A gluten-free diet (GFD) is the only safe treatment for people with gluten-related
disorders (GRDs). However, adherence to a GFD is challenging in different interconnected
aspects related to food security, safety, and sustainability. These obstacles are
critically contextualized in this review. In general, a GFD may increase the risk
of food and nutritional insecurity, especially in populations with lower educational
levels and purchasing power. Furthermore, avoiding cross-contact with foods containing
gluten is challenging, reducing the options available for consumption and increasing
fear and hypervigilance among individuals. The literature also reports gluten-free
foods and inputs contaminated with heavy metals such as arsenic, mercury, and mycotoxins,
and they may have shortened shelf life. More studies within the scope of sustainability
and more actions by the food industry, society, researchers, government, and consumer
advocacy groups are needed to improve the food safety, security, and sustainability
aspects of the GFD.
