RESEARCH PAPER Experiences of coeliac disease in a changing gluten-free landscape J. A. King, 1,2 G. G. Kaplan 1,3,4 & J. Godley 2,4 1 Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada 2 Department of Sociology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada 3 Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada 4 O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada Keywords coeliac disease, gluten-free diet, interpretive phenomenology, qualitative, semi-structured interview. Correspondence J. Godley, Department of Sociology, University of Calgary, Calgary, AB T2N 1N4, Canada. Tel.: +1 403 220 7566 Fax.: +1 403 282 9298 E-mail: jgodley@ucalgary.ca How to cite this article King, J.A., Kaplan, G.G. & Godley, J. (2018). Experiences of coeliac disease in a changing gluten-free landscape. J Hum Nutr Diet. https://doi.org/10.1111/jhn.12597 Abstract Background: Coeliac disease is an autoimmune disorder triggered by the ingestion of gluten. In recent years, there has been considerable increase in the availability of gluten-free products in North America. The present study investigated how the recent proliferation of the gluten-free industry has affected individuals living with coeliac disease, with a primary focus on their social lives and relationships. Methods: Interpretive phenomenology was utilised for study design and analysis. Semi-structured interviews were conducted with 17 adults diag- nosed with coeliac disease in Calgary, Alberta. Interviews were audio recorded and then transcribed for analysis. Results: People living with coeliac disease experience the growth of the gluten-free industry as a ‘double-edged sword’. Although they are grateful for more palatable gluten-free options, they are increasingly faced with misunderstandings about the severity of coeliac disease as a result of many noncoeliac disease individuals subscribing to the gluten-free diet. This ‘double-edged sword’ made certain types of social situations more easily manageable (e.g. more gluten-free options available at restaurants), whereas others produced distress (e.g. increased risk of inadvertently con- suming gluten). Participants also felt they may be perceived or even per- ceived themselves differently (e.g. felt high maintenance). To help mitigate these social ramifications of following the gluten-free diet, participants uti- lised various strategies. Conclusions: The sole medical recommendation of a gluten-free diet fails to acknowledge the ongoing difficulties those with coeliac disease can endure in the current gluten-free landscape. Recommendations beyond the gluten- free diet are advisable to alleviate many of the indirect burdens revealed in the present study. Introduction Coeliac disease, an autoimmune disorder resulting in intestinal damage from gluten ingestion, is estimated to affect approximately 1% of the North American popula- tion (1,2) . Treatment involves strict adherence to a gluten- free diet, with even a small amount of gluten (i.e. 50 mg) potentially provoking an autoimmune reaction (3) . Recently, individuals without coeliac disease are increasingly follow- ing a gluten-free diet in the USA (4) . Popular nutritional books and celebrities posit that a gluten-free diet will solve contemporary health problems such as obesity, dia- betes, high blood pressure and even help prevent illnesses such as dementia and attention deficit hyperactivity disor- der (5–7) . The perception of a gluten-free diet as healthy is marked in American adult populations despite a lack of 1 ª 2018 The British Dietetic Association Ltd. Journal of Human Nutrition and Dietetics