Over the past five years I have received many questions from clients, friends and colleagues about the benefit of following a gluten-free diet in the absence of a diagnosis of Celiac Disease. With the plethora of information on the proposed health benefits of the gluten-free diet it is not surprising that this topic is at the forefront of student discussions in our nutrition courses. I like to move the discussion away from the proposed health benefits of the gluten-free diet in the non-Celiac Disease population and focus on the nutritional quality of the gluten-free diet as this is an important consideration often over-looked in this debate.
Individuals following a gluten-free diet avoid wheat, barley and rye as these grains contain a protein called gluten. The presence of gluten in the digestive tract of an individual with Celiac Disease leads to damage resulting in malabsorption of vitamins and minerals. Avoiding these gluten-containing grains allows the digestive tract to heal and a “quieting” of the Celiac Disease. Exclusion of these grains in the diet while beneficial in Celiac Disease can result in a decreased intake of vitamins and minerals such as fiber, folate, calcium, niacin and iron. This occurs due to lower fortification of gluten-free grains compared to wheat grains, lower vitamin and mineral nutrient profiles in the typically used gluten-free flours such as rice, potato, and corn flours, and the decreased consumption of grain products below the recommended servings. This last factor, decreased consumption, may be attributed to the higher cost of gluten-free products.
Awareness to the potential for vitamin mineral insufficiency in the gluten-free diet can assist the individual in making intentional decisions in the types of gluten-free grains to purchase. Recent studies have shown that inclusion of three servings per day of gluten-free whole grain food sources can significantly influence the nutritional profile of the gluten-free diet. Naturally gluten-free whole grains, such as amaranth, quinoa, millet, sorghum, gluten-free oats and brown rice, have been shown to significantly improve calcium, niacin, fiber, folate, and iron profile of the gluten-free diet when compared to the standard gluten-free diet grains of white rice, potato flour and corn flour. While some of these grains may be unfamiliar they are widely available at local grocery stores and health food stores. Consumer acceptance of these products is increasing as we become more aware of their nutritional benefits.
While I have highlighted the potential for consuming low nutrient quality sources of gluten-free grains, it is important to stress that any person diagnosed with Celiac Disease requires strict adherence to the gluten-free diet to effectively manage the disease. Non-compliance with the gluten-diet for an individual with Celiac Disease leads to increased risk for vitamin and mineral deficiencies due to malabsorption, decline in health, and increased mortality. Careful selection to the type of gluten-free grains has been shown to improve the nutritional profile of the gluten-free diet. This highlights the importance of partnering with a Registered Dietitian with expertise in the Celiac Disease to ensure nutritional quality is achieved in your gluten-free lifestyle.
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Jennifer Dalton, MS, RDN, LD, is the director of didactic program in dietetics at the University of Dayton. She teaches courses on nutrition and health and specializes in functional nutrition and digestive conditions. Email: firstname.lastname@example.org.