Maintaining a strict gluten-free diet (GFD) may affect the quality of life of children with celiac disease (CD) and promote a less healthy diet by substituting gluten-containing foods with ultra-processed foods. We aimed to assess the influences of the GFD and ultra-processed food consumption on parents' perception of the quality of life of children with CD. Fifty-eight children (mean age 8.6 +/- 4.1 years) were included. The participants were divided into groups based on the time following a GFD: = 12 months (n = 37). Their dietary consumption was assessed through a three-day food record. The 20-item Celiac Disease Quality Of Life survey (CD-QOL), which contains four subscales (limitations, dysphoria, health concerns, and inadequate treatment) was used to assess the quality of life. The children who followed a GFD for >= 12 months presented poorer scores in the limitations subscale than those who followed a GFD for <6 months (p = 0.010). The mean % of the energy intake from ultra-processed foods was 47.3 +/- 13.5. Children with CD consuming more than 50% of their total energy from ultra-processed foods showed poorer scores for the limitation and inadequate treatment (both, p = 0.019) subscales than their counterparts. According to parents' perceptions, those children who consumed more than 50% of their energy through ultra-processed foods had more limitations, and their treatment was perceived as less effective.European Commission B-AGR-658Association of Celiacs and Sensitive to Gluten of the Community of MadridSpanish Government FPU17/0371
