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

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

doi:10.3390/nu9020115

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.

Highlights

Celiac disease (CD) is an autoimmune condition characterized by permanent intolerance to dietary gluten, a protein complex found in wheat, rye and barley, occurring in genetically predisposed individuals [1]
It has been shown that the protracted ingestion of traces of gluten (10–50 mg on a daily basis) may damage the integrity of the small intestinal mucosa, an increased number of intraepithelial lymphocytes (IELs) being the first marker of mucosal deterioration [3]
18 (9%) products were detected with gluten level above the maximum tolerable of 20 ppm (15 products containing less and three products more than 100 ppm of gluten) (Table 1)

Summary

Introduction

Celiac disease (CD) is an autoimmune condition characterized by permanent intolerance to dietary gluten, a protein complex found in wheat, rye and barley, occurring in genetically predisposed individuals [1]. The hallmarks of active CD are the presence of serum autoantibodies (e.g., IgA antitransglutaminase and antiendomysial antibodies) and a small intestinal enteropathy characterized, in typical cases, by villous atrophy, crypt hypertrophy and increased number of intraepithelial lymphocytes (IELs). Treatment of CD is based on the lifelong exclusion of gluten-containing food from the diet. The gluten-free diet (GFD) determines the gradual disappearance of symptoms and serum autoantibodies, and the normalization of the intestinal histological architecture [2]. A strict and lifelong gluten-free diet is the only treatment of celiac disease. The aim of this study was to test the level of gluten contamination in gluten-free products currently available in the Italian market. The gluten content was determined by the R5 ELISA Kit approved by EU regulations

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Discussion

Conclusion