title: Economic burden of a gluten-free diet.
abstract: BACKGROUND
  Coeliac disease is a common, autoimmune disorder, for which the only treatment is lifelong adherence to a gluten-free diet. This study evaluates the economic burden of adhering to a gluten-free diet.
  
  
  METHODS
  A market basket of products identified by name brand, weight or package size for both regular wheat-based products and gluten-free counterparts was developed. The differences in price between purchase venues, both type of store (general grocery store, an upscale grocery store and a health food store and four internet-based grocery sites) and region was also analysed.
  
  
  RESULTS
  Availability of gluten-free products varied between the different venues, regular grocery stores carried 36%, while upscale markets carried 41%, and health food stores 94%, compared with 100% availability on the internet. Overall, every gluten-free product was more expensive than their wheat-based counterpart (P <or= 0.05). Bread and pasta was twice as expensive as their wheat-based counterparts. Cost was affected more by shopping venue than geographic location.
  
  
  CONCLUSIONS
  This study demonstrated that gluten-free foods have poor availability and are more expensive than their gluten-containing counterparts. The impact of these findings on dietary compliance and the quality of life needs to be addressed.
authors.affiliation: Celiac Disease Center, Columbia University, New York, NY 10032, USA. arl2004@columbia.edu
authors.forename: A R
authors.initials: AR
authors.lastname: Lee
authors.forename: D L
authors.initials: DL
authors.lastname: Ng
authors.forename: J
authors.initials: J
authors.lastname: Zivin
authors.forename: P H R
authors.initials: PH
authors.lastname: Green
mesh_terms: D002446:Celiac Disease / Q000178:diet therapy*; D003132:Commerce / Q000191:economics*; D003365:Costs and Cost Analysis; D005382:Financing, Personal; D005983:Glutens / Q000008:administration & dosage* / Q000191:economics*; D006801:Humans; D020407:Internet; D010349:Patient Compliance; D014481:United States
chemical_list: D005983:Glutens