The Canadian Food Guide and Celiac Disease

Smoothie bowl with strawberries

The new Canadian Food Guide was released and it is quite a drastic change from the old 2007 edition. Overall, it’s a very welcomed step in the right direction.

The first thing to emphasize is that this a population health guide. It’s a guide that states a general pattern of healthy eating that is consistent with a reduced risk of chronic disease. It is not meant to provide specific nutrition advice for individual circumstances. More on that below.

One of my favorite reasons I like this guide is it promotes HOW to eat vs WHAT to eat. Many people have the knowledge of what is healthy, but have a hard time putting that knowledge into action. And the “how to eat,” outlines some very actionable and important steps to consider when eating food.

If you do have a health condition, such as celiac disease, then you should see a dietitian to individualize the guide to your needs. So, as a dietitian specializing in celiac disease, let’s highlight parts of the food guide that someone with celiac disease should pay attention to.

1.Set your plate up like the plate model graphic:

One of the big changes of the food guide is the removal of food groups and serving sizes. This has been replaced by a more abstract plate model encouraging Canadians to consume 1/2 of their meal as fruits or vegetables, 1/4 whole grains and 1/4 protein. This can present a few challenges for someone with celiac disease, especially including enough bone health nutrients, which I talk more about below.

However, someone with celiac disease, should try to set their plate up as the graphic shows on the Canada food guide because this will help address the fiber gap that many celiacs struggle with. In fact, lack of fiber is one of the most common nutrients of concern.

By filling your plate or bowl with half fruit and vegetables, 1/4 with protein and 1/4 with gluten free whole grains, you will be more likely to hit the fiber target each day, which is 25g for adult women and 38g for adult men.

2. Focus on calcium and vitamin D rich source of foods

The removal of foods groups, such as ‘milk and alternatives’, is a big change to this food guide. There is now less emphasis on milk and alternatives as they have been combined with the new ‘protein’ group which includes milk products, milk alternative products, nuts and seeds, beans and legumes, fish, egg, tofu, poultry and lean red meat. Instead of a whole group of foods showcasing milk and alternative products, there is now only one pot of yogurt in the protein group.

This may present challenges for those with celiac disease as calcium and vitamin D are two other nutrients of concern on a gluten free diet. Celiac disease comes along with an increased risk of developing osteoporosis so it’s important to pay attention to bone health nutrition everyday. Special attention to including daily dietary sources of bone health nutrients, especially calcium and vitamin D, is definitely needed.

Again, let’s pay attention to the plate:

For fruits and vegetables, choose these often: mushrooms, artichokes, beet greens, bok choy, broccoli, collard greens, dandelion greens, edamame, dried figs, dried prunes, grapefruit, cooked kale, turnip greens or mustard greens, kiwi, okra, orange, rutabage, seaweed, snap peas, snow peas, butternut squash

For protein foods, aim to include a variety daily: fortified plant milks, almonds, cow/goat/buffalo milk, yogurt or cheese, kefir, chickpeas, navy beans, great northern beans, pinto beans, soybeans, white beans, hummus, almonds, canned salmon with bones, sardines, shrimp, cod, tofu set with calcium sulfate

Depending on your unique circumstances, you may also need a calcium supplement, which should be discussed with your knowledgeable doctor or dietitian.

Most individuals with celiac disease (and, really all Canadians), will most likely need a Vitamin D supplement. Depending on your levels, your dietitian or doctor can individualize a supplement regime for you. A good starting dose is 2000IU taken once per day with food.

Interested to know how much daily calcium you consume and if you are meeting your unique need? You can take this fun quiz .

3. Focus on B Vitamin Rich Sources of Food

The previous food guide version had recommendations for women of child bearing years to ensure adequate folate (vitamin B9) intake. In the new guide, there is no emphasis on adequate folate.

This, again, may be problematic for those with celiac disease because lack of B vitamins, including folate, B12, B6, thiamine, riboflavin and niacin, are additional nutrients of concern for celiacs.

Although a folate deficiency anemia is not as common as iron or B12 anemias in individuals with celiac disease, it may be a good idea to ensure adequate folate intake through a general multivitamin, especially if you are of childbearing years. Ask your dietitian or doctor.

Again, let’s pay attention to the plate:

For fruits and vegetables: include a variety of green peas, mushrooms, cooked spinach, avocado, broccoli, turnip greens, collard greens, beets, asparagus, brussel spouts, artichoke, papaya.

For proteins: Edamame, lentils, beans, lean beef, eggs, fish, poultry, tofu, nuts and seeds

Here’s the bottomline for the gluten free diet and the new Canadian food guide:

  1. Eat enough fiber by ensuring that whatever you eat (whether out of a bowl or a plate) is half fruits and vegetables.
  2. Eat more plant based foods including nuts, seeds, beans, legumes and tofu as these are high in fiber and can be a good source of calcium.
  3. Choose green foods everyday, as they are a good folate source as well as calcium.
  4. Consume enough bone health rich foods, including calcium and vitamin D. Work with a dietitian to optimize your diet and to identify if you need a supplement, especially if you do not consume dairy. Or take the quiz above for a starting point.
  5. Include a variety of foods from each category of the plate. Make it a goal to buy one new or rarely eaten fruit or vegetable when grocery shopping.
  6. Consider taking a high quality, general multivitamin with folate. Especially, if newly diagnosed.

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