Level 2

ASK YOURSELF:

Which of the following questions have you asked yourself since going gluten-free?

  1. Will I still be able to eat out?
  2. How will this affect my travel for work?
  3. Where can I go overseas and eat safely?
  4. How do I trust anyone to fix my meals now?

KEY POINTS:

When you are first diagnosed with celiac disease the idea of eating outside your home can be uncomfortable or scary. And, in fact, it makes good sense to carefully prepare your gluten-free meals at home those first few months until you understand more about safe and unsafe ingredients, food labeling laws and how food is prepared in general.

Cross-contamination can occur any place where food is served, including restaurants, diners, buffet lines, vendor carts, salad bars, in stores that use open bins, and in airline food. It can occur any place where a variety of different meals are made, different ingredients come together, or the same equipment is used for both gluten-free and gluten-containing foods. 2 Before you dine out, learn everything you can about what restaurants can do to help avoid cross-contamination. This knowledge will help you ask the right questions.

At the bottom of this page are numerous resources to help you.

A large survey of people with celiac disease found that, even though most respondents followed a strict gluten-free diet, more than 80% acknowledged some level of dietary indiscretion when eating in a restaurant. 1

How can you avoid being that 80% of the population?

Steering Clear of Gluten Away from Home - Quick Dining Out Tips

Many people do not want to speak up for themselves or to draw attention to their special needs. They would rather try to make choices on what they think is safe vs. asking what is safe. The first step to safe dining is to identify yourself and ask questions. Remember that you are the one to pay the price if a mistake is made and you eat a gluten-containing food. It is your health and wellness that is at stake so do not hesitate to speak up.

HANDY TIPS 3 :

  • Know the gluten-free diet and the questions to ask.
  • Do your homework before you go. Learn about the restaurant and what it offers. This can be done online or over the phone ahead of time.
  • Identify yourself to the wait staff as someone on a special diet. 
    Anxiety about speaking up about food allergies and intolerances is a very common reason why people have reactions to food when dining out.
  • Ask specific questions of your server or the chef (and ask again!) Be sure you are talking to someone who knows both the ingredients and how the food is prepared - this is generally the chef or the manager. See below (More Tips for Dining Out) for some helpful questions.
  • When in doubt, choose a very simple meal with only a few ingredients.
  • Do not accept mistakes. Send your food back if it is not gluten-free.
  • Try to go early or late when it is not as busy for the wait staff.
  • Say thank you and tip well!

Check out this handout on Dining Out on American Cuisine.

(See Level 3 for more handouts on gluten-free ethnic cuisine.)

MORE TIPS FOR DINING OUT:

    A table full of food dishes

  • Whenever possible, review the menu ahead of time. If it is a catered event (wedding, party or conference), contact the manager or head chef in advance for the menu. Get the name of the contact person at the event who will help you with your special meal.
  • Then, have a conversation with a manager or chef who is very familiar with the menu. Ask:
    • Do you regularly serve customers on the gluten-free diet?
    • Which of your dishes are gluten-free?
    • Which dishes are off-limits?
    • Which dishes or items can be adjusted to accommodate my gluten-free diet?
  • Ask if an item can easily be made or served gluten-free:
    • Grilled or broiled fish WITHOUT bread crumbs
    • Roast beef WITHOUT au jus (sauce)
    • Vegetables cooked with herbs (instead of an unidentifiable seasoning blend)
    • Vegetables steamed over clean, boiling water (instead of boiling pasta water)
  • Very important: ask your server how the restaurant works to avoid cross-contamination, or cross-contact, of your meal with gluten-containing meals.

    "Cross-contact" is a term, similar to cross-contamination, used in the food industry. It refers to when one food comes into contact with another one causing their proteins to mix. 4 You can use this term at the restaurant and it will be very familiar to the waiter, chef and manager. 

    Some examples to avoid cross-contact:
    • Separate preparation area and utensils for gluten-free meals
    • Use of a clean part of the grill or a separate skillet
    • Fresh gloves
    • Frequent hand washing
    • Designated fryer versus shared fryer (chips and french fries may be cooked in contaminated oil used to cook flour-battered foods)
  • Discuss your dietary needs with the chef/caterer and make selections in advance. If it is buffet-style, ask if the chef can set aside a plate for you with your name on it. You can identify yourself to the server.
  • If you go through a buffet line, choose items that are obviously safe. Watch for serving utensils that may have traveled back and forth among dishes.
  • Think about the kind of dining establishment you are in. Restaurants that make their own bread, pizzas, quiches, etc., are much more likely to have issues with cross-contamination through airborne and surface gluten exposure, especially if an entirely separate area for gluten-free food production is not available. If you have no other dining choice, a safer alternative is to come with your own bread, roll, or pizza wrapped in foil and ask for it to be heated without unwrapping it.
  • Bring your own slice of gluten-free bread, roll, cookie, salad dressing, etc., to enhance your meal.
  • If the desserts are limited, (i.e. wedding cake), ask:
    • Can a substitution be made? 
      Examples: fresh fruit, ice cream, sorbet, creme Brule, frozen yogurt (check all ingredients first.)
    • Do not go to the event hungry. Have a little snack before you leave to ward off temptation in case it is difficult to find something to eat.

DINING OUT/RESTAURANT ALLERGEN CARDS & CELIAC-FRIENDLY RESTAURANT/RESOURCE SITES:

Here is a sampling of websites that offer suggestions for celiac-friendly restaurants and restaurant cards listing safe/unsafe ingredients on the gluten-free diet. You can show these cards to your server to help communicate your needs. Many come in multiple languages.

TAKE HOME MESSAGES:

  • A high degree of vigilance is required to avoid gluten exposure, and it cannot be overemphasized.
  • If possible, when newly diagnosed, spend the first few months eating at home as much as possible. You will feel more confident about dining out if you understand your own diet and can explain it to others.
  • Communicating your needs to your servers is very important. Practice asking questions about ingredients and the possibility of cross-contamination. Use gluten-free restaurant cards if you find them helpful.
  • To avoid temptation and if appropriate, bring along gluten-free snacks or treats for yourself that can enhance your meal.
  • Do not accept mistakes. Send your food back if it is not gluten-free.
  • If you received great food and service, say "thank you" and tip well.

References:

  1. Lee, et al. Living with coeliac disease: survey results from the USA. J Hum Nutr Diet. 2012 Feb 25. doi: 10.1111/j.1365-277X.2012.01236.x [Epub ahead of print]
  2. See J, Murray JA. Gluten-free diet; the medical and nutritional management of celiac disease. Nutrition in Clinical Practice, 2006;21:1-15.
  3. Cureton P. Dining Out Gluten Free - Locally and While Traveling. Eds. Dennis M, Leffler D. In Real Life with Celiac Disease: Troubleshooting and Thriving Gluten-Free . AGA Press, Bethesda, MD, 2010.
  4. Avoiding Cross-Contact. Food Allergy & Anaphylaxis Network. Accessed October 26, 2012.

Revision Date: 10-8-13
Author: Melinda Dennis, MS, RD, LDN 
Editors: Pam Cureton, RD, LDN and Daniel Leffler, MD, MS

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