10 Tips for Avoiding Gluten Cross Contact at Restaurants

 I have known about my Celiac Disease for 20 years.  It’s been a long road. I am still learning more about the history of the disease, food that has contamination issues and the direction of research for a future cure for the difficult ailment. Most people don’t realize how severely ill less than a crumb of gluten makes people with celiac disease.  Aspects of our food and drug system are lacking for those of us who suffer with the disease. The only allergens that are required to be listed on a label are wheat, dairy, shellfish, fish, tree nuts, peanuts, and soy. Wheat is not the only food item that contains gluten. Other grains such as barley, non-certified oats, spelt, and rye all contain gluten. Some companies have voluntarily labeled their food as gluten free. Yet, if you look further into the requirements for such labeling, you will understand that voluntary labels are not regulated. These foods can allow a small amount of gluten via manufacturing and still be labeled “gluten free.” This is where eating gluten free gets very complicated. Those of us with Celiac disease must navigate through food company websites, celiac specialized social media group threads, and other means to determine if an item is safe for consumption. It is imperative for Celiacs to steer clear of anything made on shared equipment with gluten. In fact, to be safe, one must eat food that is certified by a specialized and trusted Celiac focused group. When it is that much of an issue just to purchase labeled food and medications from the store, it is an even more daunting task to figure out how to safely dine at a restaurant! Can one successfully eat out with Celiac disease and not get sick?  The short answer is yes. However, dining with Celiac is much more complicated than the short answer. It takes great care and communication to eat out with Celiac disease. Unless you are at a dedicated 100% gluten free restaurant, you are ALWAYS taking the risk of getting sick. In fact, if you eat out often enough a “regular restaurants,” you will every so often get accidently contaminated. The idea is to decrease the possibility of getting sick as much as possible by ordering smart, researching, and clearly communicating of your needs. I have listed 11 Tips for safely eating out. These tips do not guarantee that you will be safe every time, because you are relying on others to handle your food. However I have found that they help me to be as safe as possible while dining out. 

1. LEAFY GREEN AT YOUR OWN RISK– Ok, so most people think…“ohhh gluten free, just eat a salad, that’s simple!”  Well, celiac safety is much more complicated than that. If you have celiac disease, you must take great care in ensuring that your food is not cross contaminated. In most restaurant kitchens, the salad materials are located in sunken bins on a line. The person preparing salad often has dozens of ingredients at his or her fingertips. Reaching in and out of the bins to create salads is common practice in most kitchens. With every reach, salad ingredients in the entire bin are compromised for a person with Celiac disease. Even if the preparation surface is cleaned, the chef changes gloves, and new bowls and utensils are used for prepping your salad, you would have to have all new and untouched ingredients for it to be safe. Most restaurants are not going to take the care you need for a salad to be 100% safe, so proceed with caution. 

2. BUFFETS ARE FOR THE BIRDS – For the same reason that salads are not safe, buffets are not safe, especially if it is a serve yourself situation. People are impatient and will use designated utensils for whatever food they want if they can reach across far enough to grab it. For this same reason, any buffet which gluten free food is next to gluten containing food is subject to cross contamination. Since being diagnosed with celiac disease, I have been exceedingly cautious about buffet style dining. I have successfully gotten food from buffets in which there are servers that are sure to have dedicated utensils per food items. I have also been successful at hotel continental breakfasts. There is not usually a lot of gluten free options, but the workers are often more than happy to let you see ingredients of sausage and ham. Grits and eggs are usually safe as well. Also, fresh fruit and packaged yogurt are generally safe and uncontaminated. Don’t forget to ask questions about every item you wish to try.

3. VEGAN RED FLAG - A lot of vegetarian and vegan specialty products are not gluten free. Gluten is an excellent food adhesive; it makes almost any food stick together. This adhesive quality why it is commonly used in vegan and vegetarian foods like veggie burgers and other meat substitutes. Popular specialty items like tempeh are literally only gluten. Luckily, there is a growing number of vegan-gluten free consumers, so the market has answered with vegan friendly gluten free (and even soy and nut free for those with other allergens). For example, Beyond Meat and Daring brands offer gluten free meat substitutes. If you search hard enough, you can find almost any vegan/vegetarian specialty product to meet your needs, however it might not be as accessible or as affordable as non-veg options. It is important to do extensive research when eating gluten free and vegan. Luckily once you find the brands you trust, you can stick to them and your shopping experience becomes less laborious.

4. SOY SAUCE NATION - Soy Sauce is usually brewed with wheat. A lot of restaurant workers don’t realize that it is not gluten free. In fact, they will swear that it is “just made of soy and salt.” This is incorrect. Only the Thai Tamari style soy sauce and specialty soy sauces are gluten free. Coconut Aminos sauce is another gluten free alternative, but it is not often used in restaurants. On a recent visit to a Polynesian restaurant, The Famous Mai Kai of Fort Lauderdale, I asked for their allergen menu. They texted me an extensive menu labeled with what contained all of the major allergens and gluten. They also listed every ingredient for each dish. I noticed that several menu items that were marked as gluten free in fact contained soy sauce. I asked my server to double check that the soy sauce was gluten free as there are certain brands and specialty brands that are gluten free. When the server came back form the kitchen, he confirmed that indeed the soy sauce was not gluten free and their allergen menu was incorrectly labeled as such. This could have been a huge issue if I had not read the ingredients and asked that the server double check for me. Soy Sauce is often used when cooking vegetables in non-Asian cuisine from Mexican Fajitas. It is also commonly used in vegetables side dishes like Brussel sprouts and home fries. Be sure to always ask what the chef uses to season/marinate meats and veggies before ordering.  Chefs that are not committed to gluten free cooking and are trying their best to accommodate, often forget about soy sauce. I ask specifically, “Do you use soy sauce, malt vinegar, thickeners, etc when cooking?” It is important when you eat out that you ask about all of the spices, sauces and marinades for everything in every dish. for example, I have found that blackening seasoning often contains gluten.  Ask several times if there is soy sauce, teriyaki sauce, hosin sauce, BBQ sauce, marinades, thicker, stocks and anything else that might contain hidden gluten. When in doubt, ask that your food be cooked in a separate pan with only butter, salt and pepper.

5. SAMMIE HANDS - If an establishment makes sandwiches, chances are, the counter is full of crumbs and the chefs hands have crumbs on them.  Basically, nothing they touch is safe. None of the ingredients are safe either, no matter how barebones you go. Places like Chipotle, Taco Bell, and Jimmy Johns have “gluten free” ingredients that are probably unsafe from cross contamination via handling. Places that make things like burritos with flour tortillas or sandwiches often have contaminated all of their ingredients long before you finished your morning coffee. I recommend steering clear of these places completely. I often order food from places that have grilled and sautéed menu items. If something is hot off the grill, the chef has used tongs to serve it onto the plate. Asking the chef to use a new set of tongs and use a dedicated pan will help keep you from getting sick.

6. ITALIAN IS HARD - Many people do not know that gluten can travel on water vapor when cooking pasta. Be careful of Italian restaurants and other places that cook pasta.  Since gluten can travel and contaminate everything, I very rarely eat at traditional Italian restaurants. I have worked at so many Italian restaurants that I have a keen understanding how unsafe most Italian restaurants are for Celiacs. Gluten in the dishwasher can leave residues and the vapors from the pasta seem to stick on literally everything. Even intensive daily cleaning can’t remove the risk of contamination. Luckily, there are Italian restaurants that have a dedicated gluten free section of their kitchen like GIOIA EATS in Hallandale FL and the famous Senza Gluten in NYC. Restaurants like these that are committed to having celiac safe foods are places we can confidently order gluten free Italian food. Interestingly, Italy has the highest number of Celiacs in the world and in Italy you can find a lot of safe gluten free food. One cultural difference between the United States and countries like Italy and Spain is that Celiac is recognized as a very serious disease in those countries instead of a food fad hoisted by celebrities as in the US. I digress, unless the Italian restaurant is heavily committed to their Celiac customers, it is best to steer clear. Sorry, I know that’s a hard one, I love a big Italian style steak. 

7.  RESEARCH The first thing you want to do is check out via the internet local gluten free friendly restaurants. Try to find reviews and see if there is a dedicatory statement on the establishment’s website. Then, call the place. You need to call at a time that is convenient for them, a time that they are likely not busy. Check and double check whether or not there are any of the following cooking methods and other key words so that you know to ask more questions: tempura, fried, thickened, battered, fluffy, dusted, pan seared, chargrilled, crispy, blackened, marinated, flaky. Ask if they know how to keep people with extreme sensitivity from getting sick. Be sure that you let them know that the person that would be dining must be kept from less than a crumb of gluten. Be sure to say over and over again, “Just the slightest amount of gluten can make me severely sick. Do you think you are able to accommodate for my extreme sensitivity?” If you get an iffy response at all whatsoever, then don’t risk it. The amount of research necessary to eat at a restaurant is why eating out while traveling can be difficult. However, once you find places that you feel safe, the reward is worth it! 

8.  SIDE OF WHAT? - Always check if crackers, croutons, bread sticks, or rolls are served on the side. Often a server will write gluten free instructions on everything about your order, but neglects to write not to serve it with bread on the side. I’m not sure why there is a disconnect, but it happens more than one would like for it to. Ask and ask again, that no bread is near your plate. Be sure that hands are washed and gloves are changed before your food is handled. Also ask that they prepare your food on a clean surface and away from anything that might contain gluten.

9. OVER STATE YOUR NEEDS AND EDUCATE - No matter where you go, it is imperative that you and your loved ones are comfortable with HARD CORE DRILLING of the staff in order for your meal to be safe. If you don’t state (and state again) and check with multiple people, you CAN EASILY be contaminated. Your family and friends must be a part of the story, letting the server know how serious your sensitivity is. Its good for them to ask questions along with you. When it becomes a conversation instead of a demand, the staff is much more attentive. Any staff that negatively responds to your ordering needs is a sign that you should not dine at that establishment. Apathetic and uneducated responses almost guarantee that your food will be vulnerable to cross contamination. Additionally, always order for yourself until you are comfortable with your family and friends ordering with you. It is up to you to educate your friends on how to keep you safe. Letting friends know about cross contamination is the best way for them to relate to how extremely sensitive you are. If you have a significant other, than you know he or she can make you sick from a “gluten kiss.” This is a good example for you to relay your sensitively level to others. People are often shocked to find out that significant others will eat gluten free to prevent you from being sick from a kiss. I am lucky to have a partner that always eats gluten free when I am with him and lets the server know, “ We are both eating gluten free because I want to be able to kiss her.” Another example of celiac precautionary measures are peanut butter jars which often can be a source of family cross contamination because if the knife being spread on the bread and then back into the jar. Giving practical examples will help your family and friends understand the type of precautions you have to take to keep you safe.

10. LISTEN TO YOUR GUT - You can find restaurants that are safe, but it takes a lot of work and a little bit of risk. If you ever get even slightly sick after eating at a restaurant, you should assume that you got cross contaminated.  If you believe that maybe your communication could have been better, and it is worth another try (and you only got slightly sick) then give it another shot. However after double downing on your communication, you get sick again, you must not got back. It is imperative that you listen to your body and read your symptoms. If you get a gut feeling that the staff misunderstood your needs, abort mission. Being safe from cross contamination is much more difficult than what most people realize. If someone’s eyes glaze over while you are speaking or they seem to not know how to react, you probably are not going to be safe. If you have a bad experience more than once at a restaurant, there is likely no way to be certain that you will ever be safe. Unfortunately, we have to gauge the safety of our food in this way. It is tedious to ask questions and stay on the upper hand of safety, but it is worth it.

Celiac disease is hard and gluten is literally everywhere. However hyper diligence helps you get better at avoiding harm as time goes on. Once you get the hang of it, gluten free dining becomes second nature. Education, awareness and advocacy is vital for those with Celiac disease to be safe in normal life situations. Dining at restaurants, eating hospital food, or enjoying a family gathering becomes easier that more you educate those around you.  Supporting restaurants with dedicated gluten free kitchens is an important part of supporting our community. Whenever possible, frequent places that work hard to keep you safe. Let others know about these dedicated restaurants and put your money where your mouth is. Gluten free specialty products are expensive and best in moderation, but these companies are on the forefront of future culinary freedom for those of us with food sensitivities. As demand for gluten free dining rises, more restaurants will respond. I hope these tips helps you dine more successfully!  Following these tips will not guarantee that you will be safe at restaurants. Cross contamination issues are determined by an overwhelming number of factors, variables and most importantly…human handling. I warn you that there will be times that you try hard and still get sick from cross contamination unless the restaurant is dedicated to being 100% gluten free. It is always up to you to take your health into your own hands. Empower yourself with knowledge and advocate for yourself as a daily part of your celiac journey.