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Coeliac Disease Social and Religious Issues

By Dr Ananya Mandal, MD

Celiac disease and Christian churches

Celiac disease patients are sensitive to gluten present in wheat, barley and rye. They would thus be sensitive to the communion offered. Most mainstream Christian churches offer their communicants gluten-free alternatives to the sacramental bread as a rice-based cracker or gluten-free bread. Most major churches including United Methodist, Christian Reformed, Episcopal, Lutheran, The Church of Jesus Christ of Latter-day Saints follow this.

The doctrine of concomitance recommends that the entirety of Christ is contained in every crumb of bread and every drop of wine. Receiving communion under either species is as good as communion under both.

Consecrated wine is considered safe for a Catholic celiac to consume provided that it has not come into contact with any wheat. Gluten is highly soluble in alcohol as well.

According to the Roman Catholic doctrine for a valid Eucharist, the bread must be made from wheat. In 2002, the Congregation for the Doctrine of the Faith approved German-made low-gluten hosts that were approved by the Catholic Church for use in Italy. It has also been approved by the Italian Celiac Association.

In August 2002, the National Italian Conference of Bishops, the Vatican’s Congregation for the Doctrine of the Faith, and the scientific committee of the Italian Celiac Association approved the use of a low gluten host which is made with Codex Alimentarius quality wheat starch and contains 0.0374 milligrams (or 37.4 micrograms) gluten.

In January 2004 the USCCB approved the use of “low gluten” wheat starch based hosts produced by the Benedictine Sisters of Perpetual Hope in Clyde, MO. The hosts were tested for gluten content by an independent laboratory (American Institute of Baking).

The gluten content was reported as “none detected”. These hosts could legally be labelled as “gluten-free” here in the U.S. and also in Europe, Canada, and Australia.

Gluten free diet and Passover

The Jewish festival of Pesach (Passover) in addition may be problematic for celiac disease sufferers. There is an obligation to eat matzo, which is unleavened bread made in a controlled manner from wheat, barley, spelt, oats, or rye. Ashkenazi Jews also avoid rice. This makes making gluten free substitutes difficult.

Many kosher-for-Passover products now avoid grains altogether and are therefore gluten-free. Potato starch is the primary starch used to replace the grains. Oats may also be used.

Although taking matzo is mandatory on the first night of Pesach alone, Jewish law holds that a person should not seriously endanger one's health in order to fulfil a commandment. This means a person with celiac disease is not required or allowed to eat any matzo other than gluten-free matzo.

Legal aspects of celiac disease

The Food Allergen Labeling and Consumer Protection Act (FALCPA), which took effect on January 1, 2006, requires food labels to clearly identify wheat and other common food allergens in the list of ingredients. FALCPA also requires the U.S. Food and Drug Administration to develop and finalise rules for the use of the term “gluten free” on product labels.

Food products labelled after January 1, 2006 must be properly labelled if contain one of 8 food allergens. More than 160 foods can cause food allergies and of these 8 allergens cause more than 90% of all food allergies. These allergens include:-

  1. milk
  2. eggs
  3. fish (bass, flounder, cod)
  4. crustacean shellfish (crab, lobster, shrimp)
  5. tree nuts (almonds, walnuts, pecans)
  6. peanuts
  7. wheat
  8. soybeans.

Celiac disease perceived as a legal disability

A disabled person is one with a physical or mental impairment which substantially limits one or more major life activities. Major life activities include walking, seeing, hearing, speaking, breathing, caring for oneself, working, performing manual tasks and learning.

ADA Amendments Act (2008) expands major life activities to include performing manual tasks, sleeping, standing, lifting, bending, reading, concentrating, thinking, communicating as well as normal function of the immune system, digestive system, cell growth, respiratory, neurological, bowel, bladder, circulatory, endocrine, and reproductive functions.

Celiac disease as a disability is assessed on a case-to-case basis. It is a disability when normal body functions are affected. Several dietary restrictions are needed and untreated it may lead to severe complications.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Apr 19, 2013

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