PD346 - RETROSPECTIVE OBSERVATIONAL STUDY ON THE ENVIRONMENTAL SUSTAINABILITY AND MEDITERRANEAN DIET ADHERENCE IN COELIAC PATIENTS

PD346

RETROSPECTIVE OBSERVATIONAL STUDY ON THE ENVIRONMENTAL SUSTAINABILITY AND MEDITERRANEAN DIET ADHERENCE IN COELIAC PATIENTS

A. Scricciolo^1,*, B. Rota¹, V. Lombardo¹, L. Elli^1,2, G. Paieri¹, S. Stella³, A. Costantino¹, F. Caprioli^2,4, L. Roncoroni^1,5

¹Center for Prevention and Diagnosis of Celiac Disease; Gastroenterology and Endoscopy Unit, Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy, ²Department of Pathophysiology and Transplantation, University of Milan, ³Epidemiology Unit, ⁴Gastroenterology and Endoscopy Unit, Fondazione IRCSS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy, ⁵Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy

Rationale: A gluten-free diet (GFD) remains the only effective treatment for coeliac disease, requiring complete exclusion of gluten-containing cereals and the use of naturally gluten-free foods or specific substitutes. However, the environmental sustainability of GFD-based food choices has been questioned.

Methods: A retrospective analysis of food diaries from 81 participants (44 coeliac and 37 non-coeliac subjects) was conducted to evaluate environmental impact and adherence to Mediterranean Diet guidelines. Weekly quantities and consumption frequencies of all foods and beverages were assessed. Water footprint and CO₂ emissions of each food item were estimated using the SU-EATABLE LIFE database. Mediterranean Diet adherence was evaluated by comparing weekly intake frequencies across food groups.

Results: Total macronutrient intake did not differ significantly between groups. However, coeliac patients showed a significantly higher environmental burden, with increased mean weekly water footprint (17,274 vs 14,442 litres, p < 0.01) and carbon footprint (19.5 vs 15.7 kg CO₂-eq/week, p < 0.01). This difference was mainly driven by greater consumption of rice- and corn-based substitutes, along with higher intake of fresh fruit and gluten-free snacks. Overall Mediterranean Diet adherence was acceptable in both groups, though coeliac patients showed lower adherence for aged cheeses.

Conclusion: Although clinically essential, GFD is associated with greater environmental impact. Supporting coeliac patients in selecting more sustainable gluten-free options represents an emerging nutritional and environmental challenge.

Disclosure of Interest: None declared