Gluten-free eating was reported by 0.9% of the U.S. population aged 6 and older in 2009–2010 and 1.7% in 2013–2014. The available evidence also separates diagnosed celiac disease from gluten avoidance without that diagnosis, while showing meaningful labeling, cost, eating-out and biomarker considerations.
Key Gluten-Free Diet Statistics
The figures below summarize the most useful measures across the available U.S. and UK evidence:
- In 2009–2010, 0.9% of the U.S. civilian noninstitutionalized population aged 6 and older reported a gluten-free diet.
- In 2013–2014, 1.7% of the same U.S. population reported a gluten-free diet.
- From 2009–2010 to 2013–2014, people without celiac disease avoiding gluten rose from 0.5% to 1.7% in the U.S. population aged 6 and older.
- Across 2009–2014, the estimated U.S. prevalence of people without celiac disease avoiding gluten was 1.1%, or approximately 3.1 million people aged 6 and older.
- In U.S. NHANES 2009–2010, celiac disease prevalence was 0.71%, equivalent to about 1 in 141 people aged 6 and older.
- In the same 2009–2010 U.S. cycle, 0.63% of participants reported following a gluten-free diet.
- U.S. celiac disease prevalence was 0.7% in 2009–2010, 0.8% in 2011–2012 and 0.7% in 2013–2014.
- In NHANES 2009–2012, positive celiac serology was found in 1.08% of non-Hispanic White participants.
- In NHANES 2009–2012, 85% of gluten-free diet reporters had never been diagnosed with celiac disease.
- In NHANES 2009–2012, 99% of gluten-free diet reporters had negative celiac disease serology.
- In the 2009–2010 U.S. survey, gluten-free diet prevalence among people without celiac disease was 0.58% in females and 0.37% in males.
- The FDA gluten-free labeling standard requires unavoidable gluten to remain below 20 parts per million in a labeled food.
- In a 2024 Coeliac UK survey, 77% of respondents reported struggling to afford gluten-free products.
- In the same UK survey, 4% of respondents with coeliac disease reported actively eating gluten because of cost concerns.
- In the Coeliac UK comparison basket, gluten-free pasta cost 3.1 times the conventional equivalent on average through March 2024.
- The Coeliac UK Eating Out Survey 2023 received 4,538 responses from UK adults on a gluten-free diet.
- In that November 2023 UK survey, 60% of respondents were aged over 55.
- Among 7,471 U.S. NHANES participants analyzed for metal biomarkers in 2009–2014, the gluten-free group had an adjusted urinary total arsenic geometric mean of 12.1 micrograms per liter versus 7.8 in the non-gluten-free group.
Contents
- U.S. gluten-free diet prevalence and trends
- Celiac disease and undiagnosed gluten avoidance
- Race, sex and participant characteristics
- Gluten-free labeling and the FDA 20 ppm standard
- Gluten-free diet cost and affordability data
- UK gluten-free eating-out survey statistics
- Measured metal biomarkers and gluten-free diets
U.S. Gluten-Free Diet Prevalence and Trends
National Health and Nutrition Examination Survey (NHANES) estimates show a rise in self-reported gluten-free diet use among U.S. people aged 6 and older. These are survey-weighted estimates for the civilian noninstitutionalized population, not clinical diagnoses.
| NHANES cycle | Total gluten-free diet prevalence | Population and measure |
|---|---|---|
| 2009–2010 | 0.9% | U.S. people aged 6+, self-reported diet |
| 2011–2012 | 1.2% | U.S. people aged 6+, self-reported diet |
| 2013–2014 | 1.7% | U.S. people aged 6+, self-reported diet |
Source: Less hidden celiac disease but increased gluten avoidance without a diagnosis in the USA.
The study’s operational category for people without celiac disease avoiding gluten, or PWAG, increased from 0.5% in 2009–2010 to 1.0% in 2011–2012 and 1.7% in 2013–2014. Across 2009–2014, the weighted estimate was 1.1%, corresponding to approximately 3.1 million Americans aged 6 and older.
Among 243 NHANES participants who reported a gluten-free diet across those cycles, 30 reported a clinical celiac diagnosis and 213 were classified as PWAG. The counts are sample observations, while the prevalence estimates are weighted; PWAG is not a confirmed diagnosis of non-celiac gluten sensitivity.
Celiac Disease Statistics Compared With Gluten Avoidance
Celiac disease and gluten avoidance are related but different measures. In NHANES 2009–2010, celiac disease prevalence was 0.71%, about 1 in 141 people aged 6 and older, while 0.63% reported following a gluten-free diet.
The celiac definition used positive serology or a reported clinical diagnosis plus a gluten-free diet, and not every case had biopsy confirmation. Of 7,798 participants, 35 met the study definition and 29 were unaware of their diagnosis based on the interview data.
| Measure | 2009–2010 | 2011–2012 | 2013–2014 |
|---|---|---|---|
| Celiac disease prevalence | 0.7% | 0.8% | 0.7% |
| Undiagnosed celiac disease | 0.6% | Not stated | 0.3% |
Source: The prevalence of celiac disease in the United States and Less hidden celiac disease but increased gluten avoidance without a diagnosis in the USA.
The differences in celiac prevalence across the three NHANES cycles were not statistically significant. Undiagnosed celiac disease fell from 0.6% to 0.3%, and its share of the study’s gluten-related occurrence categories fell from 51% in 2009–2010 to 12% in 2013–2014; that share is not general-population celiac prevalence.
Gluten-Free Diet Data by Race, Sex and Participant Characteristics
A separate analysis of 14,701 NHANES participants from 2009–2012 found serologic evidence of celiac disease in 0.79% of the U.S. sample. The study’s race and ethnicity categories produced different estimates, but subgroup results should be read with the reported confidence intervals and definitions.
- Positive celiac serology was 1.08% among non-Hispanic White participants, 0.23% among Mexican participants, 0.22% among non-Hispanic Black participants, 0.38% among other Hispanic participants and 0.15% in the study’s other-races category.
- Among serology-positive participants, both tTG and EMA were positive for 72.0% of non-Hispanic White participants and 31.7% of other-race participants.
- Weak tTG plus positive EMA occurred in 3.6% of non-Hispanic White participants and 26.4% of other-race participants within the serology-positive comparison.
Source: Racial Differences in the Prevalence of Celiac Disease in the US Population.
In that 2009–2012 analysis, 0.9% reported following a gluten-free diet. Of those reporters, 85% had never received a celiac diagnosis and 99% had negative celiac serology; negative serology does not address every possible gluten-related condition.
In the 2009–2010 U.S. survey, gluten-free diet prevalence among participants without celiac disease was 0.58% in females and 0.37% in males, a difference that was not statistically significant (p=0.34). Those reporting a gluten-free diet had a mean age of 46.6 years, compared with 40.5 years for those not reporting one; this was a cross-sectional association, not an age-specific prevalence estimate.
Gluten-Free Labeling and the FDA 20 ppm Standard
The U.S. Food and Drug Administration’s gluten-free labeling rule became effective on September 4, 2013, and FDA-regulated foods using the claim were required to comply by August 5, 2014. The claim is voluntary, but foods using it must meet the regulatory definition.
The FDA standard requires unavoidable gluten in a food bearing the gluten-free claim to be below 20 parts per million. This concentration is equivalent to 20 milligrams per kilogram of food; it is not a serving-size limit, recommended daily intake or guarantee of suitability for every person.
Foods may not use the claim when ingredients or cross-contact result in 20 ppm or more gluten in the finished food. These requirements apply to foods using the voluntary claim under FDA jurisdiction.
Source: Guidance for Industry: Gluten-Free Labeling of Foods.
Gluten-Free Diet Cost Statistics and Affordability Barriers
Coeliac UK’s 2024 survey report describes affordability among more than 1,000 community respondents, so it is not a probability sample of everyone following a gluten-free diet. Still, it documents a substantial reported barrier for respondents managing the diet.
- 77% reported struggling to afford gluten-free products in the 2024 Coeliac UK survey.
- 4% of respondents with coeliac disease reported actively eating gluten because of cost concerns.
The comparison basket used UK Minimum Income Standard products with prices collected through March 2024. The multipliers compare selected gluten-free products with conventional equivalents, rather than representing a national retail price index.
| Product category | Average gluten-free price compared with conventional equivalent | Scope |
|---|---|---|
| Pasta | 3.1 times | UK comparison basket, prices through March 2024 |
| Bread rolls | 2.1 times | UK comparison basket, prices through March 2024 |
| Cereals | 2.0 times | UK comparison basket, prices through March 2024 |
| Crackers | 2.0 times | UK comparison basket, prices through March 2024 |
| Plain flour | 1.7 times | UK comparison basket, prices through March 2024 |
Source: The Gluten Free Diet: What does it cost and why does it matter?.
UK Gluten-Free Eating-Out Survey Statistics
The Coeliac UK Eating Out Survey 2023 received 4,538 responses from UK adults on a gluten-free diet in November 2023. Because 94% were Coeliac UK members or had a gluten-related connection, the results describe a community sample rather than nationally representative UK prevalence.
The sample included 84% with coeliac disease or dermatitis herpetiformis, and 40% had followed a gluten-free diet for more than 10 years. Its duration breakdown was 13% for less than one year, 15% for one to two years, 16% for three to five years and 16% for six to ten years; rounding and the over-10-year category explain why these bands should not be treated as an exact total.
Sixty percent of respondents were aged over 55. Reported additional dietary requirements were 9% lactose-free, 6% vegetarian, 4% pescatarian, 2% vegan, 1% halal and 3% other; categories may overlap.
Source: Eating Out Gluten Free: Coeliac UK Survey 2023.
Gluten-Free Diet Statistics on Measured Metal Biomarkers
A 2009–2014 NHANES analysis examined 7,471 participants with metal biomarker data. Seventy-three self-reported a gluten-free diet, corresponding to a weighted prevalence of 1.2%; the results are adjusted cross-sectional associations and do not prove causation.
| Biomarker | Gluten-free geometric mean | Non-gluten-free geometric mean | Reported comparison |
|---|---|---|---|
| Urinary total arsenic | 12.1 µg/L | 7.8 µg/L | Adjusted ratio 1.5, 95% CI 1.2–2.0 |
| Estimated urinary total arsenic 1 | 6.1 µg/L | 3.2 µg/L | Ratio 1.9, 95% CI 1.3–2.6 |
| Estimated urinary total arsenic 2 | 8.2 µg/L | 6.4 µg/L | Ratio 1.3, 95% CI 1.1–1.4 |
| Urinary dimethylarsinic acid | 5.3 µg/L | 3.7 µg/L | Ratio 1.4, 95% CI 1.2–1.7 |
| Urinary cadmium | 0.18 µg/L | 0.16 µg/L | Cross-sectional comparison |
| Blood lead | 1.1 µg/dL | 0.96 µg/dL | Cross-sectional comparison |
| Blood inorganic mercury | 0.30 µg/L | 0.28 µg/L | Ratio close to null |
Source: The Unintended Consequences of a Gluten-Free Diet.
Urinary arsenic reflects exposure and metabolism rather than a diagnosed health outcome. The source notes that rice may contribute as a substitute grain, but the study does not establish that rice or a gluten-free diet caused the biomarker differences.