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- Kautto, Ethel, 1966-
(författare)
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Is it the gluten-free diet that matters the most? : Food, gender and celiac disease
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The only treatment for celiac disease consists of excluding gluten. Gluten is a protein complex found in wheat, rye, and barley, which are cereals commonly used in bread, pasta, pizza, etc. The overall aims of this thesis were to study; what happens with food choices and nutrient intakes when individuals are prescribed a gluten-free diet and what consequences this has on the everyday lives of young women and young men dealing with this disease.Methods: A food frequency questionnaire (FFQ) was used to study nutrient intake and how food choices were affected after a change to a gluten-free diet. The FFQ was sent to 12-13 years-old adolescents who took part in a large Swedish celiac screening study. The following three groups were studied: previously diagnosed with celiac disease, screening-diagnosed and non-celiac controls. The first FFQ was sent out before the screening-diagnosed adolescents had been told they had celiac disease, and the second was sent 12-18 months after they had been prescribed the gluten-free treatment. Semi-structured interviews were performed five years later in order to study how everyday life was affected by celiac disease in seven young women and seven young men. The interviews were analyzed by content analysis.Results: The previously diagnosed celiac disease group reported a nutrient intake in line with the non-celiac control group. Most of the participants reported nutrient intakes above the estimated average requirements. A diagnosis of celiac disease altered the intake of some foods, and this was shown by comparing the results from the baseline FFQ before the diagnosis and the follow-up FFQ after. The young women and young men reported similar experiences of the gluten-free food, but the perceived consequences of living with celiac disease differed between genders.Conclusion: This thesis shows that after a diagnosis of celiac disease food changes are necessary in order to be compliant with the gluten-free diet. One common effect is that food options will be reduced. However, as long the food intake is gluten-free, varied, and in sufficient quantity there is no reason to worry more about the nutritional intake of adolescents diagnosed with celiac disease than there is for their non-celiac peers. The findings in this thesis also show that society’s gender order has a great impact on how young women and young men experience their everyday lives, with celiac disease, and with the gluten-free diet.
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| 2. |
- Harryson, Lisa, 1982-
(författare)
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“An equal share, that’s my medicine”. Work, gender relations and mental illness in a Swedish context.
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Women and men in Sweden are in paid work to almost the same extent, but are found in different occupations and positions in the labour market. Still, women perform the bulk of the unpaid domestic work at home. Gendered inequalities in these respects leave women and men exposed to different work environments and responsibilities, which in turn can have gendered health consequences. In public health research there is a lack of studies on domestic work that include women and men, as well as a lack of qualitative studies exploring individuals’ experiences of domestic work and mental health. At the workplace level, few attempts have been made to analyse how several dimensions of gender equality at workplaces are related to health status and there is a lack of studies with a contextual approach combining many different variables that are at play simultaneously. Because of the cross-sectional design of previous studies on paid and domestic work there is a lack of analyses taking possible health-related selection into account, which makes it difficult to ascertain whether gender equality leads to better health or if good health is a prerequisite for gender equality.Aim: The aim of this thesis was to analyse gender relations of work (at workplaces and at home) in relation to mental illness among women and men.Methods: The thesis was based on data from the Northern Swedish Cohort. The baseline survey was conducted in 1981 when the participants were 16 years old (n= 1080, 574 boys and 506 girls), with follow-up at age 18, 21, 30 and 42. The response rate was 94 % throughout the last follow-up in 2007. Data from the Northern Swedish Cohort were supplemented with register data about the employees at the participants’ workplaces. The analysis methods for the questionnaire and register data were logistic regression analysis and cluster analysis. Interviews were performed with four women and four men in the Northern Swedish Cohort and were analysed with a Grounded Theory approach.Results: Women had overall greater responsibility for domestic work. Gender inequality in responsibility for domestic work and perceptions of gender inequality in the couple relationship (after adjustments for background variables and previous psychological distress) were associated with psychological distress among women and men. However, among men the relation between domestic work inequalities and psychological distress was affected by socioeconomic position relative to the partner. Having less responsibility for domestic work and a partner with higher socioeconomic position was associated with psychological distress among men. The qualitative analysis showed that gender relations were an important part of how the domestic work was unequally organised and related to experiences of mental illness among women and men. Among women the high burden of domestic work was experienced as an obstacle to experiencing good health. Among men the experience of being trapped in an outmoded masculinity was related to feelings of stress. At the workplace level, patterns of gender inequality were associated with psychological distress among women, but not among men. However, the most gender-equal pattern was related to lower as well as more similar levels of mental illness among women and men, which supports a convergence in health when women’s and men’s work conditions become more similar.Conclusion: Gender equality at home and at work is central for reducing mental illness among both women and men, but also for achieving a good average health status in the population, which is a central public health target. When investigating social inequalities in health, gender perspectives are of great importance for deepening the understanding of how and why gender inequalities in paid and domestic work are related to mental illness. Integrating gender perspectives into public health policy could be a way to acknowledge power relations that hinder good public health.
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