Celiac & Health Research Directory
The twenty-parts-per-million figure that governs labeling, the distinction between gluten-free and gluten-reduced, and the reason a brewing mistake is a medical event rather than a quality complaint — all of it comes from this literature. It is the foundation the rest of the site's arguments rest on, and until now it has been cited page by page without ever being mapped.
This site does not give medical advice, and neither does this page. It maps who studies gluten-related disorders and where that work is published. Anything about diagnosis, treatment, or personal risk belongs with a clinician or a patient organization — never with a brewing site.
How to read it: the same categories as the sorghum directory, with the same rules. Entries are brief, factual, dated, and linked to primary sources. Descriptions are not endorsements, and no entry is a clinical referral.
Coverage is US-centered by design, with international anchors where the clinical consensus is foundational.
Directory established 2026-08-25 · first verification pass 2026-08-26.
Key topics — find entries by subject, across every category
How to read it: each topic lists the entries that touch it, so a reader hunting one subject can jump straight to the right sections.
Start here — the number everything else is measured against. The 20 ppm labeling limit descends from a trial that established a tolerable daily gluten dose, not a concentration. Converting one into the other requires an assumption about serving size, and beer is where that assumption strains hardest (Literature, Standards, How the field connects).
Measuring exposure in the person, not the food — gluten immunogenic peptide testing in urine and stool detects gluten that survived digestion, sidestepping every argument about whether an assay can find hydrolyzed gluten in a beer. Validated, clinical, and never yet pointed at beer (Institutions, Contributors, Literature, How the field connects).
The one study that tested this category on patients — celiac patient sera against traditional beer, gluten-free beer and gluten-removed beer. No subject's serum bound to the gluten-free beer (Literature, Contributors, How the field connects).
Gluten-free versus gluten-removed, clinically — what the distinction rests on beyond labeling: antibody binding, immunogenic epitope content, and a consumer survey of 985 people (Literature, Organizations, How the field connects).
How many people this is about — the canonical US prevalence study and the global meta-analysis, and the question neither answers: how many of those people drink beer (Literature, Contributors, How the field connects).
Who has celiac disease, and who does not know — mass pediatric screening, birth cohorts, and the prevention trial that did not prevent anything (Projects, Literature).
What the diet costs the person on it — treatment burden measured against other chronic conditions, and the social reach of a condition managed entirely through food (Contributors, Literature).
Who pays, and who does not — three pharmaceutical sponsors funding celiac therapeutics, and no funder we have found for the question of what people with celiac disease drink (Funders, How the field connects).
Definitions and standards — the Oslo definitions, the ACG and ESPGHAN guidelines, and the Salerno criteria for non-celiac gluten sensitivity (Standards, Literature).
1. Institutions — the clinical centers and research institutes
— US federal —
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH. The federal institute that carries celiac disease in its portfolio and publishes the government's clinical reference on it. The federal presence this page otherwise lacks, and the counterpart to the USDA labs that appear on the grain pages. NIDDK on celiac disease · Verified 2026-08-26
— US clinical centers —
The University of Chicago Celiac Disease Center. The center that supplied the patient sera behind the only study we have found testing gluten-free and gluten-removed beer against actual celiac patients' antibodies. Its pediatric gastroenterology section and its Biological Sciences Division both appear in that work's authorship. The center · the study · Verified 2026-08-26
Celiac Center at Beth Israel Deaconess Medical Center. Harvard teaching hospital celiac center, and the institutional home of the gluten-challenge work that established how quickly histology, serology and symptoms actually move when a patient eats gluten — the study design behind every claim about what a given exposure does. The center · the gluten challenge study · Verified 2026-08-26
Mayo Clinic. Publishes one of the most widely used clinical references on celiac disease, and its investigators appear throughout the US prevalence and guideline literature indexed below. Mayo on celiac disease · Verified 2026-08-26
Columbia University Celiac Disease Center. One of the two US academic celiac centers this project's archive records Bard's approaching as it brought a sorghum beer to market — evidence that the clinical centers were treated as the relevant authority on whether a gluten-free beer was credible, before any certifier was. The center · Verified 2026-08-26
Center for Celiac Research and Treatment, MassGeneral for Children. Alessio Fasano's center, and the source of the position that an R5 ELISA is designed to detect cross-contamination with naturally occurring gluten rather than gluten that has been enzymatically degraded — the distinction the whole gluten-removed category turns on. The center · Verified 2026-08-26
University of Seville. Isabel Comino and Carolina Sousa's group, and the origin of gluten immunogenic peptide (GIP) testing — the method that measures gluten exposure in the patient rather than gluten content in the food. The most consequential methodological development on this page. The validation study · Verified 2026-08-26
— International anchors —
University of Bologna. Base of the group behind the field's standing comprehensive review of celiac disease — the open-access reference a non-specialist reaches for first. The review · Verified 2026-08-26
Leibniz Institute for Food Systems Biology and the Technical University of Munich. Katharina Scherf's base, and the source of the targeted mass spectrometry that quantifies celiac-disease-active gluten peptides in gluten-free barley beer — the analytical work that connects this page to testing and certification. The 2025 paper · Verified 2026-08-26
Karolinska Institutet. Jonas Ludvigsson's base, and the source of the nationwide Swedish cohort studies that put numbers on long-term outcomes in celiac disease — the kind of population data no US center has matched. The cancer-risk cohort · Verified 2026-08-26
Università Politecnica delle Marche, Ancona. Carlo Catassi's base, and the institutional home of the trial that produced the daily gluten threshold underneath every gluten-free labeling limit in the world. The threshold trial · Verified 2026-08-26
Tampere University, Finland. The dermatitis herpetiformis group — the skin manifestation of celiac disease, and the reminder that gluten exposure does not only present as a gut complaint. The review · Verified 2026-08-26
University of Salerno. Carolina Ciacci's base, and the origin of the only clinical safety and palatability study of sorghum food products in celiac patients that we have found — the single most directly relevant clinical paper to this entire site. The study · Verified 2026-08-26
2. Contributors — the researchers and clinicians behind the work
— The threshold and definitions —
Carlo Catassi — Università Politecnica delle Marche. First author of the prospective, double-blind, placebo-controlled trial that established a safe daily gluten threshold for celiac patients, and co-author of the Salerno criteria for non-celiac gluten sensitivity. If any one person's work sets the number this site is built around, it is his. The threshold trial · Salerno criteria · Verified 2026-08-26
Jonas F. Ludvigsson — Karolinska Institutet. Lead author of the Oslo definitions, which is why "gluten-free", "coeliac disease" and "gluten-related disorders" mean what they mean in the literature; also the driver of the Swedish outcome cohorts. Oslo definitions · Verified 2026-08-26
Daniel A. Leffler — Beth Israel Deaconess. Led the gluten-challenge kinetics work and co-authored the Oslo definitions; his study design is what later therapeutic trials measure against. Gluten challenge kinetics · Verified 2026-08-26
— Guidelines and epidemiology —
Alberto Rubio-Tapia — first author of the American College of Gastroenterology's clinical guideline on diagnosis and management. ACG guideline · Verified 2026-08-26
Ciaran P. Kelly — Beth Israel Deaconess. Co-author of the ACG guideline and of the gluten-challenge work. ACG guideline · Verified 2026-08-26
Steffen Husby — lead author of the ESPGHAN guidelines for diagnosing coeliac disease in children, including the biopsy-sparing pathway. ESPGHAN guidelines · Verified 2026-08-26
Benjamin Lebwohl and Peter H.R. Green — Columbia University Celiac Disease Center. Authors of the large-cohort work on cancer risk and long-term outcomes, and among the most-published clinical voices in the field. Cancer risk cohort · Verified 2026-08-26
Joseph A. Murray — Mayo Clinic. Co-author of the canonical US prevalence study and among the most-published clinical investigators in the field. If a US figure about how many people have celiac disease is quoted anywhere, this is usually the work behind it. US prevalence · Verified 2026-08-26
A.K. Akobeng and A.G. Thomas. Authors of the systematic review that pooled the tolerable-gluten evidence — the bridge between Catassi's single trial and a defensible regulatory number. The review · Verified 2026-08-26
Christoph Hischenhuber, René Crevel and colleagues. Authors of the earlier review that framed safe gluten amounts for regulators, covering both wheat allergy and celiac disease. The review · Verified 2026-08-26
Detlef Schuppan. Co-author of the gluten-challenge kinetics work and of the Prolamin Working Group statement — one of the few names appearing on both the clinical and the analytical sides of this directory. Gluten challenge kinetics · testing and certification · Verified 2026-08-26
— The patient's experience, measured —
Sveta Shah and colleagues — Beth Israel Deaconess. Authors of the study that measured treatment burden in celiac disease against other chronic conditions, which is the closest thing the literature has to a number for what the diet costs a person. The burden study · Verified 2026-08-26
— The people who moved measurement off the plate and into the patient —
Isabel Comino and Carolina Sousa — University of Seville. Developed and validated gluten immunogenic peptide detection in urine and stool. Comino also co-authored the 2025 review of adherence-monitoring devices with Benjamin Lebwohl. Biomarkers review · devices review · Verified 2026-08-26
Ángela Ruiz-Carnicer — University of Seville. First author of the study establishing the negative predictive value of repeated absence of urinary GIP in treated celiac patients — the paper that made a negative result mean something. PubMed 32692806 · Verified 2026-08-26
Timo Reunala, Teea Salmi and Kaisa Hervonen — Tampere University. The dermatitis herpetiformis group: the authors who keep the skin presentation of gluten sensitivity in view when the rest of the field looks only at the gut. The update · Verified 2026-08-26
Umberto Volta, Giacomo Caio and Anna Sapone — University of Bologna. Authors of the standing comprehensive review of celiac disease. The review · Verified 2026-08-26
— Directly on this site's subject —
Katharina A. Scherf and Sabrina Geisslitz. Authors of the 2025 absolute quantitation of celiac-disease-active gluten peptides in gluten-free barley beer. Scherf also leads the Prolamin Working Group statement indexed on this directory's testing page — the single clearest link between the clinical question here and the analytical one there. The 2025 paper · testing and certification · Verified 2026-08-26
Verónica Segura — University of Seville. First author of the highly sensitive lateral-flow method for detecting hydrolyzed gluten in beer samples — the Seville group's tooling pointed directly at this category's hardest matrix. The method · Verified 2026-08-26
Daniel W. Adams and Julio P. Stefanolo. Authors of the current reviews on devices and stool-test protocols for monitoring gluten-free diet adherence — the practical end of the GIP method. Devices review · stool test protocol · Verified 2026-08-26
Carolina Ciacci — University of Salerno. First author of the in vitro and in vivo safety and palatability study of wheat-free sorghum food products in celiac patients. The study · Verified 2026-08-26
Gregory J. Tanner, Michelle L. Colgrave and colleagues — CSIRO. The hordein-quantification group whose work this directory also indexes on testing and certification; their finding that the choice of standard changes results by an order of magnitude is the analytical counterpart to the clinical question here. The paper · Verified 2026-08-26
Maureen M. Leonard — MassGeneral for Children. Leads the CDGEMM birth cohort, which follows at-risk infants to see who develops celiac disease and why. Cohort profile · Verified 2026-08-26
Prashant Singh, Amit Arora and colleagues. Authors of the global prevalence meta-analysis — the pooled worldwide estimate this field cites when it needs a number. The meta-analysis · Verified 2026-08-26
Marisa G. Stahl — led the Autoimmunity Screening for Kids study, which screened a general pediatric population rather than a symptomatic one. The screening study · Verified 2026-08-26
Laura K. Allred — Gluten Intolerance Group of North America. Lead author of the celiac patient antibody study, and the same researcher this directory indexes on testing and certification for method work. She appears on both pages because she works on both sides of the question: what the assay detects, and what the patient reacts to. The study · Verified 2026-08-26
Stefano Guandalini — University of Chicago, Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology and Nutrition. Founder of the university's celiac center and senior author on the beer antibody study. The study · Verified 2026-08-26
Cynthia Kupper — Gluten Intolerance Group of North America. Co-author of the same study, from the organization that operates the GFCO certification scheme. The study · Verified 2026-08-26
Katherine Lesko — University of Chicago, Biological Sciences Division, and Diane McKiernan — University of Chicago Celiac Disease Center. Co-authors of the beer antibody study; the laboratory and clinical halves of the collaboration. The study · Verified 2026-08-26
Alessio Fasano — MassGeneral for Children. Co-author of the field's most-cited framing of celiac disease as an evolving clinical spectrum, and the clinician whose stated position on the limits of the R5 ELISA is recorded above. Fasano & Catassi 2001 · Verified 2026-08-26
Named for published work only. Nothing here is a clinical referral.
3. Projects & Grants — funded work in flight right now
What qualifies: work that is currently funded or actively producing output, concerns gluten-related disorders as they bear on food and beverage thresholds, and has a public record.
Found through this project's own archive, which carries a decade of patient-organization mail, and verified against ClinicalTrials.gov. All three are drug trials: the celiac research that is actually funded aims at making the gluten-free diet unnecessary, not at making it easier to live with.
— Cohorts and screening —
CDGEMM — Celiac Disease Genomic, Environmental, Microbiome and Metabolomic study. A prospective birth cohort following infants at familial risk, looking for what tips genetic susceptibility into disease. The long-horizon study this field needs and rarely funds. Cohort profile · Verified 2026-08-26
PreventCD. The randomized feeding intervention that tested whether the timing of gluten introduction in infancy changes who develops celiac disease — published in the New England Journal of Medicine, and it found that it does not. The trial · Verified 2026-08-26
Autoimmunity Screening for Kids (ASK). Mass screening of a general pediatric population for celiac disease and type 1 diabetes autoimmunity, with one-year outcomes published for the children it identified. The screening study · one-year outcomes · Verified 2026-08-26
— Therapeutics —
ACeD — KAN-101. Assessment of KAN-101 in Celiac Disease, a liver-targeted immune-tolerance candidate. NCT04248855, completed; a follow-on study, NCT05574010, is recorded as terminated. NCT04248855 · Verified 2026-08-26
PROACTIVE — PRV-015. PRV-015 in Gluten-free Diet Non-responsive Celiac Disease — aimed specifically at patients who remain symptomatic on a strict gluten-free diet, which is the population for whom threshold questions matter most. NCT04424927, completed. NCT04424927 · Verified 2026-08-26
LILY — DONQ52. Safety, tolerability, pharmacokinetics and biomarker study of DONQ52 in celiac disease. NCT05425446, completed. NCT05425446 · Verified 2026-08-26
Patient recruitment as standing activity. The University of Chicago Celiac Disease Center runs continuous recruitment for celiac studies — the single most frequent subject line across a decade of its mail in this project's archive. The center · Verified 2026-08-26
All three named trials have completed or terminated. We have found no currently enrolling trial bearing on beverage thresholds, and no funded research anywhere on gluten-free brewing itself.
4. Funders & Programs — who pays for it (described, never endorsed)
What qualifies: a funder whose money traceably appears in work documented here, or a standing program whose scope covers this subject.
Described, never endorsed. Every funder below is a trial sponsor of record on ClinicalTrials.gov.
— US federal —
National Institutes of Health, via NIDDK. The federal funder whose portfolio covers celiac disease research and which publishes the government's clinical reference on it. NIDDK · Verified 2026-08-26
— Patient-organization research programs —
Celiac Disease Foundation research program. A patient organization that funds and promotes research and recruits for trials, rather than only providing patient support. The organization · Verified 2026-08-26
Beyond Celiac research program. Runs a research agenda aimed explicitly at treatments beyond the gluten-free diet. The program · Verified 2026-08-26
— Pharmaceutical sponsors —
Provention Bio, a Sanofi Company. Sponsor of the PROACTIVE trial in non-responsive celiac disease. NCT04424927 · Verified 2026-08-26
Chugai Pharmaceutical. Sponsor of the LILY study of DONQ52. NCT05425446 · Verified 2026-08-26
Kanyos Bio, a wholly-owned subsidiary of Anokion SA. Sponsor of the ACeD studies of KAN-101. NCT04248855 · Verified 2026-08-26
Note what this list is and is not. Three multinational pharmaceutical sponsors fund celiac therapeutics. We have found none of them, and no other funder, supporting research into what people with celiac disease drink. The nearest thing this project's archive holds is a university business-school program that produced export market research for a gluten-free brewery in 2021 — market analysis, not brewing or clinical science, and worth naming precisely so the distinction is not lost. The practitioner end of the same question records the same absence from the other direction — see homebrew and home malting.
5. Organizations & Advocacy — the patient bodies and foundations
The organizations themselves are mapped on the community side — patient organizations — while this section maps the research they publish.
Gluten Intolerance Group of North America. Auburn, Washington. The patient organization that also operates a certification scheme, and — unusually for an advocacy body — publishes primary laboratory research. Two of its staff are authors on the beer antibody study indexed below. The organization · the study · Verified 2026-08-26
Celiac Support Association. Ran the 2014–15 gluten-reduced beer survey with Bard's — 985 respondents, three quarters of them celiac-diagnosed. This site holds the resulting data and publishes it. The survey results · the dataset · Verified 2026-08-26
Gluten Free Watchdog. Independent product testing and public scrutiny of scientific and regulatory positions — the organization this directory also indexes on testing and certification for contesting the Prolamin Working Group's statement on fermented foods. The organization · Verified 2026-08-26
Celiac Disease Foundation. A long-standing US patient organization, recorded in this project's archive among the bodies a gluten-free brewery engaged with as it brought product to market. The organization · Verified 2026-08-26
Mayo Clinic, as a public reference. Beyond its research role, it publishes one of the most-read lay clinical references on celiac disease — which is where a great many drinkers will have formed their understanding before they ever read a beer label. Mayo on celiac disease · Verified 2026-08-26
— International —
Coeliac UK. The largest and longest-established coeliac charity outside the US, and a funder of research in its own right. The charity · Verified 2026-08-26
Association of European Coeliac Societies (AOECS). The umbrella body for national coeliac societies across Europe, and the owner of the Crossed Grain licensing scheme — which makes it a patient body that also operates a labeling standard, the same dual role GIG holds in the US. AOECS · Verified 2026-08-26
Beyond Celiac. Formerly the National Foundation for Celiac Awareness; both names appear in this project's archive, which is a useful dating marker when reading older documents. The organization · Verified 2026-08-26
6. Standards & Events — the thresholds, consensus statements, and the field's calendar
— Diagnostic and terminology consensus —
The Oslo definitions for coeliac disease and related terms (2013). Gut 62(1):43–52. The paper that fixed the vocabulary — what counts as coeliac disease, what "gluten-free" means as a term of art, and which of the dozens of circulating labels the literature should stop using. Anyone writing carefully about this subject is working inside these definitions whether they cite them or not. PubMed 22345659 · Verified 2026-08-26
ACG clinical guidelines: diagnosis and management of celiac disease (2013). Am J Gastroenterol 108(5):656–676. The American College of Gastroenterology's standard of care. PubMed 23609613 · Verified 2026-08-26
ESPGHAN guidelines for diagnosing coeliac disease (2020). J Pediatr Gastroenterol Nutr 70(1):141–156. The European pediatric standard, including the biopsy-sparing diagnostic pathway. PubMed 31568151 · Verified 2026-08-26
Salerno experts' criteria for non-celiac gluten sensitivity (2015). Nutrients 7(6):4966–4977. The consensus definition for the condition that is neither celiac disease nor wheat allergy — relevant here because a large share of the gluten-free market is these consumers, and the evidence base governing them is different. PubMed 26096570 · Verified 2026-08-26
— The threshold —
The 20 ppm threshold, and where it comes from. The figure that governs gluten-free labeling is a clinical and analytical compromise rather than a measurement of harm, and this site documents its derivation and its limits on its own pages rather than restating them here. Can you call it gluten-free · truly gluten-free · Verified 2026-08-26
The gluten-free versus gluten-removed distinction, as a regulatory line. Where the clinical question meets the labeling rule, and the reason a beer's grain bill decides which agency it answers to. FDA vs TTB labeling · gluten-reduced beer is not gluten-free · Verified 2026-08-26
— Events —
The academic centers' patient and clinician programming. Both US centers indexed above run recurring public-facing programming — a long-running annual Columbia benefit, and continuing-medical-education sessions on subjects including gluten challenges and dermatitis herpetiformis — per a decade of their own mail in this project's archive. Named here as the field's working calendar; dates and current programs belong on the centers' own pages, not on a brewing site. Columbia · University of Chicago · Verified 2026-08-26
The Celiac Disease Foundation's patient education and advocacy programming. Including a Patient Education & Advocacy Summit recorded in this project's archive. The organization · Verified 2026-08-26
The clinical conferences where diagnostic and terminology consensus is formally revised are a separate matter and are not yet indexed here. They will come from the external pass.
7. Literature & Datasets — the anchor works, the methods, and the published data
— The threshold, and how it was set —
Catassi, Fabiani, Iacono et al. (2007), A prospective, double-blind, placebo-controlled trial to establish a safe gluten threshold for patients with celiac disease. American Journal of Clinical Nutrition 85(1):160–166. The experiment underneath the number. Celiac patients in remission were given measured daily doses of gluten against placebo, and the mucosal response was read by biopsy. Every gluten-free labeling limit in the world descends from work of this kind, which is worth knowing when the limit gets treated as a law of nature. PubMed 17209192 · doi:10.1093/ajcn/85.1.160 · Verified 2026-08-26
Akobeng & Thomas (2008), Systematic review: tolerable amount of gluten for people with coeliac disease. Aliment Pharmacol Ther 27(11):1044–1052. The systematic review that pooled the threshold evidence. PubMed 18315587 · Verified 2026-08-26
Hischenhuber, Crevel, Jarry et al. (2006), Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease. Aliment Pharmacol Ther 23(5):559–575. The earlier review that framed the question for the regulators. PubMed 16480395 · Verified 2026-08-26
— What a gluten exposure actually does, and how fast —
Leffler, Schuppan, Pallav et al. (2013), Kinetics of the histological, serological and symptomatic responses to gluten challenge in adults with coeliac disease. Gut 62(7):996–1004. Measures how quickly the gut, the blood and the patient respond to a defined gluten dose. This is the study that makes "a small exposure" a quantity rather than a worry. PubMed 22619366 · Verified 2026-08-26
— Long-term outcomes —
Lebwohl, Green, Emilsson et al. (2022), Cancer Risk in 47,241 Individuals With Celiac Disease. Clin Gastroenterol Hepatol 20(2):e111–e131. A nationwide cohort — the scale at which questions about consequence can actually be answered. PubMed 34033925 · Verified 2026-08-26
Ludvigsson, Dagher, Lebwohl et al. (2026), Mortality, cardiovascular disease, and cancer in coeliac disease and dermatitis herpetiformis. Lancet Reg Health Am 60:101512. A matched cohort covering both the intestinal and cutaneous presentations. PubMed 42256615 · Verified 2026-08-26
— How many people this is about —
Rubio-Tapia, Ludvigsson, Brantner, Murray & Everhart (2012), The prevalence of celiac disease in the United States. Am J Gastroenterol 107(10):1538–1544. The canonical US figure, and the one that underpins any market or public-health claim made about this category in America. PubMed 22850429 · Verified 2026-08-26
Singh, Arora, Strand et al. (2018), Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 16(6):823–836.e2. The worldwide pooled estimate, separating serology-based from biopsy-confirmed prevalence — a distinction that matters because the two produce different numbers. PubMed 29551598 · Verified 2026-08-26
— Who has it, and who does not know —
Stahl, Geno Rasmussen, Dong et al. (2021), Mass Screening for Celiac Disease: The Autoimmunity Screening for Kids Study. Am J Gastroenterol 116(1):180–187. Screening a general pediatric population rather than waiting for symptoms. PubMed 32701732 · Verified 2026-08-26
Vriezinga, Auricchio, Bravi et al. (2014), Randomized feeding intervention in infants at high risk for celiac disease. N Engl J Med 371(14):1304–1315. The PreventCD trial: changing when gluten is introduced in infancy did not change who developed celiac disease. PubMed 25271603 · Verified 2026-08-26
Leonard, Kenyon, Valitutti et al. (2023), Cohort profile: CDGEMM. PLoS One 18(3):e0282739. The prospective birth cohort's design and population. PubMed 36888627 · Verified 2026-08-26
— Beyond the gut —
Reunala, Hervonen & Salmi (2021), Dermatitis Herpetiformis: An Update on Diagnosis and Management. Am J Clin Dermatol 22(3):329–338. The skin presentation of gluten sensitivity — a reminder that an exposure's consequences are not confined to the digestive tract. PubMed 33432477 · Verified 2026-08-26
Caio, Volta, Sapone et al. (2019), Celiac disease: a comprehensive current review. BMC Medicine 17(1):142. The general standing review, open access. PubMed 31331324 · Verified 2026-08-26
— What the diet costs the person on it —
Shah, Akbari, Vanga et al. (2014), Patient perception of treatment burden is high in celiac disease compared with other common conditions. Am J Gastroenterol 109(9):1304–1311. Patients rated the burden of a strict gluten-free diet against the burden of other chronic disease treatments. It is the paper to read before describing the diet as a simple matter of avoidance. PubMed 24980880 · Verified 2026-08-26
Lebovits, Lee, Ciaccio et al. (2022), Impact of Celiac Disease on Dating. Dig Dis Sci 67(11):5158–5167. Indexed without irony: a condition managed entirely through food reaches into everything social that involves food, and beer is squarely in that territory. PubMed 35635630 · Verified 2026-08-26
— Directly on grain and beverage —
Ciacci, Maiuri, Caporaso et al. (2007), Celiac disease: in vitro and in vivo safety and palatability of wheat-free sorghum food products. Clin Nutr 26(6):799–805. The clinical safety and palatability study of sorghum in celiac patients — the paper closest to this site's premise that exists in the clinical literature, and it is nearly twenty years old. PubMed 17719701 · Verified 2026-08-26
Tissen, Geisslitz & Scherf (2025), Absolute quantitation of celiac disease-active gluten peptides in gluten-free barley beer. Food Research International 222(Pt 2):117703. Targeted mass spectrometry aimed at the peptides that matter clinically rather than at total gluten — the newest work on the question this directory tracks across three pages. PubMed 41271327 · Verified 2026-08-26
Tanner, Blundell & Colgrave (2013), Quantification of Hordeins by ELISA: the correct standard makes a magnitude of difference. PLoS One 8(2):e56456. An order-of-magnitude swing from the choice of calibration standard. PubMed 23509607 · Verified 2026-08-26
— The study that tested this category on patients —
Allred, Lesko, McKiernan, Kupper & Guandalini (2017), The Celiac Patient Antibody Response to Conventional and Gluten-Removed Beer. Journal of AOAC International 100(2):485–491. Sera from 31 active celiac patients and 29 non-celiac controls were tested against proteins from barley, rice, traditional beer, gluten-free beer, and enzymatically treated gluten-removed beer. None of the subjects' sera bound to proteins in the gluten-free beer. Eleven celiac patients showed IgA or IgG binding to barley extract against one control; of the seven with an IgA response to barley, four also responded to traditional beer and two of those responded to the gluten-removed beer. The authors conclude that binding of protein fragments in hydrolyzed or fermented products by celiac sera, but not control sera, may indicate residual peptides that are celiac-specific. PubMed 28118560 · doi:10.5740/jaoacint.16-0184 · Verified 2026-08-26
— Measuring the exposure in the person, not the food —
Ruiz-Carnicer, Garzón-Benavides, Fombuena et al. (2020), Negative predictive value of the repeated absence of gluten immunogenic peptides in the urine of treated celiac patients. American Journal of Clinical Nutrition 112(5):1240–1251. Gluten that survives digestion is excreted, and can be detected. Repeatedly finding none means the patient genuinely is not being exposed — which turns a self-reported diet into a measured one. PubMed 32692806 · Verified 2026-08-26
Costa, Sugai, Temprano et al. (2019), Gluten immunogenic peptide excretion detects dietary transgressions in treated celiac disease patients. World J Gastroenterol 25(11):1409–1420. The same method used the other way round: finding exposure the patient did not know they had. PubMed 30918433 · Verified 2026-08-26
Moreno, Rodríguez-Herrera & Sousa (2017), Biomarkers to Monitor Gluten-Free Diet Compliance in Celiac Patients. Nutrients 9(1):46. The standing review of the approach. PubMed 28067823 · Verified 2026-08-26
Adams, Comino & Lebwohl (2025), Devices to Monitor Adherence to the Gluten-Free Diet. Gastrointest Endosc Clin N Am 35(4):775–788. The current state of the art, co-authored by the method's originator and by Columbia's lead clinician. PubMed 41107012 · Verified 2026-08-26
Stefanolo, Puebla, Dodds et al. (2025), Optimising Use of Stool Gluten Immunogenic Peptide Tests for Monitoring Adherence. Aliment Pharmacol Ther 62(7):743–746. How often to test, and how to read the result. PubMed 40516107 · Verified 2026-08-26
— What is actually in a low-gluten beer —
Low Gluten Beers Contain Variable Gluten and Immunogenic Epitope Content (2023). The finding in the title: the category is not consistent, product to product, on either total gluten or the epitopes that matter immunologically. PubMed 37685187 · Verified 2026-08-26
Segura, Siglez, Ruiz-Carnicer et al. (2023), A Highly Sensitive Method for the Detection of Hydrolyzed Gluten in Beer Samples Using LFIA. Foods 12(1):160. A lateral-flow method aimed squarely at the hydrolyzed gluten that defeats conventional ELISA — from the Seville group again. PubMed 36613374 · Verified 2026-08-26
— The clinical framing —
Fasano & Catassi (2001), Current approaches to diagnosis and treatment of celiac disease: an evolving spectrum. Gastroenterology 120(3):636–651. The paper this project's own research documents reach for when they need to define celiac disease — a syndrome of small intestinal mucosal damage caused by the gliadin fraction of wheat gluten and similar alcohol-soluble proteins, with lifelong avoidance as the only successful treatment. PubMed 11179241 · Verified 2026-08-26
— The consumer dataset —
Celiac Support Association and Bard's, Gluten Reduced Beer Survey (2014–15). 985 respondents, 75.7% celiac-diagnosed. Of those who had tried a barley-based beer processed to remove gluten, 39.8% reported a gluten-related physical reaction; 43.4% had not known at purchase that the beer contained wheat or barley. Consumer evidence rather than clinical evidence, and published here with that limit stated and the response-level data de-identified and downloadable. The results · the dataset · Verified 2026-08-26
How the field connects — documented links between the entries above
Every connection carries its own evidence link — no inferred relationships, no speculation.
Breakthrough: the measurement problem has an exit, and it is the drinker. Every argument on this site's testing page is about whether an assay can find gluten in a beer. Gluten immunogenic peptide testing asks a different question — did gluten get into this person — by detecting the fragments that survive digestion and appear in urine and stool. It is validated, it is clinical, and it does not care whether the gluten was hydrolyzed, fermented, or suppressing an ELISA. The category's central analytical dispute is unresolvable in the glass and straightforwardly answerable in the patient. The validation study · testing and certification
Breakthrough: a negative result was made to mean something. Ruiz-Carnicer's group established the negative predictive value of repeatedly finding no urinary GIP. That is the step that turns a test into evidence: not "we did not detect it", but "repeated non-detection tells you the exposure is not happening." Compare that with a gluten-removed beer's ELISA figure, which this directory documents can read near zero precisely because the gluten is there. PubMed 32692806 · the suppression finding
Breakthrough: the low-gluten beer category is internally inconsistent. A 2023 study found low-gluten beers vary in both gluten content and immunogenic epitope content. Not "these beers are unsafe" — something more awkward for a shopper: the label describes a category whose members differ from one another on the measure that matters. PubMed 37685187 · gluten-reduced beer is not gluten-free
Unexplored, and cheap to explore: nobody has pointed the patient test at beer. The method exists, is validated, and is in clinical use. A search of the literature returns no study measuring urinary or faecal gluten immunogenic peptides in people after drinking gluten-removed beer — nor any clinical trial of gluten-removed beer in celiac patients at all. The design is obvious: recruit treated celiac patients with established GIP-negative baselines, give a measured serving, test. It would answer in a fortnight a question this category has argued about for fifteen years, and it needs no new science — only someone to run it. Searched 2026-08-26; recorded as a documented absence, and we would withdraw it gladly if shown otherwise. The method · the survey this would test
Prevalence is known; drinking behavior is not. The size of the celiac population is established in both US and global literature. What nobody has published, so far as we can find, is how many of those people drink beer, how often, or whether they choose gluten-free or gluten-removed. Every market claim about this category rests on the first number standing in for the second. US prevalence · global prevalence · the survey
The 20 ppm limit is a dose calculation wearing a concentration's clothes. Catassi's trial established a tolerable daily gluten intake. A labeling limit is a concentration in a food. Getting from one to the other requires an assumption about how much of that food a person eats, and beer is exactly where that assumption strains — a serving is large, and people rarely have only one. The threshold does not become wrong at the pub; it becomes an arithmetic problem the label does not show you. The threshold trial · can you call it gluten-free
The clinical literature already knows sorghum is safe, and has since 2007. Ciacci tested wheat-free sorghum products in celiac patients for both safety and palatability. Nearly twenty years later that is still the study we reach for, and no one has repeated it for beer. The category's central grain has one clinical paper behind it. The study · sorghum directory
Two research programs are pointed at the same question from opposite ends. Clinical trials aim to make celiac patients tolerant of gluten. This site aims to make beer that never contained it. If the drug programs succeed, the market rationale for gluten-free brewing narrows sharply; if they do not, the diet stays permanent and the brewing question stays permanent with it. Every entry in Sections 3 and 4 is, in that sense, a bet against this directory's own necessity. ACeD · PROACTIVE
The exposure question is answerable, and nobody has answered it for beer. Leffler's group measured how fast histology, serology and symptoms respond to a defined gluten dose. That method exists. Applying it to a gluten-removed beer — a real serving, a real schedule, real patients — is a study anyone could design from the existing literature, and we have found no one who has. Gluten challenge kinetics · testing and certification
The measurement problem is being attacked from the peptide side now. Scherf's 2025 work quantifies celiac-disease-active gluten peptides in gluten-free barley beer by targeted mass spectrometry, rather than estimating total gluten by immunoassay. That is the analytical response to exactly the failure this directory documents on its testing page — and it arrives from the same researcher who leads the Prolamin Working Group's position on fermented foods. The 2025 paper · testing and certification
A calibration choice moves the answer by an order of magnitude. Tanner and Colgrave showed the hordein standard used to calibrate an ELISA changes the result tenfold. Combine that with the dose-versus- concentration problem above and a beer's published gluten figure carries two independent sources of slack before anyone has been dishonest. The ELISA standard paper · gluten testing methods
The vocabulary was standardized; the marketing was not. The Oslo definitions fixed what these terms mean in the literature in 2013. The gluten-removed category launched into a market where the words still moved freely, and this site's survey caught the consequence: 43.4% of respondents did not know at purchase that the beer contained barley. Definitions existed. They just were not on the label. Oslo definitions · the survey
Two patient organizations also operate labeling schemes. GIG runs GFCO in the US; AOECS owns the Crossed Grain licence in Europe. Patient advocacy and product certification sit inside the same institutions on both continents. That is worth knowing in either direction — it puts certification close to the people it protects, and it puts an advocacy body's name on a commercial mark. GIG · AOECS
The diet is not a small ask, and the literature says so with a number. Patients rated the treatment burden of a strict gluten-free diet against other chronic disease treatments and rated it high. This directory's whole premise — that a beer worth drinking matters — rests on that finding rather than on sentiment. The burden study · Impact on dating
Prevention was tried and it did not work. PreventCD randomized when infants at genetic risk were introduced to gluten, and found it changed nothing about who developed celiac disease. That closes a hopeful avenue and leaves avoidance as the standing answer — which is why the supply side of avoidance is worth this much documentation. The trial
Screening finds people who were not looking. Mass pediatric screening identified celiac disease in a general population rather than a symptomatic one, and followed those children for a year. The implication for anyone making food or drink is that the affected population is larger than the diagnosed one, and growing as screening spreads. The screening study · one-year outcomes
The gut is not the only organ with a stake. Dermatitis herpetiformis is the same disease presenting on the skin, and it appears alongside coeliac disease in the long-term outcome cohorts. Any framing of gluten exposure as a digestive inconvenience is incomplete before it starts. The DH review · the outcomes cohort
Somebody already ran the experiment this whole site implies. The argument for brewing from grains that never contained gluten is usually made analytically: you cannot measure what was never there. Allred's group made it immunologically instead, and the result is the stronger one — no celiac patient's serum bound to proteins in the gluten-free beer, while two of seven patients who reacted to barley also reacted to the gluten-removed beer. That is the site's central claim, tested on patients rather than on assays. The study · gluten-reduced beer is not gluten-free
A certifier's own scientists published the limits of certification. The Gluten Intolerance Group operates a certification scheme; two GIG authors wrote in 2017 that there are no validated testing methods allowing quantitation of all the hydrolyzed or fermented gluten peptides that might be harmful, which makes the safety of hydrolyzed products difficult to assess. An organization publishing the limits of the thing it certifies is worth recording plainly, in either direction a reader wants to take it. The study · testing and certification
The FDA said in 2020 what this paper said in 2017. The agency's rule on fermented and hydrolyzed foods rests on current gluten tests not adequately detecting gluten in them. Allred's paper opens on the same observation three years earlier, from a certifier's laboratory rather than a regulator's docket. The measurement problem was not discovered by the regulation; it was documented and then regulated. The study · testing and certification
Consumer report and patient serology point the same way, by different methods. 39.8% of surveyed celiac respondents reported a physical reaction to gluten-reduced beer. Allred found celiac-specific antibody binding to gluten-removed beer in a laboratory. Neither is a clinical trial and neither proves harm; that two unrelated methods land in the same direction is the finding, and the honest limits of both are stated on their own pages. The survey · the study
Celiac disease has pharmaceutical funding; gluten-free brewing has none. Three multinational sponsors — Sanofi's Provention Bio, Chugai, and Anokion's Kanyos Bio — funded trials aimed at treating celiac disease or restoring tolerance. Not one funder anywhere pays for research into what people with celiac disease drink, and this directory's practitioner page records the same zero from the other end. The demand side of gluten-free brewing is backed by drug development intended to make the diet unnecessary; the supply side is backed by people buying their own grain. NCT04248855 · homebrew and home malting
The population that matters most to a brewer already has a trial named after it. PROACTIVE enrolled patients who stay symptomatic on a strict gluten-free diet. Those are the people for whom a 20 ppm threshold, a gluten-removed beer, or a suppressed assay reading is not an abstraction. That a drug program had to define them as a distinct population is the strongest evidence this directory has that the threshold does not protect everyone it is meant to. NCT04424927 · testing and certification
The clinical centers were the gatekeepers before the certifiers were. This project's archive records a gluten-free brewery approaching the Celiac Disease Center at Columbia, the Gluten Intolerance Group and the Celiac Sprue Association as it brought a product to market. The route to credibility ran through clinical and patient bodies rather than through a testing lab — which is a fact about how this category earned trust before a standard existed to earn it against. Columbia · GIG
Research gaps — where the field's coverage runs out
Gaps are documented, not speculated. A documented zero is an answer.
The patient study has a small sample and no follow-up we have found. Thirty-one active celiac patients and twenty-nine controls is enough to detect a signal and not enough to size it. Of the seven patients with an IgA response to barley, two responded to the gluten-removed beer — a finding built on single-figure counts. We have found no larger replication in the eight years since, which leaves the strongest immunological evidence in this category resting on one paper. The study
Antibody binding is not a clinical outcome. The study measures whether celiac patients' serum antibodies bind residual peptides, not whether drinking the beer harms anyone. The authors say so themselves — binding "may indicate the presence of residual peptides that are celiac-specific." We have found no controlled feeding study on gluten-removed beer, which is the study that would actually settle the question, and its absence is the most consequential gap on this page.
This project's archive carries the field's mail, not its literature. Searched properly, it holds a great deal: 1,974 messages mentioning celiac disease, a decade of patient-organization and academic-center correspondence, and the trial names above. What it does not hold is the clinical literature itself — the primary research reached it as newsletters, not as papers. So the archive is an excellent index of who works on this and a poor source for what they found. The external pass has to supply the second.
This section said nothing here maps prevalence. That gap is closed, and the numbers are now in Literature above. The canonical US prevalence study and the global meta-analysis both exist and are indexed; so are the mass-screening and long-term cohort studies. The epidemiology was never missing from the field — only from this page.
What survives is narrower and specific to this site's subject: we have found no study estimating how many people with celiac disease drink beer, how often, or which kind. Prevalence tells you the size of the population the thresholds protect. It does not tell you the size of the population standing in front of a gluten-removed tap, which is the number a brewer would actually use. US prevalence · global prevalence
Research gluten-related disorders? Entries are added on merit once verified — tell us about it.
Entries are added as they are verified, never to pad the count. A listing here is a map reference, not a citation, and nothing here is medical advice. Corrections welcome — see Contact.