Background
Maintaining a strict lifelong gluten-free diet remains the only treatment for celiac disease, yet limited Canadian research has examined barriers to maintaining a safe and sustainable gluten-free diet. This study explored affordability, product access, labelling understanding, and dietary management challenges among Canadian gluten-free consumers.
Methods
A bilingual cross-sectional online survey was conducted in 2025 by researchers at Toronto Metropolitan University and Harper Adams University in collaboration with Celiac Canada. Participants were recruited through Celiac Canada communication channels using a community-based self-selected sampling approach. The survey included 2,485 Canadian respondents with celiac disease, gluten intolerance, or caregiving responsibilities related to gluten-free food purchasing. Data sets were analyzed using descriptive statistics and subgroup comparisons.
Results
Respondents reported substantial ongoing challenges in maintaining a gluten-free diet. Overall, 84% reported difficulty finding gluten-free products, 83% regularly visited multiple stores to obtain gluten-free foods, and 53% were dissatisfied with the available product range. Gluten-free bread emerged as a major concern, with 59% reporting availability problems. Affordability pressures were widespread, with 87% disagreeing that gluten-free foods represented good value for money and 74% reporting worsening costs over time. Financial strain was associated with reducing food quantity, lowering food quality, and cutting healthier foods. Online shopping was used by 31% of respondents; however, 29% of online shoppers reported receiving substitutions in which gluten-free products were replaced with non-gluten-free alternatives. While 74% trusted gluten-free labelling, only 46% correctly identified the Canadian regulatory threshold of less than 20 ppm gluten.
Conclusions
Canadian gluten-free consumers continue to face substantial financial, logistical, and dietary management challenges despite growth in the gluten-free marketplace. Findings highlight the need for improved patient education, retail safeguards, and broader food system supports to support long-term adherence to the gluten-free diet.