The GlutenFree Diet and The Prevention of CrossContamination General Information Programs

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The Gluten-Free DietandThe Prevention of
Cross-ContaminationGeneral Information Programs
Celiac Disease
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The Nature of Celiac Disease

• Celiac Disease is an autoimmune disease.
• It is one of the most common autoimmune diseases.
• The autoimmune response occurs in the gut.
• It is triggered by Gluten, a storage protein in
  wheat, barley and rye.

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The Nature of Celiac Disease

• The onset of CD can occur at any age.
• All people diagnosed with CD will have intestinal
  damage.
• The villi become inflamed, flattened and
  disappear.
• Nutrients, including carbohydrates, proteins,
  fats, vitamins and minerals, can no longer be
  absorbed.
• This leads to malnutrition and other serious
  health problems.

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Frequency of Occurrence

• CD occurs in almost 1 of the population.
• CD occurs in 1 in 22 first degree relatives.
• CD occurs in 1 in 39 second degree relatives.
• CD occurs in 1 in 56 people with
  gastro-intestinal symptoms.
• CD occurs in 1 in 133 of the not at risk
  population.

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Treatment of CD

• The only treatment for Celiac Disease is a
• STRICT GLUTEN-FREE DIET FOR LIFE
• Even small amounts of gluten can be harmful to
  people with Celiac Disease and can cause
  continued small bowel damage.

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What Happens When Were Glutened?

• The accidental ingestion of gluten does not cause
  the profound anaphylactic response that is common
  with peanuts and other allergens.

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What Happens When Were Glutened?

• Many people with CD will have immediate
  intestinal symptoms.
• Many will have headaches or other non- intestinal
  symptoms.
• Many will have delayed symptoms.
• Many will have no symptoms but will still have
  intestinal damage which can lead to other
  illnesses.

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What Happens When Were Glutened?

• The progression of damage to the villi

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What Happens When Were Glutened?
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What Happens When Were Glutened?
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Major Concerns

• Increase Awareness
• Safe Ingredients
• Hidden Sources of Gluten
• CROSS CONTAMINATION

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Gluten Containing Grains Grain Products

• Barley Bulgar Cereal Binding
• Couscous Durum Einkorn
• Emmer Filler Farro
• Graham flour Kamut Malt
• Oats Roux Rye
• Semolina Spelt(Dinkel) Triticale
• Wheat
• Oats are currently excluded from the gluten-free
  diet because of the high risk of contamination
  from gluten containing grains

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Gluten-Free Grains Grain Substitutes

• Amaranth Arrowroot Buckwheat
• Cassava Corn (Maize) Dahl
• Flax Legumes Millet
• Nuts Poi Polenta
• Potatoes Quinoa Rice
• Sago Sorghum Soy
• Tapioca Teff Wild Rice

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Other Gluten-free Foods

• Fresh meat, poultry, fish and seafood
• Fresh vegetables and fruits
• Eggs
• Cheese and other dairy
• All products made with gluten-free ingredients

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The Questionable Products

• Baking powder Beverage mixes
• Bouillon cubes Cheese spreads
• Condiments Dried fruit
• Dry roasted nuts Flavourings
• Herbal teas HPP/HVP
• Ice cream and yogurt Icing sugar products
• Imitation seafood Licorice and candies
• Marinades and sauces Modified food starch
• Pilaf mixes Processed meats
• Puddings Rice and soy beverages
• Salad dressing Seasonings
• Seasoned fries Self basting poultry
• Smarties Soups and broths
• Soy sauce Worcestershire sauce

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Preventing Contamination Cross-contamination

• When preparing a gluten-free meal, it is
  important to prevent contamination of the
  gluten-free foods with gluten-containing food
  particles and residues.
• Even small amounts of gluten can result in
  continued intestinal damage for people with CD
  and DH
• Care must be taken to ensure that gluten-free
  foods remain gluten-free.

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Preventing Contamination Cross-contamination

• Select a preparation area that is separate from
  other food preparation areas.
• Air-borne flour and other gluten-containing
  particles can contaminate gluten-free foods.
• Ensure all preparation surfaces, cooking surfaces
  and cooking utensils have been thoroughly
  cleaned, including counter top, meat slicer,
  grill surface, cutting boards, bowls, knives,
  utensils, thermometers, cleaning cloths.

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Preventing Contamination Cross-contamination

• Use dedicated pots, pans, utensils and cutting
  boards whenever possible.
• Rolled edge pans are easier to clean.
• Scrub with soap and water to ensure removal of
  gluten-containing particle. Disinfect according
  to current standards of practice.

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Preventing Contamination Cross-contamination

• Follow impeccable hand washing practices.
• Use sanitary gloves for food preparation and
  change them before handling GF foods.
• Ensure the powder used is gluten-free. Even
  powder-free gloves can have trace amounts of
  powder.
• Become knowledgeable about special needs diets
  and menu selections.
• Educational programs are offered through many of
  the local chapters of the Canadian Celiac
  Association.

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Preventing Contamination Cross-contamination

• Ensure all ingredients are gluten-free.
• Check product ingredients regularly.
  Manufacturers and suppliers can change
  ingredients without notice.
• Ensure that anti-caking and flow agents are GF.
  These agents may not be identified in the
  ingredient lists.
• Use boldly labeled, air tight containers for all
  products designated as GF.
• Prepare GF meals before other menu selections

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Preventing Contamination Cross-contamination

• Clean utensils must be used for each condiment,
  butter, sauce and all other items.
• Use individual portions and/or squeeze bottles.
• Deep fryer oil previously used for
  gluten-containing foods is unsafe for gluten-free
  cooking.
• Fresh water must always be used for boiling,
  poaching or steaming.

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Preventing Contamination Cross-contamination

• Use the top oven racks.
• Use caution with convection ovens.
• Use toaster bags to prevent contamination of GF
  bread products.
• Arrange buffet tables with gluten-free selections
  first and separated from the gluten-containing
  selections. Label them.
• Bulk bins can be a source for cross-contamination.

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Using Safe Alternatives

• Many common food products have safe alternatives
  Eg. Soy sauce.
• Safe thickening agents can be used in place of
  flour Eg. Potato starch, tapioca starch.
• Select pure spice blends rather than seasoning
  blends that may contain gluten-containing
  fillers.

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Using Safe Alternatives

• Many foods start out gluten-free and are glutened
  in menu preparation Eg. Salads
• Many food items have gluten-free alternatives
  Eg. Pizza shells, pasta
• Develop clearly identified gluten-free
  alternatives as part of a standard menu.

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For More Information

• Our website www.calgaryceliac.com
• National website www.celiac.ca
• Links to other chapter and resource websites
• Email Jo Anne Murray murray2_at_telusplanet.net