<<Disclaimer: Verify this information before applying it to your situation.>> Bill Elkus stated in a recent communication: >Some Celiac support groups warn that there is no established minimum >level of gluten ingestion without damage..... I think that although it isn't possible to find a clear statement to the effect that there is a minimum level of gluten ingestion that will not cause damage, I will put forward for the sake of argument that such a level has been established by the studies of Holmes et al. (Malignancy in coeliac disease--effect of a gluten-free diet, Gut 30:333-338, 1989). In their paper, Holmes et al. report that people (celiac patients) eating a diet containing gluten had higher levels of lymphoma and some other cancers than the population in general. They also report that for patients consuming a strict gluten-free diet for more than five years, there was no significant increase in overall cancer risk. What Holmes et al. do not say is that the 108 patients in their group on a strict gluten-free diet were probably regularly consuming wheat starch products--because at the time their study was carried out, such products were (perhaps still are in the UK) considered acceptable in a strict gluten-free diet. I think this is a reasonable assumption although, of course, I cannot prove that the patients in the gluten-free group of Holmes et al. were eating wheat starch products. Commercial wheat starches almost certainly contain gliadin, which is part of the gluten, although it is extremely difficult to put a number on how much gluten they contain because of analytical problems. I will make a very rough estimate that a person eating 100 grams of wheat starch per day would have a gliadin (gluten) intake of 10-50 mg per day depending on how well the starch preparation had been washed. Now this is a very small amount of gluten. Nevertheless, I interpret the results of Holmes et al., if they are accepted as definitive, as indicating that there is a minimum amount of gliadin intake that causes no harm for celiac patients. Counter arguments and criticism of my logic as presented above will be welcomed. Don Kasarda, Albany, CA