MIRA research

With the cost of food soaring, is the gluten-free diet breaking the bank?

Carmody, J. Haskett, A. Otley, M. Wiepjes, D. Burnett, M. Rashid

IWK Health Centre, Department of Pediatrics, Dalhousie University, Halifax, Canada

 Introduction: Celiac disease (CD) is a disorder in which ingestion of gluten leads to small intestinal villous atrophy in genetically predisposed individuals. Currently, the only treatment for CD and other gluten-related disorders is a strict gluten-free (GF) diet. Past studies have shown the GF products to be significantly more expensive than gluten-containing (GC) products. This cost burden is of particular concern given the lifelong need for the GF diet for CD, and even more so in households with multiple family members affected. Demand and availability of GF products have grown in recent years with the increased incidence of CD as well as the general public’s interest in a GF diet for perceived health benefits. It is not clear if this has led to a reduction in the overall cost of GF products. Given the recent dramatic rise in food prices post-pandemic, our aim was to assess the current cost of GF products compared to GC counterparts.

Methods: GF food items and comparator GC items were identified through the websites of two large-chain grocery stores in Halifax, Nova Scotia, Canada between October and December 2022. Products searched included pastas, flours, breads, baking mixes, cereals, breaded chicken and fish, frozen entrees, and snack products. Only products with a GF claim on the package were selected and a similar comparator product was chosen from the same brand or manufacturer, if available. If not available, a product closely resembling the GF product was chosen. Only regularly priced items were selected. Where possible, similarly sized packages and recognizable brands versus store-owned brands were chosen. The unit cost per 100g of the product was calculated for comparison. A total of 163 GF and 150 GC products were examined. In some cases, a GC item was used as the comparator more than once where there were limited product options. The percentage difference in price was calculated between product pairs (GF and GC) and across product categories. The average unit cost per 100g of GF versus GC products was compared using a Mann-Whitney U test for non-parametric data. A significant difference was determined at p<0.05.

Results: The average unit cost per 100g of all GF products ($2.30 ± 1.34) was significantly greater than that of GC products ($1.29 ± 0.71) (p<0.001). When comparing product pairs, GF products were on average 96% more expensive. The mean cost of GF foods was significantly greater (p<0.05) for all food categories with the exception of croutons and breadcrumbs, and breaded chicken and fish products (see Figure). Pretzels (within the snack category) had the highest cost difference (217%) of all products, followed by pizza crusts (201%) and baking flours (185%).

Conclusion: Gluten-free products remain significantly more expensive than their gluten-containing counterparts. As GF diet is the only treatment for celiac disease, its cost and potential impact on adherence must be considered. It is important to take into account the financial acceptability of the GF diet in the development of advocacy efforts, governmental policies and supports for patients with CD and their families.



FIGURE: Price comparison by food category between gluten-free (n=163) and gluten-containing (n=150) products.