Gluten-free bread and other starchy products should provide a large percentage of patients' energy intake. And GPs often do not prescribe sufficient quantities. Fibre intake will fall with the omission of breakfast cereals, breads and biscuits from the diet. Less frequent bowel habits may be perceived as constipation, but are often only relative to the malabsorption diarrhoea suffered previously. Weight gain following a diagnosis of coeliac disease is likely to be due to cessation of malabsorption.
Many patients consume a diet in excess of their energy requirements when malabsorption is present.
The Coeliac Society produces a regularly updated booklet that lists all gluten-free products produced by the major manufacturers and supermarket chains. At diagnosis, many have micronutrient deficiencies as a result of malabsorption. Iron, folic acid and calcium deficiencies are most common. Such deficiencies sometimes lead to the initial diagnosis of coeliac disease. Osteoporosis risk is also elevated in coeliac disease.