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    Common Misunderstandings of Gluten-Free Alcoholic Beverages


    Gryphon Myers


    • Journal of Gluten Sensitivity Winter 2013 Issue


    Image Caption: Photo: CC--Rob Ireton

    Celiac.com 07/16/2013 - Gluten has a way of popping up in some very unexpected products.  Peers (whether online or otherwise) are sometimes our best resource for information regarding these oft-overlooked gluten-containing products, but sometimes speculation gets passed along the grapevine as fact. This has led to some very believable, but ultimately questionable rumors. Alcohol in particular has some of the most persistent rumors regarding gluten content. This is likely because the processes involved with alcohol production are confusing and widely misunderstood. With this article, I hope to address and clear up a few of the most persistent gluten-free alcohol misunderstandings that you've certainly heard before.


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    Photo: CC--Rob IretonMisunderstanding #1: “Not all wine is gluten-free: some vintners age their wine in barrels that are sealed with a wheat paste. This paste contaminates the wine, making it dangerous for consumption by celiac disease sufferers.”

    This is a big one. Wine is naturally gluten-free, but the fact that some vintners use wheat paste to seal their barrels has led many to cut wine out of their diets as a precautionary measure. It's a plausible idea, as some vintners do in fact use wheat paste to seal their barrel heads. However, there are a few key points here that you should consider before cutting wine out of your diet entirely:

     

    1. Because the Tobacco Tax and Trade Bureau currently disallows gluten-free labeling of alcoholic beverages if the producer used “storage materials that contained gluten,” any wine that is labeled gluten-free was aged using a barrel alternative and carries no risk of contamination.
    2. Wines that aren't labeled gluten-free might still be aged using barrel alternatives. Roughly speaking, the more expensive ($12+) Cabernet Sauvignons, Merlots, Zinfandels and red blends are more likely to be aged in oak barrels (and for a longer period of time).
    3. The amount of wheat paste used to seal barrel heads is minimal. It is not the staves of the barrels that are sealed with a wheat flour paste, but the barrel heads.  Furthermore, most wineries thoroughly pressure wash all barrels with boiling hot water before they are used. The last thing vintners want is a contaminated product.

    In order to lay this contamination issue to rest, Tricia Thompson tested a single winery's Cabernet Sauvignon and Merlot, which she was told by the winery were their two wines that spent the most time in wheat-sealed oak barrels. She tested each wine four times: twice with the Sandwich R5 ELISA test, and twice with the competitive R5 ELISA test. The competitive R5 ELISA is the current standard for detecting hydrolyzed (broken down) gluten, while the sandwich R5 ELISA is the current standard for detecting non-hydrolyzed gluten (1). Combined, the tests can reliably test for any possible form of gluten contamination.

    Both extractions of both wines came back with the lowest possible results for both tests:

    • Cabernet Sauvignon
      Sandwich R5 ELISA extraction 1: < 5 ppm gluten
      Sandwich R5 ELISA extraction 2: < 5 ppm gluten
      Competitive R5 ELISA extraction 1: < 10 ppm gluten
      Competitive R5 ELISA extraction 2: < 10 ppm gluten
    • Merlot
      Sandwich R5 ELISA extraction 1: < 5 ppm gluten
      Sandwich R5 ELISA extraction 2: < 5 ppm gluten
      Competitive R5 ELISA extraction 1: < 10 ppm gluten
      Competitive R5 ELISA extraction 2: < 10 ppm gluten

    Conclusion: Wine that is aged in oak barrels contains less gluten than we are currently capable of testing for, whether hydrolyzed or not.

    At this point, a lot of people will begin to shake their heads: “If wine is gluten-free, then why do I get sick when I drink __________ wine?” The likely answer is that you are reacting to something else! Many winemakers use egg whites as a clarifying agent. The amount of egg used is far more substantial than any wheat paste that might have leaked into the wine, so if you know eggs are a problem, this is likely what you are reacting to.  

    If you don't have a problem with eggs, you could also be reacting to sulfites. Many people have problems with them, and some winemakers use them as preservatives.
    Sometimes, it's best to go out and get information directly from the winemaker. They can tell you more about their aging process, and shed light on what may or may not be making you sick.


    Misunderstanding #2: “Distilled spirits that are derived from gluten-containing ingredients can be contaminated with gluten. Only distilled spirits made from non-gluten-containing ingredients, like potatoes, are safe for consumption by celiacs.”

    This idea was likely propagated due to a misunderstanding of the distillation process. Here, I will refer to Megan Tichy, Ph.D's highly informative and clearly written description of the distillation process (2). It is a great read for those who are unclear on the process, and makes it very evident why all distilled spirits are gluten-free by definition.

    To borrow Dr. Tichy's analogy, the distillation process is like boiling a kettle of water with sand at the bottom of it. Let's say you were to collect the water that boiled away as steam using a condensing tube. After boiling the entire kettle away, you would be left with a kettle with nothing but sand at the bottom of it, and a second container of pure distilled water.  There is no way the distilled water could contain any sand, as sand doesn't evaporate. In the same way, gluten doesn't evaporate, and gets left at the bottom of the 'kettle' during distillation. The likelihood of distilled alcohol being contaminated with gluten is about the same as the likelihood of you getting sand in your new cup of perfectly clean water: it would almost have to be intentional! Also keep in mind that many spirits are double, or even triple distilled. Gluten contamination over the course of a single distillation is already highly unlikely, but after consecutive distillations, it is virtually impossible.

    To this, you might ask, “But what if they were to add other ingredients afterward? Those might contain gluten, right?” That's a perfectly valid concern, and yes, you should be concerned about any added ingredients. However, distilled spirits are almost always marketed based on their purity; this is why they go to all the trouble of double and triple distilling in the first place! Manufacturers of spirits want the most concentrated alcoholic product possible, so it is not exactly in their best interest (nor in common practice) to go adding more ingredients. Even so, you should always be mindful of ingredients lists, and cross check them against a reliable gluten-containing ingredients list (such as ours [3]).

    Despite the fact that distilled spirits derived from grains are necessarily gluten-free, some people still seem to have problems with them. I don't have a ready explanation for this, as scientifically, it doesn't make sense. Celiac disease is triggered by gluten, and distilled alcohol contains no gluten. Here is a quick checklist to help rule out reasons why you may or may not react to such drinks:
    [ ] Have you checked for cross contamination possibilities (glass, container, ice cubes, dish washing liquid, drying towel, etc.)?
    [ ] Are you sure that you do not react to distilled alcoholic beverages that are not derived from grains (e.g. potato vodka)? (It could be a reaction to potent alcohol in general.)
    [ ] Did you pour the drink yourself?
    [ ] Are you sure you are not adding anything to the drink that could be cross contaminated or contain gluten?
    [ ] Have you checked the ingredients list against a reliable gluten-containing ingredients list?
    [ ] Have you considered any other allergies you have or might have?
    [ ] Have you contacted the manufacturer for their official response regarding gluten content?

    Oftentimes (especially soon after adopting GFD), the gut is still sensitive and cannot handle alcohol at high proof levels. If you had a bad experience with distilled spirits derived from grain early on in your GFD regimen, you might want to consider giving it another try after your villi have had a chance to heal. You really should not have a reaction once your gut is adjusted to the gluten-free diet. I know it is hard to trust a product derived from wheat, but distillation really, truly does remove all gluten, and it does so every single time.

    Misunderstanding # 3: “'Low gluten' or 'gluten-removed' beers are unsafe, as gluten tests underestimate gluten content in beer. This is because the brewing process breaks the gluten molecules down into pieces that are too small for gluten tests to detect, but are still harmful.”


    This is a point of fierce contention in the gluten-free community, and probably the most confusing argument to follow, as it all surrounds the validity of a variety of super scientific testing procedures. There isn't even a clear answer or 'winner' here, but I'm going to try and break all the information down for you, so you can make an informed decision about these products for yourself.

    The main beef that people seem to have with gluten-removed beers is that they are derived from gluten-containing ingredients, and the gluten removal process is oftentimes undisclosed. This is an offshoot of the same distrust people feel toward distilled spirits, though perhaps a little more warranted given the fact that distillation is a very well documented and 100% reliable form of gluten removal, whereas as far as we know, these brewers are removing gluten using magic and fairy dust.

    The reality is that these brewers (Widmer Brothers, Estrella Damm, Lammsbraeu, to name a few) are removing the gluten from their beer using one or the other, or perhaps a combination of two methods: filtration, and enzymes. Superfine filters can remove gluten particles from the beer, while added enzymes can target gluten particles, causing them to break down to a harmless state more quickly.

    Whatever their methods, these beers need to have their gluten content verified using scientific testing procedures in order to be considered safe for consumption by celiacs. This is where things start to get murky.

    As Tricia Thompson, MS, RD writes on her blog, Gluten-Free Dietitian, the current standard for testing gluten content in foods is a sandwich ELISA test (4). The R5 and omega-gliadin versions of the test are the most widely used, and both have been validated in collaborative trials.

    While sandwich ELISA tests are reliable for detecting gluten in heated and non-heated food items, they are notoriously unreliable for detecting hydrolyzed gluten. Many see this as reason not to trust gluten-removed beers: the fermentation process hydrolyzes gluten in beer, so sandwich ELISA tests cannot accurately quantify their gluten content. If the test is unreliable, we are back where we started, with a once-gluten-containing product that has supposedly been rendered gluten-free by unexplained and unverifiable means; it's a hard pill to swallow!

    However, the sandwich R5 ELISA's weaknesses are well documented and widely known. Most of these brewers are using an entirely different test that was specifically designed to detect partial gluten fragments (peptides) that may still be harmful to the gluten-sensitive. The competitive R5 ELISA is the standard test used to detect these peptides, and although it has not been validated yet, many published studies have found the competitive R5 ELISA to be a reliable indicator of hydrolyzed gluten (5) (6) (7).

    This would all seem well and good since many of these beers test well under the proposed FDA limit of 20ppm gluten content with the competitive R5 ELISA. (As an aside, studies have shown 20 ppm to be an adequately conservative standard for most celiacs [8]). Unfortunately, the discussion doesn't end there. A recent Australian study tested a broad range of both beers brewed from alternate grains (sorghum, millet, etc.), and gluten-removed beers, and found that most gluten-removed beers contained significant levels of barley gluten (hordein) fragments, while beers brewed with alternative grains did not (9). 

    Many have inferred two things from this study: 1) gluten-removed beers are unsafe, and 2) R5 ELISA testing under-reports, or is incapable of testing for the barley gluten, hordein. I would posit that these are both hasty conclusions to make, as the study begs the following questions:

    How much gluten are we talking about?
    It isn't entirely clear from the study what 'significant' levels are, as it quantifies hordein levels on a relative scale, but not in terms of ppm. Yes, it is clear from the study that truly gluten-free beers contain less hordein than gluten-removed beers. It would also seem that some hordein families are just as present in gluten-removed beers as in standard beers whose brewers make no claims as to their gluten content. But this does not mean that any of the beers are over the 20ppm standard. The study actually states that the gluten-removed beers were tested to under 10 ppm, but then indirectly implies that they were not actually under that threshold. This is not necessarily true though! One recent study found that around 50% of standard beers on the market actually test to under 20 ppm gluten content (10). In other words, the average gluten content of beer is lower than you might think. Just because gluten-removed beers may be closer to the average on the study's relative scale than might look safe, this does not mean they contain gluten at levels that would be harmful to the average celiac. Furthermore, the toxicity of hordein and hordein peptides for celiacs still hasn't been conclusively quantified (11).


    Is R5 ELISA really that unreliable?
    The study also makes some interesting claims about the limits of R5 ELISA testing procedures. Specifically, it claims that “The R5 antibody is unable to accurately detect and quantify barley gluten (hordeins) in beer.” This is a slightly misleading statement. It is true that the sandwich R5 ELISA can be inaccurate when detecting hordein levels, but it actually overestimates them, so long as they are not hydrolyzed. Furthermore, that is the sandwich ELISA; there is much evidence to suggest that the competitive R5 ELISA provides an accurate measurement of hordein peptides (6) (7) (12). Conversely, this study employed multiple reaction monitoring mass spectrometry, a testing procedure that has not been validated for gluten testing of foods or fermented alcoholic beverages. I would say that the competitive R5 ELISA has a more proven track record when it comes to testing for hydrolyzed gluten in beer.

    What does it all mean then? Should I drink gluten-removed beer or not?
    Well, that's up to you, of course. As I said before, this is a hotly debated and highly contentious issue in the gluten-free world right now, so I'm hesitant to take one side or the other. If you suffer from refractory sprue, or some other severe form of gluten intolerance, I would advise you to stay away, as the risk simply isn't worth it for you. For more mild sufferers of celiac disease or wheat sensitivity though, if you really miss the taste of beer and gluten-free beers just aren't doing it for you, there is no solid evidence to discredit the results of competitive R5 ELISA testing. Find a beer that is batch tested to under 20 ppm using this test (not sandwich R5 ELISA, though it wouldn't hurt if it was tested by both), try a few sips, and see if you react.

    I've tried to provide all the key information so you can make an informed decision about these beers for yourself, but it never hurts to do your own research! Just know that there are a lot of biased and outdated sources out there; the more recent and scientific the study, the better!

    References:
    (1) Thompson, Tricia, MS, RD. “Wine Aged in Oak Barrels Sealed with Wheat Paste: Test Results for Gluten Contamination.” GlutenFreeDietitian.com, 10 Oct. 2012. Web. 20 Dec. 2012.
    (2) Tichy, Megan, PhD. “Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free?” Celiac.com, 26 Aug. 2009. Web. 20 Dec. 2012.
    (3) Adams, Scott. “Unsafe Gluten-Free Food List (Unsafe Ingredients).” Celiac.com, 27 Nov. 2007. Web. 20 Dec. 2012.
    (4) Thompson, Tricia, MS, RD. “Standards for testing food for gluten: Issues that need addressing.” GlutenFreeDietitian.com, 6 Aug. 2012. Web. 20 Dec. 2012.
    (5) Thompson, Tricia, MS, RD. “Beer: Why it is so hard to assess fermented and hydrolyzed products for gluten.” GlutenFreeDietitian.com, 24 Jul. 2012. Web. 20 Dec. 2012.
    (6) Gessendorfer, Benedict, et al. “Preparation and characterization of enzymatically hydrolyzed prolamins from wheat, rye, and barley as references for the immunochemical quantitation of partially hydrolyzed gluten.” Analytical and Bioanalytical Chemistry 395.6 (Nov. 2009): 1721-1728. Web. 20 Dec. 2012.
    (7) Haas-Lauterbach, S, et al.”Gluten fragment detection with a competitive ELISA.” Journal of AOAC International 95.2 (2012): 377-381. Web. 20 Dec. 2012.
    (8) Thompson, Tricia, MS, RD. “How much gluten is 20 parts per million?” GlutenFreeDietitian.com, n.d. Web. 20 Dec. 2012.
    (9) Colgrave, Michelle, et al. “What is in a Beer? Proteomic Characterization and Relative Quantification of Hordein (Gluten) in Beer.” Journal of Proteome Research 11.1 (2012): 386-396. Web. 20 Dec. 2012.
    (10) Cane, Sue. “Gluten-free beer 2011. How is it made? How is its gluten content tested? And is it really safe for coeliacs?” FoodsMatter.com, 2011. Web. 20 Dec. 2012.
    (11) Thompson, Tricia, MS, RD. “Barley enzymes in gluten-free products.” GlutenFreeDietitian.com, Jun. 2009 (updated 3 Feb. 2011). Web. 20 Dec. 2012.
    (12) Guerdrum, Lindsay, Bamforth, Charles. “Levels of gliadin in commercial beers.” Food Chemistry  129.4 (2011): 1783-1784. Web. 20 Dec. 2012.

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    Guest Martin

    Posted

    I find it wrong advice to promote safety of alcoholic drinks to celiac patients on the basis of gluten content. The main risk with any alcohol (regardless of the gluten content) is that it increases intestinal permeability which allows gluten to cross to the blood stream and trigger autoimmune reaction. Without the permeability issue (caused by alcohol + other dietary and lifestyle choices) the celiac disease may never have developed.

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    Guest Justin

    Posted

    Good article. One problem with celiac disease that is very relevant here is that not every gluten exposure leads to a 'reaction,' yet villous damage may still be occurring. Celiac disease can be insidious; in fact, the majority of the time it is--it's why delay between onset of symptoms and eventual diagnosis with celiac disease averages about 8 years. I was anemic twice in the span of three years before I was diagnosed, and I never had another symptom until just prior to the diagnosis. Many celiacs feel more sensitive to gluten once they've gone gluten-free for a while but you don't have to strain credulity to think an asymptomatic exposure to gluten could occur that could still result in damage. I had an Omission beer last night with no reaction, but I know it's a calculated risk, so I do it infrequently.

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    I have celiac disease, and I won't drink alcohol made from wheat. I don't trust it. I am allergic to corn, and had severe reactions to alcohol distilled from corn. I also react to distilled vinegar made from corn. Just about all other highly corn allergic people report reactions to them, too. But the so-called experts claim that it is not possible. Maybe the distilled alcohol made from wheat wouldn't trigger my celiac symptoms, but I would rather err on the side of caution, given my experience with allergic reactions to distilled corn alcohol and vinegar. We are the only valid experts when it comes to what these products do to us, since we are the only ones who live in our bodies. Experience trumps opinion, any day. If people know that something makes them sick, then common sense suggests that they should avoid it.

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    Great article. Very informative.

     

    I obtained a list of "regular" beers that a Swedish gluten research team published several years ago. It shows how may Parts Per Milion (PPM) each of the "regular" beers had. As referenced in this article, there were several that came in at less than 20 PPM (the European standard for Gluten Free labeling). However, most of the beer they tested were European brands. While there were some North American brands, it was not an extensive list.

     

    Does anyone know if there is a similar list for North American/Mexican beer?

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    Guest Luann

    Posted

    Excellent article. Thank you

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    Guest Jared M.

    Posted

    Great article! I know of this study that showed many regular beers to have low levels of hordein. It was performed by an Australian research team. Unfortunately, their published document does not list the brands of the beers, only the types. It appears that the majority of barley-based ales and lagers came in very low in ppm (some at the same levels as gluten-free beers), while barley-based stouts came in considerably higher, but still generally below 20 ppm. The wheat-based beers were well above 20 ppm.

     

    If anyone is interested in reading this document, just google "australian study beer gluten". The result on the plosone web site is what you want.

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    Guest Cindy

    Posted

    Very informative in this ongoing saga.

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    Guest Gryphon

    Posted

    I find it wrong advice to promote safety of alcoholic drinks to celiac patients on the basis of gluten content. The main risk with any alcohol (regardless of the gluten content) is that it increases intestinal permeability which allows gluten to cross to the blood stream and trigger autoimmune reaction. Without the permeability issue (caused by alcohol + other dietary and lifestyle choices) the celiac disease may never have developed.

    That's a great point - you should write an article for us about it!

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    Guest Maggie

    Posted

    I have heard before that gluten doesn't survive the distilling process--(but) thanks for the analogy!:) My question is, when dining out alone, I always get a regular menu along with a gluten-free, to get prices, and I noticed at Outback Steakhouse, they list Irish Coffee with Bailey's Irish Creme on their "regular" menu, but not on their gluten-free menu. Would that be a case of there being something "other" in it that wouldn't be gluten-free?

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    Guest Gryphon

    Posted

    I have heard before that gluten doesn't survive the distilling process--(but) thanks for the analogy!:) My question is, when dining out alone, I always get a regular menu along with a gluten-free, to get prices, and I noticed at Outback Steakhouse, they list Irish Coffee with Bailey's Irish Creme on their "regular" menu, but not on their gluten-free menu. Would that be a case of there being something "other" in it that wouldn't be gluten-free?

    This topic from our forums addresses Bailey's: http://www.celiac.com/gluten-free/topic/64658-baileys-irish-creamgluten-free/

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    Guest JustinCase

    Posted

    Excellent information. I am currently looking in a beer called New Grist. The brewer is Lakefront. It only says it is made of Sorghum and Rice Extract. Does not state it is gluten-free, but was recommended by a member of Celiac Sprue Assoc., Restaurateur. I have drank a half bottle initially with no reaction; but the second half, I wasn't too sure. The article suggests to me, maybe I should let this one go. Just in case.

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    Excellent information. I am currently looking in a beer called New Grist. The brewer is Lakefront. It only says it is made of Sorghum and Rice Extract. Does not state it is gluten-free, but was recommended by a member of Celiac Sprue Assoc., Restaurateur. I have drank a half bottle initially with no reaction; but the second half, I wasn't too sure. The article suggests to me, maybe I should let this one go. Just in case.

    New Grist beer is safe for me...but the taste reminds me of Redbridge (Anheuser-Busch's attempt to market to celiacs); it's God awful.

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    Very good overview. I have only one objection and that is on your recommendation to "more mild sufferers of celiac disease..." on deglutenized beers. "try a few sips, and see if you react". This implies a direct connection between symptoms and damage to the intestine. I and many other Celiacs do not have discernable symptoms, but the damage would still be there. It makes me wonder if it is wise for any Celiac to use symptoms as a guide. The best practice for Celiacs is to avoid all gluten at all cost.

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    If you don't want to take chances, new Planet beer is an excellent choice for a gluten-free beer. They strictly control the whole brewing process to ensure no contamination from any source.

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    Guest Allen Haynes, DC

    Posted

    I find it wrong advice to promote safety of alcoholic drinks to celiac patients on the basis of gluten content. The main risk with any alcohol (regardless of the gluten content) is that it increases intestinal permeability which allows gluten to cross to the blood stream and trigger autoimmune reaction. Without the permeability issue (caused by alcohol + other dietary and lifestyle choices) the celiac disease may never have developed.

    Excellent point about promoting the safety of alcohol, but I disagree about the cause of the permeability issue. Zonulin has been shown to regulate permeability. Based on Dr. Fasano's research, we know that the two most powerful triggers to open the Zonulin door are gluten and gut bacteria in the small intestine.

     

    Unfortunately it takes more than adopting a gluten free diet. There are numerous lifestyle changes necessary, including avoiding alcohol.

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  • About Me

    Gryphon Myers recently graduated from UC Berkeley with a degree in interdisciplinary studies, research emphasis in art, society and technology. He is a lifelong vegetarian, an organic, local and GMO-free food enthusiast and a high fructose corn syrup abstainer. He currently lives in Northern California. He also writes about and designs video games at Homunkulus.

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    Soba Noodles4
    Soy Sauce4
    Soy Sauce Solids4
    Sphingolipids4
    Stabilizers4
    Starch1, 4
    Stock Cubes4
    Suet4
    Tocopherols4
    Vegetable Broth4
    Vegetable Gum4
    Vegetable Protein4
    Vegetable Starch4
    Vitamins4
    Wheat Starch5
    1) If this ingredient is made in North America it is likely to be gluten-free. 4) Can utilize a gluten-containing grain or by-product in the manufacturing process, or as an ingredient. 5) Most celiac organizations in the USA and Canada do not believe that wheat starch is safe for celiacs. In Europe, however, Codex Alimentarius Quality wheat starch is considered acceptable in the celiac diet by most doctors and celiac organizations. This is a higher quality of wheat starch than is generally available in the USA or Canada.

    Scott Adams
    Rice and soy beverages because their production process may utilize barley enzymes. Bad advice from health food store employees (i.e., that spelt and/or kamut is/are safe for celiacs). Cross-contamination between food store bins selling raw flours and grains (usually via the scoops). Wheat-bread crumbs in butter, jams, toaster, counter, etc. Lotions, creams and cosmetics (primarily for those with dermatitis herpetaformis). Stamps, envelopes or other gummed labels. Toothpaste and mouthwash. Medicines: many contain gluten. Cereals: most contain malt flavoring, or some other non-gluten-free ingredient. Some brands of rice paper. Sauce mixes and sauces (soy sauce, fish sauce, catsup, mustard, mayonnaise, etc.). Ice cream. Packet & canned soups. Dried meals and gravy mixes. Laxatives. Grilled restaurant food - gluten contaminated grill. Fried restaurant foods - gluten contaminated grease. Ground spices - wheat flour is sometimes used to prevent clumping.

    Scott Adams
    Celiac.com 02/20/2015 - Here is Celiac.com's most up-to-date list of gluten-free beers and alcoholic beverages.
    The gluten status of the products listed below is accurate at the present time. However, as product formulations can change without notice, it is best to verify gluten-free product status by checking the ingredients yourself, or by contacting the manufacturer.
    Unless gluten is added after distillation, all distilled alcohols are gluten-free. However, US labeling laws prohibit beverages that use cereal grains at any point in the manufacturing process from advertising themselves as 'gluten-free.'
    Many people with celiac disease choose to avoid distilled beverages that use cereal grains in the manufacturing process, while many others drink them with no adverse effects.
    So, when you do see a 'gluten-free' label on a distilled beverage, it means that no gluten ingredients have been used at any point in the production process.
    A List of Naturally Gluten-free Beers
    Anheuser-Busch Redbridge Bard's Gold Bard's Tale Beer Brasserie Dupont Forêt Libre Brasseurs Sans Gluten Glutenberg Blanche Brunehaut Bio Ambrée Brunehaut Blonde Bio Brunehaut Blanche Burning Brothers Brewing Coors Peak Dogfish Head Craft Brewed Ales: Tweason'ale Drummond Gluten Free Epic Brewing Company: Glutenator Ghostfish Brewery Glutenberg American Pale Ale Glutenberg Blonde Glutenberg Belgian Double Glutenberg India Pale Ale Glutenberg Rousse Green's Discovery Amber Ale Green's Endeavour Green's Enterprise Dry-Hopped Lager Green's India Pale Ale Green's Quest Tripel Blonde Ale Ground Breaker Corsa Rose Gold Ale Ground Breaker IPA No. 5 Ground Breaker Dark Ale Ipswich Ale Brewery: Celia Saison Joseph James Brewing Fox Tail Lakefront New Grist Ginger Style Ale Lakefront New Grist Pilsner Style Minhas Lazy Mutt Gluten Free Mongozo Premium Pilsener New Planet Belgian Style Ale New Planet Blonde Ale New Planet Pale Ale New Planet Raspberry Ale New Planet Seclusion IPA New Planet Tread Lightly Session Ale Nickel Brook Gluten Free Nouvelle France La Messagère Nouvelle-France Messagère Aux Fruits Nouvelle-France Messagère Red Ale Schnitzer Bräu Hirse Lemon Schnitzer Bräu Hirse Premium Sprecher Brewing Company's Shakparo Ale Steadfast Beer gluten-free Blonde and Pale Ales Steadfast Beer Company's Oatmeal Cream Stout To Øl Reparationsbajer Gluten Free Whistler Forager A List of Gluten-Removed Beers
    Alley Kat Scona Gold Kölsch Brunehaut Bio Tripel Estrella Damm Daura Estrella Damm Daura Marzen Lammsbräu Glutenfrei Lager Beer Mikkeller American Dream Gluten Free Mikkeller Green Gold Gluten Free Mikkeller I Wish Gluten Free IPA Mikkeller Peter, Pale And Mary Gluten Free New Belgium Glutiny brand Golden and Pale Ales Short's Brewing Space Rock Stone Delicious IPA Sufferfest Brewing Company Pale Ale and Lager Widmer Omission Lager Widmer Omission IPA Widmer Omission Pale Ale Wold Top Against The Grain Wold Top Marmalade Porter Wold Top Scarborough Fair IPA Gluten-Free Hard Cider
    Most ciders are fermented from apples or other fruits. Most are safe, however, some add barley for enzymes and flavor. Read labels!
    Gluten-free hard cider brands include:
    Ace Pear Cider Angry Orchard Blue Mountain Cider Company Blackthorn Cider Bulmer's Hard Cider Crispin Cider (including Fox Barrel products) Gaymer Cider Company Harpoon Craft Cider J.K. Scrumpy's Organic Hard Cider Lazy Jack's Cider Magner's Cider Newton's Folly Hard Cider Original Sin Hard Cider Spire Mountain Draft Cider Strongbow Cider Stella Artois Apple and Pear Hard Cidre Woodchuck Woodpecker Cider Gluten-Free Wine
    All wines, including brandy, champagne, cognac, port wine, sherry, and vermouth are safe for celiacs.
    Gluten-Free Wine Coolers
    The majority of wine coolers are made from barley products. 
    Gluten-free versions include: 
    Bartle & Jaymes - all EXCEPT malt beverages Boones - all EXCEPT their malt beverages Other Gluten-Free Alcoholic Brews, Wines and Spirits Include
    Brandy Campari Champagne Cognac—made from grapes Cointreau Grappa Midori Prosecco Khalua Coffee Liquer Kirschwasser (cherry liqueur) Old Deadly Cider Sambuca Vermouth Gluten-Free Distilled Alcohols
    Unless gluten is added after distillation, all distilled alcohols are free of gluten. However, US labeling laws prohibit beverages that use cereal grains at any point in the manufacturing process from advertising themselves as 'gluten-free.'
    So, when you do see a 'gluten-free' label on a distilled beverage, it means that no gluten ingredients have been used at any point in the production process.
    Gluten-Free Gin
    Most gins are made with gluten-containing cereal grains. The final distilled product does not contain gluten, but cannot be advertised or labeled as gluten-free. Many people with celiac disease choose to avoid these beverages, while many others drink them with no adverse effects.
    Gluten-free gin brands include:
    Cold River Gin—distilled from potatoes Brands of standard gin include:
    Aviation American Gin Beefeater Bombay Bombay Sapphire Boodles British Gin Booth's Gin  Gordon's Leopolds Gin New Amsterdam Gin Seagram's Tanqueray Gluten-Free Rum
    Distilled from sugar cane, most rums are gluten-free and safe for celiacs. Beware of pre-made drink mixes, such as those intended for piña coladas — many of these contain gluten ingredients as flavoring.
    Gluten-free rum brands include:
    Appleton Estate Jamaica Rum Bacardi—only Gold, Superior, 151, and flavored Bayou Rum Bundaberg Rum Captain Morgan Rum Cruzan Rum Malibu Rum Mount Gay Rum Meyer's Rum Gluten-Free Sake
    Fermented with rice and Koji enzymes. The Koji enzymes are grown on Miso, which is usually made with barley. The two-product separation from barley, and the manufacturing process should make it safe for celiacs.
    Gluten-Free Tequila
    Made from the agave cactus, all tequilas are gluten-free and safe for celiacs.
    Gluten-free tequila brands include:
    1519 Tequila 1800 Tequila Cabo Wabo Cazadores Chimayo Don Julio El Jimador Herradura Hornitos Jose Cuervo Patron Sauza Gluten-Free Vodka
    Vodkas distilled from potatoes, gluten-free grains or other gluten-free ingredients contain no gluten ingredients and can be labeled as gluten-free.
    Gluten-free vodka brands include:
    Corn Vodka—Deep Eddy, Nikolai, Rain, Tito's, UV Grape Vodka—Bombora, Cooranbong Potato Vodka—Boyd & Blair, Cirrus, Chase, Chopin, Cold River Vodka, Cracovia, Grand Teton, Karlsson's, Luksusowa, Monopolowa, Schramm Organic, Zodiac Rice Vodka—Kissui Sugar Cane—Downunder, DOT AU Vodkas distilled from cereal grains include:
    Many vodkas made with gluten-containing cereal grains. The final product does not contain gluten, but cannot be advertised or labeled as gluten-free. Many people with celiac disease choose to avoid these beverages, while many others drink them with no adverse effects.
    Barley Vodka—Finlandia Grain Vodka—Absolwent, Blavod, Bowman's, Fleischmann's, Orloff, Polonaise, SKYY, Smirnoff, Stolichnaya,  Wheat Vodka—Absolut, Bong Spirit, Danzka, Grey Goose, Hangar One, Ketel One, P.i.n.k Vodka Rye Vodka—Belvedere, BiaÅ‚a Dama, Platinka, Sobieski, Starka, Wisent, Wyborowa, Xellent Swiss, Å»ubrówka Gluten-Free Whiskey
    Nearly all whiskeys are made with gluten-containing cereal grains. The final product does not contain gluten, but cannot be advertised or labeled as gluten-free. Many people with celiac disease choose to avoid whiskey, while many others drink it with no adverse effects.
    Gluten-free whiskey brands include:
    Queen Jennie Whiskey, by Old Sugar Distillery is made entirely from sorghum Whiskeys distilled from cereal grains include:
    Bourbon—Benjamin Prichard's, Booker's, Buffalo Trace, Jim Beam, Early Times, Ezra Brooks, Jefferson's Bourbon, Knob Creek, Makers Mark, Old Crow, Old Forester, Old Grand-Dad Canadian Whiskey—Alberta Premium, Black Velvet, Canadian Club, Crown Royal, Tenesse Whiskey—Jack Daniels, George Dickel. Irish Whiskey—Bushmills, Jameson, Kilbeggan, Redbreast, Tullamore Dew Japanese Blended Whiskey—Hibiki, Kakubin, Nikka,  Japanese Single Malt Whiskey—Hakushu, Yamazaki, Yoichi Rye Whiskey—Alberta Premium, Bulleitt Scotch Whiskey Blends—Ballentine's, Bell's, Black Grouse, Chivas Regal, Cutty Sark, Dewar's, Famous Grouse, Johnnie Walker, Teacher's, Whitehorse Scotch Whiskey Single Malts—Bowmore, Glenfiddich, Glen Grant, The Glenlivet, Glenmorangie, Highland Park, Knockando, Lagavulin, Laphroaig, Macallan, Monkey Shoulder, Singleton, Talisker  Taiwanese Whiskey—Kavalan Classic Gluten-Free Drink Mixes
    Club Extra Dry Martini (corn & grape) Club Vodka Martini (corn & grape) Coco Casa and Coco Lopez Brands: Cream of Coconut Jose Cuervo Brand: Margarita Mix and All Jose Cuervo Blenders Master of Mixes Brand: Tom Collins, Whiskey Sour, Strawberry Daiquiri, Sweet & Sour Mixer, and Margarita Mix Mr. & Mrs. T—Except Bloody Mary Mix TGI Friday's Brand: On The Rocks, Long Island Ice Tea, Margarita, Mudslide, Pina Colada, and Strawberry Daiquiri. TGI Friday's Club Cocktails including: Gin Martini, Manhattan, Screwdriver, Vodka Martini, and Whiskey Sour mix. Other Gluten-free Beverages Mixes & Cooking Alcohol
    Club Tom Collins—made with corn Diamond Jims Bloody Mary Mystery Holland House - all EXCEPT Teriyaki Marinade and Smooth & Spicy Bloody Mary Mixes Mead—made from honey Mistico: Jose Cuervo Mistico—agave and cane Ouzo - made from grapes and anise Spice Islands - Cooking Wines - Burgundy, Sherry and White Also Godiva products contain gluten as do Smirnoff FMB's, Twisted V, and Smirnoff Ice.

    Megan Tichy
    What is Gluten?
    Gluten is a huge molecule held together by smaller molecules linked together called amino acids. A very tiny part of the gluten molecule can initiate a response. If each amino acid that makes up gluten is represented as a single letter that very tiny part would be: SGQGSFQPSQQ. There are other sequences of amino acids that cause a reaction in gluten sensitive individuals, but the point is, as tiny as this fragment is with respect to the entire gluten protein, it is still HUGE with respect to the size of ethanol (the stuff you are drinking).
    What is Alcohol?
    The alcohol you drink is ethanol. Ethanol is smaller than the size of the smallest amino acid in the smallest fragment of gluten that has been shown to initiate an autoimmune reaction. More specifically, ethanol is about 10 atomic mass units smaller than just the G in the sequence shown above.
    What are Amino Acids?
    The G is glycine, and by the way, each of these amino acids (represented by letters) by themselves is safe, and sold at most health food stores. For example Q = glutamine (yes, “L-glutamine,” the same amino acid mentioned in a recent post and used to heal intestinal damage). If the protein is viewed as beads on a string, then one of those beads might be good for you, but certain sequences strung together can initiate an allergic reaction of many types from acute peanut allergy to less-than-obvious gluten sensitivity.
    What is Distillation?
    When a distillation is performed, pure ethanol is separated away from all of the other “stuff” that forms as a result of fermentation. This is because ethanol is volatile (meaning it becomes a gas in the distillation process). Imagine a vat of fermentation products, you heat it, and only the volatile molecules like ethanol enter a tube attached to the vat. This tube is not just any tube - it is a curved condensation tube! Here is what it does: While the heated gas form of ethanol floats into it (because that is what gases do), the molecules are cooled and condense back into a liquid, and fall into a new sparkling clean vessel containing the stuff that intoxicates you and any other volatiles. So the fancier distillation columns that are actually used industrially also purify the ethanol away from other volatiles. Gluten does not stand a chance of “crossing over” because it is not volatile.
    Here is a simplified analogy. Let's say you put some sand in the bottom of your tea kettle. If you take the spout off your tea kettle, and attach a condensing tube to the opening (a curved tube would be the simplest type of condensing tube but there are many elaborate types), you could distill your water away from the sand. The condensing tube would be curved so as to open into a new clean pot. Let us pretend that the sand is gluten and the water is ethanol. When you heat to the boiling point, the liquid becomes gas so it travels into the condenser, cools and becomes liquid, then falls into the clean pot.
    Now having read that, is there any way that the new clean pot would contain any sand? No, and distilled alcohol (ethanol) does not contain any gluten. Remember, gluten is not volatile. Another non-volatile compound is table salt. So you could perform a distillation at home, with salt water. Has anyone ever inadvertently done this? Boiled a pot of salt water, perhaps to make some Tinkyada pasta, and walked away to do something else. You came back to find your pot almost empty with white crusty stuff (salt) all inside the pot.
    So the gluten is left behind in a distillation process. If malt is added to the distilled product it will be disclosed on the ingredients label.
    What is Vinegar?
    Vinegar is formed by fermentation in a similar way that ethanol is formed by fermentation. The process is to take ethanol and ferment it with bacteria. Later, there is a filtration to remove the bacteria. Rarely, vinegar is fermented from wheat-based alcohol. “Distilled vinegar,” gets its name from the fact that it was fermented from distilled alcohol.
    Why is Vinegar Still Questioned?
    The answer could be, perhaps, because so many people report a reaction to it and vinegar-based products. The never-ending fear is that cross-contamination during the fermentation process is leading to barely detectable amounts of gluten in the finished product (by barely detectable, I mean in terms of commercially available tests). Since the vinegar is rarely distilled post fermentation from the ethanol, the “messy” nature of the second fermentation step could pose a problem, especially for highly sensitive individuals. If the alcohol gets all used up by the bacteria, the bacteria go on to form carbon dioxide and water from the vinegar. So alcohol is periodically added in the fermentation process. Conceivably, one “shortcut” would be to just add beer at this juncture. Adding beer or some other form of cheap malted alcohol would keep the culture alive, and increase the “quality” and yield of the vinegar. Another fear is that the bacterial “mother” as it is called, contains trace gluten through cross-contamination. Claims that these practices actually take place are unsubstantiated by evidence.
    Why are Distilled Spirits Still Questioned?
    That is a good question, I do not know.Take a Short Quiz on this Topic:
    You bought mustard and pickles at the grocery store. These products contain “distilled vinegar” according to the ingredients labels, and the label does NOT say “contains: wheat.” Are the mustard and pickles gluten-free? Rum, gin, whiskey, and vodka are distilled beverages. If they are not flavored with something that contains wheat (would be declared on the label), rye, or barley (usually in the form of “malt”), are they gluten-free?  What is wrong with the following statements (they have all been cut and pasted from various blogs and forums on the topic of celiac disease)?a. “Most alcohols are distilled in such a way that any wheat gluten is no longer present.”b. “Even trace amounts of gluten that make it past the filter system can be harmful.”c. “It seems improbable to me, too, that gliadin could survive the distillation process.”

    Answers:
    Yes, unless you have reason to believe otherwise, in which case you should simply avoid them.
    Yes.
    3a. All alcohols, if distilled, have been removed from any type of gluten.
    3b. Distillation is nothing like a filtration. We are not separating small from large, there is no filter. Filtration would be like how your coffee pot separates water from the coffee grains. A tear in the filter would result in a big problem, right? Filtration is a separation based on size, distillation is a separation based on volatility.
    3c. Do we care whether gliadin (a name given to part of wheat gluten) “survives” the process or not? No, because it has been left behind to stew in its own juices in the distillation pot. Your stuff (the ethanol) has floated away, and entered a new, clean pot. Some people have this idea that we heat the fermented mixture to smithereens and it somehow decomposes the molecules of gluten. Clearly, such a process would be ineffective or else we could simply “cook,” “roast,” “fry,” or “burn” the gluten out of our foods, and we know that we cannot do that.

    Gryphon Myers
    Celiac.com 10/22/2012 - Wine is naturally gluten-free, making it a go-to alcoholic drink for sufferers of celiac disease. However, some vintners use oak barrels sealed with wheat paste, which has made some people wonder if it is really gluten-free. An article posted by Tricia Thompson, MS, RD on her Gluten-Free Watchdog website may have finally put this worry to rest, as she has done a series of sandwich R5 ELISA and competitive R5 ELISA tests of various wines aged in such barrels.
    So there's a wine you'd like to try, but you've heard that wine can be cross contaminated from the wheat paste some vintners use to seal oak barrels. The first thing to consider before spending too much time researching is that the Tobacco Tax and Trade Bureau currently disallows gluten-free labeling of alcoholic beverages if the producer used “storage materials that contained gluten.” This means any wine that is labeled as gluten-free was aged using a barrel alternative, and thus carries no danger of cross-contamination.
    Another factor to consider is that while many wineries still use oak barrels, barrel alternatives are highly common as well. Roughly speaking, the more expensive ($12+) Cabernet Sauvignons, Merlots, Zinfandels and red blends are more likely to be aged in oak barrels (and for a longer period of time).
    For those wines that are fermented in barrels, most wineries thoroughly pressure wash all barrels with boiling hot water before they are used. Additionally, it is not the staves of the barrels that are sealed with a wheat flour paste, but the barrel heads. The amount used to seal the head is minimal. Even so, the possibility of cross contamination has been a lingering question.
    To get a sense of just how risky this cross contamination might be, Tricia Thompson tested a single winery's Cabernet Sauvignon and Merlot, which were the two wines that spent the most time in wheat-sealed oak barrels. She tested each wine four times: twice with the Sandwich R5 ELISA test, and twice with the competitive R5 ELISA test. The competitive R5 ELISA is the current standard for testing for hydrolyzed (broken down) gluten (as would be found in fermented products), while the sandwich R5 ELISA would detect any non-hydrolyzed gluten (as from a wheat paste).
    Both extractions of both wines came back with the lowest possible results for both tests:
    Cabernet Sauvignon
    Sandwich R5 ELISA extraction 1: < 5 ppm gluten Sandwich R5 ELISA extraction 2: < 5 ppm gluten Competitive R5 ELISA extraction 1: < 10 ppm gluten Competitive R5 ELISA extraction 2: < 10 ppm gluten Merlot
    Sandwich R5 ELISA extraction 1: < 5 ppm gluten Sandwich R5 ELISA extraction 2: < 5 ppm gluten Competitive R5 ELISA extraction 1: < 10 ppm gluten Competitive R5 ELISA extraction 2: < 10 ppm gluten Thompson's findings indicate that even wine that is aged in wheat-glue-sealed oak barrels contains less gluten than we are currently capable of testing for, whether hydrolyzed or not. If you're still skeptical, you can always do your own research and find out which of your favorite wines are aged using barrel alternatives.
    Source:
    http://www.glutenfreedietitian.com/newsletter/2012/10/10/gluten-content-of-wine-aged-in-oak-barrels-sealed-with-wheat-paste/

  • Recent Articles

    Christina Kantzavelos
    Celiac.com 07/20/2018 - During my Vipassana retreat, I wasn’t left with much to eat during breakfast, at least in terms of gluten free options. Even with gluten free bread, the toasters weren’t separated to prevent cross contamination. All of my other options were full of sugar (cereals, fruits), which I try to avoid, especially for breakfast. I had to come up with something that did not have sugar, was tasty, salty, and gave me some form of protein. After about four days of mixing and matching, I was finally able to come up with the strangest concoction, that may not look the prettiest, but sure tastes delicious. Actually, if you squint your eyes just enough, it tastes like buttery popcorn. I now can’t stop eating it as a snack at home, and would like to share it with others who are looking for a yummy nutritious snack. 
    Ingredients:
    4 Rice cakes ⅓ cup of Olive oil  Mineral salt ½ cup Nutritional Yeast ⅓ cup of Sunflower Seeds  Intriguing list, right?...
    Directions (1.5 Servings):
    Crunch up the rice into small bite size pieces.  Throw a liberal amount of nutritional yeast onto the pieces, until you see more yellow than white.  Add salt to taste. For my POTS brothers and sisters, throw it on (we need an excess amount of salt to maintain a healthy BP).  Add olive oil  Liberally sprinkle sunflower seeds. This is what adds the protein and crunch, so the more, the tastier.  Buen Provecho, y Buen Camino! 

    Jefferson Adams
    Celiac.com 07/19/2018 - Maintaining a gluten-free diet can be an on-going challenge, especially when you factor in all the hidden or obscure gluten that can trip you up. In many cases, foods that are naturally gluten-free end up contain added gluten. Sometimes this can slip by us, and that when the suffering begins. To avoid suffering needlessly, be sure to keep a sharp eye on labels, and beware of added or hidden gluten, even in food labeled gluten-free.  Use Celiac.com's SAFE Gluten-Free Food List and UNSAFE Gluten-free Food List as a guide.
    Also, beware of these common mistakes that can ruin your gluten-free diet. Watch out for:
    Watch out for naturally gluten-free foods like rice and soy, that use gluten-based ingredients in processing. For example, many rice and soy beverages are made using barley enzymes, which can cause immune reactions in people with celiac disease. Be careful of bad advice from food store employees, who may be misinformed themselves. For example, many folks mistakenly believe that wheat-based grains like spelt or kamut are safe for celiacs. Be careful when taking advice. Beware of cross-contamination between food store bins selling raw flours and grains, often via the food scoops. Be careful to avoid wheat-bread crumbs in butter, jams, toaster, counter surface, etc. Watch out for hidden gluten in prescription drugs. Ask your pharmacist for help about anything you’re not sure about, or suspect might contain unwanted gluten. Watch out for hidden gluten in lotions, conditioners, shampoos, deodorants, creams and cosmetics, (primarily for those with dermatitis herpetaformis). Be mindful of stamps, envelopes or other gummed labels, as these can often contain wheat paste. Use a sponge to moisten such surfaces. Be careful about hidden gluten in toothpaste and mouthwash. Be careful about common cereal ingredients, such as malt flavoring, or other non-gluten-free ingredient. Be extra careful when considering packaged mixes and sauces, including soy sauce, fish sauce, catsup, mustard, mayonnaise, etc., as many of these can contain wheat or wheat by-product in their manufacture. Be especially careful about gravy mixes, packets & canned soups. Even some brands of rice paper can contain gluten, so be careful. Lastly, watch out for foods like ice cream and yogurt, which are often gluten-free, but can also often contain added ingredients that can make them unsuitable for anyone on a gluten-free diet. Eating Out? If you eat out, consider that many restaurants use a shared grill or shared cooking oil for regular and gluten-free foods, so be careful. Also, watch for flour in otherwise gluten-free spices, as per above. Ask questions, and stay vigilant.

    Jefferson Adams
    Celiac.com 07/18/2018 - Despite many studies on immune development in children, there still isn’t much good data on how a mother’s diet during pregnancy and infancy influences a child’s immune development.  A team of researchers recently set out to assess whether changes in maternal or infant diet might influence the risk of allergies or autoimmune disease.
    The team included Vanessa Garcia-Larsen, Despo Ierodiakonou, Katharine Jarrold, Sergio Cunha,  Jennifer Chivinge, Zoe Robinson, Natalie Geoghegan, Alisha Ruparelia, Pooja Devani, Marialena Trivella, Jo Leonardi-Bee, and Robert J. Boyle.
    They are variously associated with the Department of Undiagnosed Celiac Disease More Common in Women and Girls International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America; the Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom; the Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom; the Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom; the Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom; the Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom; and Stanford University in the USA.
    Team members searched MEDLINE, Excerpta Medica dataBASE (EMBASE), Web of Science, Central Register of Controlled Trials (CENTRAL), and Literatura Latino Americana em Ciências da Saúde (LILACS) for observational studies conducted between January 1946 and July 2013, and interventional studies conducted through December 2017, that evaluated the relationship between diet during pregnancy, lactation, or the first year of life, and future risk of allergic or autoimmune disease. 
    They then selected studies, extracted data, and assessed bias risk. They evaluated data using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). They found 260 original studies, covering 964,143 participants, of milk feeding, including 1 intervention trial of breastfeeding promotion, and 173 original studies, covering 542,672 participants, of other maternal or infant dietary exposures, including 80 trials of 26 maternal, 32 infant, or 22 combined interventions. 
    They found a high bias risk in nearly half of the more than 250 milk feeding studies and in about one-quarter of studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with probiotics during late pregnancy and lactation may reduce risk of eczema. 44 cases per 1,000; 95% CI 20–64), and 6 trials, suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitization to egg. GRADE certainty of these findings was moderate. 
    The team found less evidence, and low GRADE certainty, for claims that breastfeeding reduces eczema risk during infancy, that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus, and that probiotics reduce risk of infants developing allergies to cow’s milk. 
    They found no evidence that dietary exposure to other factors, including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake, influence risk of allergic or autoimmune disease. 
    Overall, the team’s findings support a connection between the mother’s diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitization to food, respectively.
    Stay tuned for more on diet during pregnancy and its role in celiac disease.
    Source:
    PLoS Med. 2018 Feb; 15(2): e1002507. doi:  10.1371/journal.pmed.1002507

    Jefferson Adams
    Celiac.com 07/17/2018 - What can fat soluble vitamin levels in newly diagnosed children tell us about celiac disease? A team of researchers recently assessed fat soluble vitamin levels in children diagnosed with newly celiac disease to determine whether vitamin levels needed to be assessed routinely in these patients during diagnosis.
    The researchers evaluated the symptoms of celiac patients in a newly diagnosed pediatric group and evaluated their fat soluble vitamin levels and intestinal biopsies, and then compared their vitamin levels with those of a healthy control group.
    The research team included Yavuz Tokgöz, Semiha Terlemez and Aslıhan Karul. They are variously affiliated with the Department of Pediatric Gastroenterology, Hepatology and Nutrition, the Department of Pediatrics, and the Department of Biochemistry at Adnan Menderes University Medical Faculty in Aydın, Turkey.
    The team evaluated 27 female, 25 male celiac patients, and an evenly divided group of 50 healthy control subjects. Patients averaged 9 years, and weighed 16.2 kg. The most common symptom in celiac patients was growth retardation, which was seen in 61.5%, with  abdominal pain next at 51.9%, and diarrhea, seen in 11.5%. Histological examination showed nearly half of the patients at grade Marsh 3B. 
    Vitamin A and vitamin D levels for celiac patients were significantly lower than the control group. Vitamin A and vitamin D deficiencies were significantly more common compared to healthy subjects. Nearly all of the celiac patients showed vitamin D insufficiency, while nearly 62% showed vitamin D deficiency. Nearly 33% of celiac patients showed vitamin A deficiency. 
    The team saw no deficiencies in vitamin E or vitamin K1 among celiac patients. In the healthy control group, vitamin D deficiency was seen in 2 (4%) patients, vitamin D insufficiency was determined in 9 (18%) patients. The team found normal levels of all other vitamins in the healthy group.
    Children with newly diagnosed celiac disease showed significantly reduced levels of vitamin D and A. The team recommends screening of vitamin A and D levels during diagnosis of these patients.
    Source:
    BMC Pediatrics

    Jefferson Adams
    Celiac.com 07/16/2018 - Did weak public oversight leave Arizonans ripe for Theranos’ faulty blood tests scam? Scandal-plagued blood-testing company Theranos deceived Arizona officials and patients by selling unproven, unreliable products that produced faulty medical results, according to a new book by Wall Street Journal reporter, whose in-depth, comprehensive investigation of the company uncovered deceit, abuse, and potential fraud.
    Moreover, Arizona government officials facilitated the deception by providing weak regulatory oversight that essentially left patients as guinea pigs, said the book’s author, investigative reporter John Carreyrou. 
    In the newly released "Bad Blood: Secrets and Lies in a Silicon Valley Startup," Carreyrou documents how Theranos and its upstart founder, Elizabeth Holmes, used overblown marketing claims and questionable sales tactics to push faulty products that resulted in consistently faulty blood tests results. Flawed results included tests for celiac disease and numerous other serious, and potentially life-threatening, conditions.
    According to Carreyrou, Theranos’ lies and deceit made Arizonans into guinea pigs in what amounted to a "big, unauthorized medical experiment.” Even though founder Elizabeth Holmes and Theranos duped numerous people, including seemingly savvy investors, Carreyrou points out that there were public facts available to elected officials back then, like a complete lack of clinical data on the company's testing and no approvals from the Food and Drug Administration for any of its tests.
    SEC recently charged the now disgraced Holmes with what it called a 'years-long fraud.’ The company’s value has plummeted, and it is now nearly worthless, and facing dozens, and possibly hundreds of lawsuits from angry investors. Meantime, Theranos will pay Arizona consumers $4.65 million under a consumer-fraud settlement Arizona Attorney General Mark Brnovich negotiated with the embattled blood-testing company.
    Both investors and Arizona officials, “could have picked up on those things or asked more questions or kicked the tires more," Carreyrou said. Unlike other states, such as New York, Arizona lacks robust laboratory oversight that would likely have prevented Theranos from operating in those places, he added.
    Stay tuned for more new on how the Theranos fraud story plays out.
    Read more at azcentral.com.