THE GLUTEN-FREE

NUTRITION GUIDE
OPTIMIZING THE GLUTEN-FREE DIET
By Cynthia Kupper / Executive Director
Factors affecting nutrition
Economic status
Disabilities
Immediate social situation
Living alone/isolation
Number living in home
Urban/rural living
Depression
Dependency
Mental health
Oral health
Diet related diseases or
conditions
Multiple medication
needs
Minority status
Age
Potential problems for persons
following a GF Diet:
Fiber, carbohydrate
Fat intake
Iron
Folate
Niacin
Vitamin B-12
Calcium
Phosphorus
Zinc
Vitamin D
Quality of Life
Cost of GF living
Availability of foods
Social inconveniences
Continued GI symptoms
Possible weight changes
gain vs. loss
Nutritional Adequacy of Gluten-Free Diet
Nutritional
deficiencies of a
Gluten-Free Diet
Improvement after
starting Gluten
Free Diet
Inadequate intake
after starting
gluten free diet
Serum Hemoglobin x
Iron x
Zinc X*
Fat x
Carbohydrate x
Fiber x
Niacin x
B12 x
Calcium x
Phosphorus x
Zinc X*
American Dietetic Association, Evidence Based Library,
http://www.adaevidencelibrary.com/template.cfm?template=guide_summary&key
=2102, accessed on 3/23/2011
* Zinc levels has been
shown to improve after
starting a Gluten-Free
Diet (GFD) as a result of
intestinal healing and
improved absorption, but
the average daily intake
in a GFD is inadequate
to meet RDA for zinc.
Nutritional Adequacy of GFD
If a gluten-free diet does not provide an adequate supply of the
nutrients at risk (iron, folate, niacin, vitamin B
12
, calcium, phosphorus
and zinc), it many be wise for people with celiac disease to consume
a daily gluten-free age- and sex-specific multivitamin and mineral
supplement.
Whole grain carbohydrates in the form of brown rice, wild rice,
buckwheat, quinoa, amaranth, millet, sorghum, teff can add healthy
carbohydrates as well as fiber to a GFD.
American Dietetic Association, Evidence Based Library,
http://www.adaevidencelibrary.com/template.cfm?template=guide_summary&key=2102, accessed on
3/23/2011
Potentially problematic nutrients for
mature adults:
Protein intake - leads to
muscle wasting
weakened immune status
delayed wound healing
High saturated fats and trans-
fats intake leads to
risk for chronic heart
disease
Vitamin D
Lack of sun exposure
Some meds interfere w/
metabolism
Fiber
Regularity problems
Risk of GI conditions
Potentially problematic nutrients for
mature adults:
Vitamin B12 absorption:
decreased mental function
personality change
loss of physical
coordination
May be diagnosed with a
dementia condition instead
of low B12
Low dietary intake
Vit E
Folate
Calcium
Magnesium
Zinc
Iron
Optimizing nutritional adequacy
of the gluten-free diet
http://fnic.nal.usda.gov
You might be Niacin deficient IF
In elderly common deficiency
Bad breath
Canker sores
Confusion, memory
impairment
Dermatitis, skin eruptions
Diarrhea
Emotional instability, irritability,
depression
Loss of appetite
Muscle weakness
Nausea
Inflammation
Fatigue
About Niacin (Vit B-3)
Reduces cholesterol
Important in DNA repair
Role in producing steroid hormones
Positive role in reversing atherosclerosis
Possible role in reducing Alzheimers Disease
RDA
8 mg - Kids 4-8
12 mg - Kids 9-13
14 mg Women 14+
16 mg Men 14+
Finding Niacin (Vit B-3)
Animal products
Liver, heart, kidney
Chicken, beef
Fish, tuna, salmon
Milk
Eggs
Nuts and Legumes
Whole Grains
Fruits and vegetables
Asparagus , Avocados
Broccoli, Carrots
Dates, Leafy vegetables,
Mushrooms, Tomatoes
Sweet potatoes
RDA
8 mg - Kids 4-8
12 mg - Kids 9-13
14 mg Women 14+
16 mg Men 14+
You might be Folate deficient IF
Anemia
Apathy
Diarrhea
Fatigue, insomnia
Headaches
Loss of appetite
Neural tube defects in
fetus
Paranoia
Shortness of breath
Weakness
About Folate (Vit B-9)
Important in preventing birth defects
Allergic asthma
Bone health
Helps make new cells, including red blood cells to
prevent folate-related anemia
Important in DNA function (may impact cancer risk)
RDA:
200 mcg - Kids 4-8
300 mcg - Kids 9-13
400 mcg - Women 14+
400 mcg - Men 14+
Finding Folate (Vit B-9)
Leafy vegetables (spinach,
asparagus, turnip greens,
romaine)
Other vegetables (beets,
broccoli, corn, tomato or
vegetable juices, Brussels
sprouts, bok choy)
Dried or fresh beans and peas
Fortified grain products
(cereals, flour blends),
sunflower seeds
Fruits (orange, P/A and
grapefruit juices, cantaloupe,
honeydew melon, banana,
raspberry, grapefruit,
strawberry)
Liver
RDA:
200 mcg - Kids 4-8
300 mcg - Kids 9-13
400 mcg - Women 14+
400 mcg - Men 14+
You might be B12 deficient IF
Anemia
Constipation
Depression, irritability,
mental disturbances,
moodiness
Dizziness
Fatigue
Intestinal disturbances,
low stomach acid
Headaches
Loss of vibration
sensation
Mouth lesions
Numbness
Spinal cord degeneration
About Cobalamin (Vit B-12)
Role in blood formation
B-12 helps to regulate the active folic acid
B-12 deficiency can lead to pernicious anemia
Key role in normal function of brain and nervous system
Role in normal cell activity, DNA, fatty acid synthesis and
energy production
Deficiencies can increase fatigue, depression, poor memory,
mania, psychosis
RDA:
1.0 mcg - Kids 4-8
1.8 mcg - Kids 9-13
2.4 mcg - Women 14+
2.4 mcg - Men 14+
Finding (Vit B-12)
Fish, Shellfish
Meat (especially liver)
Poultry, Eggs
Milk, Milk products
RDA:
1.0 mcg - Kids 4-8
1.8 mcg - Kids 9-13
2.4 mcg - Women 14+
2.4 mcg - Men 14+
In foods that come from animals
You might be Calcium deficient IF
Brittle nails
Cramps
Delusions,
depression, insomnia,
irritability
Osteoporosis
Palpitations
Peridontal disease
Rickets
Tooth decay
About Calcium
Vitamin D is needed to absorb calcium
Electrical conduction system in the heart
Deficiency can lead to poor blood clotting
Major role in bone health - strength and density
Role in muscle contraction and neurotransmitter release
Excess can lead to impaired kidney function and decreased
absorption of other minerals
RDA:
1000 mg - Kids 4-8
1300 mg - Kids 9-14
1000 mg - Women 14-50
1200 mg - Women 50+
1000 mg - Men 14-50
1200 mg Men 50+
Finding Calcium
Dairy foods (milk , yogurt, and
cheese)
Seaweeds (kelp, wakame, and
hijiki)
Nuts and seeds (almonds and
sesame)
Blackstrap molasses; Beans
Fruits (oranges, figs)
Whole GF grains (quinoa,
amaranth)
Vegetables (collard greens,
kale, okra, rutabaga, broccoli,
dandelion greens)
Fortified products (OJ and soy
milk)
RDA:
1000 mg - Kids 4-8
1300 mg - Kids 9-14
1000 mg - Women 14-50
1200 mg - Women 50+
1000 mg - Men 14-50
1200 mg Men 50+
You might be Vit. D deficient IF
Elderly woman
Burning sensation in
mouth
Diarrhea
Insomnia
Myopia
Nervousness
Osteomalacia,
osteoporosis, rickets
Scalp sweating
About Vitamin D
Important in bone health
Essential for promoting calcium absorption
Maintaining proper calcium/phosphorus levels
Role in neuromuscular and immune functions
Role in reducing inflammation, cancer risk and other
conditions
RDA*:
400 IU - All 8-70
600 IU - All 71+
*It is anticipated that the
FDA will raise these
values in the near future.
Finding Vitamin D
Very few foods naturally contain
vitamin D
flesh of fish (such as salmon, tuna, and mackerel); fish liver oils
beef liver, cheese, and egg yolks
Some mushrooms
Fortified Foods
Milk, yogurt , margarine, ready-to-eat breakfast cereals, cereal flours
Some OJ, Calcium-fortified fruit juices and drinks
Sunshine: Season, location, time of day, cloud cover, smog, skin
melanin content, and sunscreen impact absorption
RDA*:
400 IU - All 8-70
600 IU - All 71+
*It is anticipated that the
FDA will raise these
values in the near future.
About Phosphorus
Important in energy production and storage
Important in transmission of genetic information
Major structural component of bone and cell
membranes
Activation of enzymes, hormones and cell-signaling
Helps maintain normal acid-base balance (pH)
Binds to hemoglobin in red blood cells and affects
oxygen delivery to the tissues of the body
RDA:
500 mg - Kids 4-8
1250 mg - Kids 9-18
700 mg - Adults 19-70+
Finding Phosphorus
Meats: organ meats (liver, brains, heart, kidney,
sweetbreads) rabbit, poultry, beef, eggs/yolk, lamb, seafood
Nuts and seeds
Vegetables: chickpeas, garlic, lentils, popcorn, soybeans
Dairy: cheeses
Grains: wild rice, buckwheat, millet, oats, oatmeal, brown
rice, rice bran
Other sources: chocolate, kelp, yeast, bone meal.
RDA:
500 mg - Kids 4-8
1250 mg - Kids 9-18
700 mg - Adults 19-70+
You might be Iron deficient IF
Anemia
Brittle nails
Confusion,
depression
Constipation
Dizziness
Fatigue
Headaches
Inflamed tongue
Mouth lesions
About Iron
Carries oxygen in the blood
Prevents iron-def. anemia
Not many GF products are
fortified
Some GF grains are good sources of iron
Take with Vit. C to improve uptake of non-heme
(vegetable) sources of iron
Do not take with calcium-rich foods
RDA:
10 mg Kids 4-8
8 mg Kids 9-13
15 mg Female 14-18
18 mg Female 19-50
8 mg Female 50+
11 mg Male 14-18
8 mg Male 19 70+
Finding Iron
Heme iron
red meats, fish, and poultry
Non-heme iron
lentils and beans
Molasses
Tofu
Dark green vegetables
Enriched or Fortified cereal/grain products
Tef
RDA:
10 mg Kids 4-8
8 mg Kids 9-13
15 mg Female 14-18
18 mg Female 19-50
8 mg Female 50+
11 mg Male 14-18
8 mg Male 19 70+
You might be Zinc deficient IF
Acne, eczema
Amnesia
Apathy, depression, irritability,
memory impairment, paranoia
Brittle nails, white spots on nails
Delayed sexual maturity, growth
impairment
Diarrhea
Fatigue, lethargy
Hair loss
High cholesterol levels
Immune impairment
Impotence, male infertility
Loss of appetite, loss of sense
of taste, low stomach acid
Night blindness
Wound healing impairment
Zinc is the #1 nutritional deficiency in U.S. children (30-70%)
About Zinc
Taste acuity
Bone mineralization
Essential for cell division, synthesis of DNA
Blood clotting, cognitive functions, fetal growth
Role in activity of enzymes assoc. with protein, carbs, fat, and alcohol
metabolism
Critical to tissue growth, wound healing, connective tissue growth and
maintenance
Immune system function, proper thyroid function, sperm production
Prostaglandin production for smooth muscle contractions, Blood Pressure,
inflammation and body temp.
RDA:
5 mg Kids 4-8
8 mg Kids 9-13
9 mg Female 14-18
8 mg Female 19-70+
11 mg Male 1470+
Finding Zinc
Oysters, crab,
seafood
Beef, liver , poultry
Nuts and seeds,
peanuts and peanut
butter
Legumes
Whole grains
Tofu, Milk
RDA:
5 mg Kids 4-8
8 mg Kids 9-13
9 mg Female 14-18
8 mg Female 19-70+
11 mg Male 1470+
About Magnesium
Muscle control, and relaxation
Assisting DNA and other enzymes
that act as genetic building blocks
Distribution and creation of human energy
The production of protein
Magnesium is essential for calcium to work properly
in the body
RDA:
240 mg - Kids 8-13
360 mg Female 14-18
310 mg Female 19-30
320 mg Female 30-50+
410 mg Male 14-18
400 mg Male 19-30
420 mg Male 30-50+
Finding Magnesium
Dark green, leafy vegetables such
as spinach and even broccoli
Fruits or vegetables (such as
bananas, dried apricots, and avocados)
Nuts (such as almonds and cashews)
Peas and beans (legumes), seeds
Soy products (such as soy flour and tofu)
Whole grains (such as brown rice and millet)
RDA:
240 mg - Kids 8-13
360 mg Female 14-18
310 mg Female 19-30
320 mg Female 30-50+
410 mg Male 14-18
400 mg Male 19-30
420 mg Male 30-50+
About Fiber
Proper bowel function
Important for a healthy immune system
May reduce risk of cancers
May help with blood sugar control in diabetes
Reduce the risk of coronary heart disease (BP, Chol, Lipids)
May help with weight control (Increased satiety, Decreased
intake )
Grains with folate helpful in fetal development during
pregnancy
RDA:
25 g Kids 4-8
26 g Female 9-18
25 g Female 19-50
21 g Female 50+
31 g Male 9-13
38 g Male 14-50
30 g Male 50+
Finding Fiber
Raw Fruits
Raw Vegetables
Whole GF Grains
Nuts and Seeds
Fiber supplements and fiber-added
foods/beverages
RDA:
25 g Kids 4-8
26 g Female 9-18
25 g Female 19-50
21 g Female 50+
31 g Male 9-13
38 g Male 14-50
30 g Male 50+
GF Grains High in Fiber & Nutrients
Tef: calcium, magnesium, iron, zinc, and B vitamins
Quinoa: potassium, zinc, phosphorous, iron, B-vits,
magnesium, and calcium
Amaranth: calcium and iron
Buckwheat: magnesium, phosphorous, potassium, B6 vits,
iron, niacin, thiamin and zinc
Indian rice grass (Montina): phosphorous, iron, and B-
vitamins
Chia, flax: omega 3 fatty acids
Sorghum (milo): phosphorous, potassium, B vitamins, iron
Weight Management
GF is not calorie-free
most times GF is more caloric dense than wheat-based options
Read labels for total calories and serving size
Choose nutrient-dense foods
Watch fat, sugar and fiber in foods
Choose GF specialty foods carefully
Use more fresh fruits and vegetables and less highly refined,
processed foods
Exercise
Easy, low cost healthy
gluten-free meals
Tips for easy, healthy meals
Eat colors - Eat fresh - Eat naturally GF
Consume whole or enriched gluten-free grains and products
Eat minimally processed foods
Choose products to make cooking easy
frozen, canned, fresh
Cook in volume and freeze
Cooking parties, fresh and ready meals
Use GF specialty foods in moderation
Exercise WATER Rest Reduce stress
Add nutritional supplement if necessary
Meals with a punch
Yogurt with fresh fruit and granola
Whole grain pancakes or waffle breakfast sandwich
GF oatmeal, grits with dried fruit
Semi-homemade soups with beans and grains
Cornbread or corn cakes vs. GF breads
Lean meat stews
Steamed vegetables and salads with protein
Sweet potatoes/yams vs white potatoes
Gluten Free Super Foods
Kefir
People with Gluten Intolerance and/or Celiac Disease commonly
experience issues with their digestive tract. The pro-biotic cultures in
kefir can be beneficial to your digestive health. Kefir possesses a
high content of antioxidants and B-vitamins which can help heal the
tissues in the gut. Dairy-free alternatives are available, such as
coconut milk kefir and soy milk kefir. It makes a wonderful base for a
smoothie. As it contains yeasts, kefir can be used to make a
sourdough bread. It is also useful as a buttermilk substitute in baking.
Gluten Free Super Foods
Flaxseed
This popular seed is high in omega-3 fatty acids. Studies
have shown it has anti-inflammatory properties and has a mild
estrogenic effect that may benefit people with chronic
inflammation, skin and cardiovascular issues. It is rich in
lignans that help soothe the intestinal tracts. The fiber found in
flax seeds can help repair damage to the small intestine.
Gluten Free Super Foods
Coconut
Coconuts provide essential medium chain fatty acids that
protect and heal the body. Its meat is a densely packed
source of fats and oils that have been scientifically studied for
their anti-inflammatory and anti-pathogenic properties.
Moreover, coconut meal can be ground into a flour that is
excellent for gluten-free baking and cooking. The saturated
oils are plant based and do not have the same un-healthy
effects that animal based saturated fats do.
Gluten-Free Nutrition Guide
For more information about nutritional needs of persons
with gluten intolerances visit: www.gluten.net
This information provided by Cynthia Kupper, RD, Executive
Director of GIG with the support of Bastyr University Nutrition
and Dietetic Interns