Celiac Disease: Gluten-Free Dining Out

Dining out, for a person with celiac disease (CD), can be a bit like navigating through a minefield. Seemingly harmless substances, commonly found in food, cause an autoimmune reaction in persons with CD. The result is damage to the small intestine. The culprit is gluten, a protein found in wheat, barley, and rye. In order to enjoy a satisfying meal that does no harm, a person with CD must have a good understanding of gluten-free (GF) food, an ability to read labels, and an ability to communicate well with restaurant staff.

Once seated at a table, I briefly explain CD to the server and hand him/her a small plastic card, designed by the Gluten Intolerance Group, that spells out what I must avoid: flours, thickeners, coating mixes, sauces, some soy sauces, some marinades, malt, malt flavoring, hydrolyzed vegetable protein, modified food starch, pasta, croutons, stuffing, some herbal teas, some broths, self-basting poultry, and imitations of bacon and seafood. Some servers understand CD and know exactly how to proceed. Others have never heard of this condition, so I ask them to consult with the chef or manager.

Let's say I want to order a salad, grilled salmon, a baked potato, and steamed broccoli. First of all, I consider the salmon. Salmon is gluten-free, but if flash frozen it can be coated with an invisible glaze that contains food starch. My first question: Is the salmon fresh or frozen?

From there I move to preparation methods. The fish cannot come into contact with gluten containing foods, or be prepared on surfaces or cookware contaminated by gluten. I ask for pure butter or assurance that the margarine being used is GF. Grill paste, used to keep food from sticking to the grill, often contains gluten. Spice packets, used to season fish, sometimes contain food starch. For simplicity's sake, I generally request fresh salmon, 100% butter with a bit of garlic, a clean grill, and no grill paste. It's a lot of work for a simple piece of fish, and the rest of the meal has yet to be addressed.

A baked potato is safe, but what comes with it often is not. Once again, do they serve margarine or butter? Certain brands of sour cream and cheese are GF, but not all of them. Most bacon bits are a no-no. Even packaged bacon often contains gluten. I generally order a potato with butter and skip the rest. I request olive oil If they do not have 100% butter.

The salad vegetables are not a problem. Oil and vinegar serve as dressing. I do have to remember to let the server know to leave off the croutons, cheese, bacon bits, and ham. Sometimes the salad arrives with the croutons anyway, so I send it back, and emphasize that I need a fresh salad in a new bowl. It is not enough to just remove the croutons. Tiny amounts of gluten containing crumbs cause an autoimmune reaction.

Steamed broccoli is pretty easy. I'll use butter, oil, or eat it plain. I skip the cheese and any sauces. It isn't as much fun or as tasty, but it is nutritious and keeps me from getting sick.

Some restaurants have separate GF menus, which is generally a great way to eat safely. Once again, proceed with caution. I once went to an Italian restaurant, ordered from their GF menu, received some soup, and mid-way through I noticed bits of pasta floating in my bowl. I spoke with the manager and he apologized for the mistake. His cooks were Hispanic, he told me, and they couldn't read the ticket. I asked him why, under those conditions, he offered a GF menu. He said he was trying to work out the kinks in his system. I suggested he color code the ticket so they can deliver what they promise. I never went back to see if he followed through.

Another time, I ordered from a GF menu at a Chinese restaurant. When the appetizer arrived via a second server I said, "Gluten-free, right?" It wasn't. He took it back to the kitchen and re-submitted the order while I waited and watched the rest of my party enjoy their food.

Let me say that I fully realize the extra effort it takes to prepare a GF meal at a restaurant. When I talk with managers about mistakes, I never do so rudely and I never accept a free meal. I want them to know that what I have to say is important to all of us who have CD, and that my only goal is to help them understand our needs better. I want to recommend them to others. Out of consideration for them and for my own safety, I do not eat out during rush hours. I tip servers well and often put a note on the bill when I've received exemplary service.

In conclusion, it is possible for a person with CD to eat out safely and to have a delicious meal. I'll never forget my visit to The Aquarium Restaurant in Nashville, Tennessee. The chef came to my table, knelt by my chair, and talked to me about food I enjoy. My dietary restrictions became his personal challenge! He created a scrumptious seafood plate that I savored. I've never forgotten his kindness. Having a great meal out, without the worry of illness, is a wonderful gift.

Gluten Intolerance Group: www.gluten.net