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I am always amused by the argument that one grain or another is more likely to be contaminated than another, as I believe the real source of danger for contamination is found at mills and processing plants, and is more or less spread out equally for most gluten-free grains. Oats are often cited as having a higher chance of cross-contamination with wheat than other grains because it is often a rotational crop with wheat or barley, and kernels of these gluten-containing grains occasionally get mixed with the non-gluten grains. I do not understand why the same people who make this claim do no also include soy in this category, as it is one of the crops that is most commonly rotated with wheat. In any case, from the knowledge that I have gathered over the years about farming and processing grains, I must say that with most grains there is little likelihood of contamination due to the mixing of two different whole grains (i.e., the rotational crop hypothesis). This is due to the different sizes and shapes of different grains, and the machines which sort them after a harvest. If any grains do get mixed together the amount of actual contamination would likely be extremely low. In Trevor Pizzeys (Vice President of Operations for Can-Oat Milling) October 30, 1998 letter he expresses his belief that celiacs should avoid oats because he finds between 2.1 and 4.1 kernels of barley or wheat in every 4,000 (0.0525% and 0.1025% respectively). He says that this level can legally go up to a maximum level of 10 kernels per 4,000 (0.25%). In either of these scenarios we are talking about very low amounts. Even at these amounts the likelihood that a celiac eating these grains would eat 1 or 2 kernels of wheat or barley on a given day would be very, very low. Also, since most people who eat oatmeal tend to eat the whole oatmeal as a hot cereal, which means they can take very simple additional precautions to make their chances of eating any kernels of wheat or barley practically zero. The obvious way to do this is to look at the oats before you eat them or mill them and pull out any kernels that are of non-oat type. Now we turn to the other part of the argument to scare people away from grains that, taken by themselves, do not cause harm to people with celiac disease. This is the wheat dust in the mill (or during transport, or somewhere else) argument. There are many reasons, both health and safety, why mills take steps to keep dust levels down. Dust contamination is still possible, but I think we are also talking about even lower amounts that we were with the occasional kernel of wheat that pops up in oats, although there is no data that I know of to back this up. I think with whole oats (i.e., oatmeal) people can reduce any possible risk of wheat-dust contamination to almost zero by rinsing off their oats well with water before cooking or milling them. The famous oat study that was done in Finland and published in the NEJM used a source of non-contaminated oats to eliminate any possible factors that could ruin the results of their long and expensive study. It is possible that they could have used regular, uncontrolled Quaker oats for their study and gotten the same results, but again, the reasons for not doing so were to eliminate any possible factors that might affect the results of their study. This is the scientific process, and it is important with any study to eliminate any possible factors which could affect the outcome of the study. Last, there is a danger of contamination which comes from unclean equipment at mills, and at processing plants. This danger is present with any gluten-free grain, bean, etc., that is milled using the same equipment as is used to mill a gluten-containing grain. In other words we cannot speak of only oats with regard to this issue, as rice flour, soy flour, etc., could be contaminated equally in this way. Aside from legislation to require cleaning between milling runs, those who are worried about this need to buy flours from mills which they have researched and found to be gluten-free, or ones that adequately clean their equipment between runs. I think contamination issues are real, but need to be put in perspective with regard to other, perhaps more important issues, like labeling laws and getting agreement between the major celiac organizations in this country with regard to which grains are safe. See Also: Journal of the American Dietetic Association, Dec. 1997 v97n12p1413(4). Do oats belong in a gluten-free diet? by Tricia Thompson.
Ernesto Guifaldes, M.D. of the Pontificia Unicersidad Catolica de Chile has sent me much information, is particularly knowledgeable in this area. If you have any questions about this subject, please contact Ernesto at: firstname.lastname@example.org The following is a letter dated March 10, 1996, and was sent to the Presidents of the Episcopal Conferences from the Vatican. It represents the official position of the Catholic Church with regard to gluten and the Eucharist. Your Eminence/Excellency: In recent years, this Dicastery has followed closely the development of the question of the use of low-gluten altar breads and mustum as matter for the celebration of the Eucharist. After careful study, conducted in collaboration with a number of concerned Episcopal Conferences, this Congregation in its ordinary session of June 22, 1994 has approved the following norms, which I am pleased to communicate: I. Concerning permission to use low-gluten altar breads: A. This may be granted by Ordinaries to priests and lay persons affected by celiac disease, after presentation of a medical certificate. Conditions for the validity of the matter: 1) Special hosts quibus glutinum ablatum est are invalid matter for the celebration of the Eucharist; 2) Low-gluten hosts are valid matter, provided that they contain the amount of gluten sufficient to obtain the confection of bread, that there is no addition of foreign materials, and that the procedure for making such hosts is not such as to alter the nature of the substance of the bread. II. Concerning permission to use mustum: A. The preferred solution continues to be Communion per intinctionem, or in concelebration under the species of bread alone. B. Nevertheless, the permission to use mustum can be granted by Ordinaries to priests affected by alcoholism or other conditions which prevent the ingestion of even the smallest quantity of alcohol, after the presentation of a medical certificate. C. By mustum is understood fresh juice from grapes, or juice preserved by suspending its fermentation (by means of freezing of other methods which do not alter its nature). D. In general, those who have received permission to use the mustum are prohibited from presiding at concelebrated Masses. There may be some exceptions however: in the case of a Bishop or Superior General; or, with prior approval of the Ordinary, at the celebration of the anniversary of priestly ordination or other similar occasions. In these cases, the one who presides is to communicate under both the species of bread and that of the mustum, while for the other concelebrants a chalice shall be provided in which normal wine is to be consecrated. E. In the very rare instances of lay persons requesting this permission, recourse must be made to the Holy See. III. Common Norms: A. The Ordinary must ascertain that the matter used conforms to the above requirements. B. Permissions are to be given only for as long as the situation continues which motivated the request. C. Scandal is to be avoided. D. Given the centrality of the celebration of the Eucharist in the life of the priest, candidates for the priesthood who are affected by celiac disease of suffer from alcoholism of similar conditions may not be admitted to Holy Orders. E. Since the doctrinal questions in this area have now been decided, disciplinary competence is entrusted to the Congregation for Divine Worship and the Discipline of the Sacraments. F. Concerned Episcopal Conferences shall report to the Congregation for Divine Worship and the Discipline of the Sacraments every two years regarding the application of these norms. With warm regards and best wishes, I am Sincerely yours in Christ. The leader of the fight for Celiacs in the Catholic Church has recently died. Archbishop Derek Worlock of Liverpool was diagnosed in the 1980s with celiac disease and presented a strong case in Rome for celiac sufferers to be allowed to receive special hosts at Communion, which was reluctantly granted. He died of lung cancer on February 8, 1996.
Celiac.com 09/01/2005 - The Food and Drug Administration (FDA) will hold a public meeting to obtain expert comment and consultation from the public to help them define and permit the voluntary use on food labeling of the term ``gluten-free. The meeting will focus on food manufacturing, analytical methods, and consumer issues related to reduced levels of gluten in food. Celiac.com needs your help to speak out to make sure that this regulation will be written in such a way as to provide the greatest benefit to the gluten-free community, and to make sure that the new regulation will not create an undue burden on any exiting and future gluten-free food manufacturers. To have an influence on this process please Click Here and send your comments no later than September 19, 2005. If you feel the same way as us feel free to cut and paste the following letter into the comments area of this form: Dear FDA: We encourage you to adopt a regulation on the use of gluten-free on product labels that is in line with that which has been used in Europe and other countries (including the USA via the Codex Alimentarius) for many years--20 PPM for products that contain naturally gluten-free ingredients, and 200 PPM for products that have been rendered gluten-free such as those that may contain Codex Alimentarius quality wheat starch. The formal adoption of these existing regulations will allow for the continued importation of excellent, safe European products that are labeled gluten-free. It is very important that you do not adopt a zero tolerance regulation in this matter because doing so will cause many gluten-free food companies to discontinue their use of the term gluten-free on their labels out of fear of litigation--which is counterproductive for all people with this disease (most, if not all, gluten-free food companies do not grow, transport or mill the gluten-free grains that they use as ingredients--a fact that will make them vulnerable to litigation if a zero tolerance level is adopted). Last, the inclusion of trace levels of gluten in the diets of those with celiac disease have been shown to be safe in many scientific studies, for more details please see: https://www.celiac.com Thank you, Your Name
Celiac.com - 07/24/2001 Study: Holmes, Prior, Lane, et. al. Malignancy in Coeliac Disease - Effect of a Gluten-Free Diet Gut 1989; 30: 333-338 Comments Regarding the Study to the List (January 8, 1997): I would like to suggest that you check out some of the information on malignancy and celiac disease, especially lymphoma. One of the studies established three categories: One for those who adhere to the diet strictly; one for those who follow the diet, but not very strictly; and one for those who do not follow the diet. The first group, after 5 years, shows a significant reduction in risk. In fact, it is quite close to the risk experienced by members of the general population. The second group does experience some reduction in risk, but it remains closer to the rate of malignancy in untreated celiac disease. The third group has a very high risk of malignancy. Response by Donald D. Kasarda (January 9, 1997 - Donald D. Kasarda is a research chemist in the Crop Improvement and Utilization Research Unit of the United States Department of Agriculture): I point out that the people in the first group, which supposedly was adhering to a strict gluten-free diet, were likely to have been including foods made with wheat starch in their diet because that was, and is, common in England where the study was carried out. I have asked several celiac researchers in England if I am correct in this assumption. They agreed that I am. Therefore these people in the strictly gluten-free group were likely to be eating a small amount of gluten each day. The amount is unknown because we dont know the amount of gluten in the starch (this varies according to the manufacturer and possibly according to lot) nor which subjects ingested how much starch. The apparent small increase in cancer risk for the first group was not statistically significant for those who had been on the diet more than 5 years. In the group with a normal diet, the relative risk of lymphoma was increased 78 fold, but it should be pointed out that the incidence of lymphoma of the gastrointestinal tract in the normal population is rather low. For the 210 patients in the study, the cancer morbidity was expected to be 0.21. For the 46 patients in the normal diet group, 7 cases of lymphoma were observed. For the 108 patients on the strict gluten-free diet, 3 cases of lymphoma were observed. The statistical significance of the numbers is weak because of the relatively small numbers of patients involved. These are extremely valuable and well-done studies. No criticism is intended. To arrange a study with larger numbers will be extremely difficult although a group in Leiden (The Netherlands) is trying to arrange such a study. I have no quarrel with those who wish to play it safe, but I dont think we can say for sure that small amounts of gluten in the range of a milligram to a few milligrams per day are harmful on the basis of any scientific study of which I am aware. They may be, or they may not be. I offer these comments only with the intent of providing as much information to celiac patients as possible so that they can make informed decisions. If anything I have said is incorrect, I hope someone will point out my errors on the net. Don Kasarda, Albany, CA FYI: According to the calculations made with Don Kasarda in Nov 1995, 0.1 grams = 100 milligrams is about one-50th of a slice. Therefore, 10 milligrams is about one-500th of a slice of bread.