Part of celiac population still at risk despite current gluten thresholds

• The threshold of 20 ppm does not protect sensitive and recovering celiac patients.
• A threshold of 3 ppm would be more suitable to protect these vulnerable groups.
• Labels “low in gluten” and “very low in gluten” hold no value for celiac patients.

In order to assist celiac disease (CD) patients in making safe food choices, gluten-free food products are labelled as such. The exact meaning of the gluten-free label differs throughout the world. This paper discusses the different thresholds that are currently used to label products gluten-free and compares tolerable gluten levels to the gluten levels CD patients can be exposed to with these thresholds in place. Currently, the most applied gluten threshold to label products gluten-free does not protect the most vulnerable patients. Therefore, we propose to lower the threshold for products with a gluten-free label to 3 ppm gluten.