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      Frequently Asked Questions About Celiac Disease   04/07/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    STARBUCKS HAS A NEW GLUTEN-FREE BREAKFAST SANDWICH! OR DO THEY?


    Jefferson Adams


    • Will Starbucks guarantee its new breakfast sandwich is gluten-free?


    Celiac.com 03/24/2017 - Does it meet the FDA standard for a gluten-free product? Is it safe for people with celiac disease?


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    Starbucks' new Gluten-Free Breakfast Sandwich looks yummy. But, why does Starbucks' website feature a disclaimer saying the company cannot guarantee the absence of allergens, including wheat?

    The sandwich itself is pretty standard fare, consisting of two slices of cherrywood-smoked Canadian bacon, an egg patty and reduced-fat white cheddar on a gluten-free roll.

    The company website uses boldface type to tout the "gluten-free"-ness of the new offering, noting that the sandwich uses a "gluten-free roll," is "prepared in a certified gluten-free environment," and sealed "in its own oven-safe parchment bag to avoid any cross-contamination." Sounds good, so far, perhaps even safe for celiacs.

    But then there's this little disclaimer at the bottom of the page saying that Starbucks "cannot guarantee that any of our products are free from allergens (including dairy, eggs, soy, tree nuts, wheat and others) as we use shared equipment to store, prepare and serve them."

    Wheat? This product may contain wheat? Wheat contains gluten. Things that contain wheat are not gluten-free, and usually cannot be labeled as such.

    So, what's the deal? Is the sandwich gluten-free or not? Is this a bit like when Pizza Hut offered a gluten-free pizza crust, but wouldn't guarantee a gluten-free pizza? How much wiggle room is built into Starbucks' disclaimer? The questions are basic ones. Is the product gluten-free? Is it safe for people with celiac disease, or not? If it is, then Starbucks has been unclear in declaring the suitability of their product for people with celiac disease.

    If not, then Starbucks has been equally unclear in declaring the unsuitability of their product for people with celiac disease. Also, if the company can't guarantee a gluten-free product, and won't recommend it for people with celiac disease, then who is this product for?

    The Starbucks website features lots of talk about the "gluten-free," aspects of the product, and the serving process, but there is no language stating that the sandwich, as served is "under 20ppm" gluten, which is the FDA standard for advertising package goods as "gluten-free." There is no claim that the product is safe for people with celiac disease.

    The Starbucks Gluten-free Breakfast Sandwich sounds very much like something that many people in the celiac disease community might welcome…IF it's actually gluten-free. Let's hope it is. Let's hope this was just a mix-up by Starbucks, perhaps the result of an over-zealous legal department.

    Otherwise, it would seem that, without more clarity, people with celiac disease could be confused or mislead by the claims, and maybe influenced by the ubiquitousness of Starbucks and their promotional campaign into trying something that might harm them.

    Celiac.com is reaching out to Starbucks for comment. We look forward to sharing their reply.

    Until it becomes clear that this product is actually gluten-free, and suitable for everyone, Celiac.com urges celiac sufferers to use caution, and to follow the story here for more updates.

    Source:

     

     

     


    Image Caption: Is Starbucks' new breakfast sandwich really gluten-free? Photo: Starbucks Gluten-free Breakfast Sandwich--Starbucks
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    Seems like they also left soy out of the Allergy Information list:

     

    Allergy Information

    Contains: Milk, Egg

     

    The ingredients do list soybean oil.

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    I had one of these sandwiches yesterday and it was gluten free (the tiniest crumb will get me very sick). The sandwich was delicious and I appreciate Starbuck's willingness to take all the necessary precautions. I did notice that the used the same oven tongs to grab the sealed gluten free bag that they use to grab all the gluten-filled pastries. That just meant that I had to grab the sandwich with a napkin and eat it that way.

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    Guest Regina Smith

    Posted

    Seems like they also left soy out of the Allergy Information list:

     

    Allergy Information

    Contains: Milk, Egg

     

    The ingredients do list soybean oil.

    Which item had the soy oil?

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    Guest Katherine Keys

    Posted

    I purchased a gluten free sandwich from Starbucks yesterday for breakfast. It was served in a sealed wrapper marked with the CERTIFIED Gluten-Free symbol I always look for. It tasted just fine and caused no gastro discomfort! As a celiac, I feel comfortable purchasing this product. It's wonderful to have one more place to stop for a safe meal when I travel.

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    The sandwich is fine! If it were not for the litigious society we live in here in America, then places would not have to add such legal speak and disclaimers. I for one am happy that places are coming up with gluten-free options. We take a risk when we put anything in our mouths so do your research and get a Nima to test items if you are that concerned and we also. We'd to remember that there are other people that eat gluten-free for other health issues or desires besides those of us with celiac, we don't have the corner on that market.

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    Guest Jeff Adams

    Posted

    The sandwich is fine! If it were not for the litigious society we live in here in America, then places would not have to add such legal speak and disclaimers. I for one am happy that places are coming up with gluten-free options. We take a risk when we put anything in our mouths so do your research and get a Nima to test items if you are that concerned and we also. We'd to remember that there are other people that eat gluten-free for other health issues or desires besides those of us with celiac, we don't have the corner on that market.

    Thanks for your comment. We also agree that more gluten-free options are generally a good thing. What confused us was that Starbucks seemed to be working hard to make sure the final product was gluten-free, which is great. But the disclaimer is a bit confusing for people with celiac disease. Our aim here is to make sure people with celiac disease make an informed decision about this and other "gluten-free" products they may consume.

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    Guest James

    Posted

    I think the allergen warning is presumably because allergic reactions can occur at less than even the 20ppm that affects celiacs. So it is not necessarily contradictory to say it is gluten-free (<20ppm gluten) and and potentially an allergen risk for those allergic to wheat.

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    Guest Huntress

    Posted

    I agree with Tina. The disclaimers on fast food gluten-free items are necessary given the lawsuit happy lawyers. Since some people are more sensitive and others are less sensitive those who are the most sensitive to gluten need to keep in mind the reality of the situation. These foods exist and are prepared in places where non-gluten-free products are also present. The world isn't hermetically sealed and there is always a risk of some gluten cross-contamination. At least they're trying. If you're that afraid of it, then just don't order it, but it's a good option for those who are less sensitive. We shouldn't be discouraging companies like this from recognizing the needs of a segment of consumers.

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    Guest Alice

    Posted

    Seems like they also left soy out of the Allergy Information list:

     

    Allergy Information

    Contains: Milk, Egg

     

    The ingredients do list soybean oil.

    Frustrating to me that dairy is included in this sandwich. Many people who are celiac are also dairy free. It would be so easy to use a dairy free milk.

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    Guest Glutengirl

    Posted

    This is not a well thought out post. Of course Starbucks nor any fast food chain can guarantee that there will not be cross contamination when predominantly serving products with gluten. Perhaps you could suggest they more clearly state that products may come in contact with gluten thus potentially contaminating the bun. So to answer your question, yes it is gluten free before it is removed from the package but beyond that there are no guarantees. Be thankful they provide a warning, better to be safe than sorry.

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    Guest Pam Lewellen

    Posted

    The sandwich is fine! If it were not for the litigious society we live in here in America, then places would not have to add such legal speak and disclaimers. I for one am happy that places are coming up with gluten-free options. We take a risk when we put anything in our mouths so do your research and get a Nima to test items if you are that concerned and we also. We'd to remember that there are other people that eat gluten-free for other health issues or desires besides those of us with celiac, we don't have the corner on that market.

    Tina, why do you sound so angry. The article only states facts and just wants people to be aware to always check gluten-free foods out.

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    Guest Kelley

    Posted

    I had one - it was really yummy and I had no reaction to it. I was THRILLED to be able to get a breakfast sandwich and a coffee somewhere for once! I agree that the disclaimer is most likely covering their legal butts, so to speak.

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    Guest MamaT

    Posted

    I have celiac disease and I have eaten this sandwich. It's not only delicious but it is definitely gluten free. Because it is toasted in its own bag it avoids cross contamination in the toaster. I even tested it with my Nima sensor which confirmed it was gluten free. Most importantly I didn't get sick!

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    At first I was thinking it's just to satisfy the gluten-free movement but after looking at their page, it looks like more of a disclaimer rather than a reality. I feel it's safe to eat. rnI have been glutened at places claiming to serve gluten-free food but it was cross contaminated so now as a precaution I have a card that I give to the waitress for the chef that lists what is gluten and about the dangers of cross contamination. I feel a lot safer eating out after I got that card.

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    I had one of these sandwiches yesterday and it was gluten free (the tiniest crumb will get me very sick). The sandwich was delicious and I appreciate Starbuck's willingness to take all the necessary precautions. I did notice that the used the same oven tongs to grab the sealed gluten free bag that they use to grab all the gluten-filled pastries. That just meant that I had to grab the sandwich with a napkin and eat it that way.

    Thanks for the heads up on the tongs Stef. I have a gluten allergy so touching it will cause a reaction.rnI will ask them to use separate tongs or their hands when I buy one.

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    Guest Jefferson Adams

    Posted

    I purchased a gluten free sandwich from Starbucks yesterday for breakfast. It was served in a sealed wrapper marked with the CERTIFIED Gluten-Free symbol I always look for. It tasted just fine and caused no gastro discomfort! As a celiac, I feel comfortable purchasing this product. It's wonderful to have one more place to stop for a safe meal when I travel.

    Thanks for your comment. It's good to know that the sandwich has a gluten-free label. So far, the feedback looks good.

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    Guest susan

    Posted

    The sandwich is fine! If it were not for the litigious society we live in here in America, then places would not have to add such legal speak and disclaimers. I for one am happy that places are coming up with gluten-free options. We take a risk when we put anything in our mouths so do your research and get a Nima to test items if you are that concerned and we also. We'd to remember that there are other people that eat gluten-free for other health issues or desires besides those of us with celiac, we don't have the corner on that market.

    I agree with Tina that the disclaimer is most likely a CYA against the unexpected Even if the facility is monitored and cleaned, NO ONE can guarantee that somewhere along the supply chain someone might have dropped a bag of flour near some ingredient and it got dusted. Just about all products that are sold as gluten-free have a similar disclaimer. I am celiac but not real sensitive, so I don´t worry about these; just getting something with gluten free ingredients works for me. So thank god there is something other than the crispy rice marshmallow bars to eat with my latte.

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    Guest Jefferson Adams

    Posted

    This is not a well thought out post. Of course Starbucks nor any fast food chain can guarantee that there will not be cross contamination when predominantly serving products with gluten. Perhaps you could suggest they more clearly state that products may come in contact with gluten thus potentially contaminating the bun. So to answer your question, yes it is gluten free before it is removed from the package but beyond that there are no guarantees. Be thankful they provide a warning, better to be safe than sorry.

    That's not what Starbucks disclaimer says. It says that cannot guarantee that the item is gluten-free. Period. I do think Starbucks could be clearer about this matter, as it can create confusion. So far, the reports from people with celiac disease seem to be favorable.

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    Guest GFDad

    Posted

    This is a fear-mongering headline. The disclaimer is nothing more than a CYA. FYI Pizza Hut's pizza and preparation was certified by the Gluten Intolerance Group.

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    Guest Jefferson Adams

    Posted

    This is a fear-mongering headline. The disclaimer is nothing more than a CYA. FYI Pizza Hut's pizza and preparation was certified by the Gluten Intolerance Group.

    But Pizza Hut advises people with celiac disease to not eat their "gluten-free" pizzas, as they cannot guarantee the final product is gluten-free, and safe for celiacs. If Starbucks sandwich is safe for people with celiac disease, they need to say so. If it is not, they need to say so. This generic disclaimer does nothing to clarify the situation, and is confusing for people with celiac disease.

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    Guest Laura

    Posted

    I had one today and thought it was great. I am very sensitive celiac and had no problems. Very happy to have this option!

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    I didn't know about the labeling issues - I tried this sandwich today and thought it was decent. Did notice the gluten-free label on package. I saw one in the case, opened, and asked the clerk if it contained buckwheat or another darker gluten-free whole grain as it looked dark to me- she did not know (just checked and yes it does contain buckwheat, which to me is a plus, not commonly found in gluten-free commercial products). I find the labeling odd too though. IF it is tested gluten-free and safe for celiacs then why the disclaimer? Says is made in a gluten-free facility. So where's the gluten? Where did the ingredients come from? Is the buckwheat (and other flour) certified gluten-free? I don't know where the possible gluten would come from, if no cross-contamination and base ingredients do not contain gluten? Makes no sense- labeling. Do not think normal manufacurers would "cover their butt" this way unless it was made in facility with a cross-contamination possibility.

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    Guest Jefferson Adams

    Posted

    I had one today and thought it was great. I am very sensitive celiac and had no problems. Very happy to have this option!

    Thanks for your comment! The early reports from people with celiac disease seem to be favorable. Starbucks seems to have worked hard to get it right. Their disclaimer is still a bit confusing, but it's good to hear that people seem to have no gluten problems so far.

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    admin
    I have a big issue with what I believe to be a misleading headline in a recent joint press release by Domino's Pizza and the National Foundation for Celiac Awareness (NFCA)...here is the headline:
    "Domino’s Pizza Becomes First National Pizza Delivery Chain to Offer Gluten Free Crust"
    When you read the release further, starting at the 5th paragraph, which many people will never get to, it says:
    "While Domino’s new Gluten Free Crust is appropriate for those with mild gluten sensitivity, Domino’s and the NFCA do not recommend it for those with celiac disease. Domino’s and the NFCA found that while the crust is certified as gluten free, current store operations at Domino’s cannot guarantee that each handcrafted pizza will be completely free from gluten."
    So my question is this: How can the NFCA, a national organization dedicated to supporting celiacs, actually get behind this? Domino's is obviously a big corporation that has decided it wants to cash in and profit on the new gluten-free gold rush, but they cleary don't want to spend the money that it would take to make their pizzas truely gluten-free, and safe for celiacs.
    The Designations area of the NFCA's web site begins with: "Restaurants that complete GREAT Kitchens earn a designation based on their ability to meet gluten-free needs and avoid cross-contamination with gluten."  Just below this it describes their "Green Designation" and its "Amber Designation," and describes its Amber Designation as follows: "This level requires ingredient verification and basic training of wait staff and managers. Kitchen practices may vary with this designation, level one of the tier system, meaning those with celiac disease and non-celiac gluten sensitivity should ask questions and exercise judgment when dining at an establishment with an Amber Designation. Domino's has earned this designation."  So how has Domino's met "gluten-free needs and avoid cross-contamination with gluten"?
    Also, I think any celiac who watches the video Domino's made for this release will find it a bit scary...the same ovens, pizza scoopers, topping areas, etc., as where they make their regular gluten pizzas.
    I would exclude Domino's as an advertiser on Celiac.com based on this release.
    Some might think that the NFCA has sold out here. I invite them to respond using the comment field below, and I invite you to respond.
     
    Also, there is a lively discussion going on in our forum on this topic.  
    Here is the original press release:
    ANN ARBOR, Mich., May 7, 2012 – Domino's Pizza is responding to the needs of choice consumers, today launching a Gluten Free Crust available in all of its nearly 5,000 U.S. stores and becoming the first national pizza delivery chain to offer such a product.
    Domino’s Pizza (NYSE: DPZ) consulted with the National Foundation for Celiac Awareness (NFCA) to ensure its products and team member training meet the standards of the foundation’s GREAT Kitchens Amber Designation. NFCA’s GREAT Kitchens is an official credentialing program that has expanded to include restaurants offering gluten free products with varying kitchen practices, therefore suitable for those with gluten sensitivity under the Amber Designation.
    Domino’s new Gluten Free Crust provides a great-tasting option for consumers who previously could not enjoy pizza from the recognized world leader in pizza delivery because of sensitivity to gluten – a protein found in wheat, rye and barley.
    “Many of our customers have asked for a gluten free crust, and Domino’s is excited to offer a product to customers with mild gluten sensitivity – as well as partner with the NFCA, which has been instrumental to our learning more about how to take this step,” said J. Patrick Doyle, Domino’s Pizza president and CEO. “The prevalence of gluten sensitivity has become a real issue with significant impact on consumer choice, and we want to be a part of the solution. Now, the whole group can enjoy Domino’s with the addition of our new Gluten Free Crust.”
    While Domino’s new Gluten Free Crust is appropriate for those with mild gluten sensitivity, Domino’s and the NFCA do not recommend it for those with celiac disease. Domino’s and the NFCA found that while the crust is certified as gluten free, current store operations at Domino’s cannot guarantee that each handcrafted pizza will be completely free from gluten.
    “The NFCA is thrilled that Domino’s Pizza has developed a product that will improve the quality of life for many of the estimated 18 million Americans who are gluten sensitive,” said Alice Bast, NFCA founder and president. “Not only is Domino’s Gluten Free Crust a huge win for much of the gluten free community who can now get pizza delivered to their door, it’s also delicious. Customers aren’t going to believe they’re eating a pizza made on a gluten free crust when they try it. And the variety of fresh toppings that are available is a giant leap ahead.”
    In an effort to remain open and informative about Domino’s Gluten Free Crust, Domino’s has created a video on YouTube that allows customers to decide whether this product is suitable for their diet, found here: www.youtube.com/user/dominosvids.
    “Offering Domino’s Gluten Free Crust is a big step for us, and we wanted to make sure we were doing it right,” said Doyle. “Domino’s is doing that by partnering with experts at the NFCA and by empowering the gluten sensitive community with the information they need.”
    Domino’s new Gluten Free Crust is available in stores across the U.S. in a small, 10-inch size only, and prices vary by store.
    Domino’s pizza made with a Gluten Free Crust is prepared in a common kitchen with the risk of gluten exposure. The National Foundation for Celiac Awareness supports the availability of Domino’s Gluten Free Crust, but cannot recommend the pizza for customers with celiac disease. Customers with gluten sensitivities should exercise judgment in consuming this pizza.
    About Domino’s Pizza®
    Founded in 1960, Domino's Pizza is the recognized world leader in pizza delivery.  Domino’s is listed on the NYSE under the symbol “DPZ.”  As of the first quarter of 2012, through its global footprint primarily made up of locally-owned and operated franchises, Domino’s operated a network of 9,810 franchised and Company-owned stores in the United States and over 70 international markets.  During the first quarter of 2012, Domino’s had global retail sales of nearly $1.7 billion, comprised of over $830 million domestically and nearly $855 million internationally.  Domino's Pizza had global retail sales of over $6.9 billion in 2011, comprised of over $3.4 billion domestically and over $3.5 billion internationally. In May 2011, Pizza Today named Domino’s its “Chain of the Year” for the second straight year – making the company a three-time overall winner, and the first pizza delivery company to receive the honor in back-to-back years.  In 2011, Domino’s was ranked #1 in Forbes Magazine’s “Top 20 Franchises for the Money” list.  
     

    Jefferson Adams
    Celiac.com 01/23/2015 - This Superbowl Sunday gluten-free fans can celebrate with gluten-free Pizza Hut pizza, and, in a few lucky test markets, gluten-free Coors beer.
    You read right. First, Pizza Hut has announced that, starting Jan. 26, it will be debuting a gluten-free pizza in about 2,400 locations in the U.S. The new pizza will be a 10-inch, six-slice pizza, which will go for $9.99. The pizza crust will be made by popular gluten-free brand Udi’s Foods, and certified gluten-free by the Gluten Intolerance Group.
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    admin
    Celiac.com 08/14/2015 – Recently I took a last minute, end of Summer road trip with my family and on one of our pit stops I was delighted to discover the often rumored, highly elusive and possibly "Holy Grail" of gluten-free food: Subway's gluten-free sub rolls! Yes, I am here to tell you that they do indeed exist, even though I almost couldn't believe it even when I saw them—but there they were...a whole stack of six inch long gluten-free Subway rolls—sitting right in front of me in tidy, individually wrapped cellophane packages.
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    Celiac.com 09/27/2016 - After repeated shareholder requests, and a public admission from the CEO that the company had "really screwed up the gluten free stuff," Starbucks is announcing an expansion gluten-free and other specialty options.
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    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com