A gluten free diet is crucial for people with Coeliac Disease (CD) and those with a gluten intolerance/sensitivity to achieve and maintain their health and wellbeing. However, it isn’t without its problems. A gluten free diet (GFD) can do as much harm as it can do well if you go about it the wrong way. Some of the pitfalls with a gluten free diet are discussed below.
Unwanted weight gain
It isn’t unusual to gain weight once you start on a GFD. With CD, this may simply be due to better absorption of nutrients from the gut. This weight gain is often welcomed by those who have lost weight or have always been underweight, prior to their diagnosis, but is not often welcomed by those who had a healthy weight or were already overweight.
A GFD can readily contribute to weight gain. Generally, processed gluten free (GF) foods have more kilojoules, fat, and sugar than their gluten counterparts, often to enhance their flavor and texture. They also frequently contain refined carbohydrates such as white rice flour, cornflour, etc which are quickly digested and absorbed by the body leaving you feeling less satisfied, resulting in you wanting to eat more, and/or more frequently to compensate.
Solution: Limit the amount of processed gluten free foods, in your diet, that are predominantly high in refined carbohydrates. Instead choose a GF muesli with wholegrains, brown or wild rice or substitute with quinoa or millet and pasta made from brown rice, buckwheat, millet, quinoa and/or amaranth. When baking use wholegrain based flours.
Constipation is a common side effect of going on a GFD. This is often due to a reduction in fibre, as foods substituted are generally lower in fibre than their gluten containing counterparts.
Solution: Eat at least 2 servings of fruit, 1 ½ - 2 cups of vegetables at lunch AND dinner, a small handful of nuts and seeds, and 3 servings of gluten free wholegrains everyday. Try to also include legumes regularly into your meals.
Research has shown that a GFD can often be lacking in calcium, B vitamins, iron, zinc, and magnesium. Low calcium intakes are not the direct result of being on a GFD, but rather due to individuals limiting their intake of calcium-rich foods because of lactose intolerance, a dislike for these foods or simply not including enough of these foods in their diets. In regard to the other nutrients, not eating enough gluten free wholegrains is one of the main reasons for these inadequacies.
Solution: Increase your intake of dietary calcium, from dairy sources if you can tolerate it and like it, or non-dairy sources such as ….. If you are still struggling to get enough, then talk to your Dietitian and or Doctor about a calcium supplement.
Eat at least 3 serves per day of GF grains (see Coeliac Magazine x for more information on this).
Lack of Satiety and low energy levels
Going gluten free can cause constant hunger pains and drops in blood glucose levels. Gluten free products often contain highly processed ingredients, which causes them to be less filling, and for them to be absorbed into your blood more quickly. This results in short bursts rather than sustained levels of energy.
Solution: Choose wholegrain GF foods (not puffed) at each meal and snack Add in some protein such as meat, fish, chicken, eggs, nuts, legumes and dairy products to sustain energy levels for even longer.
Healthy gut flora (bacteria in your digestive tract)
Studies have shown that a GFD can decrease the ratio of healthy to unhealthy bacteria (gut flora) in our gut. These healthy bacteria, influence health in many ways, from helping to extract energy from food to building the body's immune system, to protecting against infection with harmful, disease-causing bacteria and are involved in the absorption and production of some vitamins.
Solution: To help maintain or improve your gut flora eat foods that feed (prebiotics) the bacteria such as: onion, leeks, garlic, asparagus, artichokes, linseed, legumes, and those that increase the number of “good” bacteria (probiotics) such as: probiotic yoghurt, sauerkraut, kimchi, kombucha, miso, tempeh.
If you are concerned about the quality and quantity of your GFD see a Dietitian who has a special interest in Coeliac Disease.
Julie Leeper is a NZ Registered Dietitian working in Christchurch and a member of the CNZ Medical Advisory Panel.