Nutritional implications of dietary gluten avoidance among Canadians: results from the 2015 Canadian Community Health Survey

Abstract

Adherence to a gluten-free diet (GFD) is the only available treatment for gluten-related disorders, although a GFD may also be followed for discretionary reasons. The main objectives of this study were to 1) describe and test for differences in key nutrient intakes among Canadians who follow a GFD compared to Canadians with no dietary exclusions; and 2) describe additional dietary avoidances, such as meat, poultry, fish, shellfish, eggs or dairy, adhered to by Canadians who avoid gluten. We conducted a secondary analysis of the cross-sectional 2015 Canadian Community Health Survey-Nutrition Survey, which included a general health survey and 24-hour dietary recall (n=20,487). Participants were categorized as those who avoid dietary gluten and those who reported no avoidances. Key nutrient intakes assessed, as a percent of Dietary Recommended Intakes, included fibre, B vitamins, vitamin D, calcium, iron, sodium, and zinc, and compared between the two groups using t-tests. Canadians who avoided gluten had significantly lower intakes of folate, vitamin B12, vitamin D, iron, sodium and calcium compared with those who did not avoid any food groups. However, Canadians who reported following a GFD were significantly more likely to use vitamin or mineral supplements in the past 30 days. More than 20% of those who avoided gluten also avoided dairy products. Findings suggest that following a GFD places Canadians at risk for nutrient inadequacies, particularly folate, calcium, and vitamin D. Further research is required to further examine how multiple dietary avoidances among those who avoid gluten may contribute to dietary inadequacies.

A Pilot Study to Evaluate the Dietary Intake of Adults Attending a Food Allergy Clinic, and Compare the Results Against the Final Diagnostic Outcome

“…A recent large survey in Australia reported that 24% of participants were avoiding wheat (gluten), half of whom were doing so as they perceived it to be better for their general health ( 12 ). Similarly, a Canadian survey found that 1.9% of Canadians follow a gluten-free diet, and those who did so had lower intakes of iron, calcium, folate, B12 and Vitamin D than those who were eating wheat ( 28 ). In our cohort, wheat was significantly more likely to be avoided by those with no FA, which is consistent with findings from other studies of individuals with conditions such as irritable bowel syndrome ( 29 ).…”

Zn Bioaccessibility in the Large Intestine of Foodstuffs after in Vitro Digestion and Fermentation with Fecal Material of Children with Gluten Related Disorders, Obesity, and Allergy/Intolerance to Cow’s Milk Proteins

“…In contrast, it has been reported that strict gluten-free diets in coeliac, after one year of maintenance, counteract Zn deficiencies and do not require longterm supplementation [30]. In the Canadian population it was found that subjects who avoided gluten in their diet did not have deficient Zn intakes compared to those who did not avoid any food group, which could be related to the fact that the former were more likely to consume mineral and vitamin supplements in the last 30 days prior to the study [32].Therefore, it would be advisable to recommend that GRD-CH treated with gluten-free diets consume foods with higher Zn content and Zn-BA, which, based on the present study, could be nuts, dairy products, vegetables, lamb, legumes and beef (Table 1), as well as non-gluten cereals. Furthermore, in gluten-free diets, rice is usually the most consumed grain, for which a low Zn intake has been indicated [33].…”

The Dietary Characteristics of An Agriculture-based Economy and Its Impact on Community Health

“…Most people are here nowadays engaging in Vegan, nutrient selection, gluten avoidance, and many other health-conscious eating decisions. Some are as a result of prescription by medical practitioners or as a sickness avoidance strategy (Mudryj et al 2021). In many developed and highly researched nations there is more preference for natural sugar instead of industrially produced sugar.…”