New guidance available for prescribing gluten-free foods

Nutrition & Food Science

ISSN: 0034-6659

Article publication date: 1 August 2004



(2004), "New guidance available for prescribing gluten-free foods", Nutrition & Food Science, Vol. 34 No. 4.



Emerald Group Publishing Limited

Copyright © 2004, Emerald Group Publishing Limited

New guidance available for prescribing gluten-free foods

“Dietitians have a key role in the management of people with coeliac disease and this new guidance will be a valuable aid for both ourselves and GPs” commented Claire Wylie, Senior Dietitian at Royal Bournemouth Hospital on the document “Gluten-free foods: a prescribing guide”, which is currently available.

The guide provides minimum recommendations for a well-balanced and varied gluten-free diet[1] and should be used together with a full dietary assessment and advice from a state-registered dietitian.

Guidance for prescribing gluten-free foods has been based on:

  • a review of consumption data from the national diet and nutrition surveys;

  • consideration of The Balance of Good Health model;

  • gluten-free prescribable foods providing 15 per cent of total energy; and

  • retaining the current average expenditure on gluten-free foods per patient.

Coeliac disease[2] is a chronic, permanent and potentially life-threatening disease which is significantly under-diagnosed and may affect as many as one in 112 people in the UK.

Jacqueline Lowdon, Paediatric Dietitian at Cardiff’s University Hospital of Wales and a member of the expert panel said: “People’s requirements for gluten-free foods vary according to their age, sex and activity levels. The minimum recommendations outlined in this document should prove to be a useful tool”.

Dr Geoffrey Holmes, Consultant Gastroenterologist, Derbyshire Royal Infirmary, and chair of the panel who produced the guidance said: “Strict adherence to a gluten-free diet is essential for people with coeliac disease in order to minimise long-term complications such as osteoporosis and infertility”.

Gluten-free Foods: A Prescribing Guide has been developed by an expert panel and approved by the British Dietetic Association (BDA), Primary Care Society for Gastroenterology (PCSG), coeliac disease working group of the British Society of Paediatric Gastroenterology Hepatology and Nutrition (BSPGHAN) and Coeliac UK. As well as setting out the minimum recommended amounts of gluten-free foods that should be prescribed, the document includes useful background information and key considerations when prescribing gluten-free foods.

For further information or a free copy ofGluten-free Foods: A Prescribing Guide, please contact. Tel: 01932 350006; E-mail:


1. Total carbohydrate should provide about 50 per cent of energy intake. Non-milk extrinsic sugars should not exceed 11 per cent of energy intake. Starches, intrinsic and milk sugars should therefore contribute about 39 per cent of energy intake (DOH, 1991). Consumption of naturally gluten-free foods such as potatoes, rice and breakfast cereals will also contribute to energy requirements.

2. Coeliac disease is a condition in which the surface of the small intestine is damaged by gluten, which reduces the ability to absorb food properly including essential nutrients such as iron and calcium. Symptoms include: anaemia, fatigue with patients complaining they are “tired all the time”, muscle pain, bone and joint pain, infertility, and short stature.

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