University of Maryland

College Park
Dietetic Internship
Topic: Gluten

INSERVICE EDUCATION LESSON PLAN

Date March 9, 2015

Audience: Dining Services Staff at Windsor Restaurant

Goal: Increase knowledge and understanding of gluten, what gluten is, what foods
contain gluten (aka what is a gluten-free diet), who needs a gluten free diet and the
difference between Celiac Disease vs. Gluten sensitivity.
Objective(s):
Discuss gluten. Describe the properties and health implications of the protein.
Review foods that contain gluten.
Explain the difference between Celiac Disease and gluten sensitivity
Discuss why it is important to see a doctor and a Registered Dietitian before
eliminating gluten from the diet
Discuss the preparation of gluten-free foods and the risk of cross contamination
Discuss foods that are naturally gluten free
Audio-visual Aids:
Outline:
A. Introduction to Gluten
a) Hello! Our names are Megan Smith and Chandler Ray. Today we would like to
discuss the protein gluten, foods that contain gluten, why gluten sometimes needs
to be eliminated from the diet, and why it is important to see a Registered
Dietitian before eliminating the protein from the diet.
b) Grains such as wheat, barley, and rye grow from a seeds known as a kernel. A
kernel contains three parts: the bran, endosperm, and the germ. (picture of a
kernel of wheat)
c) The endosperm portion of a kernel contains the greatest portion of gluten
(protein), carbohydrates, iron, and B-vitamins. It is also a source of soluble fiber.
d) Gluten protein can be found in these grains: wheat, barley, rye, and triticale.
e) Foods that contain these gluten-containing grains include: breads, baked goods,
soups, pasta, cereals, sauces, salad dressings, malt, food coloring, malt vinegar,
beer, and rye bread. (picture of these foods)
f) It is important to read food labels when looking for products that eliminate gluten.
First check label for the following grains: wheat, rye, barley, triticale, malt,
brewers yeast, and wheat starch. Also look for varieties and derivatives of wheat
including: wheat berries, durum, emmer, semolina, spelt, farina, faro, graham,
KAMUT, and einkorn.
g) Products labeled wheat free are not necessarily gluten free.

B. Who needs to eliminate gluten from their diet?

a) Celiac disease is an autoimmune disorder that can occur in genetically
predisposed people. The bodies natural immune response attacks gluten like it is a
foreign invader. These attacks lead to damage of the villi, the small fingerlike
projections that line the intestine. Damage to the villi leads to improper absorption
of nutrients. (picture of intestine)
b) Common symptoms of Celiac disease include: foggy mind, depression, abdominal
pain, diarrhea, bloating, chronic fatigue, headaches, and weight loss.
c) Celiac Disease if left untreated can cause other health problems including other
autoimmune disorders such as diabetes, as well as vitamin and mineral
deficiencies, iron deficiency anemia, and osteoporosis.
d) Currently the only treatment for celiac disease is lifelong adherence to a strict
gluten-free diet.
e) Gluten sensitivity is a condition with symptoms similar to those of celiac disease
including bloating, abdominal pain, fatigue, and a foggy mind. These individuals
do not experience the same damage to the intestinal lining as individuals with
Celiac disease.
f) It is never recommended to self-diagnose Celiac Disease or Gluten sensitivity.
The individual should visit a doctor and a Registered Dietitian before eliminating
gluten from the diet.
g) A blood test can confirm the presence of Celiac disease. Individuals with gluten
sensitivity will not test positive for Celiac disease but, an RD professional has
strategies to help these individuals determine if gluten is truly the root of their
symptoms.
C. Preparing Gluten free foods
a) When preparing gluten-free foods for a resident with Celiac disease it is important
to avoid cross-contamination with other ingredients, foods, or utensils that may
contain gluten.
b) Places where cross contact can occur include: toasters, flour sifters, shared and
containers. Wheat flour can stay airborne for many hours after usage, it is
important to thoroughly clean all exposed preparation surfaces and utensils.
c) Mass produced foods that are most often cross-contaminated with gluten include:
oats, pizza, French fries, and non-certified baked goods
d) Foods that are naturally gluten free include: Fruits, vegetables, meat, poultry, fish,
seafood, dairy, beans, legumes, nuts
e) Grains and starches that do not contain gluten include: rice, cassava, corn, soy,
potato, tapioca, beans, quinoa, millet, arrowroot, chia, buckwheat, amaranth, teff,
flax, yucca, gluten-free oats, nut flours.
D. Conclusion
a) Gluten is a protein that comes from the endosperm of a kernel of grain. Grains
that contain gluten include: wheat, rye, barley and, triticale,
b) People with Celiac Disease must eliminate gluten from the diet. Continued
consumption of gluten in these individuals can lead to further damage of the small
intestine and other long-term health problems.

c) People with gluten sensitivities should see a Registered Dietitian to help them
confirm if gluten is truly the cause of their symptoms.
d) When preparing a gluten-free meal it is important to reduce cross-contamination
in the kitchen.
e) There are many naturally occurring gluten free foods and grains including quinoa,
millet, and chia.
E. Resources
a) http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/indepth/gluten-free-diet/art-20048530
b) http://www.webmd.com/digestive-disorders/celiac-disease/features/glutenintolerance-against-grain?page=2
c) https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=163
d) http://celiac.org/live-gluten-free/glutenfreediet/food-options