Both good news and bad for coeliacs

The good news first….

The recent furore about the cost of gluten-free food on prescription (see my post here and endless comment elsewhere in the media) has had  some good fall out. Despite the fact that the figures quoted on Newsnight and elsewhere did appear to have been mistakenly inflated (see this comment), Juvela, the ‘leading manufacturer of gluten-freefood on prescription’ have done a deal with their distributors to ensure that none of their fresh bread products is subject to any extra handling or distribution charges on their way to the pharmacies. (Their other products are all ambient and are therefore stock items in pharmacies and not subject to any extra handling charges.)

Well, every little helps….

Now for the bad news.

A new study published in the American Journal of Clinical Nutrition (to be reported on in more detail on CoeliacsMatter very soon) found that of 15 different cultivars or varieties of quinoa tested, four had sufficient ‘celiac-toxic epitopes’ (‘gluten’ to most coeliacs’ understanding) to trigger a reaction.

Quinoa has become one of the more popular grain-type alternatives to wheat, rye and barley, all of which need to be excluded on a classic gluten-free diet. But, although quinoa is not a grass or a ‘true’ cereal (it is known as a pseudocereal), the bit one eats e.g. the seeds –  are seeds in exactly the same way as the bits of wheat, barley or rye that one eats are the seeds of the wheat, barley or rye plant.

(Similarly, both nuts and seeds are seeds – they both contain the kernel from which the new plant will grow – although, for the purposes of allergy definition, one is classified as a nut and one as a seed.

This is a really complicated issue which we tried to unravel a few years ago – see Cressida’s article Nuts and Seeds. When you look at the biology, there is no really significant difference between a nut and a seed – although, the immune systems of nut-allergic people appear to be able to differentiate between them. Or is it that their immune systems just recognise the specific proteins in the specific nuts which they cannot tolerate and the whole seed versus nut issue is a red herring?)

So, could all grain seeds cause a coeliac type reaction? That is what Micki Rose would argue  (see her article Gluten: No grain, no pain), as would  protagonists of the Specific Carbohydrate Diet and Dr Peter Osborne at the Gluten Free Society. But this may be overkill for the majority of those who react to the gluten in grain, either because they genuinely do only react to one protein – such as the gliadin which is found in wheat, barley and rye – or because their reactions are dose related and so they will be perfectly fine with grains/seeds with low, or very low levels of gluten-type proteins.

As yet, it seems, no one knows….