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How can we test for Gluten-Free Diet compliance?

Until now, practical methods of monitoring gluten-free diet compliance or isolating an outbreak of gluten-related symptoms have not been available. Gluten-free diet adherence is found to be challenging for many individuals, as it often requires reliance on others- such as members of the food industry- to be well-informed about the nature of gluten exposure and the regulations surrounding gluten-free products.

          In a 2016 study, 91% of participants reported gluten exposure occurring at least once a month, with cross-contamination often unsuspected until a reaction had occurred[1].

It would therefore greatly improve the lives of those who experience gluten-related issues to have a means of monitoring their gluten-free diet compliance, in addition to having a safeguard for cross-contamination such as GluteGuard.

This area of research is advancing rapidly- as tested in a study published in the American Journal of Gastroenterology in 2012, ‘gluten-derived peptides could be sensitively detected in human faeces in positive correlation with the amount of gluten intake’[2]. To develop an accurate and short-term marker of gluten-free diet compliance, the study enrolled 53 gluten-sensitive patients and 26 healthy patients to complete a gluten challenge. It also demonstrated that, even after ‘treatment with gastric and pancreatic enzymes’, gliadin remained undigested and present in faecal samples.

          After the consumption of a gluten-containing diet, all subjects showed gluten excretion in faeces with values exceeding that of gluten-free standards; indicating that, even for healthy individuals, gluten is a protein that is too complex to digest completely.

The capabilities of these new faecal gluten analysis tests provide an ‘accurate and non-invasive method’ of directly and quantitatively assessing gluten exposure[3]. Until now, methods such as self-reporting, food interviews or serological testing have been largely unreliable or invasive. Commercially-available faecal gluten analysis kits are therefore an excellent way for individuals to monitor their gluten-free diet compliance and to alert them for times when an enzyme supplement safeguard could be necessary.

References:

[1]1. Silvester, et. al., 2016, ‘Symptomatic suspected gluten exposure is common among patients with coeliac disease on a gluten-free diet’, Alimentary Pharmacology and Therapeutics, 6, p. 612.

[2]2. Comino, et. al., 2012, ‘Monitoring of gluten-free diet compliance in celiac patients by assessment of gliadin 33-mer equivalent epitopes in feces’, American Journal of Clinical Nutrition, vol. 95, no. 3, pp. 670-677.

[3]3. Comino et. al., 2016, ‘Fecal Gluten Peptides Reveal Limitations of Serological Tests and Food Questionnaires for Monitoring Gluten-Free Diet in Celiac Disease Patients’, The American Journal Of Gastroenterology, 111, 10, pp. 1456-1465.

Contributor – Georgie, Glutagen.

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