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  • Jefferson Adams
    Jefferson Adams

    Gluten-Free Restaurant Food Often Contains Gluten

    Reviewed and edited by a celiac disease expert.

      Crowd sourced Nima study reveals restaurant food labeled gluten-free often contains gluten.


    Caption: Image: CC--Nima Labs

    Celiac.com 04/05/2019 - Avoiding gluten is literally the most important dietary practice for people with celiac disease. A gluten-free diet is the only way to avoid major health problems down the line.

    Until now, anyone on a gluten-free diet looking to eat food in restaurants had to rely on lots of detective work, gathering information from menus, word of mouth, intuition, and restaurant workers' advice, with little or no supporting data. 

    Portable Gluten Detection Data Drives Restaurant Study

    With the development of handheld gluten detection devices, like Nima, it’s now possible to take some of the guesswork out of equation by testing small bits of food on site in real time before it is consumed.

    A team of researchers recently analyzed data from Nima portable gluten detection devices, collected across the United States during an 18-month period by users who opted to share the results of their point-of-care tests.

    The research team included Lerner, Benjamin A., MD; Lynn T. Phan Vo, BA; Shireen Yates, MBA; Andrew G. Rundle, Dr PH; Peter H.R. Green, MD; and Benjamin Lebwohl, MD, MS.

    They are variously affiliated with the Department of Medicine, Celiac Disease Center, Columbia University Medical Center, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA; and with Nima Labs in San Francisco, California, USA.

    The study team used crowd-sourced data from users of a portable gluten detection device to estimate gluten contamination rates and identify risk factors in supposedly gluten-free restaurant foods

    Opt-In Study Shares Gluten Data with Researchers

    The team analyzed data voluntarily shared by users of Nima gluten detection devices to check restaurant meals across the United States during an 18-month period. The team sorted data by region, restaurant type, food items, time of day, and median household income near the restaurants tested. 

    The team used the χ2 test for bivariate analysis and multiple logistic regression for multivariate analysis to identify predictors of gluten detection in restaurant food.

    Gluten Found in One-Third of Gluten-Free Restaurant Foods

    In all, the data included 5,624 tests, conducted by 804 users over 18 months. Data showed gluten in just under one-third of foods advertised as Gluten-Free in restaurants. Gluten detection was highest with dinner foods, at 34.0%, compared with 27.2% for breakfast tests (P = 0.0008). 

    Pizza & Pasta Major Gluten Culprits

    Of all the foods tested, pizza and pasta labeled as gluten-free were most likely to test positive for gluten, with gluten detected in 53.2% of pizza and 50.8% of pasta samples. 

    On multivariate analysis, food sold as gluten-free was less likely to test positive for gluten in the West than in the Northeast United States, yielding an odds ratio of 0.80 and a 95% confidence interval 0.67–0.95). This analysis of crowd-sourced data suggests that a high percentage of restaurant foods labeled gluten-free contain detectable gluten, especially pizza and pasta, where it’s over 50%.

    The Nima device is highly accurate and very sensitive to gluten. In some cases, Nima may detect levels below 20ppm. So, in theory some of these readings might be for foods that are actually gluten-free. Still, these findings are alarming. 

    The team’s findings of high rates of gluten contamination in general, and in pizza and pasta, in particular, are a sobering reminder for people with celiac disease to choose carefully when dining out. Please be careful when eating out. Stay tuned for the latest news and information regarding gluten contamination in food labeled gluten-free.

    Read more at American Journal of Gastroenterology: March 26, 2019

    Discosure: Nima is a paid advertiser on Celiac.com, but publication of this summary is not influenced by their ad.


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    Well, I'm glad there is a study to back this up, but honestly, it's not news to me.  Out of approximately every 10 visits to a restaurant that gave me 'gluten free' food I would estimate that 8 or 9 of those visits gave me a reaction.  A lot of the servers/cooks/staff are genuinely trying, but I stopped going to these places.  I just don't think they have the facilities and/or understanding to make a safe meal.  Cooking at home is just the best prospect for me at the moment.  Don't know how in the world I'm going to travel anywhere... .

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    2 hours ago, Ging said:

    Well, I'm glad there is a study to back this up, but honestly, it's not news to me.  Out of approximately every 10 visits to a restaurant that gave me 'gluten free' food I would estimate that 8 or 9 of those visits gave me a reaction.  A lot of the servers/cooks/staff are genuinely trying, but I stopped going to these places.  I just don't think they have the facilities and/or understanding to make a safe meal.  Cooking at home is just the best prospect for me at the moment.  Don't know how in the world I'm going to travel anywhere... .

    I fully agree, not only that but the restaurants have their butt's covered by the statement normally located on the Gluten Free menu or under the foods listed Gluten Free stating they cannot guarantee the food has not been cross contaminated! Or this is what's listed on the menu's I've viewed in the past at the restaurants where I'm located!

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    It’s no wonder pizza and pasta are the biggest culprits.  Think about the usual restaurant kitchen environment where pizzas and pasta are made...wheat flour is often in abundance and anyone who bakes knows flour can get in the air and settle everywhere.  As far as pasta goes, gluten-free pasta might get boiled in the same pots or even in the same water that was already used to boil regular wheat pasta.  I try to avoid restaurants where wheat or gluten-containing flour is used for fresh baking and I’ve learned not to trust gluten-free pasta in most restaurants.  I’ve had best luck with steakhouses, Mexican food places (make sure those corn tortilla are made with corn only - no wheat added), and sometimes Indian and Thai restaurants.  I avoid places that tout their own on-site baking, and Italian places in general (lots of pizza and pasta creation).

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    Guest Made in Finland

    Posted

    When it comes to traveling overseas and making sure the advertised gluten free food really IS gluten-free, I recommend to visit my natal Finland! Apart from extensive gluten-free menus at restaurants, you can also get gluten-free sandwiches and whatever pastries like everyone else when you stop at a gas station. No more "hmmmm, I'm hungry, but no FG stuff to buy" - everything everyone else can buy, you can buy a gluten-free version of. It's made separately and tastes just as awesome as regular versions! Yum! No more second guessing. In general, I've seen more gluten-free products there than anywhere else in the world, and I've lived and traveled around the world (now living in the U.S.) 😉😊  

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    As someone with "silent" celiac (no overt physical reaction) I rely on the website Findmeglutenfree.com where I can read about the experiences of other people with celiac at specific restaurants.  That usually gives me confidence when choosing a safe restaurant.  When there are no reviews or the reviews are old, I have to go with talking to a manager and emphasizing with my server the importance of avoiding gluten for me. 

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  • About Me

    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 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. 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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