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

• Published in: Nutrients Vol. 10; no. 9; p. 1274
• Main Authors: Farage, Priscila, Puppin Zandonadi, Renata, Cortez Ginani, Verônica, Gandolfi, Lenora, Yoshio Nakano, Eduardo, Pratesi, Riccardo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10-09-2018; MDPI
• Subjects: Brazil; Celiac disease; Celiac Disease - diet therapy; check-list; Checklist - standards; Classification; Contamination; Control equipment; cross-contamination; Diet, Gluten-Free; Disease prevention; Divergence; Food contamination; Food contamination & poisoning; Food Contamination - prevention & control; Food production; Food safety; Food service; Food Services - standards; Gluten; Glutens - analysis; Humans; Pollution control; Pollution prevention; Prevention; Qualitative Research; Quality of life; Questionnaires; Reproducibility of Results; Risk Assessment; Semantics; Statistical analysis; Brazil; food safety; celiac disease; gluten; check-list; cross-contamination
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu10091274

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 (
> 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.