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Celiac.com 02/28/2017 - A number of commercial brewers are opting to use enzymatic digestion, or hydrolysis, for treating gluten-containing foods and beverages to make them safe for people with gluten sensitivity, including those with celiac disease. However, some have questioned whether the process is safe for all people with celiac disease, as some celiacs complain that they experience gluten sensitivity when they drink these beers. Currently, there are no validated testing methods for quantifying levels of hydrolyzed or fermented gluten peptides in foods and beverages that might be harmful to celiac patients. This makes it difficult to determine the safety of hydrolyzed products for people with celiac disease. Some researchers finally tested the clinical response by celiac patients to gluten-free beer, gluten-removed beer, and conventional beer. They also tested a non-celiac control group. Their main goal was to determine if sera from active celiac patients can serve as an effective detection tool for residual celiac-reactive proteins in gluten-removed beer. The research team included Laura K Allred; Katherine Lesko; Diane McKiernan; Cynthia Kupper; and Stefano Guandalini. Their study used an ELISA-based method to determine whether serum antibody binding of residual peptides in a fermented barley-based product is greater among active-celiac disease patients than a normal control group, using commercial beers as a test case. The team first gathered sera from 31 active-celiac disease patients and 29 non-celiac control subjects, then assessed the binding of proteins from barley, rice, traditional beer, gluten-free beer, and enzymatically treated (gluten-removed) traditional beer. None of the 29 non-celiac control subjects reacted to all three barley-based samples (barley extract, traditional beer, and gluten-removed beer), while 2 of 31 active-celiac disease patients (6.4%) responded to all three samples. In the ELISA, none of the subjects' sera bound to proteins in the naturally gluten-free beer. Eleven active celiac patients showed immunoglobulin A (IgA) or immunoglobulin G (IgG) binding to a barley extract, compared to only one non-celiac control subject. Of the seven active celiac patients who had an IgA binding response to barley, four also responded to traditional beer, while two of these also responded to the gluten-removed beer. None of the sera from non-celiac control subjects bound to all three beer samples. Breaking down the results, only 11 of the 31 active celiac disease patients even reacted to barley. Only 4 of those 11 reacted to traditional beer; a mere 12%. Of those, only two celiacs reacted to gluten-removed beer, or about 6% of the test group. So, interestingly, while this study indicates that the vast majority of people with celiac disease seem to tolerate both traditional and gluten-free beers, it also indicates that there are residual peptides in the gluten-removed beer that may trigger reactions in a minority of celiacs. This particular study was small and highly regional, so very little can be projected to the larger celiac population. Clearly more study is warranted to more accurately determine the exact nature of the risk for celiacs who drink gluten-removed beer. This isn't the last we'll hear about the safety of gluten-removed beer. Stay tuned for more on this and other gluten-free stories. Read more about gluten-free and gluten-removed beers. Source: Journal of AOAC International. DOI: https://doi.org/10.5740/jaoacint.16-0184

Celiac.com 07/10/2017 - For anyone with celiac disease or gluten intolerance who was wondering how well food manufacturers are complying with FDA standard for gluten-free labeling, or wondering exactly how gluten-free is my gluten-free food, some early answers are in, and the news looks good. A recent report by the agency indicates that the vast majority of food manufacturers are getting it right, and, correcting where they do get it wrong. The FDA's final rule for compliance in gluten-free labeling was August 5, 2014. To gauge compliance in gluten-free food labeling, the agency conducted a sampling assignment of products labeled "gluten free" from July 2015 to August 2016. The compliance testing is an important part of the FDA's mission to ensure that products labeled on or after the compliance date are properly labeled as "gluten-free." In all, the agency's team analyzed more than 250 types of products, and tested 702 individual samples in the categories of cereals, grain bars, and flours. Their complete survey showed that just five samples from one product source contained gluten in excess of the regulatory limit of 20 parts per million (ppm). That left the overall gluten-free product-based compliance rate above 99.5 percent. The good news here is that producers major gluten-free food products are doing a very good job of following FDA labeling standards. Also, the manufacturer of the samples that showed gluten levels above 20 ppm carried out a voluntary recall, conducted an extensive root cause analysis, and immediately implemented additional corrective actions to prevent recurrence. Follow-up testing by the FDA showed acceptable levels of gluten. This is the first hard data the FDA has gathered regarding compliance with gluten-free labeling standards. To see such high levels of compliance and responsiveness by manufacturers is encouraging. Read the Analytical Results of FY2015/16 Gluten-Free Food Product Sampling. SOURCE: FDA.gov

Celiac.com 03/04/2013 - Morbid obesity is a common medical condition. In many cases, bariatric surgery is necessary. Although for decades celiac disease has been associated with chronic diarrhea and weight loss, and other classic symptoms, recent data shows that the clinical spectrum of celiac disease is extremely wide. A group of researchers recently reported on the benefits of diagnosing celiac disease during pre-operative work-up for bariatric surgery. The researchers included Federico Cuenca-Abente, Fabio Nachman, and Julio C. Bai of the Department of Surgery and Department of Medicine at Dr C. Bonorino Udaondo Gastroenterology Hospital in Buenos Aires, Argentina. They reported on the cases of five morbidly obese patients diagnosed with celiac disease during preoperative work-up for bariatric surgery. Celiac disease was suspected upon routine upper endoscopy, and confirmed by histology and positive celiac disease-specific blood tests. Interestingly, four of the five patients had no obvious symptoms. One complained of chronic diarrhea and anemia. All patients began a gluten-free diet. Due to their celiac disease diagnosis, doctors offered all five patients a purely restrictive bariatric procedure. At the time of the report, three of the patients had received a sleeve gastrectomy, while the other two were still undergoing pre-operative evaluation. The team's findings help to enlarge the clinical spectrum of untreated celiac disease. Even though rates of celiac disease in obese patients seems to be similar to that in the general population, the team recommends that patients with morbid obesity be tested for celiac disease in order to determine the best surgical strategy and outcome. Source: Open Original Shared Link