Gluten-Free Food for Treatment of Celiac Disease. Is It Time to Reconsider the Gluten Threshold? A Scoping Review
Bibliographic record
Abstract
Background/Objectives. Rules for gluten-free (GF) food varies throughout the world. A maximum gluten level of 20 parts per million (ppm) in GF items is allowed in countries adopting the Codex Alimentarius recommendation, e.g. USA, Canada, UK, and the EU. More stringent criteria (no detectable gluten) are requested in other countries, e.g. Australia. However, only few data are available on the toxicity/safety of gluten traces in the diet of patients with celiac disease (CeD). The aim of this review was to review the scientific background of the gluten threshold in GF food. Methods. Studies on the dose-effect relationship between the amount of low gluten and detectable damage in CeD patients were examined and critically reviewed within the context of the current Codex Alimentarius rules. Results. A gluten dose higher than 10 mg per day, corresponding to 500 g of daily GF products at 20 ppm, may be harmful for most CeD patients. There is wide inter-patient variability in the response to a gluten intake of 10 mg. The potential toxicity of gluten traces < 10 mg/day of gluten remains unclear. Conclusions. The 20 ppm gluten threshold is safe for most patients, however further randomized controlled trials are required to evaluate the effects of 0-10 mg/day of gluten intake and, consequently, the safety of the current threshold at 20 ppm for “hypersensitive” CeD patients. New techniques, e.g. IL-2 measurement after a single-dose gluten challenge, may facilitate the investigation of the gluten dose-response curve, particularly in the low range of gluten intake.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".