Gluten-free foods: a 'health halo' too far for oral health?

Abstract

Background Over the past decade, the rise of consumers following a gluten-free diet has increased greatly. The majority of people following a gluten-free diet have not been diagnosed with coeliac disease or gluten or wheat intolerance but believe it to be a health benefit.Aim To assess the differences between gluten-free and gluten-containing products with regards to the implications this might have on oral (and wider) health.Method In total, 50 purposively selected products (25 gluten-free and gluten-containing pairs) available to UK consumers, classified using the UK National Diet and Nutrition Survey food categories, were analysed using content analysis of food packaging. The European Union front-of-pack labelling system revealed the nutritional composition of each product, focusing on carbohydrates, sugars and energy. Cost and use of emotive language to market products was also assessed.Results A nutritional comparison of the 25 product pairings found that, on average, all gluten-free products contained more calories, total carbohydrates and total sugar. The majority of the gluten-free products were classified as 'confectionary' or 'baked goods,' emphasising that products primarily consisted of foods high in sugar. The average sugar per 100 g for each category of food ranged from 2.5-37.0 g/100 g (gluten-free) compared to 2.1-30 g/100 g (gluten-containing). All gluten-free products were considerably more expensive when compared with the conventional version; the average price difference ranged from £0.08 to £4.40.Conclusion This study emphasises the 'health halo' phenomena, where foods for special diets are regarded by consumers as healthy when in fact they are not. This results partly from the products being mainly high-sugar 'treats', which are not a core of the UK Eatwell Guide food-based dietary guidelines. As many people consuming gluten-free products in the UK do not need them from a medical perspective, this could have implications for oral and wider health. It is important that members of the dental team are aware of the possible implications of a gluten-free diet where it is not medically indicated, coupled with reliance on convenience foods.