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    Trust but Verify: "Gluten-free" Hospital Meals May Not Be Gluten-free


    Jefferson Adams

    Celiac.com 08/23/2010 - People following a gluten-free diet due to celiac-disease or other conditions, who are facing a hospital stay, might want to cheek with their hospital dietitian and staff to make sure that the 'gluten-free' meal they receive is, in fact, gluten-free.


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    That's because, even hospitals can make mistakes. Let's face it, if they can occasionally amputate the wrong limb, remove the wrong organ, or give the wrong drugs, they can accidentally slip an item containing gluten into a gluten-free meal.

    That's exactly what happened to Don MacMillan, a 68-year old Canadian man whose recovery from gall-bladder surgery was marked by a hospital mix-up that sent him a standard meal instead of the gluten-free meal he required and requested. 

    Still weak, three days after surgery, and hungry from three days of intravenous and liquid nutrition, MacMillan was looking forward to eating his first solid food. Still, he didn’t want to take any chances.

    He was suspicious of the hospital's lunch of chicken à la king and a cookie. Fortunately for MacMillan, he was both suspicious and vocal.

    ‘You sure what I’m being fed is gluten free?’ he asked the assistant.

    She answered that it was, but MacMillan asked her to please double-check. After checking in with the kitchen, she admitted that they had made an error: the meal was not, in fact, gluten-free.

    “She told me it was OK, but I just didn’t trust her ... so I asked her to verify," MacMillan added.

    Quintin Wight, spokesman for the Ottawa chapter of the Canadian Celiac Association, said what happened to MacMillan occurs more frequently in hospitals and nursing homes than is reported.

    “I sympathize with him greatly because this is a situation that we’ve heard about on and off over many years,” said Wight.

    “I’m not sure how it arises in the hospitals because the dietitians certainly know what gluten-free food is, but it doesn’t seem to get to the kitchen staff. These are organizations that should know better," he added.

    No one needs extra dietary or immune challenges when recovering from surgery. People who plan a hospital stay, and who require and request a gluten-free meal due to celiac disease or other conditions, can do themselves a big favor by taking steps to confirm the gluten-free status before eating the meal provided.

    Rule of thumb: Just because the meal is labelled gluten-free, doesn't mean it is gluten-free. When it comes to special meals in the hospital, trust, but verify.

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    Great article, yet another aspect of being gluten free I had not considered. My wife, who is gluten free, has pretty much taken to bringing her own food with here, wherever she goes. Thankfully we have not had to deal with a hospital stay!

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    When I was in the hospital for abdominal surgery, they knew I had a gluten allergy but yet, they could not tell me if any of the medications they were planning to give me were gluten free.

     

    My first meal after surgery consisted of toast and cream of wheat.

     

    I checked myself out of the hospital immediately.

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    Funny, this article was posted on Health Canada's gluten-free link on Friday too and I responded to Lance on that posting. I live in Canada too but on the West Coast in Vancouver and I really think this issue has to do with the length of your hospital stay. Being in the hospital for a month at a time several times now I have had no problems. I get very plain gluten free meals like boiled eggs, broiled chicken, rice, steamed veggies, Ener-G food bread - does not go down well not toasted but it is safer being sent not toasted, cheddar cheese slices, vegetable sticks, etc and I have had no problems. In one smaller specialty hospital (UBC)that has a higher incidence of people on a gluten free diet or they try people on a gluten free diet on the group of wards I was on, they even make Gluten-free Casein-free muffins twice a week.

    I am tired of seeing posts from people making negative comments about hospitals when there over night or for one or two meals and they do not get a gluten free meal. It takes a day or two to get into the system. You cannot get gluten free meals in the ER. You DO have to come prepared however if you end up in a hospital in an emergency and onto a ward you can just request items like rice, steamed veggies etc. while your gluten free request is making its way through the system. The dietitians do meet with you if you are a long stay patient and they work with you on your meal - such as I wanted more real fruit rather than canned fruit and I was able to get that. The hospitals were Vancouver General Hospital and University of BC Hospital.

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    When I was in the hospital for abdominal surgery, they knew I had a gluten allergy but yet, they could not tell me if any of the medications they were planning to give me were gluten free.

     

    My first meal after surgery consisted of toast and cream of wheat.

     

    I checked myself out of the hospital immediately.

    Last I checked, which was 2 days ago as I am writing an article for our Chapter newsletter, in Canada there are only 6 medications that are listed in the Pharmacy book that are NOT gluten free. All other medications, which a good portion come from the USA, are gluten free. The list of gluten-free manufacturers in the Pharmacy Book is pretty long - way longer than the list of lactose free manufacturers. The pharmacist from glutenfreedrugs.com spoke at the recent Canadian Celiac Association National Conference in June/2010 and he confirmed the same information with regards to how many medications are not gluten free anymore - very, very, very few. All IV's are gluten free as they do not go into your intestines. As I said in my other post - it is very common for your first meal to be incorrect as you had not been ordering gluten free meals - it takes about 1 day at least in the meal system (1 full day cycle) to start getting correct meals.

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    Guest Denise

    Posted

    I recently stayed overnight in a hospital (Riverbend, Springfield OR) and they had a separate gluten free menu. It was nice to see that they had dedicated the time to research and provide a clear menu of gluten free foods. It was one less thing I had to think about.

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    Funny, this article was posted on Health Canada's gluten-free link on Friday too and I responded to Lance on that posting. I live in Canada too but on the West Coast in Vancouver and I really think this issue has to do with the length of your hospital stay. Being in the hospital for a month at a time several times now I have had no problems. I get very plain gluten free meals like boiled eggs, broiled chicken, rice, steamed veggies, Ener-G food bread - does not go down well not toasted but it is safer being sent not toasted, cheddar cheese slices, vegetable sticks, etc and I have had no problems. In one smaller specialty hospital (UBC)that has a higher incidence of people on a gluten free diet or they try people on a gluten free diet on the group of wards I was on, they even make Gluten-free Casein-free muffins twice a week.

    I am tired of seeing posts from people making negative comments about hospitals when there over night or for one or two meals and they do not get a gluten free meal. It takes a day or two to get into the system. You cannot get gluten free meals in the ER. You DO have to come prepared however if you end up in a hospital in an emergency and onto a ward you can just request items like rice, steamed veggies etc. while your gluten free request is making its way through the system. The dietitians do meet with you if you are a long stay patient and they work with you on your meal - such as I wanted more real fruit rather than canned fruit and I was able to get that. The hospitals were Vancouver General Hospital and University of BC Hospital.

    Absolutely, Lynda. It's completely unacceptable that in a health care setting, one should expect a medically safe meal if they're only hospitalized for a day or so. In fact, I think diabetics should be given high-glycemic index, sugary meals and people on a kidney diet be given regular potassium, high-protein meals. Heart patients should get burgers. If you can't eat what everyone else is eating, then you should either get sicker or not eat. Sounds fair to me.

     

    I was hospitalized five years ago in California. In addition to having Celiac Disease, I have multiple, serious food allergies. I nearly starved, quite literally, during my five day stay. The dietician told me I should have someone bring me food if I wanted safe food to eat, and I had no family to do that.

     

    Frankly, I'm sick of even those with Celiac Disease themselves thinking they shouldn't be entitled to the same consideration that anyone else with a serious illness would get. Negative? After nearly starving in the hospital after a very traumatic surgery, you bet! I should add that they also served me some fish covered in something I'm allergic to, and then lied to me about what it was. The nurse told me that it had come out of the package like that, so it must be plain. I doubt anyone even had read the label.

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    Guest Gabrielle

    Posted

    Agreed 100% My type 1 diabetic & celiac daughter had two trips to the ER/hospital this summer and when we inquired about whether they understood gluten free eating, the response was as follows (and with confused looks from all with whom I spoke): "We'll try to make it as gluten free as possible" and THAT didn't inspire a whole lot of trust on my end so I brought ALL her food from home! They really do NOT get gluten free eating and these are supposedly top hospitals! Shame on them!

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    While my wife was in recovery from knee surgery, she was given Kellogg's Rice Crispies for breakfast. When questioned, she was told that "Rice is gluten free". She asked that they read the ingredients list and they were surprised.

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    Guest BarbaraDH

    Posted

    Both my husband and I have celiac disease. He had outpatient back surgery a couple of years ago and was required to eat something before they would release him the same day. After checking their menu, there was only 1 item on it that I could be sure was gluten-free - a fresh fruit plate. When I first asked the nurses what was available that was gluten-free for him, they didn't know what I was talking about. This is just scary, not to mention totally unacceptable and dangerous. What if it was a severe allergy..... would they be so casual about the possibility of inducing an anaphylactic reaction?

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    I was hospitalized for 28 days iin 2009. During my 3 1/2 week stay in ICU, I received foods that were not gluten free 4 times. Luckily, my husband was keeping a sharp eye out for errors in the diet, and I didn't eat anything that made me sick. The dietitian said, "I'm more embarrassed than I can even say." But dietitians are not in the hospital kitchens and are not able to supervise meal and tray preparation. Many kitchen employees don't even speak English and don't know what gluten is. I would advise any person with celiac disease or allergy to gluten to question any hospital meal that is not clearly gluten free.

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    Guest Christa

    Posted

    Funny, this article was posted on Health Canada's gluten-free link on Friday too and I responded to Lance on that posting. I live in Canada too but on the West Coast in Vancouver and I really think this issue has to do with the length of your hospital stay. Being in the hospital for a month at a time several times now I have had no problems. I get very plain gluten free meals like boiled eggs, broiled chicken, rice, steamed veggies, Ener-G food bread - does not go down well not toasted but it is safer being sent not toasted, cheddar cheese slices, vegetable sticks, etc and I have had no problems. In one smaller specialty hospital (UBC)that has a higher incidence of people on a gluten free diet or they try people on a gluten free diet on the group of wards I was on, they even make Gluten-free Casein-free muffins twice a week.

    I am tired of seeing posts from people making negative comments about hospitals when there over night or for one or two meals and they do not get a gluten free meal. It takes a day or two to get into the system. You cannot get gluten free meals in the ER. You DO have to come prepared however if you end up in a hospital in an emergency and onto a ward you can just request items like rice, steamed veggies etc. while your gluten free request is making its way through the system. The dietitians do meet with you if you are a long stay patient and they work with you on your meal - such as I wanted more real fruit rather than canned fruit and I was able to get that. The hospitals were Vancouver General Hospital and University of BC Hospital.

    I worked at a hospital [part of the Mayo health system] for a couple of years after I was diagnosed with celiac disease and finally quit a great job in disgust. I could not get a gluten free meal there or the trauma hospital [also associated with Mayo] that is 30 miles away, still can't. Even the hospital dietitian told me that she "couldn't help me, my diet was way too complicated." There is NO excuse for a hospital to not provide gluten free meals when I can safely eat at Outback steakhouse. The waitresses there know more than medical staff!

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    The day that I was diagnosed with celiacs (via an endoscopy) the nurses in the ambulatory surgery center gave me juice and crackers to recover from the sedative!! I knew nothing yet about what I could have but became sick on the way home and had to return to the hospital. And when I had a cervical fusion done three years later, the nurses aid came in and offered me crackers! They don't pay attention. We have to be our own advocates. Make sure you tell your family members to make sure your meals are double checked also.

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    I worked at a hospital [part of the Mayo health system] for a couple of years after I was diagnosed with celiac disease and finally quit a great job in disgust. I could not get a gluten free meal there or the trauma hospital [also associated with Mayo] that is 30 miles away, still can't. Even the hospital dietitian told me that she "couldn't help me, my diet was way too complicated." There is NO excuse for a hospital to not provide gluten free meals when I can safely eat at Outback steakhouse. The waitresses there know more than medical staff!

    Christa, You are very right about that! I feel bad for you. Hospitals should do more than they are doing.

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    Guest Lee-Anne White

    Posted

    Definitely ask, ask, ask & ask again! My stay at a local hospital (NS-F) in Georgia was wonderful when I had my daughter 18 months ago-I had different dietitians every other day. My vigilance paid off;I kept getting gluten-free/CF items included with my plate when we went over each meal individually. One day I just gave up after I sent the meal back twice-"plain" was not an acceptable word-the grits had butter in them, and someone kept on giving me milk with my meal (I requested Silk-which was on the menu). Praise the Lord I had wonderful staff and family support

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    Granted, a good number of hospitals don't have the slightest idea on how to feed a celiac. I would say it's expected to get a "gluten free" meal that is chock full of gluten. But there's more. The problem here is cross-contamination issues. Even the best dietitian and kitchen typically can't handle sensitive celiacs. The room for error is just too great, especially when you are dealing with multiple special meal requests of all sorts. I have been in the hospital and have been glutened due to cross-contamination (the food was naturally gluten free). My doctor and I had met with the RD (she seemed to be very Celiac knowledgeable) and plannd a gluten free menu, complete with my own toaster and gluten free meals. There were still some mistakes (did not eat) despite everyone's best efforts. Remember, unless the RD is going to work in the kitchen and plate your meal (unlikely), you are relying on lay dietary staff to do it. In my opinion, hospitals cannot handle gluten free. If you are a "sensitive" celiac, or just don't want to worry about possible intestinal damage even if asymptomatic, bring your OWN food. Also, as stated by someone else, always have an emergency food bag for a sudden hospital trip. ERs and Observation units cannot typically feed you. The only time I felt safe eating hospital food was the gluten free frozen meal they microwaved for me. Beware in hospitals is all I can say. There are the odd hospitals who seem pretty decent (Regina, SK, Canada), but most are simply unable to handle the most sensitive of us due to the nature of hospital kitchens.

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    How would you feel if the hospital and the doctors could care less about celiac people. I went into the ER for trouble breathing. It took eight hours before the doctor came into see me. Before she did, the nurse wanted to give me meds. I asked her if they are gluten free. She did not know what I was talking about. The doctor finally came in and told me it was my responsibility to know what meds I am allergic to. And then she told me that the celiac disease is only food restricted, therefore that the meds do not contain gluten. This hospital is in United States and in California and I have not met one doctor that is knowledgeable or they could care less. Since I had to do this all alone with this disease; the doctors tell me that I am cured. Scary is not the word for it. What happens when I go into the hospital and cannot speak. I already had two strokes. I believe if I have another one, I rather stay home and die.

     

    Thank you for your time,

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    Guest Jim Dobstaff

    Posted

    I was in the Buffalo VA Hospital for ulcerative colitis (which came about as a result of me taking dapsone for my DH) I lost 35 pounds in 5 weeks. After being on an IV for 5 days, the first meal they brought me was a pork chop with mashed potatoes and GRAVY and a slice of WHITE BREAD. The card on my tray stated "LOW GLUTEN DIET". I couldn't believe it. The very thing that put me in the hospital to begin with... (accidently glutened by ranch salad dressing which led to a bad outbreak of DH, thus the dapsone & reaction leading to the colitis and bleeding. My immune system was on fire fighting my own body.) My wife brought in all my food and snacks as I couldn't trust the hospital. It is supposed to be a NO gluten diet. I just can;t figure it out when a hospital should be a safe place where you go to get well!

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    Guest Mary Jane

    Posted

    I think this should be forwarded to every hospital out there. Maybe if they read these comments they will understand the negative effect they have on us. Unfortunately, the reality is hospitals are only really interested in the bottom line - the money, not the true safety and happiness of their patients. Until there is a lawsuit over this, probably nothing will change.

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    Guest Lesley Carol Prince

    Posted

    The above comments confirm my experience with the poor and/or faulty provision of gluten free hospital food. Keep advocating for yourself and others, send back those trays, speak with dietitians.

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    Guest Georgia Hartley

    Posted

    having done my internship at a local prominent hospital I was appalled to learn that the director of the hospital cafeteria knew NOTHING of gluten issues much less had any dietary knowledge whatsoever. You would think a hospital would require their cafe staff to offer healthy food that complied with a wide array of dietary issues. I made some comments to the hospital director but nothing changed in the year I was there.

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    Guest Shay Kell

    Posted

    Great article, yet another aspect of being gluten free I had not considered. My wife, who is gluten free, has pretty much taken to bringing her own food with here, wherever she goes. Thankfully we have not had to deal with a hospital stay!

    When I had a hospital stay for surgery, I planned ahead and made meals and froze them. The hospital called in their kitchen staff to be sure everyone understood my needs but the first meal turned out questionable and in the end the dietitian recommended my family bring in my frozen meals for the nurses to 'nuke' for me. Better safe than sorry. My nephew works in the kitchen of a hospital and understands the need for dedicated gluten-free cooking utensils (due to me) but still finds him arguing with staff & bosses who routinely violate this rule.

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  • About Me

    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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    Cut cauliflower into small pieces and place in the oiled pan.
    Roast in oven at 350F until browned on both sides.
    Remove from the oven when tender. 
    Allow roasted cauliflower to cool.
    Chop cauliflower, or break into small pieces and set aside.
    Chop cooled chicken and set aside.
    Heat 1 inch of cooking oil in a small frying pan.
    When oil is hot, use a spatula to submerge a tortilla in the oil and leave only long enough to soften, about 10 seconds or so. 
    Remove soft tortilla to a paper towel and repeat with remaining tortillas.
    Pour enough enchilada sauce to coat the bottom of a large casserole pan.
    Dunk a tortilla into the sauce and cover both sides. Add more sauce as needed.
    Fill each tortilla with bits of chicken, cauliflower, onion, and queso fresco, and roll into shape.
    When pan is full of rolled enchiladas, top with remaining sauce.
    Cook at 350F until sauce bubbles.
    Remove and top with fresh cotija cheese and scallions.
    Serve with rice, beans, and cabbage, and garnish with avocado, cilantro, and sliced grape tomatoes.

     

    Roxanne Bracknell
    Celiac.com 06/22/2018 - The rise of food allergies means that many people are avoiding gluten in recent times. In fact, the number of Americans who have stopped eating gluten has tripled in eight years between 2009 and 2017.
    Whatever your rationale for avoiding gluten, whether its celiac disease, a sensitivity to the protein, or any other reason, it can be really hard to find suitable places to eat out. When you’re on holiday in a new and unknown environment, this can be near impossible. As awareness of celiac disease grows around the world, however, more and more cities are opening their doors to gluten-free lifestyles, none more so than the 10 locations on the list below.
    Perhaps unsurprisingly, the U.S is a hotbed of gluten-free options, with four cities making the top 10, as well as the Hawaiian island of Maui. Chicago, in particular, is a real haven of gluten-free fare, with 240 coeliac-safe eateries throughout this huge city. The super hip city of Portland also ranks highly on this list, with the capital of counterculture rich in gluten-free cuisine, with San Francisco and Denver also included. Outside of the states, several prominent European capitals also rank very highly on the list, including Prague, the picturesque and historic capital of the Czech Republic, which boasts the best-reviewed restaurants on this list.
    The Irish capital of Dublin, meanwhile, has the most gluten-free establishments, with a huge 330 to choose from, while Amsterdam and Barcelona also feature prominently thanks to their variety of top-notch gluten-free fodder.
    Finally, a special mention must go to Auckland, the sole representative of Australasia in this list, with the largest city in New Zealand rounding out the top 10 thanks to its 180 coeliacsafe eateries.
    The full top ten gluten-free cities are shown in the graphic below:
     

    Jefferson Adams
    Celiac.com 06/21/2018 - Would you buy a house advertised as ‘gluten-free’? Yes, there really is such a house for sale. 
    It seems a Phoenix realtor Mike D’Elena is hoping that his trendy claim will catch the eye of a buyer hungry to avoid gluten, or, at least one with a sense of humor. D’Elena said he crafted the ads as a way to “be funny and to draw attention.” The idea, D’Elena said, is to “make it memorable.” 
    Though D’Elena’s marketing seeks to capitalizes on the gluten-free trend, he knows Celiac disease is a serious health issue for some people. “[W]e’re not here to offend anybody….this is just something we're just trying to do to draw attention and do what's best for our clients," he said. 
    Still, the signs seem to be working. D'elena had fielded six offers within a few days of listing the west Phoenix home.
    "Buying can sometimes be the most stressful thing you do in your entire life so why not have some fun with it," he said. 
    What do you think? Clever? Funny?
    Read more at Arizonafamily.com.

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    Bakery On Main started in the small bakery of a natural foods market on Main Street in Glastonbury, Connecticut. Founder Michael Smulders listened when his customers with Celiac Disease would mention the lack of good tasting, gluten-free options available to them. Upon learning this, he believed that nobody should have to suffer due to any kind of food allergy or dietary need. From then on, his mission became creating delicious and fearlessly unique gluten-free products that were clean and great tasting, while still being safe for his Celiac customers!
    Premium ingredients, bakeshop delicious recipes, and happy customers were our inspiration from the beginning— and are still the cornerstones of Bakery On Main today. We are a fiercely ethical company that believes in integrity and feels that happiness and wholesome, great tasting food should be harmonious. We strive for that in everything we bake in our dedicated gluten-free facility that is GFCO Certified and SQF Level 3 Certified. We use only natural, NON-GMO Project Verified ingredients and all of our products are certified Kosher Parve, dairy and casein free, and we have recently introduced certified Organic items as well! 
    Our passion is to bake the very best products while bringing happiness to our customers, each other, and all those we meet!
    We are available during normal business hours at: 1-888-533-8118 EST.
    To learn more about us at: visit our site.

    Jefferson Adams
    Celiac.com 06/20/2018 - Currently, the only way to manage celiac disease is to eliminate gluten from the diet. That could be set to change as clinical trials begin in Australia for a new vaccine that aims to switch off the immune response to gluten. 
    The trials are set to begin at Australia’s University of the Sunshine Coast Clinical Trials Centre. The vaccine is designed to allow people with celiac disease to consume gluten with no adverse effects. A successful vaccine could be the beginning of the end for the gluten-free diet as the only currently viable treatment for celiac disease. That could be a massive breakthrough for people with celiac disease.
    USC’s Clinical Trials Centre Director Lucas Litewka said trial participants would receive an injection of the vaccine twice a week for seven weeks. The trials will be conducted alongside gastroenterologist Dr. James Daveson, who called the vaccine “a very exciting potential new therapy that has been undergoing clinical trials for several years now.”
    Dr. Daveson said the investigational vaccine might potentially restore gluten tolerance to people with celiac disease.The trial is open to adults between the ages of 18 and 70 who have clinically diagnosed celiac disease, and have followed a strict gluten-free diet for at least 12 months. Anyone interested in participating can go to www.joinourtrials.com.
    Read more at the website for Australia’s University of the Sunshine Coast Clinical Trials Centre.

    Source:
    FoodProcessing.com.au