Coeliac patientsWhat can we do?

Tunde Koltai

Association of European Coeliac Societies

New phenomene:

Gluten sensitivity

Glutenrelated diseases

Wheat allergy

Non-coeliacgluten

sensitivityCoeliacdisease

Glutenataxia

Dermatitis herpetiformis

Classic Non-classic Symptomatic Subclinical Potencial Refracter

The gluten-free market is growing

Value Per capita Value Per capita Value Per capita CAGR 04-09 CAGR 09-14France 105.7 1.7 158.4 2.5 233.1 3.5 8.4% 8.0%Germany 100.6 1.2 191.5 2.3 324.0 3.9 13.7% 11.1%Italy 145.5 2.5 205.5 3.5 273.2 4.7 7.1% 5.9%Netherlands 35.6 2.2 46.7 2.8 57.2 3.4 5.6% 4.1%Russia 40.0 0.3 57.9 0.4 63.4 0.5 7.7% 1.8%Spain 77.6 1.8 134.5 3.0 200.8 4.3 11.6% 8.3%Sweden 16.5 1.8 24.6 2.7 34.2 3.7 8.3% 6.8%UK 113.8 1.9 228.3 3.7 374.2 6.0 14.9% 10.4%

Brazil 22.3 0.1 55.5 0.3 100.7 0.5 20.0% 12.7%US 1,134.0 3.9 1,754.3 5.7 2,298.5 7.1 9.1% 5.6%

Australia 38.4 1.9 69.9 3.3 98.6 4.4 12.7% 7.1%China 22.0 0.0 34.6 0.0 44.4 0.0 9.5% 5.1%India 24.3 0.0 47.3 0.0 69.1 0.1 14.2% 7.9%Japan 21.6 0.2 40.1 0.3 58.0 0.5 13.2% 7.7%Korea 25.1 0.5 63.9 1.3 114.1 2.3 20.6% 12.3%

Overall 1,923.3 0.5 3,113.1 0.8 4,343.4 1.1 10.1% 6.9%

2004 2009 2014

Values in millions US Dollars

Source Datamonitor

New products launched every day in Europe

Number of new GF products launched in 2009

International Coeliac Day

Officially supported by WHO

Agreement with other continents’ coeliac associations

International Coeliac Day

Goals:

•Create/increas awareness•The disease usually remain undiagnosed and frequently misdiagnosed•Coeliacs have no other therapy only the strict glutenfree diet •Support for diagnosed coeliacs and families•There is a help: AOECS/national coeliac societies give information about ‘glutenfree lifestyle’

International Coeliac Day

Target groups:

•General public•Potential coeliacs•Diagnosed Coeliacs•Families and friends of coeliacs and potential coeliacs•Medical persons•Politicians•Others: shop owners, hypermarket chaines, food producers, restaurants, caterers, etc. ...

Better life for coeliacs

Helsinki6 - 9 September 2012

http://www.confedent.fi/blc2012/venue_site/

What is the Crossed Grain Symbol?

• Created in 1969 by a member of Coeliac UK

• Today it is the internationally recognised symbol for gluten-free food needed by people with coeliac disease

• Registered by coeliac societies at national and European levels

The Crossed Grain Symbol

The consumers’ friend

• An easily recognisable symbol whatever your language

• Consumers trust the symbol as a guarantee of safety

• The best guide for consumers with coeliac disease in a growing market with ever more choice

• Harmonised and equal quality in Europe

• Guidelines for the local/small producers

The European Licensing System (ELS)

- European Charta- License contracts- AOECS Standard

II. part

Foods for Coeliacs have to be

• Safe• Controlled• of Good quality and tasty• of High nutrition value• Cheap• Available• Produced complying valid rules and laws• Easy to recognise

Legal background

CODEX STAN 118 – 1979

CODEX STANDARD FOR FOODS FOR SPECIAL DIETARY USE FOR PERSONS INTOLERANT TO GLUTEN

Was accepted in July 2008 by the Codex Alimentarius Commission

Revised Codex Standard for ‘dietetic’ products

Glutenfree food:Gluten content < 20 mg/kg

‘Very low gluten’ or ‘suitable for coeliacs’:Gluten content between 20 and 100 mg/kg

Foodstuffs suitable for gluten intolerant people

Gluten content

mg/kgreduced gluten content of wheat, rye, barley,

oats

foods for normal consumption / other special dietary foods

max. 20 gluten-free gluten-free

20 - 100 "very low gluten" NO

gluten-free

substitution of wheat, rye, barley and oats

Special dietary foods for gluten intolerant people

Foods suitable for gluten intolerant people

NO

The Crossed Grain Symbol

HACCP guidanceFLOUR, FLOUR MIXTURE AND MILL

PROCESS PHASE

HAZARD PREVENTION CORRECTION INSTRUCTIONS/ CP/CCP

PERSON IN CHARGE

Suppliers qualification

Gluten contamination in raw material

Assessment of suppliers (audit, questionnaire, etc.)

To choose another supplier / to make aware the supplier of gluten contamination risk

- List of qualified suppliers -Supplier documentation - Audit of supplier report, questionnaire, etc.

QM

Quality of raw material

Gluten contamination in raw material

Hazard analysis of the raw materials and association with a critical level (meaning a risk that the raw material might be contamined)

To change raw material / supplier CCP - List of suitable raw materials - Supplier documentation

QM

Receiving raw material

Gluten in raw material or surroundings / wrong (not GF) raw material

Inspection at the delivery, control of documents: - Certificate of gluten analysis from the producer and / or other documentation by the supplier - Documents identifying the cargo (product, GF nature, lot number, quantity, source, destination) - Random sampling (analytical plan)

Refuse the acceptance of the materials or Separated storage of the raw material (identified as not-to-be-used) waiting: to receive documents from supplier / to receive analytical testing result or Use of the raw material in another with-gluten production

CCP - Certificate of gluten analysis from the producer and / or - Declaration / documentation by the supplier

Leader of production, QM

Foods not to be licensed

UNPROCESSED CEREAL GRAINS Rice Maize

MEAT, FISH AND EGGS All sorts of fresh or frozen meat and fish not processed Tinned or canned fish with water/vegetable oil and salt, without additives or other substances Eggs

MILK AND MILK-DERIVATES Fresh milk, UHT milk, sterilized milk without additives, vitamins or other substances Infant formula Yogurt without additives, vitamins or other substances Fresh milk cream and UHT milk cream Cheese

Foods not to be licensed

VEGETABLES AND LEGUMES All sorts of plain, fresh, frozen, canned or dried vegetables and legumes

NUTS AND SEEDS All sorts of nuts and seeds, with or without shells, not processed

FRUITS All sorts of plain, fresh, frozen, canned or dried fruits

DRINKS Fruit juices Soft drinks Mineral waters Tea, pure coffee Wine Distillates for spirits

Foods not to be licensed

SWEETS Honey, sugar Marmalade and jam

DRESSINGS AND OTHERS Butter, bacon fat, lard Vegetable Oil Vinegar Spices and aromatic herbs not processed

OUR COMMON OUR COMMON CHALLANGECHALLANGE