Gluten contamination in commercially available gluten-free products in Jordan: a cross-sectional market surveillance study with public health implications.

This cross-sectional based market surveillance study examined the level of gluten contamination in commercially manufactured products labelled 'gluten-free' in Jordan and compared the results to the globally recognised 20 mg/kg gluten safety limit for people with coeliac disease and other gluten-related disorders. From August 2022 to November 2024, 182 goods from 25 different food categories were tested in retail locations in Jordan's main governorates. A validated monoclonal-based antibody-sandwich ELISA was used to determine the levels of gluten concentration, and a 95% CI was used to describe the prevalence of contamination. Overall, 47 of 182 products (25.8%; 95% CI: 19.7-32.6%) exceeded 20 mg/kg gluten. With maximum concentrations of 395.8 mg/kg, the highest non-compliance was found in rice-based goods (66.7%), milk products (50.0), and cookies (42.9). On the other hand, with the fact that several categories had rather small sample sizes, no violations were found in any of them. Jordan had a higher rate of contamination than a number of other places, including Europe (0.5%), India (10.8% of packaged items marketed as gluten-free), and Mexico (17.4%). The findings highlight clinically relevant issues with the quality of gluten-free products and support further monitoring, manufacturing supervision, and regulatory actions to better protect customers who depend on strict gluten avoidance guidelines.