Coeliac disease – catering gluten-free

About Coeliac UK • National Charity for people with coeliac disease and dermatitis herpetiformis • Founded in 1968 and is the largest coeliac charity in the world • Mission: to improve the lives of people with coeliac disease through support, campaigning and research

• 60,000+ Members with 12,000 joining us each year • Widely considered the experts in the gluten-free market

• Over 70 Local Voluntary Support Groups

What is coeliac disease? • Autoimmune disease triggered by eating gluten • One of the most common autoimmune diseases • Approximately 1 in 100

• Approximately 24% are diagnosed • Increased risk amongst first degree relatives e.g. parents and siblings • Approximately 1 in 10

• Can lead to more serious complications: • osteoporosis • cancer of the small intestine

• Treatment is a gluten-free diet

What happens in coeliac disease? • Eating gluten damages the gut in genetically susceptible - and triggers immune system to reinforce damage • Prevents absorption of nutrients from food • If untreated, can lead to a range of nutritional deficiencies (eg anaemia) or more serious complications osteoporosis, small bowel cancer and infertility

Symptoms Wind

Nausea

Bloating Constipation

Mouth ulcers

Diarrhoea

Joint & bone pain

Recurrent miscarriage

Weight loss Hair loss Short stature

Skin problems Tiredness

Depression Anaemia

Symptoms can be mild or severe and are often put down to IBS, stress or getting older

How is it diagnosed? • Is it coeliac disease campaign? Online self assessment. • Speak to a GP • Blood test • Antibodies to gluten

• Endoscopy with gut biopsy • Damage to the gut lining

• Must keep eating gluten until testing complete

The gluten-free diet is a treatment • A complete treatment for coeliac disease • Improves symptoms, quality of life – many people feel better within a few days but varies from person to person

• Minimises the risk of complications – osteoporosis, infertility and malignancy (5 years on gluten-free diet) • Helps to treat complications and nutritional deficiencies

What is gluten? Gluten is a protein found in:    

Document title here

wheat barley rye oats (similar protein)

The gluten-free diet • Naturally gluten-free foods • Rice, fruit and veg, meat, fish and poultry, lentils, cheese, milk, yogurt

• ‘Mainstream’ foods made of naturally gluten-free ingredients • Some ready meals, sauces, sausages, baked beans, jams and spreads, salads and dips

• GF substitute GF foods • Gluten-free bread, flour, pasta, crackers, breakfast cereals

The law on gluten-free • Regulation EC/41/2009 covering GF food has been in place since 1 Jan 2012. • GF covered by the law and applies to food which contains 20 parts per million (ppm) or less gluten • Essential that kitchen practices ensure dishes are below 20ppm. Testing can be a good way to check your processes are effective

Coeliac UK Research Round Up

Catering research - our agenda • To understand the levels of gluten in food prepared for people with coeliac disease • To assess whether GF labelling was appropriate in the sector • To try to identify what was needed for GF preparation in commercial kitchens •To support the catering sector

Catering research • Worked with RSSL and conducted detailed check lists coupled with site visits – restaurants, hospitals, schools etc.

• Monitored preparation of meals, collected samples analysis • 95% came back ok – without any extra effort and before the law was enforced

• Logged key ‘trends’ and effective control systems • Identified communication with customer and between staff

Key findings • Delivering gluten-free was possible • Effective communication key • Good hygienic practices = Good gluten management

Latest research – flour use • Determine variables that have a significant effect on gluten contamination in commercial kitchens when wheat flour is in use and to establish controls necessary to assure GF production • • • •

Distance Barrier Time Extraction

• Established control of a minimum of 2m distance, along with good food hygiene practices was found to be effective in preparing GF meals

How to produce GF meals

Choosing and using the right ingredients • Select ingredients labelled gluten-free • Use naturally gluten-free ingredients • Select ingredients by reading the label o Must emphasise the words wheat, rye, barley or oats o Check for ‘may contain’ statements. Manufacturers use these to indicate there is a risk of contamination • Develop processes to manage ingredient information o Database holding the information o Specification sheets from suppliers o Process for monitoring changes in ingredients

Storage • Store gluten-free and gluten-containing ingredients separately • Store gluten-free ingredients above gluten-containing in store cupboards • Ensure storage containers are cleaned before use • Be careful decanting ingredients especially flours • Clearly label decanted ingredients and seal well

Preparing gluten-free food • Develop processes to manage cross contamination at all stages of preparation and cooking, e.g.: o boiling o deep frying o grilling/griddling o toasting o cutting/slicing o oven baking. • Ensure clean utensils, equipment and surfaces • Consider separate toaster and fryer and dedicated chopping boards.

Cleaning and personal hygiene • Clean surfaces and equipment before preparing gluten-free food • Have separate utensils where necessary or use clean utensils for gluten-free • Use fresh water, detergent and force to clean equipment • Wash hands thoroughly before preparing gluten-free.

Communicating and Serving gluten-free • Train all staff on cross contamination and the importance of getting it right • Always check, never guess • Make sure your staff know who they can ask if they are not sure • Use separate serving utensils for serving gluten-free

Risk Assessment  Raw materials – assessing ingredient suppliers  Storage areas – cross contamination controlled  Cross contamination controlled during all stages of product preparation  Storing  Mixing  Kneading  Cooking  Baking  Cooling  Packaging and labelling  Cleaning – equipment, surfaces, hands

Requirements  HACCP system should be in place that includes: 

Risk assessment taking gluten contamination into account in all phases

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Steps to ensure final product meets criteria for GF

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Verification procedure to monitor final product using sampling plan

How we can help you There’s a lot we offer:  Online training  Face to face training  Bespoke training  Accreditation  Consultancy

Who we’ve accredited

Who we’ve trained

Online catering training • Coeliac disease and the GF diet • Catering GF – the practicalities • Gluten-free and the law • 20% off code for NACC members (enter NACC20). Usual price £35 + VAT, discounted price £28 + VAT www.glutenfreetraining.org

Thank you!

www.coeliac.org.uk