Evidence of high sugar intake, and low fibre and mineral intake, in the gluten-free diet


Dr G. G. Robins, York Hospitals Foundation Trust, Wigginton Road, York, North Yorkshire, YO31 8HE, UK.
E-mail: gerryrobins@hotmail.com


Aliment Pharmacol Ther 2010; 32: 573–581


Background  The only therapy for coeliac disease (CD) is a long-term gluten-free diet (GFD). Little is known about the detailed composition of such a diet.

Aim  To clarify the nutritional composition of a GFD and to compare it with a non-GFD diet in representative non-CD populations.

Methods  A total of 139 consecutive patients with CD were invited to fill in a prospective validated 5-day food diary, of whom data from 93 were analysed. Results were compared with data from the National Diet and Nutrition Survey of Adults and the UK Women’s Cohort Study (UKWCS).

Results  Individuals consuming a strict GFD generally had similar intakes of energy and nutrients to those of comparison populations, but a higher proportion of carbohydrate intake was obtained from nonmilk extrinsic sugars and intakes of nonstarch polysaccharides were low. Compared with the UKWCS sample, female patients adhering to a GFD had lower intakes of magnesium, iron, zinc, manganese, selenium and folate. In male patients, intakes of magnesium and selenium were particularly low.

Conclusions  This study reinforces the need for clinicians to recognize that avoidance of gluten cannot be the sole focus of a gluten-free diet. Maintenance of adequate intakes of essential nutrients and in particular complex carbohydrates must also be the goal for patients.