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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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    DISTILLED SPIRITS (GRAIN ALCOHOLS) AND VINEGAR: ARE THEY GLUTEN-FREE?


    Megan Tichy

    What is Gluten?


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    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:

    1. 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?
    2. 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? 
    3. 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:
    1. Yes, unless you have reason to believe otherwise, in which case you should simply avoid them.
    2. Yes.
    3. 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.


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    Guest Diane Hurd

    Posted

    Very good, understandable language and correlates with other articles already read on the same subject. Definitely would read everything this author writes on the subject. Thank you!

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    I didn't know it, but a dressing I ate on a daily basis had switched from cider vinegar to distilled vinegar. I was getting more sick everyday. I had to go back to a very bland diet and then slowly add everything I had been eating, one product at a time. Then I read the label, stopped using the dressing and started to get better. I am a very sensitive celiac, but I raise this question. If as you say, a sensitive celiac could see have problems with distilled products, isn't it very possible that other celiacs are also damaging themselves without any symptoms? I know others who can't have distilled vinegar and they aren't as sensitive as myself.

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    Clearly, more than just ethanol makes it through the distillation process, otherwise all distilled alcohols would just be Everclear--and indistinguishable from one another in taste or appearance. I think the fear was/is that, because more than Ethanol makes it through, could gluten be one of the "other" things that gets carried along?

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    I appreciate the teaching that has occurred in this article. I understand the science behind alcohol being gluten free BUT I still have a reaction to any that is distilled through grains. At first I thought my reactions may have been psychosomatic. Maybe it's just because I am questioning the validity of truly being gluten free. But not too long ago I had a very serious reaction and did research on the drink I had, Indeed it was a wheat/Barley vodka. I believe that for most people it may be fine. BUT I have always been super sensitive and am continually reminded that I must be careful.

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    Excellent article. This could not have been any more clear and to the point with regard to distillation and gluten-sensitivity. Great read!

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    Clearly, more than just ethanol makes it through the distillation process, otherwise all distilled alcohols would just be Everclear--and indistinguishable from one another in taste or appearance. I think the fear was/is that, because more than Ethanol makes it through, could gluten be one of the "other" things that gets carried along?

    Justin, the author never claimed that no other substances weren't volatile. She merely discussed ethanol and gluten for simplification. Obviously, water is volatile and would make it through distillation along with the ethanol. This is why all distillation wouldn't result in Everclear. If gluten is present in a distilled alcohol, I would suspect contamination (whether intentional or unintentional) after the distillation process.

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    Susie and Sarah- agreed.

     

    I completely understand the process of distillation. I've done it myself many times in a lab. What I don't understand is how I have reacted time after time after time to products that I find out later contained distilled vinegar or alcohol that is wheat-derived.

     

    I appreciate this article's clear explanations. I just can't seem to make the connection between the logical science and my reality.

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    I am also a very sensitive celiac. I rarely drink, because I no longer desire the taste (spilled out many drinks in the past). But even when I want to have one to be "social" or celebrate a special occasion, I double check & make sure to "go over" the distillation process & ingredients- just not worth getting sick over, from carelessness. This may sound weird but, I have noticed that top shelf alcohol seems to make a difference w me. I even enjoy the taste when all is well! I mix with cranberry or fruit juices & still keep it "very" limited though, better safe than sorry. I just happened to look at a list of gluten free beers today, from the "Gluten Free Beer Festival of 2006". Get a craving once in a great while, may try one of them in the future.

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    I appreciate the teaching that has occurred in this article. I understand the science behind alcohol being gluten free BUT I still have a reaction to any that is distilled through grains. At first I thought my reactions may have been psychosomatic. Maybe it's just because I am questioning the validity of truly being gluten free. But not too long ago I had a very serious reaction and did research on the drink I had, Indeed it was a wheat/Barley vodka. I believe that for most people it may be fine. BUT I have always been super sensitive and am continually reminded that I must be careful.

    Sarah, I have had the same experience and I don't believe that distillation means gluten free. I, as you started looking at distilled alcohol AFTER I had a reaction. Before that I hadn't even thought alcohol could be a culprit. Those who are very sensitive should just stick to things like rum, sake and wine. All the ingredients are gluten free and I have never had a problem with any of these.

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    Susie: If the company switched to distilled v from cider v, then maybe they changed the factory around a bit too. Many times when an ingredient changes, it's not just because the ingredient itself was cheaper, but because the product is manufactured somewhere else, or, in these economic times, manufactured on shared equipment with other products in order to lay off a few workers. So most likely, your reaction was triggered by poor manufacturing practices with no segregation of malicious gluten bits.

    I have had this problem with Walmart's new packages of snack foods. It used to say gluten free on the Great Value brand, but now the packaging changed from blue to white, and it no longer states that it's gluten-free.

    Others: Is it possible that your reaction was that of cheap alcohol? I get really sick off many bottom shelf brands, simply because of the impurities (like poisonous alcohols and the like). Oh, and Justin, other alcohols taste different because of the way they are aged and the like (eg in wooden barrels) and the additives (eg juniper berries in gin), NOT because of the distillation process.

    Like the author said, watch out for "malt" and we are fine.

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    I think the author makes perfectly scientific points, and I agree with them. I am not a celiac, however my fiance is. I have noticed two things:

    1. If he drinks soon after a minor contamination he gets ill. I mean really ill. In my estimation, it is not that the booze contains gluten, but the damaging of an already sensitive system that causes the horrible following reaction.

    2. Sometimes when people drink they lose the total control that they would ordinarily retain. I have heard my fiance, after a couple of drinks relax the standards he usually carries on food because he is drunk. Maybe this is a culprit.

    I also have one more comment to add about the alcohol. As was already noted, very few liquors that are sold contain pure ethanol. It would kill you. Most of them are diluted and flavored after the fact. I would guess from the color of many alcohols that they use caramel coloring (barley) and maltodextrin (malt=bad) and any number of "natural flavorings" that they are not necessarily required to itemize. My fiance stays away from anything colored (whiskey, scotch, bourbon, gold tequila) or flavored (gin, flavored vodkas etc.). Stick to things that are fermented directly from gluten free foods, (i.e. sake, wine, silver tequila). Good luck!

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    Guest Diane Lester

    Posted

    As a scientist I would have also assumed that distillation removes gluten from vinegar and alcohol. However my gut feeling is that it does not (I am highly sensitive to gluten and have a highly controlled diet). I have puzzled over this and conclude that it is possible for a distilled product derived from wheat to contain trace gluten for the following reasons

    1. the distillation process is not 100% efficient. Boiling a liquid causes it to vaporize, however it also causes the formation of aerosols (tiny droplets of liquid). These aerosols have the potential to carry gluten into the distilled product. Anyone who has worked in a laboratory will known it is standard practice to distill water twice because one round of distillation does not make water absolutely pure.

    2. Gluten has unusual solubility, being insoluble in water and highly soluble in alcohol. I believe it is also highly soluble in acid. Alcohol and vinegar are prepared from the starch fraction of wheat, which is known to contain residual gluten. This gluten probably concentrates in alcohol and vinegar because they render it highly soluble.

    The only way to demonstrate that vinegar and alcohol derived from wheat are safe for celiac disease patients is to perform a clinical trial which includes patients of all degrees of sensitivity. This has never been done and is logistically daunting.

    Gluten detection methods have shortcomings which mean they cannot, on their own, be used to declare a food safe (I have written a peer-reviewed journal article on this subject Lester DR (2008) Gluten measurement and its relationship to food toxicity for celiac disease patients. Plant Methods. 2008 Oct 28;4:26).

    My impression is that there is sufficient anecdotal evidence from forums within celiac disease support groups to raise doubt about alcohol and vinegar.

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    As a scientist I would have also assumed that distillation removes gluten from vinegar and alcohol. However my gut feeling is that it does not (I am highly sensitive to gluten and have a highly controlled diet). I have puzzled over this and conclude that it is possible for a distilled product derived from wheat to contain trace gluten for the following reasons

    1. the distillation process is not 100% efficient. Boiling a liquid causes it to vaporize, however it also causes the formation of aerosols (tiny droplets of liquid). These aerosols have the potential to carry gluten into the distilled product. Anyone who has worked in a laboratory will known it is standard practice to distill water twice because one round of distillation does not make water absolutely pure.

    2. Gluten has unusual solubility, being insoluble in water and highly soluble in alcohol. I believe it is also highly soluble in acid. Alcohol and vinegar are prepared from the starch fraction of wheat, which is known to contain residual gluten. This gluten probably concentrates in alcohol and vinegar because they render it highly soluble.

    The only way to demonstrate that vinegar and alcohol derived from wheat are safe for celiac disease patients is to perform a clinical trial which includes patients of all degrees of sensitivity. This has never been done and is logistically daunting.

    Gluten detection methods have shortcomings which mean they cannot, on their own, be used to declare a food safe (I have written a peer-reviewed journal article on this subject Lester DR (2008) Gluten measurement and its relationship to food toxicity for celiac disease patients. Plant Methods. 2008 Oct 28;4:26).

    My impression is that there is sufficient anecdotal evidence from forums within celiac disease support groups to raise doubt about alcohol and vinegar.

    I, like many of the people who have responded to this article, react to distilled alcohols. So, while I find this article helpful to some extent, I actually found Diane's answer more relevant to what my gut tells me. Thanks Diane!

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    Guest Joe_Crawford

    Posted

    As a scientist I would have also assumed that distillation removes gluten from vinegar and alcohol. However my gut feeling is that it does not (I am highly sensitive to gluten and have a highly controlled diet). I have puzzled over this and conclude that it is possible for a distilled product derived from wheat to contain trace gluten for the following reasons

    1. the distillation process is not 100% efficient. Boiling a liquid causes it to vaporize, however it also causes the formation of aerosols (tiny droplets of liquid). These aerosols have the potential to carry gluten into the distilled product. Anyone who has worked in a laboratory will known it is standard practice to distill water twice because one round of distillation does not make water absolutely pure.

    2. Gluten has unusual solubility, being insoluble in water and highly soluble in alcohol. I believe it is also highly soluble in acid. Alcohol and vinegar are prepared from the starch fraction of wheat, which is known to contain residual gluten. This gluten probably concentrates in alcohol and vinegar because they render it highly soluble.

    The only way to demonstrate that vinegar and alcohol derived from wheat are safe for celiac disease patients is to perform a clinical trial which includes patients of all degrees of sensitivity. This has never been done and is logistically daunting.

    Gluten detection methods have shortcomings which mean they cannot, on their own, be used to declare a food safe (I have written a peer-reviewed journal article on this subject Lester DR (2008) Gluten measurement and its relationship to food toxicity for celiac disease patients. Plant Methods. 2008 Oct 28;4:26).

    My impression is that there is sufficient anecdotal evidence from forums within celiac disease support groups to raise doubt about alcohol and vinegar.

    From my own experience, Russian (pure) potato vodka, if you can still find it, and just about any of the rums are the only alcohols that I can tolerate (I use to buy scotch by the case). Since I developed Celiac, and I've tested it several times, I get a reaction from scotch, beer and whiskey. During the distillation process there are contaminants the bootleggers back home (the Blue Ridges) called fusel oils. These distill off at various temperatures both below and above that alcohol. They are what give various liquors and whiskeys their distinct (i.e., both good and bad) taste. Usually the ones that distill off at lower temperatures are beneficial, those a higher temperatures give the whiskey a solvent like taste. At least in my case, something in the low temp oils gives me the same reaction that I get from gluten.

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    I think the problem with white distilled vinegar is that it turns to a poison in the body. For that reason, we avoid all white distilled vinegar except to clean with. Apple cider vinegar is NOT the same so that is probably why there isn't a problem with that one.

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    Guest Sarah L.

    Posted

    Susie and Sarah- agreed.

     

    I completely understand the process of distillation. I've done it myself many times in a lab. What I don't understand is how I have reacted time after time after time to products that I find out later contained distilled vinegar or alcohol that is wheat-derived.

     

    I appreciate this article's clear explanations. I just can't seem to make the connection between the logical science and my reality.

    Susie, Sarah, Elle -

     

    Same boat here guys, same boat. What is odd is, I can tolerate trace amounts of gluten in other products, but not alcohol. There is a very definitive outcome that results from drinking wheat based boozes, and it is unmistakably celiac (though I wish I could chalk it up to something else I ate, as I do enjoy a cocktail).

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    Guest Stacey Zappacosta

    Posted

    Many of you celiac's that react to vinegar are probably sensitive to yeast and fermented products. Celiac, gluten intolerance and yeast allergies are usually connected because of "leaky gut".

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    Guest T.H.

    Posted

    I appreciate Diane explaining the distillation process, because from the various blogs and forums I read, it seems that there is a lot of confusion about the process, and how scientifically it makes it impossible for gluten molecules to somehow make it through distillation.

     

    However, I was very disappointed in one aspect. Saying that we have nothing to fear from distilled products is, I feel, doing celiac's a disfavor, because it presumes two things that I don't believe are true: people never make mistakes, and all factories are perfect.

     

    If a factory is using products with gluten, then the possibility of contamination after distillation exists. It may not be a high probability of contamination if proper safety standards are used, but...can we guarantee that every facility that is distilling alcohol is concerned about contamination afterward? I don't believe we can - in fact, based on the the history of food production, I'd say the odds are in favor of some facilities having poorer standards and higher chances of contaminating their products post-distillation.

     

    So for those who are sensitive like me, that may mean that 1 out of 4 times I'll be fine with an alcohol distilled from wheat, and one time I'll react because I get a contaminated batch.

     

    It's disheartening to have people's reports of reactions dismissed out of hand, just as so many of us had our celiac symptoms dismissed in the first place. And I feel that we fail to truly examine the problem if we look at it only in terms of a process in theory rather than looking at how the processing works in the real world.

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    Guest Marion

    Posted

    Recently diagnosed with celiac condition, I find the articles very informative. Thanks to these folks.

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    As a scientist I would have also assumed that distillation removes gluten from vinegar and alcohol. However my gut feeling is that it does not (I am highly sensitive to gluten and have a highly controlled diet). I have puzzled over this and conclude that it is possible for a distilled product derived from wheat to contain trace gluten for the following reasons

    1. the distillation process is not 100% efficient. Boiling a liquid causes it to vaporize, however it also causes the formation of aerosols (tiny droplets of liquid). These aerosols have the potential to carry gluten into the distilled product. Anyone who has worked in a laboratory will known it is standard practice to distill water twice because one round of distillation does not make water absolutely pure.

    2. Gluten has unusual solubility, being insoluble in water and highly soluble in alcohol. I believe it is also highly soluble in acid. Alcohol and vinegar are prepared from the starch fraction of wheat, which is known to contain residual gluten. This gluten probably concentrates in alcohol and vinegar because they render it highly soluble.

    The only way to demonstrate that vinegar and alcohol derived from wheat are safe for celiac disease patients is to perform a clinical trial which includes patients of all degrees of sensitivity. This has never been done and is logistically daunting.

    Gluten detection methods have shortcomings which mean they cannot, on their own, be used to declare a food safe (I have written a peer-reviewed journal article on this subject Lester DR (2008) Gluten measurement and its relationship to food toxicity for celiac disease patients. Plant Methods. 2008 Oct 28;4:26).

    My impression is that there is sufficient anecdotal evidence from forums within celiac disease support groups to raise doubt about alcohol and vinegar.

    Diane, you just described what I suspect is the primary reason why distilled spirits have gotten this inaccurate rap for gluten content: Gluten solubility.

     

    The majority of these anecdotal stories involve people who were *not* drinking at home, of drinks they'd prepared themselves. It's folks who are out, either at a party, a bar, a restaurant, etc.

     

    You then point out that gluten is highly soluble in alcohol, which means that if you've been exposed to contamination, the alcohol is going to ensure that you absorb that contamination and disseminate it throughout your system. Further, as we're all well aware, *any* time you eat or drink away from your own home, you are at risk for exposure, because non-celiacs simply don't understand how we're affected. Every single one of us has been poisoned by cross-contamination, most of us multiple times. Blaming the alcohol for facilitating the exposure is like blaming the full moon for an uptick in emergency room visits simply because any uptick which occurs during a full moon gets noted, while any uptick on any other night is simply ignored for what it is: Random chance . It's caused by selective observation, not an underlying truth. I'm sure plenty of celiacs have had reactions after drinking tequila or other non-grain-sourced liquors and either correctly assumed they were poisoned by some other contamination, or incorrectly assumed that the liquor must've had some grain portion. (Mexican distillers find sugar a much cheaper starting point than imported wheat, and even cheap tequila is highly unlikely to have been borne of any gluten-containing source). Adulterated spirits, like gin, are certainly suspect. I'm completely puzzled by mention of caramel colorings or flavorings as a source of gluten -- both are made from carbohydrates, not proteins. Why would you make them from a starchy source that would require enzymatic action to convert it into a sugar prior to the caramelization process? To me, the moral of all these anecdotal stories is simple: Don't drink when you're away from home unless you're eating food which is virtually impossible to cross-contaminate. I don't know much about how industrial tests for gluten work, but I would be very surprised if well-made whiskies or vodkas were found to contain gluten, assuming those tests ever become accurate or sensitive enough to give a reliable result. Anecdotal evidence is always a dangerous thing to rely on. It's why we can't turn on our ipods on an airplane unless it's at cruising altitude, why many gas stations have warning signs telling you that using a cell phone while pumping gas could cause an explosion, and why many parents insist on refusing to vaccinate their children. If we're to rely on anecdotal evidence, can we at least rely on *good* anecdotal evidence? Let's have some of our brave celiac brethren enlist the aid of their spouses, and engage in blind booze exposures at home, where contamination can be controlled. Some nights mix the drinks with a "suspect" alcohol, like scotch. Other nights, use a "safe" alcohol, like potato vodka. If you get several reactions to the suspect, but none to the safe, you'll have an anecdote we can sink our teeth into. Otherwise, I suspect these reports prove what we already know: The outside world is littered heavily with gluten, and we eat in public (sadly) often at our own risk.

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    Guest Anna B2

    Posted

    I am new to this from a personal standpoint. I have just in the last few months started exhibiting symptoms that made me think there is a real problem, but my dad was diagnosed a couple of years ago with a positive DQ. He doesn't remember which one. My daughter, however, had positive allergy tests for multiple food allergies at the age of 2, including wheat, for which she has recently at the age of 6 tested negative. Fortunately??? I think she still has an intolerance after the poor child has been gorging on all the food she wasn't allowed before.

     

    I like the article. Very informative. Diane Lester's post is excellent for filling in any scientific gaps, and Amen to T.H. The real world is where we are, not in the laboratory.

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    I think the author makes perfectly scientific points, and I agree with them. I am not a celiac, however my fiance is. I have noticed two things:

    1. If he drinks soon after a minor contamination he gets ill. I mean really ill. In my estimation, it is not that the booze contains gluten, but the damaging of an already sensitive system that causes the horrible following reaction.

    2. Sometimes when people drink they lose the total control that they would ordinarily retain. I have heard my fiance, after a couple of drinks relax the standards he usually carries on food because he is drunk. Maybe this is a culprit.

    I also have one more comment to add about the alcohol. As was already noted, very few liquors that are sold contain pure ethanol. It would kill you. Most of them are diluted and flavored after the fact. I would guess from the color of many alcohols that they use caramel coloring (barley) and maltodextrin (malt=bad) and any number of "natural flavorings" that they are not necessarily required to itemize. My fiance stays away from anything colored (whiskey, scotch, bourbon, gold tequila) or flavored (gin, flavored vodkas etc.). Stick to things that are fermented directly from gluten free foods, (i.e. sake, wine, silver tequila). Good luck!

    maltodextrin is corn

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    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.

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    Celiac.com 12/10/2000 - As reported in Ann Whelans September/October issue of Gluten-Free Living, the American Dietetic Association (ADA) has released the 6th edition of its Manual of Clinical Dietetics, which offers revised guidelines for the treatment of celiac disease. This manual is currently used by hospitals and doctors all over North America, and represents the most up-to-date source of information with regard to the dietary treatment of various illnesses. The new standards set in this publication conform more closely with current international standards. Included on their safe list are items that have been on Celiac.coms safe list for over five years, including: amaranth, buckwheat, distilled vinegar (no matter what its source), distilled alcoholic beverages (including rum, gin, whiskey and vodka), millet, quinoa and teff.
    A team of American and Canadian dietitians wrote the new gluten-free guidelines, including: Shelley Case, RD, Mavis Molloy, RD, Marion Zarkadas, M.Sc.RD (all from Canada and all members of the Professional Advisory Board of the Canadian Celiac Association), and Cynthia Kupper, CRD, CDE (Executive Director of the Gluten Intolerance Group and celiac). Additional findings of this team regarding buckwheat and quinoa contradict what has been accepted as common knowledge for years by some US support groups, mainly that these two grains are more likely to be contaminated by wheat than other grains. In fact, according to the team, buckwheat and quinoa are far less likely to be contaminated than most other grains.
    At the most basic level the new guidelines mean that celiacs do not need to avoid foods containing unidentified vinegar or distilled alcohol, this alone will allow much more freedom when shopping or eating out. Further, celiacs who drink alcohol will have much more freedom and a far greater choice when they want to have a drink. Additionally, celiacs will be able to more easily maintain a well-rounded and nutritious diet because they will have access to a far greater number of highly nutritious and safe grains.
    The ADAs 6th edition of the Manual of Clinical Dietetics represents the first time that Canadian and United States dietary guidelines have come together to create a united North American gluten-free standard, and will hopefully lead to the adoption of a single standard by all US support groups so that hundreds of thousands of celiacs will not have to unnecessarily exclude more foods than necessary. These new guidelines go a long way towards an international standard, which should be the ultimate goal for all celiacs and celiac organizations in the world.

  • Recent Articles

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    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

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    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