Gluten Free Restaurant Study: Dissected

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It feels like the headlines are repeated daily. “Gluten Free Restaurant Foods are Unsafe,” or some such wording. Emotion invoking, attention grabbing headlines. However, how accurate are they? While I am no “scientist,” nor do I have a PhD, I want to share concerns I have about the recent gluten free restaurant study. So please hear me out as I explain why.

Gluten Free Restaurant Study blackboard

So, I realize my viewpoints may not be popular. However, I went to school to be an educator. My “job” is to provide others with an education, so they can be informed and have all the tools at their disposal to make decisions.  But I digress. As much as I want to be your friend, I always want to be a honest source of information. In the end, we can agree to disagree on issues. I just want to provide another viewpoint on the gluten free restaurant study.

Also, I want to make this clear. While this gluten free restaurant study was conducted using the NIMA gadget, this piece isn’t really about NIMA. This is a piece on critical thinking, about seeing beyond the catchy headlines. Many of us feel concerned about eating at restaurants. Some may have had bad experiences. I’m not saying that improvements in dining safety can’t be made.  However, when a headline reports a high percentage of restaurants (30%)  are making mistakes, I think we need to ask where that number is coming from, and how.

The Scientific Method

I forget when I learned the Scientific Method. Sometime in elementary for sure. Basically, the scientific method provides a “flow chart” of steps on how to conduct a study. We start with an observation, then formulate a question. Observation- People with Celiac Disease worry about eating safely in restaurants, Therefore, a good question would be “Are restaurants preparing gluten free food safely?” Next step – Hypothesis. Based on concern, we could formulate  that “food in restaurants contain more than 20 ppm of gluten.”

Next, experimentation to test this hypothesis. But how did Dr. Benjamin Lerner conduct his gluten free restaurant study? His data set includes results shared on the NIMA app, where users choose to self report their test findings. NIMA is a gadget consumers use to test a small sample of food on their plate. People can choose to (or not) share the data with its affiliated phone app. NIMA is not approved by the FDA as a medical device, and not recommended by the Gluten Intolerance Group.

NIMA Gluten Free Restaurant Study Controls and Variables

But let’s go back to the scientific method. What are the proper protocols for experimentation? Science Buddies, a science non-profit geared toward helping school age students learn about science states– “Test Your Hypothesis by Doing an Experiment:” It is important for your experiment to be a fair test. You conduct a fair test by making sure that you change only one factor at a time while keeping all other conditions the same.”

In other words, we should only have ONE variable, one change. In a study, only one aspect should differ from all other tests. However, there are multiple variables in this study that cannot be controlled. Here are four that concern me the most.

Gluten Free Restaurant Study Concern One – Testing Personnel & Practices

A report on this study by Health Day stated “800 investigators set out to assess the true gluten content of dishes.” To the layman, one might think that these are 800 researchers. Nope, they are every day people like you and me. Were they given the same thorough training on using the NIMA gadget? Did they all use the exact same food sample size? This is an important question to ask. Why? NIMA reports that if one uses too large of a sample, it can result in a false positive or negative. Also, NIMA doesn’t test for malt. Read more here about why that causes a headache.

Gluten Free Restaurant Study Concern Two- Testing Devices

Dr Benjamin Lerner states he crowd sourced data from the NIMA app from 804 users. Therefore, testing in the study utilized (theoretically) 804 separate NIMA units to conduct “more than 5,600 gluten tests over 18 months.” (Health Day) Did users keep their store their gadgets in safe environments? Is it possible some may be defective? This is a factor that can’t be monitored.

Nima Data Table
Screenshot from Previous Third Party Validation Performed on NIMA Gadget Itself

Gluten Free Restaurant Study Concern Three- Testing Accuracy

 NIMA states their gadget returned a “gluten found” over 30% of the time in samples containing 5 ppm of gluten. This is way below the FDA requirement of 20 ppm. Yet, Dr. Ben Lerner bases the conclusion of his study, stating “one-third of restaurant foods labeled GF contained at least 20 ppm of gluten.” However, the NIMA gadget only gives a “gluten found” or a smiley face. Not a numerical value. Therefore, is it possible that some of the “gluten found” results consumers are receiving may actually be under 20 ppm? Possibly. (For more on the independent study on NIMA effectiveness, please see this post from Gluten Free Watchdog that breaks down NIMA’s report on their accuracy.  )

Gluten Free Restaurant Study Concern Four- Testing Motivation

Motivation. I do not doubt that Dr. Benjamin Lerner cares about his patients and the advancement of Celiac Disease treatment. I do however have concern that the co-author of this paper is the CEO of NIMA. In addition, two of the additional doctors in this study sit on the NIMA advisory board. All in all, I find this to be a major conflict of interest. The data presented in this study will cause people, in my opinion, to be afraid enough of what they’re eating.  Afraid enough to buy a NIMA device to “save” them.

NIMA gluten free restaurant study conclusion

Drawing a Conclusion

In conclusion, I have concerns about this gluten free restaurant study. One, simply because I feel testing methods aren’t scientifically accurate. There are simply too many variables and not enough controls. Too many “what ifs?” However, my biggest concern is the (undue) fear that this study may create. Especially when newspapers lead with headlines “Your Favorite Gluten Free Restaurant Might Be Lying To You” by the New York Post.  Whether intended or not, I feel this study creates animosity between restaurant owners and diners. And don’t we have enough division in our world as it is?

If you’ve reached this point in my post, I thank you. This is a long article, and you may not agree with me. That’s ok. Hopefully I laid out my concerns methodically, and respectfully. I want us all to be informed, and not be controlled or manipulated by fear or anxiety. Should you like to further opinions on the issue, I highly recommend this post from Gluten Free Watchdog, and why she cautions panic from this study and related headlines.

I’d love to hear your thoughts on this as well. Please feel free to share your own respectful thoughts and ideas. 

5 Comments

  1. Thank you for this straightforward analysis and breakdown of the issues. Interesting, not long (or it didn’t feel so – I read to the end) and worrying.

    Aside from the fear this sort of reporting must generate among gluten-sensitive diners, I also worry for the effect it might have on food service providers. Are those who already provide GF options who read these reports going to be motivated to carry on doing so? Are those who don’t provide GF options going to see them and think it’s just not worth the hassle to begin to do so?

    I fear so.

    1. Dear Alex,
      Thanks for reading thru it all!
      I agree with your concerns, in addition to restaurants being maligned by NIMA results, when in fact the dishes do test below 20 ppm. I’ve worked with too many wonderful restaurant here in the states to allow their businesses to be hurt by inconsistent technology.

  2. I bought a Nima in May hoping it would help our daughter with celiac eat safely at restaurants and eat processed GF foods safely because she has very very delayed and gradual reactions to gluten. For the past 5 years she was frequently feeling bad and getting elevated bloodwork showing she was getting gluten. We could never ever identify any of the foods that were contaminated (our house is even 100% GF). Sadly even after using Nima while going to restaurants and testing packaged processed GF foods… after 4 months her symptoms were back and her bloodwork was elevated again. We went back to no eating at restaurants and no processed GF foods and all her symptoms went away. All I know is it seems like my daughter got small amounts of gluten repeatedly while using Nima. I wish Nima could become more sensitive, reliable, and accurate so my daughter can safely eat at restaurants and safely eat processed GF foods. I really hope a treatment for celiac is discovered soon so she does not even have to worry if she does get gluten. We will get her bloodwork checked again in several weeks to see if it has normalized after going back to only eating non processed gf foods at home. She feels really great while only eating non processed gf foods at home… but that is not very easy to do.

    1. Dear Margaret,
      Thank you for sharing your story. I too was excited when NIMA launched. I even organized a Skype interview with the staff for our entire Flint, MI area celiac disease support group. However, as more became known, I realized it was not all that I had hoped it would be. I also wish they could find a cure, or long term treatment, for this disease. Glad to hear that your daughter is doing better, but sorry that it has become so difficult for her.
      Sincerely,
      (Another) Margaret

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