Living With Coeliac Disease : Eating Out – Restaurants & Fast Food

Eating Out – Restaurants & Fast Food

(This is the fourth part of the series ‘Gluten Free Kids – A Practical Guide to Parenting a Coeliac Child’. To access the Introduction and subsequent ‘chapters’, please click on the drop down menu ‘Coeliac Parenting Guide’ on the menu bar).

In this section, I look at some of the ‘best’ and ‘worst’ cuisines for Coeliacs and how to manage menus and negotiate with restaurant staff (scroll down).

Chances are that when a diagnosis of Coeliac was received, the prospect of eating out with new dietary needs brought at least an element of worry or fear and perhaps even a little irritation of yet another thing to work around. If you were a family who ate out regularly and anywhere that took your fancy, the reality that this is not now as easy and requires more careful consideration can feel like a ‘given’ part of your shared life has been snatched away. But with planning (for the best experience), a little research and asking the right questions at venues (which not only reassures, but raises awareness and educates too), you will realise that actually, being Coeliac and eating out is not such a massive hurdle and that with the growing gluten free ‘trend’, it is becoming simpler every day.

Best & Worst ‘Cuisines’

In the seven years since Miss GF was diagnosed Coeliac, restaurants have come a long way in their understanding and willingness to provide for varied dietary needs. Although there remain some stragglers, eating establishments are increasingly able to cater for gluten freedom to a greater or lesser degree. The best and the worst of them may often be praised or shamed on social media. You will nonetheless find that some types of food are more versatile than others to being ‘gluten-tamed’.Wherever you find yourselves in this multi-cultural world, you will likely have an array of international cuisines on offer. From a gluten free perspective, some are more open and better set up to meet the needs of gluten-avoiders than others. The easiest way to check the likely availability of a suitable meal, is to ask if you can see the specific gluten free or allergen menu. If none exists, explain your needs carefully and if not reassured that they can cater for you or your child safely, do not hesitate in leaving and eating somewhere else. Even where there are no ‘obvious’ gluten free choices however, you may be able to negotiate a meal of fresh fish/meat/cheese/eggs simply cooked with safe vegetables.

Either way, don’t be afraid to head out and dip your toe. We live in a world where eating out is increasingly the norm and an important part of people’s social lives, so it is essential that (as young as possible) your child realises it is safe to join their friends for a meal. They need to gain the confidence to tell restaurant staff what they need and why and become discerning about their menu choices without feeling that they are creating any trouble or extra effort for anyone. They are of course, the future customers of the food-makers and the sooner they learn to shout about what they want, the better they will be heard. You… their parents are their teachers and role models.

Italian food : The Italian’s do gluten free well and with so many varieties of gluten free pasta now readily available, you will find that whether you are seeking an independent or chain restaurant, many will now cook GF pasta in a designated pan and that a whole variety of naturally gluten free sauces will be available to top it. A number of non-pasta gluten free dishes are also likely to be available, from risotto, to meat, fish and vegetables. Just remember to question for the possibility of hidden glutenous seasonings and marinades.

Pizza : I have listed pizza separately to Italian above, as although you will almost inevitably find pizza in an Italian restaurant, there are also a number of commercial chains which are aimed specifically at the pizza market. Many now do gluten free bases, but it is wise to check websites and preparation methods carefully as pizza-making can involve a lot of airborne flour and wheat can easily find its way into gluten-free zones. Most GF bases come already made to restaurants and thus can be more easily protected during preparation and cooking and some venues will even use gluten free flour when rolling their pre-delivered wheat-based dough to limit air-borne and sprinkle-risk. Either way, ask in advance if you are unsure. Some restaurants and pizza takeaway chains have accreditation from bodies such as Coeliac UK to add reassurance.

Having eaten many gluten free pizzas in many restaurants, Miss GF and myself are genuinely amazed at how variable the quality and texture of bases can be. They can be anything from hard and tooth-breaking, to chewy and gluey, to crisp and crumbly, to soft and fluffy. Each to their own… You will find your child’s favourites quicker than you realise and your choice of restaurant will almost inevitably become influenced by those preferences, at least while they are young (pizza is a childhood favourite, I am afraid).

Indian food : This is a good choice (although some little ones can baulk at the spiciness). A significant number of dishes are likely to be naturally gluten free as they use coconut milk to enrich and thicken and will be served with rice. Although you will have to avoid naan, paratha, other breads and battered bhajis, most indian poppadoms are made with gram (chickpea) flour, so (providing they are not cooked in he same oil as any wheat batter or other gluten-containing sundries) may well be a safe. Be sure to check the details of ingredients and preparation with the restaurant. If you are really lucky, you may also find gluten free Dhosa (an Indian pancake, most often made with rice and lentil flours), which is delicious and can be served with a whole variety of safe fillings.

Chinese food : Avoid at all costs (unless you happen upon a Chinese restaurant which offers dedicated gluten free food). It is unsafe due to the wheat contained in soy sauce which seems to be a fundamental component in many sauces and will be added to the wok, thus making both direct and cross contamination a serious risk. I have yet to find a Chinese restaurant that is able to safely cater for gluten-avoiders (they are rare jewels, usually in major cities), so if you want to eat Chinese food, you will need to make at home and use gluten free Tamari soy sauce.

Thai food : Much safer than Chinese food, although you still need to check for hidden soy sauce by direct enquiry. Many dishes are ‘wet’ and use coconut milk and spicy curry paste as a base with no wheat or gluten and dishes are usually served with rice or rice noodles. Miss GF loves Pad Thai, although we always check ingredients and preparation to ensure safety.

Vietnamese food : As with Thai food, Vietnamese food offers safer options than Thai as they use a lot of rice noodles, but be vigilant and ask particular questions around hidden gluten, particularly from soy sauce. (Thanks to Alice Brannen who gave me the heads-up on this one).

Mexican : Another relatively safe option, which usually can cater at some level for gluten free needs. Tacos and nachos are usually corn-based and although you cannot eat standard enchiladas or burritos (as they are generally made using wheat ‘wraps’), some of the better restaurants will now offer alternative authentic corn tortillas, so that fajitas can still be shared. For home-cooked Mexican, it is worth noting that Old El Paso now offer gluten free fajita kits with amazingly good wraps. Traditional corn tacos are also increasingly available on-line.

Spanish Tapas : Another good option as it is based around choosing a number of small dishes to share. Menus invariably include a range of naturally gluten free choices and are cooked to order, which enables the possibility to negotiate greater flexibility in avoiding glutenous ingredients. As with all eating out, be sure to negotiate your meal with restaurant staff, as risk alongside willingness to prepare safely will vary.

Greek food : Also offers varied menu choices, with the potential for a good range of gluten free options. Meat, fish and vegetables are often simply prepared with just olive oil and seasoning and thus are naturally gluten free. Check for hidden gluten risk from preparation and with side orders of chips, etc, which may have been fried in oil used for other gluten-based dishes.

Pubs/Gastro-pubs : So varied, it is difficult to outline specifically, but many are now open to catering for allergies and intolerances and either offer, or are willing to prepare appropriate meals. Check on a pub by pub basis, but remain religiously careful around the potential for hidden gluten in sauces and gravies, from seasonings or from preparation methods across dishes. Chips are a significant risk in many venues, due to the use of single fryers to cook a whole range of battered and breaded dishes.

Fish and Chip shops : Most are unsafe either for fish or chips as the batter is wheat-based and the oil for chips is also used to fry other battered items. Don’t be disheartened however. This British favourite can be found. We always on-line research a given geographical area that we are planning to visit or ask direct at a few venues when we get there. If you are really lucky, you will find a fish and chip shop that has a separate fryer for chips and can also pull together freshly gluten-free battered fish, sausages, fish cakes etc as part of their range. These places are often run by families directly affected by Coeliac, and will usually have a clear sign for ‘Gluten Free Available’ in the window.

Increasingly, you can also strike lucky with a fish and chip shop that will cater gluten free one or two nights a week… usually on the days when they clean down the fryers and change the oil. Some will be able to serve chips, but not fish due to how they use their fryers.

Specialist Gluten Free Venues : As the world of gluten free eating has grown, a whole new restaurant, bakery and cafe market, catering specifically to the gluten free audience has sprung up across the country. Most of these venues are local and unique and thus, the menus are varied, change regularly and showcase some amazing gluten free culinary flavours, ingredients, skill and learning. If you can find a gluten free restaurant/cafe/bakery local to you, then use it. I promise that seeing your child’s face light up when they realise that they can eat anything from the menu, is a vision you will treasure for ever.

Fast Food and Restaurant Chains : When we talk ‘fast food’, for most kids this means ‘burgers’. In GFHQ, we are not a big burger household (unless they are home made) and I was really proud of the fact that before Miss GF reached the age of about 8, I could count the number of times we had stepped inside a McDonalds on one hand. I will be honest… I used to be very ‘anti’ the whole multi-national, grease-fuelled, fibre-devoid experience. But you know what? My views have (shockingly) moved forward… As Miss GF has grown and has become more aware of her need to fit in and eat ‘junk’ sometimes alongside her friends, I have discovered that McDonalds is a bit of a leader amongst ‘stand and queue’ burger-joints. Their burgers are 100% beef, their chips are not coated (in the UK) and are fried (in the UK) in oil separate from other battered products, and they are happy to take the GF bun you bought with you to a ‘de-contaminated’ area to toast and fill. Hail McD! We thank you for your willingness to embrace our gluten free children’s wish to fit in (although with the recent upgrading of some restaurants, the mechanical bun-grilling process has become less safe).

I don’t say this lightly. McDonalds is the only truly fast food burger venue in the UK that can do this. Forget Burger King, Wimpy and Wendy’s… they are not safe. Interestingly however and depending on where in the world you find yourself, the gluten-free flexibility of McDonalds will vary. Whilst in a number of countries across the world they can offer you an actual gluten free bun… at the other extreme, some countries (and it all seems a little random) are unable to offer even gluten free chips and are less flexible on you turning up with even your own bun… Whilst there is no definitive list that I can find, of what you can get where, it is worth doing a bit of research before travelling (and as always, double check with the individual restaurant to assure yourself that preparation meets your required safety standards).

There are also now a few ‘artisan’ burger restaurants springing up in the UK (Byron Burgers; Handmade Burger Co; Gourmet Burger Kitchen; Honest Burgers), which all seem to cater, to a greater or lesser extent, for gluten free eating. Check their menus via their websites.

If you don’t want to do burgers, you will find plenty of other gluten free options available courtesy of fast food outlets and chain restaurants such as Leon, TGI Fridays. Zizzi, ASK, Prezzo, Chiquito, Ed’s Diner, Bella Italia, Wahaca, Jamie’s Italian, Hard Rock Cafe, Pizza Express, Pizza Hut, Frankie & Benny’s, Cafe Rouge, Carluccio’s to name a few,.. as well as a number of pub-chains.

Forget the likes of Kentucky Fried Chicken…. it’s an absolute no….. wall to wall gluten from start to finish.

Again, Coeliac UK is a fantastic resource with an accredited guide of safe eateries. Look for their accreditation symbol.

Managing Menus & Negotiating With Restaurant Staff

Whatever cuisine you decide to eat, gaining confidence in negotiating a safe restaurant meal is likely to require some practice. The British (at least) can be pretty reserved about the prospect of challenging waiting staff, usually for fear of causing offence. Let’s be honest… how often do we complain about a restaurant dish that is sub-standard? With Coeliac Disease however, the need to negotiate not only the menu, but also the preparation method is critical to the health of your child and/or yourself, so you are going to have to bite the bullet. 

It is always better to contact venues in advance of eating there to avoid disappointment and to enable less pressured conversation about the importance of getting both ingredients and preparation right. In our experience and particularly with pubs and independent restaurants, planning ahead pays huge dividends, with chefs and restauranteurs bending over backwards to provide a great meal. We have literally had chefs buying in specific ingredients to make special meals for us or going out of their way to ensure gluten free bread and cake is available.

If there isn’t time to phone ahead however, don’t worry. Having a discussion on arrival (and before you order drinks) can (mostly) be just as reassuring. Having some stock questions helps, but ultimately, being clear, assertive and confident in asking for what you need and explaining why you need it is the way to go. 

Be prepared for some interesting and often quite frustrating responses, but always hold your ground… Remember you are asking because you need safe food and it is important for restaurant staff to understand that your request is not because you are being ‘picky’ or ‘going through a fad’. Whilst Coeliacs have benefitted from the upsurge in people choosing gluten free diets for ‘health’ reasons (with a proliferation of new menus to cater for the demand), the downside is that restaurants are only too used to ‘gluten free’ customers deciding that ‘today’ they will eat something glutenous because there isn’t anything they fancy on the gluten free menu. This is not helpful to those of us who have no choice and leaves waiting staff confused when they think ‘a little bit’ of gluten isn’t going to be a problem to you. There have been many occasions when we have been met with ‘rolling eyes’ from waiting staff whilst we insist that we want to know exactly what ingredients go into the gravy, or what else has been fried in the kitchen’s oil. If necessary (and we do this often), ask to see the packets and labels for sauces, mixes, bought-in dishes, etc so that you can check them yourself. If you are not reassured after your discussions or remain unconvinced that you have been understood, ask to talk to the chef direct, or failing that, eat somewhere else. 

For each and every discussion you have, congratulate yourself and gain strength from the fact that you have just educated the food industry a little bit more… See yourself as a trailblazer when you have to work hard to get the message across and when you don’t, thank the restaurant staff for having taken the time to understand. As with everything in life, the first time is the hardest and before you know it you will be a fully-fledged gluten free crusader, joining the movement to make the food world better, safer and more Coeliac-friendly.

A word about menus :
Whilst restaurants are increasingly geared up to being able to provide printed menus listing gluten-safe options, you will sometimes find that the usual menu is annotated with either a ‘GF’ or ‘crossed grain’ symbol, or that you are provided with the staff’s ‘allergen menu’ so that you can DIY your own safe eating choices. Be absolutely clear about how these menus and lists are laid out and labelled as some will ‘tick’ allergens in dishes and some will tick dishes which are safe. If in any doubt, or if no information is provided, ask for clear guidance from staff and if not reassured, ask any and all questions you need to be happy. 

You may find surprising naivety about what constitutes gluten. We have often been advised that we can’t eat something, because it contains rice, soy beans, milk, butter, eggs or some other random ingredient. I can never quite work out whether this is laziness on the part of a ‘catch all’ approach to dealing with ‘allergens’ or genuine confusion, but it is worth bearing in mind and if you are told something is not gluten free when you are pretty sure that a ‘normal’ recipe for the dish would be safe (e.g. a cheese omelette), ask what it is that has been added to make it dangerous or whether it is about preparation methods.

Desserts :
Whether it is for you or a Coeliac little one, gluten free ‘pudding’ can feel a bit of a let down. Whilst many restaurants will be able to provide a choice of gluten free options for mains (and a lesser choice for starters), when it comes to desserts, they can be woefully inadequate. This is generally because desserts are more likely to be ‘bought in’ from external caterers and are frequently centred around, cake, pastry, or with biscuit-bases. Apart from the occasional gluten free chocolate brownie or panna cotta (which can quickly get very boring), this usually leaves ice cream, ice cream and ice cream! Not that there is necessarily anything wrong with ice cream, but be prepared for massive excitement when anyone has gone out of their way to give you more choice…. a gluten free cheesecake, apple pie, or sticky toffee pudding is a rare thing when eating out. And as fully fledged Coeliacs will tell you… ‘fruit is not a pudding’!

An ice cream warning:When it comes to ice cream, you will find that most flavours are safe (as long as they don’t contain brownie, biscuit, cookie dough, etc), but be really careful to check sauces and sprinkles (many will contain wheat flour) and along with wafers, be clear to instruct waiting staff that they must not be put in or on ice cream desserts. If glutenous wafers have been placed in ice cream, it is not okay simply to remove them as they will have already left contaminating crumbs. Always ask for a new dessert if staff (or yourself) have inadvertently forgotten to request no wafer/sauce/sprinkles.

Questions you need to explore when eating out/things you need to be clear about :

Whilst there will be lots of other questions that you formulate along the way, possibly dependent on both the circumstances of your meal and the openness of response that you receive, I have listed a few starter questions below that you may want to think about (although if I have missed anything significant, please let me know) :

• What is gluten free and safe on the menu?
• Are there any particular sources of ‘hidden gluten’ in the ingredients list (e.g. wheat flour to thicken sauces; barley in flavourings; use of commercial sauces/condiments to flavour dishes, such as soy sauce; Marmite; non gluten-free barbecue sauces, coatings for chips, etc etc.)
• How is food prepared? Are separate pans used to boil pasta? Separate fryers for gluten free food? How can you be sure the grill pan will be clean from cross-contamination? How does the kitchen ensure that the risk of cross-contamination is kept to a minimum during preparation? Does the kitchen use designated utensils for preparation and serving?
• Are condiments (including tomato ketchup and mayonnaise) also gluten free?
• Be clear with restaurant staff that eating any gluten is a health risk, not a lifestyle choice.
• If a dish has a gluten-containing ingredient which can be removed during preparation either because it is superfluous to your requirements or can be substituted for something safe (e.g. use of corn flour instead of wheat flour in sauces; removal of croutons from soups and salads; alternative salad dressings; boiled/baked potatoes instead of chips, etc), is this possible? You will find that where dishes are prepared from scratch on premises, chefs are often only-to-happy to amend ingredients, but where dishes are ‘bought in’, this will not be possible.
• As noted above, be really careful to check sauces, sprinkles and wafers for ice cream. Be clear that glutenous additions are unwanted and if you forget, always ask for a replacement dessert.
• Check that restaurant staff understand what constitutes gluten. There is often a lack of knowledge and being ‘gluten free’ will often be translated into being intolerant of a whole range of other things. I have lost count of the number of times I have said to people ‘dairy is not gluten’.
• If you are not happy with the response you receive when questioning restaurant staff and chefs, either because you are worried they don’t ‘get it’ or feel they simply aren’t that bothered, then don’t risk it. My strategy is always that if I am concerned the food won’t be safe, we leave and find somewhere else and we make clear the reasons why we are doing so.