We’re thrilled by the overwhelming response to Wesley Research Institute’s Coeliac Disease Webinar held on March 25th. The strong interest in our coeliac disease webinars reflects a growing eagerness to better understand the latest research and treatment developments for coeliac disease.
Over 150 participants tuned in to the session, which delivered valuable insights into the biological response to gluten ingestion, the effects of accidental gluten exposure, and provided practical, real‑world strategies for dining out, travelling, and socialising with confidence and safety.
Our sincere appreciation goes to our supporters of this webinar, the Rosalie Martin Event Series, as well as our guest speaker, Specialist Dietitian Paula MacDermott (APD).
Watch Webinar
Watch the Coeliac Disease Webinar recording here – https://www.youtube.com/watch?v=kPP3iWxKZi8&t
Key insights from listening to Dr James Daveson and Paula MacDermott:
The Biological Response to Gluten as a Coeliac
Smallest amounts can still make you sick: People with coeliac disease are often extremely careful about avoiding gluten because even very small amounts can make them sick. Many people around them don’t realise that this reaction is driven by real, measurable biology. Only about 30% of Australians with coeliac disease are diagnosed, and untreated disease can lead to problems like poor growth, iron deficiency, osteoporosis, fertility issues, and a small increased risk of lymphoma. This talk focused on people who are diagnosed and treated, and their strong reactions to gluten exposure.
Gluten Exposure: Among treated patients, some continue to have symptoms while others feel well, but both groups can become very unwell if they accidentally consume gluten. This constant vigilance can create social isolation, because people with coeliac disease know that even a crumb of gluten can trigger severe symptoms within one to two hours. Gluten is made of long proteins that humans cannot fully digest. Most people can tolerate the leftover fragments, but people with coeliac disease cannot. These fragments, called toxic immunogenic peptides, trigger an immune response similar to what happens during an infection. Research has identified the specific gluten peptides that cause the strongest reactions.
In clinical trials, injecting these peptides into the skin caused the same symptoms as eating gluten in a gluten challenge, especially nausea and vomiting. This confirmed that the peptides themselves are responsible for the reaction. When people with coeliac disease are exposed to gluten, their bodies release immune chemicals called cytokines, particularly interleukin‑2, which rises sharply at the same time symptoms appear. This explains why symptoms start quickly and can be intense.
Gluten Exposure: gluten exposure in treated celiac disease leads to rapid immune activation and acute symptoms like rapid vomiting within 1-2 hours, which explains why people with the condition are so careful and why their behaviour is grounded in real physiological reactions rather than preference or anxiety.
Unpacking the Gluten Threshold study: Our recent study examines the smallest amount of gluten capable of triggering a reaction, essentially looking at what happens symptomatically with something as tiny as a single bread crumb. One reason this matters is that gluten‑free standards differ widely across countries. For example, a typical bowl of “gluten‑free” pasta in the United States or Europe can contain about 3 milligrams of gluten. In contrast, Australia has much stricter limits on what can be labelled gluten‑free, meaning people here are exposed to far less gluten overall. Read the study here.
The Biological Response to Gluten as a Coeliac
Importance of a Dietitian when navigating coeliac disease: The most recent international guidelines for managing celiac disease, released by the European Society in late 2025, still emphasise that the only proven treatment is lifelong, strict adherence to a gluten‑free diet. This requirement is recognised as challenging and burdensome for people with celiac disease. The guidelines also stress the importance of referral to a dietitian who specialises in celiac disease. Dietitians play a crucial role in identifying hidden sources of gluten and supporting patients in managing them. Through structured dietary counselling, they help improve adherence to the gluten‑free diet, enhance overall well‑being, and minimise inadvertent gluten exposure. They also assist in detecting unintentional gluten intake and in evaluating persistent or recurrent symptoms that may result from it. In addition, dietitians ensure that nutrient requirements are met and that the gluten‑free diet remains varied, diverse and nutritionally adequate.
Reduced adherence to a gluten‑free diet is often linked to factors such as having no symptoms or only “silent” symptoms, not receiving the right support at the right time from the right people, eating outside one’s usual environment, being an adolescent or young adult whose diet was previously managed by carers, and the perceived or actual costs associated with maintaining a gluten‑free diet.
Foods that are naturally gluten‑free include fresh fruits and vegetables, raw unprocessed meat, poultry and seafood, eggs, and natural or minimally processed dairy products such as milk, cheese and yoghurt. Fats and oils are also safe, along with gluten‑free grains such as rice, corn, quinoa, millet, amaranth, buckwheat, sorghum and teff. Nuts, seeds, and legumes—including chickpeas, soybeans, black beans and lentils*—are naturally gluten‑free as well. *Some products do have a may contain statement
May contain’ statements: Some food labels use ‘may contain’ or ‘may be present’ statements to indicate the possible unintended presence of allergens occurring during food manufacture, such as ‘may contain milk’. This is also known as precautionary allergen labelling (PAL). These are voluntary statements made by food suppliers and the Food Standards Code does not regulate them. Allergen labelling – Coeliac Australia. As quoted in the recent European guidelines we still have a widespread use of may contain statements warning when unintentional cross-contamination during production can not be excluded, complicating assessments for patients. Given this uncertainty, I still advise patients to avoid these products to eliminate the possibility of sporadic gluten exposure. Use this recommendation:
- A Ask coeliac friend/family for a product swap
- B BROW (Barley, Rye, Oats & Wheat) and gluten
- C Check labels for above ingredients
- D Don’t assume or risk if unsure (ask for help)
Prior to grocery shopping: READ What ingredients do you need? PREPARE a shopping list. ASK a coeliac friend for brand tips AND check supermarket’s online website for products. For example: Chicken Stock. Look up brands and read ingredients/allergens on the website
Ask yourself:
- Does it include BROW (barley, rye, oats, wheat)?
- Is the word gluten mentioned?
- Does it have a may contain statement stating BROW or gluten?
Cross-contamination: Science tells us that soap and water are sufficient to remove gluten. Wash utensils and equipment between uses with warm soapy water and proceed to use.
Eating out and catering for gluten-free: It’s the responsibility of the business owner to be able to provide customers with accurate information about the allergens on the menu. Good food safety practices are essential in any kitchen and are vital in the preparation of gluten-free food. Coeliac Australia has a good training model for businesses. However, it is your responsibility as a patron to ask about the practices of these restaurants and if certain menu items are gluten-free when not stated otherwise. Always ask about utensils, shared equipment (e.g. fryers), and added sauces before ordering if you are unsure.
- READ: Research via reliable sources. Coeliac Australia, experienced dietitian, reliable social media sites.
- PREPARE: Look at the menu and review all foods not just GF listed. What is naturally GF on the menu and ask why it’s NOT labelled GF?
- ASK: Call ahead, communicate clearly. e.g. Is the steak cooked on the same grill as gluten-containing burger buns. Can the steak be cooked in a fry pan?
When Travelling: Paula shared several practical tips for travelling safely with coeliac disease, including ordering an appropriate gluten‑free meal on flights (making sure to request a GFML rather than a generic “gluten intolerant” option), understanding which food items can and cannot be taken on board in hand luggage or checked baggage, and preparing an emergency food kit to carry with you. She also recommended travelling with a letter that explains your medical condition. These strategies help guide travellers toward the right information sources, so they can plan confidently and reduce the risk of accidental gluten exposure while away from home.
Stay Engaged
Wesley Research Institute is committed to keeping the coeliac community informed and engaged.
“We encourage anyone interested to follow our research, participate in trials and stay up to date with new developments through our Coeliac Research Network,” Dr Daveson said.
Learn more about our Coeliac Disease and Immune Health Research Program, or if you haven’t already become an active member of our Coeliac Research Network.
Stay tuned for future webinars and research updates as the journey towards better treatments for coeliac disease continues. Don’t miss out, sign up for the next webinar.