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Original article
Are gluten-free food staples accessible to all patients with coeliac disease?
  1. Ozan Hanci1,
  2. Yvonne M Jeanes2
  1. 1 Department of Paediatrics, Royal Surrey County Hospital, Guildford, UK
  2. 2 Department of Life Sciences, Health Sciences Research Centre, University of Roehampton, London, UK
  1. Correspondence to Dr Yvonne M Jeanes; y.jeanes{at}roehampton.ac.uk

Abstract

Introduction Within England the removal of prescribed gluten-free (GF) foods from many Clinical Commissioning Groups has resulted in a greater reliance on commercially available GF food by adults and children with coeliac disease (CD). High cost and limited availability of GF foods are associated with poorer dietary adherence in people with CD.

Aim To assess if the rise in popularity of GF diets globally has improved the cost or availability of cereal-based GF foods over the past 6 years.

Design Observational study where data were collected on cereal-based GF foods from 50 stores and 10 internet retailers. The number of GF foods within each food category and the cost per 100 g of GF and gluten-containing (GC) foods were compared by store type.

Results GF food availability has increased in premium stores and online. The majority (82%) of GF food categories were significantly more expensive online compared with regular supermarkets. On average, GF breads were 400% more expensive compared with GC breads (p<0.001); no narrowing in cost difference over time observed. Convenience stores did not stock any GF bread nor GF pasta and only one of the budget supermarkets stocked them, similar to data reported 6 years ago.

Conclusions GF food availability has increased, predominately in premium markets. The GF food desert within convenience and budget stores will continue to disproportionately impact poor socioeconomic cohorts, the elderly and physically disabled. A lack of accessibility to GF foods impacts GF dietary adherence, increasing related comorbidities and healthcare costs.

  • coeliac disease
  • gluten-free diet

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors OH contributed to the study design, undertook data collection and preliminary analysis and co-wrote the manuscript. YMJ formulated the original study idea, contributed to the study design, supervised all aspects, undertook additional analysis and co-wrote the manuscript. Both authors approved the final version of the manuscript submitted for publication.

  • Funding OH received a Coeliac UK sponsored dissertation grant.

  • Competing interests YMJ has previously received funding from Dr Shar.

  • Patient consent Not required.

  • Ethics approval Ethical approval was granted through the procedures of the University of Roehampton Ethics Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Correction notice This article has been corrected since it published Online First. The order of the authors has been updated.

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