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  • Kelly Carter

    How to Stay Gluten-Free in a Cross-Contaminated World

    Kelly Carter


    Reviewed and edited by a celiac disease expert.

      Cross-contamination is a serious issue in the celiac community that has to be monitored and minimized. At the same time, we cannot let the disease or fear of cross-contamination rule our lives.


    Caption: Chernobyl, Ukraine. Image: CC BY 2.0--Sebastian_Fuhrmann

    Celiac.com 12/13/2019 - I wanted to add some new revelations I've had about cross contamination, including how not to go crazy worrying about it, and what I believe to be the number one way to prevent getting sick from it.

    There are a lot of posts on Facebook in the Celiac Groups about cross-contamination—let's talk about what it is and why it's bad for those with celiac disease.

    Cross-contamination is Our Worst Enemy



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    For someone with celiac disease, cross-contamination is our worst enemy. We all know that we can't have gluten—no bread, pasta, etc. We all know that even the slightest amount of gluten can hurt us.

    Studies have shown that 1/64th of a piece of bread has enough gluten to cause autoimmune problems in celiacs. The FDA has set 20 parts per million (ppm) as the maximum threshold for gluten in something labelled gluten-free. It isn't much.

    Let's use an example to describe what is happening. I'm going to use a very simple example because it's, well simple. The kids like peanut butter and jelly sandwiches, chips, and an apple for their lunch. You pull out the bread, swipe the peanut butter and jelly on, and put it in their lunch box. Put the chips into a smaller container, open the fridge, pull out an apple, and call it a day.

    Here's the issue—if you put the bread for the sandwich on a plate, awesome, except the plate must now be cleaned before you can use it for any gluten-free items. The knife you used to swipe the peanut butter and jelly across the bread likely has crumbs embedded in the remaining peanut butter and/or jelly. Then if you stuck the knife back into the peanut butter and/or jelly they are also likely contaminated and should be used by those with celiac disease. You likely have introduced crumbs into the containers that you cannot get out.

    Next are the chips—you thought you were safe there—wrong!! If you didn't wash your hands and I'm pretty sure you didn't, you may have also introduced crumbs into the chip bag. If the bag is contaminated with crumbs it is now unsafe for celiacs. Also, did you wash your hands before touching the fridge door? You get my drift.

    All of this can be controlled if we are careful. But most people don't think about any of this unless they have a food allergy or a family member who has one.

    You might think this is a little extreme. It might be. But would you say the same thing for someone with an anaphylactic reaction to peanuts? Or tree nuts? Or anything for that matter? But food is a problem for people with celiac disease and such things can be a serious issue for them.

    Many times celiac reactions aren't immediately obvious but they do come. Sometimes the reactions are even violent—explosive diarrhea or vomiting. They might be more subtle like brain fog, extreme fatigue, or joint aches or any of the other 300+ symptoms associated with celiac disease. Not to mention the longer term damage to the villi in the small intestine which can take 6 to 12 months to repair themselves. With ongoing long term damage they may never recover.

    Then, really long term there is anemia, malnutrition, and potentially cancer. So continued gluten ingestion, even in small amounts, may have the potential over time to cause cancer in those with celiac disease.

    Other hotbeds of cross-contamination are: toasters, butter dishes, scratched non-stick pans, wooden cutting boards and utensils, shared fryers, waffle irons, stirring the gluten pasta then putting the spoon in the sauce, gluten pasta water, non-squeeze bottle condiments, kitchens, etc.

    Bottom line—If it has gluten and you touch it, you must wash your hands or the item before it is safe for a celiac.

    Cross-contamination is Everywhere

    Cross-contamination is everywhere unless you are really careful. Most people don't understand it but I'm hoping this gave you a good introduction into where cross-contamination starts and why it is bad.

    Each time you leave the house, someone that has recently touched gluten will have touched something you are currently touching or are about to touch—door knobs, buttons on the card machines, grocery store carts, seats, computer keyboards, everything. All of it. Washing hands with soap and water before cooking or preparing food is the number one way to prevent this from causing an issue.

    A recent study suggested that using a common toaster, cooking gluten-free pasta in pasta water previously used to cook pasta, or using a knife that was previously used to cut a cake may not pose a significant risk of gluten contamination. Each scenario tested to below 20ppm for gluten. I'm not 100% sure I'm on board with this study, but it does make me a little less worried about cross-contamination. I would say, however, if you can avoid the such scenarios, do so just to be on the safe side.

    There are a couple of other scenarios I see talked about often—non-stick pans, separate plates for gluten and gluten-free food, kissing someone that has recently consumed gluten, or simply having prepackaged gluten foods next to pre-packaged gluten-free foods.

    The non-stick pans and separate plates issue—if you can replace the non-stick pans, great. If not, hand wash and then run the pans and dishes through the dishwasher and they should be safe.

    Kissing someone who recently consumed gluten, I think you are okay on this one, too, especially if they have a glass of water or other gluten-free beverage before engaging in a lip lock! As a side note, I would not let this disease get in the way of a passionate kiss, EVER! But that's just my bias.

    If a package of gluten-free food is in a sealed container and the seal is not broken, the food in the package is still gluten-free.

    I saw a recent post about a college student wanting to take Lysol wipes into class to wipe down desks before she sat down for fear that someone before her might have been eating a gluten snack at the same desk. My answer was first, are you going to be eating off the desk? Second, are you going to be able to wash your hands before the next meal? If the answer to the first question is yes, then yes, take wipes and wipe everything down. But why the heck are you eating directly off a desk in a strange place and maybe you need to rethink your eating habits. If the answer to the second question is yes, then no you don't need wipes. A good hand washing should be sufficient to protect you from any incidental cross-contamination picked up in the outside world.

    We Have to Live in a World That is Covered in Gluten

    Cross-contamination is a serious issue in the celiac community that has to be monitored and minimized. At the same time, we cannot let the disease or fear of cross-contamination rule our lives. We cannot be afraid to go out or to do anything for fear of getting sick. There must be a balance. My balance may look different from your balance, but we have to find a way to get to a place where we feel comfortable living our lives without being in constant fear. What I might see as acceptable risk, someone else may not, and that is fine. My whole point is that you have to find a way to be comfortable and not make your life feel like you are living in a gluten-free jail.

    Balance and the ability to live a full gluten-free life with few restrictions is the entire point of my blog—in addition to providing information about celiac drugs, new studies and talking about celiac disease.


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    When I was first diagnosed over 15 years ago, my hubby kept a chart without telling me of what he had for breakfast before giving me a goodbye kiss when I went to work.  To keep it simple, he only ate raisin bran cereal or hominy grits as a hot cereal. The kiss was a quick peck. Then he would check with me to see if I had tummy troubles at work that day.

    At the end of a couple of weeks, he showed me the results.  There was a clear correlation between what he ate and my health.  I had been arguing that he didn't have to go gluten-free since I had Celiac, not him. I didn't think it could be that sensitive. That was when our house became gluten free.  He didn't want to accidentally make me sick just because he might not be paying attention on a particular day.

    The recent study that was published here irritated me to no end because Celiac is already touchy to the point that you question yourself. Having a source like this site carrying a review of a study that makes us sound delusional isn't helpful. And how many gluten hits of less than 20 ppm does it take to have a cumulative effect on your immune system? 

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    Great article!  Newly-diagnosed Celiac sufferers, especially, can benefit from this kind of advice and support.  I remember how overwhelming and scary it all seemed when I was first diagnosed. Gradually, over time, with the help of others and doing my own reading, I became more empowered and less depressed about it all, learning that so much is under my control. It’s so important to understand Celiac and gain the confidence to stick up for oneself regarding diet restrictions, including sensitivity levels to cross-contamination.  It’s important to know oneself and not feel that one size fits all.  Very well-said in the article, “What I might see as acceptable risk, someone else may not, and that is fine.“ 

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    I believe that the study to which you refer DID find gluten on the pasta that was cooked in gluten water. Quoting said article about the study,  “The team found that Gluten was detected in all pasta samples cooked in water used for gluten-containing pasta, ranging from 33.9ppm to 115.7ppm. The rinsed gluten-free pasta samples tested at 5.1 ppm and 17.5 ppm detectable gluten. 

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    Hi, I agree with the vigilance required for cross-contamination.  The other day I was visiting my brother's family.  I was helping out in their kitchen by plating gluten containing crackers.  I failed to remember to wash my hands.  Minute after plating the crackers I was eating my own gluten-free crackers.  I got a gluten attack 45 minutes later and the effects, as with all my gluten attacks, was extreme fatigue, brain fog for 24 hours and food issues for days perhaps even longer.   Cross contamination is a real concern for many celiacs. 

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    22 hours ago, Karen B. said:

    When I was first diagnosed over 15 years ago, my hubby kept a chart without telling me of what he had for breakfast before giving me a goodbye kiss when I went to work.  To keep it simple, he only ate raisin bran cereal or hominy grits as a hot cereal. The kiss was a quick peck. Then he would check with me to see if I had tummy troubles at work that day.

    At the end of a couple of weeks, he showed me the results.  There was a clear correlation between what he ate and my health.  I had been arguing that he didn't have to go gluten-free since I had Celiac, not him. I didn't think it could be that sensitive. That was when our house became gluten free.  He didn't want to accidentally make me sick just because he might not be paying attention on a particular day.

    The recent study that was published here irritated me to no end because Celiac is already touchy to the point that you question yourself. Having a source like this site carrying a review of a study that makes us sound delusional isn't helpful. And how many gluten hits of less than 20 ppm does it take to have a cumulative effect on your immune system? 

    That study bothered me too. It mentioned the less than 20ppm as safe for people with gluten sensitivity and noted that very few people with Celiac still react to less than 5ppm. But like you, unfortunately I'm sensitive enough that I react to my hubby's kisses if he's had something since last brushing his teeth. It came to the point we tend to avoid kissing most of the time, which is psychologically sad, I know. But when it comes to food at home, our entire kitchen is gluten free because we tried otherwise before and I just kept getting sick, and for me that meant life threatening hypoglycemic attacks and blistering rashes. The only place in our house you'll ever find gluten contamination is my hubby's desk where he sometimes eats fast food or a grocery store hot meal and I never touch anything on it just to be safe. Not that I have any business at his desk anyway, so easy avoidance. 

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    22 hours ago, Karen B. said:

    When I was first diagnosed over 15 years ago, my hubby kept a chart without telling me of what he had for breakfast before giving me a goodbye kiss when I went to work.  To keep it simple, he only ate raisin bran cereal or hominy grits as a hot cereal. The kiss was a quick peck. Then he would check with me to see if I had tummy troubles at work that day.

    At the end of a couple of weeks, he showed me the results.  There was a clear correlation between what he ate and my health.  I had been arguing that he didn't have to go gluten-free since I had Celiac, not him. I didn't think it could be that sensitive. That was when our house became gluten free.  He didn't want to accidentally make me sick just because he might not be paying attention on a particular day.

    The recent study that was published here irritated me to no end because Celiac is already touchy to the point that you question yourself. Having a source like this site carrying a review of a study that makes us sound delusional isn't helpful. And how many gluten hits of less than 20 ppm does it take to have a cumulative effect on your immune system? 

    Thank you for this comment! What a loving husband you have! I am recently in a serious relationship with a wonderful man who is going gluten-free so he can kiss me without fear of making me sick and I was feeling kind of bad about it and like maybe I was being too careful. But I appreciate that your husband did that experiment and found a correlation. It makes me feel more confident and less crazy in my decision to avoid small amounts of cross-contamination as much as possible. 

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    My daughter has Celiac.  We have a gluten-free toaster.  For the most part our home is gluten-free.

    Disposable plates and knives are used for the occasional English Muffin Dad eats.

    Our problem was finding a college with gluten-free options. Handing out a box of Cheerios and a lunch and dinner salad(shrink wrapped) should not count.  The school ranked as gluten-free in ratings do not have good controls or you have to eat in a different building, with Allergy students, away from your friends.

    She ended up at Salve Regina in Newport, RI.

    Separate food service, for allergy students, within the main cafeteria.  We happened to find this gem.  There is an Allergy chef.

    Schools touting their ability to take care of allergy students have a different story when the Disability department gets involved.

    One suggested they would allow her to cook her own food.

    There is a need for a list of Colleges who have reasonable dietary programs for Allergy.

    A list of schools, produced by Udi buyers is not an accurate measure of the programs ability to keep our kids safe.

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    That was a nice article on an important subject. For those celiacs who were diagnosed as adults due to symptoms like anemia and various vitamin deficiencies, there is no alarm bell that goes off when gluten is accidentally digested; no feedback on what caused the problem so it can be avoided later; no suggestion that the antibodies have been set off to wreak long term havoc.  The damage goes on but it takes place over time and it is unseen, excepting when it shows up in long term blood tests or other chronic symptoms.  Any possible source of cross contamination just has to be strictly avoided.

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    1/64th of a piece of bread is really large piece. I just drew out a bread sized rectangle and then gridded it to 64. That’s over a centimeter squared. Maybe this is why I so rarely feel glutened. I’m very careful about cross contamination, but if a few crumbs won’t trigger it, and it really takes that much, then all the verbiage about what celiacs need to do is off. 

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    16 hours ago, Guest Jim said:

    Hi, I agree with the vigilance required for cross-contamination.  The other day I was visiting my brother's family.  I was helping out in their kitchen by plating gluten containing crackers.  I failed to remember to wash my hands.  Minute after plating the crackers I was eating my own gluten-free crackers.  I got a gluten attack 45 minutes later and the effects, as with all my gluten attacks, was extreme fatigue, brain fog for 24 hours and food issues for days perhaps even longer.   Cross contamination is a real concern for many celiacs. 

    When I was first diagnosed and trying to do everything right I was so frustrated by a hot dog luncheon we had at work.  Hot dogs, we thought, would be easy to do normal for everyone else and gluten-free for me.  I brought my own dog and chili and even made my own bun.  Best guess is that I was defeated by doorknobs and microwave buttons.  Now, when I heat something in the group microwave, I use two paper plates (top and bottom) and I wash my hands after handling things.  I had to develop the habit of washing hands before eating and after helping coworkers at their keyboards because we all eat at our desks.

    People don't realize what an act of faith it is for someone with Celiac to eat food someone else has prepared.

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    I think the college student wanting to wipe down their desk has a legitimate concern even if she won't be eating off the desk, and I don't like the dismissive way you address that.  If the surface of the desk is contaminated with gluten, than means her hands, books, notebooks, pens, phone, and whatever else touches the desk, or that she touches after touching the desk, could get contaminated.  I'm a little paranoid about my belongings becoming contaminated, since my house is gluten-free.  If my phone, purse, or whatever other belonging gets contaminated with gluten, that means I'm then going to be introducing it to my house when I go home.  I realize I can't control the entire world, and some cross-contamination is inevitable, but I think doing whatever you can to minimize it is important.  Cross-contamination isn't just about what you're going to immediately be consuming, since it can stay on things and become a problem later.  Unless you never touch anything else while you cook and eat even in your own home, yes, you do need to be concerned about what your commonly used non-food items come into contact with outside your house.

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  • About Me

    I was diagnosed with Celiac in 2012 and have been gluten free ever since.  I live in Atlanta with my husband and two medium sized children.  I run a blog at FatCeliac.net that covers real life issues with celiac disease, upcoming drug trials, and try to be a reliable source of information for the celiac community.

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