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So What Does Gluten-Free Mean, Really?

By: Peter on February 15, 2011.

It’s well known that eating food containing gluten is a critical factor in the development of celiac disease.  The disease develops as a result of an “autoimmune reaction”, meaning that the body considers part of the intestine to be “foreign” and launches an immune attack on itself, resulting in damage to the small intestine.

Gluten-free diet is the only known treatment for celiac disease

Unfortunately, although the disease is quite well understood, there is no known treatment, other than avoiding foods that contain gluten.  As with any food sensitivity, the severity of the reaction depends on the amount of gluten consumed, so celiac patients are instructed to adopt a gluten-free diet.  But what does gluten-free mean?  Surprisingly, this is a very hard question to answer, since everyone reacts to gluten in a different way, and the damage can take years to develop, and a long time to heal.

Gluten-free food labeling

U.S. FDA regulators have struggled with the question of how to provide guidance to consumers by defining a limit for what is “safe”, with the intention of creating a label that manufacturers can use for foods which are “gluten-free”.  Indeed, a regulation was due in 2008 or earlier.  Over the past few years, with input from the scientific community— plus the public and industry— draft guidelines have been created.  The most informed guideline from the FDA states that foods labeled as “Gluten-Free” can be summarized as follows:

  1. Not containing flour from wheat, barley or rye
  2. Containing less than 20 ppm (parts per million) gluten; in other words, roughly 20 milligrams of gluten in 1,000,000 milligrams of food.

The Codex Alimentarius, prepared by the World Health Organization, and used as a guideline in Europe and other countries, gives recommendations similar to the FDA guidelines.

What is 20 ppm gluten in food?

Most people don’t think in terms of ppm, so here’s a rough, quick way to think about it:  20 ppm is like having the amount of gluten typically contained in a crumb of bread (about the size of a grain of rice) in a one-ounce serving of food (about 30 g).  (N.B. Rice does not contain gluten).

How can gluten content be measured?

Again, this is not as simple as it might seem.  A test called an ELISA is used to measure gluten; however, since glutens vary between different sources, and the reactivity of the test depends on the particular form of the gluten protein, all values should be viewed as approximate.

Sources:

FDA, 2007:  Gluten-Free Labeling of Foods

Codex Alimentarius

Systematic review: tolerable amount of gluten for people with coeliac disease by A.K. Akobeng & A.G. Thomas, Alimentary Pharmacol. & Ther., 2008, 27, 1044-1052 - Wiley Online Library.

Gluten measurement and its relationship to food toxicity for celiac disease patients by D. R. Lester, Plant Methods, 2008, 4, 26.

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