<<Disclaimer: Verify this information before applying it to your situation.>>

Re Wheat starch and gluten free foods:

This email is sent from New Zealand.

Up until 1999, a particular wheat starch based product, X, was labelled
as 'gluten free' and available via prescription for biopsy-diagnosed
celiacs.

During 1999 the NZ Commerce Commission requested analysis of product X
by Crop and Food Research, New Zealand Institute for Crop and Food
Research Ltd. The analysis was performed using a '96 WELL ELISA TEST
KIT' produced by Medical Innovations, Australia.

The analysis of two separate samples showed:
Sample 1: Gluten level of 7.8 mg gluten per 100g dry product.
Sample 2: Gluten level of 11.5 mg gluten per 100g dry product.

The test procedure states:
'It is estimated that 50% of the gluten protein is in the form of
gliadin.'

Thus, halving the above values gives the approximate toxic gliadin
contents.

In view of these results, namely that the product contained measurable
gluten, the New Zealand Commerce Commission insisted the product be no
longer labelled as 'gluten free'. i.e. the words 'gluten free' must mean
what they say, otherwise the labelling is false and prosecutions would
follow. ( The product X remains available, but under the new descriptor,
'Low Gluten' )

The NZ national pharmaceutical purchasing agency, Pharmac, has now
accepted the meaning of  'gluten free' as meaning 100% free of all
gluten.

It might be asked whether this outcome is purely legal-commercial in
nature with little real significance in health management of New Zealand
celiac patients.

However, in my own experience - with high personal gluten sensitivity - the
use of product X from 1974-1990 (when I realised the nature of the problem)
contributed to ongoing health difficulties.  Expert medical opinion on my
situation, obtained in 1993, stated:

'there has been a problem in the past with some celiac patients having
difficulty with (X ).    ........a number of patients were still symptomatic
despite using this product and lost their symptoms and regained their
normal health by switching to another product....'

Thus, my experience, confirmed by expert opinion, suggests that even
pharmaceutical grade wheat starch can present problems for at least some
celiac patients.

The first of the following research papers - the abstracts can be
accessed via Medline - draws a similar conclusion. The second paper,
however, arrives at an opposing conclusion.
( References to these papers have been previously posted to the List.)

At this point, I suspect, the patient who is confronted with the wheat
starch issue needs to make some personal decisions, particularly if
their health remains less than optimal.

Regards,
Graeme


Paper 1

Title
     Wheat starch intolerance in patients with celiac disease.
Author
     Chartrand LJ; Russo PA; Duhaime AG; Seidman EG
Address
     Research Center of Ste Justine Hospital, Quebec, Canada.
Source
     J Am Diet Assoc, 1997 Jun, 97:6, 612-8

APPLICATIONS:
     The innocuousness of the long-term ingestion of "gluten-free"
     products containing wheat starch is still unproven, and prolonged
     use of such products by patients with celiac disease cannot be
     recommended.

Paper 2

Title
     Wheat starch-containing gluten-free flour products in the
     treatment of coeliac disease and dermatitis herpetiformis.  A
     long-term follow-up study.
Author
     Kaukinen K; Collin P; Holm K; Rantala I; Vuolteenaho N; Reunala T;
     Maki M
Address
     Dept. of Medicine, Tampere University Hospital, Finland.
Source
     Scand J Gastroenterol, 1999 Feb, 34:2, 163-9

CONCLUSION: Wheat starch-based gluten-free flour products were not
     harmful in the treatment of coeliac disease and dermatitis
     herpetiformis.