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Consumption of gluten-free products: should the threshold value for trace amounts of gluten be at 20, 100 or 200 p.p.m.?
Eur J Gastroenterol Hepatol. 2006 Nov; 18(11):1187-95.EJ

Abstract

OBJECTIVE

The threshold of gluten contamination in gluten-free products of both dietary and normal consumption is under debate. The objective of this study was to gather information on consumption of gluten-free products intended for dietary use of people under a gluten-free diet. This information is essential to ascertain the exposure of coeliac patients to gluten through their diet and deduce the maximum gluten content that these products should contain to guarantee a safe diet.

METHODS

A diet diary of consumption of gluten-free products intended for dietary use was distributed to the coeliac societies of two typical Mediterranean countries (Italy and Spain) and two Northern countries (Norway and Germany). The diet diary included a self-weigh table of the selected food items and a 10-day consumption table. Results were reported in percentiles as distributions were clearly right skewed.

RESULTS

The respondents included in the study accounted for 1359 in Italy, 273 in Spain, 226 in Norway and 56 in Germany. Gluten-free products intended for dietary use contributed significantly to the diet of coeliac patients in Italy, Germany and Norway and to a lesser degree in Spain. The most consumed gluten-free product in all countries was bread, and it was double consumed in the Northern countries (P<0.001). Mediterranean countries showed consumption of a wider variety of gluten-free foods and pasta was eaten to a large degree in Italy.

CONCLUSIONS

The differences between Northern and Mediterranean countries were not in the total amount of gluten-free products but in the type of products consumed. The observed daily consumption of gluten-free products results in the exposure to rather large amounts of gluten, thus the limit of 200 p.p.m. should be revised. A limit of 20 p.p.m. for products naturally gluten-free and of 100 p.p.m. for products rendered gluten-free is proposed to guarantee a safe diet and to enable coeliac patients to make an informed choice. These limits should be revised as new data become available.

Authors+Show Affiliations

SMAP Celíacs de Catalunya, Coeliac Society, Barcelona, Spain. agibert@celiacscatalunya.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17033440

Citation

Gibert, Anna, et al. "Consumption of Gluten-free Products: Should the Threshold Value for Trace Amounts of Gluten Be at 20, 100 or 200 P.p.m.?" European Journal of Gastroenterology & Hepatology, vol. 18, no. 11, 2006, pp. 1187-95.
Gibert A, Espadaler M, Angel Canela M, et al. Consumption of gluten-free products: should the threshold value for trace amounts of gluten be at 20, 100 or 200 p.p.m.? Eur J Gastroenterol Hepatol. 2006;18(11):1187-95.
Gibert, A., Espadaler, M., Angel Canela, M., Sánchez, A., Vaqué, C., & Rafecas, M. (2006). Consumption of gluten-free products: should the threshold value for trace amounts of gluten be at 20, 100 or 200 p.p.m.? European Journal of Gastroenterology & Hepatology, 18(11), 1187-95.
Gibert A, et al. Consumption of Gluten-free Products: Should the Threshold Value for Trace Amounts of Gluten Be at 20, 100 or 200 P.p.m.. Eur J Gastroenterol Hepatol. 2006;18(11):1187-95. PubMed PMID: 17033440.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Consumption of gluten-free products: should the threshold value for trace amounts of gluten be at 20, 100 or 200 p.p.m.? AU - Gibert,Anna, AU - Espadaler,Montserrat, AU - Angel Canela,Miguel, AU - Sánchez,Anna, AU - Vaqué,Cristina, AU - Rafecas,Magda, PY - 2006/10/13/pubmed PY - 2007/1/5/medline PY - 2006/10/13/entrez SP - 1187 EP - 95 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 18 IS - 11 N2 - OBJECTIVE: The threshold of gluten contamination in gluten-free products of both dietary and normal consumption is under debate. The objective of this study was to gather information on consumption of gluten-free products intended for dietary use of people under a gluten-free diet. This information is essential to ascertain the exposure of coeliac patients to gluten through their diet and deduce the maximum gluten content that these products should contain to guarantee a safe diet. METHODS: A diet diary of consumption of gluten-free products intended for dietary use was distributed to the coeliac societies of two typical Mediterranean countries (Italy and Spain) and two Northern countries (Norway and Germany). The diet diary included a self-weigh table of the selected food items and a 10-day consumption table. Results were reported in percentiles as distributions were clearly right skewed. RESULTS: The respondents included in the study accounted for 1359 in Italy, 273 in Spain, 226 in Norway and 56 in Germany. Gluten-free products intended for dietary use contributed significantly to the diet of coeliac patients in Italy, Germany and Norway and to a lesser degree in Spain. The most consumed gluten-free product in all countries was bread, and it was double consumed in the Northern countries (P<0.001). Mediterranean countries showed consumption of a wider variety of gluten-free foods and pasta was eaten to a large degree in Italy. CONCLUSIONS: The differences between Northern and Mediterranean countries were not in the total amount of gluten-free products but in the type of products consumed. The observed daily consumption of gluten-free products results in the exposure to rather large amounts of gluten, thus the limit of 200 p.p.m. should be revised. A limit of 20 p.p.m. for products naturally gluten-free and of 100 p.p.m. for products rendered gluten-free is proposed to guarantee a safe diet and to enable coeliac patients to make an informed choice. These limits should be revised as new data become available. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/17033440/Consumption_of_gluten_free_products:_should_the_threshold_value_for_trace_amounts_of_gluten_be_at_20_100_or_200_p_p_m_ L2 - https://doi.org/10.1097/01.meg.0000236884.21343.e4 DB - PRIME DP - Unbound Medicine ER -