Abstract
INTRODUCTION: Several studies suggest that the cost and availability of gluten-free foods may be factors associated with adherence to treatment. To date, no national studies have evaluated the cost, availability and nutritional value of gluten-free foods, how they differ from their gluten-containing counterparts, and their potential relationship with adherence to the gluten-free diet. Obtaining this information is extremely useful for decision-making at both the individual and population levels in the redefinition of socio-economic policies. OBJECTIVE: To know the cost, availability and nutritional value of different gluten-free food groups in different geographical regions of Argentina and their possible relationship with adherence to the gluten-free diet. MATERIAL AND METHODS: A descriptive, cross-sectional, comparative, multicenter, multicenter study. Ten varieties of gluten-free premixes and substitute flours, fifteen gluten-free substitute foods and ten industrialized foods were analyzed, as well as their counterparts with gluten. Individuals diagnosed with celiac disease and treated with a gluten-free diet for at least one year were included in the study, calculating an approximate number of 40 individuals per geographic area, for a total of 7 geographic areas. RESULTS: The basic food basket for celiac patients was 68.8% more expensive than the general basic food basket (p < 0.0001). Gluten-free substitute foods were 253.2% more expensive than their gluten-containing counterparts (p < 0.0001). Their availability was limited in different geographical areas, with an average of 50.4% of the 35 proposed gluten-free foods available. 75.9% of individuals reported that the higher cost of substitute foods did not affect their adherence to the gluten-free diet. In terms of nutritional value, the gluten-free substitute foods were found to have 39% less protein and 68% less fiber than their gluten-containing counterparts. The substitute foods had zero iron and B-complex vitamins. CONCLUSIONS: This study is the first to evaluate the cost and availability of gluten-free foods in different geographical areas of Argentina. This research presents two perspectives; a direct one, with information collected in the field, and a subjective one coming from the opinion of the person with celiac disease.