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Thanks to everyone who wrote with their very supportive comments.
Everyone seemed to agree that most of us do not believe in a "safe"
threshold level of gluten. I will quote one person: "I find these sorts
of studies quite ludicrous. Would they study arsenic and come up with
such an idea? This sort of idea of acceptable amounts is controversial in
regards to mercury, too, and parents of children affected do not accept
any amount. Nor can those with children with the life-threatening peanut
allergy. ....It is interesting to note that because such a reaction is
clear and cannot be discounted, that it is believed to have happened from
a trace amount, but those of us who suffer from trace amounts of gluten
are doubted, as our reactions are not as dramatic. "
Other people also objected to researchers even doing these types of
studies.
Personally, I do believe it is important to do these studies - to have
the knowledge, but I think we need to look at how the message of these
studies is being given across. The message from the original study that
started this whole discussion was: "The ingestion of contaminating
gluten should be kept lower than 50 mg/d in the treatment of CD". In
looking over the abstract from this study, again, although technically
this conclusion is correct, I personally do not believe it accurately
reflects their conclusions - where the villi of the control group showed
slight improvement, essentially no change in those given 10 mg gluten and
a worsening of those given 50. I do not know if these differences were
statistically significant, but looking at these results, personally, I
would conclude that possibly even 10 mg gluten per day is deleterious -
especially when 1 of their subjects relapsed with 10 mg gluten - and
again, I am assuming the study subjects were "less sensitive", for lack
of a better term, to gluten. When setting public policy, such as
defining "gluten-free", it sounds very different to say "keep gluten less
than 50 mg/day" as opposed to "possibly as little as 10mg per day may be
harmful".
I am copying a couple of other items about how much is this:
"I just weighed a slice of Food-For-Life bread. It was 46 grams. There
are
1000 milligrams in one gram. So the slice weighed 46,000 mg. If wheat
bread is 10% gluten then a slice would be 4,600 mg of gluten. That would
be
almost 100 times the 50 mg sample. (A quick Google showed wheat flour as
10-14% gluten, but other ingredients would lower that slightly.)"
Another poster found this: "A value that has been suggested as safe is
exposure to about 30 mg/day. This is a tiny amount. With typical wheat
flour having 40% gluten, 30 mg comes from less than 100 mg of wheat flour
(a teaspoon full is about 3,000 mg, so 1/30th of a teaspoon). "
Another poster reported on some info from the recent international Celiac
Symposium:
"I attended the celiac symposium in NY this past Nov. and Dr. Semrad
(Univ. of Chicago) provided the following concerning one study:
Gluten Level Symptoms? Intestinal Permeability? Biopsy
(up to 3 months ingestion)
10 mg No Symptoms Not Studied
Normal
25 mg Yes Not Studied
? I think it was normal
100 mg Yes Normal
Minimal Changes
500 mg Yes Increased Permeability
More Pronounced Changes
Conclusion:
< 10 mg of gliadin per day – most patients can tolerate with no damage
< 5 mg of gliadin per day – recommended for patients that are highly
sensitive
To understand what the measurements, Dr. Semrad said 10 mg of gliadin
equals about 20 mg of gluten or less than 1/8 teaspoon of flour.
Thus, 50 mg equates to 5/16 of a teaspoon of flour (or just a little over
1/4 tsp.).
Many of the people who wrote are extremely sensitive. Since we will
never be the ones who are studied, I personally do not think the studies
will ever get truly accurate information, and will always overestimate
the "safe" level. Nevertheless, as one person pointed out, the part of
the message that is very important to get out is that it is very
important to be careful with our diets as very low levels of gluten do
cause damage at the cellular level. This is why I believe these studies
are important, as just as there are many of us who know that even minor
contamination could kill us, there are probably many more folks - with no
or minimal symptoms, who do not believe that a "little bit" is harmful.
(I'm sure we all know people like that.) That is the message that we
need to publicize from these studies.
Again, thanks for everyone's feedback.
I did get one e-mail with a bunch of links. I will paste it below if
people are interested in checking them out
Diane
Denver
How much gluten is in a normal diet, and how much does it take to cause
damage in a celiac?
< http://www.celiac.com/st_prod.html?p_prodid=3D39 >
US FDA/CFSAN March 2006
Approaches to Establish Thresholds for Major Food Allergens and for
Gluten in Food
< http://www.cfsan.fda.gov/~dms/alrgn2.html >
US FDA/CFSAN March 2006
FDA's Responses to Public Comments on the Draft Report "Approaches to
Establish Thresholds for Major Food Allergens and for Gluten in Food"
< http://www.cfsan.fda.gov/~dms/alrgcom.html >
US FDA/CFSAN August 19, 2005
Detection of Cereal Proteins and DNA Using MS, ELISA, and PCR
< http://www.cfsan.fda.gov/~dms/gluthurk.html >
FARRP Commercial Allergen Analyses
< http://www.farrp.org/kitinfo.htm >
R-Biopharm RIDASCREEN=AEFAST Gliadin test
< http://www.r-biopharm.com/foodandfeed/ridascreenfast_gliadin.php >
RIDASCREEN=AEFAST Gliadin
Enzyme immunoassay for the quantitative analysis of gliadins and=20
corresponding prolamines
(Paste this link together on 1 line)
<
http://www.r-biopharm.com/foodandfeed/pdf/R7002%20FAST%20Gliadin%2005-0=
9-
01kk.pdf >
"The RIDASCREEN=AE Gliadin test uses the same R5 antibody leading to the
accurate identification and labelling of gluten free cereals."
< http://www.r-biopharmrhone.com/news/dec05.html >
=20
European Food Research and Technology Volume 222, Numbers 1-2 /
January2006 p78-82
Monoclonal antibody R5 for detection of putatively coeliac-toxic gliadin
peptides
Franka Kahlenberg, Daniel Sanchez, Ingolf Lachmann, Ludmila Tuckova,=20
Helena Tlaskalova, Enrique Mendez and Thomas Mothes
< http://www.springerlink.com/content/34312w0665g01668/fulltext.html >
< http://www.springerlink.com/content/34312w0665g01668/fulltext.pdf >
BMC Genomics. 2006; 7: 1.=20
Alpha-gliadin genes from the A, B, and D genomes of wheat contain=20
different sets of celiac disease epitopes
Teun WJM van Herpen, Svetlana V Goryunova, Johanna van der Schoot,=20
Makedonka Mitreva, Elma Salentijn, Oscar Vorst, Martijn F Schenk, Peter A
van Veelen, Frits Koning, Loek JM van Soest, Ben Vosman, Dirk Bosch, Rob
J Hamer, Luud JWJ Gilissen, and Marinus JM Smulders
< http://www.biomedcentral.com/1471-2164/7/1 >
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