Cross-Contact and Celiac Disease 101

Cross-contact and celiac disease go hand in hand. This is why cross-contact is a very important aspect of a gluten-free lifestyle. If you have celiac, you need to watch out for your food coming into cross-contact with gluten.

What is Cross-Contact?

Cross-contact is a newer term as of 2013 used to differentiate biological contamination and allergenic contamination. This term was developed in the USA Food Safety Modernization Act (FSMA) as they wanted to clarify differing sanitation protocols between removing microbes and allergenic proteins.

So cross-contact refers to the contamination of a food by allergenic proteins that would not already be present in the food.

Cross-contact happens when one food comes into contact with other food and their proteins mix. As a result, each food then contains small amounts of other food. These amounts are so small that they usually can’t be seen.


Another resource states:

[It’s the] unintentional transfer of allergenic proteins from a food containing the proteins to one that does not. 


When you have celiac disease, it is important to be aware of cross-contact because even though you can’t see the gluten proteins on/in your food, they could still trigger a response. And unlike cross-contamination of microbes, you can not kill allergenic proteins, you must remove them. Which gets us into cross-contamination…

What is Cross-Contamination?

Cross-contact is the correct term to use when discussing celiac disease and the prevention of gluten contaminating food. However, people used to and still refer to cross-contact as cross-contamination. However, the term cross-contact was developed to create a more appropriate description for exposure to allergens.

Cross-contamination now typically refers to the biological contamination of foods. Think food-borne illnesses. The key difference here is, with cross-contamination you can kill the bacteria that contaminate food, but with cross-contact you must remove the allergenic proteins. In the case of celiac, you must remove the gluten. You can not kill it.

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Are Cross-Contact and Cross-Contamination the same?

Cross-contact and cross-contamination are not the same. Cross-contact refers to the transfer of food proteins to other foods thus potentially exposing people to allergens. Cross-contamination is the transfer of microbes (like viruses and bacteria) between food.

For example, cross-contact and celiac disease might look like this: a food handler prepared a regular sandwich made with normal bread. This food handler doesn’t change their gloves when they go to make your gluten-free sandwich. Now their gloves that have touched gluten are transferring gluten to your gluten-free food (and you might not be able to see it).

Cross-contamination on the other hand would look something like this: a food handler cuts raw chicken on a cutting board and then cuts lettuce on the same cutting board with out washing it. Those who order a salad now will be exposed to the bacteria that was present on the raw chicken and will likely get sick from that exposure.

Why do you say Gluten Exposure?

If you’ve been following along with me for a while, you might have notice I often refer to gluten consumption of all forms as “gluten exposure”. For me, cross-contact isn’t the only form of being “glutened” so I refer to gluten exposure to encompass everything (especially since often when we are recovering from gluten exposure, we don’t always know how we were exposed, just that we were exposed).

Cross-Contact and Celiac Disease

Now that we know what cross-contact is, let’s talk about cross-contact and celiac disease.

Do I Need to Worry About Cross-Contact and Celiac Disease?

Yes! Some of you might know this but believe it or not, not everyone is (including doctors). Do you know how many people have told me that their doctors said they only needed to be 80% gluten-free? Or that they didn’t have to worry about certain forms of cross-contact?

If you have celiac disease, you absolutely need to worry about gluten coming into contact with your food. Even if you can’t see it, even if you don’t experience any symptoms, it could still be damaging your small intestine. This goes for all food that has “barely” touched gluten.

I’m not trying to scare you, but just know you need to do your best to avoid cross-contact. And in some cases, you may need to work with a dietitian to determine how strict your cross-contact precautions need to be. Like in the case of a non-responsive celiac diet.

Examples of Unsafe Cross-Contact for Celiac

Now that we know what cross-contact is, what does cross-contact and gluten look like? Here are some examples:

  • Someone sticks a knife into the butter tub, peanut butter, jelly,
    mayo etc. and spreads it on wheat bread and then sticks the knife back
    in to get more. That spread they put their knife in has now come into
    cross-contact with gluten and is unsafe.
  • Using water that has boiled regular pasta to boil gluten-free pasta.
  • Preparing anything that’s not gluten-free and then preparing
    gluten-free foods without washing your hands or changing your gloves.
  • Someone eating regular/gluten crackers and then reaching into a gluten-free chip bowl with the same hands.
  • Someone dipping pita bread into a shared hummus bowl.

The list goes on. Keep your eyes out for cross-contact and learn from your gluten exposures. I know that that list can seem overwhelming. If it was overwhelming for you, feel free to reach out to me, and here’s a post on how to deal with overwhelming food situations that hopefully can help.

If you need help with dealing with cross-contact in your home, Celiac Crash Course. This is a self-paced course that walks you through how to avoid gluten in food, medications, supplements WHILE also avoid cross-contact at home, at social events, restaurants and beyond…

If you need help with cross-contact, definitely check out this course.

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