintaining a gluten-free diet outside the home. Patients reported difficulties with gluten-free options in school and workplace cafeterias, and they consumed lunch in such cafeterias less often than controls, at 18% versus 38%.

Snack and food choices differed between the groups in several respects. Those with celiac disease consumed ice cream more frequently, 0.9 versus 0.3 times per week, as well as low-fiber bread, 1.6 versus 0.8 times per week, and plant oil-based margarine or fat spreads, 2.4 versus 1.2 times per week.

At the same time, the celiac group used sugar-sweetened beverages less often as a snack, 0.6 versus 1.2 times per week, along with whole grain noodles, 0.0 versus 0.4 times per week, and butter and other margarines, 2.0 versus 2.8 times per week. They also reported consuming less alcohol and tobacco than the control participants.

When asked what influenced their snack purchases, respondents pointed to taste, ease of transport and price as the key factors.

The authors conclude that the celiac group had more frequent meal patterns and consumed less alcohol and tobacco, but that their choices also reflected dietary limitations, including low-fiber and added-sugar snacks and reduced use of school or workplace cafeterias. As a novel finding, they report that these well-known limitations of the gluten-free diet were also evident in snack choices, which may have implications for overall diet quality.

The study is an open-access article published on 27 October 2026 and shared as an early version of the peer-reviewed, accepted manuscript, which is citable and carries a permanent DOI but remains subject to further edits before the final version of record is released. Because the data come from a survey of society members and students, and the majority of respondents were women and students, the findings describe the patterns reported by these groups rather than the general population.

Subject of Research: Meal and snacking patterns of adolescents and young adults with celiac disease following a gluten-free diet compared with controls

Article Title: Meal frequency and snacking patterns among adolescents and young adults without any food restrictions or with celiac disease and following a gluten-free diet

Article References: Pihlajamäki, H., Nissinen, K., Autio, R., Kivelä, L., Arnala, S., Laurikka, P., Kaukinen, K., Kurppa, K., & Aitokari, L. (2026). Meal frequency and snacking patterns among adolescents and young adults without any food restrictions or with celiac disease and following a gluten-free diet. BMC Nutrition. https://doi.org/10.1186/s40795-026-01534-7

Image Credits: AI Generated

DOI: 10.1186/s40795-026-01534-7

Keywords: celiac disease, gluten-free diet, meal frequency, snacking, adolescents, young adults, diet quality, nutrition survey, BMC Nutrition, food choices, Meal, frequency