What’s surprising is that in spite of a much larger number and variety of gluten-free products on the market today compared to 1999, the nutritional composition and enrichment status of many products is still clearly inadequate.
The resulting impact on the gluten-free diet of the individual can be profound. Dietitian Anne Lee reviewed the diets of 50 patients of the Celiac Disease Center at Columbia University to find that rice cereal was the most common breakfast food. For lunch, most were having bread made of white rice or tapioca or rice cakes or crackers. Fifty-five percent of snacks were chips, pretzels, cookies, cakes or doughnuts. When patients did include a grain or starch, white rice was the most common.
Lee shifted the nutritional composition of the patients’ diets by substituting gluten-free oats at breakfast,, a high-fiber brown rice bread at lunch and quinoa for dinner instead of the patient’s standard dietary pattern. Her study, published in the Journal of Human Nutrition and Dietetics in 2009, found that the alternative dietary pattern was significantly more nutritious.
It’s important to note that enriched-gluten-containing products (breads and other baked products, cereals, pastas and flours) contribute a large percentage of the daily folic acid and iron intake. Unfortunately, many gluten-free products are not enriched with iron, folic acid and other B vitamins.
Yet change can come. Let’s encourage gluten-free manufacturers to get on the healthy bandwagon with enriched foods and whole grains. And remember to check the nutrition facts table. Just like looking for words that warn of gluten’s presence, it’s not hard to do, once you make it a habit.
Tips for Healthy Gluten-Free Eating
Shelley Case, RD, is an international celiac nutrition expert, consulting dietitian and author of Gluten-Free Diet: A Comprehensive Resource Guide. See www.glutenfreediet.ca.