Celiac.com 12/19/2017 - The Canadian Celiac Association (CCA) finds itself facing questions of rumor-mongering and inaccuracy in the face of its ongoing comments about General Mills and Gluten Free Cheerios.

The CCA recently retracted a controversial October 20 press release in the face of questions about the accuracy and validity of its statements. The retraction reads as follows: "The CCA retracts its statement of October 20, 2017 and replaces it with this statement due to errors in the original statement." They retracted every claim made in the first press release. 

In addition to its erroneous, and now retracted press release, the CCA has made numerous public statements casting doubt on the process General Mills uses to create their Gluten-Free Cheerios, and other oat-based cereal products. The CCA has spread fear and confusion about the gluten-free status of Cheerios, and implied widespread gluten contamination in Cheerios. For example, the following statement attributed to the CCA was published on October 26, 2017 by Globalnews.ca: "[CCA] expressed doubt in the company's mechanical sorting system and claim of 100 per cent removal of cross-contaminants."

Additionaly, Canadiangrocer.com reported in August 2016 that the CCA was, to paraphrase, "awaiting evidence showing the new line [of Gluten Free Cheerios] is 100% free of gluten." The article quotes Sue Newell, the CCA Manager, Education and Special Projects, as saying: "Our fear is that there are hot spots in their oats. Any given box may be fine, but every third or fifth box may not."

Canadiangrocer.com has quoted the CCA's Manager making a very specific claim about the gluten-free status of Cheerios. If her claim is correct it would mean that 20% to 30% of all Cheerios boxes are contaminated with gluten above 20 ppm, and General Mills is producing millions of boxes of tainted cereal per month which are fraudulently labeled "gluten-free." When Celiac.com invited Sue Newell to further clarify her position she would neither confirm nor deny making the quotes, but instead said that her quotes were simply "media impressions." Although Celiac.com requested more clarification, Ms. Newell would not respond to further written questions (re-printed below) about her "media impressions." 

Celiac.com also requested that the CCA produce any evidence to back up their claims, but so far the CCA hasn't produced anything. In response to our questions (re-printed below), which mostly remain unanswered, the CCA demurred with vague claims about general levels of gluten contamination in raw oats, and even more vague claims about the unreliability of optical sorting systems in removing gluten. They referred to studies that, after further review, appear to be unrelated to General Mills' proprietary sorting and production processes.

CBC reported on August 31 2016, that the "Canadian Celiac Association is warning against gluten-free Cheerios products over concerns the cereal is not 100 per cent safe for people with celiac disease." What does the CCA mean by "100 percent safe for people with celiac disease?" To our knowledge General Mills has never made the claim that their sorting process results in "100 percent removal" of gluten from the oats used in their Cheerios. It is our understanding that General Mills has only ever claimed that their process results in gluten levels under 20 ppm, which allows them to be labeled "gluten-free" in both the USA and Canada, and as such they are considered safe to consume for those with celiac disease. When Celiac.com asked the CCA to provide a source for the "100% free of gluten" General Mills claim, or for clarification of her "100 per cent safe for people with celiac disease" statement, no response was provided. 

Is the CCA hinting that the labeling standard for gluten-free products should be 0 ppm allowable gluten? Again, they would not answer this question.  It seems that the CCA made this recommendation and their associated statements based not on independent product testing, or on any confirmed accounts of gluten-exposure in people with celiac disease who had consumed Cheerios, but instead on anecdotal evidence and innuendo. 

For their part, General Mills has at least publicly described their optical sorting process, and have gone on the record as saying that their raw unsorted oats contain anywhere from 200 ppm to 1,000 ppm gluten. They describe exactly how their sorting process reduces the gluten content in their oats to below 20 ppm, and how they then pulverize, process, and mix their sorted oats to make Cheerios (from Celiac.com's perspective it is this milling/pulverizing and mixing process that should eliminate any chance of "hot spots"). They have even applied for a patent on their optical sorting technology, and in order to receive this patent their process needs to function as described. Ultimately General Mills stands by their product every day by putting a "Gluten Free" label on every box right next to their trade mark. 

Remember Paul Seelig? Back in 2011, before we even had gluten-free labeling laws in the USA, he sold regular bread that was labeled as "gluten-free." He was tried and convicted of fraud and was sentenced to 11 years in prison. The idea that people can just slap a gluten-free label on a product that contains gluten above 20 ppm and somehow escape our judicial system, whether it be private attorneys who sue them or criminal prosecutors, is highly unlikely.

Ultimately the CCA is calling General Mills, Health Canada and the FDA into question when they make unfounded claims based solely on fear and innuendo. The CCA is also casting doubt on U.S. and Canadian gluten-free standards. If 20% to 30% of Cheerios contain "hot spots" of gluten contamination, then why can't the CCA, or anyone else, produce a single box that is tainted? Where are the trial lawyers who ought to be lining up to sue them?

Cheerios are are subject to regular, random testing by both Health Canada and the FDA. The FDA recently tested major American gluten-free brands for gluten-free labeling compliance and found that 99.5% of products tested are compliant with current gluten-free standards. The FDA found just one non-compliant product out of the hundreds they tested. They worked with the manufacturer to recall the tainted product and correct the manufacturing process. There is no indication that the non-compliant product was Cheerios or any other General Mills product.

In this case the burden of proof for such extraordinary claims lies with the CCA, and not with General Mills. Someone can claim that the Earth is flat, or that humans never walked on the moon, however, the burden of disproving such claims doesn't lie with scientists who spent their entire lives creating a massive body of evidence which support what are now generally accepted facts, but with those making the extraordinary claims. Accordingly, it is only fair that the CCA must back up their claims with more than the equivalent of a vague conspiracy theory, which to disprove, would require General Mills to literally test every piece of cereal in every box of Cheerios (i.e., billions of boxes).

General Mills returned our telephone calls and freely answered our questions. They provided a reasonable description of their sorting process and answered our questions about it. The CCA has been coy and evasive when questioned about their past statements, their claims about Cheerios, and their stance on the 20 ppm gluten-free standard, or any other standard for gluten-free labeling. Until such time as the CCA stands by their statements, and until they provide actual evidence to back up their claims, their claims should be regarded with skepticism.

In their reply to our questions, the CCA included three links to articles they feel support their position on oats:

1. https://www.ncbi.nlm.nih.gov/pubmed/21623493  Koerner et al 2011
2. http://www.sciencedirect.com/science/article/pii/S0308814616312614  Fritz et. al 2016
3. http://onlinelibrary.wiley.com/doi/10.1111/ijfs.13288/full Fritz et al 2016

Celiac.com addresses those studies in a separate article, entitled: Why Do Quaker and General Mills Approach Gluten-Free Oats Differently?

Questions Emailed to the CCA by Celiac.com, followed by their response:

Celiac.com 11/09/2017 - Did you know that the precautionary labeling regarding allergies is widely misunderstood, (meaning you are not the only one that is confused!). Not only is the writing so small you need a microscope to read it, this warning is not necessarily listed in the "Ingredients" column.

The United States and Canada have different laws concerning allergy labeling. A survey presented in March at the AAAAI Allergists' Conference in Los Angeles reveals that 40 percent of consumers avoiding one or more allergens bought foods manufactured in a facility that also processes allergens.

Beyond buying habits the researchers also found a lack of awareness of labeling. Another problem occurs with differences in the food laws of our two countries, the United States and Canada. 45 percent of people surveyed were unaware that precautionary warnings are not required by law. In Canada labeling regulations do require manufacturers to clearly indicate if major allergens are ingredients of a product. But there are no legal guidelines on how companies should identify products that may have come into contact with food allergens during manufacturing. As a result, the manufacturers have been choosing their own phrasing for precautionary labels.

Recently, Health Canada recommended companies limit the advisories to the phrase "may contain", but this is not a legal requirement. A recent study tested 186 products with precautionary peanut labels and found 16, just under nine percent, contained the allergen. A 2009 audit of nearly 100 U.S. supermarkets found that half of all chocolate, candy and cookie products had precautionary labels, many worded in different ways.

The consequences to allergic consumers ignoring labels have proved tragic. Bruce Kelly, a 22 year old Minnesota man with a peanut allergy, died of anaphylaxis in January after eating chocolate candy with a label that said it had been made in a plat that also processed peanuts. "There are too many different types of wording" says study author Dr. Susan Waserman, a professor of Medicine in the division of allergy and immunology at McMaster University in Hamilton, Ontario. She stated, "Patients assume that differences in wording imply a lower level of risk, which they don't." Gupta and Waserman would like to see precautionary labels reduced to one or two clearly defined phrases. For instance, Gupta says if a "May contain" label meant that the food might have up to 100 milligrams of an allergen, then patients could work with their doctors to find out just how much of their allergen may be safe to consume and purchase foods accordingly. The study noted that research is "underway to develop thresholds" for such labels.

Meanwhile, we as two neighboring countries need to urge the U.S. Food and Drug Administration and the Canadian FDA to work with foods coming into our countries that have no labeling advisories at all. For example my husband and I picked up Sweet Shoppe candies sold in both countries, but made in Argentina. The Starlight Mints mints sold in the United States list at the very bottom in small print, "Made in facility that also processes peanuts, tree nuts, soya, milk and eggs." The label did not list wheat, at least on the green and white mints. I have eaten the green and white striped mints in the United States and have had no reaction to them (I am very sensitive to gluten), but yesterday my husband crossed the border to the United States and picked up a package of the Starlight Mints with the red and white stripes. The ingredients listed are glucose syrup, sugar, natural flavor, (peppermint) artificial colors, Titanium Dioxide, FD&C red #40, FD&C blue, Sunflower oil, Propylene Glycol. Nowhere on this packaging does it show "gluten-free" or "wheat-free," or the "Cover all Bases" listing of "Made in a facility that processes...".

I will keep you in touch with my findings, but beware, especially with many of us living close to the U.S./Canada borders that the same products may carry different labeling. It may mean that I am on the internet or calling companies like this one to determine their guidelines for allergy labeling. I am particularly surprised by the United States allowing this Starlight Mint into the country without any "Cover all Bases" type of listing for allergies. Canada often looks to the United States for their guidelines, or rulings for other countries, The researchers at the AAAA1 Allergist' Conference in Los Angeles in March cautions, "In the meantime avoid products with precautionary labels...(i)t still seems to be the best way to maximize safety" says Waserman.

We have to be pro-active, just like the people struggling with peanut allergies have been for years. They fought the airlines with over serving peanuts to passengers, only to have them substituted for pretzels, which are poison to celiacs. We need to get on the Bandwagon and "unite and fight" until we get the same consideration as those with peanut allergies. Ironically, the peanut folks are now trying to get the same parts per million type labeling that we celiacs won years ago on products that are labeled "gluten-free."

Celiac.com 09/20/2017 - A half-time report on what we've learned about each other so far in the Relational Aspects of Food Sensitivities research.

The study is geared toward gaining perspective on the perceived impact one adult's food restrictions cause in a household when cohabitating with other adults. It may ultimately yield strategies to address the social and emotional impact of living with food sensitivities. It aims to provide coping strategies, solidarity and empowerment to our community.

If you haven't had a chance to take the survey, unfortunately it's not too late. If you have, thank you! More about the survey will appear in the next issue and the four lucky $25 Amazon gift card winners will be announced next month as well.

Here's what we've learned so far:
Ninety-six percent (96%) of those who took the survey have a diagnosis that leads them to be on a gluten-free diet. Fifty-one percent (51%) have been diagnosed for 8+ years; 28% have been diagnosed between 4-7 years, 13% between 1-3 years, 5% between 7 months and 1 year, and 3% between 0-6 months. Most began eating a gluten-free diet immediately after being diagnosed. Fifty-two percent feel that the way they were diagnosed affects how seriously the other adult(s) living in the household take their dietary requirements and 23% report that the way they were diagnosed doesn't affect the behavior of the other residential adults at all.

When it comes to how diagnosed, 73% were diagnosed by an MD; 12% by themselves; 5% by a Practitioner, 5% by "Other;" 3% by a Naturopath and 2% by a Nutritionist. Forty-six percent (46%) report that they check in with a medical or health professional to monitor their health/diet once a year, and 21% get checkups several times a year. Most of us get our medical, health and dietary information we implement into our lifestyle from online sources (39%), books/magazines (21%) and from the MD (17%). The other 23% who took the survey get information from TV/Media, friends, and other sources. Because of the high-quality content available on websites such as Celiac.com, 87% report they are definitely not confused as to which foods are considered to be gluten-free. Sixty-percent (62%) of the respondents' report that other adults in the household are definitely not confused as to which foods are considered to be gluten-free.

Ninety-two percent (92%) of us are not confused about what constitutes a "healthy diet." Thirty-eight percent (38%) feel they eat a healthy diet all the time, 48% eat a healthy diet most of the time, 11% eat a healthy diet sometimes, and 3% never eat a healthy diet. Our diet includes gluten-free grains 83% of the time, while 17% of us are grain-free.

Adult cohabitants 'almost always' follow the same dietary requirements as we do in 56% of the households, 'sometimes' in 32% and 'rarely' in 12% of the households. Fifty-seven percent (57%) of us report that we eat different foods than the other adults living in the household 'sometimes,' while 22% of us do that 'rarely' and 21% almost always eat different foods. Adults with food sensitivities in 19% of the households enjoy meals prepared by another adult most of the time, 'sometimes' in 46% and never in 36% of the homes. Sixty-seven percent (67%) of those who eat meals prepared by another adult in their household trust that the meals are safe for them to eat.

Fifty-one percent (51%) of those who took the survey report that someone else in the household prepares meals for them one to five times a week while 45% report they make all of their meals themselves. Most of us (95%) never cheat on the gluten-free diet.

Demographics of the Respondents
Eighty-five percent (85%) of the respondents are female and 15% are male. Ninety-two (92%) are white, most (65%) live with one other adult. Thirty-four point sixty two percent (34%) have a Bachelor's degree and 23% have a Masters degree. Household income was between $75-149K for 33% of the respondents.

In-Depth Interview – Phase II
For those of you who answered, "yes" to the Phase II interview (the longer-term portion of the research) and haven't heard from me yet, please be patient. I'm working with some time constraints now that fall quarter classes have begun and will be contacting some of you in the coming months to schedule a time to talk.

Celiac.com 09/12/2017 - Are we at the beginning of the end for celiac disease? The last few years have seen numerous advances in celiac diagnosis and treatment. People diagnosed recently and in the future face a very different world than that faced by celiacs just five or ten years ago.

In the old days, the process of properly diagnosing involved blood tests, endoscopies, and biopsies. In the near future, a simple blood test may do the trick.

In the old days, the only treatment was a life-long gluten-free diet. That is still true, but the writing of change is on the wall.

Here are five advances that will change the way celiac disease is diagnosed and treated in the future. These advances may well signal the beginning of the end of celiac disease as we know it.

Blood Test Diagnosis (Without Biopsy)

Researchers are getting better at identifying likely celiac cases using blood tests alone, without biopsy. As these techniques are refined and integrated into medicine, chances are pretty good that in the near future, large numbers of people will be diagnosed for celiac disease without the need for biopsy confirmation.

• Can Antibodies Spot Celiac Disease in Kids Without a Biopsy?
• Kids Can Get Accurate Celiac Diagnosis Without Biopsy
• Celiac Diagnosis Without Biopsy Can Be Useful in Some Cases

Portable Gluten Detectors

Imagine a future where you can take a bit of food you're not sure about, and pop it in a portable tester that will tell you if the food is gluten-free. A few years ago, that might have been the future of science fiction. With several companies looking to introduce just such kits, that future looks a lot more certain.

• Innovative Device Eliminates Gluten-Free Guesswork 
• This Device Can Help Tell You If Your Food Is Actually Gluten-Free

Enzymes

Enzymes that break down gluten might help people with celiac disease to enjoy a more normal life by protecting them from minor gluten contamination, and allowing them a bit more confidence when eating away from home. A number of manufacturers are currently working on enzyme treatments that are specifically designed to break down gluten for people with celiac disease.

• AN-PEP Shows Promise in Breaking Down Gluten in Stomach 
• Enzyme Shows Promise In Dissolving Gliadin Peptides in Celiac Patients
• Could Carnivorous Plant Enzymes Act Like Beano for Gluten?
• Could Enzymes from Oral Bacteria Treat Celiac Disease

Bio-Therapeutics—Hookworms

They sound gross. The thought of having their guts infected with a parasitic worm makes people's skin crawl. However, researchers have documented the gut healing abilities of parasites like hookworm. When hookworms are introduced into the gut of people with celiac disease in the right amount, and kept at therapeutic levels, patients see their celiac symptoms disappear and their guts return to a healthy, normal condition. While still very much in the experimental phase, researchers are keen to investigate various strains and to determine the best therapeutic levels for these treatments. If all goes well, treatments based on parasitic worms will likely become more viable and more common in the future.

• Celiac Patients Tolerate Wheat Spaghetti After Hookworm Treatment 
• Have Celiac Disease? Try a Little Hookworm with that Pasta!
• Can Bloodsucking Parasites Help Treat Asthma and Celiac Disease?
• Controversial Pig Parasite May Soon Be Sold In Germany To Treat Disease

Bio-Therapeutics—Fecal Transplant

Could fecal transplants be used to cure or to treat celiac disease? Much like hookworms, once you get past the 'yuck' factor, fecal transplants are proving to be cheap, easy, reliable way to treat gut conditions like C-Diff and, possibly celiac disease. The idea is to get some healthy poop in your gut to inoculate it with beneficial microbes. The effects are nothing short of astonishing. As they are studied, developed and refined, look for bio-therapeutic approaches like fecal transplant to play a role in treating gut contains like celiac disease.

• A Case of Refractory Celiac Disease Cured By Fecal Microbiota Transfer

Vaccine

A vaccine against celiac disease would be a holy grail of sorts. Receive a dose, or maybe multiple doses over time and become immune to the adverse effects of gluten. Several companies are working on a vaccine that would basically eliminate celiac disease. Many of these have moved through the early trial phases and several have shown enough promise to move to trials in humans. This is a very exciting area of research that may pay huge dividends in the near future.

• Celiac Disease Vaccine Set to Begin Full Human Trials 
• Would You Try a Vaccine for Celiac Disease?
• Celiac Vaccine Clears First Big Clinical Trial
• This Vaccine Could Be a Game-Changer for People with Celiac Disease 

The main takeaway from these developments is that we are now living in an age where the diagnosis and treatment of celiac disease is the focus of tremendous research and development on numerous fronts. Many of these will likely result in products, tests, or treatments for celiac disease that were unimaginable just 5 or 10 years ago.

Celiac.com 09/08/2017 - When you or a loved one has celiac disease there is often a plethora of dishes made with rice. Tired of plain old rice in most of your meals? Try cauliflower rice instead! Stir fry is easy and quick to make for company, family meals, dinner, during the week or weekend. It's even delicious for lunch.

Use different proteins to change the flavor profile. This stir fry can use protein of choice such as tofu, mung beans, beef, seafood, pork or chicken. Fun to mix it up and use cauliflower rice instead of the usual brown or white rice! I used pork for this recipe. It was eaten so fast there were no left overs in our house.

Ingredients:

• Thick pork chop boneless, cut into small cubes (or other protein about 1 lb.)
• Riced cauliflower (buy pre-made packaged or use your food processor to pulse fresh uncooked chopped head of cauliflower into rice size pieces)
• 1 carrot, peeled and chopped
• 1 small onion, peeled and chopped
• 1 celery rib, strings removed and chopped
• 1.5 lbs. chopped veggies like mix of mushrooms, snow peas, bell peppers and water-chestnut (*fresh or frozen)
• 1 garlic clove, crushed, peeled and minced
• ½ inch piece of fresh ginger root, peeled and minced
• 1 cup gluten-free vegetable broth
• 2 tbs gluten-free soy sauce or gluten-free Tamari sauce
• 1 tbs sugar
• 1 tbs gluten-free rice wine vinegar
• 1 tsp gluten-free corn starch
• 2 tbs cooking olive oil for stir fry
• ¼ cup fresh green onion sliced thin or fresh cilantro leaves for garnish, optional
• Salt and pepper to taste

Directions:

First make the sauce: mix the broth, gluten-free soy sauce, sugar, rice wine vinegar and cornstarch in a bowl with a whisk or fork, combine well. Let sit aside while cooking.

Heat oil to stir fry in a wok or large fry pan over medium-high heat. When oil is very hot add the protein, I used chopped pork. Brown the protein. Season lightly with salt and pepper then remove cooked pieces and set aside on a plate with a paper towel to drain any excess oil off.

Next, add the bell peppers, onion and celery then stir occasionally until tender. Add the remaining vegetables and add the cauliflower rice. Stir fry for 2 minutes, stirring in the garlic and ginger. Stir frequently for about another 30 seconds to a minute.

Add the cooked protein back to the pan or wok. Stir with other ingredients to mix well. Then pour the sauce (give it a quick stir before adding) into the pan and let bubble to thicken a minute and remove from heat. Let set a minute or two and then serve in bowls with the green sliced onion or cilantro leaves, sprinkled on top as garnish.

Note: Can reserve the cauliflower rice to the side; cook it separate and serve the veggies and meat mixed with sauce- served over the plain cauliflower rice instead.

Celiac.com 09/08/2017 - For for the overwhelming majority of our time here on this planet we've all followed a paleo, or hunter-gatherer, diet. This is not a way of eating invented by the latest Hollywood guru – though truth be told there are now plenty of stars who eat this way. It's common sense, really, if you're able to unlearn a good portion of the dietary wisdom we've been force-fed over the last generation or two.

Paleo means little more than, in the words of Ray Audette, what you could find to eat if you were "naked with a sharp stick.” And the foods you'd find would have to be, at least in theory (though usually not in practice), edible raw. So what foods would have been available to our ancestors?

Meat, for sure. There are no known hunter gatherer populations who were vegetarian/vegan. Animal protein is vital to human health. Why then do we hear about healthy vegetarian diets? Because they are healthy as compared to the modern Western diet, with its ubiquitous high fructose corn syrup, artificial fats and sweeteners, and high-glycemic carbohydrates.

Ok, so animal protein. What else could have been found by our ancestral hunter-gatherers? Fruit and true vegetables, in season.

That's basically it: meat, fruit, vegetables. And of course, plenty of good, cold water.

What did we not eat then? Grains in any form, gluten-free or not. Legumes, which are extremely toxic raw and have to be soaked and cooked in order to be edible. (Hint: peanuts are legumes!) New world foods like chocolate, coffee. The list goes on and you should have the hang of it by now. Again, the standard: foods edible raw that would have been available to our ancestors.

Question: Would dairy have been available to our ancestors? The answer is clearly no, other than in the form of human breastmilk for the first few months or years of life. Bovine milk, meant for calf populations, is not a natural human food.

Sound overly restrictive? Let me tell you today's menu: For breakfast, three eggs over easy with bacon and a glass of fresh-squeezed orange juice. Lunch was tuna on romaine lettuce with sliced almonds and a vinaigrette with iced green tea to drink. And dinner, a mere five minutes away, is grassfed flank steak lettuce-wrap tacos with roasted hatch green chile guacamole. And a nice glass of New Zealand Sauvignon Blanc.

Give paleo a try. It's the ultimate gluten-free way of eating.

Celiac.com 09/01/2017 - A recent story by Buzzfeed does little to answer the question of whether Cheerios and other General Mills cereals are actually gluten-free and safe for people with celiac disease.

There are a number of folks in the gluten-free community who complain that General Mills is making people sick by selling Cheerios that they know to be contaminated with gluten due to a faulty sorting process. Because General Mills uses a flawed sorting process, the story goes, their boxes of Cheerios are subject to gluten "hot spots," which is making some gluten-sensitive folks sick, thus the complaints.

They point to regular complaints logged by the FDA to argue that Cheerios are clearly not gluten-free, and thus not safe for people with celiac disease. Comment sections on articles covering this topic show that plenty of people claim that Cheerios makes them sick, and triggers gluten-related symptoms.

But, one useful measure of the basic scope of an issue is numbers. What kind of numbers are we talking about? How many complaints? How many boxes of Cheerios?

It's important to realize that General Mills produces huge numbers of Cheerios each week. How many exactly? Well, according to their website, General Mills ships 500,000 cases of Cheerios each week. At about 12 boxes per case, that's about 6 million boxes each week, or 24 million boxes each month.

We know that the FDA received a number of consumer complaints in 2015, when a mix-up at a Cheerios plant in California led to mass gluten contamination, and eventually to a full recall of 1.8 million boxes by General Mills.

During that three month period, after the gluten contamination but prior to the recall, when many consumers were eating Cheerios made with wheat flour, the FDA says it received 136 complaints about adverse reactions to the product. So, during the 90 days when we know there was gluten contamination in nearly 2 million boxes of Cheerios, when people were definitely having gluten reactions, the FDA got 136 complaints. During that time General Mills shipped about 72 million boxes, and later recalled nearly 2 million of those due to gluten contamination. That's a complaint rate of about one complaint per 529,411 total boxes, and about one complaint for every 5,000 people with celiac disease; if each person with celiac ate 1 box, and the complaints came only from people with celiac disease. (Obviously this is simplified assumption for discussion purposes).

Let's imagine another 2 million gluten-contaminated boxes got to consumers. Again, imagine that 1% of those buyers were celiac, so that 20,000 boxes of the 2 million went to celiacs—one box each. 146 complaints for 20,000 boxes is about 1 complaint per 140 boxes, give or take, for each person with celiac disease. That seems like a substantial complaint rate. So, how does that rate compare to the current rate, after the recall?

Since the beginning of 2016, the FDA has received 46 reports of people with celiac disease or sensitivity to gluten or wheat linking their illness to General Mills cereals, including Cheerios and Lucky Charms.

Let's forget about Lucky Charms for a minute, let's focus on Cheerios. During the 18 months from January 2016 to July 2017, General Mills has shipped something like 450 million boxes. That's about one complaint for every 10 million boxes of Cheerios, or about one complaint for every 100,000 people with celiac disease.

And those numbers don't include Lucky Charms, which account for some portion of the 46 complaints since early 2016. If General Mills is having an issue with sorting oats, then why have complaint ratios gone down so sharply?

Also, General Mills uses its optically sorted gluten-free oats for other products. The FDA is certainly taking all of this into account. When they get complaints, they look at large amounts of data to help them put things into perspective. Has the FDA seen corresponding numbers of complaints for different General Mills products made from the same oat sorting process? It doesn't seem so.

Celiac.com has covered the gluten-free Cheerios story from the beginning, and will continue to do so. We stand on the side of science, and accurate information.

Beyond the obvious gluten-contamination that led to the recall, we have been skeptical of claims that General Mills' sorting process is flawed, and that their products, including Cheerios are routinely contaminated with gluten.

If this were true, we think the numbers would be very different, and that the pattern of official complaints would reflect that reality. We also feel that General Mills would be facing down lawsuits from hungry trial lawyers looking to put a big trophy on the wall.

We have simply not seen any good evidence that supports claims that Cheerios and other General Mills products are contaminated with gluten "hotspots" that cause reactions in people with celiac disease. We have also not seen evidence that rules out adverse oat reactions as the cause of many of these claims.

If someone out there has different numbers, or better information, we are all ears. However, until we see convincing evidence to the contrary, Celiac.com regards Cheerios and other General Mills products as safe for people with celiac disease and gluten-sensitivity. We do offer the caveat that people should trust their own judgement and avoid any food they think makes them sick.

Stay tuned for more on this and other stories on gluten-free cereals and other products.

Read more at BuzzFeed.com and GeneralMills.com.

Celiac.com 08/31/2017 - A possible mechanism behind the cause of refractory celiac disease and why fecal transplantation (fecal microbiota transfer) may provide a cure was presented in "Synthetic Stool May Advance Fecal Transplant Therapy for Celiac Disease" 02/13/2013.[1]  In September 2016, the article "Serendipity in Refractory Celiac Disease: Full Recovery of Duodenal Villi and Clinical Symptoms after Fecal Microbiota Transfer" was published in the Journal of Gastrointestinal and Liver Disease[2] describing the first known case of refractory celiac disease cured by a fecal transplant.  The patient in that case was being treated for a recurrent Clostridium difficile infection.  This very important milestone article somehow missed the light of the news media at that time.

The 68-year old woman patient was a 10-year diagnosed victim of refractory celiac disease on a gluten-free diet.  On admission for treatment of severe diarrhea, the patient exhibited Marsh IIIA villous atrophy.  The patient was already receiving on-going treatment for refractory celiac disease with drugs.  Additional drugs and antibiotics were given to treat the diarrhea.  Eventually, the patient tested positive for C. difficile.  Antibiotics were ineffective to treat the recurrent C. difficile infection.  A fecal microbiota transfer was then performed.  The C. difficile infection and diarrhea resolved, and, 6 months after the fecal transplant, villous atrophy resolved and went to Marsh 0.  All symptoms of refractory celiac disease were eliminated.  The patient remains symptom free on a continuing gluten-free diet.

The case clearly demonstrates the need to fully investigate the use of fecal microbiota transfers to treat celiac disease.  As suggested in my earlier reference[1], a standardized synthetic stool should be developed to enable full scale clinical trials.  Also a full scale research effort into completely healing and restoring the intestinal mucosa with the novel protein R-spondin1 needs to be funded and restarted.

Sources:

• 1. Synthetic Stool May Advance Fecal Transplant Therapy for Celiac Disease.
  Roy S. Jamron.
  Celiac.com 2013 Feb 13.
• 2. Serendipity in Refractory Celiac Disease: Full Recovery of Duodenal Villi and Clinical Symptoms after Fecal Microbiota Transfer.
  van Beurden YH, van Gils T, van Gils NA, Kassam Z, Mulder CJ, Aparicio-Pages N
  J Gastrointestin Liver Dis. 2016 Sep;25(3):385-8.