What you need to know
Nutrient deficiencies linked with the gluten-free diet
Nutrient deficiency in the gluten-free diet is quite common. Take a moment to read below and learn about the reasons behind nutritional deficiency in celiac disease, common macronutrients and micronutrient deficiencies to look out for, and what you can do to maximize the gluten-free diet.
Damage to the small intestinal mucosa is common in undiagnosed and recovering celiac patients, resulting in malabsorption of macro- and micronutrients. Nutritional deficiency is also often the result of strictly consuming a gluten-free diet as it is fundamentally nutritionally inadequate. Removing gluten-containing grains from the diet is associated with decreased intake of fibre, specific minerals, and vitamins.
What causes nutrient deficiencies?
What can I do to improve nutrition in gluten-free diet?
Diversify your grains.
Adding naturally gluten-free grains such as quinoa, gluten-free oats, or amaranth adds magnesium, iron, and fiber to the diet. Ask your dietitian if it is safe for you to consume gluten-free oats!
Be mindful of processed foods.
Eating gluten-free can include processed foods that are safe to eat. Be mindful not to make processed foods a staple in your diet. These products often contain a high amount of fat and sugar and have minimal nutritional value.
Focus on naturally gluten-free foods.
Fruit, vegetables, plant and animal sources of protein, and dairy provide a solid foundation to the gluten-free diet. Including these foods in your diet will help you to eat a variety of nutrients every day.
Ask for help.
Seek guidance from a Registered Dietitian when you need support. They are a great resource to help you understand how to get the most out of the gluten-free diet and find options that work for you.
Speak to your doctor about checking your bloodwork to monitor your micronutrient levels. If you experience malabsorption due to intestinal damage or cannot meet the recommended levels of micronutrients through the gluten-free diet, supplementation is a great way to meet your nutritional needs. Make sure all supplements are labelled gluten-free and are approved by your doctor before consumption.
Vitamin D Rich Foods – Fatty fish (salmon, tuna, mackerel), Vitamin D fortified cow’s milk and milk substitutes (soy, nut, pea)
B12 Rich Foods - Animal products (fish, meat, poultry, dairy, and eggs), fortified GF cereals
Folate Rich Foods – Liver, legumes, fortified GF cereals, peanuts, spinach, asparagus, broccoli, peas
Iron Rich Foods - Lean meats, nuts, seafood, beans, seeds, fortified GF cereals, dried fruit, and leafy vegetables
Calcium Rich Foods – Dairy (milk, yogurt, and cheese), kale, fortified milk substitutes (soy, nut, pea), broccoli
Zinc Rich Foods – Oysters, poultry, red meat, nuts, beans, GF fortified cereals, dairy products
Vitamin B6 Rich Foods – Chickpeas, salmon, liver, tuna, chicken, GF fortified cereals
Dennis, M., Lee, A., & McCarthy, T. (2019). Nutritional Considerations of the Gluten-Free Diet. Gastroenterol Clin N Am, 48(1): 53-72.
Melini, V., & Melini, F. (2019). Gluten-Free Diet: Gaps and Needs for a Healthier Diet. Nutrients. 11(1): 170.
Vici, G. et al. (2016). Gluten-free diet and nutrient deficiencies: A review. Clin Nutr, 35(6): 1236-1241.
Theethira, T., & Dennis, M. (2015). Celiac Disease and the Gluten-Free Diet: Consequences and Recommendations for Improvement. Dig Dis, 33: 175-82.
Jamieson, J., Weir, M., & Gougeon, L. (2018). Canadian packaged gluten-free foods are less nutritious than their regular gluten-containing counterparts. PeerJ. 6;6: e5875.
Shepherd, S.J., & Gibson, P.R. (2013). Nutritional inadequacies of the gluten-free diet in both recently diagnosed and long-term patients with coeliac disease. J Hum Nutr Diet. 26: 349-358.
Common Macro & Micronutrients Deficiencies