Economic Burden of a Gluten-Free Diet

Department of Biological Sciences, Columbia University, New York, New York, United States
Journal of Human Nutrition and Dietetics (Impact Factor: 1.99). 11/2007; 20(5):423-30. DOI: 10.1111/j.1365-277X.2007.00763.x
Source: PubMed


Coeliac disease is a common, autoimmune disorder, for which the only treatment is lifelong adherence to a gluten-free diet. This study evaluates the economic burden of adhering to a gluten-free diet.
A market basket of products identified by name brand, weight or package size for both regular wheat-based products and gluten-free counterparts was developed. The differences in price between purchase venues, both type of store (general grocery store, an upscale grocery store and a health food store and four internet-based grocery sites) and region was also analysed.
Availability of gluten-free products varied between the different venues, regular grocery stores carried 36%, while upscale markets carried 41%, and health food stores 94%, compared with 100% availability on the internet. Overall, every gluten-free product was more expensive than their wheat-based counterpart (P <or= 0.05). Bread and pasta was twice as expensive as their wheat-based counterparts. Cost was affected more by shopping venue than geographic location.
This study demonstrated that gluten-free foods have poor availability and are more expensive than their gluten-containing counterparts. The impact of these findings on dietary compliance and the quality of life needs to be addressed.

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Available from: Peter H R Green, Jun 05, 2014
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    • "Both conditions require lifelong dietary exclusion of gluten-like proteins in wheat (gliadin and glutenins), barley (hordeins), rye (secalins) and in some 8% of coeliacs, oats (avenins) (Hardy et al., 2014). Gluten-free diets are traditionally low in fibre, high in fat and economically more costly (Lee et al., 2007; Ohlund et al., 2010; Wild et al., 2010). In addition up to 90% of coeliacs remain currently undiagnosed, a phenomena termed the 'coeliac iceberg' (Catassi et al., 1996; Ravikumara et al., 2007). "
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    ABSTRACT: Coeliac disease is a well-defined condition that is estimated to affect approximately 1% of the population worldwide. Noncoeliac gluten sensitivity is a condition that is less well defined, but is estimated to affect up to 10% of the population, and is often self-diagnosed. At present, the only remedy for both conditions is a lifelong gluten-free diet. A gluten-free diet is often expensive, high in fat and low in fibre, which in themselves can lead to adverse health outcomes. Thus, there is an opportunity to use novel plant breeding strategies to develop alternative gluten-free grains. In this work, we describe the breeding and characterization of a novel ultra-low gluten (ULG) barley variety in which the hordein (gluten) content was reduced to below 5 ppm. This was achieved using traditional breeding strategies to combine three recessive alleles, which act independently of each other to lower the hordein content in the parental varieties. The grain of the initial variety was shrunken compared to wild-type barleys. We implemented a breeding strategy to improve the grain size to near wild-type levels and demonstrated that the grains can be malted and brewed successfully. The ULG barley has the potential to provide novel healthy foods and beverages for those who require a gluten-free diet.
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    • "One reason noted for the exclusion of this portion of the diet was due to the increased cost of the gluten-free products in the USA. The increased cost of gluten-free foods was confirmed in our recent study that looked at cost and availability across different regions of the USA (Lee et al., 2007). The alternative grains selected provide the specific nutrients that are lower in the standard gluten-free diet menu pattern (Thompson, 2000). "

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    • "The present study suggests that the limited availability of GF products and the elevated prices of these products can have a negative impact on the adherence to a GF diet. These issues negatively affect the quality of life of individuals with CD and can lead to clinical and nutritional complications (Lee et al., 2007; Singh & Whelan, 2011). Low palatability and social pressure are also factors that have been identified as harmful to the adherence to a GF diet (Lerner, 2010). "
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    ABSTRACT: Abstract The present study investigated the perceptions of individuals with celiac disease about gluten-free (GF) products, their consumer behavior and which product is the most desired. A survey was used to collect information. Descriptive analysis, χ(2) tests and Multiple Logistic Regressions were conducted. Ninety-one questionnaires were analyzed. Limited variety and availability, the high price of products and the social restrictions imposed by the diet were the factors that caused the most dissatisfaction and difficulty. A total of 71% of the participants confirmed having moderate to high difficulty finding GF products. The logistic regression identified a significant relationship between dissatisfaction, texture and variety (p < 0.05) and between variety and difficulty of finding GF products (p < 0.05). The sensory characteristics were the most important variables considered for actual purchases. Bread was the most desired product. The participants were dissatisfaction with GF products. The desire for bread with better sensory characteristics reinforces the challenge to develop higher quality baking products.
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