If you have traveled to Europe or Australia from the United States and you have celiac disease, you may have noticed a difference in symptoms. If you were on the gluten-free diet, you might have had less exposure to gluten in “gluten-free” foods. If not on the gluten-free diet, you might have had less symptoms eating wheat in some areas.
There are differences between countries that can affect people with celiac disease. Some of these have to do with the foods normally eaten, which varies from country to country. There are many places, like Japan, where rice and not wheat is the carbohydrate staple at meals. Mexican tortillas can be made from corn; in parts of Africa, bread is made from other grains, like tepp.
Some people think that wheat has been made more difficult to handle for people with celiac disease as it has been modified over the years. The wheat in the United States is very different genetically than the wheat early humans first cultivated, and is also different than some of the wheat grown in other countries. Wheat varies from place to place, which may affect symptoms. How much difference this actually makes to people with CD is not clear.
People following a gluten-free diet and looking for products that are not intrinsically gluten free can find better labeling in some countries than others. European countries follow what is called the Codex Alimentarius Standard. The Codex Alimentarius Commission, which first met in 1963, was formed by the World Health Organization (WHO) and the Food and Agricultural Organization (FAO) of the United States to ensure fair trade in regards to food as well as protect consumers’ health. There are 180 governments that are members of the CAC, with the European Union as one member.
Codex Alimentarius means food code in Latin. Twenty technical committees meet to gather the best scientific evidence about food in order to fashion standards to keep food safe that can be used across the world.
The rules about gluten were adopted in 1979, amended 1983, and revised 2008. The Codex says:
“Gluten-free foods are dietary foods consisting of one or more ingredients from wheat (i.e., all Triticum species, such as durum wheat, spelt, and kamut), rye, barley, oats or their crossbred varieties, which have been specially processed to remove gluten, and the gluten level does not exceed 20 mg/kg in total, based on the food as sold or distributed to the consumer.”
Similar products with gluten levels of 20 mg/kg to 100 mg/kg can be sold and labeled as reduced in gluten, but cannot be called gluten free. This is to be decided on a national level and varies from country to country.
Milligrams per kilogram (mg/kg) is the same amount as parts per million. 20 parts per million is the cutoff for “gluten-free” food proposed by the FDA. It is also the cutoff used in Canada.
However, there are countries with tighter standards, like Australia and New Zealand. Their Food Standards Code of 2011 states:
“A claim to the effect that a food is gluten free must not be made in relation to a food unless the food contains –
(a) no detectable gluten; and no –
(i) oats or their products; or
(ii) cereals containing gluten that have been malted, or their products.”
It is believed that testing may be able to pick up 5 ppm of gluten. If that is true, gluten-free food in Australia and New Zealand may be more completely free of gluten than similarly labelled food in Europe and the United States.
If you are traveling to another country, you can usually find information on their gluten regulations online. If the countries you plan to visit do not have policies in regard to gluten, you may have to chose naturally gluten-free food during your trip.