Gluten-free foods are expensive and nutritionally imbalanced than their gluten-containing counterparts

Wajiha Mehtab; Samagra Agarwal; Harsh Agarwal; Anam Ahmed; Ashish Agarwal; Shubham Prasad; Ashish Chauhan; Anjali Bhola; Namrata Singh; Vineet Ahuja; Anita Malhotra; Govind K Makharia

doi:10.1007/s12664-024-01519-z

Gluten-free foods are expensive and nutritionally imbalanced than their gluten-containing counterparts

Indian J Gastroenterol. 2024 May 16. doi: 10.1007/s12664-024-01519-z. Online ahead of print.

Authors

Affiliations

¹ Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India.
² Department of Home Science, University of Delhi, New Delhi, 110 021, India.
³ Department of Gastroenterology, All India Institute of Medical Sciences, Jodhpur, 342 005, India.
⁴ Department of Gastroenterology, Indira Gandhi Medical College, Shimla, 171 001, India.
⁵ Department of Home Science, Lakshmibai College, University of Delhi, New Delhi, 110 052, India.
⁶ Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India. govindmakharia@gmail.com.

PMID: 38753225
DOI: 10.1007/s12664-024-01519-z

Abstract

Objectives: Nutritional quality of gluten-free (GF) food products is very important, as patients with celiac disease consume these products for lifelong. There is paucity of data on the nutritional content and cost of GF food products compared with their gluten-containing (GC) counterparts from India (Asia).

Design: After a detailed market survey, packaged and labeled GF food products (n=485) and their packaged GC counterparts (n=790) from the supermarkets of Delhi (India) and e-commerce websites were included. Nutritional content and cost/100 g food (in US dollars) were calculated using the information on food label.

Results: Gluten-free food products were 232% (range: 118% to 376%) more expensive than their GC counterparts. Energy content of all GF food products was similar to their GC counterparts, except cereal-based snacks (GF: 445 kcal vs. GC: 510 kcal, p<0.001). The protein content was significantly lower in GF pasta and macaroni products (single-grain: GF: 6.5 g vs. GC:11. 5 g, p-0.002; multigrain: GF:7.6 g vs. GC:11.5 g, p-0.027), cereal flours (single-grain: GF: 7.6 g vs. GC: 12.3 g, p<0.001; multigrain: GF:10.9 g vs. GC: 14.1 g, p-0.009) and nutritional bars (GF: 21.81 g vs. GC:26 g, p-0.028) than their GC counterparts. Similarly, the dietary-fiber content of GF pasta and macaroni products, cereal flours, cereal premix and nutritional bars of GF foods was significantly lower than their GC counterparts. Gluten-free bread and confectionary items, biscuits and cookies and snacks had higher total fats and trans-fat content than their GC counterparts. Gluten-free cereal-based snacks had higher sodium content than their GC counterparts (GF: 820 mg vs. GC:670 mg; p<0.001).

Conclusion: GF foods are significantly more expensive, contain less protein and dietary fiber and higher fat, trans-fat and sodium than their GC counterparts. Strategies must be developed to reduce the cost and improve the nutritional profile of GF foods.

Keywords: Celiac disease; Comparison; Cost; Gluten; Gluten-containing food; Gluten-free diet; Gluten-free foods; Nutritional quality; Nutritive value; Small intestine.