Group, in cooperation with the Food Services, Inc., a
subsidiary of the Orthodox Union, a kosher certifica-
tion agency, has developed a gluten-free certification
program. This program benefits consumers by giving
them confidence that a product is gluten-free through
a process whereby products have been tested and the
manufacturing site inspected. The program also saves
the consumer time that would have been spent calling
the manufacturer for the gluten-free status of the
product. Certification is a yearly process based on
ingredient review, on-site inspection and product test-
ing. The Celiac Sprue Association (CSA) also has the
CSA Recognition Seal Program that certifies gluten-
free products. Requirements for obtaining the CSA
Seal for products include:
Ingredient review and verification by testing to assure
products are free of wheat, barley, rye and oats
Provision of written facility procedures and on-site
facility audits to assure that procedures are in place
to control any cross or outside contamination in
processing and packaging
Foods may contain gluten, although gluten will
not be indicated on the ingredient list, because it was
not included in the formulation of the product. For
example, a conveyer belt may be dusted with a gluten-
containing material to prevent foods from sticking
and may contaminate the finished food product.FunctionThe gluten-free diet is used by persons who are
gluten-sensitive to prevent damage to their small intes-
tines and to prevent serious complications such as
gastrointestinal cancers, iron-deficiency anemia, and
decreased bone mineral density.BenefitsA gluten-free diet has been shown to greatly reduce
the risk forcancerand overall mortality for individuals
with symptomatic celiac disease.
For many people with celiac disease, following a
gluten-free diet will stop the symptoms of the disease
and result in improved health, usually within several
months (for some persons, recovery may take up to one
year) However, the health of some people with exten-
sive damage to their small intestines may not improve.
Refractory coeliac disease (RCD) is a rare syndrome
with a poor prognosis, defined by malabsorption due
to gluten-related enteropathy after initial or subse-
quent failure of a strict gluten-free diet and after exclu-
sion of any other disease or disorder mimicking celiac
disease. Other treatments may be necessary to treat the
RCD, such as the use of corticosteroids and immuno-
suppressant drugs, but data on their effectiveness is
lacking.KEY TERMS
Antibodies—Any of numerous protein molecules
produced by the immune system as a primary
immune defense to destroy or neutralize foreign
objects. Each antibody recognizes a specific target,
referred to as the antigen. These antigens may include
foreign proteins, microorganisms, or toxins. Some
antibodies attack the body’s own tissues.
Autoimmune Disease —An illness that occurs when
the body tissues are attacked by its own immune
system.
Enteropathy—A disease of the intestinal tract
Lymphoma—Any of various usually malignant
tumors that arise in the lymph nodes or in other
lymphoid tissue.
Osteomalacia—Softening of bone, particularly bone
weakened by demineralization (loss of mineral) and
most notably by the depletion of calcium from bone.
Osteomalacia may be caused by poor dietary intake
or poor absorption of calcium and other mineralsneeded to harden bones. Osteomalacia is a charac-
teristic feature of vitamin D deficiency in adults.
Osteopenia—Mild thinning of the bone mass, but
not as severe as osteoporosis. Osteopenia results
when the formation of bone is not enough to offset
normal bone loss. Osteopenia is generally consid-
ered the first step to osteoporosis.
Osteoporosis—A decrease in bone mass and bone
density and an increased risk and/or incidence of
fracture.
Tropical sprue—A condition of unknown cause
whereby abnormalities in the lining of the small
intestine prevent the body from absorbing food nor-
mally. This disease is not associated with gluten
enteropathy. It has been associated with travel and
residence in tropical areas.
Villi—The tiny, finger-like projections on the surface of
the small intestine that help absorb nutrients.Gluten-free diet