I’m Catholic, I’m an immunologist, and I have coeliac disease. So I’m giving this a crack.
This post has some religion [here defined as a concept or belief that cannot be disproved] and some science. For a rational debate to occur, we must accept the co-existence of those two concepts.
Is coeliac disease an allergy?
No. It’s an autoimmune disease. Many people understand that rheumatoid arthritis and lupus are autoimmune diseases, but fail to realise that coeliac disease has a similar autoimmune mechanism causing illness and can lead to multiple organ failure and increased risk of lymphoma if not treated. It is treated by a gluten-free diet because the protein called gluten triggers the autoimmune process. Gluten is found in wheat, barley, rye and oats.
What is the immediate issue?
On 15 June 2017 the Roman Catholic Church’s Congregation for Divine Worship and the Discipline of the Sacraments reaffirmed the ban on gluten-free Hosts for Communion.
Is this a new issue?
No. The Code of Canon Law stipulates the bread must be ‘wheaten’ and ‘unleavened’ and the last 13 years has seen continuing public debate about this issue. The availability of Hosts made of gluten-free cereal, the easy exchange of views on social media, and the knowledge that coeliac disease affects 1-2% of the world’s population (many more undiagnosed) have all made this a trending topic once more.
Can a Catholic receive Communion without ingesting the Host?
Yes. If offered at the Church, a sip of the Consecrated Wine complies with complete Communion. The Catholic teaching on so-called Transubstantiation is that, during the Eucharist, the Host and Wine are each turned into the Body and Blood of Christ.
Is this a practical solution?
No. Only the Host is offered at many churches, particularly those with large congregations.
What if the priest giving the Mass has coeliac disease?
If he is giving the Mass alone (the usual situation), then he is in real strife. The priest offering the Eucharist must, under Canon Law, partake of both the consecrated bread and wine. Failure to do that will render the Eucharist null and void.
What does the Church actually say about the bread used as Host?
“[48.] The bread used in the celebration of the Most Holy Eucharistic Sacrifice must be unleavened, purely of wheat, and recently made so that there is no danger of decomposition.[123] It follows therefore that bread made from another substance, even if it is grain, or if it is mixed with another substance different from wheat to such an extent that it would not commonly be considered wheat bread, does not constitute valid matter for confecting the Sacrifice and the Eucharistic Sacrament.[124] It is a grave abuse to introduce other substances, such as fruit or sugar or honey, into the bread for confecting the Eucharist. Hosts should obviously be made by those who are not only distinguished by their integrity, but also skilled in making them and furnished with suitable tools.[125]“
This letter reaffirms a previous Circular Letter of 24 July 2003 which states:
“Hosts that are completely gluten-free are invalid matter for the celebration of the Eucharist. Low-gluten hosts (partially gluten-free) are valid matter, provided they contain a sufficient amount of gluten to obtain the confection of bread without the addition of foreign materials and without the use of procedures that would alter the nature of bread” (A. 1-2).”
So the concept of not being ‘gluten-free’ as a requirement for the Host was first promulgated in 2003?
There were some documents on this question from the 1980s
Do low-gluten Hosts (as opposed to gluten-free Hosts) allow those with coeliac disease to take Communion?
No. Those with coeliac disease must only eat gluten-free food defined as less than 20 parts per million (ppm).
Note: Please skip the following paragraph unless really interested in numbers.
We need to distinguish disease caused by the total amount of gluten per day and the concentration of gluten per ingestion. The best calculation of the amount of gluten that causes disease is 10-50 mg per day. This is equivalent to 0.5-2.5 KG of ‘gluten-free’ food at 20 ppm per day. But no-one really knows the minimum amount of gluten per day that causes disease. In addition, there is no information known about the concentration of gluten per ingestion that causes disease. I am indebted to Alex Gazzola @HealthJourno for the link to the analysis of low-gluten Hosts made by the Benedictine Sisters. The Hosts weigh 33mg and the gluten concentration is measured at 56.5 ppm, equivalent to only 0.0019 mg gluten per Host. One slice (1 oz) of ‘gluten-free’ bread is 28350 mg weight and at 20 ppm gluten contains 0.57 mg gluten. So the Hosts contain a trivial amount of gluten…BUT:
We know that NO gluten causes NO disease. No-one really knows the minimum level of gluten that causes disease.
We have a feel for the total gluten amount per day that might cause disease, but we have no idea of the concentration of gluten that might cause disease.
Is a certain amount of gluten the ‘sine qua non’ of wheat?
No. Wheaten means made from wheat. Wheat is defined by its derivation from a specific genus of botanical grass called Triticum. The amount of gluten does not define wheat, so that for example 15 parts per million (which is ‘gluten-free’ to a person with coeliac disease) is enough to call it wheat.
Well, would genetically-modified Triticum that contained less than 20 parts per million gluten comply with Church Law?
Yes. It would and it does.
Does this mean that it is possible to make Hosts for Communion that both comply with Church Law and allow ingestion of what is called a ‘gluten-free’ product by the (minimum) 12,000,000 Catholics with coeliac disease?
Yes
And you did say that no-one knows the minimum level of gluten that causes disease?
Yes
And there are many people who object to genetically-modified food?
There are. And there are many who support the notion of genetic modification of food that increases its acceptance, and/or nutrition. GM food is a separate argument.
Is there an easier and safer way?
Yes. The Congregation for Divine Worship and the Discipline of the Sacraments, in consultation with the Pope, could grant dispensation to those afflicted with any severe medical condition that does not allow the ingestion of unmodified wheat so that those people could ingest a consecrated Host made from a non-gluten cereal e.g. rice.
After all, when I was a child, disobeying the Church by eating meat on Friday was considered a grave (mortal) sin. Yet Pope Paul VI, after Vatican II, on Feb 17 1966 (incidentally the day I started my medical course) in his PAENITEMINI (Apostolic Constitution On Penance), writes that Bishops could now (Chap 3): “Substitute abstinence and fast wholly or in part with other forms of penitence and especially works of charity and the exercises of piety”. This decree allowed the eating of meat on Fridays, which previously had been a grave sin, by substituting an ‘exercise of piety’.
By the way, does this mean that those with a true wheat allergy causing anaphylaxis (as opposed to coeliac disease) would be able to ingest gluten-free Hosts made from wheat?
No. True wheat allergy is a completely different disease and can be triggered by various wheat proteins. In some cases it is a co-factor with exercise and can lead to profound anaphylaxis. Complete avoidance of wheat is needed. Those with wheat allergy would have to partake of the wine only.
Would I accept a role as Consultant Immunologist to the Roman Curia if asked?
Is the Pope a Catholic?
