For many people, the gluten-free diet might be little more than a modern fad, but for the approximately 1% of the population who have celiac disease, eating gluten-free foods is imperative if they want to be healthy. A new study suggests that maintaining a gluten-free diet is much more difficult than anticipated. According to the research, patients adhering to a gluten-free diet are frequently exposed to low levels of gluten that contribute to symptoms and persistent intestinal damage.

Gluten-free bread. Image via Wikipedia.

Gluten is an umbrella term for the proteins found in wheat. Unfortunately, some people are unable to properly process gluten — a condition by the name of Celiac disease. Celiac disease is a chronic, autoimmune disorder which primarily affects the small intestine after the ingestion of wheat, barley, rye, and derivatives. People may suffer severe symptoms and might suffer greatly after consuming gluten, and naturally, try to avoid that as much as possible.

Most people consume between 5 and 15 grams of gluten per day, on average. For severe Celiac sufferers, even 50 mg a day can cause significant distress — so they try to eliminate gluten completely from their diet. But even keenly aware people may simply be unable to do that. As it turns out, even people who thought they were eating 100% gluten-free had detectable amounts of gluten in their body. So, while some people are more diligent than others and reduce more gluten from their diets, it was almost impossible to completely eliminate gluten from the equation.

The Hidden Gluten

According to a meta-analysis of previously published studies, despite the best efforts of Celiac patients, it’s nigh impossible to escape Celiac. UCI’s Jack Syage and colleagues estimate that typically, Celiac patients consume up to 244 mg of gluten per day. The study estimated the average to be from 150-400 mg using the stool test and 300-400 mg using the urine test. However, it should be recognized that the stool and urine tests are relatively new and the methods continue to be improved, researchers note.

These quantities are sufficient to trigger symptoms, which is already worrying. But where is the gluten coming from? Unfortunately, we don’t know yet. These are just preliminary results which aimed at mapping involuntary gluten consumption. Hopefully, future research will identify the source of this unwanted hidden gluten.

Source: Syage JA et al. Determination of gluten consumption in celiac disease patients on a gluten-free diet. The American Journal of Clinical Nutrition, Volume 107, Issue 2, 1 February 2018, Pages 201–207, https://doi.org/10.1093/ajcn/nqx049