As pressures on the NHS grow, there have been increasing calls to stop prescribing gluten-free food. But often, these calls are clouded by misinformation. Coeliac UK have provided the gluten free facts.

Myth 1. Gluten free food has come down in price

Research shows that gluten free staple foods are 3-4 times more expensive than gluten containing equivalents. Gluten free bread is the least accessible in terms of cost, with recent data showing that gluten free white bread is still on average 6 times the cost of gluten containing by volume, and has not reduced since 2008.[1] Gluten free staple foods on prescription therefore help to address the financial burden for patients and are essential for people on fixed or low incomes.

Myth 2. There is no longer a need for prescriptions, as gluten free food can be found in supermarkets

Gluten free prescriptions are still needed as availability in supermarkets is by no means universal and provision is patchy. Peer reviewed research has reported extremely limited availability of gluten free food in small retailers and discount supermarkets, which are often used by people on low incomes. Convenience stores are usually the only option for food in isolated or rural areas and here gluten free food is usually limited or non existent. People with mobility issues can also have access problems and these patients rely on deliveries from NHS community pharmacies. While a lot of the bigger supermarkets have gluten free food, they are often out of stock and our members continue to report difficulties with access.

Myth 3. Patients are prescribed pizza bases, digestive biscuits and cakes

Biscuits and cakes have not been on the prescribed list for a long time. Pizza bases provide a quick meal for parents with children with coeliac disease. Older people find the pizza bases a good alternative to bread.

Myth 4. Patients with coeliac disease can live on rice and potatoes

Rice and potatoes do not have equivalent nutritional values of gluten free bread. In the UK bread is an important source of energy, dietary fibre, vitamins and minerals. It provides more than 10% of our intake of protein, B vitamins and iron, and one fifth of our dietary fibre and calcium. Replacing the average amount of bread consumed daily in the UK (72g or roughly 2 slices) with other carbohydrates may therefore have a significant effect on the nutrient content of the diet.

For example, replacing 72g gluten free bread with a portion of rice containing the same amount of calories would reduce the iron content by 96% and the calcium content by 90%. Similarly, replacing gluten free bread with a portion of peeled, boiled potatoes containing the same amount of calories would reduce the iron content by 71% and the calcium content by 93%.

Calcium recommendations for people with coeliac disease are higher (1,000 mg) than the general population (700 mg) therefore including gluten free bread in the diet can help to meet these requirements.

Myth 5. The NHS can’t afford gluten free foods

The annual cost of gluten free products prescribed to patients with coeliac disease is around £25 million or £195 per patient per year. The NHS annual budget is £117.2 billion, of which gluten free food accounts for just 0.02% and we believe, is significantly smaller than the potential cost of non adherence to the diet and future complications. There are alternative models of providing gluten free food to people with coeliac disease that should be explored by the NHS to make efficiency savings whilst also offering support to those who most need it.