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28-09-2011 | Gastroenterology | Article

High cost, low availability of gluten-free foods problematic for celiac patients


Free abstract

MedWire News: The high cost and low availability of gluten-free foods makes following a strict gluten-free diet difficult for celiac disease patients, say researchers.

"Making gluten-free foods more accessible and affordable may improve compliance, and therefore potentially decrease the risk of negative clinical sequelae associated with coeliac disease," write Kevin Whelan and J Singh from Kings College London, UK.

Problems with accessibility and cost have been cited by patients as reasons for incomplete compliance with a gluten-free diet. Whelan and Singh therefore investigated the truth of these claims by evaluating the price and availability of 20 gluten-free products in 30 different stores in five different categories (quality supermarkets, regular supermarkets, budget supermarkets, health food shops, and convenience stores).

The products investigated included 10 normally wheat-based foods, namely, bread (loaf and rolls), flaked breakfast cereal, pasta, plain flour, cream crackers, sweet biscuits, fruit pies, pizza base, and whole cake; and 10 everyday foods that commonly contain gluten. The latter included stock cubes, gravy granules, barbecue-, brown-, or soy sauce, frozen beef burgers or sausages, and frozen meals including chicken in sauce, fish fingers, and shepherd's pie.

On average, the authors found that 8.2 (41%) of the 20 gluten-free products were available in each store.

When stratified by store type, the results showed that regular supermarkets stocked the highest number of gluten-free products, selling 18.0 out of 20.0 (90%) on average.

Health food shops and quality supermarkets stocked an intermediate amount at an average of 9.8 (49%) and 9.7 (48%) products, respectively. Budget supermarkets and convenience stores had the worst availability, stocking an average of 1.8 (9%) and 1.8 (9%) products, respectively.

All 10 gluten-free versions of normally wheat-based foods were significantly more expensive than their gluten-containing counterparts in all stores, with costs ranging from 1.76 to 5.18-fold more than the standard products.

Some, but not all, gluten-free versions of everyday foods were significantly more expensive than their gluten-containing counterparts, such as soy sauce, brown sauce, and frozen sausages. The price of these products ranged from being 2% to 24% more expensive than standard products.

"The present study has demonstrated the limited availability and higher cost of gluten free foods across many stores, both of which may have a negative impact on compliance with a gluten-free diet," write the authors in the Journal of Human Nutrition and Dietetics.

"These findings support the need for further research on the impact of availability and cost on dietary compliance, quality of life and the subsequent risk of complications," they conclude.

By Helen Albert

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