Medical Advances to Change the Face of Gluten Free
Opinion | 24 Oct 2012
Gluten-free food is flourishing, with strong growth set to continue over the next few years. In the medium-to-long term, however, two major medical developments currently in the pipeline will exert a lasting impact on the gluten-free food market: the cheap and rapid diagnosis of celiac disease, followed by the long-awaited vaccination against the disorder.
Gluten free market explosion
Our latest health and wellness data show that, on a global level and based on fixed 2012 US$ exchange rates, gluten-free food experienced a 76% value sales increase over the 2007-2012 review period, reaching US$1.8 billion. In North America, sales more than doubled, in France they tripled, and in New Zealand, they rocketed by 426%. In Western Europe, where the category is most developed and where half the global sales are generated, value rose by a respectable 54%.
Gluten free’s distribution channel breakthrough was accompanied by a transformation from cardboard-textured buns and loaves and pasta of rather pallid appearance to a wide range of bakery and other food items just as pleasing to the palate as their standard, gluten-containing counterparts. Premium pricing has made gluten free an attractive diversification option for brand manufacturers and private label alike.
A divided world
As for gluten-free consumers, there are essentially two types; those medically diagnosed with coeliac disease (an allergy to gluten that damages the intestinal lining), and those who believe that gluten avoidance will result in a wide range of health benefits, including weight loss and higher energy levels. And although there is, as yet, no sound scientific basis for the premise that gluten is in any way detrimental to the wellbeing of non-coeliacs, the concept has gained immense traction, not least through endorsement by a growing number of celebrities in recent years.
While coeliac disease sufferers cannot tolerate any gluten at all and often have a tough time selecting suitable packaged food, particularly when eating out, the second group tends to be less stringent about its gluten-avoidance strategies. These consumers may, for instance, be fairly committed to purchasing gluten free for their weekly grocery shop, but not worry too much if there is no gluten-free food option on a restaurant’s menu, and they will happily indulge in the occasional slice of gluten-laden birthday cake, for example. Often, they will opt for products labelled ‘wheat free’, a category which has seen significant growth on the back of gluten free.
As a result, gluten free is also divided. On the one hand, there are genuine gluten-free products, usually carrying a gluten free label, and then there is another, much larger group of items, whose main ingredients are free of gluten, but which are liable to contain a minor additive with traces of gluten, and/or which may have been subject to accidental gluten contamination somewhere along the production process.
Breakfast cereals are a case in point. Corn and rice, for example, do not contain gluten, and hence one might assume that corn flakes and puffed rice cereals are gluten-free, but this is not necessarily the case. Due to auxiliary ingredients and/or gluten-containing grains (like wheat, barley and rye) being processed into breakfast cereals (and other bakery products) on the same production lines as non-gluten containing grains, traces of gluten can end up on the finished product. Kellogg, for one, cannot vouch for the total absence of gluten in its iconic Cornflakes. And although a growing number of mainstream bakery products manufacturers, like General Mills, have launched gluten-free ranges, including breakfast cereals, in recent years, many shy away from the investment required in setting up separate production facilities to avoid cross-contamination.
Accidental cross-contamination poses a particular problem in foodservice, where supposedly gluten-free foods and beverages are prepared on the same work surfaces using the same utensils as gluten-containing products. Starbucks and Domino’s Pizza are two high profile foodservice companies that have come under fire for their supposedly freshly prepared “gluten-free” hot beverages and pizza crusts in the past.
On the brink of a diagnostics revolution
Once thought to be a very rare disorder, it has now been recognised that coeliac disease affects about 1% of the population. This means that there are around 70 million coeliac sufferers across the world. However, most are not even aware that they are affected, and that their general malaise and unpleasant symptoms are down to a disease which compromises their digestive systems, rendering them unable to absorb sufficient nutrients from their diets.
Widespread lack of awareness in the medical community, compounded by complicated and costly means of diagnosis involving digestive tract tissue biopsies, have made a swift and accurate diagnosis of coeliac disease virtually impossible. Even within the European Union with its comprehensive and low cost (to patients) medical services coverage, only one in seven sufferers is accurately diagnosed, and it can take over a decade before a conclusive diagnosis is reached.
Fortunately, this is changing. In 2012, a four-year €12.8 million European Commission-funded project finally came to fruition. Soon, this breakthrough will allow a diagnosis to be made cheaply as well as rapidly, involving just a drop of blood applied to a so-called lab-on-a-chip-device.
This revolutionary new technology, developed by 19 partners including Kings College London, is called DC-Medics. It will be officially presented at MEDICA 2012, the largest medical trade fair in the world, due to take place in Düsseldorf, Germany, in November 2012. The project leaders expect the product to be market ready within two years.
Vaccine in the pipeline
The second medical milestone, which has the potential to significantly reshape the gluten-free market in years to come, is the development of a vaccine. To this day, coeliac disease is an incurable auto-immune disorder, which can only be managed by strict gluten-avoidance. But now there is a ray of hope on the horizon for millions of sufferers: In September 2012, US-based biotechnology company ImmunsanT reported that it had commenced clinical trials testing its Nexvax2 vaccine.
Nexvax2, according to the company, works by modulating coeliac sufferers’ immune systems into developing a tolerance to gluten, eventually allowing people to return to a normal diet without suffering any further ill effects. The company expects the vaccine to be potentially effective for 90% of coeliac sufferers. The stipulated year of release is 2017.
Gluten-free boom to continue indefinitely?
What do these new medical developments mean for the future of the Gluten-free Foods market? Well, in the short term, no significant changes are expected. We predict that over the 2012-2017 forecast period, global value sales are to rise by another 30%, equating to a CAGR of just over 5%. This is less than the double digit CAGR achieved over the review period, taking into account the impact of the global recession, encroaching market saturation in the most highly developed packaged food markets, and the gradual waning of the gluten-free celebrity trend, which has just about reached its peak by now.
The impact of the diagnostics revolution is unlikely to be felt before the end of the forecast period. The widespread dissemination and adoption of the novel DC-Medics technology across EU – and, eventually, worldwide – healthcare systems will require investment, training effort and, above all, time.
Once the number of medically diagnosed coeliac sufferers starts to rise in half a decade or so, this group may provide a counterbalance to the shrinking base of consumers adhering to the gluten-restriction trend. For the industry, this will mean a continued demand for bona fide gluten-free foods, but less of a market for those exposed to potential cross contamination or containing traces of gluten for other reasons, including wheat free options.
Looking ahead even further and assuming that the vaccination approach will prove effective, the number of coeliac sufferers may fall significantly. The practice of strict gluten avoidance is very onerous and socially restrictive, so most coeliac sufferers who have access to this kind of treatment are expected to venture down this route.
However, the total elimination of the disorder among the global consumer base is unlikely, as coeliac disease is caused by a range of genetic issues, not all of which may benefit from desensitisation treatment. Even among the 90% of sufferers, who, according to ImmusanT should respond to its Nexvax2 vaccine, a proportion may never develop the desired gluten tolerance. More insight into the success rates that are likely to be achieved in clinical practice should be gleaned once ImmusanT completes its clinical trials.
Given this, there will always be a market for gluten-free products, although growth rates are likely to level off in the medium to long term.
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