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Processed Foods Containing Wheat Starch May be Safe for Many People with Celiac Disease 09/08/2008 - Processed foods often contain ingredients derived from starch, such as dextrose (glucose) and maltodextrins. In the United States, these starch products are typically made from corn and are safe for people with celiac disease. However, more than 50% of the processed foods from Europe contain ingredients that are made from wheat starch and therefore contain trace amounts of gluten. This can pose a problem when eating imported foods or when traveling because the amount of gluten required to trigger symptoms in people with celiac disease is still under investigation and not yet completely understood.  For this reason, researchers in Finland have tested the safety of eating processed foods containing these wheat starch products.

Researchers recruited 90 adults who had been eating a strict gluten-free diet for at least a year, and randomly assigned them to one of three groups. Depending on the group assignment, participants daily consumed drinks containing wheat-based glucose syrup, wheat-based maltodextrins, or a placebo with no wheat starch. The amount of glucose syrup or maltodextrins given to the participants in the first two groups was comparable to the amount of gluten a person might consume while eating an average amount of processed foods.

 Effects of the wheat starch products were tested in several ways. To determine whether the trace amounts of gluten were sufficient to trigger an immune reaction, researchers examined biopsies of the small intestine for signs of inflammation and damage, and tested the blood for specific antibodies that are elevated after gluten consumption.  Small intestine biopsies taken after 24 weeks of wheat starch product consumption did not show increased damage or inflammation compared to biopsies taken before the study began, or compared to biopsies of subjects consuming the placebo.  Similarly, levels of antibodies were not increased by daily consumption of this very small quantity of gluten.

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Because eating gluten reduces nutrient absorption in people with celiac disease, blood levels of iron, folic acid, and calcium were tested in all three groups before and after the 24 week study.  Concentrations of these nutrients did not decrease in any of the groups during the study, indicating that nutrient absorption was not affected by this amount of wheat starch consumption. Additionally, gastrointestinal symptoms, such as diarrhea, indigestion, constipation, abdominal pain, and gastro-esophageal reflux, did not increase significantly in any group and none of the patients who suffered from dermatitis herpetiformis developed a rash during the study.

Results of this study suggest that the trace amounts of gluten in processed foods containing wheat starch products were not harmful for most people with celiac disease. Although additional studies will help clarify the issue, it may be unnecessary for people to avoid these products, making it easier to adhere to a “gluten-free” diet.

Kaukinen K, Salmi T, Huhtala H, et al. Clinical trial: gluten microchallenge with wheat-based starch hydrolysates in celiac disease patients:  a randomized, double-blind, placebo-controlled study study to evaluate safety. Alimentary Pharmacolgy 

Aliment Pharmacol Ther. 2008 Aug 17.
Departments of Gastroenterology and Alimentary Tract Surgery, University of Tampere and Tampere University Hospital, Tampere, Finland. welcomes your comments below (registration is NOT required).

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17 Responses:

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said this on
10 Sep 2008 6:36:16 AM PST
Although this article's claims might scientifically turnout to be correct, in practice it seems risky. Celiacs must already rely so heavily on trust that ingredients are listed correctly and foods are prepared safely. If suddenly it's considered 'ok' to have certain wheat ingredients in 'safe-for-Celiac's' foods, who will be policing the manufacturers to find out exactly 'how much' gluten is in a particular product? Also, if you start diluting the message that wheat is dangerous for Celiacs, then Celiacs will have a much harder time explaining to others what they can and cannot have. It will weaken the gains Celiacs have made with Restaurants, food manufacturers, etc. I fear it will lead to much more liberal, arbitrary decisions by food preparers about what is safe to serve to Celiacs, resulting in dangerous foods being served to Celiacs.

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said this on
10 Sep 2008 10:07:47 AM PST
This study was done in a country that diagnoses Celiac Disease much sooner than other countries. The tests done after the ingestion are known not to be 100% accurate and can miss the damaged areas. Also, ingestion of gluten, even if it causes no 'obvious' symptoms can cause harm to other areas, it's an 'autoimmune' disorder. I wish they would stop trying to find how much gluten is 'safe', and concentrate on finding a solution to the problem so that generations to come will not have the limitations that I have.

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said this on
10 Sep 2008 1:28:46 PM PST
How is this wheat starch (from the study) similar or dissimilar to the wheat starch found in bread products in Europe that are Celiac-friendly but not recommended here in the U.S.?

Frank O'Barski
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said this on
10 Sep 2008 2:01:06 PM PST
I question the accuracy of this study. It is difficult to judge without knowing the methodology of the study. Who were the subjects? Were they self selected, or diagnosed with Celiac via medical testing? I think there is still much we do not know about the way the body deals with such toxic attacks. I went undiagnosed until I was in my late forties, (after a lifetime of miserable health) and have absolutely no tolerance for wheat gluten now. I have acquaintances who were diagnosed as children, and can tolerate wheat based foods for short periods.
Even if the study is accurate, I think it is only one piece of the puzzle. I would caution people with the disease not to abuse their ability to handle this insult to their system.

H Terri Brower
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said this on
10 Sep 2008 3:35:29 PM PST
Very helpful research.

Ron Soulis
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said this on
10 Sep 2008 4:27:19 PM PST
I am a Celiac, and I've suspected that the concentration of Gluten must be low in wheat starch since I have not had any symptoms even though I've been eating 'Corn Pops' which contain a small amount of wheat starch.

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said this on
10 Sep 2008 10:12:03 PM PST
This so-called study does not change the fact that if you ingest gluten, you are damaging your body regardless of the amount ingested. The study also does not say how much of the wheat starch, never mind that it was comparable to what is consumed in processed foods on a daily basis, was given to participants. Lets not get people's hope's up here. I am hyper sensitive to gluten and will not give up the good health I have worked so hard to maintain since being diagnosed 4 years ago on one study from Europe where standards are much different. And I hope you all do the same.

Paul Jackson
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said this on
10 Sep 2008 11:19:29 PM PST
I was diagnosed with celiac in May of '07 and have only had a handful of relapses--all of them unwitting. One of these consisted of a California sushi roll made of unprocessed, whole, natural seafood; fresh cucumber; fresh avocado; all in a mayonnaise dressing, 'gluten-free' (so I was told!) and wrapped in nori seaweed without any soy sauce whatsoever. Over a fortnight (2 weeks), I ate about ten servings of this dish, which I later learned did have a single wheat ingredient, viz., wheat starch, in the dressing, over a fortnight.

Although I have no known GI problem besides celiac, the effects were simply awful: intestinal gas, as well as symptoms typical of a gluten attack on me (edema or bloating, mental fog, and nervous tension).

Of course, I do not know whether my gut was damaged by this experience. But I do know that I'm highly symptomatic whenever glutened, and that I did not experience any symptoms until the second week of this experience. So I share O'Barski's skepticism: 'I think there is still much we do not know about the way the body deals with such toxic attacks.' At best, the study is a small, incremental step in the nascent scientific understanding of celiac, which is a very complex disease.

And, I know I now lack trust in the kitchen staff at my employer's cafeteria, and that I will do my best to avoid wheat starch, no matter how 'safe' Finnish researchers consider it to be.

S. Jones
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said this on
11 Sep 2008 4:52:15 PM PST
Great article!

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said this on
11 Sep 2008 5:59:59 PM PST
I was diagnosed in 1997 after 13 years of suffering and I too am completely intolerant to any gluten whatsoever. I agree, stop trying to figure out how much some people can have and concentrate efforts on understanding the entirety of this disease. It is not only gastrointestinal, it also has an intense impact on the endocrine and neurological systems. Was that tested, no. And because these aspects don't get attention, it is next to impossible to get doctors to pursue these problems. It is so great to read about others who are ultra sensitive like myself. I am not alone in this. However, we do not have any organizations out there fighting for our protection like all of those that can have some gluten and we need protection from the little bit that is going to be allowed by the FDA.

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said this on
11 Sep 2008 8:53:57 PM PST
This article is indeed interesting, but much more study to support the supposition contained therein will indeed be needed to clarify and confirm their findings.
Certainly all Celiacs would be delighted to know that Maltodextrin, modified food starch and such were identified on prepared food labels as wheat and/or corn products, which is NOT now required in labeling, but should be!!!
Avoiding any trace of gluten is a nearly impossible challenge! We need better and more accurate food labeling requirements.

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said this on
14 Sep 2008 12:06:25 PM PST
When reading articles such as these I think the thing to take away, is that reading labels is the best way to avoid gluten. That said, after almost 40 years as a celiac (yes that was before blood tests etc), I have found my own level of comfort with the disease. One thing that I learned many years ago, is not be be paranoid.
I have, over the years, taken the burger out of the bun, picked the chicken flesh out of battered 'stuff', and scrapped dressing off lettuce leaves - all with no physical detriment except perhaps frustration.
I do know when I have had gluten (even teeny tiny amounts such as in a multivitamin that I took), and my blood work shows no antibodies, so I figure I am doing ok.
So I really think these studies are helpful - at least they are trying to find out tolerances - and they may just find that we all have different tolerances - who knows, but publishing these articles should be encouraged.

Sarah Co.
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said this on
21 Sep 2008 11:28:17 AM PST
Good article!
Keep us updated with any new things you find please.

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said this on
07 Jan 2010 10:40:37 AM PST
Greetings from Finland! I'm checking out how coeliac disease is handled elsewhere in the world, and what kind of articles are published via organizations. I started the diet in my early 20s after blood tests and biopsies - and it improved the quality of life. Some of the gluten-free products here contain wheat starch, but my test results have remained good. Glucose syrup and maltodextrins are considered completely safe - I've understood that the traces are microscopic. At the moment, gluten free food is reasonably available at grocery stores, restaurants, cafeterias and schools, as the coeliac disease is quite common and tested.

European standards aren't always total BS, though sometimes they are...I do acknowledge that some might need stricter diet and science is never certain...

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said this on
23 Aug 2012 2:36:58 PM PST
Hello, Stina. I'm in the U.S. Gluten-free foods can be found in most of our grocery stores now. But going out to eat, cafeterias and schools are nearly impossible to navigate here for patients with coeliac disease. Most processed foods are right out, though if you are willing to read labels you may find other foods that are indeed gluten-free (but only god knows if it's been contaminated in the plant it was canned in). It's been a rough journey for me this summer, from depression after my diagnosis, to glee finding out as a baker I still had options to bake in my kitchen. I still end up with bad days after accidental contamination. But overall, I am beginning to enjoy eating again! Many homeschooled students opt out of public schools due to extreme allergies to nuts, glutens and inhalant caused asthma. It is that difficult to "survive" the most available options for is here.

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said this on
10 Feb 2011 11:21:37 AM PST
I just think that many of us need to listen to our bodies and that labeling in the United States needs to be better. Maltodextrin in this country tends NOT to be wheat starch, which is good, and we need a better understanding of of celiac. However, this at least is a start. They need to test the neurological and endocrological effects. It's a start though.

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said this on
22 Dec 2011 6:18:24 AM PST
This is a helpful article, but it is not specific enough concerning which products can be safely used. Wheat starch itself does not meet the <20 ppm threshold needed for healthy use for celiacs. Wheat starch hydrolysates (derivatives of wheat starch), such as maltodextrin, however, are low enough in gluten levels to be safe. This article needs to point that out. Go to Gluten Free Dietician and look up articles in the newsletter section for examples.

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