Considering a more sustainable gluten-free diet? Gluten-free cereals in European dietary practice

The inclusion of minor and pseudo-cereals enhances the nutritional quality of a gluten-free diet. Yet, affordability determines practical implementation. Environmental concerns should also be considered as moving towards a more sustainable diet. How do these aspects of sustainability manifest themselves in a special diet, such as gluten-free?

An international pilot survey among practicing dietitians was conducted during the Congress of The European Federation of the Associations of Dietitians (EFAD, Budapest, 2023). Respondents marked their recommendation for eight gluten-free cereals based on five criteria, including nutritional quality, accessibility/price, and climate change. Differences were analysed using Cohran’s Q and pairwise post-hoc tests (N = 38).

There were significant differences in the recommendation for cereals (p < 0.05 for each grain), with quinoa (89.5%), gluten-free oats (89.5%), rice (86.8%), and corn (65.8%) being the most recommended. Buckwheat (55.3%), millet (50.0%), amaranth (44.7%) and sorghum (26.3%) were less recommended. Although gluten-free oats were recommended overall, quinoa was recommended for its nutritional content, and rice and corn were recommended for accessibility/price. No cereal received a high recommendation for climate change.

According to this pilot survey, nutritional content and accessibility/price were the most important criteria for evaluating gluten-free grains. Dietitians were willing to integrate climate change considerations into practice, but more information is needed. The recommendation for minor and pseudo-cereals contradicted the importance emphasised by the literature. Further research is needed to integrate these aspects, helping dietitians formulate recommendations.