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  • Jefferson Adams
    Jefferson Adams

    Can Some Celiac Patients Drink Regular Beer?

    Reviewed and edited by a celiac disease expert.

    Celiac.com 06/17/2016 - What role does individual sensitivity play in celiac disease severity and reactions to gluten?

    Researchers in Italy reported on an interesting case of a of a man with a clear diagnosis of celiac disease who nevertheless drank gluten-containing beer, with no physical symptoms, and no clinical issues.



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    The research team included Fabiana Zingone, Ilaria Russo, Angelo Massari, and Carolina Ciacci. They are variously affiliated with the Department of Medicine and Surgery, and the Department of Clinical Pathology and Transfusion Medicine at AOU San Giovanni di Dio e Ruggi D'Aragona in Salerno, Italy.

    The team found that a 4-week period of drinking gluten-containing beer did not provoke significant changes in the intestinal mucosa of this patient with celiac disease nor did it elicit any relevant symptoms. Blood antibody levels rose, but did not reach a pathological threshold.

    It is of course possible that a longer gluten challenge might lead to symptoms and to clinically relevant changes in IgA antitransglutaminase levels. In this case, though, the patient seemed fine and showed no signs of an adverse celiac disease reaction, even though he drank standard non-gluten-free beer.

    Celiac cases like this may be uncommon, but they do show that individual gluten sensitivity can impact symptoms, immunological response and intestinal mucosa health differently, depending on the patient. They also teach us how much more we have to learn about celiac disease.

    Source: BMJ Case Reports 2016; doi:10.1136/bcr-2016-214686



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    All I can say is that many gluten free people have beers of some sort and the topic is definitely hot. When I was diagnosed in UK in the 1970s we were told that gluten is too heavy to pass thru the distillation process. I do drink light beers and have specifically asked for a test a year ago for evidence for contamination in my diet and there were no signs in the blood of gluten antibodies. I have long wanted someone to assess barley gluten and see if there is some way it is seen in the body as different from wheat and rye (which give me reaction by just inhaling the dust from putting an open packet down on the counter!). They did find that oats are gluten free which they were not considered gluten-free for many years.

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    I have had celiac disease for years and switched from beer to rum and coke for a while. I have a niece who went to commissary school in Vancouver and they spent a week on gluten free cooking. She said that beer has gluten in it but there are also"chemicals" in beer that counter act the gluten. I tried a couple of beers without any problems. I stay away from beers listed as wheat beers and have had no problems since. It is nice to be able to drink beer that doesn't cost over $9 a six pack.

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    I read somewhere that gluten was "theoretically" removed from beer during the distillation process. It would be interesting to have this beer drinking man with celiac disease be monitored as he ate or drank other items that have gluten.

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    I read somewhere that gluten was "theoretically" removed from beer during the distillation process. It would be interesting to have this beer drinking man with celiac disease be monitored as he ate or drank other items that have gluten.

    Beer is brewed and fermented, rather than distilled, but this process does remove most gluten.

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    I was diagnosed with celiac several years ago and was quite shocked, as I consumed beer, bread, and all the other wonderful things like pizza at a rate probably exceeding the average and never had any noticeable symptoms. I protested but the doctor said it was a triple confirmed diagnosis (visual scallops, biopsy, and blood work, in that order). I gave up real beer and haven't found any really good gluten-free beers but occasionally "cheat" with pizza or cake, and do not notice any change. If it wasn't for the increased risk of colon cancer and lymphoma I'd probably go back to eating a normal diet. Does anybody else not really have any symptoms despite a firm diagnosis of celiac?

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    I am diagnosed celiac. I cannot eat gluten containing food, without severe pain, cramping, and diarrhea.One or two cookies or crackers, or one slice of bread, is all it takes.Yet I can handle beer fine. I only started a few months ago, I was afraid to try beer, but I was so tempted by all the flavored craft beers out there. My theory is that drinking beer may not be the same as ingesting food, because beer is drunk, rather than eaten, it might bypass the gut.

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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    Scott Adams
    This statement is being distributed by Sapporo Breweries:
    "A representative from Sapporo Breweries, Ltd./Tokyo has advised that Sapporo beer does contain barley. However, after the barley is boiled, the gluten is filtered out along with the barley skins. The representative assured me that although the barley itself does contain gluten, their brewing process effectively removes all the gluten from their beer."
    The following comments were written by Donald D. Kasarda who is a research chemist in the Crop Improvement and Utilization Research Unit of the United States Department of Agriculture. If you have any questions or comments regarding the piece, you can address them to Don at: kasarda@pw.usda.gov.
    The reason that this doesnt make sense for celiac patients has to do with the digestion of the barley hordeins, the proteins that are similar to wheat gliadins in barley. During the malting and fermentation processes, the barley hordeins are broken down into smaller pieces called peptides. It is true that no intact hordein proteins can generally be found in beer. However, the smaller pieces of these proteins resulting from enzymatic digestion are often quite water soluble so that they remain in the beer throughout the complete processing to the final product. (Remember that beer is not a distilled product as are whiskey or vodka. Filtration of the beer will not remove these small water-soluble hordein polypeptides.) A barley hordein might have a polypeptide chain including 300 amino acids in its sequence, yet it is reasonably well established by experiments that polypeptides with as few as 13 amino acid residues in the chain can still retain toxicity for celiac patients. These small pieces of the original proteins can (and do) have very different properties from the original larger proteins. In the strict sense, Sapporo is correct that there are no more intact hordeins in their beer. What they cannot claim is that there are no hordein peptides in the beer that might harm celiac patients.
    There is some evidence from analytical methods involving antibodies prepared to gliadins that there are peptides in beer that react with these antibodies. It is not proved beyond any doubt that the peptides in beer are actually toxic to celiac patients, but it is quite possible that the peptides remaining in any barley-based or wheat-based beer, Sapporo included, are harmful to celiac patients. The amount of harmful peptides, if they are present, is likely to be small, but there is no satisfactory analytical data, in my opinion, that defines the amount exactly. So it could be in a range that would be harmful to a celiac patient drinking beer on a regular basis. My guess is, and I emphasize that I cant back this up with scientific results, that a glass of beer once every few months would not do lasting harm to the average celiac patient. By average celiac patient, I mean those who have no obvious allergic character to their disease and do not notice any immediate reaction when they ingest gluten. 


    Scott Adams
    Frederik Willem Janssen is head of the Chemistry Department, Food Inspection Service in Zutphen, and a subsidiary of the Inspector of Health Protection (similar to the FDA in America). Their lab has a special interest in.... modified gluten, edible packaging materials (which may contain gluten), and detection of hidden gluten in foods, including the development of improved detection methods. He is also a member of the Medical/Scientific Advisory Committee of the Dutch Celiac Society.
    Distillation quite effectively removes the gluten and it is very unlikely that splashes of fermented (we call it "moutwijn", i.e. malt wine, can't remember the correct English word for it) will be carried over to the final distillate. If they are present they must have been added afterwards. A couple of years ago we analyzed some distilled liquor for presence of gluten proteins but we couldn't detect any in this set (about 40 different types). The beer test, which consisted of a set of 50 different brands, showed that most brands (35) did contain immunoreactive protein in amounts between 1 and 200 mg/liter. Only 15 contained less than 1 mg/liter. There was a strong correlation between the gluten content and whether wheat had been used as an ingredient!
    I found a report in a periodical by the Flemish Celiac Society of an investigation that was published in 1992 about immunological determination of gluten in beer and some distilled liquor. This confirmed our findings that the gluten content of beer is quite variable (the authors found levels from zero to 400 mg /liter gluten).
    They did find gluten in distilled liquor! The levels varied from zero to 200-mg gluten/liter. The highest amount was found in a "Creme de Framboise" (200 mg/liter) but second was a French brandy VSOP with a score of 180 m g/liter. A Dutch gin was negative, which might be an indication that gluten in these type of liquor is not a carry over to the distillate! My guess is that this gluten is derived from the caramel coloring, though there is no proof about this yet. I always advise sensitive patients to abstain from brown colored liquor!
    I would like to stress that the determination of gluten in these types of products is very unreliable and we have to count with false positive as well as false negative values. The gluten proteins could have been broken down to small (but still toxic) peptides and in that case a sandwich-type ELISA might produce false negative results because in that case you always need to two epitopes (binding sites for the antiserum) on one molecule to get a positive reaction. A competitive type assay would be the choice for this type of product, but we haven't tried this type of analysis yet. We did use it on a soy sauce, which was prepared with wheat gluten and didn't find any gliadin, which might be an indication that gluten had been broken down to very small peptides with less than one binding site.
    Best wishes,
    Frederik Willem Janssen, Zutpen, The Netherlands. 
     


    Scott Adams
    Celiac.com 07/12/2004 - There have been numerous claims that traditional barley-based beers are gluten free or that all beers are gluten free. Unfortunately, the area is very grey and substantiated on technicalities. The purpose of this post is to eliminate the confusion about gluten as it relates to beer. Gluten is an umbrella term used to describe a mixture of individual proteins found in many grains. Celiac disease (celiac sprue or gluten intolerance, gluten sensitivity) is an autoimmune disorder that is triggered by the ingestion of some of these glutens. People with classic celiac disease are intolerant to the gluten proteins found in wheat, barley, rye, spelt and a couple other lesser known grains. All these grains have a relative of the gluten protein. Interestingly, corn, rice and sorghum also have gluten proteins but are not toxic to celiacs. Herein lies one of the fundamental problems; the use of the term gluten intolerance to cover only certain gluten containing grains is confusing for consumers and food manufacturers alike. Unfortunately, it seems that the inertia for using celiac disease and gluten intolerance as synonyms is unstoppable. Therefore, it becomes the responsibility of both consumers and manufacturers to make sure the terms being discussed are defined and understood.
    As this relates to beer, there is a gluten protein found in barley. This protein is known as hordein. Wheat gluten is known as gliadin. Rye gluten is known as secalin. Presently, assay tests (or lab tests) are only commercially available for the testing of gliadin. We are unaware of any tests for hordein or any manufacturer that presently tests for hordein (Note: If you know of anyone that does in fact test specifically for hordein, please let us know). Therefore the idea that a barley based beer can be considered gluten free based upon the lack of testing is very difficult to fathom. It should be understood that a company using an assay test for gliadin to test for hordein will not return accurate results.
    There has been widespread speculation that the brewing process eliminates these hordein proteins making all beers gluten-free. Although commercial assay tests for hordein are not available there is conclusive evidence that the brewing process does not degrade hordein to non-toxic levels. A research study in Australia on improving beer haze shows that hordein is still present in beer after the brewing process (http://www.regional.org.au/au/abts/1999/sheehan.htm). Therefore, claims that hordein or gluten is destroyed in the brewing process is unsubstantiated and clearly, based upon the Australian research, is highly questionable.
    Based upon the continuous claims by beer companies that beers are gluten free, it is clear that the issue is misunderstood and, as always, it is up to the consumer to educate them on the facts. Hopefully, the information provided here will give consumers and manufacturers alike the ability to discuss these gluten issues intelligently and effectively.
    About the author: Kevin Seplowitz is the President and Co-founder of the Bards Tale Research Company, LLC and organization that researches the correlations between nutrition, diet, and autoimmune disorders. Bards Tale Research owns and operates Bards Tale Beer Company, LLC (www.bardsbeer.com) a company that develops commercial gluten-free beers. Mr. Seplowitz is a diagnosed Celiac.


    Jefferson Adams
    Celiac.com 09/11/2009 - When is a beer not a beer? When it's gluten-free. Until now.
    Beer perpetually hovers near the top of most celiac lists of things they'd love to have if they could. Until recently, the regulation of labels for beer, wine and spirits fell to a little known government agency called the Alcohol and Tobacco Tax and Trade Bureau.
    Because their regulations relied on the Federal Alcohol Administration Act of 1935, which defined beer as a beverage brewed from malted barley and other grains, gluten-free beers did not meet the strict definition, and could not therefore be labeled as 'gluten-free beer,' as no such standard existed.
    That situation has changed, and the Food and Drug Administration is now charged with the regulation of beer labels. Because of this, gluten-free beer can now be labeled 'gluten-free beer' instead of 'sorghum beer' or 'beer made without wheat or barley', or some such silliness.
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    In people with celiac disease, the immune system reacts to gluten, a protein found in wheat, rye and barley, which causes inflammation in their gut and interfers with the absorption of nutrients.
    All traditional beers are brewed with malted barley and contain gluten. However, specialty micro brewers began making beer from malted sorghum, an African grain, and sometimes rice. Anheuser-Busch followed later with its own sorghum beer. Beers brewed with sorghum and rice are gluten free, which is great for celiacs, but was not in line with the Federal Alcohol Administration Act of 1935, which defines beer as a beverage brewed from malted barley and other grains.
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