(Open access funding provided by Semmelweis University)
Background The inclusion of minor and pseudo-cereals enhances the nutritional quality
of a gluten-free diet. Yet, affordability determines practical implementation. Environmental
concerns should also be considered as moving towards a more sustainable diet. How
do these aspects of sustainability manifest themselves in a special diet, such as
gluten-free? Methods An international pilot survey among practicing dietitians was
conducted during the Congress of The European Federation of the Associations of Dietitians
(EFAD, Budapest, 2023). Respondents marked their recommendation for eight gluten-free
cereals based on five criteria, including nutritional quality, accessibility/price,
and climate change. Differences were analysed using Cohran's Q and pairwise post-hoc
tests (N = 38). Results There were significant differences in the recommendation for
cereals (p < 0.05 for each grain), with quinoa (89.5%), gluten-free oats (89.5%),
rice (86.8%), and corn (65.8%) being the most recommended. Buckwheat (55.3%), millet
(50.0%), amaranth (44.7%) and sorghum (26.3%) were less recommended. Although gluten-free
oats were recommended overall, quinoa was recommended for its nutritional content,
and rice and corn were recommended for accessibility/price. No cereal received a high
recommendation for climate change. Conclusions According to this pilot survey, nutritional
content and accessibility/price were the most important criteria for evaluating gluten-free
grains. Dietitians were willing to integrate climate change considerations into practice,
but more information is needed. The recommendation for minor and pseudo-cereals contradicted
the importance emphasised by the literature. Further research is needed to integrate
these aspects, helping dietitians formulate recommendations.