Are Gluten-Free Diets More Nutritious? An Evaluation of Self-Selected and Recommended Gluten-Free and Gluten-Containing Dietary Patterns

Gluten-free (GF) eating patterns are frequently perceived to be healthier than gluten-containing (GC) ones, but there has been very little research to evaluate this viewpoint. The effect of GF eating patterns on dietary composition was assessed using two independent approaches. One approach compared macronutrients and typical shortfall nutrients between MyPlate example menus developed with either GC or equivalent GF foods. In this analysis, the GF menus were significantly lower in protein, magnesium, potassium, vitamin E, folate, and sodium (p = 0.002–0.03), with suggestive trends towards lower calcium and higher fat (p = 0.06–0.08). The second approach was a meta-analysis of seven studies comparing information on the nutrient intakes of adults with celiac disease following a GF diet with control subjects eating a GC diet, and differences were evaluated using paired t-tests or Wilcoxon Signed rank tests. In this analysis, consuming a GF diet was associated with higher energy and fat intakes, and lower fiber and folate intakes compared to controls (p < 0.001 to p = 0.03). After adjusting for heterogeneity and accounting for the large mean effect size (−0.88 ± 0.09), the lower fiber remained significant (p < 0.001). These combined analyses indicate that GF diets are not nutritionally superior except for sodium, and in several respects are actually worse.

[1]  M. Barone,et al.  A comparison of the nutritional status between adult celiac patients on a long-term, strictly gluten-free diet and healthy subjects , 2016, European Journal of Clinical Nutrition.

[2]  A. Rubio‐Tapia,et al.  The Prevalence of Celiac Disease in the United States , 2012, The American Journal of Gastroenterology.

[3]  C. Hallert,et al.  Dietary habits of Swedish adult coeliac patients treated by a gluten-free diet for 10 years , 2001 .

[4]  V. Kosma,et al.  Osteoporosis in adult patients with celiac disease. , 1999, Bone.

[5]  A. Lucas,et al.  Measurement of urinary constituents and output using disposable napkins. , 1985, Archives of disease in childhood.

[6]  P. Gibson,et al.  Nutritional inadequacies of the gluten-free diet in both recently-diagnosed and long-term patients with coeliac disease. , 2013, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[7]  KulaiTasha,et al.  Assessment of Nutritional Adequacy of Packaged Gluten-free Food Products , 2014 .

[8]  P. Gibson,et al.  Sensitivity to wheat, gluten and FODMAPs in IBS: facts or fiction? , 2015, Gut.

[9]  S. Angadi,et al.  Navigating the gluten-free boom , 2015, JAAPA : official journal of the American Academy of Physician Assistants.

[10]  M. Cirillo,et al.  Long-Term Follow-Up of Celiac Adults on Gluten-Free Diet: Prevalence and Correlates of Intestinal Damage , 2002, Digestion.

[11]  J. Murray,et al.  Hematologic manifestations of celiac disease. , 2007, Blood.

[12]  M. Bustamante,et al.  Nutritional Differences Between a Gluten-free Diet and a Diet Containing Equivalent Products with Gluten , 2014, Plant Foods for Human Nutrition.

[13]  Sung Kyu Ha,et al.  Dietary Salt Intake and Hypertension , 2014, Electrolyte & blood pressure : E & BP.

[14]  Alessia Pia Scarlato,et al.  Dietary exposure to fumonisins and evaluation of nutrient intake in a group of adult celiac patients on a gluten-free diet. , 2012, Molecular nutrition & food research.

[15]  C. Hallert,et al.  Evidence of poor vitamin status in coeliac patients on a gluten‐free diet for 10 years , 2002, Alimentary pharmacology & therapeutics.

[16]  W. Marcason Is there evidence to support the claim that a gluten-free diet should be used for weight loss? , 2011, Journal of the American Dietetic Association.

[17]  P. Howdle,et al.  Evidence of high sugar intake, and low fibre and mineral intake, in the gluten‐free diet , 2010, Alimentary pharmacology & therapeutics.

[18]  M. Bardella,et al.  Body composition and dietary intakes in adult celiac disease patients consuming a strict gluten-free diet. , 2000, The American journal of clinical nutrition.

[19]  B. Neal,et al.  Are gluten-free foods healthier than non-gluten-free foods? An evaluation of supermarket products in Australia , 2015, British Journal of Nutrition.

[20]  Flávia Xavier Valente,et al.  B vitamins related to homocysteine metabolism in adults celiac disease patients: a cross-sectional study , 2015, Nutrition Journal.

[21]  L. Hagfors,et al.  What happens to food choices when a gluten-free diet is required? A prospective longitudinal population-based study among Swedish adolescent with coeliac disease and their peers , 2014, Journal of nutritional science.

[22]  Peter HR Green,et al.  Spectrum of gluten-related disorders: consensus on new nomenclature and classification , 2012, BMC Medicine.

[23]  S. McGuire,et al.  Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Washington, DC: US Departments of Agriculture and Health and Human Services, 2015. , 2016, Advances in nutrition.

[24]  S. Burden,et al.  A dietary survey to determine if patients with coeliac disease are meeting current healthy eating guidelines and how their diet compares to that of the British general population , 2008, European Journal of Clinical Nutrition.