Enforcement of FDA gluten-free food labeling begins

Enforcement of FDA gluten-free food labeling begins

On August 5th, the FDA began enforcement of a rule promulgated last year defining the term "gluten free." The threshold for the use of the claim will be 20 parts per million, which means that, unless a packaged food meets that standard, it can't be labeled "gluten free" or similar terms, such as "no gluten" and "without gluten."  The FDA also said that restaurant menus "should" comply with the rule, although there is some question whether "should" is the legal equivalent of "must."

According to Michael R. Taylor, the FDA’s Deputy Commissioner for Foods and Veterinary Medicine,

Celiac disease is a serious health issue and there is no cure. The only choice for the more than 3 million Americans living with the disease is adherence to a diet free of gluten — proteins that occur naturally in wheat, rye, barley and cross-bred hybrids of these grains. To do otherwise is to risk gradually damaging the intestines, preventing the absorption of vitamins and minerals, and possibly leading to a host of other health problems.

Celiac disease is an autoimmune disease, not a food allergy.  There was some thought that a condition labeled non-celiac gluten sensitivity (NCGS) might the source of patient symptoms that didn't test as true celiac.  However, according to an article appearing last December in Current Allergy and Asthma Reports

Recent randomized controlled re-challenge trials have suggested that gluten may worsen gastrointestinal symptoms, but failed to confirm patients with self-perceived NCGS have specific gluten sensitivity. Furthermore, mechanisms by which gluten triggers symptoms have yet to be identified. 

Interestingly, new trials were done by the same researchers who did the original research suggesting NCGS might be responsible for symptoms.  Good scientists that they are, the went back and did more research, this time with better controls.

Analyzing the data, Gibson [one of the researchers] found that each treatment diet, whether it included gluten or not, prompted subjects to report a worsening of gastrointestinal symptoms to similar degrees. Reported pain, bloating, nausea, and gas all increased . . .  Even in the second experiment, when the placebo diet was identical to the baseline diet, subjects reported a worsening of symptoms! The data clearly indicated that a nocebo effect, the same reaction that prompts some people to get sick from wind turbines and wireless internet, was at work here. Patients reported gastrointestinal distress without any apparent physical cause. Gluten wasn't the culprit; the cause was likely psychological. Participants expected the diets to make them sick, and so they did. The finding led Gibson to the opposite conclusion of his 2011 research: “In contrast to our first study… we could find absolutely no specific response to gluten."

This doesn't mean there's not something in food that's causing symptoms.  It does mean that the "gluten is the root of all evil" craze now in full swing is based not in sound science. In fact, going gluten-free when you don't have to can actually be bad for your health if you don't replace the fiber in your diet.

Of course, the lack of evidence never stopped the CAM crowd.  Naturopaths are great believers in food "sensitivities" that actual allergy specialists somehow miss. But they don't let science get in the way of "finding" these "sensitivities" with, among other diagnostic methods, worthless IgG antibody tests.  Gluten is no exception -- it is the sensitivity du jour

So, good for the FDA for establishing a clear standard that food manufacturers and restaurants can follow and consumers can rely on.  It will be interesting to see if gluten-free foods fade from the headlines, of concern only to those with celiac disease. Food crazes usually do. The nocebo effect of imagined gluten sensitivity may be cured by the appearance of the next root cause of all disease. Remember yeast? Of course, naturopaths still believe in that one too. 








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