Gluten Contamination in Naturally or Labeled Gluten-Free Products Marketed in Italy

Anil K Verma, Simona Gatti, Tiziana Galeazzi, Chiara Monachesi, Lucia Padella, Giada Del Baldo, Roberta Annibali, Elena Lionetti, Carlo Catassi, Anil K Verma, Simona Gatti, Tiziana Galeazzi, Chiara Monachesi, Lucia Padella, Giada Del Baldo, Roberta Annibali, Elena Lionetti, Carlo Catassi

Abstract

Background: A strict and lifelong gluten-free diet is the only treatment of celiac disease. Gluten contamination has been frequently reported in nominally gluten-free products. The aim of this study was to test the level of gluten contamination in gluten-free products currently available in the Italian market.

Method: A total of 200 commercially available gluten-free products (including both naturally and certified gluten-free products) were randomly collected from different Italian supermarkets. The gluten content was determined by the R5 ELISA Kit approved by EU regulations.

Results: Gluten level was lower than 10 part per million (ppm) in 173 products (86.5%), between 10 and 20 ppm in 9 (4.5%), and higher than 20 ppm in 18 (9%), respectively. In contaminated foodstuff (gluten > 20 ppm) the amount of gluten was almost exclusively in the range of a very low gluten content. Contaminated products most commonly belonged to oats-, buckwheat-, and lentils-based items. Certified and higher cost gluten-free products were less commonly contaminated by gluten.

Conclusion: Gluten contamination in either naturally or labeled gluten-free products marketed in Italy is nowadays uncommon and usually mild on a quantitative basis. A program of systematic sampling of gluten-free food is needed to promptly disclose at-risk products.

Keywords: R5 ELISA; buckwheat; celiac disease; gluten-free products; lentils; naturally gluten-free; oats.

Conflict of interest statement

Carlo Catassi has received consultancy funds from Schär. Other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Types of food products analyzed in this study.
Figure 2
Figure 2
Number of food products containing gluten >20 ppm in different groups.
Figure 3
Figure 3
Percentage of contaminated products in each food group.
Figure 4
Figure 4
Distribution of price indexes (PIs) according to the level of gluten contamination.

References

    1. Fasano A., Catassi C. Current approaches to diagnosis and treatment of celiac disease: An evolving spectrum. Gastroenterology. 2001;120:636–651. doi: 10.1053/gast.2001.22123.
    1. Lionetti E., Castellaneta S., Francavilla R., Pulvirenti A., Tonutti E., Amarri S., Barbato M., Barbera C., Barera G., Bellantoni A., et al. Introduction of gluten, HLA status, and the risk of celiac disease in children. N. Engl. J. Med. 2014;371:1295–1303. doi: 10.1056/NEJMoa1400697.
    1. Catassi C., Fabiani E., Iacono G., D’Agate C., Francavilla R., Biagi F., Volta U., Accomando S., Picarelli A., De Vitis I., et al. A prospective, double-blind, placebo-controlled trial to establish a safe gluten threshold for patients with celiac disease. Am. J. Clin. Nutr. 2007;85:160–166.
    1. Gibert A., Kruizinga A.G., Neuhold S., Houben G.F., Canela M.A., Fasano A., Catassi C. Might gluten traces in wheat substitutes pose a risk in patients with celiac disease? A population-based probabilistic approach to risk estimation. Am. J. Clin. Nutr. 2013;97:109–116. doi: 10.3945/ajcn.112.047985.
    1. Codex Alimentarius Commission . Foods for Special Dietary Use for Persons Intolerant to Gluten Codex STAN 118-1979. Codex Alimentarius Commission; Rome, Italy: 2008.
    1. European Commission, COMMISSION REGULATION No 41/2009 of 20 January 2009 Concerning the Composition and Labelling of Foodstuffs Suitable for People Intolerant to Gluten. 2009. [(accessed on 14 December 2015)]. Available online: .
    1. Lee H.J., Anderson Z., Ryu D. Gluten contamination in foods labeled as “gluten free” in the United States. J. Food Prot. 2014;77:1830–1833. doi: 10.4315/0362-028X.JFP-14-149.
    1. Lanzini A., Lanzarotto F., Villanacci V., Mora A., Bertolazzi S., Turini D., Carella G., Malagoli A., Ferrante G., Cesana B.M., et al. Complete recovery of intestinal mucosa occurs very rarely in adult coeliac patients despite adherence to gluten-free diet. Aliment. Pharmacol. Ther. 2009;15:1299–1308. doi: 10.1111/j.1365-2036.2009.03992.x.
    1. Farage P., de Medeiros Nóbrega Y.K., Pratesi R., Gandolfi L., Assunção P., Zandonadi R.P. Gluten contamination in gluten-free bakery products: A risk for coeliac disease patients. Public Health Nutr. 2016;15:1–4. doi: 10.1017/S1368980016002433.
    1. Koerner T.B., Cléroux C., Poirier C., Cantin I., Alimkulov A., Elamparo H. Gluten contamination in the Canadian commercial oat supply. Food Addit. Contam. Part A Chem. Anal. Control Expo. Risk Assess. 2011;28:705–710. doi: 10.1080/19440049.2011.579626.
    1. Zilić S., Barać M., Pešić M., Dodig D., Ignjatović-Micić D. Characterization of proteins from grain of different bread and durum wheat genotypes. Int. J. Mol. Sci. 2011;12:5878–5894.
    1. Wieser H., Antes S., Seilmeier W. Quantitative determination of gluten protein types in Wheat flour by reversed-phase high-performance liquid chromatography. Cereal Chem. 1998;75:644–650. doi: 10.1094/CCHEM.1998.75.5.644.
    1. Haas-Lauterbach S., Immer U., Richter M., Koehler P. Gluten fragment detection with a competitive ELISA. J. AOAC Int. 2012;5:377–381. doi: 10.5740/jaoacint.SGE_Haas-Lauterbach.
    1. Halbmayr-Jech E., Hammer E., Fielder R., Coutts J., Rogers A., Cornish M. Characterization of G12 sandwich ELISA, a next-generation immunoassay for gluten toxicity. J. AOAC Int. 2012;95:372–376. doi: 10.5740/jaoacint.SGE_Halbmayr-Jech.
    1. Mujico J.R., Dekking L., Kooy-Winkelaar Y., Verheijen R., van Wichen P., Streppel L., Sajic N., Drijfhout J.W., Koning F. Validation of a new enzyme-linked immunosorbent assay to detect the triggering proteins and peptides for celiac disease: interlaboratory study. J. AOAC Int. 2012;95:206–215. doi: 10.5740/jaoacint.11-042.
    1. Valdés I., García E., Llorente M., Méndez E. Innovative approach to low-level gluten determination in foods using a novel sandwich enzyme-linked immunosorbent assay protocol. Eur. J. Gastroenterol. Hepatol. 2003;15:465–474. doi: 10.1097/01.meg.0000059119.41030.df.
    1. Koerner T.B., Cleroux C., Poirier C., Cantin I., La Vieille S., Hayward S., Dubois S. Gluten contamination of naturally gluten-free flours and starches used by Canadians with celiac disease. Food Addit. Contam. Part A Chem. Anal. Control Expo. Risk Assess. 2013;30:2017–2021. doi: 10.1080/19440049.2013.840744.
    1. La Vieille S., Pulido O.M., Abbott M., Koerner T.B., Godefroy S. Celiac Disease and Gluten-Free Oats: A Canadian Position Based on a Literature Review. Can. J. Gastroenterol. Hepatol. 2016;2016:1870305. doi: 10.1155/2016/1870305.
    1. Gatti S., Caporelli N., Galeazzi T., Francavilla R., Barbato M., Roggero P., Malamisura B., Iacono G., Budelli A., Gesuita R., et al. Oats in the Diet of Children with Celiac Disease: Preliminary Results of a Double-Blind, Randomized, Placebo-Controlled Multicenter Italian Study. Nutrients. 2013;5:4653–4664. doi: 10.3390/nu5114653.
    1. Giménez-Bastida J.A., Zieliński H. Buckwheat as a Functional Food and Its Effects on Health. J. Agric. Food Chem. 2015;63:7896–7913. doi: 10.1021/acs.jafc.5b02498.
    1. La Vieille S.L., Dubois S., Hayward S., Koerner T.B. Estimated Levels of Gluten Incidentally Present in a Canadian Gluten-Free Diet. Nutrients. 2014;6:881–896. doi: 10.3390/nu6020881.
    1. Mudryj A.N., Yu N., Aukema H.M. Nutritional and health benefits of pulses. Appl. Physiol. Nutr. Metab. 2014;39:1197–1204. doi: 10.1139/apnm-2013-0557.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever