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Is hydrolysed vegetable protein (HVP) gluten-free?

Hydrolysed vegetable protein (HVP) can be made from different cereals or soya. If a cereal that contains gluten, such as wheat, has been used manufacturers must list this in the ingredients (for example, hydrolysed wheat vegetable protein) in line with the EU wide allergen labelling law.

All prepacked foods bought in the UK are covered by current EU wide food labelling legislation. This means that if gluten is used as a deliberate ingredient it must appear on the ingredients list, no matter how much is used.

Manufacturers will name the grain, for example, wheat, rye, barley, oats, or some will use the word gluten as well such as wheat gluten. This information must be declared in the ingredients list and emphasised, for example in bold. Read more about the information that manufacturers must provide.

What about accidental contamination? There have been recall cases in retail over last few years.

Increase in product recalls reflects increase in product availability in retail and most product alerts relate to mislabelling rather than problems with contamination. Both prescribed and non-prescribed products have to meet regulatory standards and in fact most companies supplying to the NHS also provide retail products. Contamination risks need to be properly controlled regardless of supply chain.

What was the outcome of the Westminster debate on gluten free prescribing?

You can find a full transcript of the debate at: https://hansard.parliament.uk/commons/2016-11-01/debates/4BB02B4E-A485-477B-81D9-569AFDDA81ED/CoeliacDiseaseAndPrescriptions

The Parliamentary Under Secretary of State for Health committed to completing a review of the issue within six months of the debate, which was held on 1 November 2016. The Department of Health consultation was issued on 31 March 2017. Coeliac UK was not contacted during the intervening period. 

 

I like Juvela foods and they’re not available in the supermarkets. What will happen to them?

We have been talking to manufacturers for many years about the possibility of changes in access to prescriptions and we would welcome better access in retail to all gluten free foods for people with coeliac disease. In the end individual companies will need to make the business decisions on where best to supply their products.

Can I test meals myself in restaurants (Nima)?

There are companies that produce testing kits to test the level of gluten in ready prepared foods. Nima is a recently marketed device aimed at testing levels of gluten in meals served in restaurants.

Many people would like to be able to have the option of using such a test but it is important to consider what the test is looking for and how samples are tested.

Reliability of products like this should always be considered because the user may not maintain control of the conditions needed for accurate testing. For example, testing a small sample of a certain meal will not necessarily represent the gluten content of the complete meal. It is also important to make sure that all gluten is extracted from a food before testing using the chemicals provided. It is therefore very important to follow the manufacturers’ guidance on using the test kits.

Nima was launched in January 2017 in the US. To date, neither validation of the methodology or data regarding the accuracy have been independently reviewed by experts and published.  We have been in contact with Nima for information on how the test works and at present we have not received a clear response on how the test works and its level of accuracy. When the information on the validation is available we will be looking at the evidence carefully to assess whether the product will be a useful tool for people with coeliac disease. Until then we would not recommend this product.

What happens if the Government decides to keep gluten free food on prescription? Do CCGs that have removed gluten free prescriptions have to reinstate them?

The consultation is proposing to change secondary legislation only. The options are for gluten free products to be “blacklisted” ie GPs would be banned from prescribing them on the NHS, or to add differing ranges of products to the prescribing list, or to maintain the list.

The consultation does not propose minimum levels of access, and does not propose changes to the Health and Social Care Act 2012. Therefore, it must be assumed that Clinical Commissioning Groups (CCGs) will continue to have the ability to make local policies in this area.

This means that where prescribing has been ended, that this is likely to continue, and that CCGs will continue to make proposals to adjust policies in this area, if they feel it necessary. The framework being proposed facilitates the continuation of local policy making by CCGs. However, if the outcome of the consultation is to allow the continuation of prescribing we will use the Department of Health response to go back to the CCGs and point out that the Government have clearly accepted that it is legitimate to prescribe gluten free products.

Which foods are listed in Section 2?

Section 2 lists supermarket own brand foods made without gluten containing ingredients and have controls in place to minimise the risk of cross contamination with gluten containing ingredients.We have also included a reference list of everyday mainstream brands. These brands produce some products that are made without gluten containing ingredients. You can check these products on our Gluten free food checker app, or on our website or call our Helpline on 0333 332 2033.

What should I do if a product I have bought contains gluten although it is listed in the Food and Drink Guide?

Manufacturers sometimes change their ingredients without notifying us. Please call us on 0333 332 2033, selecting option 2, or email us on foodanddrink@coeliac.org.uk so that we can follow this up. To assist with your query we will need the following information: brand and product name, pack size, barcode number and the nature of your query e.g may contain statement, contains wheat etc. 

Welsh Assembly Member and Coeliac UK Governor Dai Lloyd asked the Cabinet Secretary for Health, Well-being and Sport for a statement on gluten-free prescriptions. What was the response?

Vaughan Gething AM said:

Gluten-free products are an essential part of the clinical treatment of coeliac disease. National prescribing guidance was published in 2013 to support healthcare professionals in the management of patients with coeliac disease. Coeliac UK has supported the development of the guidance including the updated version published in March 2016.

Read in more detail at:

30 June 2017

www.assembly.wales/en/bus-home/pages/plenaryitem.aspx?category=written%20question&itemid=3431&c=Written%20Question&startDt=24/05/2017&endDt=30/06/2017

13 July 2016

www.assembly.wales/en/bus-home/pages/qnr.aspx?meetingid=3617&assembly=5&c=Record%20of%20Proceedings

What are the symptoms of coeliac disease?

The symptoms of coeliac disease vary from person to person and can range from very mild to severe. Common symptoms include:

  • frequent bouts of diarrhoea or loose stools
  • nausea, feeling sick and vomiting
  • stomach pain and cramping
  • lots of gas and bloating
  • feeling tired all the time, ongoing fatigue
  • anaemia (you would be told if you’re anaemic following a blood test)
  • weight loss (although not in all cases)
  • regular mouth ulcers
  • constipation or hard stools
  • skin rash (dermatitis herpetiformis, the skin manifestation of coeliac disease).

If you have any of these symptoms, you can take our online assessment which is a short questionnaire on symptoms and other risk factors for coeliac disease.

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