Gluten-free Foods

Gluten-free Foods

Coeliac disease is a lifelong condition for which a gluten-free diet is the only treatment currently available.

Coeliac Disease

Coeliac disease is an autoimmune condition where the consumption of gluten (found in wheat, barley and rye) triggers the immune system to react and damage the lining of the small intestine. This lining, which is made-up of tiny finger-shaped projections called villi, becomes inflamed and flattened if sufferers of coeliac disease eat gluten. The damage caused decreases the surface area of the villi, causes much pain and discomfort for the sufferer, and reduces the ability of the small bowel to absorb nutrients from food properly.

Coeliac disease is often unrecognised and consequently under diagnosed. It is estimated that half a million people in the UK are currently suffering from coeliac disease, but are unaware of what is causing their symptoms. Coeliac UK – the UK’s main charity for coeliac patients – has reported that on average it takes 13 years for someone in the UK to be diagnosed with coeliac disease, as symptoms are commonly mistaken for other conditions, such as Irritable Bowel Syndrome (IBS).

Coeliac disease is an autoimmune disorder which affects 1 in 100 genetically susceptible people in the UK

Dermatitis herpetiformis is the skin manifestation of coeliac disease. This is a rash, commonly found on the elbows, knees, shoulders, buttocks and face.

BSNA member companies provide a range of gluten-free foods which are manufactured to meet the specific dietary requirements of patients with coeliac disease. These are fortified, where needed, with the fibre, iron and calcium that can be missing from gluten-free diets. These products are manufactured in dedicated facilities to minimise any risk of cross-contamination with gluten-containing ingredients. 

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Gluten-free foods on prescription

Gluten-free foods on prescription

We believe that it is important to establish and maintain an appropriate care pathway for patients diagnosed with coeliac disease. The provision of a gluten-free prescription for a reasonable quantity of staple products, such as gluten-free bread and flour mix, should form part of this. This ensures that staple gluten-free products are easily accessible for patients via their local community pharmacy. There is also the opportunity for the recommendation of an annual review, as outlined in the NICE Quality Standard for coeliac disease (QS 134), to be met in a community pharmacy setting via an annual health check.


Coeliac disease is a serious medical condition. The use of prescription gluten-free products has been used to support strict adherence to a gluten-free diet. Non-adherence to dietary treatment can result in an increased risk of long-term complications, including osteoporosis and intestinal malignancy. However, recent NHS cuts have seen certain areas choosing to restrict or remove this support for patients leading to considerable variation in care of patients with coeliac disease across the country. There is some evidence that these policies can have a negative impact on coeliac patients' ability to manage their own condition, leading to health inequalities.

The NICE Quality Standard for coeliac disease (QS 134) highlights that access to staple gluten-free foods may be more difficult for certain groups of patients and that they may need more support. These include those on low incomes, those where more than one member of a family is affected, or those with limited mobility. Despite a growth in the number of gluten-free products over the last few years, the availability of these products in supermarkets can still be lacking and wildly variable.

Legislation

Regulation (EU) No. 1169/2011

The legislation for gluten-free foods is covered by Regulation (EU) No. 1169/2011 on the provision of food information to consumers. 

Commission Implementing Regulation (EU) No 828/2014 on the requirements for the provision of information to consumers on the absence or reduced presence of gluten in food, provides a definition for the claims ‘gluten free’ and ‘very low gluten’. 

·         'gluten-free': at 20mg/kg of gluten or less

·         'very low gluten': at 100mg/kg of gluten or less - however, only foods with cereal ingredients that have been specially processed to remove the gluten may make a 'very low gluten' claim

The Regulation applies to all foods, pre-packed or sold loose, such as in health food stores or in catering establishments. 

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