In-Service: Celiac Disease & Gluten Cross-Contamination

I was assigned with designing, implementing, and summarizing a special in-service topic for the hostesses at Mon Gen. I picked the topic of celiac disease and gluten cross-contamination last week, and I conducted the in-service presentation this morning.  I decided to pick the topic of gluten, because once in a while there’ll be a gluten-free tray on the line, and the employees on the tray line will change their gloves like they are supposed to. But I thought that perhaps some of them don’t know much more than “gluten-free means they can’t have gluten.”  I wanted to give the why behind the reasoning.  So I researched the topic, using sources such as and designed a handout as well as an 8-question quiz at the end to test their knowledge.

For a PDF of my handout, click here: Living Gluten-Free: Preventing Cross-Contamination

Celiac Disease & Gluten Cross-Contamination

  • Celiac disease is an autoimmune disease caused by sensitivity to gluten, a protein found in wheat, barley, and rye.
  • 1 out of every 133 Americans has celiac disease, or a little less than 1%. Since it is genetic, if you have an immediate family member that has celiac disease, your chances of having it become 1 in 22.
  • If gluten is consumed by a person with celiac disease, an immune response is triggered and damage is caused to the lining of the small intestine.
  • Symptoms of celiac disease include: gas, diarrhea, stomach pain, fatigue, joint pain, weight loss, and an itchy skin rash.
  • Since most of the nutrients in your food are absorbed in the small intestine, if it is damaged, nutrients cannot be fully absorbed which can lead to nutritional deficiencies and weight loss.

  • There is no cure for celiac disease.  The only treatment for celiac disease is to eat a gluten-free diet. When a gluten-free diet is followed well, the condition can be managed and the person can live a long, healthy life.
  • There are plenty of foods that are naturally gluten-free, such as: fruits, vegetables, beef, poultry, fish, nuts, eggs, and more.  There are also a growing number of gluten-free products available for the public.
  • Grains to include:
    • Amaranth, corn, quinoa, millet, rice, sorghum, teff
  • Plant foods/starches to include:
    • Arrowroot, buckwheat, flax, indian rice grass, lentils, potato, sago, soy, tapioca, wild rice, yucca
  • Grains to avoid:
      • Wheat
      • Barley
      • Rye
      • Other cross-bred varieties of grain including triticale (a cross between wheat and rye)
      • Oats—Those with celiac disease can tolerate small amounts of pure oats in their diet. However, gluten can get into oats during the processing and packaging of oats, so it’s best to look for “gluten-free” on food labels for any foods containing oats
  • If a package says “gluten-free,” it means the manufacturer has ensured there is no gluten in that food product. However, food products that seem like they would be gluten-free, such as a rice mix, may have traces of gluten if the manufacturer makes other products with gluten in the same facility. If a food does not have a “gluten-free” claim on the package, check directly with product manufacturers for more information.

When you see “gluten-free” on the packaging, you can have your cake and eat it too!

  • Some processed foods and ingredients that may contain wheat, rye and barley (check labels!):  beer, bouillon cubes, cold cuts, hot dogs, salami, sausage, French fries, gravy, imitation fish, malt, modified food starch, rice mixes, sauces, chips/snacks, soups, and soy sauce.

“For people with celiac disease, even just a microscopic amount of gluten can cause a reaction and damage to the intestines, such as a single bread crumb on a plate or speck of wheat flour on manufacturing equipment,” – Rachel Begun, MS, RD, Spokesperson for the Academy of Nutrition and Dietetics.”

  • The key is to keep things clean and separated.
    • Crumb-free food preparation surfaces
    • Separate or carefully clean cooking equipment and serving utensils for gluten-free foods.
    • Wash dishes, pots, pans, utensils & surfaces well
    • Identify gluten-free foods with permanent pen or stickers
    • Store gluten-free foods above gluten-containing products in fridge or pantry so gluten particles don’t fall or settle into gluten-free foods
    • Mon Gen policy: Gloves must be changed by all employees when there are gluten-free trays on the line.
  • Watch out:
    • Are eggs cooked on the same griddle as pancakes?
    • Are gluten-free grains being cooked in the same pot of water that pasta was just cooked in?
    • Are fried gluten-free items placed in the same fryer as breaded items?
    • Is the same toaster used to toast wheat bread as gluten-free bread?
    • Is the same cutting board and knife used to slice wheat bread as gluten-free bread?

Hostesses and other kitchen employees play a huge role in making sure that those with celiac disease do not eat food contaminated with gluten.  Employees are handling bread and flour and other food items containing gluten, so when there is a gluten-free tray on the line, it’s important for them to change gloves so that any gluten that may be on their gloves, does not get into a gluten-free tray.  Taking simple precautions like this in food storage and during tray assembly can prevent a patient from damaging their intestine, developing a rash, or experiencing gastrointestinal discomfort.

Categories: Clinical Nutrition, Education in the Community | Tags: , , , , , , , , , , , , , | 2 Comments

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2 thoughts on “In-Service: Celiac Disease & Gluten Cross-Contamination

  1. Your handout looks great.

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