This document discusses gluten and the gluten-free diet. It begins by defining gluten as a protein found in wheat, barley, rye and triticale that can cause inflammation in those with celiac disease or gluten sensitivity. It then lists many common foods that contain gluten and acceptable gluten-free alternatives. Guidelines are provided for preparing gluten-free foods safely to avoid cross-contamination. Specific policies and practices of certain restaurants and hospitals regarding gluten-free options are also outlined. Lastly, tips are given for baking, storage and ensuring strict gluten-free preparation in kitchens. References are included at the end from nutrition and celiac organizations.

1. Laura Simonitch
B.S. Dietetics, University of Nebraska-Lincoln
Dietetic Intern, Graduate Student
University of Kansas Medical Center

2.  A family of storage proteins found in wheat,
barley, rye and triticale
 Found in the mature seed of these cereal grasses
 Harmful for those who have Celiac Disease or
gluten sensitivity/intolerance
 Inflammation in small intestines
 Symptoms: bloating, abdominal pain, etc.

3.  Wheat
 Barley
 Rye
 Farina
 Graham Flour
 Semolina
 Durham
 Bulgur
 Kasha
 Matzo meal
 Spelt (a form of flour
 Oats (by contamination)

4.  Bread
 Pasta
 Breading
 Pizza Crust
 Crackers
 Cookies
 Cake
 Muffins
 Soups
 Salad Dressing
 Sauces/Gravies
 Imitation Bacon or
Seafood
 Luncheon and
processed meats
 Malt or Malt Flavoring
 Marinades
 Soy Sauce

5.  Stabilizer
 Starch
 Flavoring
 Emulsifier
 Food Starch
 Vegetable Gum
 Hydrolyzed
 Vegetable
 Protein
 Flour or Cereal
 products
 Vegetable Protein
 Malt or Malt
 Flavoring
 Modified Starch or
 Modified
These words on a food
label usually indicates
that a gluten-containing
grain was used.

6. Amaranth
Arrowroot
Buckwheat
Cassava (manioc)
Corn
Flax
Indian rice grass
(Montina)
Job's tears
Legumes (dry beans,
peas, lentils)
Millet
Finger millet (Ragi)
Nuts
Potatoes
Quinoa
Rice
Sago
Seeds
Sorghum
Soy
Tapioca
Tef (or teff)
Wild rice
Yucca

7.  Prepare gluten-free foods first
 Change gloves before preparation
 Use separate food prep & serving utensils for
gluten-free foods
 Color code cutting boards for gluten and non
gluten foods
 Clean & sanitize food production surfaces
before, during and after food preparation

8.  BryanLGH Medical Center (Nebraska):
 Majority is frozen/ pre packaged and stays in the
package that it comes in.
 Change gloves when handling gluten-free foods
 Milks and the juices have both been cleared as
OK
 Rice cereal is cooked on its own and served with
separate utensils

9.  Olive Garden:
 Disclaimer: “Olive Garden created this menu for our gluten
intolerant guests. Please be aware that the handcrafted nature
of our menu items, variety of procedures in our kitchens,
cross-contamination with ingredients containing gluten and our
reliance on suppliers may result in variations in the ingredients
of these menu items. We therefore make no guarantees
regarding the gluten content of these items.”
 Manager: “Sanitize surfaces, clean grill, change gloves, use
different utensils, make all gluten-free food from scratch; a
gluten-free order is highlighted green so that employees know
to take extra precautions.”
 Ruby Tuesday:
 Lists meals that are gluten-free from their regular menu

10.  Cheeseburger in Paradise:
 Serves gluten-free hamburger buns
 Disclaimer: “This menu and the information on it are
provided by Cheeseburger in Paradise, in cooperation
with the Gluten Intolerance Group (GIG), as a service
to our customers. Cheeseburger in Paradise and GIG
assume no responsibility for its use and any resulting
liability or consequential damages are denied.
Cynthia Kupper, a Registered Dietician with GIG,
prepared this information (which has not been verified
by Cheeseburger in Paradise.) Our management teams
and service staff are not trained on the intricacies of
Celiac Disease or gluten intolerance and cannot be
expected to provide recommendations or other
advice on this issue. All questions should be directed
to GIG or the Cheeseburger in Paradise home office.
Patrons are encouraged to consider the information
provided, to their own satisfaction and individual
needs and requirements.”

11.  Measure flours and starches carefully because
inaccurate measurements can affect the quality of a
gluten-free product.
 Flour should be measured loosely by spooning it into the
measuring cup. Level top with flat side of a knife for
accurate measuring.
 You can improve the flavor of gluten-free baked
products by using more spices, herbs, and flavorings
to compensate for loss of wheat flavor (about one-
third to one-half more).
 Use shiny, light-colored pans (gray, not black) when
baking. Products bake and brown more evenly in
them than in dark pans.
 Reduce oven temperature by 25°F when using glass
baking pans and non-stick metal baking pans (gray,
not black).

12.  Generously grease pans before baking.
 Gluten-free bread dough and other baked
goods tend to be softer, stickier and more
batter-like.
 Adding xanthan gum (or guar gum) to a
gluten-free product is a good idea if
available at Saint Luke’s.
 A gluten-free stabilizer that improves the texture
of gluten-free products (helps keep baked goods
from falling apart).
 Some commercial flour blends already contain
xanthan gum. Check the ingredient list if you
purchase an all-purpose flour blend…
Product Amount of xanthan gum to use
Breads: 1 tsp per 1 cup flour mix
Pizza dough: 2 tsp per 1 cup flour mix
Other baked products: ½ - ¾ tsp per 1 cup flour mix

13.  Keep gluten-free flours and starches in containers
that are plastic, airtight, and have tight-fitting lids.
Store these containers in the refrigerator or freezer
and date them.
 Gluten-free items in separate part of kitchen, or at
least above items containing gluten.
 Gluten-free flours do not have preservatives, so
baked products can become stale and can spoil
quickly.
 Freeze if not eaten within 1 to 2 days to maintain
quality.
 Breads should be cooled thoroughly, sliced and each
slice should be separated with waxed paper, placed
in a plastic bag and frozen.
 Thaw at room temperature instead of the microwave.

14.  Strictly gluten-free:
 Sifters
 Deep-fryers
 Pasta servers
 Colanders
 Pizza stones
 1 toaster
 Hard-to-clean surfaces/gluten-attracting items

15.  Duker Freuman, T. (2012, July 24). What is gluten, anyway?. Retrieved
from http://health.usnews.com/health-news/blogs/eat-
run/2012/07/24/what-is-gluten-anyway
 Gluten-Free Diet: A Comprehensive Resource Guide by Shelley Case. Case
Nutrition Consulting, 2006 and 2008.
 How to (really) go gluten-free in your kitchen. Plate - The Gluten-Free
Issue, Retrieved from http://www.plateonline.com
 http://www.olivegarden.com/Menu/Gluten-Allergen/
 http://www.cheeseburgerinparadise.com/Our-Menu/Gluten-Free-
Menu.aspx
 Pocket Dictionary: Acceptability of Foods and Food Ingredients for the
Gluten-Free Diet. Published by the Canadian Celiac Association, 2005.
 Recommended Foods – Celiac Disease. Nutrition Care Manual. Academy of
Nutrition and Dietetics 2012.
 Sweeten, T. (2012). Gluten free diets in schools. Retrieved from
http://americanceliac.org/wp-
content/uploads/2009/09/Gluten_Free_Diets-in-Schools.pdf
 The CSA Gluten-Free Product Listing – 13th Edition.