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A gluten-free diet (GFD) is a diet that excludes gluten, a protein composite found in wheat, barley, rye, and all their species and hybrids (such as spelt, kamut, and triticale). The inclusion of oats in gluten-free diet remains controversial. Avenin present in oats may be also toxic for coeliac people. Its toxicity depends on the cultivar consumed. Furthermore, oats are frequently cross contaminated with gluten-containing cereals.
Gluten causes health problems in sufferers of gluten-related disorders, which include coeliac disease (CD), non-coeliac gluten sensitivity (NCGS),gluten ataxia, dermatitis herpetiformis (DH) and wheat allergy. In these patients, the gluten-free diet is a demonstrated effective treatment. In addition, at least in some cases, the gluten-free diet may improve gastrointestinal and/or systemic symptoms in other diseases, such as irritable bowel syndrome, rheumatoid arthritis, multiple sclerosis or HIV enteropathy, among others.
Gluten proteins have low nutritional and biological value, and the grains that contain gluten are not essential in the human diet. However, an unbalanced selection of food and an incorrect choice of gluten-free replacement products may lead to nutritional deficiencies. The replacement of gluten-containing cereals flour with gluten free flours in commercial products traditionally made with wheat or other gluten-containing cereals may lead to a lower intake of some important nutrients, such as iron and B vitamins. Some gluten-free commercially replacement products are not enriched / fortified as their gluten-containing counterparts and often have greater lipid / carbohydrate content. Especially children often abuse the consumption of these products, such as snacks and biscuits. Nutritional complications can be prevented by a correct dietary education.
A gluten free-diet should be mainly based on naturally gluten-free foods with a good balance of micro and macro nutrients. Meat, fish, eggs, legumes, nuts, fruits, vegetables, potatoes, rice, maize are all appropriate. If commercially prepared gluten-free replacement products are used, it is preferable to choose those are enriched or fortified with vitamins and minerals. Furthermore, a healthy alternative to these products are pseudocereals (such as quinoa, amaranth, and buckwheat) and other minor cereals, which have high biological and nutritional value.