Imported foods sold in Australian supermarkets and labelled as "gluten-free" do not comply with Australian standards, prompting renewed calls for an international standard defining the true meaning of "gluten-free".
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Taste test: sugar, butter and gluten-free desserts
They may look like the real thing, but these desserts cater to those averse to the things desserts are usually made of. So are they any good?
In an analysis of 169 imported food products labelled "gluten-free" published in the The Medical Journal of Australia, researchers detected gluten in 24 products, albeit in "extremely low levels".
Crackers, bread, biscuits, cereals, flour, grains, condiments, sauces, spices, pasta, drinks, soups, snacks and confectionery were among the products tested, originating from Europe, Asia and North and South America.
"Saying that something is truly gluten-free is almost a misnomer," said Professor Geoff Forbes from the University of Western Australia, who conducted the research with Ken Dods, from Perth testing facility ChemCentre.
"There is an incredibly small amount of gluten in any food. It just depends what is a practical amount to be included and for a coeliac patient to be exposed to. But coeliac patients should feel safe consuming most 'gluten-free' products in Australia."
It comes after Coeliac Australia reissued its support earlier this year for the Australian standard, which states that products labelled ''gluten-free" must contain no detectable levels of gluten.
The peak body had previously supported plans by the Australian Food & Grocery Council (AFGC) to apply to relax Australian standards, in line with more lenient codes in Europe.
Coeliac disease is a condition that causes the immune system to react abnormally to gluten, a protein found in wheat, rye, barley and oats. It affects around one in 70 Australians.
Coeliac patients who ingest gluten can experience abdominal discomfort, poor absorption of certain nutrients and changes in bowel habits.
But Professor Forbes has described the national standards as "impractical", arguing that restricting gluten levels to less than one part per million (ppm) would sufficiently protect the majority of coeliac patients.
"To put it into perspective, in one slice of ordinary bread there are 2.5 grams of gluten. One ppm is the equivalent of one 5000th of that slice of bread," he said.
"Allowing for 1ppm is not about being more lenient, its about being more practical. I think what happens at the moment is, when foods are tested and found to have very low levels, authorities ignore it. We have a standard which is set but it's not complied with."
In Europe and the United States, the standard is less than 20ppm, or 20 milligrams of gluten per kilogram.
The WA study assessed the compliance of imported "gluten-free"-labelled foods with the local food standard, as well as the international capacity of industry to comply with Australian standards.
While it found 14 per cent of products were non-compliant with the current Australian standard, none contained levels of gluten greater than 1.1ppm.
A spokesman for the AFGC said it was yet to make a formal submission to Food Standards Australia New Zealand, requesting a standard of 20ppm.
"We need to ensure consumers are fully informed and that there is a safe level based on best science," he said.
"We want to make sure companies who invest in these products now can continue to make 'gluten-free' claims as detection technology improves."
Professor Forbes said he felt "very strongly that there wasn't evidence to support" a move to the European standard, insisting that, "if Australia can achieve a gluten-free threshold of close to 1ppm, then there should be no reason other countries can't follow suit".
Coeliac Australia's current perspective was informed by the 2016 Cochrane Review on the Safe Level of Gluten, which concluded that "a safe threshold level of gluten intake for people with coeliac disease could not at present be defined, a finding consistent with the current Australian standards".
"Coeliac Australia supports the current ... definition of gluten free, that is, nil gluten detected, until further research becomes available defining a safe level of consumption for coeliac sufferers," said president Michael Bell.