The Gluten-Free diet: who is it for and how to improve it?

By Yara Gholmie
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The Diet, Health & Fitness section at the bookstore seems to constantly expand its collection of new gluten-free diet and cook books. At grocery stores gluten-free product abound. The gluten-free market is one of the most flourishing markets in the field of food and beverages and it is expected to further expand in the near future[1]. But is a gluten-free diet for everyone? Gluten-free is only a recognized diet for the treatment of celiac patients. Celiac disease is an immune mediated disorder that triggers symptoms in individuals that are genetically susceptible to eating gluten, a protein found in wheat, rye and barley. Foods that contain gluten may stimulate symptoms in certain people that do not have Celiac Disease. However, non-celiac gluten sensitivity is typically self-diagnosed and confused with irritable bowel syndrome or lactose intolerance symptoms[2]. The gluten-free diet has recently become a “healthy lifestyle” trend, whereby individuals who do not have celiac disease nor gluten sensitivity opt to follow a gluten free diet. But there is no evidence yet to support the benefits of a gluten-free diet as opposed to a regular diet in these cases.

In Europe and the United States, around 1% of the population is diagnosed with Celiac Disease [3]. And despite the fact that proper management of celiac disease is to follow a gluten-free diet, this diet is restrictive. Patients with the disease do not receive proper guidance to follow a gluten-free diet appropriately. A recent study compared eating patterns of 10 to 23-year olds with celiac disease to a group of the same age range without celiac. The study reported that individuals following a strict gluten-free diet have a higher consumption of added sugar and total fat as opposed to a regular diet [4]. While trying to avoid high-priced gluten containing products, these individuals consume more eggs and meats that are richer in fat as well as sweetened beverages containing added sugars. In fact, processed gluten-free products are higher in fat and added sugar and lower in fiber and protein than the regular products [4,5]. The same study also showed that the majority of participants following the gluten-free diet did not meet the general recommendations for folic acid, calcium, iron and magnesium.

That being said, a well-studied and well-balanced gluten-free diet can be as nutritious as a healthy regular diet if followed properly. If you or your child needs to follow a gluten-free diet, here are few tips to consider:

-       Follow up with a registered dietitian nutritionist who specializes in Celiac disease. You will be receiving proper guidance in choosing foods to meet your nutritional recommendations today and in the long run.

-       Instead of paying more on costly processed gluten free products, save money and opt for your natural gluten-free foods that are lower in fat and added sugar. So instead of 1 cup of gluten-free pasta just have 1 cup of brown rice. A cup of brown rice is higher in fiber and will help you meet 22% of your daily values of magnesium. You can also replace the gluten-free pasta with as much spaghetti squash as you want when they are in season!

 

Follow these 4 steps to cooking spaghetti Squash in the oven: 

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1.     Heat oven to 400F.

2.     Slice squash in half from end-to-end and spoon out the seeds.

3.     Place the squash halves with the cut edge facing down on a baking sheet and roast them in the oven until soft, for about 45-50 minutes.

4.     Use a fork to graze the “spaghetti” out.

 

-       Did you know that meat is not the only source of folate and iron? 1 cup of spinach is low in fat and can meet 66% of your folate daily values, 34% of your iron daily values and 40 % of your magnesium daily values. You can add it to your morning baked eggs, as part of a dip, a salad and simply a side dish!

-       Have you considered a yogurt parfait for breakfast? 8 ounces of low fat yogurt can meet 42 % of your calcium daily values. Top it up with some fresh or frozen berries and drizzle some maple syrup or honey and you get a yummy breakfast.

 

References

1.         Miranda, J., et al., Nutritional differences between a gluten-free diet and a diet containing equivalent products with gluten. Plant Foods Hum Nutr, 2014. 69(2): p. 182-7.

2.         Reilly, N.R., The Gluten-Free Diet: Recognizing Fact, Fiction, and Fad. The Journal of Pediatrics. 175: p. 206-210.

3.         Catassi, C., S. Gatti, and A. Fasano, The new epidemiology of celiac disease. J Pediatr Gastroenterol Nutr, 2014. 59 Suppl 1: p. S7-9.

4.         Babio, N., et al., Patients With Celiac Disease Reported Higher Consumption of Added Sugar and Total Fat Than Healthy Individuals. J Pediatr Gastroenterol Nutr, 2017. 64(1): p. 63-69.

5.         Kulai, T. and M. Rashid, Assessment of Nutritional Adequacy of Packaged Gluten-free Food Products. Can J Diet Pract Res, 2014. 75(4): p. 186-90.