Making Foods Safe for Celiacs: Domino's Pizza and a Bit of Philosophy

As we mentioned in our last post, May is Celiac Awareness Month. In honor of this, Dominos Pizzarecently released a gluten free crust, which was awarded an Amber designation by the National Foundation for Celiac Awareness. Although the ingredients don’t contain gluten, the pizzas are still made in the same ovens as regular pizzas, potentially causing cross-contamination and making the pizzas unsafe for those with celiac disease. So the question must be asked: Is this really a good thing?

Celiac disease is a condition where individuals are unable to eat any products containing gluten. That means no bread, no pasta, no beer, nothing that contains wheat or barley. If they eat gluten, it seriously damages their intestinal wall, leading to harsh symptoms and serious long term health effects, including increased risk of certain types of cancer.

As we discussed in our gluten free regulation post, there is no concrete recommendation regarding how much gluten celiacs can tolerate without negative consequences. A limit of 20 ppm was set by the WHO and one study confirmed this as an appropriate measure. However, a study by the FDA found that much lower levels of gluten can still have negative long-term health effects.

This raises an important issue in the gluten free community. Whenever there’s a risk of cross contamination, the goal is usually to ensure that the gluten content is below the 20 ppm limit to make it safe for celiacs. If you use naturally gluten free ingredients and control cross-contamination, you can ensure that the levels are effectively zero.

Since the science is still inconclusive, this divides many celiacs into two different camps:

  • Hard Line: Since the effects are uncertain, some argue that only food made from gluten free ingredients should be designated “gluten-free.” In other words, food must contain no gluten. The group argues that this avoids confusion and protects the most sensitive gluten-free eaters.
  • Soft Line: A counterargument supports the 20 ppm limit, as well as food made from wheat, barley, or rye that has had the gluten removed. They argue that this is safe according to the WHO, and that setting the bar at 0 ppm gluten would block many perfectly safe gluten-free foods from the market. This could negatively impact the gluten-free community as a whole.

Without getting too philosophic, this actually goes back to an age old question, which is the basis of many commonly debated issues. One side argues that we must maximize the average well being of the group (the “Soft Liners” above). This is a utilitarian philosophy. The other argues that we must instead maximize the well-being of those who are the worst off (the “Hard Liners”). This is the minimax theory, proposed by John Rawls in his book A THEORY OF JUSTICE.

As of yet, the FDA has no conclusive ruling on gluten free food labeling, though they’re expected to pass a regulations sometime this fall. In their place, celiac advocacy organizations like the NFCA have stepped in. Their Amber designation for Domino’s pizza indicates that they have gluten free “ingredient verification and basic training of wait staff and managers indicated.” Some celiacs and celiac organizations are protesting this decision, as well as the Amber designation in general. They feel it confuses the issue and risks hurting celiacs, especially considering that the pizzas could easily be above 20 ppm. In light of the upcoming FDA decision, the Celiac Sprue Association conducted a survey of their members to determine whether labels should be strict and allow no gluten (Hard Line) or more lenient and allow under 20 ppm (Soft Line). The survey overwhelming favors the “Hard Line” approach, which would block foods made from ingredients containing gluten.

Hopefully the FDA ruling will settle some of the debate. But it will certainly continue, as will studies to determine the appropriate levels of gluten. It won’t be fully resolved for some time and the best thing that anyone with celiac disease or gluten intolerance can do is keep themselves educated.

What do you think about Dominos releasing a pizza from gluten-free ingredients? Where should the line be drawn? Let us know by posting a comment below.