by Robin Allen
What a great webinar and questions “The Scoop on Gluten Free: Research and Practice Tips” presented by Amy Jones, MS, RDN, LD. We had so many questions we could not address them all in the webinar. Amy has answered these questions in this blog. If you missed the webinar, RDNs can still earn 1.0 CPEU by listening to the recording and completing the evaluation on the event page.
Questions from the Gluten webinar:
What is your recommendation of screening if a patient reports excessive bloating post meals that include bread items and no bloating when avoiding all bread items and eat fruits, vegetables, potatoes, and protein sources without any gluten in them?
I would recommend this patient be screened for celiac disease, especially before they get too far into the gluten-free diet. If they are gluten-free for too long, they risk a false-negative screening blood test. If celiac tests come back negative, non-celiac gluten sensitivity (NCGS) certainly may be the correct diagnosis. However, remember there is no definitive test for diagnosing NCGS. The patient should keep a log of how they feel while eating gluten-free for a few weeks, and then re-challenge gluten back into the diet to see if their negative symptoms return.
How long does it take for someone to be eating GF before the lab tests are affected?
The University of Chicago Celiac Disease Center recommends 12 weeks of daily gluten intake before testing. If you’ve been gluten-free for only a few days, I would think it would be unlikely that you would see an effect on screening blood tests.
Can you explain more why malt items cannot be in GF products even if ppm is under 20?
This is certainly a major issue as we are seeing with manufacturers. Several believe that they can still label a product gluten-free, even if it contains malt. The FDA stated in a 2014 Academy of Nutrition and Dietetics Webinar that malt and malt extract are ingredients derived from a gluten-containing grain (barley) and would not be considered ingredients treated to remove gluten. Therefore, they would not be allowed to be in a food bearing the gluten-free claim. Just like a manufacturer wouldn’t be able to allow a “little bit” of wheat or rye flour in a product (even if the final product contains <20ppm gluten).
Do you worry about a health halo effect with the gluten free label?
I do, and it’s ironic that some gluten-free foods contain more fat, calories, and sodium than their gluten-containing counterparts!
Would buying the naturally gluten free grains from somewhere like Whole Foods guarantee them being safer from contamination than regular grocery stores?
Not necessarily. I would recommend buying naturally gluten-free grains specifically labeled “gluten-free” (based on research on gluten contamination of naturally gluten-free grains), regardless of which store they are purchased in. For example, quinoa that is purchased at Whole Foods that is not labeled gluten-free may not be safe. For more information on the gluten contamination of naturally gluten-free grains, check out the study here.
I have heard of imported pizza dough from Italy that is touted to be made from “gluten-free” wheat. Apparently, the dough is treated with beneficial bacteria which MAY digest some of the gluten… Have you heard of this? Would this product be allowed for sale without FDA approval in the US?
I’m not familiar with that particular product, but there has been testing on some products like this, and they have turned out not to be safe. Read more here:
Purbread Gluten Neutralized Bread (not labeled gf)
Dan the Baker Country Sour Bread (NOT LABELED GF)
What kind of response would someone have if they ate gluten when eating out? Is there any way to treat it? Or they just have it suffer through the symptoms until it passes?
There are plenty of home remedies suggested out there (drinking more water, etc), but there isn’t any evidence that they are effective. I don’t recommend the over-the-counter gluten-enzyme products (Gluten Cutter, etc.) They don’t provide any protection.
If you have more questions about gluten-free or comments OneOp Nutrition and Wellness team would love to hear from you. You can leave your comments here or connect with on the OneOp Nutrition and Wellness on our website, on Facebook, on Twitter, and LinkedIn.
Additional Reference:
https://www.ncbi.nlm.nih.gov/pubmed/20497786
This blog was posted by Robin Allen, a member of OneOp (MFLN) Nutrition and Wellness team that aims to support the development of professionals working with military families. Find out more about the OneOp Nutrition and Wellness concentration on our website, on Facebook, on Twitter, and LinkedIn.
