Pretty good article mith....
This is in general a very well thought out and well written article on celiac disease. It touches on a lot of important information, how many different products can have gluten in them, how diagnosis can be a problem because the symptoms can match so many different disorders, etc. There are only a few things that I should add that the article either didn't touch on, or didn't explain clearly.
With regard to how things get cross contaminated: The article explained how cross contamination can occur from using the same utensils/oil to cook a dish for a celiac allergic individual when they used that utensil/oil to cook something that contained gluten. Cross contamination can also be transmitted by hand contact from a gluten product to an item for the allergic person (this is why in my restaurant plastic gloves are used at all times and are changed when they get an allergy ticket) plus the utensils must be washed clean and WIPED DRY. This last point is very important. In the same way that oil can harbor traces of gluten, water can be a conduit as well. This is why the method that something is cooked is just as important as the ingredients used in the dish. Let me give an example.
If someone comes into my restaurant (it's a seafood restaurant) and has a severe shellfish allergy we can still serve them other food on the menu that is not shellfish (salmon for example) or an item on the menu that is not seafood at all (filet mignon). Most people would think, if you are severely allergic to shellfish, why would you go to a seafood restaurant and tempt fate? Well, as a company, we don't want to 1) turn away that person's business and 2) make them feel uncomfortable and that there is something wrong with them for having an allergy that they very well could've inherited genetically. Now this is where the preparation comes into play...that guest can order two side dishes with their salmon or filet mignon. They pick steamed broccoli and white rice. You as the server don't check with the kitchen manager or the front of the house manager to discuss any possible interactions for that meal. You serve the allergic guest their dish and watch in panic as they begin to choke. They aren't able to breathe and can't locate the epi pen in their pocket/purse. Congrats! You've just killed your guest. How did you do it? The broccoli and rice that you thought was fine because they aren't shellfish was contaminated in the steamer oven. It turns out that the restaurant steams its lobsters in the same steamer that steams the rice and broccoli. What can cause an allergic reaction is not only the offending object but the oils or juices that can come off it. So for nut allergies it would be the nut oils, in our example it would be juices from the lobster meat that get trapped in water molecules and are spread around the inside of the steamer. The same thing can happen if you wash the utensils, but then don't properly dry them. Wiping them dry with a clean cloth ensures that you are wiping away any last traces of the offending allergen. The reason this is especially important for celiac allergies is that the damage it causes is not visible (such as someone choking because of anaphylactic shock) but internal (in your intestines).
The other thing that bothered me was the part of the article that states:
"It's not clear whether ingesting gluten causes a person to develop celiac or simply triggers symptoms of the disease."
Then the author contradicts this statement a few pages later:
"It's also possible for a person to just be gluten-intolerant or have a wheat allergy without having the genetically linked celiac disease."
Let me be clear that celiac disease is a genetic disease. It can lay dormant until a stressor (surgery, pregnancy, childbirth, viral infection, or severe emotional stress) causes the immune system to weaken and then you may begin to experience symptoms. The difference between a gluten sensitivity and celiac allergy is the fact that with the allergy there is an immune system response and with the sensitivity there is not.
Since a person with a sensitivity does not have the allergic reaction, they may still be allowed to eat gluten in very small quantities. Just how much we still don't know and requires further research. This is why my chef can educate a guest about the possibility of some kind of reaction with a sensitivity but ultimately it is up to the guest whether or not they eat it. With a clear cut allergy, we have the right to refuse responsibility (note: refuse responsibility, NOT SERVICE) if we inform the guest that what they are ordering will definately cause an allergic reaction. This way both me and my restaurant are not legally liable if someone dies or gets seriously injured from our food, because we warned them first.
With regard to how things get cross contaminated: The article explained how cross contamination can occur from using the same utensils/oil to cook a dish for a celiac allergic individual when they used that utensil/oil to cook something that contained gluten. Cross contamination can also be transmitted by hand contact from a gluten product to an item for the allergic person (this is why in my restaurant plastic gloves are used at all times and are changed when they get an allergy ticket) plus the utensils must be washed clean and WIPED DRY. This last point is very important. In the same way that oil can harbor traces of gluten, water can be a conduit as well. This is why the method that something is cooked is just as important as the ingredients used in the dish. Let me give an example.
If someone comes into my restaurant (it's a seafood restaurant) and has a severe shellfish allergy we can still serve them other food on the menu that is not shellfish (salmon for example) or an item on the menu that is not seafood at all (filet mignon). Most people would think, if you are severely allergic to shellfish, why would you go to a seafood restaurant and tempt fate? Well, as a company, we don't want to 1) turn away that person's business and 2) make them feel uncomfortable and that there is something wrong with them for having an allergy that they very well could've inherited genetically. Now this is where the preparation comes into play...that guest can order two side dishes with their salmon or filet mignon. They pick steamed broccoli and white rice. You as the server don't check with the kitchen manager or the front of the house manager to discuss any possible interactions for that meal. You serve the allergic guest their dish and watch in panic as they begin to choke. They aren't able to breathe and can't locate the epi pen in their pocket/purse. Congrats! You've just killed your guest. How did you do it? The broccoli and rice that you thought was fine because they aren't shellfish was contaminated in the steamer oven. It turns out that the restaurant steams its lobsters in the same steamer that steams the rice and broccoli. What can cause an allergic reaction is not only the offending object but the oils or juices that can come off it. So for nut allergies it would be the nut oils, in our example it would be juices from the lobster meat that get trapped in water molecules and are spread around the inside of the steamer. The same thing can happen if you wash the utensils, but then don't properly dry them. Wiping them dry with a clean cloth ensures that you are wiping away any last traces of the offending allergen. The reason this is especially important for celiac allergies is that the damage it causes is not visible (such as someone choking because of anaphylactic shock) but internal (in your intestines).
The other thing that bothered me was the part of the article that states:
"It's not clear whether ingesting gluten causes a person to develop celiac or simply triggers symptoms of the disease."
Then the author contradicts this statement a few pages later:
"It's also possible for a person to just be gluten-intolerant or have a wheat allergy without having the genetically linked celiac disease."
Let me be clear that celiac disease is a genetic disease. It can lay dormant until a stressor (surgery, pregnancy, childbirth, viral infection, or severe emotional stress) causes the immune system to weaken and then you may begin to experience symptoms. The difference between a gluten sensitivity and celiac allergy is the fact that with the allergy there is an immune system response and with the sensitivity there is not.
Since a person with a sensitivity does not have the allergic reaction, they may still be allowed to eat gluten in very small quantities. Just how much we still don't know and requires further research. This is why my chef can educate a guest about the possibility of some kind of reaction with a sensitivity but ultimately it is up to the guest whether or not they eat it. With a clear cut allergy, we have the right to refuse responsibility (note: refuse responsibility, NOT SERVICE) if we inform the guest that what they are ordering will definately cause an allergic reaction. This way both me and my restaurant are not legally liable if someone dies or gets seriously injured from our food, because we warned them first.