Researchers compared children with celiac disease to their healthy brothers and sisters and other healthy kids their age. They found that while all three groups ate similar amounts of nutrients, children with celiac disease weighed less and had lower self-esteem and confidence. Interestingly, their healthy siblings also struggled with self-esteem and felt less confident at school and with friends. The study suggests that celiac disease affects the whole family’s emotional well-being, not just the child’s diet. This means families need support beyond just watching what kids eat—they need help with feelings and emotions too.

The Quick Take

  • What they studied: How children with celiac disease compare to their healthy siblings and other healthy kids in terms of what they eat, their body size, and how happy and confident they feel
  • Who participated: 265 children total: 81 kids with celiac disease, 78 of their healthy siblings, and 106 healthy kids from the general population. All were similar ages and had roughly equal numbers of boys and girls
  • Key finding: Kids with celiac disease weighed less and had lower confidence and self-esteem than healthy kids. Surprisingly, their healthy siblings also had lower confidence. All groups ate similar amounts of nutrients overall
  • What it means for you: If your child has celiac disease, paying attention to their emotional health and confidence is just as important as managing their diet. Their siblings may also need extra emotional support. Talk to your doctor about counseling or support groups for the whole family

The Research Details

Researchers gathered three groups of children and collected information about what they ate, measured their height and weight, and asked them questions about how they felt about themselves, their friendships, and school. They used special forms to collect information about family background and nutrition, and a questionnaire called the Kid-KINDL scale to measure quality of life. The researchers then compared the three groups to see if there were differences in nutrition, body size, and emotional well-being.

This type of study is called a comparative research design because it looks at differences between groups. The researchers collected all their information at one point in time, which is different from studies that follow people over months or years. This approach lets researchers see what’s happening right now but doesn’t prove that celiac disease causes the differences they found.

By comparing children with celiac disease to both their healthy siblings and unrelated healthy kids, the researchers could see whether differences were due to the disease itself or to family factors. Including siblings is especially important because it helps show how a chronic illness in one child affects the whole family. This type of comparison gives a more complete picture than just studying kids with celiac disease alone

The study included a reasonable number of children (265 total) and made sure the groups were similar in age and gender, which strengthens the findings. The researchers used established, validated questionnaires to measure quality of life, which is good. However, the study was done at one point in time, so we can’t know if these patterns continue over time or what caused them. The study was published in a respected medical journal, which suggests it went through careful review

What the Results Show

Children with celiac disease weighed less and had lower body mass index (BMI) compared to their healthy siblings and healthy peers, even though they were the same height. This difference was statistically significant, meaning it wasn’t due to chance. Interestingly, when researchers looked at what all the children ate and whether they got enough nutrients, the three groups were very similar. The celiac group actually ate slightly more protein than the other groups.

When asked about their quality of life and happiness, children with celiac disease reported lower self-esteem (confidence in themselves), fewer positive feelings about friendships, and more difficulties at school compared to healthy children. About 40% of children with celiac disease reported having a low quality of life overall. Their healthy siblings also showed lower self-esteem and school-related concerns compared to healthy children, even though they didn’t have celiac disease themselves.

The overall quality of life scores were different between the three groups, with children with celiac disease and their siblings reporting lower overall quality of life than healthy children. This suggests that having celiac disease in the family affects emotional well-being beyond just the child who has the disease.

The study found that protein consumption was higher in the celiac group, which may reflect parents’ efforts to ensure adequate nutrition for their child. The fact that healthy siblings showed emotional and social challenges similar to those with celiac disease suggests that family stress and dynamics related to managing a chronic illness can affect all children in the household, not just the one with the disease. This is an important finding because it shows that celiac disease impacts family relationships and emotional health

Previous research has shown that children with celiac disease often struggle with emotional well-being and quality of life. This study adds new information by showing that healthy siblings are also affected emotionally, which hasn’t been studied as much. The finding that nutritional adequacy is similar across groups is somewhat surprising and suggests that families managing celiac disease may be doing a good job with nutrition, but emotional support may be lacking

This study looked at children at only one point in time, so we can’t know if these patterns stay the same or change over time. The study was done in one location, so the results may not apply to all children with celiac disease everywhere. We don’t know how long children had celiac disease or how well they were following a gluten-free diet, which could affect the results. The study measured quality of life through questionnaires, which rely on children’s own reports and may not capture everything about how they’re really doing. Finally, the study shows differences between groups but can’t prove that celiac disease causes lower self-esteem or quality of life issues

The Bottom Line

If your child has celiac disease, work with your healthcare team to ensure they’re getting proper nutrition (which this study suggests families are doing well). Additionally, strongly consider adding emotional and psychological support to your child’s care plan. This could include counseling, support groups, or talking with a mental health professional. Also pay attention to how your other children are doing emotionally, as they may be affected by family stress related to the celiac disease diagnosis. These recommendations are supported by the study’s findings showing emotional challenges in both children with celiac disease and their siblings

Parents of children with celiac disease should pay close attention to these findings. Healthcare providers caring for children with celiac disease should screen for emotional and social challenges, not just nutritional issues. Teachers and school counselors should be aware that children with celiac disease may struggle with school-related confidence. Healthy siblings of children with celiac disease may also benefit from emotional support. This research is less relevant to families without celiac disease, though it highlights how chronic illness affects whole families

Emotional and confidence issues may develop gradually over time as children manage celiac disease. Improvements in self-esteem and quality of life with psychological support typically take several months to become noticeable. It’s important to start emotional support early rather than waiting, as these issues can affect school performance and friendships. Nutritional improvements from a gluten-free diet may happen faster (weeks to months), but emotional healing takes longer

Want to Apply This Research?

  • Track your child’s emotional well-being weekly using a simple 1-10 confidence scale, noting specific situations where they felt good or struggled (like at school, with friends, or at home). Also track adherence to the gluten-free diet and any physical symptoms, as these may connect to emotional patterns
  • Use the app to set reminders for family check-in conversations where everyone shares how they’re feeling about managing celiac disease. Create a mood tracker that helps identify patterns between diet adherence, physical symptoms, and emotional well-being. Set goals for positive social activities with friends and school participation
  • Monitor trends over 3-month periods to see if emotional well-being improves with consistent gluten-free diet adherence and added family support. Track whether siblings show improvement in confidence when family stress decreases. Use the app to share progress with your healthcare provider during check-ups

This research describes patterns found in one study and should not replace professional medical advice. If your child has celiac disease or shows signs of low self-esteem or emotional difficulties, please consult with your pediatrician or a mental health professional. This study suggests that emotional support is important alongside nutritional management, but individual needs vary. Always work with your healthcare team to create a treatment plan tailored to your child’s specific situation. This information is for educational purposes and is not a substitute for professional medical diagnosis or treatment