title: Estimated levels of gluten incidentally present in a Canadian gluten-free diet.
abstract: Avoiding exposure to gluten is currently the only effective treatment for celiac disease. However, the evidence suggests that for most affected individuals, exposure to less than 10 mg/day is unlikely to cause histological changes to the intestinal mucosa. The daily diet of people with celiac disease does not rely solely on gluten-free pre-packaged foods, but also on naturally gluten-free grains (e.g., rice, buckwheat, ...) and foods with grain-derived ingredients (i.e., flour and starches) used for cooking and baking at home. The objective of this study was to estimate the level of incidental gluten potentially present in gluten-free diets from a Canadian perspective. We have conducted gluten exposure estimations from grain-containing foods and foods with grain-derived ingredients, taking into consideration the various rates of food consumption by different sex and age groups. These estimates have concluded that if gluten was present at levels not exceeding 20 ppm, exposure to gluten would remain below 10 mg per day for all age groups studied. However, in reality the level of gluten found in naturally gluten-free ingredients is not static and there may be some concerns related to the flours made from naturally gluten-free cereal grains. It was found that those containing a higher level of fiber and that are frequently used to prepare daily foods by individuals with celiac disease could be a concern. For this category of products, only the flours and starches labelled "gluten-free" should be used for home-made preparations.
authors.affiliation: Director General's Office, Food Directorate, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, ON K1A 0K9, Canada. sebastien.lavieille@hc-sc.gc.ca.
authors.forename: Sébastien
authors.initials: S
authors.lastname: La Vieille
authors.affiliation: Bureau of Policy, Intergovernmental and International Affairs, Food Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada. sheila.dubois@hc-sc.gc.ca.
authors.forename: Sheila
authors.initials: S
authors.lastname: Dubois
authors.affiliation: Bureau of Food Surveillance and Science Integration, Food Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada. stephen.hayward@hc-sc.gc.ca.
authors.forename: Stephen
authors.initials: S
authors.lastname: Hayward
authors.affiliation: Bureau of Chemical Safety, Food Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada. terry.koerner@hc-sc.gc.ca.
authors.forename: Terence B
authors.initials: TB
authors.lastname: Koerner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D002446:Celiac Disease / Q000178:diet therapy; D002648:Child; D002675:Child, Preschool; D055050:Diet, Gluten-Free; D002523:Edible Grain / Q000737:chemistry; D002149:Energy Intake; D005260:Female; D005433:Flour / Q000032:analysis; D005983:Glutens / Q000032:analysis*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D013213:Starch / Q000032:analysis; D055815:Young Adult
chemical_list: D005983:Glutens; D013213:Starch