Limited availability and higher cost of gluten-free foods

J Hum Nutr Diet. 2011 Oct;24(5):479-86. doi: 10.1111/j.1365-277X.2011.01160.x. Epub 2011 May 24.


Background: A gluten-free diet is the only treatment for patients with coeliac disease, although it can be burdensome to follow and result in inadequate nutrient intake. The cost and availability of a gluten-free diet has been cited as a cause of incomplete dietary compliance; however, this has not been extensively investigated. The aim was to investigate the availability and cost of gluten-free foods across a wide range of stores.

Methods: The availability and cost of 20 foods (both wheat-based and everyday foods) was surveyed at 30 different stores across five different store categories. For each of the 20 foods, four products were selected (branded gluten-free, cheapest gluten-free, branded standard, cheapest standard) resulting in sampling of up to 80 products in each of the 30 stores.

Results: In general, there was limited availability of gluten-free foods, with an average of 8.2 of the 20 (41%) foods being available in a gluten-free version per store. Regular supermarkets had a greater availability (18.0/20, 90%), whereas budget supermarkets (1.8/20, 9%) and corner shops (1.8/20, 9%) had almost no gluten-free versions (P < 0.001). All 10 gluten-free versions of wheat-based foods were more costly than their standard counterparts (76-518% more expensive; P < 0.001). Some gluten-free versions of everyday foods were also more costly than standard counterparts (2-124%).

Conclusions: There is limited availability of gluten-free foods and they are generally more expensive than their standard counterparts. This may impact on compliance to a gluten-free diet, with potential nutritional and clinical consequences, together with an increased risk of complications.

MeSH terms

  • Celiac Disease / diet therapy*
  • Celiac Disease / economics
  • Costs and Cost Analysis
  • Diet, Gluten-Free / economics*
  • Food / economics*
  • Food Supply / economics
  • Food Supply / statistics & numerical data
  • Humans
  • North America
  • Patient Compliance / statistics & numerical data
  • Triticum