Vol.4, No.5, 253-258 (2012) Health doi:10.4236/health.2012.45041 The happy celiac: An oxymoron or a possibility? Maurizio Esposito Department of Human and Sport Sciences, University of Cassino, Cassino, Italy; m.esposito@unicas.it Received 21 February 2012; revised 6 March 2012; accepted 20 March 2012 ABSTRACT Background: Several international studies, con- firmed in Italy too, show a hard presence of so- cio-relational problems inside the celiac popula- tion. Methods: Qualitative study involving per- sons with celiac disease and their families. 25 individual semi-structured interviews were con- ducted in three Italian regions. Results: Prob- lems of management of social life for celiac per- sons are experienced, specially in the fields of: school, work, travels and life outside the home. Conclusion: Chronic illness is a “biographical disruption” [1] and the whole society has to be invested to fight the burden of celiac persons in their possibility of access to public life. Keywords: Celiac; Social; Quality of Life; Qualitative; Chronic Illness 1. INTRODUCTION The relation between society and eating behaviors has long been demonstrated; in fact, the psychologist Gèrard Apfeldorfer asserts that the eating behavior is the cement of every human society [2]. Relations with others are of- ten identified in the eating habits which may become part of the “transitional” element of connection but also, con- versely, can become a “barrier” between in-group and out-group. In some circumstances, this circuit stops, or goes through a moment of “anomic” suspension: these are conditions of chronic disease in which the life-food bond sometimes strongly affects the quality of life and access to social relations; this is certainly the case of celiac dis- ease (CD), defined as permanent intolerance to gluten. Eating is, as said, more than swallowing food in a physiological manner: it is a vehicle to correlate social and relational needs among people; a social, even politi- cal act, in some sense. Therefore, if a specific diet, such as the diet necessary for the celiac, limits the possibility of eating out, traveling and so on, it actually becomes a “burden” in terms of socialization, and, therefore, limits access to social opportunities. 2. THE SOCIO-RELATIONAL EFFECTS OF CELIAC DISEASE. INTERNATIONAL RESEARCH DATA A few years ago [3], I asserted that the specificity of the chronically ill is that of a person who lives his life “inside” his disease, and considers his relationship with professional figures (doctors, nurses, therapists etc.) as one of the different moments of his existence; after all, his disease does not remain confined to the hospital only, but follows him home, to work or in his leisure activities, in all the relations he decides to have: it becomes his “existential background”, a part that cannot be elimi- nated from his entire biography. Therefore, it becomes an existence, paradoxically, lived with continued effort of “normalization” because the main activity of the chro- nically ill is not only to stay alive or to keep his symp- toms under control, but especially to live as normally as possible, despite his symptoms and illness [4]. The bar- rier that divides health and disease is thus a grey colored limen, which when surpassed forces the person to come to terms with his life, often making him reflect upon his own existence and the meaning of life itself. Regarding our specific topic, a research conducted by Green et al. [5] confirms that gluten-free diet adherence for the celiac person is a significant social problem, demonstrating that one fourth of the subjects violate the diet when eating out and one fifth do not follow it at par- ties or social occasions. Another study conducted by Columbia University [6] analyzes the quality of life of people with CD in detail, describing the social, emo- tional and psycho-relational aspects: in a sample of 254 adults with CD, the researchers demonstrate that the so- cial problems do not actually depend on the pathology— as is well known, it does not affect the physical and psy- chosocial status stricto sensu—but from following a strict diet; and, in fact, its negative impacts mainly occur when eating out (86%), when traveling (82%), in daily life at home (67%), and in terms of job and career (41%). These data are supported by a study conducted by Karajeh and associates [7], showing that diet compliance is very difficult for people with CD, especially when eating away from home. In particular, this may depend on the lack of knowledge that staff preparing food in Copyright © 2012 SciRes. Openly accessible at http://www.scirp.org/journal/health/