A lot of opinions and heated discussions have been occurring surrounding the Nima gluten sensor. Honestly, I see valid points on both sides, and I wanted to weigh into the discussion to help those considering a Nima Sensor make an informed decision.
Because there is so much being said and written about these portable gluten detection devices, I want to make sure I address it all. That means this post is very long, because well… there is a lot to be said about this device, the purpose behind it, how accurate it is, the research behind it, the limitations of it, the health risks, and the overall community response.
First things first, let’s start with the basics… What is a Nima Gluten Sensor?
Nima gluten sensors were developed by the brand Nima, to provide people with a portable device that can detect gluten. Essentially, using this device you can test and see if foods contain gluten within just 2-3 minutes. All it requires is that you place a pea-size amount of the food you want to test in the Nima gluten test capsule, twist the lid shut to grind the food, let chemicals in the capsule mix with the food, and then the sensor will give you a result with in minutes.
This sounds amazing in theory, with it being difficult to trust food labels and restaurants, how amazing is it to have a device take the guesswork out of the equation?
Especially when research such as this study from 2014 found that celiac disease has been researched to have a poor quality of life score comparable to end-stage renal disease and above all other compared chronic diseases.
There are a few things, however, that I think are important to consider with Nima sensors, that I’ve yet to see Nima supports address. But more on that later, now you’ve got the quick and dirty on what a Nima gluten sensor is. So if you’ve been wondering if there is a device that can detect gluten in food, there is, but keep reading because there are some important things you need to know about it.
So we’ve established quality of life is low with celiac patients, and that there’s a lot of guesswork assumed by celiac patients in determining the gluten-free safety of foods. Add all of that on top of the fact that patients often aren’t given the proper follow-up care and education sufficient to help them change their entire life to be celiac-safe, and the appeal of the Nima Gluten Sensor is understandable.
After all, when you aren’t sure what to look for on a food label to make sure it’s actually gluten-free or you don’t know what to ask for at a restaurant to make sure you get safe food, then a device that offers you reassurance is extremely appealing. And even if you do know how to do all of these things, a device the double checks could be helpful, at the very least offer total peace of mind.
Did you think Nima Sensors were discontinued? A lot of people thought so too after the owner, Shireen Yates sold the business to Medline and all outlets of purchasing the product were ghosted. Then in 2021 Nima Sensors relaunched under new ownership with Medline as Nima Partners and is now back in business.
The limited research we have on the Nima Gluten Sensor shows that the Nima sensor is accurate in identifying gluten in samples of foods in most cases (we’ll talk about some outliers later). In fact, in some cases it can be TOO accurate in all the wrong ways.
The key here is that the sensor is accurate in detecting gluten in most samples, but first, these samples aren’t representative of the entire food, and second, the accuracy of gluten detection is more sensitive than needed in some cases, and not sensitive enough in others. I’ll talk more about what I mean by this with the research later on…
Let’s take a break from talking about the Gluten Nima Sensor for a minute, and let’s talk about the federal definition of gluten-free for food labels. As I am writing this, the USA FDA defines gluten-free as food products with <20 parts per million of gluten with no gluten-derived ingredients (unless such derived ingredients are tested to <20ppm individually).
This is not some imagined number of safety, this is supported by research and is a standard that many countries follow. This is also, impressively, something that is noted in the 2019 research study featuring 15/16 Nima employees.
Essentially, researchers conducted studies where they determined that intestinal damage with celiac disease can occur when someone with celiac eats anywhere from 10-100mg of gluten. And to err on the side of caution, researchers developed the 20ppm standard to protect those who could be triggered by the minimum 10mg/day number. To put this in perspective, for someone to eat 10mg of gluten when eating gluten-free foods that test at exactly 20ppm of gluten, they would have to eat the equivalent of 17 slices of gluten-free bread in a day.
And I would argue the 20ppm limit not only protects the integrity of our small intestine, but also protects our mental, emotional, and social quality of life. Because eating foods with even smaller parts per million of gluten leaves zero room for error, heavily restricts our diet even more, and honestly, has not been clinically proven necessary except for in a very small percentage of the population, and even then, interventions that restrict beyond 20ppm are generally temporary.
Summary: The 20 parts per million limit of gluten in gluten-free food has been clinically proven to keep us safe and is not the government trying to pull one over on us but merely trying to make it easier to live in a gluten-centered world not built for us.
Okay, back to Nima gluten sensors… In opinion pieces on the Nima Gluten Testers, I see many people talking about the need to be aware of the limitations of the Nima sensor, but I struggled to find anyone who clarified them. However, studies highlight the very real limitations of this device, and Nima confirms them.
Additionally, there is a lot to unpack when it comes to the research of Nima Gluten Sensors and the concerns that come with the studies. In the next few sections, I will be citing the same studies over and over, simply because there are so few studies and each study validates several key points. Please stick with me here as I try to keep this section as easy to read as possible.
All that said, let’s talk about the limitations of portable gluten detection devices.
The first limitation of the Nima sensor is that the device was confirmed to not be able to correctly detect gluten in fermented foods like soy sauce and barley malt. Now, this would not seem like a big deal, and honestly, this is the least of my concerns.
However, it’s important to note that in a 2019 author manuscript of a study on benefits and barriers of Nima sensors, they found a knowledge deficit in 30 participants who were instructed on how to use the device. Many of these participants were unable to remember what foods Nima sensors could not accurately detect gluten in, despite participants receiving training. “[T]his knowledge deficit is concerning, and would likely be even greater among the general population” the study noted.
Additionally, in this 2018 study, they found that the Nima detection device poorly detected gluten in bread, pasta, and corn puffs at above 20ppm, not reaching ~97.5% detection until 40ppm. However gluten in other food categories were accurately detected at 20 ppm of gluten in 96.5% of occasions. This is another area where celiacs need to remember, in these foods (bread, pasta etc.) results may not be accurate.
In the 2019 study conducted by 15/16 Nima employees, they acknolwedged they could not accurately assess gluten-free status of pure guar or xanthan gums as they interfered with LFIA development. And they could not accurately test some salad dressings and some yogurts as they interfered with strip development.
Again, this isn’t the biggest deal if you remember limitation. However, it’s important to note while I unpack the research. Because right off the bat, there are already signs of difficulty in accurately using or interpreting results. With better awareness, I’m sure this limitation of the device and user error could be reduced and for now, it’s important to note.
Another limitation of the Nima gluten sensor is that it defines gluten-free as <2ppm. Yes, you read that right, NOT the researched safety level of <20ppm, but <2ppm.
The 2019 study conducted by mostly Nima employees stated that “For foods without gluten, which we defined as <2 ppm, the device should report a GF result” then then proceed to say “the need to guarantee detection of 20 ppm with a wide range of foods and weights meant the device was not able to distinguish among foods containing gluten at 3–19 ppm”. That means the Nima Gluten Tester can flag a food to contain gluten at less than the generally considered safe <20 ppm limit (remember, this is the researched and proven amount safe for celiacs).
This was confirmed in the 2019 author manuscript where gluten was accurately detected at 5ppm ~35% of the time and at 10ppm ~56% of the time. (By accurately detected I mean, the device reported there was gluten in the product, despite the product have <20ppm of gluten).
And another 2018 study found the same thing. They cited the device to be so accurate in detecting gluten in samples that it detected gluten in foods at 10ppm of exposure in 44 out of 78 subsamples (at a rate of 56%) and it detected gluten in foods with <5ppm of gluten in 21/78 subsamples (a rate of 28%).
Nima justifies this high sensitivity of gluten detection of <2ppm equaling gluten-free (which is far beyond federally declared safe amounts) as necessary to be able to detect levels of 20ppm. They continue to cite consumer reports of wanting to be notified of any amount gluten detected.
This is a big problem, especially since in that 2019 author manuscript mentioned above, 87% of adults reported having the Nima sensor indicate “gluten-found” in gluten-free foods. Of those 87% of adults, 77% reported always trusting that finding despite training. Meaning these products they tested could have very well been gluten-free and met gluten-free FDA standards, but the NIMA sensor is so sensitive it is scaring these people away from these foods.
And this was feedback some people in the 2019 study on benefits and barriers to the device gave, they said some participants “felt the device to be too sensitive for their personal needs. Users should be aware of Nima’s limitations, particularly for foods with gluten levels close to the 20 ppm cutoff”.
A big issue I am seeing across the board from those who oppose and those who support the Nima Gluten Sensor is that no one is talking about hypervigilance. Which is a big problem I see with this <2ppm definition of gluten-free. More on that later…
Another big concern is that the Nima Gluten Sensor has been researched to provide varied results depending on the user. And not just in the general public, but even in the lab with trained researchers who are in a controlled environment.
In the 2021 study “A Portable Gluten Sensor for Celiac Disease Patients May Not Always Be Reliable Depending on the Food and the User”, they found that despite researchers having detailed training on how to use the device, there was high variability in results depending on the user. This 2021 study, by the way, was the only study I could find that didn’t have Nima employees involved. I find it very interesting that the only study without any Nima affiliation had trouble with controlling the testing variables…
Regardless, this variance in results based on the different users is a documented challenge in the 2019 Nima-funded research, with them writing “we specified clear instructions in our User Manual and the Start Guide, encouraging users to put in a pea-sized amount. However, as with other consumer devices, not all users followed the instructions, leading to wider weight variations in the field”. I must admit, I see a lot of people on the internet filming their Nima tests, not using pea-sized amounts for testing…
What’s also interesting is this 2019 research article is cited by some Nima supporters to be third-party scientific data, yet only 1 out of the 16 authors was NOT employed by Nima, this is definitely a conflict of interest.
Regardless, the variance in results based on who is using the device brings up valid concerns. It’s not a matter of if people are too “hysterical” or if they can be “trusted” to use these devices. Instead, this high variability in results is a very real issue not just impacting the general public (as even acknowledge by Nima) but one that has also been documented and observed in the most controlled setting with the most trained professionals (who are not Nima affiliated).
Lastly, another limitation of the Nima gluten sensor is that it only tests one small portion of the food with many users only testing the food once. This is another limitation Nima themselves acknowledges in their 2019 study where 15/16 of the researchers were Nima employees.
In this study, it’s noted that “[o]nly a small portion of foods can be tested per dish or per package. If gluten contamination is not distributed evenly within the same sample (homogenous), the portion tested will not reflect the entire serving”. And in almost all real-world cases, gluten contamination is not going to be evenly distributed throughout the sample or food.
Basically, here they are acknowledging that the ppm status of the entire food is what matters and that testing with Nima only gives you insight into a small piece of that food. So yes, their testing is highly accurate in detecting gluten in a small sample but remember, that small sample does not accurately depict the entire food. Whereas sandwich ELISA testing involves a bigger picture of the entire food status with multiple tests taken.
But they go on to say ELISA testing can be inaccurate too, with one study showing inconsistent results of <5ppm->160ppm and implying that this is just the nature of testing. However, this study on ELISA testing was done to convey the importance of repeated tests of foods as single tests, even with ELISA where you grind and mix amounts of food to represent the entire food, can be unrepresentative of the true ppm amount.
First, saying ELISA also can be inaccurate as a defense for the Nima device being inaccurate does not make it any better. And also, it almost seems as if they misrepresented that study on ELISA inaccuracies to try to justify the limitations of their own device. Do not mistake the difference in testing here: ELISA better represents the status of the entire food, Nima is just testing a small piece.
And I totally understand if you consider all of these limitations and you decide it’s still worth it, but please hear me out on a few more things…
While not a researched limitation of the Nima sensor, I feel like I do have to address the concern of cost when it comes to the testing capsules. Listed at $39.99 for 6 capsules on their website, this works out to be around $6.67 per capsule. That’s adding a $6.67 price tag to whatever food you test.
Honestly, though, $6.67 per Nima test capsule can easily be deemed worth it to those who use the product if it reassures them of safety. However, we have to acknowledge the privilege required to use or rely on this product without feeling a financial burden.
This isn’t meant to guilt or shame anyone for having or not having privilege, but it is to point out another limitation: the limitation of accessibility. Especially if that accessibility impacts proper usage of the device. For example, this 2018 study suggests taking duplicate samples of certain foods like bread, pasta, and extruded snacks to improve reliability, as this device has limitations in detecting gluten in these foods. But at $6 a test, how many people will take 2 or 3 tests?
And in acknowledging the cost of a Nima sensor we also need to acknowledge the privilege of accessing any kind of support with celiac. With lack of insurance coverage to lack of referrals for proper follow-up care, it can be largely inaccessible to get any help with celiac. Health care in general, unfortunately, is a huge privilege and I try to acknowledge that often.
Know that there are many free resources out there to help too, like gluten.org (who also has expressed similar reservations on the Nima sensor due to limitations discussed) and beyondceliac.org.
All of this to say, I can see when the Nima gluten sensor may be helpful.
For example, for those who live in countries with lack of awareness or regulation of gluten-free foods the Nima sensor may be considered better than nothing.
Additionally, some may find it helpful to use it as “proof” in social settings where people doubt their needs. And in this case, I’m holding space for the lack of respect there is in people words around their medical needs. It’s awful to even think you’d need a device to prove what you already know that you need.
There may be other cases too that I have not yet thought of. If you’d like to share your thoughts, feel free to contact me.
I have never been gifted a Nima sensor, I’ve never been gifted testing cartridges, I have never been paid by Nima, I’ve never been affiliated, and I also make zero money off of selling test results of products.
There’s a lot of shade thrown in this conversation at professionals who are just trying to fight for what they believe is right. So I have a lot of empathy for that but seriously, I really have no skin in this game.
And personally, I have kept my mouth shut for too long, and by doing that I’ve been complacent in allowing hypervigilance to spread. Because here is the thing, promoting a device that has been proven to give positive gluten contamination results at clinically proven safe amounts, without acknowledging that very real limitation, is promoting hypervigilance.
It’s promoting hypervigilance because this level of obsession with staying gluten-free beyond what’s clinically proven as safe fosters fear, distrust, and an excessively restrictive lifestyle for most people with celiac. Because if they can’t trust a gluten-free certified food because the Nima sensor is detecting gluten at safe levels (which certifiers test between 5, 10, and 20ppm depending) then what can they trust?
And yes, avoiding products testing at 5, 10 or even 18ppm is excessively restrictive with celiac. It’s excessively restrictive because we do not need to eat food with <2ppm of gluten in it! Even the gluten-free certifiers don’t even test to 2ppm. And I worry that people with celiac will continue to blame smaller and smaller gluten ppm amounts for continued symptoms without considering other triggers.
As mentioned, I believe there is a real risk in the Nima gluten sensor promoting hypervigilance in the celiac community. And that’s a piece of the conversation I have not seen anyone address.
For reference, hypervigilance with celiac disease is an extreme obsession over living gluten-free. Often with people making fear-based decisions as opposed to cautionary ones. Hypervigilance with celiac disease can look like avoiding otherwise celiac-safe foods (*coughs* Nima *coughs*), isolating yourself from social and life events, and other forms of avoidance.
And it makes sense that Nima defined gluten-free as <2ppm based on the following statement from their 2019 article,
“The need to guarantee detection of 20 ppm with a wide range of foods and weights meant the device was not able to distinguish among foods containing gluten at 3–19 ppm. We performed user studies to better understand the impact of such uncertainty on consumers and concluded that most would be happy for the device to report any gluten”.
Basically, users who want to use this device already have a history or are at risk of hypervigilance and are using this device to cope (that might have stung to read if you’re a Nima user and I encourage you to get curious about it). So naturally, they want a device that indicates any amount of gluten and Nima is giving them that, regardless of if the amounts are clinically proven as safe.
In this way, this device is enabling hypervigilance and could perpetuate fear and distrust of products as it marks clinically proven safe food as gluten contaminated, giving the user no way of knowing if it’s contaminated at safe or unsafe levels. In some ways, there’s also a risk for dependency on this device if a certain level of distrust in food grows beyond someone’s ability (or trust in their own ability) to determine if a food is safe or not using their own knowledge and skill.
Hypervigilance with celiac disease is very serious, Nima Gluten Sensor involvement or not. And, I know many celiacs brush off the concerns of hypervigilance but I urge you not to.
First, hypervigilance is directly tied to poor quality of life according to this 2018 study conducted on celiac teenagers. And according to another 2018 study on Coeliac Disease Food Attitudes and Behaviours, hypervigilance is a key player in disordered eating in celiacs. In fact, I’d go as far as to say it is disordered eating.
So personally, as a dietitian who works hard to help celiacs heal and prevent hypervigilance and disordered eating, I have to highlight and emphasize the very real limitations of these devices. I also have to acknowledge my bias as a specialized provider here. Because I specialize in hypervigilance, I am more attuned to identifying potentially triggering situations, and sometimes I can be overly cautious. But more on that later…
Nima gluten sensors may be highly accurate in detecting gluten in samples, and as laughable as some might think it is, that is exactly where I draw my biggest issues. And it’s important to make it clear here: Nima is accurate in the wrong way. Nima can accurately detect gluten at alarmingly low parts per million that are deemed safe. All while not accurately representing the entire food. And in some cases, not being accurate enough in other foods (which p.s. can you remember which foods those were? Asking to semi prove a point here).
And I don’t think the risk of hypervigilance, fear, and growing confusion around food caused by detection that indicate gluten but are at safe levels is any bit a laughing matter nor is it ridiculous to be concerned about.
And if you want to say “you have no research to prove Nima sensors directly cause hypervigilance”. You’re right, I don’t. I could only find 4 studies on the topic of Nima gluten sensors (which by the way only 1/4 studies I found on the topic had zero sponsorship or Nima employees involved (see disclosures, conflicts of interest, and acknowledgment sections of these studies to check for yourselves)).
And the one study that did indicate a hint of risk, the 2019 manuscript of Benefits and Barriers to Portable Detection of Gluten, had only 30 participants and was only 3-months long. This is both a very short time to run the study and a very small cohort. Limitations of the study aside, they did find that teenagers (more so than adults) agreed that using the Nima sensor made them anxious. And this is the same study where 87% of adults reported the Nima sensor detecting gluten in foods thought to be gluten-free. I can’t help but wonder if we measured this anxiety for a longer period of time, with more results following the same path if more anxiety and hypervigilance would appear. This is just pure speculation.
Now, to clarify, hypervigilance and fear of foods versus vigilance and caution are two very different things. And it’s important to take a moment to acknowledge that so we’re on the same page.
With hypervigilance, you act out of fear. You live in fear, and so decisions with celiac disease are based in fear.
With vigilance, you act out of caution. Assessing risk and mitigating very real threats, like asking for proper cross-contact precautions at restaurants. This might look like asking for a baked potato that’d be cooked in a convection oven to be wrapped in foil to prevent cross-contact.
I share real points of cross-contact on social media, with clients and beyond, not to scare anyone, but to help you understand risks and take precautions. Because as Nima supporters are so quick to emphasize, Nima does not substitute having proper safety conversations with restaurant staff…
All of this to say, there is a very big difference between using a Nima sensor with caution, and using Nima sensor with fear. Make sure if you do choose to go the Nima route, you have the proper education on cross-contact points and label-reading.
By now I’ve written about 8 pages of information about Nima gluten sensors and I’ve only shared my opinion. However, other celiac dietitians agree that there’s a risk for hypervigilance here. Registered Dietitian, Erin, from The Celiac Space wrote:
“If we know <20 ppm is the safe level for someone with celiac disease, why should we promote a product that would lead to more restriction and fear around food? As I celiac dietitian I have seen firsthand the downsides of hyperviligance around food.
Using the Nima sensor could potentially lead users down a road of fear around food that is actually celiac safe. It also creates a narrative that even gluten-free food is not “gluten-free enough”… which isn’t the case.
The Nima sensor creates a false safety net for those with celiac. When in reality, long-term use and reliance has the potential to put the user in a prison.”
Selena Devries, a celiac dietitian in canada (and @celiac_dietitian on Instagram) wrote:
“When national celiac bodies and celiac experts worldwide describe that the NIMA sensor is not able to reliably detect gluten, you should take notice. The NIMA sensor either promotes food hypervigilance or gives individuals a false sense of security that they are following the diet correctly.
Using the NIMA may seem like an innocent thing to do, like ‘why not? It’s just an extra layer of protection right?’ However, it provides no protection at all. By promoting food hypervigilance, it can lead to anxiety and depression on the GF diet which can contribute to persistent symptoms such as diarrhea, constipation, bloating, and abdominal pain.
On the other side of hypervigilance by providing a false sense of security, it may lead celiacs to not ask the questions they should when eating out which can lead to inadvertent unsafe levels of gluten consumption, and over time, may lead to complications of celiac disease. Innocent? I think not.”
I think Selena said it best: when national celiac agencies (like the Canadian Celiac Association’s position) and celiac experts are saying this device is is risky: take note.
This opinion piece is not meant to be interpreted as “militant” hate or me trying to influence “hate” for the Nima Gluten Detection Sensors. Instead, it’s meant to promote extreme caution.
I do not condone shaming or hate mail sent to Nima supporters or users. Nor am I trying to employ cancel culture to “cancel” Nima or any supporter of Nima. What I am doing is bringing up valid concerns and criticism supported by Nima’s statements and the limited research that we have on this device.
I have the most empathy and understanding for those who lean on this device for security in their food decisions. And I have empathy for the very real limitations of this device being publicized and potentially discrediting people’s leverage they may have when using these devices to test and verify if food is safe in restaurants.
However, I think it’s unfair to blame those who highlight the unreliability of this device in determining the true safety of food for any negative interactions you’ve had around it. These concerns again are valid and supported by research.
I also have a lot of empathy for the Nima Sensor company trying to navigate a very heated area in the celiac community and potentially facing difficulties in business due to the concern around the product. They’ve been faced with difficult decisions, and as a business owner myself, I can relate to things not going as I’ve hoped.
However this is no longer a small business, as I mentioned earlier, the company was sold by the owner to Medline in 2020. So this is a company owned by Medline and I feel the argument a “big dog” like a celiac association is attacking a small business is… a stretch.
Still, I have empathy for the rebranded company Nima Partners struggling with how the limitations of their device may impact their business, however, it does not lessen the seriousness of the device’s limitations.
I also don’t care if you support Nima or not. I won’t engage in hate or lash back on people who use these devices or hate for the company. And I don’t condone hate or lash back conducted by others. Do not mistake this post as hate, as it’s mere criticism of common arguments made on behalf of Nima and criticism of very real limitations of the device.
Honestly, the company has been honest from the get-go about the limitations of the device. And that warrants a lot of respect. I think it’s important though, that the people supporting this device also remain fully transparent about these limitations (making sure to fully spell them out, instead of briefly mention there are limitations). This is essential so that consumers make informed decisions around the use of this product.
For that reason, I must emphasize there are very valid concerns around the use of this product and as a celiac specialized professional, there are very few situations where I can ethically recommend this device for reasons outlined in this post. I will, however, remain open to changing my stance if new research supports doing so.
So do I, a dietitian specializing in celiac disease, recommend the Nima gluten sensor? In most cases no. Why? Because:
And I’m not the only one who doesn’t usually recommend it. According to the 2023 American College of Gastroenterology Guidelines, they also don’t advise patients to use gluten detection devices in their dietary decision-making.
That said, the Nima gluten sensor may be useful in countries without gluten-free labeling laws and protections. And in countries with a huge lack of awareness and support for people with celiac. It may also help give people a boost of confidence when advocating for their needs in social settings.
Now I do want to emphasize, this article is written with the celiac experience and needs in mind. Non-celiac gluten sensitivity is a completely different condition than celiac and I could see more reasons for use of this device in that population, but I think limitations should be weighed heavily in making those decisions.