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Low Availability and Increased Cost of Gluten-Free Foods 12/06/2007 - Celiac is an autoimmune disease triggered by consumption of gluten in genetically predisposed people. The only treatment for celiac disease is a diet free of gluten, a group of proteins found in some grass-related grains such as wheat, rye, and barley. A healthy gluten-free diet is typically rich in unprocessed foods like fruits, vegetables, and meats; previous studies have established the high relative cost of such a diet. Researchers from the Celiac Disease Center at Columbia University sought to further understand the economic burden of a gluten-free diet by focusing on the gluten-free substitutes for naturally gluten-containing foods.

Using data from the United States Department of Agriculture (USDA) about typical household food consumption, researchers assembled “market baskets” of regular and gluten-free foods. The availability and the difference in price between the 11 regular and gluten-free items in the market basket were compared according the type of store and the region in which the items were purchased.  Researchers surveyed local grocery stores, upscale grocery stores or regional chains, health food stores, and 4 online sites. Regions of the country were represented by New York City and Westchester County, Portland OR, Atlanta GA, Rapid City SD, and Chicago IL.

The researchers found that health food stores and online sites had the largest selection of gluten-free foods, carrying 94% and 100% of the market basket items respectively, compared to availability of 41% in upscale markets and 36% in local grocery stores. Although local grocery stores generally carried the smallest selection of gluten-free foods, Portland’s stores were unique with a relatively high availability of 82%. However, when considering availability in all types of stores, gluten-free foods were most available in the New York area (i.e., 73%).

In general, the price of the gluten-free foods was about 79% greater than their normal counterparts. gluten-free cereals were the exception with a small and statistically insignificant increase in cost compared to the non-gluten-free cereals. The internet appears to be the most expensive place to buy gluten-free foods, followed by health food stores and upscale markets. However, these differences were not statistically significant due to the small number of stores and internet sites surveyed. Interestingly, even though availability of gluten-free foods varied widely among the geographic locations, cost did not.

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The economic burden of a gluten-free diet has important implications for people with celiac disease. Compliance with a gluten-free diet is made more difficult by the low availability and relatively high cost of packaged gluten-free foods. Noncompliance with a gluten-free diet is associated with an increased mortality rate and worse quality of life.


Lee, A., Ng, D., Zivin, J., and Green, H. (2007) Economic burden of a gluten-free diet. J. Hum. Nutr. Diet. 20, 423-430. welcomes your comments below (registration is NOT required).

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17 Responses:

Claudette R /Cranor
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said this on
11 Dec 2007 2:35:46 PM PST
Nice to have what we know to be true in a concise, documented article.

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said this on
12 Dec 2007 6:15:26 AM PST
I am so happy to have come across this article. I live in Jerusalem, Israel and I am struggling to find a proper selection of some of the basic substitutes for gluten full foods. (I have researched the whole country) And yes I actually have family sending me some of these from NY. Also financially it is costing me more than double to provide my family with gluten free meals since we all need to be gluten free. This really echoes my latest sentiments

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said this on
12 Dec 2007 10:13:48 AM PST
I hope they didn't spend too much time or money on this study. Any of us dealing with this diet every day could have told them this, and my reaction to the article is 'Duh'.

Robena Lasley
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said this on
12 Dec 2007 11:52:17 AM PST
Believe me, I know first hand about the increased cost of living gluten free. I also must eat dairy and soy free. Being retired on a fixed income, makes it near impossible to be able to afford the high priced foods. To compensate for the financial burden, I am growing as many of my own fruits and vegetables as possible. Hopefully in the future, as Celiac disease becomes more diagnosed in the U.S., there will be some kind of financial relief.

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said this on
12 Dec 2007 2:50:08 PM PST
I have been told that since gluten free foods were more expensive that I could right it off on my taxes as a medical expense.

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said this on
12 Dec 2007 3:43:23 PM PST
I agree with the no brainer of this article. I have found that it is not that expensive to live gluten free. JUST DON'T BUY PROCESSED FOODS! What is so hard about buying the basics and actually cooking for a change? Once I got used to not eating Rice a Roni and that kind of fare, cooking was and is a breeze. There are many ways to cook Veggie dishes and Beans without adding wheat.

Doris K. Roane
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said this on
14 Dec 2007 7:11:08 AM PST
I agree with the writer who said that we all know this to be true. What to do about it would be the better course of action. Shipping costs are exorbitant. The tax deduction route proved to me to be useless for one person. We need some more answers.

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said this on
14 Dec 2007 9:20:00 AM PST
I agree with comment #6. Eating healthy doesn't have to include many, if any, special special foods. It makes shopping a lot easier to buy fresh, naturally gluten-free items! There is less worry about contamination in production too. Plus, I feel a lot better than when I eat something pre-packaged or processed.

laura Pritchard
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said this on
14 Dec 2007 4:27:59 PM PST
I agree that the money spent on this research study was pointless. Anyone who shops for a gluten-free person knows it is more expensive. While I whole-heartedly, completely agree it is healthier and cheaper to eat more veggies-rice, back to the basics food and we do in our family when we are at home. There are times however when prepackaged food is just appropriate in our very busy lives today, especially with teens and children. It is very important to me to be able to visit family, attend church functions, end of the season sports parties and many other functions that we attend as a family. Without frozen dinners, pizza, cookies, cakes etc... being able to attend these events would be challenging to say the least. Yes I know that I can make most of these things from scratch but as a homeschooling mom, working part-time, with a dh that works crazy hours, I just don't have the time or the energy to always think and prepare far enough in advance to always have food prepared and frozen and ready to travel at a moments notice. So, I do buy gluten free foods and I do really wish it was cheaper.

Carol Frilegh
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said this on
21 Dec 2007 4:13:27 PM PST
One of the things about the most popular gluten-free diet is the plethora of store bought convenience foods available in the U.S. and Canada. Thinking of the gas and time spent going to a store and hidden costs like packaging. it is cheaper to do some things at home.

The Special Carbohydrate Diet allows very few store bought foods. Under federal law, 2% of ingredients on labels do not have to be disclosed which creates the possibility that small amounts of restricted ingredients may exist.

In the past few years there are a few good sources of nut flour baked goods that comply with starch, sugar, yeast and gluten free requirements of the diet and they taste pretty good. It is a mistake to overdo nut consumption even if the cakes, cookies, crackers and breads meet specifications. Home baking is very easy. We substitute nut butters or nut flours for grain, rice or potato flour. Nut butter is just nuts ground for a longer time.
Baking soda takes the place of baking powder

We have one incredible cake made of Medjool dates that tastes and feels like 'fudge-y' chocolate.

Make great 'chips' and 'fries' from butternut squash, popcorn from roasted cauliflower and 'rice' also from cauliflower .

Sauces and gravies can be thickened with roasted or boiled pureed onion.

You can even create a traditional 'roux' base out of butter and almond flour and add liquid and drippings for a thick gravy.

A good system is to set aside a few hours once a week to bake and cook. Most things can be frozen. My favorite is the basic Special Carbohydrate Diet muffin recipe. I use pecan flour instead of almond flour and the muffins are moist and really melt in your mouth.

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said this on
27 Dec 2007 7:53:36 PM PST
I agree that this is known by anyone who needs this diet. I am a single mom with three kids working 60+ hrs a week. Finding time to cook is just one of the problems. Some of us are having to do not only a gluten-free diet but also dairy-free. that gets expensive and hard on not only me the parent but also the children who all of a sudden have to change their diet and watch friends and family eat things they love and not be allowed these things. That is why I get some of the gluten-free foods for my son. I just wish it was easier to find and didn't cost so much.

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said this on
31 Dec 2007 10:27:16 PM PST
They were written with true sincerity and experience. I am trying to bake my own gluten-free breads. I think the cost of these items as with other food prices are expected to be higher but NOT as high as they are. What Can we do about it?

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said this on
01 Jan 2008 11:55:50 AM PST
Hey Patricia, I know where you are coming from--we too have a time buying the 'EXPENSIVE ' flours to make anything we use to like. I have posted a easy corn dog recipe and it goes a long way and isn't too expensive. Not sure what you would substitute for the buttermilk though (I hope you can find a substitute). They freeze well and last a long time in the freezer and we serve them with gluten free ketchup and mustard. I have an easy cheap recipe for gluten-free pizza crust if anyone would son loves it.

Good Luck to all and yes there will in time be an answer for cheaper ways to eat healthy and gluten-free.

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said this on
02 Jan 2008 5:47:52 AM PST
It doesn't matter if you cook fresh food everyday...the basic ingredients are still too expensive. I'm talking about flour, pasta, pancake mix, etc. The point is that we have no financial help at all and it's not easy to tell your child that he can't have pancakes for breakfast. I cook 3 meals every day! In other countries like Italy people with celiac disease have great support from the government--they get a set amount of money every month to buy basic food like bread, flour, pasta, cereal and some desserts. Hopefully soon something will be done!

sophie O'Toole
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said this on
22 Jan 2008 11:39:48 AM PST
I do most of my own baking for Celiac, but I find it expensive also I am from Canada and the government doesn't seem to consider celiac a disease.

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said this on
15 Mar 2008 3:15:16 PM PST
I've been on a gluten-free diet for over three years and agree with others about the higher cost of ingredients and the extra time needed to maintain a normal lifestyle.
I make bread almost every week and tend to rely too much on quick gluten-free frozen entrees for dinner. I'd like to bake more and would sure like to have Belinda's (#13) recipe for gluten-free pizza crust.

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said this on
16 Jun 2008 11:26:44 AM PST
We have to get everyone in power (insurance, gov't) to consider our food as medicine, not just food. When we stay on our diets and are healthy, it saves money in the long run. It is like exercise, you have to do your best to find the time to grow vegetables, or bake, or price shop. We bought all of the on sale rice flour from our local store. It might help to form associations regionally to buy ingredients in bulk from the companies.

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