Who can deny the allure of dining out? It can be a fast and convenient meal. In addition, many social gatherings and celebrations are centered around food and restaurants. But for an individual with food sensitivities, eating out can literally be a health hazard. I tell my clients at the end of their 30 day elimination diet (in which they are not allowed to eat out) dining out GF is like flipping a coin…based on my experience there is a fifty percent chance you are going to get sick from an infraction or some other food reaction. In my opinion, the risk is too high especially if you are in advanced healing mode…trying to heal leaky gut, for instance.

Lately, many restaurants are jumping on the “gluten-free” band wagon trying to take advantage of the growing market without taking the time and effort to be properly trained in serving the gluten-free community. It’s not as simple as substituting gluten-free bread, pizza crust or pasta. Proper cross-contamination procedures must be taken. Even when the kitchen staff are trained properly, there is still room for error within the dining room staff where high turnover is common. It can be hard for restaurants management to keep staff properly educated on the importance of “getting it right” when serving a gluten-free customer. Luckily evolving programs like the Gluten-free Food Service Training & Management Certification (GFFS) training program through the Gluten Intolerance Group of North America make it possible for a restaurant to be properly educated and trained on gluten-free food preparation.

I recently ate at a pizzeria in a small town in Nebraska that had the GFFS training and have to say it was a great experience. The staff was properly trained and had all the correct answers to my questions which helped me feel secure about eating there. I had a salad, pizza (no cheese) and a hard cider by Angry Orchard. The food was delicious (especially the hard cider) and I did not get sick. I often do with pizza so this was especially amazing and pleasing to me. Needless to day with limited options in Beatrice, Nebraska, I ate there three times that week. The restaurant, Sam and Louie’s also did a great job advertising their gluten-free options. This sign featured below was on every table. The Chef to Plate sign featured below hung in the window and apparently, they did their publicity work because the local newspaper ran an article about the restaurant’s new gluten-free offerings. Our family had noticed the article and took us there to try it out. Our local Red Robins restaurant offers gluten-free Udi’s hamburger buns and will cook your fries in dedicated oil but they’ve yet to advertise it anywhere. How are people supposed to know?

I was very impressed with Sam and Louie’s and can’t help but speculate if this GFFS training weighed heavily into our positive experience. I’ve discovered that you can do a search on the GIG Web site to find certified restaurants in the area you live or are traveling. I think I will be checking this list frequently. I hope they come up with a smart phone app soon (hint, hint…GIG).

Many people in my gluten-free circle ask me about eating out and what’s the best way to go about it so I’ve decided to create these guideline based on what I’ve learned eating out gluten-free for over seven years. I hope they are helpful to you in having a positive and “safe” GF dining experience.

1) Be prepared to accept the risk. The first thing I have to say is that eating out gluten-free is risky. There are so many elements out of your control so be aware and very careful. Take these suggestions very seriously and if you are in serious healing mode…trying to heal leaky gut or grow back damaged villi, I suggest NOT eating out until your health stabilizes. Sorry but this is the cold hard truth. I know all the safe places to eat (and the safe meals to order) around my local area and I sometimes still get sick. It’s not fun.

2) Educate yourself on your local restaurants with GF options. Look up the restaurants trained by the GFFS program. Join local chat rooms for either gluten sensitive or those focused on celiac disease…even if you don’t have a celiac disease diagnosis. You will learn a lot about staying safe from these experienced people. Very often these groups will know the “safe” places to frequent and the best food selections to order. The Web sites to search for these groups are Yahoo Groups, Google Groups, MeetUp, Facebook, etc. You can also call your local celiac or GIG organizations and ask about local support groups or online forums. Health centers that specialize in celiac disease or other gastroenterology issues may have info on support groups or other resources.

You can also check programs on Web sites or smart phone apps such as Find Me Gluten Free, Gluten Free Registry, GF Fast Food, GF Pizza, Gluten Freed, Food Spotting and G-Free Foodie. Even Yelp will allow you to do a gluten-free search. I have a page on Yelp where you can read my reviews of various restaurants I have visited. Triumph Dining publishes a guide called The Essential Gluten-Free Dining Guide. They also have a smart phone app ($17.99). I have found that different apps are better in particular areas so I have several and check which app gives me the best selection and details for a particular area. I have my own e-guide, called Eating out Gluten and Dairy-Free. It is primarily for the bay area of San Francisco but does include some chains. My guide is unique in that I try to provide special notes about dedicated fryers and bakeries and also notes about dairy-free options. Studies show that 50% of people with a celiac diagnosis can’t tolerate dairy either.

3) Call ahead and research their menu ahead of time. You can get a good feel about a restaurant’s gluten-free guidelines just with a quick phone call. If they seem uneducated or unwilling to help, I would avoid the place. Once you have a good feel for a restaurant, let them know when you are coming (if they take reservations) and ask them to make a notation that you are gluten-free so the chef will be on alert. Open Table as a special area for “notes.” Ask for the name of the person you should ask for when you arrive so you have a personal connection and don’t have to repeat your story.

Various wallet size GF info cards are available that you take with you to restaurants. When you join GIG, you will receive the card featured below in your welcome package.

4) Plan ahead when on the road. When I take my daughter to college, I do a search ahead of time for restaurants I know I can eat at somewhat “safely” such as Chiptole. I plan the timing so that I swing through the area around meal time. I also find hotels with a small refrigerator or kitchenette so I can fix our own food. I also research local grocers such as Whole Foods Market, New Leaf Community Markets or Trader Joe’s in that particular area.

5) Ask questions once you arrive. I used to be shy and reserved about asking questions in a restaurant….not anymore. I soon learned that it is I who pays the price for a gluten infraction. A slight gluten infraction will cause cramping up and down my sides, diarrhea or loose stools within 20 minutes to an hour after consumption (sometimes vomiting as well) and then I will spiral into a depression that lasts for about four days coupled with large boils around my hair line (neck and forehead)…fun and attractive! I am the one that has to live with these ramifications so guess what…I will no longer feel awkward or embarrassed to ask questions and neither should you.

Here are some of the questions you should ask: What gluten-free options to you offer? Is your restaurant trained in gluten-free food preparations such as using a separate or cleaned area for food free of gluten? This includes a clean cutting and prep area, clean utensils and gloves and uncontaminated condiments. If they are dipping a spreading spatula or knife into a large container of mustard or mayonnaise, the condiment is contaminated with gluten. Most serious restaurants will gladly open a fresh jar for you. If not, leave. If the restaurant offers gluten-free pasta, ask if the pasta is cooked in clean, dedicated GF water. Most restaurants have a large pasta water pot that is used all day for cooking pasta. Your gluten-free pasta should not be cooked in the same water that has boiled gluten pasta. The same goes with deep fryers. If your gluten-free French fries (fries that have not been dusted with flour to prevent caking) are cooked in the same oil as chicken tenders or onion rings coated with flour, the oil is now contaminated with gluten. Some restaurants offer dedicated fryers (such as In N Out Burger) so ask. If the restaurant offers GF pizza, ask how the dough is handled and baked. Most restaurants that take this serious bake the pizzas in a separate area. Some just use parchment paper to cover the baking stone or pan. Of course a clean knife and/or pizza cutter and spatula must be used as well. I would avoid toasters, Panini grills, waffle irons and any other shared equipment and surfaces that cannot be cleaned thoroughly. Ask if they have a dedicated equipment to handle your GF food. A local restaurant in my town offers both GF waffles and pancakes. I would opt for the GF pancakes instead of the waffles because the flat surface is easier to clean thoroughly (unless of course they have a dedicated GF waffle iron).

If your table server does not seem educated, feel free to ask the chef to come to the table. Through this process, I’ve found that more and more chefs know somebody who is gluten sensitive and really “get it.” This can help assure you have a positive dining experience. If you don’t get a warm and fuzzy feeling from any of the staff…leave. If they comment that this particular restaurant is not the safest for gluten-free eating, do not be offended…consider yourself lucky they were honest and then leave. This is where calling ahead helps…you don’t have to have an awkward moment when you decide to exit.

6) Be on high alert at all times. Just recently I joined a dinner table that was in full swing. I had not planned on eating and did not order anything so I was relaxed and did not worry about too much. Someone offered me some marinated cucumbers. I assumed they were GF. Had I looked closer and noted that they were not on the right plate, I would have avoided a gluten infraction. The cucumbers were indeed not GF and had been delivered to the wrong table. If a restaurant is busy or it is late in the evening, be on extra high alert questioning everything.

7) Understand where gluten lurks. Eventually you will realize that you know more about gluten then anyone around you. Therefore it becomes very important that you understand all the places gluten lurks since you will have to advocate for yourself. Some of the not so evident places gluten can hide are soy sauce, sushi rice, salad dressings, spices/seasonings (taco, for example), corn tortillas (including tortilla chips), barley based miso, malt vinegar, barbecue sauce, grain based alcohol and tea (usually in the form of barley malt). Do your research and question everything.

8) Be aware of other potential food sensitivities. Very often individuals with gluten sensitivity have other food sensitivities as well due to leaky gut. If one does not have a full understanding of their food sensitivities, they could react to something else in the restaurant food. It’s almost impossible to have complete control over what is used in the kitchen. For example, I noticed a pattern of getting sick on salads at restaurants even though they would confirm that the salad and dressing were GF. Once I switched to using olive oil and lemon on salads while eating out, I quit getting sick on salads. I wonder if I was reacting to the potential Genetically Modified (GM) canola oil that is commonly used in restaurant salad dressings (used because of the cheap cost). I recently ate at a restaurant that was completely gluten-free, due to the nature of the food, so I relaxed and went a little crazy. I ended up sick and then found out later that they cook all their food in soybean oil (most likely a GM soy oil) which is most likely what made my stomach hurt. I have found that following the K.I.S.S rule (Keep It Simple Stupid) can be very helpful in choosing food while eating out. I ask for salmon (seasoned with salt and pepper and then cooked in olive oil) brown rice and steamed veggies (no butter). It works well every time.

9) Note how the food is marked. Note if there is an option within their ordering system to indicate your food order is gluten-free (on the receipt for instance…see below). Is the food marked with something (a flag or stamp for instance…see the photos below) or is it served on a specially marked plate like seen below at PF Chang’s. These seemly small efforts help me feel more secure that the order is correct and indicates to me that the restaurant takes it seriously. This also indicates to the food “runner” (the person who often delivers your food) that the food is gluten-free. If the food is not marked, always, always double check. If the runner or server is not absolutely certain that they are serving gluten-free food, have it remade….SERIOUSLY. Do not feel bad about this. It’s their fault for not having a better handle on the situation. There should be no doubt in anyone’s mind that the food being served is gluten-free.

10) Be clear and firm when ordering…It may sound silly but I find it helpful to point on the menu to what I want (drawing attention to the gluten-free menu or item). Always mention “gluten-free” when you specify the food or beverage (e.g. I’ll have the gluten-free beer, Red Bridge). Tell your server that you are very sensitive to gluten and to alert the chef/food prep person that you need them to take extra precaution against cross contamination.

11) Check and then double check. As mentioned above, if the food is not marked GF, I always double check with the person serving the food that it is indeed gluten-free. On occasion, my diet restrictions have spurred a long conversation with the table server about gluten and health. I think sometimes after the extended conversation, the waiter actually forgets to mark the food GF within the system. You can head off a potential infraction (and health issues) simply by double checking.

12) Send the food back. Don’t be afraid to refuse the food if you have any doubts that it’s not what you ordered. Again…you are the one that will pay the price with your health by eating gluten contaminated food. For more casual dining, it can be helpful to frequent places that you can watch the food preparation. Again, don’t be afraid to watch their every move. If they accidentally place a piece of bread or croutons on your salad or serve your hamburger with a bun, they should remake your food. It is not sufficient to just remove the bread or croutons. The food has been contaminated by the gluten. The first time this happened to me, I was embarrassed to insist they remake the food and I became sick.

13) Visit during slower traffic times. Restaurants can be very hectic and fast paced during specific meal hours. The busier the restaurant, the more likely they will make a mistake. To error is human. If you go early (11:30 am lunch or 5:00 pm dinner), you will more likely have the full attention of your table server and your food prep person. The more in control of the situation you are the less likely you will have an infraction and end up sick.

14) Tip well if they get it right and do a positive review. If you have a positive experience at a restaurant, share the good news on Yelp or other gluten-free app or Web site. Express your gratitude with your server, the chef and the manager. The more feedback you give the restaurant, the more they will realize how important this is to our GF community and most importantly, tip your server well…”TIPS” stands for To, Insure, Prompt, Service. They will be more likely to serve the next gluten-free customer adequately and happily if they have a positive experience with you.

15) Relax and enjoy. After you have all your bases covered, try your best to relax. After all, that’s why you’re eating out in the first place…to relax and have fun. Be sure to take time to enjoy the experience. You will grow more comfortable with the GF eating out process and will feel in more control over time. Soon…you will be thriving gluten-free…even while eating out.