In people with celiac disease (CD), nutritional deficiencies can occur because of both low intake and poor absorption. When there is damage in the small intestine, the absorption of certain nutrients can be reduced. The vitamins and minerals most commonly affected include iron, calcium, folate, vitamin B12 and all of the fat soluble vitamins (vitamins A*, D*, E* and K*).
Once the intestine has healed and recovered from the damage that is characteristic of CD, nutrient absorption improves, but reduced intake may still be a problem. In the case of non-celiac gluten sensitivity, absorption of nutrients is not compromised, but foods consumed may be low in nutrients.
Very few gluten-free grain products are enriched or fortified with the vitamins and minerals that gluten-containing grain products are. Deficiencies in these vitamins and minerals can occur as a result. Some people with celiac disease also have lactose intolerance during the early stages of their treatment on a gluten-free diet, so there may be low intake of many of the nutrients provided by dairy foods (such as calcium, magnesium, and Vitamin D).
Deficiencies which are common in gluten-related disorders and some of their gluten-free and dairy-free sources
Vitamins & Minerals / Food Sources
Thiamin: Sunflower seeds, black beans, tuna, green peas, lentils
Riboflavin: Mushrooms, cooked spinach, venison, soybeans
Niacin: Mushrooms, avocados, broccoli, tuna, salmon, chicken breast
Folate: Green leafy vegetables (spinach, romaine lettuce, turnip greens), asparagus, lentils, beets, broccoli
Iron: All types of meat, lentils, soybeans, tofu
Calcium: Green leafy vegetables (spinach, turnip greens, collard greens), sardines, almonds, sesame seeds, seaweed (nori, kelp)
Vitamin D**: Salmon, sardines, shrimp, cod
Magnesium: Green leafy vegetables (spinach, Swiss chard), pumpkin seeds, sunflower seeds, black beans
Vitamins B12: All types of meat, poultry & fish, eggs, dairy products
Vitamin A: Green leafy vegetables (spinach, turnip greens), sweet potato, carrots, red bell peppers
Vitamin E: Green leafy vegetables (spinach, mustard greens, turnip greens), sunflower seeds, almonds, hazelnuts
Vitamin K: Green leafy vegetables (kale, spinach, Swiss chard, collard greens), broccoli, Brussels sprouts
*An increased risk of these deficiencies only occurs when there is fat malabsorption.
**There are only a few food sources of Vitamin D. Especially if you live in a northern climate, a supplement may be needed.
Increasing Fiber on a Gluten-Free Diet
Eating enough fiber when following a gluten-free diet can sometimes be a challenge. However, there are many ways to increase your fiber intake because fiber is found in virtually all plant foods.
Examples of gluten-free sources of fiber include:
Fruits: apples, pears, oranges, figs, plums, prunes, berries
Gluten-Free Whole Grains: amaranth, quinoa, buckwheat, brown rice, teff, millet, corn
Legumes: lentils, split peas, black beans, pinto beans, kidney beans, lima beans, garbanzo beans
Nuts & Seeds: almonds, pistachios, pecans, flax seeds, sunflower seeds, chia seeds
Vegetables: squash, broccoli, artichokes, peas, green leafy vegetables, carrots
Getting the Most Nutrients Out of Your Food
Eat Foods as “Whole” as Possible: Whole, unprocessed foods have nutrients that processed foods no longer contain. Look for groceries around the perimeter of the store, because this is where most whole foods are located.
Cook Vegetables Lightly: Nutrients are lost when a food is fried or boiled in water for an extended time. Lightly sauté, steam, or bake vegetables rather than frying them or boiling them in water.
Be Colorful: Choose foods that are naturally bright in color. In general, each color represents a different nutrient. For example, while red tomatoes and pink watermelon have a nutrient called lycopene, orange sweet potatoes and pumpkin have a nutrient called beta-carotene. For a nutrient-rich and appetizing meal, try to include several different colors of fruits and vegetables.
This article has been assessed and approved by a Registered Dietitian Nutritionist.