Living gluten-free has challenges, but you can manage them

The awareness to Celiac Disease has been increasing in the United States over the past 10 years. With this increased awareness comes an improved ability to diagnose this autoimmune disease that causes intestinal destruction with even the smallest consumption of foods that contain gluten.

Following a gluten-free diet is an essential part of successfully healing the gut and successfully managing Celiac Disease. While the gluten-free diet brings therapeutic benefits to the body, it has been reported to impact the quality of life for many who have been diagnosed with this disease.

Eating a gluten-free diet decreases the ability to be spontaneous in eating out, impacts the shared meal experience, and can affect the way in which individuals with Celiac Disease travel and experience other cultures.

Americans eat out an average of four to five times per week — it’s become a prominent part of American culture. Eating out for a person with Celiac Disease is difficult and likely detrimental to their health. In order to eat out safely, a restaurant would need to ensure they are avoiding cross contamination of gluten to the size of a breadcrumb. This would be a difficult task for any restaurant that serves gluten-containing meals.

Since the chance of getting cross-contaminated is so high, many individuals with Celiac Disease choose to avoid eating out at restaurants — but that can have a negative impact on their social life. People who do choose to eat out spend significant amount of time researching restaurants to determine how “safe” it is to eat at a particular place.

Calling ahead to restaurants is key to determining the level of awareness a restaurant has to avoiding or minimizing cross-contamination. A few key criteria to look for include: separate preparation areas, designated gluten-free colanders and cutting boards, separate ovens and grills (or cookware) for gluten-free foods. It is important to note that any restaurant serving gluten cannot guarantee a gluten-free food item is free from cross-contamination in that kitchen. Only a restaurant or bakery serving only gluten-free items can guarantee items have not been cross-contaminated.

Further, the social life of an individual with Celiac Disease is also impacted by the strict adherence to the gluten-free diet. Individuals with Celiac Disease often report avoiding social events or eating prior to arriving in an attempt to normalize the social eating experience. This is the most challenging aspect of managing Celiac Disease as social experiences are so tightly tied to eating experiences. One way to maintain the social experiences is to hold gatherings at your home. This will allow you to eat safely while entertaining but will also introduce friends and family to gluten free foods. If you are invited to a potluck or gathering, ask if you can bring an entrée and salad to share with everyone so that your food will be part of the meal rather than separate from the meal.

Finally, traveling can be challenging to an individual with Celiac Disease. The lack of safe gluten-free foods in restaurants and the inability to be spontaneous with food choices impacts the travel experience. First, careful investigation to restaurants or grocery stores is an important first step in planning a vacation. Most hotels will provide you with a mini-ridge and microwave free of change if you explain you have a medical condition that requires medical foods. Airport restaurants have limited if any safe gluten-free options, so bringing along your own food is an essential when traveling. While this requires planning for extra luggage, check with your airline to see if you can take a small cooler that is marked “medical” for your gluten-free food. Focus on visiting museums, athletic events, parks, hiking routes, and other historic places of interest rather than focusing on the food culture.

Eating gluten-free is essential to successfully managing Celiac Disease reducing complications from chronic exposure to gluten. Following a gluten-free diet can impact quality of life for those with Celiac Disease as it relates to shared eating experiences and traveling. Dietitians specializing in management of Celiac Disease can assist individuals in adopting a gluten-free lifestyle while minimizing adverse impact to quality of life and maximizing nutritional management of the illness.