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  • Jefferson Adams
    Jefferson Adams

    The Gluten Contamination Study We've Been Waiting For

    Reviewed and edited by a celiac disease expert.

    Do you really need that dedicated gluten-free toaster and dedicated flatware? A new study says you might not.

    The Gluten Contamination Study We've Been Waiting For - Image: CC BY-SA 2.0--threefingeredlord
    Caption: Image: CC BY-SA 2.0--threefingeredlord

    Celiac.com 10/14/2019 - One of the big debates among people with celiac disease concerns how vigilant celiacs need to be to make sure they avoid gluten. What does science say about gluten contamination in three common scenarios? How careful do you need to be about gluten contamination?

    For example, how likely are you to get gluten over 20ppm if you share a toaster, pasta water, or slice a cupcake with the same knife used to cut a non-gluten-free cupcake?

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    A team of researchers recently set out to assess three common scenarios where people with celiac disease might reasonably fear gluten contamination. How did the actual risk for each situation measure up?

    • Scenario 1: Water used to cook regular pasta is reused to cook gluten-free penne and fusilli. The gluten-free pasta is then rinsed and served.
    • Scenario 2: Toasting Gluten-Free Bread in an Uncleaned Shared Toaster Gluten-containing bread is toasted in a toaster. Immediately afterward, gluten-free bread is toasted in the same toaster.
    • Scenario 3: Slicing a Gluten-Free and Regular Cupcake with Same Knife

    The research team included Vanessa M. Weisbrod, BA; Jocelyn A. Silvester, MD PhD; Catherine Raber, MA; Joyana McMahon, MS; Shayna S. Coburn, PhD; and Benny Kerzner, MD. They are variously affiliated with the Celiac Disease Program, Children’s National Health System, Washington, DC, USA; and the Harvard Celiac Disease Program, Boston Children’s Hospital, Boston, MA.

    Their paper titled, Preparation of Gluten-Free Foods Alongside Gluten-Containing Food May Not Always Be as Risky for Celiac Patients as Diet Guides Suggest, appears in Gasterojournal.org.

    Control samples of gluten-free pasta, bread, and cupcakes all tested below the limit of detection. Samples were individually packaged in plastic bags with randomized sample numbers. To avoid “hot spots” and ensure even analysis, all items were homogenized for analysis. 

    Gluten content was measured with R5 sandwich ELISA (R7001, R-Biopharm, Darmstadt, Germany) which has a limit of detection of 5 ppm gluten by Bia Diagnostics (Colchester, Vermont). All control samples were similarly tested. 

    The team then quantified gluten samples as under 5ppm, 5-10ppm, 10-20ppm, or over 20ppm, and based their confidence intervals upon binomial distribution.

    Boiling Gluten-Free Pasta in Regular Pasta Water

    In the first scenario, the team boiled sixteen-ounce packages of gluten-containing Barilla brand penne and fusilli separately in stainless steel pots in fresh tap water for 12 minutes, then removed with strainers. The water was reused to cook Dr. Schar gluten-free penne and fusilli. The team also tested the effect of rinsing some samples of the cooked and contaminated pasta under cold tap water for 30 seconds. 

    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. 

    Interestingly, rinsing pots with water alone after cooking gluten-containing pasta was as effective as scrubbing with soap and water to prevent detectable gluten transfer. 

    Toasting Gluten-Free Bread After Non-Gluten-Free Bread

    In the second scenario, the team toasted regular gluten-containing bread in two rolling toasters in a busy hospital cafeteria at 20-minute intervals, or in one of three shared pop-up toasters. Immediately after toasting the gluten-containing bread, they toasted Dr. Schar Artisan White Bread. Gluten-containing crumbs were visible in all toasters. They team did not clean the toasters. 

    The team found that toasting in a shared toaster was not associated with gluten transfer above 20ppm; the four samples with detectable gluten had levels ranging only from 5.1 ppm to 8.3 ppm gluten.

    Slicing a Gluten-Free Cupcake with Knife Used on Gluten Cupcake

    In the third scenario, the team used a knife to slice frosted gluten-containing cupcakes. The knife was then reused to slice a frosted gluten-free Vanilla Cupcake from Whole Foods Gluten-Free Bake House. 

    The knife was then washed in soap and water, rinsed in running water, or cleaned with an antibacterial hand wipe (Wet Ones) and a new gluten-free cupcake was sliced. Both gluten-free cupcakes were analyzed for gluten content.  Although 28/30 cupcake samples had detectable gluten transfer, only 2/28 tested over 20ppm. 

    The team found that cutting cupcakes with a knife used to cut frosted gluten-containing cupcakes was associated with low-level gluten transfer even when crumbs were visible on the icing adhered to the knife. All three knife washing methods tested were effective in removing gluten. 

    The team acknowledges the limitations of their study, including small sample size, etc. They are calling for further study to assess best kitchen practices for people with celiac disease who are trying to avoid gluten contamination in shared kitchens.

    Main Takeaways

    1) Some kitchen activities may pose less of a risk of cross-contact with gluten than is commonly believed. 
    2) Standard washing effectively removes gluten from shared utensils.
    3) Cooking gluten-free pasta in the same water as regular gluten-containing pasta is likely okay, as long as the pasta gets rinsed well.
    4) Sharing a toaster is unlikely to result in gluten contamination.

    Read more in Gastrojournal.org

    Conflict of Interest Declaration: JAS has served on an advisory board of Takeda Pharmaceuticals and received research support from Cour Pharma, Glutenostics, and the Celiac Disease Foundation. The other authors have no conflicts of interest to disclose. Funding Source: Supported by philanthropic gifts from the Celiac Disease Foundation, Dr. SCHAR USA, and Bia Diagnostics. JAS is supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number K23DK119584. 



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    kareng

    When this “ article” came out, someone posted it on out local FB Celiac page.  2 restaurants commented “ that’s interesting” or “ something to think about”.  These were 2 places that we have all worked with and been very safe Places to eat.  Now they are thinking we are making too much of a fuss.  
     

    I think common sense tells us that, just because 1 bite of the bread doesn’t have gluten on it , that doesn’t mean that another part of the slice is free of crumbs.  
     

    saying that using the same pasta water is OK?  When gluten was detected on the pasta?   And most people and restaurants are not going to rinse pasta - I don’t want cold pasta.  
     

    so thanks people who did this rather unscientific study- you reinforce the notion that Celiacs are nuts and shouldn’t worry about a little gluten

    Edited by kareng
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    GFinDC

    It seems to me they found gluten transfer occurred in almost 100 percent of tests.  Maybe not at 20 PPM in all cases but at some lower level.  So the study does show gluten transfer /contamination is possible and does happen with poor kitchen hygiene.

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    Guest Kate G

    I think this is total b$#@@#$$ and a scam. To merely use the general public as a scientific tool to see how sick they can actually make us so in a few years they can retract the study. Just because one piece of an area of food may not have the concentration of gluten that their looking for does not mean it is not cross contaminated, cross contamination is a very real thing. I have severe celiac disease. I can’t even eat oats. Someone like myself would be put in the hospital for weeks. I have tachycardia, seizures, asthmatic breathing conditions that are a response to gluten. Is someone really going to take this risk of presenting the general Celiac disease public with taking the chance. Word will get out of their practices and kill off their business. Any kind of flour component is airborne for 24 hours after using it. If it used continuously it’s in the air, ventilation system, every little crack  and cranny of the restaurant is contaminated. They already have a cross contamination problem without adding it to water and toasters and chopping boards. I for one don’t buy this study, as I over the past 20yrs have had contamination due to these practices and gotten very sick. And remember celiac disease is an auto immune disease.

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    Guest Rebecca G

    Posted

    Dr. Fassano, a leading celiac researcher, released a video shortly after this study was released saying he recommended that those of us living with this disease disregard this study and continue to take the same precautions we always have. 

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    anonymousplease

    I agree with all of you. This study still seems totally pointless to me and I'm still not sure why it was even conducted. To disprove celiacs who say that cross contamination is a problem? To make it seem like a single crumb isn't really enough to make anyone sick? To make us all seem like we're exaggerating? We know we're not, we know what we experience. I wish someone would do a study about what successfully healing celiacs do in order to heal. How about a study about how many restaurants are labeled as safe for celiacs but are really not safe. And not some local news bull with scare tactics, like a real database of restaurants that make false claims. Maybe this would result in restaurants not labeling their menus gluten free, which tends to negatively impact people who are newly diagnosed and children whose parents don't fully understand celiacs the most. How about an instructional video for folks who do not have allergies who are dating or living with people with celiacs and want to keep their loved one safe and healthy. *Side note: my boyfriend had a hard time believing a lot of what I claimed to be my needs as a person with celiacs, but when he heard it from other people via links I sent him to this forum, he immediately understood I was not the only one in the world and not exaggerating. Allowed him to accept more easily that we would be having a gluten free kitchen when I moved in. Made things a lot easier for him to hear it from others not just myself! Any of these things would be more helpful than telling us what we already know in this study.

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    trents

    I think this is a very enlightening article and should help the average celiac who is not particularly sensitive to CC relax a little. But still, it doesn't address the needs of those who are sensitive. The rinsing of the noodles is the most important take away for me and all celiacs should inquire about this when eating out or insist that their gluten-free noodles be boiled in a dedicated pot.

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    Jojer
    On 10/21/2019 at 8:12 AM, Guest Reader said:

    The biggest flaw in this study is that no one who actually knows how to prepare pasta properly would rinse it after cooking it,

    Well, I'm pretty sure I know how to make pasta. Sometimes when I do, I rinse it to cool it to stop it cooking when I make extra for quick meals later. 

    I've used pasta water in my sauce. I don't think it has any positive effect on my sauce.

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    sc'Que?
    4 hours ago, Jojer said:

    Well, I'm pretty sure I know how to make pasta. Sometimes when I do, I rinse it to cool it to stop it cooking when I make extra for quick meals later. 

    I've used pasta water in my sauce. I don't think it has any positive effect on my sauce.

    On gluten-free pasta, it does not. 

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    sc'Que?
    On 10/4/2022 at 3:14 PM, trents said:

    I think this is a very enlightening article and should help the average celiac who is not particularly sensitive to CC relax a little. But still, it doesn't address the needs of those who are sensitive. The rinsing of the noodles is the most important take away for me and all celiacs should inquire about this when eating out or insist that their gluten-free noodles be boiled in a dedicated pot.

    I mean, the very method of cooking pasta involves adding salt, but WHY?  Because adding salt to pasta water INCREASES OSMOTIC EXCHANGE: it gets the water INTO the pasta; the result is that micro-solids come out of the pasta and into the water.  

    If you're using "dirty" pasta water to cook gluten-free pasta and your water is salted (and you need to keep adding salt, or cooking is inconsistent) then you're going to get osmotic exchange of gluten into your gluten-free pasta!  

    So much about this article is irritating.  And I'm VERY thankful to Celiac.com for keeping  the comments section open and live as we continue to learn more through science.  

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    trents
    9 hours ago, sc'Que? said:

    I mean, the very method of cooking pasta involves adding salt, but WHY?  Because adding salt to pasta water INCREASES OSMOTIC EXCHANGE: it gets the water INTO the pasta; the result is that micro-solids come out of the pasta and into the water.  

    If you're using "dirty" pasta water to cook gluten-free pasta and your water is salted (and you need to keep adding salt, or cooking is inconsistent) then you're going to get osmotic exchange of gluten into your gluten-free pasta!  

    So much about this article is irritating.  And I'm VERY thankful to Celiac.com for keeping  the comments section open and live as we continue to learn more through science.  

    sc'Que?, I think your science is bad. Osmosis is the movement of liquid in a solution across a semipermeable membrane from an area of higher solution concentration to an area of lower solution concentration. Hard pasta is not in solution and there is no semipermeable membrane present. The salt simply raises the boiling temperature of the water and also adds a little flavor.

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    sc'Que?
    17 hours ago, trents said:

    sc'Que?, I think your science is bad. Osmosis is the movement of liquid in a solution across a semipermeable membrane from an area of higher solution concentration to an area of lower solution concentration. Hard pasta is not in solution and there is no semipermeable membrane present. The salt simply raises the boiling temperature of the water and also adds a little flavor.

    Just because hard pasta is hard does not mean it's impermeable. 

    Your description of how chefs and trained restaurant cooks observe cooking is not complete. By the very definition of how osmosis works, whatever is in the (salted) water creates an osmotic exchange with the pasta.  Same as pickling cucumbers.  If this were not true, then you would not add spices like peppers and garlic to the brine. 

    When you cook pasta, whatever is in your water "seasons" the pasta itself: stock, veg, spices....  If previously used pasta water is your current pasta water for gluten-free pasta, aqueous osmotic exchange will occur.  Salt and heat are the catalysts here that cause the interaction. Water is the medium. Water is exchanged, along with whatever is "dissolved" in the water.  

    I use the term dissolved here loosely: it is a suspension, not a solution.  But those particulates (and also solutions) in various micron-level sizes do engage in osmotic exchange.  Otherwise, chefs would not waste their time and their boss' money.  

    Add fish-sauce to your pasta water (in increasing quantity), and your pasta will display the taste of fish-sauce.  

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    trents
    4 hours ago, sc'Que? said:

    Just because hard pasta is hard does not mean it's impermeable. 

    Your description of how chefs and trained restaurant cooks observe cooking is not complete. By the very definition of how osmosis works, whatever is in the (salted) water creates an osmotic exchange with the pasta.  Same as pickling cucumbers.  If this were not true, then you would not add spices like peppers and garlic to the brine. 

    When you cook pasta, whatever is in your water "seasons" the pasta itself: stock, veg, spices....  If previously used pasta water is your current pasta water for gluten-free pasta, aqueous osmotic exchange will occur.  Salt and heat are the catalysts here that cause the interaction. Water is the medium. Water is exchanged, along with whatever is "dissolved" in the water.  

    I use the term dissolved here loosely: it is a suspension, not a solution.  But those particulates (and also solutions) in various micron-level sizes do engage in osmotic exchange.  Otherwise, chefs would not waste their time and their boss' money.  

    Add fish-sauce to your pasta water (in increasing quantity), and your pasta will display the taste of fish-sauce.  

    What you are describing is reconstitution, not osmosis.

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


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