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Gluten

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Understand gluten and gluten related disorders.
Identify instances of cross contact.
Describe proper methods of preparing and serving food to a guest with a gluten allergy.

To understand the impact of gluten related disorders and explain how to successfully eliminate gluten from the diet.

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Purpose:

Objectives:

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What is Gluten?

Gluten is a protein found in barley, rye, oats, and wheat.
Wheat and gluten are not interchangeable terms.

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Sources of Gluten

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Gluten is found in most grains, pastas, cereals, and processed foods. Corn, rice, and soy do not naturally contain gluten. While these ingredients do not naturally contain gluten, some food products may contain gluten in hidden or unexpected ways.

While rice is gluten free, rice pilaf is not gluten. This rice contains orzo, which is a small wheat pasta, making it a source of gluten.
Many salad dressings contain gluten. If the salad dressing contains malt vinegar it is a source of gluten because malt is made from barley.
Pickles can even be made using malt vinegar, which can make them a source of gluten.
Vegetable soup may contain a broth (as a base) that uses yeast extract derived from barley. This soup contains gluten.
Soy is naturally gluten free but soy sauce is not. Soy sauce is often made with wheat, which contains gluten.
Even if you prepare a sandwich on gluten free bread, it may contain gluten. The mustard on the sandwich may contain wheat flour, making it a source of gluten
Surprisingly, taco seasoning packets are even a source of gluten. These seasoning packets may add a gluten based starch to prevent spices from clumping together

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23,000,000

Individuals are intolerant to gluten.

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Gluten Related Disorders

Autoimmune Disorder

Celiac Disease
Causes an immune response.

Gluten Intolerance

Non-Celiac Gluten Sensitivity
Not an Autoimmune disorder.

Causes digestive upset

Bloating, Diarrhea, Nausea, Headache, Constipation, Joint Pain, Discomfort.

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What is celiac and non-celiac gluten sensitivity? These are the two gluten related disorders.

Non-celiac gluten sensitivity is an intolerance to gluten. A gluten intolerance is a digestive reaction where an individual is not able to properly break down and absorb the food. This can causes symptoms in the gut such as bloating, diarrhea, nausea, headaches, constipation, pain, and fatigue.

In contrast, celiac disease is an autoimmune disorder. An autoimmune disorder occurs when an individual's genetic information affects the functioning of their immune system. The immune system protects the cells in our body from invaders (such as bacteria, viruses, toxins) that can cause us harm. In an autoimmune disorder the individuals body attacks healthy cells rather than harmful ones. The next few slides will focus on the details of an autoimmune disorder.

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Autoimmune Disease

Digestive System:

Breaks down food we consume into usable parts.
The small intestine absorbs nutrients into the bloodstream.
The digestive system is surrounded by a protective lining.

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Autoimmune Disease

Consumption of Gluten:

Gluten protein will initiate intestinal damage.
Proteins pass through the damaged intestine.

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Autoimmune Disease

Attack of Foreign Proteins:

Antibodies see the protein as a foreign invader and attack.
Antibodies continue to attack self proteins that are similar.
Damage to the body continues.

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Types of Celiac Disease

Classic

Classic GI symptoms of abdominal pain, diarrhea, nausea, vomiting, vitamin deficiencies, mineral deficiencies.
Malabsorption of nutrients

Atypical

No GI symptoms but other health issues such as thyroid problems, skin rashes, bleeding, nerve damage, infertility, depression, etc.

Silent

Little/no symptoms but still affects the body.

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There are three types of celiac disease. The different types differ in their range of severity of symptoms

The first type of celiac disease is Classic. Patients with classic celiac disease will experience damage to their small intestine along with GI symptoms. This may include abdominal pain, diarrhea, nausea, vomiting, weight loss, or growth failure

The second type of celiac disease is atypical celiac disease. Patients with atypical celiac disease may have mild-no gastrointestinal symptoms and instead manifests as non-GI symptoms. These symptoms may include iron deficiency anemia, thyroid problems, nerve damage, nerve damage, skin rashes, etc.

The third type of celiac is is silent. Individuals with silent celiac disease have no symptoms, but will still receive damage to their small intestine that will affect their nutrient absorption.

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Diagnosis of Celiac Disease

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Genetics

Must posses specific gene.
Gene is passed from parent to child.

Trigger

Gluten consumption
Infections/illnesses
Pregnancy
Surgery
Stress

Can occur at ANY time in life

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Treatment

Gluten-Free Diet

Less than 20 ppm gluten.
Prevent cross-contamination and cross-contact.

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Gluten-Free Labeling

“Gluten-Free”

The product meets all the regulations of the FDA.
Contains less than 20 ppm of gluten
Safe

“Certified Gluten-Free”

A third party has tested the product to ensure no gluten.
80 step process
Safe

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Nutrition Facts Label

Allergy Listing

Example: “Contains: Wheat, Milk, and Soy”
Lack of an allergen listing does NOT mean the product is gluten free.

Ingredients

Wheat, Barley, Rye, Malt, Brewers Yeast, Oats, Triticale, etc.
Gluten derivatives:

Dextrin
Flavorings
Seasoning
Food starch

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Just because a food is not labelled “gluten free” or “certified gluten free” does not mean it does not contains gluten. Gluten is not one of the top 9 allergens that are required to be listed by manufacturers. To figure out if a food contain gluten it is important to look at the ingredients of nutrition facts label. This is the white box on the back of your food products that contains the nutrition information, serving size, and ingredients.

In the ingredients section of the nutrition facts label there will be bold print that states the allergens that the food contains. This is called an allergen listing. An example of this would be “contains, wheat, milk, and soy ingredients.” Wheat contains gluten, so if this allergen is listed it indicates that the food contains gluten, and is not safe for consumption.

A lack of an allergen listing does NOT mean that the product is gluten free. It is important to look at the list of ingredients to confirm there are no products that contain gluten. When reading the ingredients, look for wheat, rye, barley, oats, and their derivatives.

It is also necessary to read the ingredients label for hidden sources of gluten. These products may be listed as a name that consumers are unfamiliar with. Semolina, spelt, and durum all are forms of wheat. Barley can be commonly found as malt. Flavorings and seasonings may come from barley or wheat fillers. Food starch can be made from wheat

If you are ever unsure if a product or ingredient contains gluten, you can call the manufacturer or visit the company websi9te for verification. When in doubt it is best to leave the product out.

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Cross-Contact

Food

People

Equipment

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Food

Deep Fryers
Cooking oil
Boiling Water

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Person

Hands
Gloves
Shortcuts

Croutons on salad
Roll on a plate

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Equipment

Pots/pans
Utensils
Preparation surfaces
Refrigerators
Cleaning supplies

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Equipment can be a source of cross contact between gluten containing foods and gluten free foods.

Examples of food to equipment cross contact that can cause the transfer of a gluten protein include

Pots and pans. Using the same pots/pans to cook a gluten free food and a gluten containing food
Utensils. Using the same utensils to cook a gluten free food and a gluten containing food
Preparation surfaces. Preparing gluten foods and gluten free foods in the same prep area
Refrigerators. Storing dressings or items with gluten above gluten free foods. This may cause the foods with gluten to leak onto gluten free foods
Cleaning supplies. Using the same sponge/cleaning bucket to clean gluten foods and gluten free foods can cause food particles to be deposited. A separate cleaning sponge/bucket is recommended

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Serving Your Guest

Document standard procedures
Frequently train staff

Education

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Why?

Customer service/reputation
Liability

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Serving Your Guest

Check Ingredient Statements
Color Coding

Tray Cards
Cookware
Food

Separate gluten free prep area
Storage
Bulk prep gluten free foods

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Summary

Gluten is a protein found in foods we eat.
Celiac disease is an autoimmune disease.

Gluten protein damages the intestinal wall.

All gluten related disorders are treated with a gluten free diet.
Labels must be read to identify gluten free foods.
Special precautions must be taken to avoid cross contact from gluten containing foods.

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Thank you.

If you have questions,

Please contact the Nutrition Resource Center at:

1.800.968.4426

nrc@gfs.com