How strict should I be if cross contamination (cross contact) doesn’t bother me?

Katarina Mollo MEd, RDN, LDN
Q: I only get very mild symptoms from ingesting gluten despite being clinically diagnosed with celiac disease. How strict should I be with my diet? Cross-contamination doesn't usually bother me symptom-wise, but am I harming my body internally by not avoiding it more consciously?

Answer


The severity of symptoms can vary widely from person to person. However, people with celiac disease will still have damage to the intestine if they consume gluten, even if there are no outward symptoms. If you have celiac disease, we recommend you stay completely gluten-free to avoid complications. Generally, 10 mg gluten (per day) is considered the threshold for gluten consumption (1). This is the amount of gluten in a 350th piece of a slice of bread - so really just crumbs!

The issue of cross-contact is a bit unclear, it depends on the type of cross-contact and how much gluten would be transferred to the food. For instance, a recent study showed that washing pots and pans with detergent and water was enough to get rid of gluten and safe to cook gluten-free food in (no need for completely dedicated GF pans). However, the same study showed that cutting GF foods with the same knife as gluten-containing foods and not washing it in between transferred too much gluten, while washing it was enough to get rid of the gluten. They found that washing is key to remove gluten and recommend to wash hands and surfaces with soap and water to remove gluten (2).

I would recommend that you use dedicated items for things that are porous or difficult to clean. Cleaning with soap and water or running through the dishwasher should be enough to get rid of gluten from any non-porous material. When hand-washing items make sure to use dedicated gluten-free sponges/brushes and rags as they can get gluten stuck to them and introduce gluten on dishes and surfaces.

Below are items that are too hard to clean and we recommend using a dedicated gluten-free version:

  • Wood cutting boards/utensils/rolling pins

  • Strainer/colander

  • Sifter

  • Cast iron pans

  • Breadmaker/ sandwich maker/waffle iron

  • Use a dedicated toaster or use foil in a toaster oven

References:

  1. Catassi C, Fabiani E, Iacono G, et al. A prospective, double-blind, placebo-controlled trial to establish a safe gluten threshold for patients with celiac disease. Am J Clin Nutr. 2007;85(1):160‐166. doi:10.1093/ajcn/85.1.160
  2. Weisbrod VM, Silvester JA, Raber C, McMahon J, Coburn SS, Kerzner B. Preparation of Gluten-Free Foods Alongside Gluten-Containing Food May Not Always Be as Risky for Celiac Patients as Diet Guides Suggest. Gastroenterology. 2020;158(1):273‐275. doi:10.1053/j.gastro.2019.09.007

Note: This information is provided by NCA and Katarina Mollo MEd, RDN, LDN, NCA's Director of Education. This information is meant for educational purposes only and is not intended to substitute for personalized medical advice or replace any medical advice provided directly to you by your health care provider. No liability is assumed by the NCA or Katarina Mollo, MEd, RDN, LDN by providing this information.

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