Lola O’Rourke, MS, RDN

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Kitchen appliances exist to make cooking and food preparation better: quicker, easier, sometimes healthier and often tastier. But should they need to raise any red flags regarding gluten cross-contamination? Let’s take a look:

Dishwasher  

Have you ever wondered if it is safe to wash plates that have had both gluten-free (GF) and gluten-containing on them, in the same load? As long as you are using a functional dishwasher that effectively removes food particles and cleans thoroughly, this is fine.

Oven, Standard

When you can, cook gluten-free and gluten-containing items separately in the oven.  If this isn’t possible, position the gluten-free items on the higher rack, so that if any crumbs or bits of gluten-containing food escape from the non-GF item, they won’t fall onto your gluten-free food. Cover the gluten-free items if possible, even when they’re on top, for extra safety.

Oven, Convection

Convection ovens blow air throughout the oven from a fan located in the back of the oven.  So, wheat dust or food particles could be blown about and cause cross-contamination. Do not cook gluten-free and gluten-containing items at the same time (if absolutely necessary, cover the gluten-free item).  Even when your gluten-free item is the only thing in the oven, always cover it, since gluten-containing wheat dust or food particles from previous oven sessions may be blown onto the gluten-free food by the convection fan.

Microwave

It is safe for gluten-free members of the household to share the same microwave with those who do eat gluten, but don’t heat items up together. Because microwave ovens are generally quite small, there could be a significant risk of items spilling onto each other.  Microwaves do quick work, so you’ll hardly notice the extra time it takes to heat up items separately.  It is also good practice to wipe down the microwave after each use if it is being shared with gluten-containing foods since remains of previously “exploded” items could remain and then spatter onto your gluten-free food.

Grill

As temperatures ramp up and days get longer, grills are likely to take on a more central role in our meal preparation. On grills which are used for both gluten-free and non-gluten-free foods, surfaces must be thoroughly cleaned before cooking gluten-free items. An alternate solution is to consider purchasing an extra set of grill grates to use exclusively for gluten-free grilling. A quick fix is to place your GF items on tin foil (this is also a good trick to use when going over to your neighbor’s for a BBQ). Contrary to some popular beliefs, gluten cannot be “burned” off by high temperature.

Pizza stone  

Traditional pizza stones are porous, so could harbor gluten from use with non-GF pizzas. Ideally, don’t share, or be sure to place your GF pizza on parchment paper if you do. If you’re a big pizza fan, treat yourself to your own dedicated gluten-free pizza stone.

Air fryer  

Fryer baskets may be hard to thoroughly clean, even in a dishwasher. Just as you don’t share colanders or sifters (which have similar hard-to-clean structures) between gluten-free and non GF items, keep these separate. Simply get an extra frying basket and dedicate one for gluten-free use.

Bread machine

This is a place where we don’t recommend sharing. Having a dedicated gluten-free bread machine is the safest approach.

The following items have removable components, which can be put in a dishwasher or  thoroughly washed in the sink, as well as other parts (stands, bases, etc.) that cannot. Be sure that no bits of gluten-containing foods have remained on non-washable parts in such a way that they may get wiped into, or fall into your gluten-free food. Wipe down surfaces thoroughly before use with gluten-free foods, and take care to avoid cross-contact between the gluten-free food you are preparing and these surfaces.

Crock pot or instant pot  

Treat the same way you would any cooking vessel: clean thoroughly between use with non gluten-free and gluten-free items.

Food processor, blender, stand mixer

Thoroughly wash all components that will come in contact with your food, between use with gluten-free and non-gluten-free foods.

Non-stick pans

Not an appliance, but something you may be wondering about: non-stick pans. Non-stick surfaces can get scratched and develop grooves where gluten could remain. Don’t share between gluten-free and non-gluten-free items.   

Pregnancy and celiac disease both call for extra considerations when it comes to nutrition. What if you fall into both categories? Do some of the needs overlap, and are there special nutritional issues that arise for pregnant women who have celiac disease? 

Significant evidence supports the role of a healthy diet in optimizing pregnancy outcomes. The nutrients found in a healthy, varied diet are needed to maintain mother’s health and to support normal development of the fetus. Needs for iron and folic acid are greater in pregnant women, and supplementation is generally recommended. A healthy, varied diet should provide other needed nutrients, but a prenatal vitamin supplement can help ensure adequate intake, in addition to providing extra needed iron and folic acid. Maintenance of a healthy weight and appropriate weight gain during pregnancy are also important diet-related aspects of pregnancy which are associated with better outcomes.  

To learn more, read Dining Out With Celiac Disease During Pregnancy

When assessing your own dietary needs and weight gain during pregnancy, it is important to discuss your unique situation with your personal healthcare team. 

Some of the key nutrients needed in pregnancy

Iron

Used in creation of hemoglobin in red blood cells, which carries oxygen to cells and organs throughout the body. Extra iron is needed to supply oxygen to the fetus.  Good sources: lean red meats, poultry, beans & lentils, fortified grain products.

Folic Acid    

Needed to help prevent neural tube defects. Since its role is important during the very first part of pregnancy, before many women know they are pregnant, it is recommended that all women of childbearing age who may become pregnant consume sufficient folic acid.  In 1998 the FDA required that folic acid be added to enriched grain products to help prevent neural tube defects. Good sources: Brussels sprouts, broccoli, beans & lentils, spinach and other greens.   [“Folic acid” is named after the Latin word for “leaf” (just like “foliage”) due to the fact that leafy vegetables are a good source.]

Calcium   

Necessary for building bones and teeth in the fetus.    Good sources: milk and other dairy products (choose low fat versions more often), plant-based alternative milks that are calcium fortified. Other sources: calcium set tofu, beans, almonds.

Omega 3 fatty acids  

Play important role in brain development of the fetus.   Best sources are fish and shellfish. Other sources: walnuts, canola oil, ground flaxseed, edamame.

*To limit exposure to mercury, which has been linked to some birth defects and which has been found in some fish, avoid: shark, swordfish, king mackerel, orange roughy, bigeye tuna, Tilefish from the Gulf of Mexico. Limit albacore tuna to  6 oz/ week.  If you eat fish from local streams or lakes, check local advisories on these bodies of water. For more information on which fish to choose, click here.

Other dietary considerations   

Alcohol should not be consumed during pregnancy.  This is because, especially during early pregnancy, alcohol intake may result in neurological or behavioral problems in the offspring. Research on caffeine is not entirely conclusive; the general recommendation is to keep intake below 200 mg per day (the approximate amount in about 12 ounces of coffee).   As stated above, appropriate weight gain is important. Obesity and excessive weight gain can increase risk of gestational diabetes, other health issues and C-section.    Not enough weight gain is associated with having a baby who is too small, which can increase risk in the infant of illness and possibly of developmental delays.

Now that we’ve seen what some of the main nutritional considerations are during pregnancy, let’s look at how these needs may be impacted in a mother-to-be who has celiac disease.

For further information, read A Nutritionist’s Guide to a Healthy Gluten-Free Pregnancy

Iron  

In women recently diagnosed with celiac disease, nutritional deficiencies which occurred due to intestinal damage may not yet have had a chance to reverse.  Iron deficiency anemia is one of the most common symptoms of celiac disease in adults.  Discuss assessment of iron status with your healthcare team, before becoming pregnant. 

Folic Acid

Gluten-free grain based products are less likely to be enriched or fortified, and so less likely to provide significant amounts of folic acid. Intestinal damage may also cause deficiency of this nutrient.    Discuss supplementation before becoming pregnant.

Calcium

Some people with celiac disease – especially in early stages after diagnosis – may lose ability to digest lactose, and therefore may need to limit dairy intake.   Ensure adequate intake from other food sources, and/or from supplements.

Other vitamins and minerals

Intestinal damage can cause deficiencies of various vitamins and minerals, including zinc, vitamin D, vitamin B12 and other B vitamins. Vitamins and minerals play numerous important roles in fetal development.  Discuss with your healthcare team assessment of potential deficiency status, potential supplementation,  and maintain a healthy, varied diet

What about a mother to be who has celiac disease but has not been diagnosed?   Each of the nutrient issues discussed above may exist to a greater degree and could increase risk of pregnancy problems. Undiagnosed/untreated mothers are at higher risk for miscarriage, infertility, intrauterine growth retardation and low birth weight babies.   If you suspect you may have symptoms of celiac disease, or have had concerns about fertility or miscarriages, talk to your doctor about celiac disease testing.

For further discussion, read Where Diagnosed Celiac Disease Fits into Pregnancy

After baby is born to a parent with celiac disease

Because celiac disease has a genetic component, there is a greater chance that a child of a parent with celiac disease may also develop the condition.   Estimates are that celiac disease will develop in approximately 4-16% of children (and other first degree relatives) of those who have been diagnosed.   Unless your infant has symptoms, screening is generally not recommended until a child is 3 years old.   

Find much more information here. You may also want to consider having genetic testing done to see if your child carries the genes necessary for the development of celiac disease.  A positive genetic test means that celiac disease could possibly develop in the future – keep in mind that about 33% of the general population carry these genes, but only 1% develop celiac disease. A positive test means you will want to watch for symptoms and have testing done when/if necessary. A negative test is more conclusive: it tells you that your child will not develop celiac disease, and that no additional monitoring or testing is necessary.

Does how you feed your infant – including the choice of whether to breastfeed or not – influence risk of developing celiac disease? What about timing of gluten introduction? Research has been done on these factors, but there is currently no scientific consensus.   Breastfeeding does not seem to provide protective effects regarding development of CD, (but it does have many other benefits). When it comes to introduction of gluten to an infant’s diet, research has looked at whether either avoiding early (before 4 months of age) or later (after 6 or 12 months of age) introduction has an effect.  Again, there is as yet no conclusive evidence.

For more information, read Does Breastfeeding Prevent Celiac?