Bread and breakfast cereals are at the heart of the British diet and provide the nation with a good source of essential nutrients such as calcium, iron, vitamin D and fibre. That's why achieving an adequate intake of these vital nutrients can be a challenge for people with coeliac disease, as so many staple foods contain gluten.
In recent months several misleading press article have appeared accusing gluten free food manufacturers of excessive charging for delivering prescription products. Members of the BSNA provide these products to the NHS at a fixed and consistent price and they never charge extra administration or delivery charges because these are already paid for by the manufacturers.
The recently revised Gluten-Free Prescribing Guidelines 2011 recommends that people with medically diagnosed coeliac disease should have access to a reasonable amount of basic staple gluten-free foods on prescription to assist them in managing their condition.
Gastrointestinal disorders, such as coeliac disease, are reported to account for around ten percent of NHS clinical work. However, despite being one of the most common long term chronic conditions, the prevalence of coeliac disease is still not formally recorded by the NHS. Consequently, it's not surprising that coeliac disease is not always well managed in general practice.
The long awaited Food Information to Consumers Regulation was published in November 2011. This new Regulation will result in changes to most food and drink labels, including those of specialist nutrition products. The majority of these label changes will need to be made by December 2014 in accordance with the transition periods for the Regulation.
The European Commission's proposal to revise the current legislation for Foods for Particular Nutritional Uses (PARNUTs), known as the 'PARNUTs Framework Directive', has been under discussion by the European Council of Ministers since October 2011 and the Polish Presidency of the Council has issued a report on the progress to date as part of its handover to the new Danish Presidency which will take over from 1 January 2012.
The European Commission published a proposal to revise the current legislation for Foods for Particular Nutritional Uses (PARNUTs), known as the 'PARNUTs Framework Directive', in June 2011. The Commission proposal is now under discussion by the European Council of Ministers.
The largest ever survey of 3,500 people with coeliac disease found that 79% rated having access to a regular supply of essential gluten-free foods via the NHS helped them adhere to a life-long gluten-free diet. Overall the findings of this survey confirmed the long term value for the NHS in providing a foundation of support for coeliac patients.
The UK Department of Health has launched a consultation on the proposals put forward by the European Commission for the revision of the current legislation for Foods for Particular Nutritional Uses (PARNUTs), known as the 'PARNUTs Framework Directive'.
BSNA is pleased that the Welsh Government has refuted recent reports in the press which exaggerated the cost to the NHS of gluten-free products on prescription.
These reports in the national press had suggested that a loaf of gluten free bread costs the NHS in Wales £32. This figure appears to have been arrived at following a misinterpretation of NHS prescribing statistics - which show the total number of prescriptions dispensed, rather than the total number of loaves prescribed.
The BSNA gluten-free working group has produced a new document entitled 'A guide to the role of the gluten-free prescription in the management of coeliac disease'. The guide was compiled to inform key stakeholders and healthcare professionals, involved in the provision of care for patients with coeliac disease, of the importance of a gluten-free prescription in the successful management of this lifelong disease.
The European Commission published new proposals for the Dietetic foods sector on 20 June 2011. These proposals suggest that slimming foods (meal replacements), sports nutrition products and gluten-free foods become “general” foods.
A new series of fact sheets reviewing each of the specialist nutrition categories from a European view has been published by IDACE. IDACE is the European Trade Association for specialist nutrition products and is based in Brussels. The fact sheets cover infant and follow-on formula, complementary foods, medical foods, gluten free foods, sport foods and slimming foods. These categories are governed by the PARNUTs Framework Directive (Foods for PARticular NUTritional purposes). The PARNUTs Framework Directive is currently undergoing review and redrafting in Brussels and these fact sheets provide information on each category and show the importance of clear regulation for these important products.
Many dietitians working in the area of coeliac disease are facing tough challenges at present. Not only are financial pressures creating a review of the ongoing prescription of gluten-free products in some localities, but many secondary care specialist NHS coeliac clinics are under threat with a review of their funding.This creates a pressure on gastroenterology specialist dietitians to prove their clinical and cost effectiveness, yet continue to offer optimal care for our patients with coeliac disease.
SACN and COT were asked by the Department of Health and the Food Standards Agency to review the evidence on the timing of introduction of gluten into the infant diet and subsequent risk of developing coeliac disease and Type 1 Diabetes Mellitus. Their report has been published and states that introduction of gluten before 13 weeks is not appropriate but the evidence is not strong enough to give specific advice about the timing of introduction of gluten beyond three months of age.
People with coeliac disease must avoid all foods which contain gluten, a protein found in wheat, rye and barley. Therefore, these individuals have to avoid many cereal-based products which are considered part of a normal, staple diet. Because of these limitations, people with coeliac disease may have a restricted and potentially unbalanced diet and could be at risk of having an inadequate intake of key nutrients such as fibre, calcium, iron and folic acid.
The British Society of Gastroenterology (BSG) has produced updated guidance on the 'Management of Adults with Coeliac Disease'. It is intended to assist in the diagnosis and clinical management of adults with coeliac disease within the UK and was compiled following a comprehensive literature search.
The importance of clear labelling of food products suitable for individuals intolerant to gluten, such as those with coeliac disease is well recognised. Key to clear labelling of foods has been the agreement and implementation of internationally agreed standards and testing methods for defining 'gluten free'. A new dual Codex standard was adopted in 2009 with two labelling categories of foods suitable for gluten intolerant individuals.