East Auckland chefs and cook’s knowledge, awareness and practices of coeliac disease, the gluten free diet and implementation of gluten free food policies in a variety of food service providers

Abstract

Background and Objectives: Coeliac disease (CD) is an autoimmune response to gluten. People with CD are required to follow a strict lifelong gluten free diet (GFD). This can make eating out challenging. The present study was designed to investigate East Auckland chefs and cook’s knowledge, awareness and practices of CD, GFD and implementation of gluten free food policies in a variety of food service providers. Methods and Study Design: One hundred and thirty food service providers were identified, categorised and sampled by proportion of their category. Providers offering gluten free food were invited to participate in the study. The head chef or cook completed a questionnaire compromised of: chef or cook characteristics, food service provider characteristics, awareness and knowledge of CD, GFD and gluten free policies, and a gluten free quiz. Results: Forty-six chefs and cooks participated, representing the following food services: 30% cafes, 33% ethnic eateries, 22% fast food outlets, 4% pubs and bars and 11% restaurants. 39% of participating chefs and cooks were not aware of CD, all of whom were non-NZ European and 78% worked in ethnic eateries and fast food outlets. Compared to chefs and cooks working in ethnic eateries and fast food outlets, a higher percentage of those working in cafes, pubs and bars, and restaurants identified as NZ European (p <0.008), had heard of CD (p = 0.01), identified gluten as a triggering agent in CD (p <0.03), correctly identified mozzarella as not containing gluten (p=0.03) and had an overall CD and GF knowledge score of >50% (p<0.02). Implementation of the 6 GF policies varied, 54% used the policy separate preparation areas and 98% used the policy choosing GF ingredients. Conclusions: There was a lack of agreement between the level of awareness and knowledge of CD and GFD, practical identification of gluten containing ingredients and implementation of gluten free food policies. It is recommended for GF food standards to be changed to mandatory enforced regulation systems, inhouse education and training to be delivered to all food service staff, and subsequently, the implementation of necessary gluten free food policies to give people with CD more confidence eating out and choosing GF foods without inadvertently ingesting gluten.