Gluten free diet and nutrient deficiencies: A review
Abstract
Background & aims The only available treatment for celiac disease (CD) is lifelong adherence to gluten free (GF)-diet. However, GF-diet may lead to possible nutrient unbalance resulting in improper nutritional quality of diet. The aim of this study is to evaluate the nutritional quality of GF-diet. Methods MEDLINE ® /PubMed and Cochrane Library were electronically searched for articles published between 1990/01/01 and 2015/09/01. Results GF-diet was found to be poor in alimentary fiber due in particular to the necessary avoidance of several kinds of foods naturally rich in fiber (i.e. grain) and the low content of fiber of GF product that are usually made with starches and/or refined flours. Micronutrients are also found to be poor, in particular Vit. D, Vit. B12 and folate, in addition to some minerals such as iron, zinc, magnesium and calcium. Moreover, an inadequate macronutrient intake was reported related above all to the focus on the avoidance of gluten that often leaving back the importance of nutritional quality of the choice. In particular, it was found a higher content of both saturated and hydrogenated fatty acids and an increase in the glycemic index and glycemic load of the meal. Conclusions Despite the GF-diet is necessary in celiac disease treatment and the attention is on gluten avoidance, the evaluation of nutritional quality of the diet must be considered. Moreover, educational strategies based on the relationship between nutrients and food and human health…
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Compared to gluten-containing products, gluten-free alternatives are often based on starch and/or refined flours, have a higher content of saturated fats and sugars and less fibre, resulting in meals with higher glycaemic index.
“Compared to gluten-containing products, gluten-free alternatives are often based on starch and/or refined flours, have a higher content of saturated fats and sugars and less fibre, resulting in meals with higher glycaemic index (87,102-104).”
There is conflicting evidence on iron and calcium intakes on a gluten-free diet.
“There is conflicting evidence on iron and calcium intakes on a GFD (87,89,94).”
Children and adolescents on a gluten-free diet are at higher risk of insufficient intake of fibre, folate, magnesium, selenium and vitamin D, and have higher intakes of saturated and hydrogenated fats as well as sugars compared to children on a gluten-containing diet.
“Children and adolescents on a GFD are at higher risk of insufficient intake of fibre (86,87), folate, magnesium, selenium and vitamin D (88,89), and have higher intakes of saturated and hydrogenated fats as well as sugars compared to children on a gluten-containing diet (86,87,90).”
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Culetu, A., Susman, I. E., Duta, D. E., & Belc, N. (2021) · Applied Sciences · doi:10.3390/app11146283 · Cited by 146 · see citing works
Serum Vitamins and Minerals at Diagnosis and Follow‐up in Children With Celiac Disease
Deora, V., Aylward, N., Sokoro, A., & El‐Matary, W. (2017) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001475 · Cited by 78 · see citing works
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- Authors
- Vici, G., Belli, L., Biondi, M., & Polzonetti, V.
- Affiliations
- Università di Camerino (IT)
- Corresponding author
- Polzonetti, Valeria
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 35
- Issue
- 6
- Pages
- 1236-1241
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2345937023
- Cited by
- 522
- References
- 0
- Citations by year
- 2026: 42 · 2025: 61 · 2024: 60 · 2023: 57 · 2022: 59 · 2021: 52 · 2020: 69 · 2019: 55 · 2018: 31 · 2017: 31 · 2016: 5
- FWCI
- 6.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Unicam Scientific Publications (University of Camerino) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- gluten-free diet, celiac disease, nutritional deficiency, dietary fiber, micronutrients, vitamin D, vitamin B12, folic acid, iron, zinc, magnesium, calcium, macronutrient intake, saturated fatty acids, glycemic index, glycemic load, nutritional value, nutrition education
- MeSH terms
- Diet, Healthy, Celiac Disease, Diet, Dietary Fiber, Humans, Nutrition Disorders, Nutritive Value, Vitamins, MEDLINE, Micronutrients, Diet, Gluten-Free
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