Gluten-Free Diet: From Development to Assessment of a Check-List Designed for the Prevention of Gluten Cross-Contamination in Food Services

Nutrients. 2018 Sep 10;10(9):1274. doi: 10.3390/nu10091274.

Abstract

Gluten cross-contamination in gluten-free food may jeopardize treatment of celiac patients. Considering the deficit of appropriate instruments to enable the implementation of safe production practices for gluten-free food, this study aimed to evaluate the application of a check-list elaborated for gluten cross-contamination prevention in food services. The instrument was applied in 60 Brazilian food services. Interobserver reproducibility and internal consistency of the check-list were tested. A score classification was created for establishments according to the food contamination risk assessment. Subsequent to the application and statistical analysis, the original instrument was reduced to a 30-item check-list. In the reproducibility analysis, none of the 30 items showed significant divergence among the evaluators (p > 0.05 in the Cochran Q test). The 30-item version of the check-list presented Kuder⁻Richardson Formula 20 (KR-20) = 0.771, indicating good internal consistency. The proposed classification score is obtained by adding 1 point for each item with an "adequate" response; therefore, the final score may vary between 0 and 30 points. Establishments with up to 15 points exhibit risk of gluten contamination, while establishments with a score above 16 points exhibit low risk of contamination. The check-list displayed good reproducibility and internal consistency, suggesting that it could be a useful gluten contamination control instrument in food services.

Keywords: celiac disease; check-list; cross-contamination; food safety; gluten.

Publication types

  • Evaluation Study

MeSH terms

  • Brazil
  • Celiac Disease / diet therapy
  • Checklist / standards*
  • Diet, Gluten-Free*
  • Food Contamination / prevention & control*
  • Food Services / standards*
  • Glutens / analysis
  • Humans
  • Qualitative Research
  • Reproducibility of Results
  • Risk Assessment

Substances

  • Glutens