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    Traveling Gluten-Free in New Zealand


    Phyllis Morrow
    Image Caption: Photo: CC--megoizzy

    Celiac.com 04/16/2013 - For a celiac traveler from the United States, New Zealand is a pleasure. Gluten awareness is widespread, there are gluten-free food options virtually everywhere you go, and product labeling for allergens and gluten is typical. Because New Zealand is English-speaking, there is no problem communicating gluten-free needs. And, of course, it’s summer there when it’s winter here and it’s beautiful. Who could ask for anything more (other than a shorter plane flight)?


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    Photo: CC--megoizzyWhen my husband and I were planning an extended trip in 2009, I decided that traveling gluten-free would be easier in NZ than in the other destinations that we considered: Bali and Thailand. While Southeast Asian cuisines are rice-based and do include many gluten-free foods, conversations with friends who have lived there made me hesitate. The main problem for us is that we travel mostly on bicycle and like to be away from the major tourist areas. While staff at tourist hotels and luxury resorts may be familiar with food intolerance, once you go off the beaten track, people are unused to accommodating the “odd” requests of foreigners. I knew that in Southeast Asia language barriers would be an issue. My friends warned that the idea of food allergies and intolerance is not well-known there and they thought, too, that cultural conventions of politeness might lead people to assure us that foods were safely gluten-free when, in fact, they were not. On the other hand, my son had spent a week in New Zealand and his scouting report read: “gluten-free products, including bread and crackers, are easy to find even in the smallest convenience stores.”  

    We bicycled in New Zealand again in 2012, and once more we spent two months there. Now, I have suggestions and experiences to report from both North and South Islands.

    First, it’s always good to do some homework.  Before leaving and also while In New Zealand, I suggest  cruising the Internet for information. A useful site is http://www.glutenfreeliving.co.nz/ which displays restaurant and retail store options for various locations. The information is not always up to date (restaurants may close or change hands), but “no worries, mate,” as they say. Other gluten-free options are almost always easy to find.

    If you are traveling on New Zealand Air, be sure to order gluten-free meal options on your trans-Pacific flights. In 2009, I had some concern when I saw the term “low-gluten” in the subject line rather than “no-gluten” or “gluten-free” when customer service replied to my e-mail, but that may have been a legal precaution on their part. In addition to requesting gluten-free meals well in advance, be sure to double-check at the airline counter to make sure that the requests are in the system. I found the food entirely acceptable (and a choice of 77 in-flight movies also helped pass the time…). In fact, on the most recent flight there was an unexpected benefit to being gluten-free: special meals are the first to be served. While the flight attendant was handing my tray to me, the plane hit turbulent air. Meal service was instantly suspended and as far as I could tell I was the only passenger who got to eat for the next hour. Of course, I always take the precaution of carrying some gluten-free food/snacks, as well. You never know when you might need them.

    Actually, I did need them on the 2012 trip – but ironically that was when I couldn’t have them! We had decided to layover for a few days in Fiji to break up the long flight. I anticipated (correctly) that there would be little gluten-awareness in Fiji, so I was traveling with plentiful supplies. But I was dismayed to find that arriving passengers were required to discard all food items, without exception, at the airport. That made the next five days in Fiji a little challenging. I relied on cooking locally available basic resources that I bought in public markets, such as eggs, vegetables, coconut, fish, meat and yams. It was hard to find food that I was sure would be safe in grocery stores and almost impossible in restaurants.

    Because I am a budget traveler, and because I want good control over what I eat, I do prefer to buy and cook my own food in any case. In New Zealand, food items tend to be clearly labeled, much better than they are in the US. All of the larger supermarkets, such as New World, Pack n’ Save, Woolworth’s (locally known as “Woolli’s”), and Countdown have gluten-free breads of various sorts, as well as rice crackers, sweets, and an array of pre-packaged items such as soups, risotto, and curries that may be labeled gluten-free. However, there are always hidden surprises; for example, it was hard to find hummus that did not indicate the possible presence of wheat in the chickpeas (only Lisa’s Organic hummus was gluten-free). The ubiquitous smaller grocery outlets, such as dairies (the equivalent of convenience stores) might or might not have much in the way of gluten-free foods. Traveling by bicycle in more remote areas, such as heading towards East Cape from Opotiki, stores were sometimes far apart and minimally stocked. I occasionally found myself with nothing to eat for lunch but tinned salmon or sardines. Anyone traveling in a car could easily avoid such a situation, though.

    As might be expected, health food and organic food stores typically have a selection of gluten-free food items including bread, snacks, baked goods, pasta and alternative grains. Sometimes they carry gluten-free meat pies and other entrees in the freezer case. They tend to have easily identifiable names, such as Homestead Health, Bin Inn Wholefoods, Commonsense Organics (which carries, among others, Breadman brand fresh baked breads), etc. Always use your own commonsense, though. I did see occasional red flags, such as purportedly gluten-free baked goods unwrapped and sitting in a display case next to other goods baked with wheat flour. In those situations, I politely say that I would like to buy certain items but cannot do so if there’s a chance of gluten contamination. Also, I tell them that I worry that if this is an issue in one part of the store, I can’t be sure about other items they carry. They usually listen carefully to requests that might improve their sales.

    Having stocked upon gluten-free items at a shop in Auckland before a long train trip on the Tranz Scenic to Wellington, I discovered that I would have done fine without that precaution. The canteen on the train featured a line of prepackaged meals under the Wishbone label, all of which were very visibly marked for dietary restrictions including dairy free, gluten free, no meat, low fat, and low glycemic index. I enjoyed the "butter chicken"(tandoori spiced chicken with rice and sliced almonds) for lunch and saved my gluten-free groceries for dinner. On the other hand, when traveling by bus over long distances, I found it necessary to carry my own food. Meal stops on the bus routes were rarely more than ½ hour, and generally restricted one’s choice to a single café or cafeteria-style restaurant that did not have much for the gluten-free traveler.

    We stayed mostly in "backpackers," hostels that have kitchen facilities. They are found everywhere. One tip is to pick backpackers that have high ratings in the BBH New Zealand backpackers network guide. These will be the cleanest and best-organized places. The more highly rated hostels will cost more (it’s okay – they are worth more), but you will save a bit with a BBH membership. Backpacker accommodations range from dormitory-like arrangements to private rooms with bath. They may be large and full of boisterous young people, or small and quiet. With small places, you may have the kitchen almost completely to yourself. In the communal kitchen and eating area there will be a varying selection of cookware, utensils, and dishware. We carry camping gear including a thin plastic cutting board, a nesting pot set, lightweight cups, bowls and utensils, and plastic storage containers labeled with our name. I often used our own cooking pots and plates in backpacker hostels since hostel guests do not always do the best job of cleaning up their dishes. If I did use communal pans or utensils, I washed them thoroughly beforehand, using something other than a possibly contaminated communal sponge or dishrag. It is a good idea to cook and eat outside of the most crowded mealtimes, particularly at large, popular hostels. Otherwise, the atmosphere of “combat cooking” may defeat your efforts to keep gluten off surfaces and people may assume that your newly washed pot is there for them to use.  But it is wonderfully convenient to be able to cook your own food and refrigerate your groceries and leftovers. You need to bag your food, clearly label it with name and date, and make sure that it is sufficiently protected to prevent contamination from other people’s food in a stuffed refrigerator.

    A lot of restaurants and cafés throughout New Zealand offer gluten-free menus or menu options. While you need to be prepared for this not to be true in the more remote areas, even there you will often have pleasant surprises. I do recommend that you advise the waitperson that you are celiac.  If they look at you blankly, say that this requires that you be very strictly gluten-free. If they still look blank, go somewhere else to eat. In a properly gluten-free-conscious place, the staff will confirm with the chef that your menu choice is safe and note the need for special care on your order. I had one worrisome experience after eating at an Indonesian restaurant in Napier. The Dutch owner seemed very knowledgeable about celiac and told me exactly what I could have, including sauces. Afterwards, as we were paying for the meal, I saw that some of the bottled sauces were for sale. I read the label on one and it clearly contained wheat. The owner was mortified and assured me that these were from older stock and that the sauces I was actually served were gluten-free. Life as a celiac is never risk-free – but since I had no reaction later, I can hope he was right.

    The bottom line is that New Zealand really is a great destination for the gluten-free traveler.

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    Thank you so much for this it was a big help when other sites were not much help at all.

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    Guest Gluten free

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    I recently returned from a trip to New Zealand and have a few comments. I thoroughly researched gluten free bakeries and restaurants online while there. I'm sure the bakeries are awesome but, unfortunately, all of the ones in Auckland were closed while I was there over the Christmas holiday. Some were shut until February! Most of the fish and chip shops were not gluten free and we did not have time to go to the few that said they were. That said, food was not a problem as many of the larger grocery stores stock gluten free items. Many of the restaurants also offer a few items (some more than others) and it can be hit or miss. They might not have a full menu but they do have a few things. In Lake Taupo, we did find some restaurants and cafes with gluten free offerings. While limited, it was still better than having to resort to just salads or eggs. Again, it was very hit or miss and I was not able to find any information ahead of time for many of the places. Also note that a lot of the blogs are pretty old and some of the gluten free places simply do not exist anymore.

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    To make blueberry-flavored vodka, Maine Distilleries infuses macerated blueberries in its classic vodka.  After several days of infusing, the ethanol is drawn off and blended with the deionized spring water and a small amount of cane sugar.  No artificial flavors or aromas are added to this product.
    In August 2010, Maine Distilleries launched its third product, Cold River’s gin.  Botanicals are added to the classic vodka to make the gin.  The botanical blend, which dates back to the early days of British gin, contains juniper berries, coriander, lemon peel, orange peel, orris root, angelica root, and cardamom.  After the botanicals are added to the classic vodka, it is distilled for a fourth time and then blended with the deionized spring water to produce Cold River’s gin.
    Alcohol beverage labeling is regulated by the Alcohol and Tobacco Tax and Trade Bureau of the U.S. Treasury.  Under the Bureau’s current labeling regulations, Maine Distilleries is not permitted to print “gluten-free product” on its bottles.  Since the passage of the U.S. Food Allergen Labeling and Consumer Protection Act in 2004, the Bureau has promised to finalize and implement labeling regulations that would require allergen statements on all bottles.  Three million people with celiac disease and another 18 million with gluten sensitivity have been eagerly awaiting the final approval of these long overdue regulations.
    Cold River’s classic vodka has acquired an impressive number of awards for such a new product.  In September 2007, it earned a Five-Star Premium Recommendation from Spirits Journal. In 2008, it was named to Wine Enthusiast’s prestigious list of “Top 50 Spirits,” and earned the magazine’s sole “Classic (96-100) / Highest Recommendation” rating for 2008.  It went on to earn Double Gold at San Francisco’s 2008 World Spirits Competition, and was featured as “The Best American Vodka” in spirits expert F. Paul Pacult’s Kindred Spirits 2.
    Are Cold River’s vodkas and gin gluten free?  Until the new regulations are finalized, it’s tough to say.  Meanwhile, disclosure at Maine Distilleries is as clear as the Cold River.
    FOR MORE INFORMATION:
    Green Thumb Farms
    http://greenthumbfarms.com
    Maine Distilleries
    http://www.mainedistilleries.com
    Gluten Free Dietician - Labeling of Alcohol
    http://www.glutenfreedietitian.com/newsletter/2011/01/18/gluten-free-labeling-of-alcohol/
    Note:  Alcohol beverage labeling for gluten free beer; or, wine and cider containing less than 7 percent alcohol (by volume), is regulated by the Food & Drug Administration.


  • Recent Articles

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics

    Jefferson Adams
    Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination.
    A team of researchers recently set out to develop a method to determine gluten intake and monitor gluten-free dietary compliance in patients with celiac disease, and to determine its correlation with mucosal damage. The research team included ML Moreno, Á Cebolla, A Muñoz-Suano, C Carrillo-Carrion, I Comino, Á Pizarro, F León, A Rodríguez-Herrera, and C Sousa. They are variously affiliated with Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain; Biomedal S.L., Sevilla, Spain; Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Celimmune, Bethesda, Maryland, USA; and the Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, Sevilla, Spain.
    For their study, the team collected urine samples from 76 healthy subjects and 58 patients with celiac disease subjected to different gluten dietary conditions. To quantify gluten immunogenic peptides in solid-phase extracted urines, the team used a lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant GIPs and an LFT reader. 
    They detected GIPs in concentrated urines from healthy individuals previously subjected to gluten-free diet as early as 4-6 h after single gluten intake, and for 1-2 days afterward. The urine test showed gluten ingestion in about 50% of patients. Biopsy analysis showed that nearly 9 out of 10 celiac patients with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed signs of gut damage.
    The ability to use GIP in urine to reveal gluten consumption will likely help lead to new and non-invasive methods for monitoring gluten-free diet compliance. The test is sensitive, specific and simple enough for clinical monitoring of celiac patients, as well as for basic and clinical research applications including drug development.
    Source:
    Gut. 2017 Feb;66(2):250-257.  doi: 10.1136/gutjnl-2015-310148.