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 “Individuals who are on a gluten free diet are consuming more gluten
than we actually imagined. It’s not uncommon for them to be
consuming on average a couple of hundred milligrams a day,” Dr. Jack
A. Syage, CEO of ImmunogenX in Newport Beach, California, and the
study’s lead author, told Reuters Health in a telephone interview.
In people with celiac disease, consuming even microscopic amounts of
the gluten protein in wheat, rye or barley triggers an autoimmune
response that harms the lining of the small intestine. Left
untreated, celiac disease can lead to a host of long-term ill
effects including anemia, osteoporosis and fertility problems.
Hidden gluten is ubiquitous in medications, food additives,
seasonings, sauces, lipsticks and lip balms, fried foods and many
other sources.
Dr. Syage and his team quantified gluten exposure by analyzing
amounts of gluten excreted in stool and urine in people with celiac
disease who were following a gluten-free diet but still experiencing
moderate to severe symptoms.
As reported in the American Journal of Clinical Nutrition, they
estimated that these adults were still being exposed to an average
of 150 to 400 milligrams (or less than two one-hundredths of an
ounce) of gluten a day.
Up to 10 mg of gluten per day is generally considered safe for
people with celiac disease, according to the University of Chicago
Celiac Disease Center.
The study wasn't designed to identify the sources of accidental
gluten exposure.
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Estimates of gluten exposure in the new study are indirect, and
based on several unproven assumptions, said Dr. Carlo Catassi, head
of pediatrics at the Universita Politecnica Delle Marche in Ancona,
Italy, who studies celiac disease but did not participate in the new
research.
“The risk of gluten contamination in the diet of treated celiacs is
very well known,” Dr. Catassi said, adding that the new study’s
estimate was surprisingly high. “Should these data be confirmed by
direct evidence of a frequent high gluten contamination, further
treatments beyond the gluten-free diet would certainly be an
option.”
He added: “The data of this study suggest a ‘pessimistic’ view about
the possibility to maintain a correct gluten-free diet that is not
justified in my opinion, until further studies directly measuring
the amount of gluten contamination will be available.”
Still, the authors conclude, the data suggest “that individuals on a
gluten-free diet cannot avoid accidental gluten intrusions and these
small amounts are sufficient to trigger severe symptomatic
responses.”
Celiac disease patients who are still having symptoms should
re-evaluate their diets under the guidance of a clinician or
dietician, they suggest.
SOURCE: http://bit.ly/2G8B2M9 American Journal of Clinical
Nutrition, online February 26, 2018.
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