ESPEN 2026 Congress Poster PP030 Conference poster companion

Gluten-free dining in the UK is over 11× more available than in Greece

A standardized, menu-verified audit of 4,379 restaurants across seven European and Commonwealth territories finds a stark north-south divide in eating-out access for people with coeliac disease, and shows that online "gluten-free" tags can't be taken at face value.

Research team
Vaios Svolos, Stylianos Karlos, Georgia Lavasa, Ilia Anna Verdou, Ioannis Manolarakis, Irini Pavlou, Dimitra Eleftheria Strongylou, Odysseas Androutsos
Corresponding author
Dr. Vaios Svolos, Post-Doctoral Researcher, Research & Teaching Fellow
Department of Nutrition and Dietetics, University of Thessaly, Argonafton 1C, Trikala
vaiossvolos@gmail.com
Primary finding

Gluten-free dining availability in the UK is over 11× higher than in Greece (40.5% vs. 3.6% verified menu offerings), revealing a north-south European disparity in eating-out access for coeliac patients.

Restaurants screened
4,379
Standardized protocol across 7 countries and 534 cities.
UK verified GF access
40.5%
Pooled across England, Scotland, Wales and Northern Ireland; Scotland leads at 47.6%.
Greece verified GF access
3.6%
The lowest of any country studied; Cyprus is close behind at 4.2%.
Platform overestimation
2.1×
Overall factor by which TripAdvisor's tag overstates verified availability (67.3% vs. 32.1%); up to 14× in Cyprus.

Geographic disparity

Verified menu GF availability, highest to lowest.

Scotland47.6%
Wales42.4%
England39.3%
Northern Ireland34.5%
Ireland23.6%
Cyprus4.2%
Greece3.6%

Practical implications

What this means for people managing coeliac disease.

  • Regional gap: in Greece and Cyprus, verified GF availability is under 5%, forcing near-constant direct inquiry with kitchen staff.
  • Don't trust a tag alone: TripAdvisor's "GF Options" tag has high sensitivity (83.9%) but low specificity (40.5%). It rules out unavailability well but is unreliable for confirming it.
  • Verification still matters: separate device-based testing has found that a meaningful share of restaurant meals labelled gluten-free still contain detectable gluten, so a menu label is a starting point, not a guarantee.
  • Cost isn't the main barrier: GF options were priced higher only in Greece, Wales and Northern Ireland, and were, if anything, slightly cheaper in England.

Verified availability vs. platform claims, by country

Overall, 32.1% of restaurants had a clearly menu-labelled GF dish (χ² p<0.001 across countries). The badge above each pair is the overestimation factor: how many times higher the TripAdvisor figure is than the verified one.

Menu (verified) TripAdvisor "GF Options" tag (claimed)
CountryMenu %TripAdvisor %Overestimation
England39.3%82.2%2.1×
Scotland47.6%79.6%1.7×
Wales42.4%58.1%1.4×
Northern Ireland34.5%60.6%1.8×
UK (pooled)40.5%76.9%1.9×
Ireland23.6%58.3%2.5×
Cyprus4.2%59.2%14.0×
Greece3.6%32.3%9.0×
Overall (7 countries)32.1%67.3%2.1×

Towns with at least one verified GF restaurant

Beyond restaurant-level rates, this looks at coverage: what share of towns and cities have any menu-verified GF option at all (χ²=369.9, df=6, p<0.001).

Menu depth: dishes per restaurant, once it has any GF option

England had the deepest GF menus (mean 24.2 dishes, median 20), Northern Ireland the shallowest (mean 13.9, median 8). Greece's few GF restaurants (n=26) still average 20.3 dishes with a median of 13.5, more than most of the UK and Ireland despite the country's near-total lack of overall availability, though that estimate rests on very few restaurants (26 in Greece, 3 in Cyprus) and should be read with caution. Box shows the interquartile range, the line inside is the median, the diamond is the mean, and dots beyond the whiskers are outliers.

Interquartile range (box) Median Mean Outlier

Can you trust the platform's "GF Options" tag?

Comparing TripAdvisor's tag against actual menu labelling (n=4,379): the tag is good at telling you where GF options are absent, but unreliable at telling you where they're genuinely present.

Confusion matrix
Menu: yes
Menu: no
Tag: yes
True positive
1,178
False positive
1,768
Tag: no
False negative
225
True negative
1,205
Sensitivity83.9%
Catches most restaurants that truly have GF options.
Specificity40.5%
Mislabels most restaurants that don't have GF options as if they do.
Positive predictive value39.9%
A "yes" tag is confirmed on the menu only about 4 times in 10.
Negative predictive value84.2%
A "no" tag is correct about 8 times in 10.

Practical takeaway

If TripAdvisor says a restaurant has no GF options, that's fairly reliable. If it says yes, verify against the actual menu or by contacting the restaurant before relying on it.

Standardized, menu-verified protocol

4,379 restaurants were screened on TripAdvisor across England, Scotland, Wales, Northern Ireland, Ireland, Cyprus and Greece, using a single standardized checklist applied restaurant by restaurant.

1

Geography: Built-Up Areas, not administrative borders

Settlements were defined as Built-Up Areas (BUAs) rather than municipal boundaries, because a BUA reflects the continuous urban footprint a resident actually experiences, and lines up with how TripAdvisor itself groups its restaurant listings. Where no BUA-equivalent existed, official administrative boundaries were used instead.

2

Population thresholds

England used a ≥50,000-resident threshold. Wales, Scotland, Northern Ireland, Ireland and Cyprus used a ≥10,000 threshold, all drawn from the same 2021 census Built-Up-Areas (or national equivalent) data. The higher England-only figure was a practical choice to keep the restaurant count manageable within the project timeline; 534 settlements were sampled across 45 regions in total.

3

London, treated as 39 neighbourhoods

London's size and demographic complexity, and the fact that TripAdvisor itself lists restaurants under 39 neighbourhoods rather than its 32 boroughs, meant it was analyzed at neighbourhood level instead of as one city or by borough, to stay consistent with how the platform actually organizes its listings.

4

Northern Ireland, Ireland and Cyprus

Northern Ireland settlements were mapped to Local Government Districts for reporting, with Belfast treated as a single unit. Ireland's town and village boundaries came from the 2022 census, cross-referenced with 2011 county-level codes and province groupings. Cyprus used the 2021 national census; areas outside government control were excluded from sampling.

5

Per-restaurant screening

Up to 10 restaurants with a legible, accessible menu were screened per settlement. For each one: explicit GF labelling on the menu, TripAdvisor's own "Gluten-Free Options" indication, the number of distinct GF-labelled dishes, and the TripAdvisor price tier (1–4).

6

Statistical analysis

Chi-square tests for country-level differences in availability and city coverage; Kruskal-Wallis and Mann-Whitney for menu depth and price comparisons, since dish counts and prices were not normally distributed; sensitivity, specificity, PPV, NPV, McNemar's test and Cohen's kappa for agreement between the platform tag and the menu.

Does going gluten-free cost more?

Within-country comparisons only; this study did not compare price levels between countries. GF options were priced significantly higher in Greece, Wales and Northern Ireland; England's GF options were, if anything, slightly cheaper. Scotland, Ireland and Cyprus showed no significant price difference.

CountryMean price, GFMean price, non-GFp-valueResult
Greece2.502.080.002GF pricier
Wales2.412.250.004GF pricier
Northern Ireland2.402.230.029GF pricier
England2.392.470.005GF cheaper
Scotland2.492.450.39not significant
Ireland2.452.430.61not significant
Cyprus2.502.430.88not significant