Nutritional Quality of the Gluten Free Diet

Very few studies have been conducted on the nutritional adequacy of the gluten-free diet, and to date, only one of these studies has evaluated the diet in the United States. The U.S. study assessed the intake of fiber, iron, calcium, and grain foods of adults with celiac disease. Notable findings included below-recommended intake of dietary fiber, iron, calcium, and grain foods among the majority of female participants. In fact, recommended amounts of fiber, iron, and calcium were consumed by only 46 percent, 44 percent, and 31 percent of women participants, respectively. The situation was a bit better for men, but 12 percent and 37 percent of male participants did not consume recommended amounts of fiber and calcium, respectively. While all readers should be mindful of the nutritional adequacy of their diet, women in particular should pay close attention to their intakes of these nutrients.

The following sections will show you how to avoid the nutritional pitfalls of the gluten-free diet. Armed with this knowledge and the delicious and nutritious recipes in Chapter 6, you can eat as well as, if not even better than, someone with no dietary restrictions.

B Vitamins, Iron, and Dietary Fiber

Whole-grain and enriched or fortified varieties of grain food such as bread products, pasta, and breakfast cereals contribute a significant amount of B vitamins, iron, and dietary fiber to the diets of Americans. It may be difficult to get the nutrients you need on a gluten-free diet because the majority of specially manufactured gluten-free breads, pastas, and cereals are neither whole grain nor enriched. As a result, they contain very little thiamin, riboflavin, niacin, folate, iron, and dietary fiber, which are all crucial for leading a healthy lifestyle.

Specially manufactured gluten-free breads, pastas, and cereals often are made from starch such as rice starch, cornstarch, and potato starch, or refined flour such as milled rice and milled corn. During the milling process, when a whole grain such as brown rice is refined to make white rice, the bran and germ of the grain are removed. Much of the vitamins, minerals, and dietary fiber found in grains come from these portions.

In the United States, most refined wheat-based breads and pasta are voluntarily enriched with thiamin, riboflavin, niacin, folic acid (the synthetic form of folate), and iron. Enrichment means that the nutrients (with the exception of fiber) lost during the milling process are added back into the food. Also, most regular breakfast cereals are fortified with vitamins and minerals. Unfortunately, most refined, specially manufactured gluten-free breads, pastas, and breakfast cereals are neither enriched nor fortified. It is unclear why most manufacturers of gluten-free foods do not enrich their products. Perhaps the reason is simply that they are not required to. Because enrichment of refined wheat-based grain foods is voluntary in the United States, gluten-free substitutes for these products do not have to be enriched.

Historical Nuggets

  • As recently as 2000, no manufacturers of specially formulated gluten-free foods available in the United States were enriching or fortifying pasta products or ready-to-eat breakfast cereal. But at present, Maple Grove Food and Beverage (Pastariso and Pastato brands) enriches a variety of pasta products, and Enjoy Life Natural Foods (Enjoy Life and Perky's brands) fortifies a variety of ready-to-eat breakfast cereals.
  • In a survey of celiac disease support groups in the United States in 2000, there was no consensus on whether the grains millet and sorghum and the pseudocereals amaranth, buckwheat, and quinoa are gluten free (they are). Now these whole grains are used by several manufacturers of gluten-free foods, and you can find them in a wide variety of products.

Enriched Versus Fortified Foods. You will sometimes see the terms enriched and fortified used interchangeably when referring to food products, but they are not quite the same. In general, when the word enriched appears on a food label, it means that vitamins and minerals have been added back to a refined grain food that originally contained them until they were removed during the milling process. Under regulations of the Food and Drug Administration, only certain foods in the United States may be voluntarily enriched with specific vitamins and minerals. This is done in part to prevent overconsumption of a specific nutrient. Foods that may be enriched include bread, rolls, buns, flour, macaroni, noodle products, rice, cornmeal, and farina. To be labeled enriched, these products must contain certain amounts of thiamin, riboflavin, niacin, folic acid, and iron.

In addition, foods may be fortified with a wide variety of vitamins and minerals that may or may not have been found in the original food product. The amounts of specific nutrients that may be added to fortified food products may or may not be regulated, depending on the specific food and nutrient. Examples of foods that may be fortified include breakfast cereal, soy milk, orange juice, and energy bars.

Whole Grains Versus Refined Grains. To give you an idea of the nutritional differences between a whole grain and a refined grain, consider the following comparison between white- and brown-rice flour:

Nutrient Comparison: White-Rice Flour and Brown-Rice Flour

White-Rice

Brown-Rice

Percentage

Flour

Flour

Difference

Amount

1 cup (158 grams)

1 cup (158 grams)

Calories

578

574

Iron (mg)

0.55

3.13

469%

Riboflavin (mg)

0.03

0.13

333%

Thiamin (mg)

0.22

0.70

218%

Niacin (mg)

4.09

10.02

145%

Dietary fiber (g)

3.8

7.3

92%

Folate (DFE*)

6.0

25.0

32%

Calcium (mg)

16.0

17.0

6%

*DFE stands for dietary folate equivalent, discussed later in this chapter.

Enriched Grains Versus Unenriched Grains. To get an idea of the nutritional differences between an unenriched and an enriched refined grain, consider the following comparison between unenriched and enriched cornmeal:

Nutrient Comparison: Unenriched Degermed Cornmeal and

Enriched Degermed Cornmeal

Cornmeal,

Cornmeal,

Percentage

Unenriched

Enriched

Difference

Amount

1 cup (138 grams)

1 cup (138 grams)

Calories

587

587

Iron (mg)

1.75

6.87

393%

Riboflavin (mg)

0.08

0.66

825%

Thiamin (mg)

0.22

0.98

445%

Niacin (mg)

1.59

8.44

531%

Dietary fiber (g)

6.4

6.4

Folate (DFE*)

48.0

549.0

1,144%

Calcium (mg)

5.0

5.0

*DFE stands for dietary folate equivalent, discussed later in this chapter.

As the preceding examples illustrate, whole-grain and enriched foods are more nutrient dense than refined and unenriched foods. This means they provide higher levels of nutrients for the same calorie content. The recipes in this book will give you some great ideas for cooking with a variety of gluten-free whole grains.

Gaining Weight 101

Gaining Weight 101

Find out why long exhausting workouts may do more harm than good. Most of the body-building workout and diet regimens out there are designed for the guys that gain muscle and fat easily. They focus on eating less and working out more in order to cut the excess fat from their bodies while adding needed muscle tone.

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