When Going Gluten-Free Is Not Enough: New Tests Detect Hidden Exposure

For people with celiac disease, incidental ingestion of gluten can lead to painful symptoms and lasting intestinal damage. Two new studies suggest such exposure may be greater than many realize, even for those following gluten-free diets.

For the 3 million people in America (myself included) with celiac disease — an autoimmune disorder triggered by the ingestion of gluten — culinary life is a series of intricate leaps, accommodations and back-steps. We peer at labels, know the difference between “gluten-free” and “certified-gluten free” and keep a dedicated set of dishes and pots at home to avoid contamination by flour dust, crumbs of bread and bits of pasta indulged in by family members or roommates.

Even so, there are regular mishaps — like the gluten-free Cheerios that weren’t, or the news this past February that Chobani had recalled almost 85,000 cases of Flip Key Lime Crumble yogurt because they contained gluten, even though the containers were labeled gluten-free.

But now, two worrying new studies suggest that accidental gluten exposure, even among celiacs following a gluten-free diet, may be far greater than we ever realized. A February study in the American Journal of Clinical Nutrition looked at gluten exposure detected by two new tests, one for urine and the other for stool. The tests detect peptides of gluten that make it through the digestive tract intact in all of us. (Nobody completely digests gluten, but most individuals don’t have an adverse reaction to the undigested molecules).

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