Celiac Disease
The Gluten-Free Diet
and
The Prevention of Cross-Contamination
Culinary Arts Version
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The Nature of Celiac Disease
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Celiac Disease (CD) 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
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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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Genetic Properties
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Celiac Disease is a true autoimmune
disease
The genetic predisposition (HLA), the
exogenous trigger (Gluten) and the
autoantigen (tTG) are all known
CD is currently the only autoimmune
disease for which all three factors are
known
Unlike many other autoimmune diseases,
the cause of the disease has been
identified
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Frequency of Occurrence
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CD occurs in almost 1% of the
population.
CD occurs in 1 in 22 first degree
relatives. Canadian Research 12-15 per cent
CD occurs in 1 in 39 second degree
relatives. Canadian Research 5-12 percent
CD occurs in 1 in 56 people with gastrointestinal symptoms.
CD occurs in 1 in 133 of the ‘not at risk
population.
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Diagnosing Celiac Disease
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A series of serologic tests can assist in
the preliminary screening for CD
An intestinal biopsy must be performed
to confirm the diagnosis of CD
The Gluten-Free Diet should never be
started without an accurate diagnosis of
Celiac Disease
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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 We’re
Glutened?
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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 We’re
Glutened?
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Many people with CD will have
immediate intestinal symptoms.
Many will have headaches or other nonintestinal 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 We’re
Glutened?
The progression of
damage to the
villi
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What Happens When We’re
Glutened?
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What Happens When We’re
Glutened?
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Major Concerns
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Increase Awareness
Safe Ingredients
Hidden Sources of Gluten
CROSS CONTAMINATION
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What is Gluten ?
Gluten refers to several different
cereal grain storage proteins, or
prolamins.
 Gliadin in wheat
 Secalin in rye
 Hordein in barley
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Gluten Containing Grains &
Grain Products
Barley
Couscous
Emmer
Graham flour
Oats*
Semolina
Wheat
Bulgar
Durum
Filler
Kamut
Roux
Spelt(Dinkel)
Cereal Binding
Einkorn
Farro
Malt
Rye
Triticale
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
Cassava
Flax
Nuts
Potatoes
Sago
Tapioca
Arrowroot
Corn (Maize)
Legumes
Poi
Quinoa
Sorghum
Teff
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Buckwheat
Dahl
Millet
Polenta
Rice
Soy
Wild Rice
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Other Gluten-free Foods
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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
Bouillon cubes
Condiments
Dry roasted nuts
Herbal teas
Ice cream and yogurt
Imitation seafood
Marinades and sauces
Pilaf mixes
Puddings
Salad dressing
Seasoned fries
Smarties*
Soy sauce
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Beverage mixes
Cheese spreads
Dried fruit
Flavourings
HPP/HVP
Icing sugar products
Licorice and candies
Modified food starch
Processed meats
Rice and soy beverages
Seasonings
Self basting poultry
Soups and broths
Worcestershire sauce
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Preventing Contamination &
Cross-contamination
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When preparing a gluten-free meal, it is
important to prevent contamination of
the gluten-free foods with glutencontaining 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
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Select a preparation area that is
separate from other food preparation
areas.
Air-borne flour and other glutencontaining 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
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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
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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
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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
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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 glutencontaining 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
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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 crosscontamination.
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Using Safe Alternatives
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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
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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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Baking Gluten-Free
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Gluten-free baking can be very
challenging
Gluten is the ingredient that allows bread
to rise and stay moist and fluffy
Gluten-free products can be dry and
dense
Where do you start to make it great???
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Baking Gluten-Free
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Use a combination of gluten-free flours
Course flours require more leavening
than wheat flour – 2 ½ tsp B Powder per
cup
Using buttermilk in place of regular milk
gives a lighter texture
Add more egg or oil to increase moisture
Gelatin also increases moisture
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Baking Gluten-Free
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Xanthan gum can be used as a stabilizer
and binder – 1 tsp per cup
Guar gum is also a stabilizer and is less
expensive
Guar gum is best used in baking that
doesn’t require yeast
Bake in small portions at a lower
temperature for a longer time
Use dull or dark pans to absorb heat for
better browning
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Baking Gluten-Free
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Adding chips, nuts and dried fruits
improves the flavour
Let non-yeast doughs rest for 30 minutes
before baking
Cornstarch and tapioca can be used to
thicken sauces and fruit pies
Let pancake batter rest for 15 minutes
before cooking. Do not stir before use
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Baking Gluten-Free
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Brown rice cereal or flaked rice can be
substituted for oatmeal
Instant potato flakes and crushed rice
cakes can be substituted for bread
crumbs
Store baked products in plastic bags
while still warm
Freeze baked products to minimize loss of
moisture and flavour
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Bread and Buns
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Use fresh ingredients
Be exact in your measurements
Use ingredients at room temperature
Different brands and grinds of rice flour
may require a variation in the amount of
liquid
Whipping the eggs or egg substitutes
gives a better texture
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Bread and Buns
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Unflavoured gelatin adds spring to the
texture of the bread
A teaspoon of vinegar or dough enhancer
helps the yeast to work
Changes in weather and season can
affect bread making. It may be necessary
to adjust ingredients
Gluten-free dough has the consistency of
thick cake batter
Gluten-free bread doesn’t require
kneading
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Bread and Buns
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It is not necessary to let gluten-free
bread rise twice as there is no gluten to
develop
Gluten-free dough likes to be cuddled –
use small loaf pans
Place a pan of water in the oven during
baking
Allow the bread to cool before slicing.
Separate slices with wax paper before
freezing
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Cookies
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Use glutenous flour for ½ the flour
requirement in a recipe
Use crumbled sliced almonds, flaked GF
cereal or textured soy protein to replace
oatmeal
For delicate butter cookies, choose a flour
mix with more starch (tapioca or potato)
and sweet rice
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Cookies
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Xanthan and/or guar gum are seldom
needed in cookie dough
Add an extra egg to prevent crumbling
Rice bran and rice polish add flavour,
fiber and nutrition
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Pastry
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GF pastry does not toughen when rolled
repeatedly
When mixed, pastry should be very moist
Wrap in plastic and chill several hours,
until cold and firm
Use white rice flour to flour the surface
for pastry rolling
When used for quiche, bake the unfilled
shell 5 minutes before filling
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For More Information
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Our website: www.calgaryceliac.com
National website: www.celiac.ca
Links to other chapter and resource
websites
Email: Jo Anne Murray
murray2@telusplanet.net
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