Q: I've been experiencing increased anxiety around eating new foods and at new restaurants. Do you have any tips for being able to manage this? It is starting to affect my general happiness and my ability to participate in social situations.
Eating out can be very anxiety provoking when you have celiac disease and with good reason. In a study of 105 patients with celiac disease 29% of gluten exposure was attributed to problems ordering at restaurants.1 There is always going to be a risk of getting exposed to gluten when eating away from home. However, with a bit of research and extra communication it is possible to enjoy a gluten-free (GF) meal at a restaurant.
It can be hard balancing living a normal life and staying vigilant about gluten exposure.
A recent study of adults and teens with celiac disease showed that those who were hypervigilant about their diet had a lower quality of life than those who were not.2
If you have a lot of anxiety about eating out then stick to places you know have good awareness of the GF diet and choose menu items that you know are naturally GF. I would also talk to your family and friends about your fears so that they can be supportive when you go out to eat. Ask to be the one picking the restaurant so you can do adequate research ahead of time. If the anxiety gets overwhelming it can be very helpful talking to a licensed mental health professional who can come up with appropriate strategies to manage the anxiety. Another thing that can be helpful is to connect with others that have celiac disease and hear about their approaches to eating out. You can search for a support group near you here:
Here are some general tips for safely eating out at restaurants:
- Look up restaurants and menus online, check out our restaurant search tool: https://nationalceliac.org/gluten-free-restaurants/
- Call the restaurant and ask about GF options and preparation methods– off hours are best as staff may not have time to talk on a busy night
- Use an app such as Find Me Gluten-Free to find restaurants near you and read reviews
At the restaurant:
- Alert the manager and all staff about your GF requirement, tell them it is a serious health issue not a lifestyle choice
- Ask for a GF menu if available
- Use a restaurant card that explains the GF diet:
General food preparation guidelines:
- Wash hands and change gloves
- Separate preparation and cooking station
- Separate/dedicated equipment, fryer, utensils, and tools
- Clean grill before cooking
- Place items on aluminum foil when toasting
- Do not steam, bathe or warm vegetables over pasta water
Ask about all foods and ingredients used. The dishes below almost always contain gluten:
- Sauces and thickeners
- Broths and soups
- Soy sauce
- Spice mixes and flour dusting
- Salad croutons and dressings
- Breaded or battered foods
- Fried foods (fried in non-dedicated fryolator)
- Bread served on top or side of food
- Vegetables cooked in pasta water3
When you receive your order always confirm with the server or manager that the meal is indeed GF. Some restaurants will use different shaped or colored plates for GF meals, even so, always verbally confirm before eating. Bon appetite!
- Silvester JA, Graff LA, Rigaux L, Walker JR, Duerksen DR. Symptomatic suspected gluten exposure is common among patients with coeliac disease on a gluten-free diet. Aliment Pharmacol Ther. 2016;44(6):612-619. https://www.ncbi.nlm.nih.gov/pubmed/27443825 . Accessed January 4, 2020.
- Wolf RL, Lebwohl B, Lee AR, Zybert P, Reilly NR, Cadenhead J, Amengual C, Green PHR. Hypervigilance to a Gluten-Free Diet and Decreased Quality of Life in Teenagers and Adults with Celiac Disease. Dig Dis Sci. 2018 Jun;63(6):1438-1448.
- National Celiac Association. Gluten-Free, Off to A Fresh Start. Presentation. Updated May 4, 2018.
Note: This information is provided by NCA and Katarina Mollo MEd, RDN, LDN, NCA's Director of Education. This information is meant for educational purposes only and is not intended to substitute for personalized medical advice or replace any medical advice provided directly to you by your health care provider. No liability is assumed by the NCA or Katarina Mollo, MEd, RDN, LDN by providing this information.