Grain Products Are a Top Source of Energy and Nutrients among Nova Scotian Adults Following a Gluten-Free Diet

Publication: Canadian Journal of Dietetic Practice and Research
9 September 2020

Abstract

To determine the food sources of energy and 13 core nutrients, 89 diet recalls were analyzed from an explanatory mixed-methods pilot study with adults following a gluten-free diet (GFD) for any reason. Nonconsecutive dietary recalls were collected through a web-based, Automated Self-Administered 24-Hour (ASA24®—Canada-2016) Tool. Mean nutrient intakes were compared with Dietary Reference Intakes. Food items (excluding supplements) were extracted and categorized according to the Bureau of Nutritional Sciences Food Group Codes. Percentages of total dietary intakes from food sources were ranked. Grain products were the highest ranked contributor of energy (21.4%), carbohydrate (30.3%), fibre (29.1%), and iron (35.3%). Breakfast cereals, hot cereals, yeast breads, and mixed grain dishes (mainly rice or pasta-based) were the most important nutrient contributors for grains, despite most (64.3%) commercial cereals and breads being unenriched. Legumes and seeds were not frequently consumed. Nutrient density in the GFD could be improved with more emphasis on gluten-free (GF) whole grains, legumes, seeds, and enriched breads and cereals. More research is needed on the nutrient composition of GF foods to identify food sources of folate, other B vitamins, zinc and magnesium—nutrients of concern for those requiring a GFD.

Résumé

Afin de déterminer les sources alimentaires d’énergie et les 13 principaux nutriments, 89 rappels alimentaires ont été analysés à partir d’une étude pilote explicative à méthodes mixtes menée auprès d’adultes suivant un régime sans gluten (RSG) pour une raison quelconque. Des rappels alimentaires non consécutifs ont été recueillis par l’entremise de l’outil Web Automated Self-Administered 24-Hour (ASA24®–Canada-2016). Les apports moyens en nutriments ont été comparés aux apports nutritionnels de référence. Les produits alimentaires (à l’exclusion des suppléments) ont été extraits et catégorisés selon les codes des groupes alimentaires du Bureau des sciences de la nutrition. Les pourcentages des apports alimentaires totaux provenant de diverses sources alimentaires ont été classés. Les produits céréaliers constituaient la principale source d’énergie (21,4 %), de glucides (30,3 %), de fibres (29,1 %) et de fer (35,3 %). Les céréales à déjeuner, les céréales chaudes, les pains à la levure et les plats à base de produits céréaliers mélangés (principalement à base de riz ou de pâtes) étaient les plus importantes sources de nutriments parmi les produits céréaliers, malgré que la plupart (64,3 %) des céréales et pains commerciaux n’étaient pas enrichis. Les légumineuses et les graines n’étaient pas fréquemment consommées. La densité en nutriments du RSG pourrait être améliorée en mettant davantage l’accent sur les grains entiers, les légumineuses, les graines, et les pains et céréales enrichis sans gluten (SG). D’autres recherches doivent être menées sur la teneur en nutriments des aliments SG afin d’identifier les sources alimentaires d’acide folique, d’autres vitamines B, de zinc et de magnésium – des nutriments importants pour les personnes qui doivent suivre un RSG.

Get full access to this article

View all available purchase options and get full access to this article.

Financial support: Funding was provided by Nova Scotia Health Research Foundation (DI-2016-812).
Conflicts of interest: The authors declare that there are no conflicts of interest.

References

1
Ludvigsson JF, Bai JC, Biagi F, Card TR, Ciacci C, Ciclitira PJ, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014;63(8):1210–28.
2
Elli L, Branchi F, Tomba C, Villalta D, Norsa L, Ferretti F, et al. Diagnosis of gluten related disorders: celiac disease, wheat allergy and non-celiac gluten sensitivity. World J Gastroenterol. 2015;21(23):7110–9.
3
Catassi C, Alaedini A, Bojarski C, Bonaz B, Bouma G, Carroccio A, et al. The overlapping area of non-celiac gluten sensitivity (NCGS) and wheat-sensitive irritable bowel syndrome (IBS): an update. Nutrients. 2017;9(11):1268.
4
McAllister BP, Williams E, and Clarke K. A comprehensive review of celiac disease/gluten-sensitive enteropathies. Clin Rev Allergy Immunol. 2019 Oct;57(2):226–43.
5
Shewry PR and Hey SJ. The contribution of wheat to human diet and health. Food Energy Secur. 2015;4(3):178–202.
6
Government of Canada. Food and drug regulations. Ottawa, ON: Minister of Justice; 2019.
7
Government of Canada. Canadian nutrient file. 2015 ed. Ottawa, ON: Government of Canada; 2015.
8
Downey L, Houten R, Murch S, and Longson D. Guideline Development Group. Recognition, assessment, and management of coeliac disease: summary of updated NICE guidance. BMJ. 2015;351:h4513.
9
Roesler N. The future of ancient grains [Internet]. Food Business News; 2018 Apr 19. 6 screens [cited 2019 Jun 6]. Available from: https://www.foodbusinessnews.net/articles/11644-the-future-of-ancient-grains.
10
Agriculture and Agri-Food Canada. “Gluten free” claims in the marketplace [Internet]; 2014. p. 1–8 [cited 2019 Jun 6]. Available from: http://www.agr.gc.ca/resources/prod/doc/pdf/free_claims_gluten_sans_allegations2014-eng.pdf.
11
Subar AF, Krebs-Smith SM, Cook A, and Kahle LL. Dietary sources of nutrients among US children, 1989–1991. Pediatrics. 1998;102(4 Pt 1):913–23.
12
Cotton PA, Subar AF, Friday JE, and Cook A. Dietary sources of nutrients among US adults, 1994 to 1996. J Am Diet Assoc. 2004;104(6):921–30.
13
O’Neil CE, Keast DR, Fulgoni VL, and Nicklas TA. Food sources of energy and nutrients among adults in the US: NHANES 2003–2006. Nutrients. 2012;4(12):2097–120.
14
Garriguet D. Sodium consumption at all ages. Ottawa, ON: Statistics Canada; 2007.
15
Garriguet D. Bone health: osteoporosis, calcium and vitamin D. Ottawa, ON: Statistics Canada; 2011.
16
Vatanparast H, Whiting S, Hossain A, Mirhosseini N, Merchant T, and Szafon M. National pattern of grain products consumption among Canadians in association with body weight status. BMC Nutr. 2017;3:59.
17
Jamieson JA and Gougeon L. Adults following a gluten-free diet report little dietary guidance in a pilot survey exploring relationships between dietary knowledge, management, and adherence in Nova Scotia, Canada. Nutr Res. 2019;66:107–14.
18
Willett W. Nutritional epidemiology. New York, NY: Oxford University Press; 2012.
19
Cook A, Friday JE, Subar AF. Dietary source nutrient database for USDA survey food codes. Washington, DC: USDA Agricultural Research Service; 2004.
20
Kulai T and Rashid M. Assessment of nutritional adequacy of packaged gluten-free food products. Can J Diet Pract Res. 2014;75(4):186–90.
21
Jamieson JA, Weir M, and Gougeon L. Canadian packaged gluten-free foods are less nutritious than their regular gluten-containing counterparts. PeerJ. 2018;6:e5875.
22
Elliott C. The nutritional quality of gluten-free products for children. Pediatrics. 2018;142(2):e20180525.
23
Statistics Canada. Nutrient intakes from food, 2015. Ottawa, ON: Statistics Canada; 2017.
24
Shepherd SJ and Gibson PR. Nutritional inadequacies of the gluten-free diet in both recently-diagnosed and long-term patients with coeliac disease. J Hum Nutr Diet. 2013;26(4):349–58.
25
Wild D, Robins GG, Burley VJ, and Howdle PD. Evidence of high sugar intake, and low fibre and mineral intake, in the gluten-free diet. Aliment Pharmacol Ther. 2010;32(4):573–81.
26
Lee AR, Ng DL, Dave E, Ciaccio EJ, and Green PH. The effect of substituting alternative grains in the diet on the nutritional profile of the gluten-free diet. J Hum Nutr Diet. 2009;22(4):359–63.
27
Government of Canada. Canada’s Food Guide. Ottawa, ON: Government of Canada; 2019. Available from: https://food-guide.canada.ca/en/.
28
Vici G, Belli L, Biondi M, and Polzonetti V. Gluten free diet and nutrient deficiencies: a review. Clin Nutr. 2016;35(6):1236–41.

Supplementary Material

File (cjdpr-2020-023suppla.docx)

Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 82Number 1March 2021
Pages: 21 - 26

History

Version of record online: 9 September 2020

Authors

Affiliations

Jennifer A. Jamieson PhD
Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
Emily Rosta BSc
Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS
Laura Gougeon PhD, RD
Department of Human Nutrition, St. Francis Xavier University, Antigonish, NS

Metrics & Citations

Metrics

Other Metrics

Citations

Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

There are no citations for this item

View Options

Login options

Check if you access through your login credentials or your institution to get full access on this article.

Subscribe

Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF

View PDF

Full Text

View Full Text

Media

Media

Other

Tables

Share Options

Share

Share the article link

Share on social media