Transcript Coeliac patients What can we do? Tunde Koltai

Coeliac patients
What can we do?
Tunde Koltai
Association of European Coeliac Societies
New phenomene:
Gluten sensitivity
Gluten
related
diseases
Wheat allergy
Classic
Non-coeliac
gluten
sensitivity
Non-classic
Coeliac
disease
Symptomatic
Gluten
ataxia
Subclinical
Dermatitis
herpetiformis
Potencial
Refracter
The gluten-free market is growing
France
Germany
Italy
Netherlands
Russia
Spain
Sweden
UK
2004
Value
Per capita
105.7
1.7
100.6
1.2
145.5
2.5
35.6
2.2
40.0
0.3
77.6
1.8
16.5
1.8
113.8
1.9
2009
Value
Per capita
158.4
2.5
191.5
2.3
205.5
3.5
46.7
2.8
57.9
0.4
134.5
3.0
24.6
2.7
228.3
3.7
2014
Value
Per capita CAGR 04-09 CAGR 09-14
233.1
3.5
8.4%
8.0%
324.0
3.9
13.7%
11.1%
273.2
4.7
7.1%
5.9%
57.2
3.4
5.6%
4.1%
63.4
0.5
7.7%
1.8%
200.8
4.3
11.6%
8.3%
34.2
3.7
8.3%
6.8%
374.2
6.0
14.9%
10.4%
Brazil
US
22.3
1,134.0
0.1
3.9
55.5
1,754.3
0.3
5.7
100.7
2,298.5
0.5
7.1
20.0%
9.1%
12.7%
5.6%
38.4
22.0
24.3
21.6
25.1
1.9
0.0
0.0
0.2
0.5
69.9
34.6
47.3
40.1
63.9
3.3
0.0
0.0
0.3
1.3
98.6
44.4
69.1
58.0
114.1
4.4
0.0
0.1
0.5
2.3
12.7%
9.5%
14.2%
13.2%
20.6%
7.1%
5.1%
7.9%
7.7%
12.3%
1,923.3
0.5
3,113.1
0.8
4,343.4
1.1
10.1%
6.9%
Australia
China
India
Japan
Korea
Overall
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
Helsinki
6 - 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/kg
Special dietary foods for gluten
intolerant people
Foods suitable for gluten intolerant
people
reduced gluten content
substitution of wheat, rye,
of wheat, rye, barley,
barley and oats
oats
foods for normal
consumption / other
special dietary foods
max. 20
gluten-free
gluten-free
gluten-free
20 - 100
"very low gluten"
NO
NO
The Crossed Grain Symbol
HACCP guidance
FLOUR, FLOUR MIXTURE AND MILL
PROCESS
PHASE
HAZARD
PREVENTION
Suppliers
qualification
Gluten
Assessment of suppliers (audit,
contamination questionnaire, etc.)
in raw
material
CORRECTION
INSTRUCTIONS/
CP/CCP
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.
CCP
- List of suitable raw
materials
- Supplier
documentation
CCP
- Certificate of gluten
analysis from the
producer and / or
- Declaration /
documentation by the
supplier
Quality of raw Gluten
material
contamination
in raw
material
Hazard analysis of the raw materials To change raw material / supplier
and association with a critical level
(meaning a risk that the raw
material might be contamined)
Receiving
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)
Gluten in
raw material
or
surroundings /
wrong
(not GF)
raw material
Refuse the acceptance of the
materials
or
Separated storage of the raw
material (identified as not-to-beused) waiting: to receive
documents from supplier / to
receive analytical testing result
or
Use of the raw material in another
with-gluten production
PERSON
IN
CHARGE
QM
QM
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
CHALLANGE