Celiac Disease and Gluten-Related Disorders

Potential ways for gluten contamination of gluten-free grain and gluten-free foods: the buckwheat case

Buckwheat has been reported to be responsible for gluten contamination in manufactured gluten-free foods (mGFFs) although it is inherently gluten-free (GF). It could happen through buckwheat grains contacting gluten-containing (GC) grains and surfaces contacted by GC grains during pre-manufacturing practices. To simulate grain contact, whole and broken GC grains (wheat, rye, barley, and oat) were mixed into buckwheat grains at the ratio of 2.5-10.0%. Grains were agitated in vessels with inner surfaces covered with buckwheat grain. Gluten was not detected in buckwheat grains contacting whole GC grains at all mixing ratios. It was not detected in the case of broken GC grains at the mixing ratio of 2.5% and oat grains at all mixing ratios. Gluten concentration increased with the increasing mixing ratio and the natural gluten concentration of broken GC grains. To simulate surface contact, GC grains were first agitated in galvanised steel vessels and then buckwheat grains were agitated together under the same conditions. Gluten was detected on galvanised steel surfaces contacted by whole and broken GC grains. It was not detected in buckwheat grains contacting the surfaces contaminated by whole GC grains. Gluten was detected in buckwheat grain in the case of the broken GC grains except for oats. Gluten concentrations increased with increasing natural gluten concentration of GC grains. Contamination of mGFFs could be linked to potential contact with buckwheat grain. This contamination issue could be resolved through regulations mandating the proof of being GF for ingredients used in the production of mGFFs.

Nutritional quality, cost and availability of gluten-free food in England

Purpose

Coeliac disease (CD) is a life-long condition requiring strict adherence to a gluten-free (GF) diet. Due to wide claims of availability and lower costs of gluten-free food (GFF) and clinical commissioning groups (CCGs) in England needing to save costs, access to prescriptions for patients with CD is being limited in England. The purpose of this paper is to investigate the availability and cost of GFF in an area where patients with CD have restricted access to prescriptions and to assess the nutritional composition of GFFs available in comparison with foods containing gluten (FCG).

Design/methodology/approach

Eight food categories that were representative of a range of commonly purchased GFFs were selected. Availability and cost of the cheapest and most expensive branded and non-branded GFFs and gluten containing equivalents were surveyed at physical stores (n=19) and online stores (n=8). The nutritional composition of some of the widely available GFFs identified (n=190) and comparable FCGs (n=218) were calculated using MyFitnessPal.

Findings

None of the budget stores or corner shops surveyed stocked any of the surveyed cereal-based GFFs. Online stores had more availability than physical stores; however, there was no significant difference in cost. GFFs cost, on average, 2.18 times more than FCG. When making nutritional comparisons with gluten-containing food, protein content was lower across 55 per cent of GFF categories. There was significantly less sugar in GF brown bread, crackers, and wholegrain pasta compared with those containing gluten (CG). Another main finding was GF ready-meals contained significantly less salt than ready-meals CG.

Originality/value

Limited resources and perceived wide availability of GF products resulted in reduced GF prescriptions to patients in England. The findings in this study revealed that there is no availability of cereal-based GFFs in budget stores, high cost and limited access to prescriptions can influence adherence to a GF diet and is most likely to affect patients from deprived groups. This study recommends that the prescription of GFF to patients with CD should be continued.