Search Results (19)

Ensuring the safety of gluten-free foods is essential for individuals with coeliac disease and other gluten-related disorders, for whom even minimal gluten exposure can cause adverse effects; this study aimed to evaluate the long-term compliance of gluten-free labeled foods marketed in Italy. A total of 4139 pre-packaged gluten-free products were collected between 2015 and 2024 and analyzed using validated analytical methods. Products were categorized into macro-categories: cereal-based foods, processed non-cereal-based foods, confectionery, flours, baby foods, and dietary supplements. A descriptive analysis and risk modeling were generated to visualize relative risks. Overall non-compliance remained consistently very low (<1%) throughout the 10-year period, with an average rate of 0.27% and minor peaks in 2016 and 2018. The highest frequencies of gluten contamination were observed in cereal-based products and flours-particularly corn flour-while occasional non-compliance occurred in some processed non-cereal-based foods and confectionery; no non-compliance was detected in baby foods or dietary supplements. These findings are reassuring and consistent with, or better than, available EU data, confirming the effectiveness of current control systems and highlighting the importance of continuous monitoring, validated analytical methods and effective allergen management strategies. Strengthened collaboration among regulators and manufacturers remains essential to prevent cross-contamination and protect consumer health. Full article

Strict adherence to a gluten-free diet (GFD) is the cornerstone of treatment in coeliac disease, yet gluten cross-contamination in household settings poses a persistent challenge. Guidance from dieticians and patient organizations is often not evidence-based. This study quantified gluten contamination risks associated with common kitchen appliances and evaluated the effectiveness of various cleaning methods in typical Dutch households. We performed a two-phase analysis of 417 samples of 275 chopping boards, 34 toasters/sandwich makers, and 108 deep-fat fryers/air fryers. Gluten levels were assessed on appliances and food items under different cleaning protocols, with Bayesian modeling used to estimate contamination probabilities. Plastic chopping boards showed the highest risks, with probabilities up to 0.868 when rinsed with cold water, compared with 0.147 after dishwasher cleaning. Glass and wooden boards cleaned in dishwashers had the lowest probabilities (0.0102 and 0.0194). Toasters and sandwich makers tested positive in 1 of 34 samples; at the 20 ppm threshold, contamination probability was 0.00001. In fryers, probabilities were 0.125 for deep-fat fryers and 0.070 for air fryers at the 5 ppm threshold, decreasing to 0.0405 and 0.0326 at 20 ppm. Across all appliances, gluten levels seldom exceeded the clinically relevant threshold of 20 ppm. This study highlights the importance of dedicated cleaning protocols and appliance-specific recommendations to mitigate gluten exposure. While complete elimination of gluten is challenging, adopting rigorous practices can substantially mitigate exposure for coeliac patients, enhancing safety and quality of life. Full article

Background/Objectives: Following gluten-free diet is challenging, due to risk of gluten cross-contamination. The study aimed to assess the non-cereal products gluten cross-contamination exposure risk in patients with coeliac disease. Methods: The study was conducted in a population of 699 Polish female members of the Polish Coeliac Society purchasing gluten-free products on-line (445 patients, 254 relatives). Participants were asked about frequency of buying and availability of gluten-free alternatives of non-cereal products characterized by the gluten cross-contamination risk (‘hidden’ gluten sources). Results: The most frequently bought non-cereal gluten-free alternatives of the ‘hidden’ gluten sources were baking powders, spices, side dishes, ice cream, chocolate and chocolate products, snack bars and candies. The caregivers often declared buying ‘often’ gluten-free baking powder, snack bars, chocolate and chocolate products, candies, ice cream, as well as often declared problems with the availability of gluten-free spices, chocolate and chocolate products, while patients often declared buying ‘often’ gluten-free beer, as well as often declared problems with its availability. The older respondents often declared buying ‘often’ gluten-free baking powder, while younger respondents often declared buying ‘often’ gluten-free chocolate and chocolate products, as well as often declared problems with the availability of gluten-free instant soups, and beer. The respondents living in small towns/villages often declared problems with the availability of gluten-free powder sauces. The respondents not purchasing in hypermarkets often declared buying ‘often’ gluten-free baking powder, spices, candies. The respondents who most often purchased gluten-free products often declared problems with the availability of gluten-free side dishes, chocolate and chocolate products. Conclusions: The majority of patients diagnosed with coeliac disease do not buy a number of gluten-free alternatives of the ‘hidden’ gluten sources, so they may be prone to gluten exposure, due to non-cereal products’ gluten cross-contamination risk. Full article

The approach to ensure food safety (FS) has evolved, including the concept of FS culture, which has been shaped by both the legislation and the scientific literature. In this study, two companies that produce foods associated with potential risks of cross-contamination (gluten-free foods and frozen pastry, respectively) and are certified according to international voluntary FS standards, such as the British Retail Council Global Standard (BRC) and the International Featured Standards Food Version (IFS), were investigated to assess: (a) if the assessment of FS culture’s pillars can uncover unexpected critical areas; (b) if the scores of the FS culture’s pillars are related to personal traits, namely, age, seniority in the company and locus of control orientation, i.e., the beliefs that an event is the result of external factors (luck, destiny or superior beings), or the result of internal factors (human behavior). Questionnaires for the survey and the scoring system applied were selected from the literature. Results showed that all food handlers had an optimistic bias, which paradoxically could be the consequence of the rigorous application of hygienic procedures. The younger food handlers had significantly (p < 0.05) lower commitment than the older ones. Moreover, the segment of food handlers having an external locus orientation demonstrated weaker normative beliefs than those having an internal locus of control orientation. Results showed that the FS culture survey, which is related to the shared FS culture, could disclose unknown weakness in third-party certified companies, even if the well implemented principles of voluntary FS standards are aligned with the FS-culture pillars. Moreover, the segmentation of food handlers according to their age and the locus of control assessment could provide additional information on the individual orientation toward FS behavior. Hence these tools could assist the leaders in the management of the dynamic nature of human capital. Full article

Diet is the only treatment for celiac disease (CeD), and good adherence to a gluten-free diet (GFD) is the only way to ensure complete remission and to prevent complications. Limited education about the disease and a GFD is an attributing factor to inadequate adherence. Thus, our aim was to assess the current knowledge about a GFD and the clinical monitoring of adherence to the diet among CeD people and HCPs. Specific questionnaires were designed and distributed to assess the knowledge of CeD people (Q1 questionnaire) (n = 2437) and to analyze the follow-up of the disease from the perspective of patients (Q2 questionnaire) (n = 1294) and HCPs (Q3 questionnaire) (n = 346). Two-thirds of HCPs specialized in pediatric care, while one-third did so in adult care. In CeD people, general questions regarding food classification and cross-contamination are well understood. When patients have doubts, 51.4% reported using the Internet and social networks. Thus, it is crucial that resources like social media are reliable and provide valuable information. Q3 revealed the lack of time to follow up the diet after diagnosis (48% of HCPs allocate < 15 min), the interest in further training, and the need for a professional specialized in diets within the healthcare system. In conclusion, it is essential to enhance nutritional education to increase awareness of a GFD. Full article

The avoidance of allergen intake is crucial for persons affected by peanut allergy; however, the cross-contamination of food is common and leads to unpredictable consequences after the consumption of supposedly “safe” food. The aim of the present study was to eliminate harmful traces of peanut allergens from food using purified clinoptilolite-tuff (PCT)—a specially processed zeolite material. Analyses were performed using a peanut ELISA and a Coomassie blue (Bradford) assay. Mimicking conditions of the human gastrointestinal tract demonstrated a higher efficacy of PCT in the intestine (pH 6.8) than in the stomach (pH 1.5). Adsorption rates were fast (<2 min) and indicated high capacities (23 µg and 40 µg per 1 mg of PCT at pH 1.5 and pH 6.8, respectively). Allergenically relevant peanut protein concentrations were sorbed in artificial fluids (32 µg/mL by 4 mg/mL of PCT at pH 1.5 and 80.8 µg/mL by 0.25 mg/mL of PCT at pH 6.8) when imitating a daily dose of 2 g of PCT in an average stomach volume of 500 mL. Experiments focusing on the bioavailability of peanut protein attached to PCT revealed sustained sorption at pH 1.5 and only minor desorption at pH 6.8. Accompanied by gluten, peanut proteins showed competing binding characteristics with PCT. This study therefore demonstrates the potential of PCT in binding relevant quantities of peanut allergens during the digestion of peanut-contaminated food. Full article

Celiac disease (CD) is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals, affecting 1.4% of the world population. CD induces an inflammatory reaction that compromises small intestine villi, leading to nutrient malabsorption, and gastro and extraintestinal manifestations. Although other treatment approaches are being studied, adherence to a gluten-free diet (GFD) is the only effective intervention to date. Despite this, about 50% of patients experience persistent inflammation, often associated with unintentional gluten ingestion through contaminated food. There are regulations for labeling gluten-free foods which specify a limit of 20 mg/kg (20 ppm). The risks of gluten cross-contamination above that level are present throughout the whole food production chain, emphasizing the need for caution. This review explores studies that tested different procedures regarding the shared production of gluten-containing and gluten-free food, including the use of shared equipment and utensils. A literature review covering PubMed, Scielo, Web of Science, VHL and Scopus identified five relevant studies. The results indicate that shared environments and equipment may not significantly increase gluten cross-contamination if appropriate protocols are followed. Simultaneous cooking of gluten-containing and gluten-free pizzas in shared ovens has demonstrated a low risk of contamination. In general, shared kitchen utensils and equipment (spoon, ladle, colander, knife, fryer, toaster) in controlled experiments did not lead to significant contamination of samples. On the other hand, cooking gluten-free and gluten-containing pasta in shared water resulted in gluten levels above the established limit of 20 ppm. However, rinsing the pasta under running water for a few seconds was enough to reduce the gluten content of the samples to less than 20 ppm. Full article

Celiac disease is a systemic autoimmune disease that occurs in genetically predisposed individuals and means a lifelong intolerance to gluten, which is found in wheat, barley, rye and oats, and leads to inflammatory changes in the lining of the small intestine. This is not a rare disease; it occurs in about 1% of the population. Recently, there has been a noticeable increase in the number and assortment of gluten free foods, which is marked with a crossed grain symbol or “gluten free” wording. The labeling, presentation and content of gluten in food intended for people intolerant to gluten is prescribed by the EU Regulation 828/2014 which has been harmonized in Serbian regulation. Gluten content not exceeding 20 mg/kg or 100 mg/kg justifies “gluten free” and “very low gluten” claims, respectively. The aim of this study was to assess gluten content in grain-based “gluten free” foods. Sixty samples of various grain-based food products (flour, bread, pasta, breakfast cereals and snacks, mainly made from corn, rice, buckwheat and millet) were analyzed using a commercially available sandwich ELISA test RIDASCREEN^® Gliadin (R-Biopharm AG, Darmstadt, Germany). Gluten was not detected (<5.0 mg/kg) in 75% of the samples, 10% had gluten content up to 20 mg/kg, while 8% slightly exceeded the limit for gluten free products (22.0–24.0 mg/kg), which could be tolerated taking into account measurement uncertainty. One flour (52.0 mg/kg), one snack (58.0 mg/kg) and one pasta sample (96.6 mg/kg) had gluten concentrations at the levels requiring “low gluten content” product labeling instead of “gluten free” displayed on their packages. Furthermore, one snack product reached 196 mg/kg of gluten. The labeled composition of this product did not indicate the presence of raw materials that are natural sources of gluten. If true, this implicates cross contamination. The presented results indicate that there is a need for continuous education and rise of awareness among producers of gluten free food as well as improved efficiency of market control. Although the restaurants that offer a gluten free menu are nowadays a rarity in Serbia, they too should be included in control programs. Full article

Celiac disease (CD) is the chronic immune-mediated enteropathy of the small bowel, manifesting when exposure to gluten occurs in genetically predisposed individuals. Nowadays, the only treatment considered safe for CD is a gluten-free diet (GFD). However, one of the problems faced by celiac patients is the cross-contamination of gluten-free food when preparing meals, in addition to utensils, surfaces and equipment. This study aimed to evaluate cross-contamination in gluten-free products and strategies for removing gluten from cross-contamination in cooking environments. The selection of papers for this integrative review was carried out by searching different databases. Gluten cross-contamination is a global concern for celiac patients in food environments. Although some practices are positive, such as gluten labeling on processed food in several countries, it is crucial to promote good practices in food services around the world. Only a few studies showed effective results in removing gluten from surfaces and utensils; furthermore, sampling was limited, making it difficult to identify appropriate procedures to reduce cross-contamination. The variation in contamination in different kitchen environments also highlighted that celiac patients must continue paying attention to the methods used to prepare gluten-free food. More research is needed, especially into methods of removing gluten from surfaces and utensils, to ensure food safety for celiac patients in many food environments. Full article

Current clinical studies confirm that the consumption of oats for people suffering from celiac disease is safe. Some studies have confirmed different levels of immunoreactive gluten epitopes of oats in different cultivars, while others explain these differences due to contamination with gluten-rich species or as random cross-reactivity ELISA of homologous oat epitopes with anti-wheat gliadin antibodies. The aim of our two-year study was therefore to map cross-reactive oat epitopes in a set of 132 oat cultivars using a G12-based ELISA kit. The results were focused on the varietal and annual level of cross-reactivity (interference) of avenin epitopes with the G12 antibody on the identification of potential cultivars with significantly different interferences and assessing the degree of risk of possible false-contamination with external gluten. Although repeated evaluations confirmed high year-to-year variability (RSD ≥ 30%) in approximately 2/3 of the cultivars, the content of interfering avenin epitopes with G12 did not exceed the considered safe limit (20 mg·kg⁻¹) for celiacs. At the same time, not only annual but, above all, significant cultivar dependences in the interference of avenins to the G12 antibody were demonstrated. Genetic dependence was further confirmed in connection with the proven avenin polymorphism as well as immunoblotting with the identification of interfering peptides with the G12 antibody in the 25 and 30 kDa regions. It was the occurrence of two bands around 30 kDa that predominantly occurred in oat cultivars with a relatively higher content of cross-reactive avenins (12–16 mg·kg⁻¹). Due to the fact that the contents of interfering avenins ranged in several cultivars even over 16 mg·kg⁻¹, the choice of a suitable oat cultivar may be crucial for gluten-free food producers, as it reduces the risk of a possible false-response of the commercial ELISA kits when checking the real-gluten contamination. Full article

Food allergies are an important global health concern, with many countries following the World Health Organisation’s guidelines with regards to due labelling of foods and, as such, providing forewarning about the presence of potential allergens to potential consumers. While for some produce, the link to specific allergens might be very clear to most consumers, this is not the case for all produce. People with specific food-related allergies usually know what to look out for, but occasionally, unexpected allergens are present in trusted produce. Beer is known to most to contain barley, which will contain gluten-like proteins that can cause allergic reactions in some people. Similarly, beer might contain sulphites and other potential allergens traditionally associated with beers. This review aims to examine a wide range of allergens that have entered the beer production process in recent years. As a result, examples of beers that contain one or more of the 14 EU-UK listed allergens are described, different allergen regulations in different countries are emphasised and their impact explained, and a number of case studies involving allergic reactions following exposure to and the ingestion of beer are highlighted. Full article

Celiac disease (CD) is a chronic gluten-responsive immune mediated enteropathy and is treated with a gluten-free diet (GFD). However, a strict diet for life is not easy due to the ubiquitous nature of gluten. This review aims at examining available evidence on the degree of adherence to a GFD, the methods to assess it, and the barriers to its implementation. The methods for monitoring the adherence to a GFD are comprised of a dietary questionnaire, celiac serology, or clinical symptoms; however, none of these methods generate either a direct or an accurate measure of dietary adherence. A promising advancement is the development of tests that measure gluten immunogenic peptides in stools and urine. Causes of adherence/non-adherence to a GFD are numerous and multifactorial. Inadvertent dietary non-adherence is more frequent than intentional non-adherence. Cross-contamination of gluten-free products with gluten is a major cause of inadvertent non-adherence, while the limited availability, high costs, and poor quality of certified gluten-free products are responsible for intentionally breaking a GFD. Therefore, several studies in the last decade have indicated that many patients with CD who follow a GFD still have difficulty controlling their diet and, therefore, regularly consume enough gluten to trigger symptoms and damage the small intestine. Full article

A gluten-free diet (GFD) is currently the only effective treatment for celiac disease (CD); an individual’s daily intake of gluten should not exceed 10 mg. However, it is difficult to maintain a strict oral diet for life and at least one-third of patients with CD are exposed to gluten, despite their best efforts at dietary modifications. It has been demonstrated that both natural and certified gluten-free foods can be heavily contaminated with gluten well above the commonly accepted threshold of 20 mg/kg. Moreover, meals from food services such as restaurants, workplaces, and schools remain a significant risk for inadvertent gluten exposure. Other possible sources of gluten are non-certified oat products, numerous composite foods, medications, and cosmetics that unexpectedly contain “hidden” vital gluten, a proteinaceous by-product of wheat starch production. A number of immunochemical assays are commercially available worldwide to detect gluten. Each method has specific features, such as format, sample extraction buffers, extraction time and temperature, characteristics of the antibodies, recognition epitope, and the reference material used for calibration. Due to these differences and a lack of official reference material, the results of gluten quantitation may deviate systematically. In conclusion, incorrect gluten quantitation, improper product labeling, and poor consumer awareness, which results in the inadvertent intake of relatively high amounts of gluten, can be factors that compromise the health of patients with CD. Full article

To date, the only available treatment for celiac disease (CD) patients is a life-lasting gluten-free diet (GFD). Lack of adherence to the GFD leads to a significant risk of adverse health consequences. Food cross-contamination, nutritional imbalances, and persistent gastrointestinal symptoms are the main concerns related to GFD. Moreover, despite rigid compliance to GFD, patients struggle in achieving a full restoring of the gut microbiota, which plays a role in the nutritive compounds processing, and absorption. Pivotal studies on the supplementation of GFD with probiotics, such as Bifidobacterium and Lactobacilli, reported a potential to restore gut microbiota composition and to pre-digest gluten in the intestinal lumen, reducing the inflammation associated with gluten intake, the intestinal permeability, and the cytokine and antibody production. These findings could explain an improvement in symptoms and quality of life in patients treated with GFD and probiotics. On the other hand, the inclusion of prebiotics in GFD could also be easy to administer and cost-effective as an adjunctive treatment for CD, having the power to stimulate the growth of potentially health-promoting bacteria strains. However, evidence regarding the use of prebiotics and probiotics in patients with CD is still insufficient to justify their use in clinical practice. Full article

This study aimed to evaluate the occurrence of gluten contamination in naturally gluten-free meals from food services in the Federal District, Brazil. This is an exploratory cross-sectional quantitative study in which a total of 180 samples of naturally gluten-free dishes were collected from 60 food services in Brazil. The enzyme-linked immunosorbent assay was used for the quantification of gluten. As established by the Codex Alimentarius, the threshold of 20 ppm of gluten was considered as the accepted upper gluten level for gluten-free food. A total of 2.8% (95% CI: 0.3–5.2%) gluten contamination was found in the samples. Among the 60 food services, 6.7% (95% CI: 2.7–10.6%) displayed at least one contaminated food in our sample. The occurrence of gluten contamination in naturally gluten-free preparations was uncommon and low on a quantitative basis. Full article