A leading coeliac disease specialist has called for transparency on testing of gluten-free labelled foods in Australia to help patients avoid inadvertent gluten exposure.

Perth gastroenterologist Dr Geoffrey Forbes says it is no surprise that almost one in six food products labelled gluten free have been found to contain gluten because testing is left to the food industry and is poorly governed.

In a letter to the MJA, Dr Forbes noted that recent studies found detectable gluten in 14% of imported gluten-free foods (0.5–1.1 parts per million [ppm]) and in 2.7% of “commonly purchased” gluten-free foods (5–49 ppm).

He said compliance with the current gluten-free food code was “unsatisfactory” because testing was carried out by industry and because there was no co-ordinated oversight of standards at a national or state level by government bodies such as the Food Standards Australia New Zealand (FSANZ) or the Australian Competition and Consumer Commission (ACCC).

“The very least that patients with coeliac disease should expect is negligible additional contamination from foods that are labelled gluten-free. Transparent testing of gluten-free labelled foods is therefore critical,” he wrote.

With government bodies unlikely to implement regular testing over “ad hoc and unreported industry-based testing”, he said mandating the regular publication of laboratory test results would at least reassure consumers with coeliac disease.

Speaking to the limbic, Dr Forbes said although a small amount of gluten making its way into a patient’s diet might not be immediately injurious, “the issue … is the total burden of gluten”.

“Added all together it’s the cumulative effect that is going to be important for the patient,” he said.

But equally a “gluten-hit” could make a patient acutely unwell within a couple of hours and in some cases patients may need to take days off work.

In a disease where the only current treatment was a gluten free diet, there was “ample room for improvement” said Dr Forbes.

He told the limbic the food standards authorities were set up to handle public health problems such as a salmonella outbreak but not something as all-encompassing and global as gluten free monitoring.

State authorities had still not investigated non-compliance for imported gluten-free foods he had outlined in 2016 and local governments responsible for testing could not nationally coordinate oversight of gluten testing.

His suggestion for a “simple way forward” would be for companies marketing gluten free products to put their test standards and the results on their website or on their packaging .

“It’s a little bit like the quality assurance we as doctors are expected to give patients,” he said.