Gluten-Free Foods in Rural Maritime Provinces: Limited Availability, High Price, and Low Iron Content.

We investigated the price difference between gluten-free (GF) and gluten-containing (GC) foods available in rural Maritime stores. GF foods and comparable GC items were sampled through random visits to 21 grocery stores in nonurban areas of Nova Scotia, New Brunswick, and Prince Edward Island, Canada. Wilcoxon rank tests were conducted on price per 100 g of product, and on the price relative to iron content; 2226 GF foods (27.2% staple items, defined as breads, cereals, flours, and pastas) and 1625 GC foods were sampled, with an average ± SD of 66 ± 2.7 GF items per store in rural areas and 331 ± 12 in towns. The median price of GF items ($1.76/100 g) was more expensive than GC counterparts ($1.05/100 g) and iron density was approximately 50% less. GF staple foods were priced 5% higher in rural stores than in town stores. Although the variety of GF products available to consumers has improved, higher cost and lower nutrient density remain issues in nonurban Maritime regions. Dietitians working in nonurban areas should consider the relative high price, difficult access, and low iron density of key GF items, and work together with clients to find alternatives and enhance their food literacy.