Thinking about going wheat-free? Evidence of nutritional inadequacies in the dietary practices of wheat avoiders

To assess dietary intake and nutritional adequacy amongst self-identified symptomatic wheat-avoiders.

Thirty-four self-identified symptomatic avoiders of wheat-based products without a diagnosis of coeliac disease or wheat allergy were recruited to participate in a dietary assessment study. Dietary intake was assessed via a three-day weighed food record. Participants were aged 33 to 83 years, were predominantly women (n = 30) and had been avoiding wheat for a mean of six years. Nutrient intakes were compared with Nutrient Reference Values. Food group intakes were assessed and consumption of wheat-containing and wheat-free cereal-based foods described.

Inadequate intakes of key protective nutrients such as fibre and calcium were common; many participants reported avoiding dairy as well as wheat. Intakes of total and saturated fat exceeded recommendations. Although 85% of the sample reported avoiding all wheat products, at least one third of cereal products and dishes consumed in this group, comprising mostly discretionary-type foods, were wheat based.

Dietary intake patterns and resulting nutrient imbalances in individuals restricting or eliminating wheat to manage symptoms are cause for concern. The situation is likely exacerbated by the tendency for many wheat avoiders to report also avoiding other foods, especially dairy products. A bi-disciplinary approach from medical practitioners and dietitians to individuals experiencing unexplained gastro-intestinal symptoms and strategies to support informed food choice is needed to combat longer-term health consequences of a diet with this nutritional profile.