Evaluation of Professional Kitchen Chefs’ Knowledge, Attitudes, and Practices Regarding Celiac Disease and Gluten Sensitivity

Yıl 2026, Cilt: 10 Sayı: 1, 177 - 191, 02.01.2026

Ayşe Yorulmaz , Kadir Çetin

Öz

Celiac disease and gluten sensitivity are increasingly recognized as significant public health issues worldwide, causing individuals to experience substantial limitations and psychosocial challenges, particularly in out-of-home eating contexts. Knowledge gaps among food service personnel, inadequate hygiene practices, and risks of cross-contamination further restrict safe dietary options for individuals with celiac disease. This study aimed to assess the knowledge, attitudes, and practices of professional kitchen chefs in Turkey regarding celiac disease and gluten sensitivity, to identify strengths and weaknesses in gluten-free food preparation processes, and to provide evidence-based recommendations for the sector. Data were collected via an online survey from 267 professional chefs working in food and beverage establishments across Turkey between January and March 2025. Findings indicate that chefs generally hold positive attitudes toward celiac disease and gluten-free nutrition; however, notable deficiencies in technical knowledge were observed. Based on these results, comprehensive training programs focused on gluten-free production, prevention of cross-contamination, and hygiene management are recommended for professional kitchen staff.

Anahtar Kelimeler

Food intolerance , cross-contamination , dietary risk management , knowledge-attitude-practice model

Etik Beyan

This article was presented as an abstract at the 7th International Turkish World Tourism Congress.

Profesyonel Mutfak Şeflerinin Çölyak Hastalığı ve Gluten Hassasiyetine Yönelik Bilgi, Tutum ve Uygulamalarının Değerlendirilmesi

Öz

Çölyak hastalığı ve glüten hassasiyeti, dünya genelinde artış gösteren önemli bir halk sağlığı sorunu olarak, bireylerin özellikle ev dışı beslenme pratiklerinde ciddi kısıtlamalar ve psikososyal zorluklar yaşamalarına neden olmaktadır. Gıda hizmeti sektöründe karşılaşılan bilgi eksiklikleri, hijyen uygulamalarındaki yetersizlikler ve çapraz bulaşma riskleri, çölyak hastalarının güvenli beslenme olanaklarını sınırlamaktadır. Bu araştırma, Türkiye’deki profesyonel mutfak şeflerinin çölyak hastalığı ve glüten hassasiyetine yönelik bilgi, tutum ve uygulama düzeylerini ölçmek, glütensiz yemek üretim süreçlerindeki güçlü ve zayıf yönleri belirlemek ve elde edilen bulgular doğrultusunda sektöre yönelik geliştirici öneriler sunmak amacıyla yürütülmüştür. Ocak-Mart 2025 tarihleri arasında Türkiye genelinde faaliyet gösteren yiyecek-içecek işletmelerinde görev yapan 267 profesyonel şeften çevrimiçi anket yoluyla veri toplanmıştır. Bulgular, şeflerin çölyak hastalığı ve glütensiz beslenme konularına ilişkin genel olarak olumlu tutumlar sergilediklerini, ancak teknik bilgi düzeylerinde belirgin eksiklikler bulunduğunu ortaya koymuştur. Elde edilen sonuçlar doğrultusunda, gıda sektöründe görev yapan profesyonel mutfak personeline yönelik glütensiz üretim, çapraz bulaşmanın önlenmesi ve hijyen yönetimi konularında kapsamlı eğitim programlarının geliştirilmesi önerilmektedir.

Anahtar Kelimeler

Gıda intoleransı , çapraz bulaşma , diyet risk yönetimi , bilgi-tutum-uygulama modeli

Etik Beyan

Bu makale 7. Uluslararası Türk Dünyası Turizm Kongresinde özet metin olarak sunulmuştur.

Kaynakça

• Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-T
• Araújo, H. M. C., Araújo, W. M. C. (2011). Coeliac disease. Following the diet and eating habits of participating individuals in the Federal District, Brazil. Appetite, 57(1), 105–109. https://doi.org/10.1016/j.appet.2011.04.007
• Aziz, I., Karajeh, M. A., Zilkha, J., Tubman, E., Fowles, C., Sanders, D. S. (2014). Change in awareness of gluten-related disorders among chefs and the general public in the UK: A10-year follow-up study. European Journal of Gastroenterology & Hepatology, 26(11), 1228–1233. https://doi.org/10.1097/MEG.0000000000000166
• Case, S. (2005). The gluten-free diet: how to provide effective education and resources. Gastroenterology, 128(4), 128–134. https://doi.org/10.1053/j.gastro.2005.02.020
• Catassi, C., Fasano, A. (2008). Celiac disease. Current Opinion in Gastroenterology, 24(6), 687–691. https://doi.org/10.1097/MOG.0b013e32830edc1e
• Choi, J. H., Rajagopal, L. (2013). Food allergy knowledge, attitudes, practices, and training of foodservice workers at a university foodservice operation in the Midwestern United States. Food Control, 31(2), 474–481. https://doi.org/10.1016/j.foodcont.2012.10.023
• Clayton, D. A., Griffith, C. J., Price, P., Peters, A. C. (2002). Food handlers’ beliefs and self-reported practices. International Journal of Environmental Health Research, 12(1), 25–39. https://doi.org/10.1080/09603120120110031
• Cudeck, R. (1980). A comparative study of indices for internal consistency. Journal of Educational Measurement, 17(2), 117–130. https://doi.org/10.1111/j.1745-3984.1980.tb00820.x
• Dalgıç, B., Sarı, S., Özcan, B., Baştürk, B., Ensari, A., Eğritaş Gürkan, Ö., Barış, Z. (2011). Türk çocuklarında çölyak hastalığına ilişkin faktörler ve semptomların değerlendirilmesi. Türk Pediatri Arşivi, 46 (4), 323–330.
• Damasceno, R. P. B., Zandonadi, R. P., Mendes, M., Cunha Junior, L. C., Raposo, A., Teixeira-Lemos, E., Farage, P. (2024). Risk of gluten cross-contamination due to food handling practices: a mini-review. Nutrients, 16(8), 1198. https://doi.org/10.3390/nu16081198
• Dillman, D. A., Smyth, J. D., Christian, L. M. (2014). Internet, phone, mail, and mixed-mode surveys: The tailored design method (4. baskı). John Wiley & Sons.
• Dupuis, R., Meisel, Z., Grande, D., Strupp, E., Kounaves, S., Graves, A., Frasso, R., Cannuscio, C. C. (2015). Food allergy management among restaurant workers in a large U.S. city. Food Control, 63, 147–157. https://doi.org/10.1016/j.foodcont.2015.11.026 ¬¬¬
• Eren, R., Çetin, M., Eren, A., Çetin, K. (2021). Food allergy knowledge, attitude, and practices of chefs in resort hotels in Turkey. International Journal of Gastronomy and Food Science, 24, 100345. https://doi.org/10.1016/j.ijgfs.2021.100345
• Evans, J. R., Mathur, A. (2005). The value of online surveys. Internet Research, 15(2), 195–219. https://doi.org/10.1108/10662240510590360
• Falcomer, A. L., Araújo, L. S., Farage, P., Monteiro, J. S., Nakano, E. Y., Zandonadi, R. P. (2018). Gluten contamination in food services and industry: A systematic review. Critical Reviews in Food Science and Nutrition, 60(3), 479–493. https://doi.org/10.1080/10408398.2018.1541864
• Figueroa-Gómez, X., Oliveras-López, M. J., Rodríguez Silva, J. M., Poyanco, M., López, H., Araya, M. (2024). Experiences and perceptions of people with celiac disease, food allergies and food intolerance when dining out. Frontiers in Nutrition, 11, 1321360. https://doi.org/10.3389/fnut.2024.1321360
• Fiva, J. H., Hægeland, T., & Rønning, M. (2010). Health status after cancer: does it matter which hospital you belong to?. BMC Health Services Research, 10(1), 204. https://doi.org/10.1186/1472-6963-10-204
• Giousmpasoglou, C., Marinakou, E., Cooper, J. (2018). Banter, bollockings and beatings. International Journal of Contemporary Hospitality Management, 30(3), 1882–1902. https://doi.org/10.1108/IJCHM-01-2017-0030
• Glasman, L. R., Albarracín, D. (2006). Forming attitudes that predict future behavior: A meta-analysis of the attitude-behavior relation. Psychological Bulletin, 132(5), 778–822. https://doi.org/10.1037/0033-2909.132.5.778
• Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E. (2019). Multivariate data analysis (8. baskı). Pearson Prentice Hall.
• Karajeh, M. A., Hurlstone, D. P., Patel, T. M., Sanders, D. S. (2005). Chefs’ knowledge of coeliac disease (compared to the public): A questionnaire survey from the United Kingdom. Clinical Nutrition, 24(2), 206–210. https://doi.org/10.1016/j.clnu.2004.08.006
• Khafagy, A. A., Qari, W. K., Filimban, S. S., Bahalaq, A. M., Bulkhi, A. A., Khafagy, A., Bulkhi, A. (2022). A cross-sectional study of celiac disease awareness in the food industry in the western region of Saudi Arabia. Cureus, 14(6), e26322. https://doi.org/10.7759/cureus.26322
• Ko, W. (2012). The relationship among food safety knowledge, attitudes and self-reported HACCP practices in restaurant employees. Food Control, 29(1), 192–197. https://doi.org/10.1016/j.foodcont.2012.05.076
• Kollmuss, A., Agyeman, J. (2002). Mind the gap: Why do people act environmentally and what are the barriers to pro-environmental behavior? Environmental Education Research, 8(3), 239–260. https://doi.org/10.1080/13504620220145401
• Laheri, Z. (2019). Diet diversity of university students with food allergies and food allergen knowledge and practices of catering staff (Master’s thesis, University of Central Lancashire). CLoK. https://clok.uclan.ac.uk/id/eprint/34548
• Lally, P., Gardner, B. (2011). Promoting habit formation. Health Psychology Review, 7(sup1), 137–158. https://doi.org/10.1080/17437199.2011.603640
• Launiala, A. (2009). How much can a KAP survey tell us about people’s knowledge, attitudes and practices? Some observations from medical anthropology research on malaria in pregnancy in Malawi. Anthropology Matters, 11, 1. https://doi.org/10.22582/am.v11i1.31
• Lebwohl, B., Ludvigsson, J. F., Green, P. H. (2015). Celiac disease and non-celiac gluten sensitivity. British Medical Journal, 351, https://doi.org/10.1136/bmj.h4347
• Lee, Y. M., Sozen, E. (2016). Food allergy knowledge and training among restaurant employees. International Journal of Hospitality Management, 57, 52–59. https://doi.org/10.1016/j.ijhm.2016.05.004
• Lewis, N. R., Scott, B. B. (2006). Systematic review: the use of serology to exclude or diagnose coeliac disease (a comparison of the endomysial and tissue transglutaminase antibody tests). Alimentary Pharmacology & Therapeutics, 24(1), 47–54. https://doi.org/10.1111/j.1365-2036.2006.02967.x
• Lorenzo-Seva, U., Ferrando, P. J. (2012). TETRA-COM: A comprehensive SPSS program for estimating the tetrachoric correlation. Behavior Research Methods, 44(4), 1191–1196. https://doi.org/10.3758/s13428-012-0200-6
• Malalgoda, M., Ohm, J. B., Simsek, S. (2019). Celiac antigenicity of ancient wheat species. Foods, 8(12), 675. https://doi.org/10.3390/foods8120675
• Martínez-Martínez, M. I., Alegre-Martínez, A., García-Ibánez, J., Cauli, O. (2019). Quality of life in people with coeliac disease: psychological and Socio-economic aspects. Endocrine, Metabolic & Immune Disorders-Drug Targets, 19(2), 116–120. https://doi.org/10.2174/1871530318666180723100003
• McCarthy, M., Brennan, M., Kelly, A., Ritson, C., De Boer, M., Thompson, N. (2005). Who is at risk and what do they know? Segmenting a population on their food safety knowledge. Food Quality and Preference, 18(2), 205–217. https://doi.org/10.1016/j.foodqual.2005.10.002
• Mistry, A., Tosto-Sheppard, L. (2020). Food allergen and gluten training and awareness among restaurant workers serving gluten-free foods. Current Developments in Nutrition, 4, nzaa051_016. https://doi.org/10.1093/cdn/nzaa051_016
• Mustalahti, K., Catassi, C., Reunanen, A., Fabiani, E., Heier, M., McMillan, S., Murray, L., Metzger, M., Gasparin, M., Bravi, E., Mäki, M. (2010). The prevalence of celiac disease in Europe: Results of a centralized, international mass screening project. Annals of Medicine, 42(8), 587–595. https://doi.org/10.3109/07853890.2010.505931
• Park, S., Kwak, T., Chang, H. (2010). Evaluation of the food safety training for food handlers in restaurant operations. Nutrition Research and Practice, 4(1), 58–68. https://doi.org/10.4162/nrp.2010.4.1.58
• Ramírez-Sánchez, A. D., Tan, I. L., Gonera-de Jong, B. C., Visschedijk, M. C., Jonkers, I., Withoff, S. (2020). Molecular biomarkers for celiac disease: past, present and future. International Journal of Molecular Sciences, 21(22), 8528. https://doi.org/10.3390/ijms21228528
• Sabença, C., Ribeiro, M., Sousa, T. D., Poeta, P., Bagulho, A. S., Igrejas, G. (2021). Wheat/gluten-related disorders and gluten-free diet misconceptions: a review. Foods, 10(8), 1765. https://doi.org/10.3390/foods10081765
• Sapone, A., Bai, J. C., Ciacci, C., Dolinsek, J., Green, P. H., Hadjivassiliou, M., Fasano, A. (2012). Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine, 10(1), 13. https://doi.org/10.1186/1741-7015-10-13
• Schultz, M., Shin, S., Coppell, K. J. (2017). Awareness of coeliac disease among chefs and cooks depends on the level and place of training. Asia Pacific Journal of Clinical Nutrition, 26(4), 719–724. https://search.informit.org/doi/10.3316/ielapa.870214100431650
• Shafie, A., Azman, A. (2015). Assessment of knowledge, attitude and practice of food allergies among food handlers in the state of Penang, Malaysia. Public Health, 129(9), 1278–1284. https://doi.org/10.1016/j.puhe.2015.03.016
• Silvester, J. A., Graff, L. A., Rigaux, L., Walker, J. R., Duerksen, D. R. (2016). Symptomatic suspected gluten exposure is common among patients with coeliac disease on a gluten‐free diet. Alimentary Pharmacology & Therapeutics, 44(6), 612–619. https://doi.org/10.1111/apt.13725
• Simpson, S., Lebwohl, B., Lewis, S., Tennyson, C., Sanders, D., Green, P. (2011). Awareness of gluten-related disorders: A survey of the general public, chefs and patients. E-SPEN the European e-Journal of Clinical Nutrition and Metabolism, 6(5), e227–e231. https://doi.org/10.1016/j.eclnm.2011.08.001
• Soon, J. M. (2018). ‘No nuts please’: Food allergen management in takeaways. Food Control, 91, 349–356. https://doi.org/10.1016/j.foodcont.2018.04.024
• Sverker, A., Hensing, G., Hallert, C. (2005). Controlled by food– lived experiences of coeliac disease. Journal of Human Nutrition and Dietetics, 18(3), 171–180. https://doi.org/10.1111/j.1365-277X.2005.00591.x
• Şanlı, S. C., Metin, U. (2020). Mersin Marina AVM’de bulunan restoranlarda çölyak hastalarına yönelik sunulan yiyecek hizmetlerini belirlemeye yönelik bir araştırma. Journal of Tourism & Gastronomy Studies, 8(1), 478–488. https://doi.org/10.21325/jotags.2020.559
• Taraghikhah, N., Ashtari, S., Asri, N., Shahbazkhani, B., Al-Dulaimi, D., Rostami-Nejad, M., Rezaei-Tavirani, M., Razzaghi, M.R., Zali, M. R. (2020). An updated overview of spectrum of gluten-related disorders: Clinical and diagnostic aspects. BMC Gastroenterology, 20(1), 258. https://doi.org/10.1186/s12876-020-01390-0
• Tatli, M., Akoğlu, A. (2020). Food allergy knowledge, attitude and practices of restaurant employees in İstanbul, Turkey. Akademik Gıda, 18(2), 125–134. https://doi.org/10.24323/akademik-gida.758812
• Thompson, T., Keller, A. (2023). Gluten cross contact in oats: Retrospective database analysis 2011 to 2023. Frontiers in Nutrition, 10, 1284636. https://doi.org/10.3389/fnut.2023.1284636
• Tuncer, T., Akoğlu, A. (2020). Food safety knowledge of food handlers working in hotel kitchens in Turkey. Food and Health, 6(2), 77–89. https://doi.org/10.3153/fh20009
• Vázquez-Polo, M., Navarro, V., Larretxi, I., Perez-Junkera, G., Lasa, A., Matias, S., Edurne, S., Churruca, I. (2023). Uncovering the concerns and needs of individuals with celiac disease: a cross-sectional study. Nutrients, 15(17), 3681. https://doi.org/10.3390/nu15173681
• Zopiatis, A. (2010). Is it art or science? Chef’s competencies for success. International Journal of Hospitality Management, 29(3), 459–467. https://doi.org/10.1016/j.ijhm.2009.12.003