Gluten-Free Labeling Is Misused Frequently in Foods Marketed in Northwestern Mexico

Background: Patients with celiac disease (CD) require a gluten-free (GF) diet, including industrialized products containing ≤ 20 mg gluten/kg. The market status of GF food products is almost unknown in Mexico. Therefore, we studied the GF-labeled products on the northwestern Mexican market and analyzed their gluten content. Methods: We searched for GF type of foods in three different supermarkets of each chain in Mexicali Baja California and Hermosillo Sonora and corroborated the price, origin, and GF certification of each item using internet sites. We quantified the gluten in the foods using the sandwich R5-enzyme-linked immunosorbent assay (ELISA) and detected their immune-reactivity for IgA from patients with CD. Results: The study included >263 different GF-labeled foodstuffs, and 55% of them were made in Mexico. The Mexican items were principally flours, sausages, bread and bakery, milk-type products, and tortillas, while pasta, snacks, and breakfast cereals were mainly imported. The cost ratio of GF products to the conventional mean was 3.5, ranging principally from 1 to 13. The most common GF-labeled foods were flours and pasta (34), cookies and snacks (32), breakfast cereals, sausages, and milk-type products (18–20). Although 36% of the products were certified, 17.4% of the analyzed samples contained >20 mg gluten/kg, mainly the non-certified ones and those made in Mexico. IgA from patients with CD reacted in vitro against gluten proteins from the contaminated GF-labeled products. Conclusion: The accessibility of GF products in the northwestern Mexican market is wide; however, such products are expensive, and some could be risky for patients with CD because they contain gluten, which is recognized by the immune systems of these patients.