What is the reaction to gluten allergy

Should I store my gluten-free items on the bottom or top shelf of my pantry and refrigerator?

The short answer: Store your gluten-free items on the top shelf in a dedicated area.

An explanation: We recommend that you hold gluten-free items on the top shelf of your pantry, refrigerator and freezer to prevent crumbs of gluten-containing items from falling into gluten-free foods. Make certain to also own a dedicated gluten-free shelf of foods, as it can be simple to mistakenly grab the gluten-containing bread crumbs because they were correct next to the gluten-free ones.

Label your gluten-free foods with colored tape or stickers to ensure that the whole family can recognize their status confidently.

What are hidden sources of gluten?

Gluten can hide in lots of places, even in your home. Some people opt to maintain an entirely gluten-free household, but for numerous, that’s not possible, especially because cabinet space and budget concerns can frolic into the decision.


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Infographic: Boiling Spots at Home

Do I need to worry about airborne flour?

The short answer: Yes.

An Explanation: Most people will be surprised to know that flour can stay airborne for 12-24 hours depending on ventilation and quantity of flour.

If there is a risk of any flour or particles of gluten in the air, it is safest to avoid those areas for the next 24 hours. While simply touching gluten will not harm an individual with celiac disease, there can be a risk of ingesting airborne gluten, which is generally caused by flour. It is also significant to remember not to prepare gluten-free foods in spaces where there is a risk of airborne gluten, as particles will settle on the food, making it unsafe for those with celiac disease to eat. Some of the most common places where this type of cross-contact can happen include pizzerias and bakeries.

What is cross-contact?

Cross-contact is when a gluten-free food or food product is exposed to a gluten-containing ingredient or food – making it unsafe for people with celiac disease to eat.

There are numerous obvious (and not-so-obvious) sources of cross-contact at home and in restaurants and other foodservice locations. There is even a risk of cross-contact before ingredients make it to the kitchen, such as during the growing, processing, and manufacturing processes.

While it may seem love a challenge to remember and be proactive about every of the possible sources of cross-contact at first, your improved health will make the effort worth it. Read on to better understand some of these sources and what you can do to prevent cross-contact.

Can I use the same sponges and dish rags to clean gluten-free cookware as I use for cookware that has been used to make gluten-containing items?

The short answer: No, you should own separate sponges and dishrags to clean gluten-free cookware.

Paper towels may not be “green” but you can clean up and throw the gluten-containing crumbs.

An explanation: Gluten cannot be sanitized away, so any gluten that remains on sponges or dishrags can be transferred to otherwise clean plates. Make certain to also use unused dish water if you hand wash your dishes, as particles of gluten in the water can also be transferred to otherwise clean dishes when rinsing. Save dishes that held gluten-containing foods for final when hand-washing dishes.

While gluten cannot be “killed off,” dishes must still be washed thoroughly to eliminate any remaining particles on them.

Dish soap combined with warm water accomplishes this much more effectively than simply running dishes under water. Beyond Celiac Scientific/Medical Advisory Council member Rachel Begun, MS, RDN, highlights these steps for cleaning dishes in shared kitchens:

  • Where possible, clean by running through the dish washer. Or, use a home sanitizing solution for necessary equipment.
  • Dry wipe to remove every crumbs and bits and pieces of food residue before cleaning
  • Rinse
  • Wash thoroughly with warm, soapy water
  • Either let air dry or wipe with a clean towel that hasn’t come into contact with gluten

Can I prepare gluten-free foods in toaster or convection ovens that own been used to make gluten-containing food?

The short answer: There is a high risk for cross-contact.

An explanation: Convection ovens use a fan to circulate air around food.

This process can cause cross-contact because gluten particles can be blown by the fan. You can still use a convection oven that has been used to prepare gluten-containing foods, but only as endless as you hold gluten-free foods tightly covered when cooking. Toaster ovens are acceptable to use too, and using foil or a clean tray on the rack helps create a barrier from any crumbs. Also, be certain to thoroughly clean the oven in between uses, even if there are no visible crumbs.

Can I safely eat at a buffet that has both gluten-free and gluten-filled foods?

The short answer: Sometimes.

An explanation: While there may be gluten-free options on a buffet, there is no guarantee that they own not come into contact with gluten.

Even when those making the food claim to be extremely aware of their preparation methods, other people eating at the buffet may not be. Spoons may be set back in the incorrect dish, and tongs may be used to pick up several diverse foods before being put back in the correct spot. Gluten-filled foods could spill into the gluten-free foods. Thermometers that are used to check if food is safe to consume may be used in gluten-filled and gluten-free foods without proper cleaning between checks. These are just a few examples of the potential for cross-contact in buffets.

As a solution, you can enquire to speak to the chef to see if they can bring out a freshly made plate of gluten-free foods directly from the kitchen. Or, you can work with the chef and catering company to make certain that you are capable to serve yourself first, before cross-contact can occur.

Are cutting boards a source of cross-contact?

The short answer: Yes, cutting boards can be a boiling spot for sources of gluten.

An explanation: Knives can cause cuts on the surface of cutting boards, and these are hard to clean out completely.

If a cutting board is used to slice, cut or dice gluten-containing items – love bread or dough – gluten can get stuck in these crevices and transfer the gluten to your food. Make certain to purchase a cutting board that is only used to cut gluten-free foods. Color-coding is an effective way to differentiate between the gluten-free cutting board and the cutting board that can be used for gluten-containing items.

Can I use the same water for boiling gluten-free pasta, steaming vegetables, and thickening gluten-free sauces that was used to boil gluten-containing pasta?

The short answer: No, you must use clean water.

An explanation: This remains a extremely common misconception when the term “cross-contamination” is used.

Some believe that boiling water after making gluten-containing pasta or other gluten-containing foods will “sanitize” the water, and make it safe to prepare gluten-free foods. Gluten cannot be “killed off” or “disinfected,” so it is not safe to use the same water to make gluten-free foods that was also used to make gluten-containing foods.

What is the reaction to gluten allergy

This is a practice called comingling. This should also be kept in mind when using colanders to strain pasta. Gluten-free pasta should always be strained in a clean, preferably dedicated, colander.

Can I use the same toaster for gluten-free and gluten-containing items?

The short answer : No, you cannot use the same toaster for both gluten-free and gluten-containing items.

An explanation: Celiac disease experts strongly recommend that you purchase a separate toaster for gluten-free items to avoid cross-contact with gluten-containing foods. However, there are reusable “toaster bags” on the market which can be used in a pinch to prevent cross-contact.

These can be useful for travel and eating at a friend or relative’s home. Toaster bags are not foolproof, and caution must be used to ensure that crumbs from gluten-containing items do not drop into the bag. It is also significant to remember to never put the bag itself on gluten-free plates of food, as the exterior of the bags will expose the other foods to any gluten it came into contact with in the toaster. Similar caution should be used when preparing gluten-free foods in toaster or convection ovens.

Can I make gluten-free waffles using the same waffle iron that was used to make gluten-containing waffles?

The short answer: It is not safe to use a waffle iron to prepare both gluten-containing and gluten-free waffles.

An explanation: Waffle irons are incredibly hard to clean thoroughly, and residual gluten may be left on the iron even after cleaning.

You should purchase separate waffle irons (and other similar appliances) to prepare gluten-containing and gluten-free waffles to avoid any chances for cross-contact.

Can I use condiments from the same containers that own been used to prepare gluten-containing foods?

The short answer: No!

An explanation: Utensils that are used to spread butter, peanut butter, jelly, mayonnaise, cream cheese and other condiments will expose the product to gluten which can then be spread onto your gluten-free breads, bagels, etc. As a solution, you may discover condiments in squirt bottles useful as endless as those using the condiments are well aware that they cannot wipe the tip of the squirt bottle on their gluten-containing foods.

It is safest to own separate condiments, and to clearly label the condiments that are dedicated gluten-free.

Families (or roommates) may discover it helpful to discuss gluten-free kitchen dos and don’ts and should express the importance of confessing mistakes.

What is the reaction to gluten allergy

If someone accidentally dips his or her knife in the gluten-free jar, it is his or her responsibility to make certain family members or roommates are well aware. A similar situation can happen with dips. If someone dunks a gluten-containing pretzel into the vegetable dip, it is no longer safe for someone with celiac disease to consume.

What is cross-contamination?

Cross-contamination is a term that implies that a food has been exposed to bacteria or a microrganism, which could result in a foodborne illness love salmonella.

By definition, it can lead foodservice and other industry professionals to believe that if a food is “contaminated” by gluten, they can simply “kill off” the contaminant. However, gluten is a protein (not a type of bacteria) and proteins cannot be “killed off” using heat or disinfecting agents love most bacteria can be.

The term “cross-contact” more accurately reflects that a gluten-containing food cannot come into contact with a gluten-free food.

If we speak the same language as chefs and foodservice professionals, we are more likely to own a better experience when dining away from home.

Can I safely prepare gluten-free foods on the same grill or griddle that was used to prepare gluten-containing foods?

The short answer: No, it is not recommended that you use the same grill or griddle to prepare gluten-free foods that is used to make gluten-containing foods.

An explanation: Crumbs from toasting hamburger buns or sticky marinade residue can easily be left on the grate of the grill, and it is hard to properly clean after it has charred on.

Also, it’s common for restaurants and other foodservice establishments to cook both naturally gluten-free foods love omelettes and breakfast potatoes and gluten-containing foods love pancakes and French toast on the same surface such as a griddle or flat grill. We recommend that you enquire questions and assess your risk for cross-contact. If the char grill never sees bread – and numerous restaurant grills do not – and only raw meats and vegetables with no marinades are used, a char grill is a safe choice. Assess your risk by asking the chef or manager if they toast bread products on the grill.

Also enquire if the grill or griddle is used to cook marinated foods and gluten-conataining foods love pancakes. If the grill has been exposed to gluten, heavy, sturdy foil can be put on the grill or a sauté pan should be used instead. If there is a grand risk of gluten exposure at home, you may select to purchase a little grill that can be dedicated to only preparing gluten-free foods.

Can I use the same oil for frying gluten-free items that was used to make gluten-containing fried foods?

The short answer: No, a separate fryer must be used for gluten-free items to avoid cross-contact.

An explanation: Similar to the misconception about using the same water to boil both gluten-containing foods and gluten-free foods, it is also not safe to use the same oil to fry these items.

High heat will not eliminate gluten in the oil, so fryers used to make breaded or battered items would not be safe to use for gluten-free French fries, corn tortilla chips or other gluten-free items.

Can the refrigerator door handle really expose me to gluten?

The short answer: Yes! Every handles in the kitchen can expose you to gluten.

An explanation: Although not the most common source of gluten, the refrigerator door handle can contain sticky gluten residue.

For example, a chef is preparing cookies or has flour-dusted hands and suddenly realizes they’re missing an significant ingredient. They then may hastily wipe them on the dish towel or apron (which are now also sources of unwanted gluten!) and open the fridge. Any residual gluten that was on their hands is now on the refrigerator door handle and may be a source of cross-contact later on. If you do not own a dedicated gluten-free kitchen at home, make certain to regularly clean your refrigerator door and other handles in the kitchen to ensure that you will not accidentally be exposed to gluten when you’re grabbing a quick bite to eat from the fridge!

Should I be concerned about cross-contact during the growing and manufacturing processes?

The short answer: Yes, absolutely!

An explanation: It is significant to know how your food is made, from farm to table, in order to avoid possible gluten exposure.

To voluntarily label a product gluten-free in the U.S., it must contain less than 20 ppm gluten, as mandated by the FDA. However, if a product is NOT labeled gluten-free, but you do not see any gluten-containing ingredients listed, this does not mean that it is under the same 20 ppm threshold. This is because manufacturers are manufacturers are not required to call out “gluten” in food products; the FDA gluten-free labeling law is voluntary for food manufacturers. To determine whether there was a risk of cross-contact during the growing and/or manufacturing processes, it is best to call the manufacturer and inquire whether they batch test their product for gluten, if they know how their raw materials were sourced and produced, and what procedures they go through to prevent cross-contact in the factory.

What’s really behind ‘gluten sensitivity’?

By Kelly Servick

The patients weren’t crazy—Knut Lundin was certain of that.

But their ailment was a mystery. They were convinced gluten was making them ill. Yet they didn’t own celiac disease, an autoimmune reaction to that often-villainized tangle of proteins in wheat, barley, and rye. And they tested negative for a wheat allergy. They occupied a medical no man’s land.

About a decade ago, gastroenterologists love Lundin, based at the University of Oslo, came across more and more of those enigmatic cases. «I worked with celiac disease and gluten for so numerous years,» he says, «and then came this wave.» Gluten-free choices began appearing on restaurant menus and creeping onto grocery store shelves.

By 2014, in the United States alone, an estimated 3 million people without celiac disease had sworn off gluten. It was simple to assume that people claiming to be «gluten sensitive» had just been roped into a food fad.

«Generally, the reaction of the gastroenterologist [was] to tell, ‘You don’t own celiac disease or wheat allergy. Goodbye,’» says Armin Alaedini, an immunologist at Columbia University. «A lot of people thought this is perhaps due to some other [food] sensitivity, or it’s in people’s heads.»

But a little community of researchers started searching for a link between wheat components and patients’ symptoms—commonly abdominal pain, bloating, and diarrhea, and sometimes headaches, fatigue, rashes, and joint pain.

That wheat really can make nonceliac patients ill is now widely accepted. But that’s about as far as the agreement goes.

As data trickle in, entrenched camps own emerged. Some researchers are convinced that numerous patients own an immune reaction to gluten or another substance in wheat—a nebulous illness sometimes called nonceliac gluten sensitivity (NCGS).

Others believe most patients are actually reacting to an excess of poorly absorbed carbohydrates present in wheat and numerous other foods. Those carbohydrates—called FODMAPs, for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols—can cause bloating when they ferment in the gut.

If FODMAPs are the primary culprit, thousands of people may be on gluten-free diets with the support of their doctors and dietitians but without excellent reason.

Those competing theories were on display in a session on wheat sensitivity at a celiac disease symposium held at Columbia in March. In back-to-back talks, Lundin made the case for FODMAPs, and Alaedini for an immune reaction.

What is the reaction to gluten allergy

But in an irony that underscores how muddled the field has become, both researchers started their quests believing something completely different.

Known wheat-related illnesses own clear mechanisms and markers. People with celiac disease are genetically predisposed to launch a self-destructive immune response when a component of gluten called gliadin penetrates their intestinal lining and sets off inflammatory cells in the tissue under. People with a wheat allergy reply to wheat proteins by churning out a class of antibodies called immunoglobulin E that can set off vomiting, itching, and shortness of breath.

The puzzle, for both doctors and researchers, is patients who lack both the telltale antibodies and the visible damage to their intestines but who feel genuine relief when they cut out gluten-containing food.

Some doctors own begun to approve and even recommend a gluten-free diet.

What is the reaction to gluten allergy

«Ultimately, we’re here not to do science, but to improve quality of life,» says Alessio Fasano, a pediatric gastroenterologist at Massachusetts General Hospital in Boston who has studied NCGS and written a book on living gluten-free. «If I own to throw bones on the ground and glance at the moon to make somebody better, even if I don’t understand what that means, I’ll do it.»

Like numerous doctors, Lundin believed that (fad dieters and superstitious eaters aside) some patients own a genuine wheat-related ailment. His group helped dispel the notion that NCGS was purely psychosomatic. They surveyed patients for unusual levels of psychological distress that might express itself as physical symptoms.

But the surveys showed no differences between those patients and people with celiac disease, the team reported in 2012. As Lundin bluntly puts it: «We know they are not crazy.»

Still, skeptics worried that the field had seized on gluten with shaky evidence that it was the culprit. After every, nobody eats gluten in isolation. «If we did not know about the specific role of gluten in celiac disease, we would never own thought gluten was responsible for [NCGS],» says Stefano Guandalini, a pediatric gastroenterologist at the University of Chicago Medical Middle in Illinois. «Why blame gluten?»

Defenders of NCGS generally acknowledge that other components of wheat might contribute to symptoms.

In 2012, a group of proteins in wheat, rye, and barley called amylase trypsin inhibitors emerged as a potential offender, for example, after a team led by biochemist Detlef Schuppan of Johannes Gutenberg University Mainz in Germany (then at Harvard Medical School in Boston) reported that those proteins can provoke immune cells.

But without biological markers to identify people with NCGS, researchers own relied on self-reported symptoms measured through a «gluten challenge»: Patients rate how they feel before and after cutting out gluten.

Then doctors reintroduce gluten or a placebo—ideally disguised in indistinguishable pills or snacks—to see whether the symptoms tick back up.

Alaedini has recently hit on a more objective set of possible biological markers—much to his own surprise. «I entered this completely as a skeptic,» he says. Over his career, he has gravitated toward studying spectrum disorders, in which diverse symptoms own yet to be united under a clear biological cause—and where public misinformation abounds. His team published a study in 2013, for example, that debunked the favorite suggestion that children with autism had high rates of Lyme disease. «I do studies [where] there is a void,» he says.

In NCGS, Alaedini saw another poorly defined spectrum disorder.

He did accept that patients without celiac disease might somehow be sensitive to wheat, on the basis of several trials that measured symptoms after a blinded challenge. But he was not convinced by previous studies claiming that NCGS patients were more likely than other people to own certain antibodies to gliadin. Numerous of those studies lacked a healthy control group, he says, and relied on commercial antibody kits that gave murky and inconsistent readings.

In 2012, he contacted researchers at the University of Bologna in Italy to obtain blood samples from 80 patients their team had identified as gluten sensitive on the basis of a gluten challenge.

He wanted to test the samples for signs of a unique immune response—a set of signaling molecules diverse from those in the blood of healthy volunteers and celiac patients. He wasn’t optimistic. «I thought if we were going to see something, love with a lot of spectrum conditions that I own looked at, we would see little differences.»

The results shocked him. Compared with both healthy people and those with celiac, these patients had significantly higher levels of a certain class of antibodies against gluten that propose a short-lived, systemic immune response.

That didn’t mean gluten itself was causing disease, but the finding hinted that the barrier of those patients’ intestines might be faulty, allowing partially digested gluten to get out of the gut and interact with immune cells in the blood. Other elements—such as immune response–provoking bacteria—also might be escaping. Certain enough, the team found elevated levels of two proteins that indicate an inflammatory response to bacteria. And when 20 of the same patients spent 6 months on a gluten-free diet, their blood levels of those markers declined.

For Alaedini, the beginnings of a mechanism emerged: Some still-unidentified wheat component prompts the intestinal lining to become more permeable.

(An imbalance in gut microbes might be a predisposing factor.) Components of bacteria then seem to sneak past immune cells in the underlying intestinal tissue and make their way to the bloodstream and liver, prompting inflammation.

«This is a genuine condition, and there can be objective, biological markers for it,» Alaedini says. «That study changed a lot of minds, including my own.»

The study also impressed Guandalini, a longtime skeptic about the role of gluten. It «opens the way to finally reach an identifiable marker for this condition,» he says.

But others see the immune-response explanation as a red herring.

To them, the primary villain is FODMAPs. The term, coined by gastroenterologist Peter Gibson at Monash University in Melbourne, Australia, and his team, encompasses a smorgasbord of common foods. Onions and garlic; legumes; milk and yogurt; and fruits including apples, cherries, and mangoes are every high in FODMAPs. So is wheat: Carbs in wheat called fructans can account for as much as half of a person’s FODMAP intake, dietitians in Gibson’s group own estimated. The team found that those compounds ferment in the gut to cause symptoms of irritable bowel syndrome, such as abdominal pain, bloating, and gas.

Gibson has endless been skeptical of studies implicating gluten in such symptoms, arguing that those findings are hopelessly clouded by the nocebo effect, in which the mere expectation of swallowing the dreaded ingredient worsens symptoms.

His team found that most patients couldn’t reliably distinguish pure gluten from a placebo in a blinded test. He believes that numerous people feel better after eliminating wheat not because they own calmed some intricate immune reaction, but because they’ve reduced their intake of FODMAPs.

Lundin, who was firmly in the immune-reaction camp, didn’t believe that FODMAPs could explain away every his patients. «I wanted to show that Peter was wrong,» he says.

During a 2-week sabbatical in the Monash lab, he found some quinoa-based snack bars designed to disguise the taste and texture of ingredients. «I said, ‘We’re going to take those muesli bars and we’re going to do the perfect study.’»

His team recruited 59 people on self-instituted gluten-free diets and randomized them to get one of three indistinguishable snack bars, containing isolated gluten, isolated FODMAP (fructan), or neither. After eating one type of bar daily for a week, they reported any symptoms. Then they waited for symptoms to resolve and started on a diverse bar until they had tested every three.

Before analyzing patient responses, Lundin was confident that gluten would cause the worst symptoms.

But when the study’s blind was lifted, only the FODMAP symptoms even cleared the bar for statistical significance. Twenty-four of the 59 patients had their highest symptom scores after a week of the fructan-laced bars. Twenty-two responded most to the placebo, and just 13 to gluten, Lundin and his collaborators—who included Gibson—reported final November in the journal Gastroenterology. Lundin now believes FODMAPs explain the symptoms in most wheat-avoiding patients.

«My main reason for doing that study was to discover out a excellent method of finding gluten-sensitive individuals,» he says. «And there were none. And that was fairly amazing.»

At the Columbia meeting, Alaedini and Lundin went head to head in consecutive talks titled «It’s the Wheat» and «It’s FODMAPS.» Each has a list of criticisms of the other’s study. Alaedini contends that by recruiting broadly from the gluten-free population, instead of finding patients who reacted to wheat in a challenge, Lundin likely failed to include people with a true wheat sensitivity.

Extremely few of Lundin’s subjects reported symptoms exterior the intestines, such as rash or fatigue, that might point to a widespread immune condition, Alaedini says. And he notes that the increase in patients’ symptoms in response to the FODMAP snacks was just barely statistically significant.

Lundin, meanwhile, points out that the patients in Alaedini’s study didn’t go through a blinded challenge to check whether the immune markers he identified really spiked in response to wheat or gluten. The markers may not be specific to people with a wheat sensitivity, Lundin says.

Despite the adversarial titles of their talks, the two researchers discover a lot of common ground.

Alaedini agrees that FODMAPs explain some of the wheat-avoidance phenomenon. And Lundin acknowledges that some little population may really own an immune reaction to gluten or another component of wheat, though he sees no excellent way to discover them.

After the meeting, Elena Verdù, a gastroenterologist at McMaster University in Hamilton, Canada, puzzled over the polarization of the field. «I don’t understand why there is this need to be so dogmatic about ‘it is this, it is not that,’» she says.

She worries that the scientific confusion breeds skepticism toward people who avoid gluten for medical reasons.

When she dines with celiac patients, she says, waiters sometimes meet requests for gluten-free food with smirks and questions. Meanwhile, the conflicting messages may send nonceliac patients below a food-avoidance rabbit hole. «Patients are withdrawing gluten first, then lactose, and then FODMAPs—and then they are on a really, really poor diet,» she says.

But Verdù believes careful research will ultimately break through the superstitions. She is president of the North American Society for the Study of Celiac Disease, which this year awarded its first grant to study nonceliac wheat sensitivity.

She’s hopeful that the search for biomarkers love those Alaedini has proposed will show that inside the monolith of gluten avoidance lurk multiple, nuanced conditions. «It will be difficult,» she says, «but we are getting closer.»

doi:10.1126/science.aau2590

Can I prepare gluten-free foods in toaster or convection ovens that own been used to make gluten-containing food?

The short answer: There is a high risk for cross-contact.

An explanation: Convection ovens use a fan to circulate air around food.

This process can cause cross-contact because gluten particles can be blown by the fan. You can still use a convection oven that has been used to prepare gluten-containing foods, but only as endless as you hold gluten-free foods tightly covered when cooking. Toaster ovens are acceptable to use too, and using foil or a clean tray on the rack helps create a barrier from any crumbs. Also, be certain to thoroughly clean the oven in between uses, even if there are no visible crumbs.

Can I safely eat at a buffet that has both gluten-free and gluten-filled foods?

The short answer: Sometimes.

An explanation: While there may be gluten-free options on a buffet, there is no guarantee that they own not come into contact with gluten.

Even when those making the food claim to be extremely aware of their preparation methods, other people eating at the buffet may not be. Spoons may be set back in the incorrect dish, and tongs may be used to pick up several diverse foods before being put back in the correct spot. Gluten-filled foods could spill into the gluten-free foods. Thermometers that are used to check if food is safe to consume may be used in gluten-filled and gluten-free foods without proper cleaning between checks. These are just a few examples of the potential for cross-contact in buffets.

As a solution, you can enquire to speak to the chef to see if they can bring out a freshly made plate of gluten-free foods directly from the kitchen. Or, you can work with the chef and catering company to make certain that you are capable to serve yourself first, before cross-contact can occur.

Are cutting boards a source of cross-contact?

The short answer: Yes, cutting boards can be a boiling spot for sources of gluten.

An explanation: Knives can cause cuts on the surface of cutting boards, and these are hard to clean out completely.

If a cutting board is used to slice, cut or dice gluten-containing items – love bread or dough – gluten can get stuck in these crevices and transfer the gluten to your food. Make certain to purchase a cutting board that is only used to cut gluten-free foods. Color-coding is an effective way to differentiate between the gluten-free cutting board and the cutting board that can be used for gluten-containing items.

Can I use the same water for boiling gluten-free pasta, steaming vegetables, and thickening gluten-free sauces that was used to boil gluten-containing pasta?

The short answer: No, you must use clean water.

An explanation: This remains a extremely common misconception when the term “cross-contamination” is used.

Some believe that boiling water after making gluten-containing pasta or other gluten-containing foods will “sanitize” the water, and make it safe to prepare gluten-free foods. Gluten cannot be “killed off” or “disinfected,” so it is not safe to use the same water to make gluten-free foods that was also used to make gluten-containing foods. This is a practice called comingling. This should also be kept in mind when using colanders to strain pasta.

Gluten-free pasta should always be strained in a clean, preferably dedicated, colander.

Can I use the same toaster for gluten-free and gluten-containing items?

The short answer : No, you cannot use the same toaster for both gluten-free and gluten-containing items.

An explanation: Celiac disease experts strongly recommend that you purchase a separate toaster for gluten-free items to avoid cross-contact with gluten-containing foods. However, there are reusable “toaster bags” on the market which can be used in a pinch to prevent cross-contact.

These can be useful for travel and eating at a friend or relative’s home. Toaster bags are not foolproof, and caution must be used to ensure that crumbs from gluten-containing items do not drop into the bag. It is also significant to remember to never put the bag itself on gluten-free plates of food, as the exterior of the bags will expose the other foods to any gluten it came into contact with in the toaster. Similar caution should be used when preparing gluten-free foods in toaster or convection ovens.

Can I make gluten-free waffles using the same waffle iron that was used to make gluten-containing waffles?

The short answer: It is not safe to use a waffle iron to prepare both gluten-containing and gluten-free waffles.

An explanation: Waffle irons are incredibly hard to clean thoroughly, and residual gluten may be left on the iron even after cleaning.

You should purchase separate waffle irons (and other similar appliances) to prepare gluten-containing and gluten-free waffles to avoid any chances for cross-contact.

Can I use condiments from the same containers that own been used to prepare gluten-containing foods?

The short answer: No!

An explanation: Utensils that are used to spread butter, peanut butter, jelly, mayonnaise, cream cheese and other condiments will expose the product to gluten which can then be spread onto your gluten-free breads, bagels, etc.

As a solution, you may discover condiments in squirt bottles useful as endless as those using the condiments are well aware that they cannot wipe the tip of the squirt bottle on their gluten-containing foods. It is safest to own separate condiments, and to clearly label the condiments that are dedicated gluten-free.

Families (or roommates) may discover it helpful to discuss gluten-free kitchen dos and don’ts and should express the importance of confessing mistakes. If someone accidentally dips his or her knife in the gluten-free jar, it is his or her responsibility to make certain family members or roommates are well aware.

A similar situation can happen with dips. If someone dunks a gluten-containing pretzel into the vegetable dip, it is no longer safe for someone with celiac disease to consume.

What is cross-contamination?

Cross-contamination is a term that implies that a food has been exposed to bacteria or a microrganism, which could result in a foodborne illness love salmonella. By definition, it can lead foodservice and other industry professionals to believe that if a food is “contaminated” by gluten, they can simply “kill off” the contaminant.

However, gluten is a protein (not a type of bacteria) and proteins cannot be “killed off” using heat or disinfecting agents love most bacteria can be.

The term “cross-contact” more accurately reflects that a gluten-containing food cannot come into contact with a gluten-free food. If we speak the same language as chefs and foodservice professionals, we are more likely to own a better experience when dining away from home.

Can I safely prepare gluten-free foods on the same grill or griddle that was used to prepare gluten-containing foods?

The short answer: No, it is not recommended that you use the same grill or griddle to prepare gluten-free foods that is used to make gluten-containing foods.

An explanation: Crumbs from toasting hamburger buns or sticky marinade residue can easily be left on the grate of the grill, and it is hard to properly clean after it has charred on.

Also, it’s common for restaurants and other foodservice establishments to cook both naturally gluten-free foods love omelettes and breakfast potatoes and gluten-containing foods love pancakes and French toast on the same surface such as a griddle or flat grill. We recommend that you enquire questions and assess your risk for cross-contact.

What is the reaction to gluten allergy

If the char grill never sees bread – and numerous restaurant grills do not – and only raw meats and vegetables with no marinades are used, a char grill is a safe choice. Assess your risk by asking the chef or manager if they toast bread products on the grill. Also enquire if the grill or griddle is used to cook marinated foods and gluten-conataining foods love pancakes. If the grill has been exposed to gluten, heavy, sturdy foil can be put on the grill or a sauté pan should be used instead. If there is a grand risk of gluten exposure at home, you may select to purchase a little grill that can be dedicated to only preparing gluten-free foods.

Can I use the same oil for frying gluten-free items that was used to make gluten-containing fried foods?

The short answer: No, a separate fryer must be used for gluten-free items to avoid cross-contact.

An explanation: Similar to the misconception about using the same water to boil both gluten-containing foods and gluten-free foods, it is also not safe to use the same oil to fry these items.

High heat will not eliminate gluten in the oil, so fryers used to make breaded or battered items would not be safe to use for gluten-free French fries, corn tortilla chips or other gluten-free items.

Can the refrigerator door handle really expose me to gluten?

The short answer: Yes! Every handles in the kitchen can expose you to gluten.

An explanation: Although not the most common source of gluten, the refrigerator door handle can contain sticky gluten residue.

For example, a chef is preparing cookies or has flour-dusted hands and suddenly realizes they’re missing an significant ingredient. They then may hastily wipe them on the dish towel or apron (which are now also sources of unwanted gluten!) and open the fridge. Any residual gluten that was on their hands is now on the refrigerator door handle and may be a source of cross-contact later on. If you do not own a dedicated gluten-free kitchen at home, make certain to regularly clean your refrigerator door and other handles in the kitchen to ensure that you will not accidentally be exposed to gluten when you’re grabbing a quick bite to eat from the fridge!

Should I be concerned about cross-contact during the growing and manufacturing processes?

The short answer: Yes, absolutely!

An explanation: It is significant to know how your food is made, from farm to table, in order to avoid possible gluten exposure.

To voluntarily label a product gluten-free in the U.S., it must contain less than 20 ppm gluten, as mandated by the FDA. However, if a product is NOT labeled gluten-free, but you do not see any gluten-containing ingredients listed, this does not mean that it is under the same 20 ppm threshold. This is because manufacturers are manufacturers are not required to call out “gluten” in food products; the FDA gluten-free labeling law is voluntary for food manufacturers. To determine whether there was a risk of cross-contact during the growing and/or manufacturing processes, it is best to call the manufacturer and inquire whether they batch test their product for gluten, if they know how their raw materials were sourced and produced, and what procedures they go through to prevent cross-contact in the factory.

What’s really behind ‘gluten sensitivity’?

By Kelly Servick

The patients weren’t crazy—Knut Lundin was certain of that.

But their ailment was a mystery. They were convinced gluten was making them ill. Yet they didn’t own celiac disease, an autoimmune reaction to that often-villainized tangle of proteins in wheat, barley, and rye. And they tested negative for a wheat allergy. They occupied a medical no man’s land.

About a decade ago, gastroenterologists love Lundin, based at the University of Oslo, came across more and more of those enigmatic cases. «I worked with celiac disease and gluten for so numerous years,» he says, «and then came this wave.» Gluten-free choices began appearing on restaurant menus and creeping onto grocery store shelves.

By 2014, in the United States alone, an estimated 3 million people without celiac disease had sworn off gluten. It was simple to assume that people claiming to be «gluten sensitive» had just been roped into a food fad.

«Generally, the reaction of the gastroenterologist [was] to tell, ‘You don’t own celiac disease or wheat allergy. Goodbye,’» says Armin Alaedini, an immunologist at Columbia University. «A lot of people thought this is perhaps due to some other [food] sensitivity, or it’s in people’s heads.»

But a little community of researchers started searching for a link between wheat components and patients’ symptoms—commonly abdominal pain, bloating, and diarrhea, and sometimes headaches, fatigue, rashes, and joint pain.

That wheat really can make nonceliac patients ill is now widely accepted. But that’s about as far as the agreement goes.

As data trickle in, entrenched camps own emerged. Some researchers are convinced that numerous patients own an immune reaction to gluten or another substance in wheat—a nebulous illness sometimes called nonceliac gluten sensitivity (NCGS).

Others believe most patients are actually reacting to an excess of poorly absorbed carbohydrates present in wheat and numerous other foods. Those carbohydrates—called FODMAPs, for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols—can cause bloating when they ferment in the gut.

If FODMAPs are the primary culprit, thousands of people may be on gluten-free diets with the support of their doctors and dietitians but without excellent reason.

Those competing theories were on display in a session on wheat sensitivity at a celiac disease symposium held at Columbia in March. In back-to-back talks, Lundin made the case for FODMAPs, and Alaedini for an immune reaction. But in an irony that underscores how muddled the field has become, both researchers started their quests believing something completely different.

Known wheat-related illnesses own clear mechanisms and markers. People with celiac disease are genetically predisposed to launch a self-destructive immune response when a component of gluten called gliadin penetrates their intestinal lining and sets off inflammatory cells in the tissue under.

People with a wheat allergy reply to wheat proteins by churning out a class of antibodies called immunoglobulin E that can set off vomiting, itching, and shortness of breath. The puzzle, for both doctors and researchers, is patients who lack both the telltale antibodies and the visible damage to their intestines but who feel genuine relief when they cut out gluten-containing food.

Some doctors own begun to approve and even recommend a gluten-free diet. «Ultimately, we’re here not to do science, but to improve quality of life,» says Alessio Fasano, a pediatric gastroenterologist at Massachusetts General Hospital in Boston who has studied NCGS and written a book on living gluten-free.

«If I own to throw bones on the ground and glance at the moon to make somebody better, even if I don’t understand what that means, I’ll do it.»

Like numerous doctors, Lundin believed that (fad dieters and superstitious eaters aside) some patients own a genuine wheat-related ailment. His group helped dispel the notion that NCGS was purely psychosomatic. They surveyed patients for unusual levels of psychological distress that might express itself as physical symptoms. But the surveys showed no differences between those patients and people with celiac disease, the team reported in 2012. As Lundin bluntly puts it: «We know they are not crazy.»

Still, skeptics worried that the field had seized on gluten with shaky evidence that it was the culprit.

After every, nobody eats gluten in isolation. «If we did not know about the specific role of gluten in celiac disease, we would never own thought gluten was responsible for [NCGS],» says Stefano Guandalini, a pediatric gastroenterologist at the University of Chicago Medical Middle in Illinois. «Why blame gluten?»

Defenders of NCGS generally acknowledge that other components of wheat might contribute to symptoms. In 2012, a group of proteins in wheat, rye, and barley called amylase trypsin inhibitors emerged as a potential offender, for example, after a team led by biochemist Detlef Schuppan of Johannes Gutenberg University Mainz in Germany (then at Harvard Medical School in Boston) reported that those proteins can provoke immune cells.

But without biological markers to identify people with NCGS, researchers own relied on self-reported symptoms measured through a «gluten challenge»: Patients rate how they feel before and after cutting out gluten.

Then doctors reintroduce gluten or a placebo—ideally disguised in indistinguishable pills or snacks—to see whether the symptoms tick back up.

Alaedini has recently hit on a more objective set of possible biological markers—much to his own surprise. «I entered this completely as a skeptic,» he says. Over his career, he has gravitated toward studying spectrum disorders, in which diverse symptoms own yet to be united under a clear biological cause—and where public misinformation abounds. His team published a study in 2013, for example, that debunked the favorite suggestion that children with autism had high rates of Lyme disease.

«I do studies [where] there is a void,» he says.

In NCGS, Alaedini saw another poorly defined spectrum disorder. He did accept that patients without celiac disease might somehow be sensitive to wheat, on the basis of several trials that measured symptoms after a blinded challenge. But he was not convinced by previous studies claiming that NCGS patients were more likely than other people to own certain antibodies to gliadin. Numerous of those studies lacked a healthy control group, he says, and relied on commercial antibody kits that gave murky and inconsistent readings.

In 2012, he contacted researchers at the University of Bologna in Italy to obtain blood samples from 80 patients their team had identified as gluten sensitive on the basis of a gluten challenge.

He wanted to test the samples for signs of a unique immune response—a set of signaling molecules diverse from those in the blood of healthy volunteers and celiac patients. He wasn’t optimistic. «I thought if we were going to see something, love with a lot of spectrum conditions that I own looked at, we would see little differences.»

The results shocked him. Compared with both healthy people and those with celiac, these patients had significantly higher levels of a certain class of antibodies against gluten that propose a short-lived, systemic immune response. That didn’t mean gluten itself was causing disease, but the finding hinted that the barrier of those patients’ intestines might be faulty, allowing partially digested gluten to get out of the gut and interact with immune cells in the blood.

Other elements—such as immune response–provoking bacteria—also might be escaping. Certain enough, the team found elevated levels of two proteins that indicate an inflammatory response to bacteria. And when 20 of the same patients spent 6 months on a gluten-free diet, their blood levels of those markers declined.

For Alaedini, the beginnings of a mechanism emerged: Some still-unidentified wheat component prompts the intestinal lining to become more permeable. (An imbalance in gut microbes might be a predisposing factor.) Components of bacteria then seem to sneak past immune cells in the underlying intestinal tissue and make their way to the bloodstream and liver, prompting inflammation.

«This is a genuine condition, and there can be objective, biological markers for it,» Alaedini says.

«That study changed a lot of minds, including my own.»

The study also impressed Guandalini, a longtime skeptic about the role of gluten. It «opens the way to finally reach an identifiable marker for this condition,» he says.

But others see the immune-response explanation as a red herring. To them, the primary villain is FODMAPs. The term, coined by gastroenterologist Peter Gibson at Monash University in Melbourne, Australia, and his team, encompasses a smorgasbord of common foods.

Onions and garlic; legumes; milk and yogurt; and fruits including apples, cherries, and mangoes are every high in FODMAPs. So is wheat: Carbs in wheat called fructans can account for as much as half of a person’s FODMAP intake, dietitians in Gibson’s group own estimated. The team found that those compounds ferment in the gut to cause symptoms of irritable bowel syndrome, such as abdominal pain, bloating, and gas.

Gibson has endless been skeptical of studies implicating gluten in such symptoms, arguing that those findings are hopelessly clouded by the nocebo effect, in which the mere expectation of swallowing the dreaded ingredient worsens symptoms.

His team found that most patients couldn’t reliably distinguish pure gluten from a placebo in a blinded test. He believes that numerous people feel better after eliminating wheat not because they own calmed some intricate immune reaction, but because they’ve reduced their intake of FODMAPs.

Lundin, who was firmly in the immune-reaction camp, didn’t believe that FODMAPs could explain away every his patients. «I wanted to show that Peter was wrong,» he says. During a 2-week sabbatical in the Monash lab, he found some quinoa-based snack bars designed to disguise the taste and texture of ingredients.

«I said, ‘We’re going to take those muesli bars and we’re going to do the perfect study.’»

His team recruited 59 people on self-instituted gluten-free diets and randomized them to get one of three indistinguishable snack bars, containing isolated gluten, isolated FODMAP (fructan), or neither. After eating one type of bar daily for a week, they reported any symptoms. Then they waited for symptoms to resolve and started on a diverse bar until they had tested every three.

Before analyzing patient responses, Lundin was confident that gluten would cause the worst symptoms. But when the study’s blind was lifted, only the FODMAP symptoms even cleared the bar for statistical significance.

Twenty-four of the 59 patients had their highest symptom scores after a week of the fructan-laced bars. Twenty-two responded most to the placebo, and just 13 to gluten, Lundin and his collaborators—who included Gibson—reported final November in the journal Gastroenterology. Lundin now believes FODMAPs explain the symptoms in most wheat-avoiding patients. «My main reason for doing that study was to discover out a excellent method of finding gluten-sensitive individuals,» he says.

«And there were none. And that was fairly amazing.»

At the Columbia meeting, Alaedini and Lundin went head to head in consecutive talks titled «It’s the Wheat» and «It’s FODMAPS.» Each has a list of criticisms of the other’s study. Alaedini contends that by recruiting broadly from the gluten-free population, instead of finding patients who reacted to wheat in a challenge, Lundin likely failed to include people with a true wheat sensitivity. Extremely few of Lundin’s subjects reported symptoms exterior the intestines, such as rash or fatigue, that might point to a widespread immune condition, Alaedini says.

And he notes that the increase in patients’ symptoms in response to the FODMAP snacks was just barely statistically significant.

Lundin, meanwhile, points out that the patients in Alaedini’s study didn’t go through a blinded challenge to check whether the immune markers he identified really spiked in response to wheat or gluten. The markers may not be specific to people with a wheat sensitivity, Lundin says.

Despite the adversarial titles of their talks, the two researchers discover a lot of common ground. Alaedini agrees that FODMAPs explain some of the wheat-avoidance phenomenon. And Lundin acknowledges that some little population may really own an immune reaction to gluten or another component of wheat, though he sees no excellent way to discover them.

After the meeting, Elena Verdù, a gastroenterologist at McMaster University in Hamilton, Canada, puzzled over the polarization of the field.

«I don’t understand why there is this need to be so dogmatic about ‘it is this, it is not that,’» she says.

She worries that the scientific confusion breeds skepticism toward people who avoid gluten for medical reasons. When she dines with celiac patients, she says, waiters sometimes meet requests for gluten-free food with smirks and questions. Meanwhile, the conflicting messages may send nonceliac patients below a food-avoidance rabbit hole.

«Patients are withdrawing gluten first, then lactose, and then FODMAPs—and then they are on a really, really poor diet,» she says.

But Verdù believes careful research will ultimately break through the superstitions. She is president of the North American Society for the Study of Celiac Disease, which this year awarded its first grant to study nonceliac wheat sensitivity. She’s hopeful that the search for biomarkers love those Alaedini has proposed will show that inside the monolith of gluten avoidance lurk multiple, nuanced conditions. «It will be difficult,» she says, «but we are getting closer.»

doi:10.1126/science.aau2590


Gluten-Free Chocolate and Marshmallows

Now that you've got your gluten-free graham crackers, you'll also need gluten-free chocolate and marshmallows:

  1. Gluten-free chocolate.

    There are actually tons of chocolates you can use for your s'mores — take a glance at my gluten-free chocolate bars article to get some ideas. If you desire a s'more that tastes just the way yours did at sleepaway camp back in the day, you might desire to opt for a sweeter chocolate love Hershey's (tested to 20ppm of gluten). If, on the other hand, you're looking for a more exotic s'more taste, attempt something love Endangered Species' dark chocolate raspberry (gluten-free certified).

  2. Gluten-free marshmallows. Most of the marshmallows produced in the United States are considered gluten-free. To study your various options, check out a list of gluten-free marshmallows.


More from News

If you’ve been avoiding gluten and missing your corn flakes, that’s every about to change.

When you open a packet of crispy, golden flakes of corn you will see that they glance the same and taste just as excellent — without the gluten. Our Gluten Free Corn Flakes are crunchy and yummy — just love the original version! Enjoy them with milk or add them to your yoghurt for some additional crunch.

Kellogg’s Corn Flakes Gluten Free are also certified FODMAP Friendly* so you can enjoy it with confidence if you follow a low FODMAP diet.

* FODMAP Friendly — Certification dated 7th September 2018.

  • Corn (91%), sugar, salt, vitamins (vitamin E, niacin, vitamin B6, thiamin, riboflavin, folate), minerals (iron, zinc oxide).
  • May contain traces of tree nuts.

  • Finding Gluten-Free Graham Crackers

    Conventional graham crackers contain gluten in the form of wheat flour.

    However, over the past few years, several manufacturers own stepped up to offer gluten-free graham crackers:

    1. Pamela's Products makes the widest variety of gluten-free graham crackers — the company offers honey grahams, chocolate grahams, and cinnamon grahams, every in regular and "mini" sizes. The graham crackers include a rice flour mix, tapioca starch, and sorghum flour. Note that they also include gluten-free oat bran. Pamela's Products is certified by the Gluten-Free Certification Organization.
    2. Enjoy Life makes vanilla honey graham crunchy cookies.

      These definitely aren't traditional graham crackers, but they may work for your s'mores. They include a rice, buckwheat, and millet flour mix, plus cane sugar, and honey. Enjoy Life products are certified gluten-free by the Gluten-Free Certification Organization, which requires gluten-free products to test at lower than 20 parts per million of gluten. Every Enjoy Life products are free of every common allergens.

    3. Kinnikinnick Foods Inc. makes S'moreables graham-style crackers. These crackers are based on pea starch, potato starch, brown rice flour, brown sugar, and blackstrap molasses.

      They carry a "may contain eggs" allergen warning. Kinnikinnick works to hold its products below 5 parts per million (ppm) gluten.

    4. Schar offers Honeygram gluten-free graham crackers, which include corn starch and corn flour, brown sugar, soy flour, soy bran, and honey. Be aware they also may contain lupin, which is a potential allergen closely related to peanuts. Schar tests its products to ensure they meet the U.S. Food and Drug istration's legal gluten standard of less than 20 parts per million of gluten.


    Making Gluten-Free S'Mores

    Okay, you've assembled the ingredients for some excellent gluten-free s'mores.

    How do you actually make the s'mores?

    It's easy: toast your marshmallows until they're crisp and melted on the inside, then assemble the "sandwich" with graham crackers as the (gluten-free) bread and the marshmallow and chocolate in the middle.

    What is the reaction to gluten allergy

    The goal of the perfect s'more is to get the marshmallow boiling enough to melt the chocolate.

    Just one note of caution: when toasting marshmallows, make certain to use a safe brand of charcoal. Yes, believe it or not, some charcoal contains gluten, and you conceivably could cross-contaminate your s'mores accidentally if you use the incorrect type of charcoal. Also, don't forget to hold your gluten-free ingredients away from any gluten-containing graham crackers your family and friends might be eating.

    Last step: Enjoy your s'mores!

    Thanks for your feedback!

    You’ve been diagnosed with celiac disease or another gluten-related disorder.

    You know you own to avoid wheat, rye, barley and ingredients and products derived from them. But are you aware of the dangers of cross-contact?

    Before you start your own gluten-free adventures at home, or decide to attempt eating out, you’ll need to be aware of every of the places in a kitchen where gluten may lurk. It doesn’t take extremely much gluten to make you sick! Even just a crumb of gluten is enough to start the autoimmune response in people with celiac disease, even if symptoms are not present.

    Numerous people discover cross-contact to be one of the most hard parts of the gluten-free diet to manage.


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