Celiac disease is a genetic, autoimmune, digestive disease that affects 1 in every 100 children.
When children with Celiac disease eat gluten, the protein found in wheat, barley, and rye, it causes inflammation and damage to their small intestine. When this inflammation and damage goes unchecked, it can lead to a disruption in every system in the body-gut, brain, skin, bones, etc.
A strict gluten-free diet is the only treatment for celiac disease. 20 parts of gluten per one million parts of a food sample (20 ppm) or less, is the accepted standard for products that are labeled gluten-free. Gluten is found in foods as well as everyday products such as medication, vitamins, lotions, lipstick, and Play-Doh to name a few.
Common recommendations to avoid gluten contamination in children with Celiac disease include having a separate toaster and not playing with Play-Doh. However, recent studies show that these precautions may not be necessary. Researchers from the celiac disease program at Children’s National Medical Center in Washington D.C. looked at whether, and how much, gluten could be transferred from contaminated foods and school supplies to children’s hands, work tables and gluten-free food.
Cross-contamination with gluten was measured in three kitchen scenarios:
- Using a common toaster
Gluten levels remained at less than 20 ppm when gluten-free bread was toasted in the same toaster as regular bread, even when gluten-containing crumbs were present at the bottom of the toaster
- Using common pots and water to cook pasta
Cooking gluten-free pasta in the same water as regular pasta did cause significant gluten transfer, sometimes as high as 115 ppm. However, if the gluten-free pasta was rinsed under running tap water after cooking, the gluten transfer dropped to less than 20 ppm. If the pasta pot was simply rinsed with fresh water before being reused, then gluten transfer was undetectable.
- Using a common knife to slice cupcakes
Gluten levels remained below 20 ppm in most cases when a knife used to cut frosted gluten-containing cupcakes was then used to cut gluten-free cupcakes, even when visible crumbs were stuck to the icing on the knife
Exposure to gluten while performing common school activities was also measured in 10 children without celiac disease, aged 4 to 16 years. The activities included:
- using papier-mache
- playing with Play-Doh
- playing with dry and cooked gluten-containing pasta
- applying lotion containing gluten
- making sandwiches with gluten-containing bread
- cutting cupcakes with and without gluten
Playing with Play-Doh (median, 1.25 ppm), touching dry pasta (median, 1.25 ppm), applying lotion (median, 2.06 ppm), making a sandwich (median, 8.17 ppm), and cutting cupcakes (median, 8.97) were all associated with a low-to-medium risk for exposure to gluten. The highest exposures came from papier-mache (median, 1,339.38 ppm) and playing with cooked pasta containing gluten (median, 241.12 ppm).
The study also showed that washing hands, utensils or work tables with soap and water or water alone was sufficient to remove detectable gluten.
Using basic cleaning methods for hands, tables and utensils removes gluten. The most important thing families can do to prevent gluten reactions is practicing simple hygiene steps that include washing their hands with soap and water before preparing gluten-free food and washing pots, pans and kitchen utensils with soap and water before using them to prepare gluten-free food. If you would like more information about gastrointestinal (GI) digestive disorders and nutrition in children, please contact Dr. Mona Dave’s Plano Office or Southlake Office.