CD: Wheat Starch (2006)
How does the inclusion of wheat starch-based gluten-free foods (as defined by the Codex Alimentarius), in a dietary pattern for people with celiac disease, impact the effectiveness and acceptability of their dietary pattern (as compared to a gluten-free diet comprised solely of naturally gluten-free foods, as defined by Codex)?
Studies have shown that both natural and wheat starch-based gluten-free diets produce similar histological and clinical recovery in people with celiac disease. Overall compliance with a gluten-free diet may be more important than the specific type of diet followed (i.e., natural or wheat starch-based), as evidenced by the incomplete bowel mucosal recovery and positive serology generally seen in those study subjects with dietary lapses. Further research regarding the acceptability of wheat starch-based gluten-free foods and the threshold level of tolerance for gluten is needed.
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
Evidence Summary: How does the inclusion of wheat starch-based gluten-free foods (as defined by the Codex Alimentarius), in a dietary pattern for people with celiac disease, impact the effectiveness and acceptability of their dietary pattern (as compared to a gluten-free diet comprised solely of naturally gluten-free foods, as defined by Codex)?
- Quality Rating Summary
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- Chartrand LJ, Russo PA, Duhaime AG, Seidman EG. Wheat starch intolerance in patients with celiac disease. J Am Diet Assoc 1997; 97: 612-618.
- Faulkner-Hogg KB, Selby WS, Loblay RH. Dietary analysis in symptomatic patients with coeliac disease on a gluten-free diet: the role of trace amounts of gluten and non-gluten food intolerances. Scand J Gastroenterol 1999; 34: 784-789.
- Kaukinen K, Collin P, Holm K, Rantala I, Vuolteenaho N, Reunala T, Maki M. Wheat starch-containing gluten-free flour products in the treatment of coeliac disease and dermatitis herpetiformis. A long-term follow-up study. Scand J Gastroenterol 1999; 34: 163-169.
- Lohiniemi S, Maki M, Kaukinen K, Laippala P, Collin P. Gastrointestinal symptoms rating scale in coeliac disease patients on wheat starch-based gluten-free diets. Scand J Gastroenterol 2000; 35:947-949.
- Peraaho M, Kaukinen K, Paasikivi K, Sievanen H, Lohiniemi S, Maki M, Collin P. Wheat-starch-based gluten-free products in the treatment of newly detected coeliac disease: Prospective and randomized study. Aliment Pharmacol Ther 2003; 17:587-594.
- Selby WS, Painter D, Collins A, Faulkner-Hogg KB, Loblay RH. Persistent mucosal abnormalities in coeliac disease are not related to the ingestion of trace amounts of gluten. Scand J Gastroenterol 1999; 34: 909-914.
- Thompson T. Questionable foods and the gluten-free diet: Survey of current recommendations. J Am Diet Assoc 2000; 100(4):463-465.
Search Plan and Results: CD: Inclusion of Wheat Starch 2007