Australia and NZ Have the Safest Gluten Free Labeling Requirements. But Are They Necessary?

NZ and Australia have the safest gluten free labeling requirements for celiacs in the world. But there is a lot of debate worldwide, as to what is a safe level of gluten for celiacs to consume, if any. Many countries have adopted 20 ppm as the level to adhere to on food labels, and less than 20 ppm is the accepted standard in many countries, including the USA, UK and Europe, for food manufacturers to adhere to.  The International CODEX standard, also defines ‘foods containing less than 20 ppm of gluten’ as safe and suitable for a celiac diet.

So are the strict gluten free labeling laws so necessary in Australia and NZ? These two countries continue to implement “no gluten detected” as the acceptable standard, Gluten is treated as an allergen under the Australia New Zealand Food Standards Code (ANZFSC). Standard 1.2.3 of the ANZFSC states that a food business must declare the presence of any gluten in its food product. Additionally, where a food product’s label claims that the product is ‘gluten free’, the ANZFSC, Standard 1.2.7 stipulates that ‘the food must not contain detectable gluten’.  

Australian regulators have a strict view on the regulation of allergens. Both the Australian Competition and Consumer Commission (the ACCC) and the New South Wales Food Authority (the NSWFA) have upheld an exacting interpretation of the term gluten free and require that in foods labelled as gluten free, gluten must be completely non-detectable. The consequence of a false claim on a gluten free label is usually a food recall.

Now, we would all have to agree that gluten free labeling requirements have been implemented for the protection and safety of those with celiac disease, but are the levels adopted by NZ an and Australia putting too big a burden on manufacturers to comply with such low level requirements, and does this in turn affect the celiac by forcing the price up for gluten free products which comply with the standards?

It is my view that consideration of market factors or profits must remain secondary to the necessity to provide safe food for the celiac. And this in turn means that the celiac has to pay higher prices for gluten free products that are safe for them to eat. All people who consume a gluten free diet are aware of the fact that they have to pay more, and in my opinion good health is worth the extra price, because what would be the cost of not eating gluten free compliant food?  The cost to your health would be way too high!

NZ and Australia currently have a fantastic variety of readily available gluten free foods that test well below 20 ppm, so obviously providing gluten free foods at this very low level is commercially viable. There is no reason why, especially as testing becomes more sensitive, that the status quo in NZ and Australia cannot be maintained.

Reducing the detectable level of gluten in foods on a global basis would be a good thing for the health of celiacs. But not everyone agrees with reducing the level of detection for gluten in foods.

Compliance with gluten free standards, even at current levels, is obviously not being regulated enough in some countries. There have been many scares lately about foods labelled gluten free which are actually not and have caused severe reaction in celiacs who have consumed them. If food manufacturers do not have the best interests of celiacs in mind they will be pushed out of the market especially if lower detection levels are implemented.

Also, many cafes and restaurants who have a gluten free menu do not really understand what it means to be gluten free and dining out is one of the biggest concerns that a celiac has. The fear of being “glutened” is a real threat for those with celiac disease, and yet very few countries regulate the level of gluten free on menus. The FDA says that given the public health significance of gluten free labeling, restaurants making a gluten free claim on their menus should be consistent with FDA's definition. In the UK the law relating to gluten applies to both packaged foods and to foods sold in catering establishments such as cafes and restaurants.

 Not all experts support the view that there is robust evidence that 20 ppm is actually a safe level for celiacs. Some argue that less than 10 milligrams per kilogram would be safer for celiacs.  The Health Hazard Assessment for GlutenExposure, recommends a level of less than 1ppm gluten in foods labelled gluten free “In summary, these findings indicate that a less than 1 ppm level of gluten in foods is the level of exposure for individuals with celiac disease on a gluten free diet that protects the most sensitive individuals with celiac disease and thus, also protects the most number of individuals with celiac disease from experiencing any detrimental health effects from extended to long-term exposure to gluten”.  It is interesting to note that the FDA did not adopt these recommendations. More research needs to be conducted to look into the safe levels for celiacs.

The Australian Food and Grocery Council (the AFGC) is proposing that Food Standards Australia & New Zealand (ANZFS) alter the standard of ‘gluten free’ in Australia. The AFGC wants ANZFS to allow a food to contain up to 20 milligrams of gluten per kilogram to still be called ‘gluten free’. This would bring the Australian regulation of ‘gluten free’ claims in line with British and European standards as well as the Codex.  This move is supported by Coeliac Australia.

One of the issues of having not detected as the standard is the lack of definition and definitive guidelines and it becomes a moving target. The ANZFS does not stipulate a threshold or a specific testing methodology in the gluten free standard. However, the definition of gluten free requires that gluten be ‘not detectable’. So what does that actually mean?

Trying to measure small amounts of material can be tricky. When testing products, some analytical services refer to a Limit of Detection (LOD) whereas others refer to a Limit of Quantitation (LOQ). The LOD is the level at which something can be detected with a level of certainty, while the LOQ is the level at which the amount of that something can be measured with a level of certainty. Most test results refer to a value that is less than the LOD or LOQ for the test method used, such as < 20 ppm of gluten detected. So what does not detected mean in the NZ and Australia?

Current testing methods can measure the level of gluten in food down to less than 3 parts per million (<3 ppm). Thus in NZ and Australia, foods advertised as being gluten free' and displaying the Crossed Grain symbol must not contain detectable gluten which can only be detected to <3 ppm.

As food testing technologies are constantly evolving, the levels of detection and quantitation are becoming lower and lower. On the one hand, this allows more certainty in measuring the presence of smaller quantities of a substance in a food product. However, one of the problems with testing at lower levels is the risk of cross contamination of the test itself, for example the presence of gluten in the air of a testing facility may be picked up as being present in the food product when in fact that might not be the case. The lower the detection limit of a test, the lower the certainty could be.

There are also important commercial and legal ramifications for the food industry if gluten free claims continue to be defined by lack of detection as in the ANZFS. It means they would have to use the latest method and the lowest detection levels possible. New tests will be able to detect minute traces of gluten (maybe as low as parts per billion) meaning that foods currently defined as gluten free may disappear.

This would be disastrous for people with celiac disease who rely on safe gluten free food as a medical necessity, not a lifestyle choice.  In fact, zero tolerance gluten rule limits food options for people with celiac disease and will eventually become unworkable as testing methods become extremely sensitive. A new definition of gluten free may give celiacs in NZ and Australia a wider food choice and do away with unnecessary food recalls.

So should the ANZFS re-define a safe and practical maximum level of gluten? Technically speaking this would be the right thing to do. If the ANZFS were to adopt the widely accepted worldwide trend, then ‘foods containing less than 20 ppm of gluten’ could be labelled as gluten free. Or if it were to keep to its current levels, then ‘foods containing less than 3 ppm of gluten’ would be considered to be gluten free.

It is my opinion that the level of detection must be stipulated in the gluten free standard and that NZ and Australia should be in line with the rest of the world. But whether this means NZ and Australia raising their levels, or the rest of the world lowering theirs is a matter for debate. I believe the safest practical testing level should be observed, and currently it has been proven that gluten free food can be manufactured and tested effectively at a level of <3 ppm, so I can see no reason why this should not be adopted as the new worldwide standard. No-one has really proven categorically what a safe level of gluten is and research into this matter needs to continue.

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The 5 Mistakes People Need To Avoid When Going On A Gluten Free Diet

Whether it’s due to celiac disease, autoimmune disease, an allergy or simply a desire to eat better, more and more people are taking on a gluten free diet. This can have an enormous impact on your health overall, but only if you do it correctly.

If you do not remove 100% of the gluten in your diet, you won’t get the full benefits and, especially if you have celiac disease of one of the related conditions, you may continue to have symptoms from the very trace amounts of gluten you may not realize you are still consuming.

Here is how to avoid five of the main mistakes people make when going on a gluten free diet:

1. Learn Which Foods Besides Wheat Contain Gluten

This is a really important first step when starting on a gluten free diet. You probably know that gluten is a protein in wheat, but it is also found in rye and barley, and it is debatable whether it is also found it oats.  It is important to read the label of every processed product you buy because a lot of products have hidden gluten in them.

Remember the acronym "BROW" when reading labels; it stands for barley, rye, oats and wheat. When you first start on a gluten free diet , you’ll probably eliminate wheat based foods like bread and pasta, but did you know that gluten is also found in soy sauce, licorice and artificial crab? Learn the common and not-so-common sources of gluten and read labels carefully.

2. Do Not Overeat Processed Foods On Your Gluten Diet

Overeating processed foods is never good for you especially if you are on a gluten free diet. Gluten free food products are sold everywhere these days, which certainly makes changing to a gluten free diet easier for some people. However, these processed products are often less nutritious than their gluten containing counterparts. Gluten free breads, crackers, cookies and other processed foods often contain high levels of starch and sugar. Many people with celiac disease may also have diabetes I so you do not want to challenge your blood sugar, promote inflammation or put on weight.

Processed foods may not be 100% gluten free because by law they can contain up to 20 ppm (parts per million) of gluten. This tiny amount is not enough to trigger a reaction from a single serving, but if you are eating large amounts of “gluten free foods” like cereal, bread and pasta for every meal, you could be ingesting enough gluten, accumulatively, to impair the progress of your gluten free diet.

Like all processed foods eat in moderation.

3. Focus On High Quality Gluten Free Foods.

Many people start a gluten free diet because of a particular health issue such as being diagnosed with celiac disease. The person’s gastrointestinal system is damaged and they need to focus on eating healthily to allow the damage to heal. It is not enough to simply replace gluten containing processed foods with gluten free processed foods.

If you have been unwell for a sometime, your body may be deficient in micronutrients, minerals and vitamins, so it is best to put the emphasis on fresh natural products foods that are naturally gluten free like meat, eggs, fish, vegetables, fruit, nuts and seeds to help replenish your stores.

These foods help reduce inflammation (unlike high starch gluten-free foods which promote inflammation) and in conjunction with the elimination of gluten can have a huge impact on how you feel overall.

 4. Make Sure Your Personal Care Products, Cosmetics, Vitamins, Supplements and Medicines are Gluten Free

Hidden gluten can be found in the oddest of places such as in personal care products, cosmetics, vitamins, supplements and medicines This might not seem as obvious to people who aren’t used to dealing with food allergies, but it’s a common source of accidental gluten. Even though there is no scientific evidence to prove gluten is absorbed through your skin, these products can be a source of gluten contamination even if you are not you aren’t eating them. Be particularly careful with eye and lip products, as they sometimes contain vitamin E that is derived from wheat germ.

Check the labels on your vitamins, supplements and check with your pharmacist for ingredients of any prescription medication you take. Gluten is found in everything from iron supplements to headache medication, and it’s important to read the labels each and every time.

5. Learn About Cross Contamination

Before you first go on a gluten free diet, it’s hard to understand the need to be 100% gluten free, and how even a little gluten can trigger a reaction. Gluten free foods made on shared production lines or prepared in the same kitchen as gluten containing foods run the risk of being cross contaminated with gluten. It takes as little as 20 ppm of gluten to trigger a reaction in people with celiac disease. To be on a 100% gluten free diet, food needs to be stored, prepared and served separately.

When first going on a gluten free diet, it is advisable to get new condiments that are free of crumbs, a new toaster, new cutting boards and make sure that you have super clean cooking surfaces. Do not share food prep surfaces, cooking surfaces or utensils with gluten containing foods. When eating in restaurants, be sure to ask about their allergy protocol and don’t be shy about asking about ingredients in seasonings and dressings.

Now that you know the top five mistakes to avoid when going on a gluten free diet you may want to learn more, or have a handy resource you’re your family and friend to learn how to be 100% gluten free. I have written a resource book on how to be 100% gluten free which you can purchase by clicking the following link:

http://www.cooking.what-is-gluten-free.org/

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Is It Gluten or FODMAP's Which Causes Self-Diagnosed Non-Celiac Gluten Sensitivity?

Gluten sensitive individuals cannot tolerate gluten and may develop gastrointestinal symptoms similar to those in celiac disease, but the overall clinical picture is typically less severe. Non-celiac gluten sensitivity refers to an adverse reaction to eating gluten that usually does not lead to damage of the small intestine.

Non-celiac gluten sensitivity was virtually unrecognized a decade ago but is now a perplexing problem that has driven many studies in the past few years. Its prevalence appears to be more wide spread than celiac disease itself.  It was a topic of hot debate at the International Celiac Disease Symposium in late 2013, where it was widely debated if the frequency of gluten sensitivity is really due to gluten, or whether other factors and food culprits could be part of the cause.

For people with self-diagnosed non-celiac gluten sensitivity, it may not be gluten which is causing their problem. An Australian researcher into gluten sensitivity, Peter Gibson, of Melbourne's Monash University believes that people who get relief with a gluten free diet, do so because they avoid FODMAPs rather than gluten itself. ''What our study has shown is that, in people with gut symptoms who have had some relief with the gluten free diet, it is not the gluten that is the culprit, but it is more likely to be FODMAPs,'' Gibson says. 

FODMAP’s stands for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides And Polyols. They are all short-chain carbohydrates found in many foods, particularly in the western diet,  which can be poorly absorbed by some people. They are in particularly high amounts in wheat, rye and barley, the three cereals that contain gluten. So researchers are curious whether the benefits of the gluten-free diet among people with gluten sensitivity may actually be a result of reducing FODMAP intake.

Examples of oligosaccharides include fructans (polymers of fructose); disaccharides include lactose; monosaccharides include fructose; and polyols include sugar alcohols such as sorbitol and mannitol.

Poor absorption of most FODMAP carbohydrates is common to everyone. Any FODMAPs that are not absorbed in the small intestine pass into the large intestine large where bacteria normally found in the gut ferment them. The resultant production of gas potentially results in bloating and flatulence. Most individuals do not suffer significant symptoms but some may suffer the symptoms of IBS. Restriction of FODMAP intake in IBS sufferers has been found to result in improvement of symptoms.

As for people mistakenly believing they are gluten sensitive, Gibson suggested that there were two other possible explanations, other than gluten sensitivity itself which could be making them feel better on a gluten free diet:

1.   People felt better for avoiding wheat and gluten products because of their high percentage of FODMAPs. He suggests that FODMAPs might be the factor leading to the symptoms such as bloating and gut distress, rather than gluten itself. Gibson says, 'Why gluten has been blamed is that people do often improve with a gluten free diet because wheat, rye and barley, the three cereals that contain gluten, all have high amounts of FODMAPs in them.” 

2.   Gibson also believes people may report improvements on a gluten free diet because it makes them quite literally ''feel better'', even if their gastro-intestinal symptoms do not improve. Current evidence suggests that many patients with self-reported non-coeliac gluten sensitivity continue to experience gastrointestinal symptoms on a gluten free diet but continue to restrict gluten as they report 'feeling better'. Gibson suggests that 'It may be that people with gut symptoms feel better on the gluten-free diet because they are less depressed.

However, when considering the involvement of FODMAPs in non-celiac gluten sensitivity, it is important to remember that FODMAPs are found in a variety of other foods as well, like onions, broccoli, beans, apples and milk.  All of these foods can be difficult for some people to digest and cause gastrointestinal symptoms as well, but do people with non-celiac gluten sensitivity react to these products as well?

Recent research has revealed that gluten or wheat sensitivity occurs in approximately 30% of people with IBS (Irritable Bowel Syndrome), a prevalence rate that is much higher than in the general population. So should IBS be included as part of the spectrum of gluten sensitivity disorders? While some people with IBS may benefit from a gluten free diet it isn’t the solution for all people with IBS, and there are other factors to uncover.

Dietitian Susan Shepherd developed the low FODMAP diet in 1999 as a treatment for IBS, and over the last several years it has gained significant attention among both patients and researchers for effectiveness. A study published in June 2013 found that, in some people with gluten sensitivity and IBS, reducing the intake of FODMAPs alleviated symptoms better than a gluten free diet. However, other studies found that people with IBS and gluten sensitivity reported improved symptoms on a gluten free diet, and the benefits remained even when high FODMAP foods like beans were reintroduced.

What these studies on IBS and FODMAPs demonstrate is that what works for one person may not work for another, and each person needs to have an individualized dietary plan that suits them. Whether the symptoms are caused by gluten or by FODMAPs the important thing for the sufferer is know which foods affect them and to avoid those foods.

From my personal experience with my own family that makes sense. Peppermint makes me sneeze, capsicum makes me vomit, my eldest daughter has sub-acute lupus so has to avoid any viral infections, my second daughter is allergic to nickel and cannot eat seafood, my third daughter has celiac disease so of cause cannot eat gluten and my son has a skin reaction to the sun. So we are all of the same DNA but all have our peculiarities as far as allergies etc. are concerned.  We just cater for everyone’s needs and it is not a problem at all.

Find out how I dealt with gluten free for my family and for the cafe I owned . 

Seven Reasons Someone With Celiac Disease May Not Be Responding To A Gluten Free Diet

If you have been diagnosed with celiac disease and have implemented a gluten free diet but you still experience symptoms, then you need to determine the reason why. Approximately 20% of people diagnosed with celiac disease will have persistent symptoms even after starting on a gluten free diet. There are many reasons for this but the seven most common are:

1. Your Diet is Not 100% Gluten Free

The most common reason for persistent symptoms is that you continue to ingest gluten, either knowingly or unknowingly. Cross contamination due to improper food preparation techniques is one of the most likely causes of this. Even a crumb of gluten can make someone with celiac disease ill, so good kitchen procedures need to be implemented.

There are so many sources of “hidden” gluten that a person with celiac disease needs to be aware of. For example, if you take communion it will have gluten in it. My daughter has a specially prepared gluten free host administered to her by her priest. Check to make sure that your hair products and make-up are gluten free, especially lipstick which is easily licked and swallowed. If it is a child with celiac disease make sure they have gluten free playdoh and do not share other children’s food. Gluten is often in medicines as well so that is another source of gluten contamination.

Gluten is often hidden in foods you may not suspect so it is really important to learn how to read labels. Also a café of restaurant meal may be gluten contaminated even though it states it is gluten free on the menu, so only dine at cafes and restaurants you can trust. Celiacs are encouraged to meet with a dietitian knowledgeable about celiac disease and the gluten free diet to learn about the “hidden” source of gluten in food.  

 Read more about how to achieve a 100% gluten free diet in my book about Gluten Free Cooking http://www.cooking.what-is-gluten-free.org/

2.   Microscopic Colitis, Crohn’s Disease and Ulcerative Colitis

People with celiac disease have an increased incidence of microscopic colitis and inflammatory bowel disease such as Crohn’s disease and ulcerative colitis. Microscopic colitis is an inflammation of the colon, or large intestine; Crohn’s disease is a chronic inflammatory disease of the digestive tract and ulcerative colitis is type of inflammatory bowel disease that causes sores in the colon. A colonoscopy is required to diagnose these.

3.   Small Intestinal Bacterial Overgrowth (SIBO)

Bacterial overgrowth is a condition in which unusually large numbers of bacteria are present in the small intestine. The types of bacteria found in the small intestine are similar to the bacteria found in the colon. This is usually diagnosed by a hydrogen breath test.

4.   Pancreatic Insufficiency

Pancreatic insufficiency is the inability to properly digest food due to a lack of digestive enzymes made by the pancreas. This can be diagnosed by the measurement of enzymes in the stool.

5.   Other Food Intolerances

People with celiac disease may also have other food intolerances such as lactose or fructose intolerance, both of which can be diagnosed by a hydrogen breath test. Some research has shown that FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) may be responsible for the symptoms of IBS (irritable bowel syndrome) and/or inflammatory bowel disease. Sufferers may benefit from a diet low in FODMAPs.

6.   Refractory Celiac Disease

Refractory celiac disease, also known as refractory sprue, affects up to 5% of people with celiac disease.  Unfortunately for this group of patients, the damage to the villi in the small intestine does not heal despite being on a gluten free diet. These patients are usually treated with steroids and immunosuppressant’s.

7.   Diabetes Type 1

Celiac disease and type 1 diabetes are genetically based disorders sharing similar genes (DQ2 and DQ8). That is why they both often occur in a susceptible individual. About 3.5 to 10 percent of individuals with celiac disease develop type 1 diabetes and vice versa. Diabetes is usually diagnosed first because the symptoms are more easily recognized and can be picked up with a general blood or urine test for sugar.

The symptoms for each mimic other diseases and therefore diagnosis can be quite confusing. If you suffer from any of the related symptoms it is critical to consult a doctor for a proper diagnosis.

Both diseases are activated by environmental triggers and have increased risk for other associated autoimmune diseases.

Summary 

So if you are totally sure that you are 100% gluten free, then it may be time to revisit your doctor because these other diseases could exist alongside your celiac disease. Your doctor may need to run other tests to determine to cause.

The University of Chicago, research center for celiac disease in the U.S., once posted that:

“While healing may take up to 2 years for many older adults, new research shows that the small intestines of up to 60% of adults never completely heal, especially when adherence to the diet is less than optimal”

This goes to show that being sure that you are on a 100% gluten free diet if you have celiac disease is critical.  Read more about how to achieve a 100% gluten free diet in my book about Gluten Free Cooking  

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