The Availability and Nutritional Adequacy of Gluten-Free Bread and Pasta

Abstract

Management of coeliac disease (CD) requires the removal of gluten from the diet. Evidence of the availability, cost, and nutritional adequacy of gluten-free (GF) bread and pasta products is limited. GF flours are exempt from UK legislation that requires micronutrient fortification of white wheat flour. This study surveyed the number and cost of bread and pasta products available and evaluated the back-of-pack nutritional information, the ingredient content, and the presence of fortification nutrients of GF bread and pasta, compared to standard gluten-containing equivalent products. Product information was collected from four supermarket websites. Standard products were significantly cheaper, with more products available than GF (p < 0.05). GF bread products were significantly higher in fat and fiber (p < 0.05). All GF products were lower in protein than standard products (p < 0.01). Only 5% of GF breads were fortified with all four mandatory fortification nutrients (calcium, iron, niacin, and thiamin), 28% of GF breads were fortified with calcium and iron only. This lack of fortification may increase the risk of micronutrient deficiency in coeliac sufferers. It is recommended that fortification legislation is extended to include all GF products, in addition to increased regulation of the nutritional content of GF foods.

Keywords: celiac disease; coeliac disease; cost; fortification; gluten; gluten-free diet; micronutrient.

Figure 1

The average number of standard and gluten-free products available in four major UK supermarket websites. Key: * = p < 0.05, ** = p < 0.01, *** = p < 0.001.

Figure 2

The average cost (£/100 g) of standard and gluten-free products available in four major UK supermarket websites. Key: * = p < 0.05, ** = p < 0.01, *** = p < 0.001.

Figure 3

Key ingredients used in gluten-free (A) bread products and (B) pasta products. Ingredients frequently used in multiple products are indicated by larger font sizes. For a full list of ingredients, please refer to supplementary material.

Figure 4

The average nutritional values of standard and gluten-free products for (A) total energy; (B) fat; (C) saturated fat; (D) carbohydrate; (E) sugars; (F) fiber; (G) protein; (H) salt. Key: * = p < 0.05, ** = p < 0.01, *** = p < 0.001.