The effect of substituting alternative grains in the diet on the nutritional profile of the gluten-free diet

J Hum Nutr Diet. 2009 Aug;22(4):359-63. doi: 10.1111/j.1365-277X.2009.00970.x. Epub 2009 Jun 10.


Background: The only treatment for coeliac disease is lifelong adherence to a gluten-free diet. Several studies have reported nutritional deficiencies in individuals on a gluten-free diet. The present study aimed to determine whether the nutritional profile of gluten-free diet could be improved through the use of alternative grains.

Methods: A retrospective review of diet history records by a celiac specialist dietitian were used to establish a 'standard' gluten-free dietary pattern. An 'alternative' gluten-free dietary pattern was developed that substituted naturally gluten-free grains or gluten-free products made from 'alternative' flours (oats, high fibre gluten-free bread and quinoa) in the standard pattern. A paired t-test was performed to identify statistical significance between the 'alternative' and standard gluten-free dietary pattern.

Results: Analysis of standard pattern indicated that 38% of meals and snacks contained no grain or starch choice. Of those meals that contained a grain or starch component, rice was the grain chosen 44% of the time. The inclusion of alternative grains or grain products provided a higher nutrient profile compared to the standard gluten-free dietary pattern (P = 0.002). Several nutrients; protein (20.6 g versus 11 g), iron (18.4 mg versus 1.4 mg), calcium (182 mg versus 0 mg) and fibre (12.7 g versus 5 g) were significantly increased by changing the grain or starch component in the dietary pattern. The B vitamin content (riboflavin, niacin and folate) was improved, although this was not statistically significant (P = 0.125).

Discussion: The inclusion of alternative grain-based products increased the nutrient profile of the gluten-free dietary pattern significantly.

MeSH terms

  • Diet Records
  • Diet, Gluten-Free* / standards
  • Dietary Carbohydrates / administration & dosage*
  • Edible Grain*
  • Humans
  • Nutritive Value
  • Retrospective Studies
  • Starch / administration & dosage*


  • Dietary Carbohydrates
  • Starch