Trace Amounts of Gluten Acceptable in the Treatment of Celiac Disease

Alimentary Pharmacology & Therapeutics, Volume 19 Issue 12 Page 1277 - June 2004

Celiac.com 06/28/2004 – According to celiac disease researchers gluten contamination in gluten-free products cannot be totally avoided. With this in mind they set out to determine the safe threshold of gluten in the diets of those with celiac disease. To determine this level they measured the gluten content of 59 naturally gluten-free and 24 Codex quality wheat starch-based gluten-free products using the enzyme-linked immunosorbent assay test. The daily intake of flours was calculated in 76 adults on gluten-free diets and was then compared with their biopsies (mucosal histology). The researchers found that 13 of the 59 naturally gluten-free products and 11 of 24 Codex quality wheat starch-based gluten-free products contained gluten in the amount of 20 to 200 ppm (=mg/kg). The average flour intake for the group was 80g, and this ranged between 10g at the low end, and 300g on the high end.

The researchers conclude that the threshold for gluten in the diets of those with celiac disease can safely be set at 100 ppm. Even those in the study who consumed flour at the high end--300g per day with a gluten level of 100 ppm--only consumed 30mg of gluten per day. The researchers determined that this level was safe when correlated to their histology in both clinical and challenge studies. Last, this level can be achieved by the food industry, will not make the diet too cumbersome, and will have the additional benefit of encouraging additional food companies to get into the gluten-free food market.