People withceliac diseaseface complicated nutritional challenges, even if they are following the gluten-free diet. First, they must recover (as much as possible) from the nutrientmalabsorptionthat occurred while they were still eating gluten, which might have caused anemia, low bone mineral density andosteoporosis, vitamin deficiencies, and other problems.
As if that weren’t enough, unlike gluten-containing products in the supermarket, few commercial gluten-free products are enriched or fortified with extra vitamins, making it difficult for people with celiac disease to get enough vitamins in their diet.
Gluten-free productsare often low in B vitamins, calcium, vitamin D, iron, zinc, and fiber. In fact, research has shown that a gluten-free diet may even increase the risk of several side effects, includingobesity, in people with celiac disease.
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Why a Dietitian Is Important
Because of all these nutritional risks, health experts recommend a registered dietitian should be part of the healthcare team that monitors the patient’s nutritional status and compliance with the diet.
Furthermore, studies show that for some people with celiac disease, a major reason why they can’t stay gluten-free is that they don’t understand the diet.Wouldn’t it be a relief to get some help from a professional?
Should You See a Nutritionist or Dietitian?
Unlike the credential RD, there is no national standard and credential associated with the titles of “dietitian” (without the word “registered”) or “nutritionist” and no guarantee that the person using those titles has had any formal education in food and nutrition.
According to the Bureau of Labor Statistics of the U.S. Department of Labor, many states require that practitioners are licensed. Others only require state registration or certification to use certain titles. A few states have no regulations for this occupation.
Be sure that your nutrition professional has met the requirements for the state (or country) where they practice.You can verify your nutrition professional’s credentials using theCommission on Dietetic Registration Online Credential Verification System.
How to Find a Registered Dietitian
In the U.S., you can visit the Academy of Nutrition and Dietetics’Find a Nutrition Expert siteto find a dietitian near you. Of course, you can also ask your healthcare provider or members of your celiac disease support group if they can recommend anutrition professional.
In Australia, visitDietitians Australia; in Canada,Dietitians of Canada; in Hong Kong,Hong Kong Academy of Accredited Dietitians; in Ireland, theIrish Nutrition and Dietetic Institute; in New Zealand, theNew Zealand Dietetic Association; in the UK, theBritish Dietetic Association.
Will Insurance Pay?
The American College of Gastroenterology guidelines for the management of celiac disease say, “A visit with a dietitian after diagnosis is mandatory, and subsequent visits as needed to reinforce gluten-free diet (GFD) education and adherence should be encouraged.”
Given these guidelines, insurance companiesshouldpay for celiac disease patients’ consultations with RDs. Still, there’s a good chance you’ll need to convince your insurance company that you require care from a dietitian.
The only exceptions are patients with both celiac disease and diabetes. Because Medicare has ruled that patients with diabetes require medical nutritional counseling, other insurance companies will approve nutritional counseling forpeople with diabetes.
If you are faced with the challenge of convincing your insurance company to give its approval, you need to prove that medical nutritional therapy from a registered dietitian is (1) medically necessary in your case and (2) the standard of care for patients with celiac disease. The following suggestions might help:
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Aguiar EV, Santos FG, Krupa-Kozak U, Capriles VD.Nutritional facts regarding commercially available gluten-free bread worldwide: Recent advances and future challenges.Critical Reviews in Food Science and Nutrition. 2023;63(5):693-705. doi:10.1080/10408398.2021.1952403Marciniak M, Szymczak-Tomczak A, Mahadea D, Eder P, Dobrowolska A, Krela-Kaźmierczak I.Multidimensional disadvantages of a gluten-free diet in celiac disease: A narrative review.Nutrients. 2021;13(2). doi:10.3390/nu13020643Abdi F, Zuberi S, Blom JJ, Armstrong D, Pinto-Sanchez MI.Nutritional considerations in celiac disease and non-celiac gluten/wheat sensitivity.Nutrients. 2023;15(6). doi:10.3390/nu15061475Villafuerte-Galvez J, Vanga RR, Dennis M, et al.Factors governing long-term adherence to a gluten-free diet in adult patients with coeliac disease.Aliment Pharmacol Ther. 2015;42(6):753-760. doi:10.1111/apt.13319Academy of Nutrition and Dietetics.Becoming a registered dietitian nutritionist.Academy of Nutrition and Dietetics.About RDNs and NDTRs.Bureau of Labor Statistics, U.S. Department of Labor.Occupational Outlook Handbook, Dietitians and Nutritionists.Rubio-Tapia A, Hill ID, Semrad C, et al.American College of Gastroenterology guidelines update: diagnosis and management of celiac disease.Am J Gastroenterol. 2023;118(1):59-76. doi:10.14309/ajg.0000000000002075
Aguiar EV, Santos FG, Krupa-Kozak U, Capriles VD.Nutritional facts regarding commercially available gluten-free bread worldwide: Recent advances and future challenges.Critical Reviews in Food Science and Nutrition. 2023;63(5):693-705. doi:10.1080/10408398.2021.1952403
Marciniak M, Szymczak-Tomczak A, Mahadea D, Eder P, Dobrowolska A, Krela-Kaźmierczak I.Multidimensional disadvantages of a gluten-free diet in celiac disease: A narrative review.Nutrients. 2021;13(2). doi:10.3390/nu13020643
Abdi F, Zuberi S, Blom JJ, Armstrong D, Pinto-Sanchez MI.Nutritional considerations in celiac disease and non-celiac gluten/wheat sensitivity.Nutrients. 2023;15(6). doi:10.3390/nu15061475
Villafuerte-Galvez J, Vanga RR, Dennis M, et al.Factors governing long-term adherence to a gluten-free diet in adult patients with coeliac disease.Aliment Pharmacol Ther. 2015;42(6):753-760. doi:10.1111/apt.13319
Academy of Nutrition and Dietetics.Becoming a registered dietitian nutritionist.
Academy of Nutrition and Dietetics.About RDNs and NDTRs.
Bureau of Labor Statistics, U.S. Department of Labor.Occupational Outlook Handbook, Dietitians and Nutritionists.
Rubio-Tapia A, Hill ID, Semrad C, et al.American College of Gastroenterology guidelines update: diagnosis and management of celiac disease.Am J Gastroenterol. 2023;118(1):59-76. doi:10.14309/ajg.0000000000002075
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