4 ms·

So I think we should distinguish between "gluten intolerance" (which is often self-diagnosed) and "celiac disease" (actual medical condition with allergic react

So I think we should distinguish between "gluten intolerance" (which is often self-diagnosed) and "celiac disease" (actual medical condition with allergic reaction to gluten). For people with the latter, even trace amounts of gluten are harmful: https://www.ncbi.nlm.nih.gov/pubmed/1923558 https://www.ncbi.nlm.nih.gov/pubmed/1923558 Even inhaled gluten is enough to cause immune system reaction: https://www.nejm.org/doi/pdf/10.1056/NEJMc063112 https://www.nejm.org/doi/pdf/10.1056/NEJMc063112 The generally accepted safe threshold of gluten intake for people with celiac disease is somewhere on the order between 6 and 30mg (depending on the study). Even that may be high, there are case studies of individuals where as little as 1mg of gluten prevented recovery of their gut: https://www.ncbi.nlm.nih.gov/pubmed/15497770 https://www.ncbi.nlm.nih.gov/pubmed/15497770 So the parent that asked for separate utensils is not insane; sharing a bread knife between gluten-free and gluten-containing bread can be harmful already. (A close family member and another close friend of mine have celiac disease, and it is seriously not a joke)

amluto 8y ago
Minor nit: celiac disease isn’t an allergy. It’s a very different underlying mechanism with very different effects.
fiter 8y ago
A slice of bread weighs about an ounce or 28 grams. There is less than 3 grams of protein in a slice of bread. About 80% of the protein is gluten which gives 2.5 grams of gluten per slice. So at the lowest exposure level, 1 milligram, this would mean making sure not to eat 1/2500th of the slice of bread. The slice of bread is about 4 inches by 4 inches by 0.5 inches giving a volume of 8 cubic inches. 1/2500th of that slice is 0.0032 cubic inches or a cubic piece >1/8 inch on each side. Based on the above calculation, I think it's probably ok to use the same utensil as long as there are no obvious crumbs.

amluto 8y ago

Minor nit: celiac disease isn’t an allergy. It’s a very different underlying mechanism with very different effects.

fiter 8y ago

A slice of bread weighs about an ounce or 28 grams. There is less than 3 grams of protein in a slice of bread. About 80% of the protein is gluten which gives 2.5 grams of gluten per slice. So at the lowest exposure level, 1 milligram, this would mean making sure not to eat 1/2500th of the slice of bread. The slice of bread is about 4 inches by 4 inches by 0.5 inches giving a volume of 8 cubic inches. 1/2500th of that slice is 0.0032 cubic inches or a cubic piece >1/8 inch on each side. Based on the above calculation, I think it's probably ok to use the same utensil as long as there are no obvious crumbs.