1. Introduction
Bread, pasta, breakfast cereals, crackers, and cookies comprising wheat, rye, and barley are stable food items in several European countries [
1,
2]. However, in the past two decades, these staples have been replaced by gluten-free options in many households [
3,
4,
5,
6]. The European market for gluten-free food products will be worth USD 3.62 billion (EUR 3.28 billion) in 2024 and is governed by EU regulation No. 609/2013, stipulating the labelling of food ingredients. Gluten is an ingredient that requires extra attention from food producers and marketers as it can contribute to gluten-related intolerances and can affect customers with disorders such as celiac disease [
7,
8,
9]. Reportedly, about 1% of the EU population suffers from celiac disease, but the actual percentage is assumed to be higher, as many cases remain undiagnosed or unreported [
10]. Celiac disease is an autoimmune disorder where, at present, there is no treatment available, other than removing gluten from the diet [
11,
12]. Accomplishing this dietary adjustment requires related lifestyle changes, which affect food consumption and purchases [
13,
14].
Products sold in European food retail that are labelled as ‘gluten-free’ are not allowed to exceed gluten concentrations of 20 mg/kg [
7,
15,
16]. While gluten-free food items are closely associated with health claims and beliefs, many gluten-free food items contain highly refined flour, are lower in fiber, and are high on the glycemic index. In comparison with regular food items, they are often inferior in taste and texture. To make up for this shortcoming, manufacturers may add fats, sugars, or other ingredients to their gluten-free products. These factors, and their very high price point, are said to be hindering the growth of the European gluten-free food market [
17]. Another food-safety-related issue is the cross-contamination of gluten-containing ingredients throughout the production process. Therefore, food shopping with this dietary restriction can be difficult.
The extant literature discusses consumer sensory perceptions and preferences for gluten products such as bread, pasta, and pizza [
18], consumer acceptance of new product formulas, and willingness to pay for gluten-free products [
19], as well as health motivations and addiction to gluten-free diets for consumers that do not require gluten-free diets. However, research dedicated to the point of sale is rather scant. The identification of a basic gluten-free European food basket and purchasing frequencies, differences among consumer groups buying gluten-free food, and their levels of product satisfaction are yet to be uncovered. Understanding differences between consumers, namely, those affected by celiac disease, those choosing to eat gluten-free food, and those that are caregivers to gluten-free consumer groups, is necessary to gain a more complete picture of the European gluten-free consumer market and these specific target groups. The present study is dedicated to addressing this gap in the literature and aims to provide best practice recommendations for marketers in European food retail. This study will provide answers to the following questions: How do the three target groups differ in their gluten-free purchasing habits and how do they assess their shopping experience of gluten-free products in European food retail?
2. Literature Review
2.1. The European Gluten-Free Food Basket
Food baskets are commonly used to indicate the monthly budget required for food purchases for reference households in European countries to reach an acceptable standard of living [
20]. They are grounded in cultural food habits and informed by nutritionists and dietary guidelines. The budget accounts for food purchases, food preparation, and storage equipment. The underlying assumptions for budget and product suggestions are that households consist of children and adults who are in good health and live in capital cities [
20]. Given that many of the foods typically found in a food basket are not gluten-free, gluten-free consumers do not meet the requirements of the standard basket. In addition, if celiac-diagnosed, they may not meet the health criterion, and the food basket budgets do not account for the price premiums for many gluten-free products. Thus, research toward the establishment of European gluten-free food baskets is required [
11,
21].
The recent body of literature provides information on gluten-free food baskets. A study from Cyprus investigated the affordability of a gluten-free food basket for people with low income [
22]. The study indicated that the basket is unaffordable for low-income households, as the basket accounts for 40–60% of their income. Consequently, this group in the population is likely to be exposed to food insecurity or food stress and to be at risk of compromising their long-term health if they are forced to abandon a gluten-free diet [
22]. The study confirms earlier findings from Australia, which indicated the gluten-free basket was considered unaffordable for three of the four common family types in Australia. The authors warn that for people relying on public welfare [
17,
23], dietary compliance is more difficult and that welfare considerations should be made to assure equitable access to gluten-free food [
23].
An early study from the United Kingdom was dedicated to product assortments and the availability of gluten-free food products in physical and online shops [
24]. The study found that budget stores or convenience stores had a very limited assortment. This limited assortment in budget stores was confirmed in a later study, which reported a slight increase in assorted gluten-free products in budget stores [
16]. In contrast, online stores had a wider product range but often at up to twice the cost [
25]. Further, Hopkins and Soon (2019) remark that from a nutritional perspective, gluten-free products such as bread, crackers, and cookies were lower in protein and sugar compared to regular products [
25]. Similarly, readily prepared gluten-free meals contained less salt compared to regular meals. Consistent with previous studies, the authors criticize the high price points and the lack of availability in budget stores, which disadvantage low-income groups. Estévez et al. (2024) and Jamieson et al. (2018) identify availability, nutrition, and price point as persistent barriers to complying with a gluten-free diet [
26,
27].
2.2. Consumers Assessment of Availability and Quality of Gluten-Free Food Items
Vriesekoop et al. (2020) conducted consumer research in the United Kingdom. Their work emphasizes consumer dissatisfaction with gluten-free food items. Their dissatisfaction addresses price points, sensory experiences of staple foods items such as bread, pasta, and crackers, and shelf-life [
16]. Consumers indicated improvements in the taste, texture, and smell of gluten-free foods but suggested that the mouthfeel of some gluten-free breads is reminiscent of cardboard and needs to be toasted to be palatable [
16,
28,
29]. While bread was heavily criticized, consumers appeared to be more content with pasta [
16].
These results align with consumer studies in Italy, which show that the product quality of pasta appears to be satisfactory [
30]. Consumers in the UK reported unhappiness with gluten-free food going bad or moldy before use-by dates. It is unclear whether this was due to inaccurate shelf-life estimations or poor climate control, storage, or stocking procedures in the supermarkets or supply chains. The study indicated high dissatisfaction with gluten-free products regarding value for money. On a positive note, consumers in the United Kingdom trust gluten-free labelling [
16]. This may be attributed to clear government labelling regulations for gluten-free products. While the study emphasizes distinct groups of people consuming gluten-free food, including people diagnosed with celiac disease and caregivers of the other consumer groups, shopping and consumption differences between these groups have not been reported [
16].
2.3. Consumer Target Groups
Gutowski et al. (2020) and Fiori et al. (2024) provide important information about the buying behaviors of different consumer target groups [
15,
31]. Gutowski’s work (2020) [
31] discusses the inability of consumers with celiac disease to correctly choose gluten-free items based on product labelling, as labels specify unsafe ingredients in ambiguous ways, e.g., wheat derivates. The study indicates that some consumers with celiac disease incorrectly assumed that natural and artificial flavors, cornstarch, spices, and seasonings are gluten-free products, and they misidentified soy products as gluten-containing. Consumers with celiac disease must learn to identify gluten-free food items and perfect their skills and knowledge to avoid harming themselves. Sielicka-Różyńska et al.’s (2020) eye-tracking study found that at the point of sale, gluten-free consumers actively search for written cues and that graphical indicators, such as the crossed-out grain image, only provide additional information [
32].
Fiori et al. (2024) [
15] investigated adherence to a gluten-free diet and report that caregivers, often parents of adolescents or small children, are extra careful and known for their strict adherence to offering a gluten-free diet. Young parents seem to be the strictest and most worried group. These individuals were more frequently concerned when thinking about food and when choosing what to eat, and they were more frequently confused when going about their grocery shopping. Approximately 40% of the sample population indicated occasionally diverging from a gluten-free diet and admitted feeling guilty about it [
15]. Other studies report that some consumers of gluten-free products do not follow medical advice but follow health and wellness trends or wish to reduce their weight [
33,
34,
35,
36]. These consumers appear less strict than those with celiac disease or caregivers of those with gluten-free diets.
2.4. Hypothesis Development
Building on the presented literature review, it is posited that there are attitudinal and behavioral differences between gluten-free consumer groups (see
Figure 1).
The recent body of literature discusses purchasing frequencies for consumers requiring a gluten-free diet. However, to date, the understanding of purchasing frequencies has been limited to individual country contexts [
16,
37,
38] and a general understanding of gluten-free diets and consumer demands [
39]. Distinctions between celiac-diagnosed consumers, gluten-intolerant consumers, and caregivers in their purchasing frequencies have not yet been presented. Understanding the differences between these groups is important from consumer and marketer perspectives alike. Information about purchasing frequencies provides insight into demand, segmentation and targeting [
40], pricing, and promotion, as well as requirements for product assortments and product innovation [
41]. Purchasing frequencies may be indicators of adherence to diets in order to achieve symptom-free status and improve quality of life. On these grounds, is the following is proposed:
Hypothesis 1. Within European food retail, there are significant differences in purchasing frequencies of gluten-free food offerings between consumers following a gluten-free diet, consumers with a celiac diagnosis, and caregivers of those with gluten-free diets.
Similarly, consumer satisfaction with gluten-free products and product assortments has been studied at the individual country level [
13,
16,
42,
43,
44], but multi-country insights are rather limited [
29]. There is consensus in the literature that product assortment and product availability have improved in the last decade, although recent assessments of quality and sensory experiences among gluten-free products are still mixed [
13,
16,
29,
39,
44]. Examples of products that satisfy gluten-free consumers are pasta and crackers [
13,
16], while bread still requires the attention of food producers, as it often causes consumer dissatisfaction [
6,
16,
29]. A distinction between consumer groups is required, as people follow a gluten-free diet for varying reasons, and their respective dependencies, product acceptance, and satisfaction with gluten-free products may vary [
45]. Therefore, the following hypothesis is proposed:
Hypothesis 2. Within European food retail, there are significant differences in satisfaction with gluten-free food offerings between consumers following a gluten-free diet, consumers with a celiac diagnosis, and caregivers of those with gluten-free diets.
Various studies have reported the challenges and problems that consumers who need to follow a gluten-free diet face when going grocery shopping [
2,
13,
46]. These include a previously discussed limitation in product assortment or quality [
16,
29]. In addition, the identification/labelling of gluten-free products, cross-contamination of food, food recalls, and shopping for a nutritious diet are other challenges that are widely discussed [
47,
48]. The health literature emphasizes that people with gluten sensitivity from other health-related issues face the least problems, as they may be able to tolerate small amounts of gluten [
31,
32]. It is discussed that celiac-diagnosed consumers are more affected, as the element of care and the stronger dependency on the products intensify these outlined issues [
31,
32]. Coping mechanisms to mitigate these issues and distinctions among different consumer target groups are not yet widely studied [
2]. Amidst this background, the following hypotheses are proposed.
Hypothesis 3. Within European food retail, there are significant differences in the problems experienced with gluten-free food offerings between consumers following a gluten-free diet, consumers with a celiac diagnosis, and caregivers of those with gluten-free diets.
Hypothesis 4. Within European food retail, there are significant differences in the coping strategies of gluten-free food offerings between consumers following a gluten-free diet, consumers with a celiac diagnosis, and caregivers of those with gluten-free diets.
3. Materials and Methods
Data from the present study stem from a multi-country investigation in Greece [GRE], the Netherlands [NLD], Belgium [BEL], France [FRA], Spain [ESP], Italy [ITA], Great Britain [GBR], Poland [POL], Turkey [TUR], Ireland [IRL], Cyprus [CYP], Finland [FIN], and Lebanon [LBN]. Ten-minute online surveys were disseminated with the assistance of the various national celiac associations in 2021. Survey participants were invited to answer questions about their consumption and purchasing habits, e.g., purchasing frequency and their assessment and reaction to their gluten-free shopping experience. To assure the comparability of purchasing frequencies, 33 products were chosen that are commonly part of European diets and that are, with some exceptions, available in each country as gluten-free alternatives. The base list of products and the survey questions were derived from Vriesekoop et al. (2020) [
16]. The survey questions for the present study can be classified into three categories: sociodemographic information and gluten-free consumer group identification, as listed in
Table 1, the purchasing frequency of the 33 products, as shown in
Table 2, and satisfaction, problems, and coping strategies, as shown in
Table 3. Because the data were merged from a series of individual country datasets, adaptations made in individual countries resulted in some issues, mainly the removal of some products due to a lack of popularity or availability (e.g., cosmetics or hair products) or the merging of food products (e.g., pasta with noodles). Overall, 20 products were collected in all 13 countries, 5 products were collected in 12 countries (flatbread, condiments, sausages, beer, cake mixes, pasta), 3 products in 11 countries (pasta, pot noodles, burgers), 1 in 10 countries (crackers), 2 in 9 countries (noodles, meal kits), and 2 in 6 countries (cosmetics, hair products).
The purposive sampling approach underpinning this study is deemed appropriate, despite being a non-probability sampling approach. A purposive sampling approach requires the researcher to determine the characteristics of the survey participants that are necessary for inclusion in the sample. In this case, the requirements were as follows: responsibility for the household food shopping, and either being sensitive to gluten, diagnosed with celiac disease, or being a caregiver for children or elderly persons who require a gluten-free diet. Recruiting was performed through national celiac associations that allow immediate access to these specific consumer groups. Recruiting through the celiac associations was critical to recruiting suitable respondents and securing reliable data, especially when considering the alternative, targeting gluten-free consumers via opt-in panel providers or crowd-sourcing platforms.
The research instrument was initially developed in English language and subsequently translated into various European languages. To assure translation accuracy and cultural appropriateness, translations were facilitated by individuals who are co-authors of this work, are native speakers, and use English as their professional language. In health and dietary studies, translation accuracy has become increasingly important in the last two decades [
49,
50]. This study received ethical approval through Harper Adams University, United Kingdom, with the identification number 0439-202106-STAFF.
After data cleaning, the sample consisted of 7296 European consumer respondents. Cleaning involved the deletion of responses which were incomplete or had not been carefully completed. Online surveys are often subject to speeding behavior, where survey participants complete a survey much faster than the average completion time. The data were analyzed via the software package SPSS 29, using descriptive statistics to describe the European consumer sample. Analysis of variance (one-way ANOVA) and the Games–Howell post hoc tests were used to identify differences among the three consumer target groups. One-way ANOVA is a parametric test specifically used to determine if there are statistically significant differences between the means of two or more independent groups (in this case, the three consumer groups). If significant differences are found (using F statistics at
p < 0.05), this provides the justification necessary to use post hoc analyses to identify whether the responses of specific groups are statistically significantly different from each other. The choice of the specific post hoc test is based on group sizes and parametric assumptions [
51]. One such assumption is equality of variance, tested using the Levene statistic, where if significant (
p < 0.05), it indicates that post hoc tests should be limited to those that do not assume equality of variance, such as the Games–Howell post hoc test, which is appropriate for uneven group sizes and is not limited to small samples [
39,
40]. These post hoc tests provide confidence intervals for group mean differences and indicate whether each pairwise comparison is statistically significant (
p < 0.05).
4. Results
The overall sample can be described as predominantly female and consisted of 15.4% men and 84.4% women. Only 0.3% of the sample identified as a different gender concept or preferred not to reveal their gender identity. Approximately 64.6% had been diagnosed with celiac disease, 14.2% were affected by gluten intolerance, and 21.2% indicated being a caregiver of someone with a gluten-free diet. In terms of age, the sample was reasonably well balanced, with the exception of the age groups 65–84 and 85+, which amounted to a total of 8.3%. Mid-age groups, namely 35–44 and 45–54 years old, made up much of the sample, with 47.3%. The individual information for each country can be obtained from
Table 1.
To test Hypothesis 1, gluten-free consumers were presented with 33 gluten-free product types and asked how frequently they purchased the product type, with the response options of 0 = never, 1 = seldom, 2= sometimes, and 3 = often.
Table 2 shows that except for “ready-meals”, all the gluten-free product categories had significant one-way ANOVAs (
p < 0.05), indicating differences in purchasing frequency across the three gluten-free consumer groups. This was sufficient evidence to claim support for Hypothesis 1. Post hoc tests were performed to establish significant differences between the groups. Caregivers generally reported higher purchasing frequencies compared with the other groups. Specifically, caregivers reported higher purchasing frequencies than both the celiac-diagnosed and gluten-intolerant groups for 19 of the 33 product types and higher than only one of the other groups for 9 product types. The group with the second-highest purchasing frequency was those with a celiac diagnosis, reporting higher purchasing frequencies than both the other groups for 3 product types and higher than only one other group for 18 product types. The gluten-intolerant group reported higher purchasing frequencies than both the other groups for only one product type and higher purchasing frequency for only one other group for five product types.
Table 2 also presents the product type results sorted by the highest overall mean purchasing frequency. The rankings of product types for the consumer groups are also reported to highlight any notable deviations (bolded), defined as a deviation of five or more ranking positions from the overall ranking. Overall, and for all the consumer groups, the most frequently purchased gluten-free product types were pasta, bread, flour, and biscuits/cookies, and the least purchased product types were couscous, meal kits, ready-meals, and cake mixes. The celiac group had no notable deviations from the overall ranking, but this consistency can be explained by the fact that it was the largest of the three groups in the sample. The caregivers also had a consistent ranking, with only two notable deviations (crackers and pot noodles). The gluten-intolerant group diverged the most with eight notable deviations. Finally, a mean rank deviation score was calculated as the average absolute value of the ranking deviations and is reported in
Table 2. The celiac-diagnosed group had a mean rank deviation of less than 1 rank position (0.67), the caregivers deviated more with 1.82 rank positions, and the gluten-intolerant group deviated the most, deviating 2.67 rank positions.
Hypothesis 2 was tested by examining seven satisfaction items measured on five-point Likert scales. One-way ANOVAs showed that the groups reported significantly different satisfaction ratings, supporting Hypothesis 2 (see
Table 3). Post hoc analyses showed that the celiac-diagnosed group reported higher levels of satisfaction than both the gluten-intolerant and carer consumer groups for three of the items and higher than just the carer group for three items. Perhaps this is an indication that those with celiac diagnoses are simply more appreciative of having gluten-free options to choose from. Like in
Table 2, the satisfaction scores were sorted by the highest overall scores, showing that “trust in the labels” was positive (3.720 or ~ agree) and “enjoyment of the gluten-free offerings” and “satisfaction with the quality and range of gluten-free offerings” was neutral (2.730 to 3.160 or ~ neutral). Responses for “gluten-free offerings as good as non-gluten-free offerings” and “the ‘Free-from’ aisles are well stocked” were neutral to negative (2.380–2.470 or ~ neutral/disagree), and “gluten-free offerings are good value” was negative (2.150 or ~ disagree). This suggests that the quality and range of gluten-free offerings are good, but the range could be better stocked and are often overpriced.
Hypothesis 3 was tested by examining two items asking whether the gluten-free consumers had experienced problems with gluten-free offerings. One-way ANOVAs were significant for both items, providing support for Hypothesis 3. Post hoc analyses revealed that caregivers had experienced more availability problems than the other groups. Overall, the results were not positive, with 79% of the gluten-free consumers experiencing problems with availability and 66% experiencing problems with the quality of gluten-free offerings.
Hypothesis 4 was tested by examining differences across the groups in using two coping strategies for issues in the quality or availability of gluten-free offerings. One-way ANOVAs were significant for both strategies, supporting Hypothesis 4. Post hoc analyses indicated that caregivers were more likely than the other groups to shop at several stores to find all the gluten-free products they needed. The caregivers were also more likely to make their own gluten-free products than the celiac-diagnosed consumers.
5. Discussion
The celiac-diagnosed, caregivers of the gluten-free, and the gluten-intolerant are related but distinct segments of gluten-free consumers. Caregivers seemed to have the highest purchasing frequency for most of the gluten-free offerings throughout the most popular to the least popular product groups. They were the least satisfied with the gluten-free product offerings, quality, and availability. They experienced more problems with availability, and they engaged in more coping strategies to obtain the products they need.
There are several possible explanations for these findings. First, caregivers are often parents, family, or professional caregivers, and since their charges are the ones who will experience the uncomfortable-to-dangerous consequences of gluten contamination, they are likely to be more vigilant providers of gluten-free food. Also, unless they and the rest of the household follow a gluten-free diet, the carers are more likely to rely on packaged foods that are known to be gluten-free for their charges. Food that is clearly labelled and can be kept separate from non-gluten-free food is much easier to manage in such a situation, so this could explain why prepared gluten-free foods such as breakfast cereals, condiments, pizza, sausages, and sweets are more common on a caregiver’s shopping list. These findings complement medical and dietary studies. Following Caetano-Silva et al. (2024), a gluten-free diet requires eating competence from the affected person or their caregivers [
52]. A gluten-free diet requires strict compliance, knowledge about food products and their ingredients, meal planning, food storage, and meticulous attention to product choices. Caregivers of children or the elderly must have the highest degree of food competence, which involves shopping, food preparation, and consumption [
52]. Bariyah et al. (2024) also indicate that caregivers have moderate-to-high knowledge about gluten-free diets, but they experience problems when putting this knowledge into practice [
53]. The study outlines accessing food ingredients, costs, and quality as major issues to strictly following a gluten-free diet. Hameed and Sondhi (2023) acknowledge the critical role of the caregiver [
54]; while the findings of the present study echo their findings related to food competence, they further emphasize that attitudes towards the disease, income, education, and influence of other parties in the household play an important role on a caregiver buying and consumption behavior. Non-acceptance of the disease, pressure, switching behavior, and distrust towards products and out-of-home eating are addressed in the study.
Adult celiac-diagnosed consumers tended to purchase most of their gluten-free products less frequently than caregivers but more than the gluten-intolerant group. Because of the medical consequences, it is unlikely that this group will eat any non-gluten-free food, so they have likely changed their food preferences, meaning that they do not often need to buy some gluten-free versions of typical products. While they may have developed the culinary skills to make their own gluten-free options, they reported using this coping strategy less than the caregiver group. Other explanations could include having more out-of-home meals or eating less processed foods like pizza and sausages. At present, there is no information on the purchasing frequency of celiac-diagnosed consumers in comparison with caregiver or gluten-intolerant consumers in multiple European countries. However, it is known that shopping and consumption habits, including purchasing frequency, contribute to food competency and success in adherence to gluten-free diets [
15,
55].
Finally, the gluten-intolerant group was distinct from the other gluten-free consumer groups, in that most gluten-free products were purchased less frequently, with the notable exception of porridge/oats. This group seemed to be less satisfied than the celiac-diagnosed group, experienced fewer problems than caregivers, and were less likely to shop at several stores to obtain gluten-free products. Their shopping behavior was consistent with someone who feels better when they avoid eating gluten but does not face life-threatening consequences when they do not. Perhaps their higher frequency of buying gluten-free porridge/oats is the best evidence of this. For many gluten-intolerant consumers, the level of possible cross-contamination of gluten from other grains may not be a problem, but for celiac-diagnosed consumers, it could be. Some studies outline that gluten-free food is consumed because consumers believe that gluten-free products are healthier, help improve other medical conditions, are helpful to reducing weight, and can mitigate acne [
6,
56]. Moreover, consumers not required to follow a gluten-free diet may still do so for psychological or well-being reasons [
6]. Moreover, other non-celiac, but gluten-sensitive, disorders may allow for some variation in the gluten-free diet. Those diets may allow for certain non-wheat cereals that contain gluten analogues or allow for limited quantities of gluten resulting from cross-contamination [
57].
Another finding of this study is that there seems to be a hierarchy of gluten-free products for most European gluten-free consumers. Coupled with concerns about large price premiums for gluten-free products, knowing the most common products could be beneficial for establishing gluten-free food baskets and ultimately gluten-free budgets. While pasta, bread, flour, and biscuits/cookies top the purchasing frequency, it could be argued that any gluten-free product with a purchasing frequency score of ≧1.5 (midpoint between “seldom” and “sometimes” alternatives) should be considered for such a basket. For caregivers, this list would include 15 products, for the celiac-diagnosed, 9 products, and for the gluten-intolerant, 8 products.
6. Conclusions
The present study fills an important gap in the literature, with its focus on the comparison of three consumer target groups and with respondents from multiple European countries. Studies with consumer data from multiple countries are rare, but they are increasingly important as gluten sensitivity and celiac diagnoses continue to be an increasing health issue across the European market. The knowledge gained about the purchasing habits, satisfaction, and coping mechanisms of gluten-free consumers and caregivers complements research in the medical, health, and dietary fields. Scholars in these disciplines have frequently called for this information, as strict dietary adherence is the only way for consumers requiring a gluten-free diet to lead healthy lives. Understanding purchasing habits, satisfaction, and coping mechanisms can be important factors contributing to disease management. While product availability and consumer satisfaction/dissatisfaction are receiving wider attention in recent times, coping strategies have been underexplored. Coping strategies are an important predictor of food knowledge and eating competency, as the coping mechanisms result from the absence or inconsistent availability of desired gluten-free items. The absence of desired products triggers a search for alternative offerings and consideration of the opportunity cost to undertake additional shopping in other retailers. This requires a wider understanding of retail offerings and sufficient food knowledge to consider alternative food options. Deepening the knowledge of caregivers, their diets, and the impact on their dependents is a promising avenue for future studies. The paradox of marketing to caregivers is likely an interesting lens.
As such, the current work is of interest to both food and health marketers. Marketing campaigns should address the development of food competence and work with influencers to support the educational efforts of medical practitioners and celiac associations. Marketing campaigns should be grounded in lifestyle marketing, as following a gluten-free diet is a major lifestyle adjustment to the food purchasing and eating habits of the affected person, their immediate family, and their social circles. Lifestyle marketing allows for the positioning of gluten-free food products or food-related and dietary services to possess the needs, desires, and aesthetics that the target audience identifies with.
While this study shows that product assortments have been improved, quality, value for money, and availability were still seen as barriers for all the gluten-free consumer target groups. Food retailers who are willing to mitigate these issues may have a unique advantage in distinguishing themselves from competitors. Given that gluten-free diets are becoming a necessity for an increasing number of people in Europe, price points and food basket recommendations should account for this. This issue can lead to food inequality and requires a wider discussion among policymakers, health professionals, and the food industry.
Future research should focus on gluten-free food basket choice experiments following Caputo and Lusk (2022) [
58]. Such work may help inform food-related food security and welfare policies. The purchasing frequencies from the current study coupled with a detailed analysis of prices for the most purchased gluten-free products could provide an excellent foundation for a European gluten-free food basket and associated household budget. Furthermore, further work could focus on generational cohorts and gluten-free consumption, understanding the perspectives of caregivers and young consumers in the context of brand loyalty or switching behavior for bread, pasta, cereals, and other selected products. While the high price point of products suggests switching behavior to be likely, the sensory properties of specific products and brands may suggest loyalty.
Author Contributions
Conceptualization, F.V. and W.d.K.; methodology, F.V.; validation, F.V. and W.d.K.; formal analysis, D.D. and M.R.; investigation, H.L.V., S.L., T.B., G.A., M.T., E.H., H.H., M.B., S.A., D.G. (Dominika Głąbska), D.G. (Dominika Guzek), S.v.d.B., L.O., P.R., E.B. and M.K.; data curation, F.V.; writing—original draft preparation, M.R. and D.D.; writing—review and editing, F.V. and W.d.K.; supervision, F.V., P.M., V.X., B.U., S.C. and A.S.; project administration, F.V. All authors have read and agreed to the published version of the manuscript.
Funding
No specific funding has been attributed to the project.
Institutional Review Board Statement
This study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Human Ethics Committee at HAU, United Kingdom, as 0439-202106-STAFF.
Informed Consent Statement
All participants gave their informed consent for inclusion before they participated in this study.
Data Availability Statement
The raw data supporting the conclusions of this article will be made available by the authors on request.
Acknowledgments
We most gratefully acknowledge the support of various national celiac societies: Coeliac UK, Coeliac Society of Ireland, Finnish Coeliac Society, Polish Coeliac Society, Nederlandse Coeliakie Vereniging, Vlaamse Coe-liakie Vereniging, Société Belge de la Cœliaquie, Cyprus Coeliac Association, French Association of Gluten Intolerants, Greek Coeliac Association, Italian Coeliac Association, Federation of Coeliac Associations of Spain, Life with Celiac Association (Turkey).
Conflicts of Interest
The authors declare no conflict of interest.
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