Gluten-Free Basics & School Meals...(order from your central) Gluten free English Muffin-(302779...

© COPYRIGHT 2017 SCHOOL NUTRITION ASSOCIATION | #ANC17 | ATLANTA, GA© COPYRIGHT 2017 SCHOOL NUTRITION ASSOCIATION | #ANC17 | ATLANTA, GA

Gluten-Free Basics& School Meals

Addressing the Needs of Students with Celiac Disease

© COPYRIGHT 2017 SCHOOL NUTRITION ASSOCIATION | #ANC17 | ATLANTA, GA

Presenter

Beckee Moreland

Director of GREAT Schools

Beyond Celiac

Ambler, PA


Learning Objectives

• Identify medical conditions associated with the gluten-free diet

• Recognize common and hidden sources of gluten

• Identify gluten-free substitutions for ingredients

• Describe menu substitutions and provide examples

• Identify potential areas in the cafeteria kitchen for gluten

cross-contact and provide control solutions

• Illustrate product storage and equipment needs for special

diet accommodations


Definitions

• Food Allergy - A food allergy results when the immune system

mistakenly targets a harmless food protein – an allergen – as a

threat and attacks it. (IgE mediated)

• Food Intolerance – Can cause some of the same symptoms as a

food allergy but not anaphylaxis, no immune reaction, e.g.

lactose intolerance

• Food Sensitivity – Foods that cause reaction/discomfort, e.g.

sulphite sensitivity


What is Gluten?

• A protein; a tiny

component of

wheat, rye and

barley.

• It gives baked goods

their structure


What is Celiac Disease?

• Bloating, gas, abdominal pain

• Diarrhea or constipation

• Fatigue

• Itchy skin rash (DH)

• Tingling/numbness in hands or

feet

• Discolored teeth or loss of

enamel

• Canker sores

• Joint pain

• Irritability or behavior changes

• Significant unexplained weight

loss

• Poor weight gain

• Delayed growth

• Missed menstrual periods

• Fractures or thin bones

Celiac disease is a genetic autoimmune disorder triggered by the protein gluten.

Symptoms before diagnosis and treatment

Treatment: 100% strict gluten-free diet


Gluten Damage

• Inflammation and immune

response in the small

intestine that damages the

villi

• Symptoms occur

• Body is unable to absorb

nutrients into bloodstream

• Can lead to malabsorption

• Villi become healthy by

removing gluten from diet


Non-Celiac Gluten Sensitivity• Also known as gluten sensitivity

• Bodily reaction to gluten that causes

symptoms similar to celiac disease

• Exact cause is unknown

• Blood tests for celiac disease cannot

diagnose NCGS

• Does not involve damage to the small

intestine

• Estimated 6% of the U.S. population or 18

million Americans

Treatment: Gluten-free diet

© 2016 Beyond Celiac www.greatGFKitchens.org


“What happens when you get glutened?”

• Vast range of experiences – no two cases alike

• Reaction time – hours to days

• Severity – mild to debilitating

• Multitude of symptoms or none

• Internal damage and autoimmune reaction still

occurs

• Vomiting, stomach cramps, brain fog, mood

swings, rash, bloating, chills, depression,

diarrhea, canker sores, tremors…



Who’s Eating Gluten-Free?



Most Difficult Lifestyle Situations



Impact on Relationships & Daily Life

• “Unwanted Visibility”

• Neglect and/or being “forgotten”

• Risk-taking/not wanting to disclose the gluten-free diet

• Constantly being “on call” and at-risk

• Changes in social life



Needs of the Gluten-Free Student

Food Safety• Safe food is first priority

• Health consequences to

eating gluten

• Debilitating symptoms

challenge students’ ability to

learn and participate in

activities



Variety• Offering tasty and appealing

menu options

• Mirror traditional menu options

• Substitute nutritious gluten-free

alternatives

• Provide variety of options to

support dietary compliance



Nutrition

• Nutrition deficiencies are common

with celiac disease diagnosis

• Typical gluten-free diet lacking

nutrients

• Gluten-free foods not required to be

fortified



Emotional

• Feel welcome and included

• Treated with respect

• Feel comfortable asking food

questions about safety

• Build relationships in order to

develop trust and confidence


Section 504

Section 504 of the

Rehabilitation Act of 1973

• Requires accommodating students

with special dietary needs,

including the gluten-free diet for

medical reasons

• Dietary modifications documented

within students Individual

Education Plan (IEP)/504 plan


Process to Identify Students

1. Parents get the necessary paperwork

for school meal modifications

completed by health professional.

2. Forms to Health Office or School

Office - shared with the kitchen staff.


Process to Identify Students

3. Collect additional information on child’s

condition, severity of the diet provided

through the nurses/parents.

(Follow up is done for diets that are

unclear or not specific enough.)

4. If possible parents pre-select the foods

from gluten- free menu for students.


Communication & Team Work

• Meet with parents and all school

personnel assisting with the

student’s food choices (classroom

and lunchroom).

• Parents share the level of dietary

restriction needed for child

– Often times what is on file at school is

more restrictive than what the parents

are allowing at home- a new medical

statement is needed if the diet has

changed.


Creating Gluten-Free Options


Challenges to Conquer

• Identify ingredients with allergens and gluten

• Transparent communication with students and

parents

• Education & commitment to training staff

• Eliminate & control allergen/gluten ‘hot spots’

• Create systems to execute controls precisely and

consistently



What is Gluten?

• Protein found in wheat, barley and

rye and their derivatives:

– Wheat varieties include spelt,

triticale, semolina, durum, farina,

farro… (not a complete list)

– A sticky substance that gives many

foods shape, texture and

consistency

• Most commonly found in flours,

breads, pastas, crackers, cake and

cookies


Gluten-Free Grains

• Rice (all forms)

• Corn (corn bran, grits,

hominy, hasa marina)

• Potato (starch & flour)

• Soy

• Tapioca

• Bean

• Amaranth

• Quinoa

• Buckwheat

• Millet

• Teff

• Nut Flours

• Sorghum

• Arrowroot

• Wild Rice

• Mesquite


Overlooked Sources of Gluten

• Soy sauce

• Licorice

• Imitation

seafood

• Communion

wafers

• Play-Doh©

• Gravies and

Sauces

• Broth/Bouillon

• Deli Meats

• Veggie

Burgers

• Refried Beans

• Seasoned Rice

Mixes

• Self-basting

poultry

• Pudding

• Taco

Seasoning


Food AllergyLabeling Consumer Protection Act-2004

• Top 8 allergens – peanuts, tree nuts, egg, soy, fish, shellfish,

wheat, dairy

• All packaged foods sold in the U.S. - FDA regulated

• Must be clearly labeled in plan English if food contains the

allergen

• Statements like “may contain” “made in facility” etc. not

required & not regulated


FDA Gluten-Free Labeling - 2013

• Label “gluten-free”- the product must

contain less than 20 parts per million of

gluten

• Gluten = wheat, rye, barley and cross-

bred hybrids (derivatives)

• Voluntary labeling claim - if labeled

“gluten-free” you must follow the

regulation


20 Parts Per Million

• 20 milligrams in one

kilogram

• One wheat seed in

5,000 lentils


Is It Gluten-Free?


Research Ingredients

• Undeclared ingredients need to be researched (Colorings,

seasonings and flavorings)

• Many companies will not make promises about their

products

• Commodity foods are difficult to have verification of

ingredient statements prior to the product arriving in your

kitchen

• Create a policy of product usage based on best practices

and FDA guidelines


Modifying a Standard Menu

• Mirror standard menu if possible.

• Main entrées and side dishes may be easier to adapt

• Save extra portions of foods to use for gluten-free options

(rice or ground beef)

• Similar meals for special diets students creates inclusion,

confidence, pleasant experience

• Wheat/gluten substitutions: gluten-free bread, pasta, waffles,

buns, rolls


Creating SubstitutionsStandard Menu Option

• Soft shell beef taco on flour

tortilla

• Hot Dog on Bun

• Cheesy Taco

• Chef salad with roll

Gluten-Free Option

• GF Taco – no taco

seasoning, plain ground

beef or diced chicken on

hard corn taco shell

• Hot Dog on gluten-free

bun

• Cheesy Taco – NO

OPTION

• Chef Salad with gluten-

free muffin

Standard &

Gluten-Free

Refried Beans

Shredded Lettuce

Tomato

Plum & Grapes

Peaches

Low Fat Milk


Gluten-Free Breakfast Menu

Monday Tuesday Wednesday Thursday Friday

Cereal:

• Cinnamon

Rice Chex

• Cheerios (GF)

With Gluten free

toast (bread)-

302792 & jelly

Gluten Free

waffles- 302798

Syrup is gluten

free

Yogurt with

Gluten free muffins

(order from your

central)

Gluten free English

Muffin-(302779 with

jelly, order from

your central kitchen

Cereal:

• Cinnamon

Rice Chex

• Cheerios (GF)

With Gluten free

toast (bread)-

302792 & jelly

Lincoln Public Schools, Lincoln, NE


Controlling Gluten Hot Spots

Courtesy of www.easyeats.com


Gluten or allergen-containing food

transfers to gluten or allergen-free

food - PROTEIN TRANSFER

✓Production

✓Transportation

✓Storage

✓Preparation

Unsafe for those with gluten-related

disorders or food allergies

Cooking at high temperatures does

not kill gluten/allergen

Cross-Contact



Bacteria and some virus transfer to food- can lead to food-borne illnesses

✓Production✓Transportation✓Storage✓Preparation

Unsafe for EVERYONE

Proper cooking can kill bacteria – some virus – limits food-borne illnesses

Cross-Contamination



Cross-Contact ExamplesDirect - Indirect

• Bread knife cutting a baked potato

• Salad dressing on a salad bar

• Peanut or sun butter sandwiches – gluten cross contact (multiple

allergens)

• Tongs used for hot dogs on bun

• Gloved hands – Salad, roll – not changing gloves

• (picture or samples of purple gloves – kids see the gloves they

know you have their backs)


Communication is Key

• Educate staff, train, again

– Focus on seriousness of conditions –

medical necessity

– Cross-contact

– Make mistake; start over

• Assign staff to special diet duty

• Build relationship with student

• Identify student with correct meal -

label

• Talk with student about what THEY like

• Attend 504 planning meeting


Keep it Simple and Separate

• Be aware of the crumb factor; airborne

flour

• Wash hands; change gloves often

• Separate gluten & gluten-free foods, i.e.

cold & dry storage, warmers, serving

racks

• Identify best prep area for gluten-free


© 2016 Beyond Celiacwww.greatGFKitchens.org

Keep it Simple and Separate

• Clean & sanitize surfaces before use

• Label – menus, products, menu items, meals

• Color-code – products, meals, equipment

• Use barriers in production and for meals


Ordering Channels for Special Diets

• Use foodservice website for purchasing and sourcing products

• Add slide of Rice Krispies

• Foodservice distributors can assist in sourcing and providing

smaller orders

• Caution using commodities (averaging used on labels, natural

foods okay)

• Parents offering to provide certain products – Check with the

Health Dept.

• Work with local grocery stores – RD’s, Big Box online ordering


Resources

Beyond Celiac:

• Quick & Easy to Fix, Nutritious Gluten-Free Snacks

• Gluten-Free Menu Planning: Budget-Friendly Tips

• The Gluten-Free Diet

• Back-to-School Toolkit

• GREAT Schools, Colleges, & Camps program


Questions?

Beckee Moreland

Director of GREAT Schools, Colleges, and Camps

Beyond Celiac

Ambler, PA

[email protected]

www.greatgfkitchens.org

www.beyondceliac.org

mailto:[email protected]

http://www.greatgfkitchens.org/

http://www.beyondceliac.org/

Date post:	02-Jun-2020
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Gluten-Free Basics & School Meals...(order from your central) Gluten free English Muffin-(302779...

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