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Is Any Amount of Gluten Safe for Those with Celiac Disease?
Celiac Disease is essentially an autoimmune disorder that is triggered by eating foods containing gluten, which is in wheat, rye, and barley products. While there are blood tests to detect the disease, the true confirmation of the diagnosis requires doing a biopsy of several sites in the small bowel. If the villi in the small bowel show damage, the diagnosis is confirmed.
Non-celiac gluten sensitivity: does it exist?
There's been a fair amount of coverage in the health news on recent research into non-celiac gluten sensitivity (NCGS). A study that appeared to confirm the existence of NCGS was refuted by a later study, performed by the same team. Their conclusion was that despite their earlier research, they could find no evidence that non-celiac gluten sensitivity exists.
Got IBS? You Might Have Celiac Disease
We don't know exactly what causes Irritable Bowel Syndrome (IBS). Those with IBS often have stomach pain, bloating and diarrhea, and their symptoms come and go: people with IBS can go for some time without symptoms and then have flare-ups. The guidelines that doctors use to diagnose IBS vary from country to country and even professional association to professional association.
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In my column, "10 Things you Need to Know About Reading Food Labels," I explain the FDA rules on labeling foods things like "no cholesterol," "low-calorie," or "more fiber." The FDA is now considering a proposed rule regarding the labeling of foods as gluten-free, under the Food Allergen and Consumer Protection Act. This would work much like the "no cholesterol" rule, in which a label can state "corn oil margarine, a no cholesterol food," because ALL corn oil margarines do not contain cholesterol. Foods with a single ingredient, such as a non-wheat grain like millet, could then carry a gluten-free label because millet does not contain wheat gluten.
But what if these foods might be contaminated during processing, or even in the field? Schar, a food manufacturer spec\ializing in gluten-free foods (we've reviewed some of their foods, including a gluten-free pizza crust), worked with an independent nutritional consultant to gauge the amount of gluten contamination, if any, in foods that under the proposed rule would be considered gluten-free (J Am Diet Assoc 2010;110(6):937-940).
The consultant purchased 22 grains, seeds and flours from local grocery stores or by mail order, then without opening the products, had them sent to a company that specializes in analyzing for gluten content, using a standardized test.
The international standard for considering a food gluten-free is less than 20 parts per million (ppm). Of the 22 tested foods, 13 of these foods registered less than 5 ppm of gluten, meaning that they are legitimately gluten-free, even though 3 were labeled with an allergen statement indicating that they might be contaminated.
Nine of the 22 foods contained unacceptable amounts of gluten, ranging from 8.5 ppm to 2,925 ppm. Only four of these were labeled with a gluten contamination advisory statement, however.
Even though all of the foods tested would, under the proposed FDA rule, be able to be labeled "a gluten-free food," Schar's analysis demonstrates that not all of these foods would be considered gluten-free according to accepted testing standards.
While this is a very small study and is somewhat suspect due to its funding by a company that produces gluten-free foods, it is certainly cause for some caution. If you have Celiac disease and are concerned about cross-contamination in foods such as millet, buckwheat flour, soy flour, cornmeal, or other non-wheat flours, look for a statement that the food is tested and confirmed gluten-free.
First posted: March 2, 2011