10 Tips for a Healthy Gluten-Free Diet

By Amy Burkhart MD, RD

The gluten-free diet has become the national punch line in cartoons and late-night comedy. As a result, people who have celiac disease or non-celiac gluten sensitivity encounter skepticism about their need to follow a gluten-free diet. The following are 10 tips to help those who require a strict gluten-free diet stay healthy.

Many of the articles and TV segments mention celiac disease and gluten sensitivity, but unfortunately, that information often gets lost in the drama (and comedy). A fad or a hoax is far better press than a medical condition. The public is confused, as are the journalists who write the stories.

An article in the Wall Street Journal discussed whether or not the gluten-free diet has real health benefits. I had the pleasure of being interviewed in the video segment. In my initial discussion with the journalist, I was surprised to find that she thought the gluten-free diet’s popularity was due solely to celebrity influence and media hype. In fact, research by the Mayo Clinic reveals that the incidence of celiac disease has quadrupled since the 1950s. The Wall Street Journal author was not aware of the rise in medical need for a gluten-free diet, and she is not alone.

There is no denying a fad component to the phenomenon, and that will pass. The diet is difficult to adhere to if you do not have the negative reinforcement of illness with gluten ingestion. It is also expensive and socially inconvenient. When the fad component fades, we will still be left with an increasing population of celiac disease and non-celiac gluten sensitivity who need a gluten-free diet to stay healthy. But is it nutritionally sound and balanced? If not, what can we do to ensure that it is?

Prior studies have found as many as 38% of patients with celiac disease have some nutrient deficiency with components such as protein, fiber or vitamins, and minerals. A recent study published in the journal Plant Foods for Human Nutrition compared what would happen if you substituted gluten-free products for their gluten-containing counterparts. The study team compared over 200 foods and their gluten-free equivalents. The results reinforced previous studies’ findings, indicating that a gluten-free diet is not necessarily more nutritionally sound than a gluten-containing diet.

In fact, the study suggested that a gluten-free diet may negatively impact cardiovascular health and other key aspects of health. Undesired health outcomes may occur if there is a heavy reliance on packaged gluten-free products.  These products are often lower in protein and fiber and higher in fat (especially saturated fat), cholesterol, sugar, and calories. Gluten-free products are generally lower in B vitamins and iron, although this study did not evaluate these nutrients.

For people who must follow a gluten-free diet for medical reasons, there are many ways to improve the diet’s nutritional profile. Consuming a predominantly plant-based diet of whole foods, including lean meats and fish, is a great start. The following are a few suggestions to make your transition to a healthier gluten-free diet easier.

1. Eat real food. Avoid processed gluten-free foods as much as possible. When you do eat packaged food, choose the items with the least number of ingredients.
2. Increase fiber. Consume more beans, vegetables, fruit, and grains such as quinoa, amaranth, millet, and chia.
3. Increase protein. Eat plenty of nuts, seeds, beans, dairy, and lean meats and fish.
4. Improve your vitamin and mineral intake. One way is to drink your greens in juice or a smoothie. This will also help your fiber intake immensely. Find a favorite recipe and drink it daily.
5. Decrease your sugar intake. Switch from soda, juice, and sugary coffee drinks to sparkling water with a splash of juice. If you drink coffee, try stevia as a sweetener.
6. Plan ahead. Forgetting always to have “back-up” foods is more likely to result in a nutritionally poor meal.
7. Lower your fat intake. Bake and broil your foods whenever possible, rather than frying.
8. Reassure yourself that you are not “deprived.”The availability of gluten-free options is increasing daily, and feeling deprived leads to overeating and poor food choices. Planning helps with this. Having a substitute at hand minimizes feelings of deprivation. Focus on the positive. You feel better if you don’t eat gluten!
9. Decrease your cholesterol intake by using the “plate” method.  Assign one half of your plate to vegetables, ¼ to carbohydrate, and ¼ to protein, preferably plant-based. Plant foods do not contain cholesterol and contain fiber, which is proven to help manage cholesterol levels.
10. Enjoy your food. Enjoy it with others often. The pleasure of eating and socializing is a vital part of a healthy eating plan.

For those days when cooking from scratch is next to impossible, you don’t have to settle for potato chips for dinner. Food manufacturers are beginning to address the consumer demand for healthier versions of gluten-free foods, and more products are on the way. Manufacturers are starting to use alternative grains with more nutritional value than the typical blend of rice, potato, and tapioca flours. The higher protein content is being achieved through the use of bean and nut flours. The future looks bright for more of these types of products as the demand for them increases, and they can be incorporated into a healthy gluten-free diet focused on fresh, whole foods.