Your soon-to-be high school or college graduate can see the light at the end of the tunnel by now. In just weeks he or she will be marching to “Pomp and Circumstance” and receiving a hard-earned diploma. So now is the time to start preparing for that gluten-free graduation party.

Lorae Raeder’s daughter Miranda, who has gluten sensitivity, graduated from high school in 2015. Raeder, who’s from the Southern Tier region of New York, said she didn’t know where to begin when it came to planning a party.

“Throwing a gluten-free graduation party scares me because I want the whole menu to be gluten free,” Raeder said. “The last thing I want to do is be the ‘food police’ with the honoree, my daughter, at a party being thrown in her honor.”

There are a lot of considerations when you plan a graduation party: cost, access to gluten-free food in your area, caterers’ gluten-free training, venues and your time and resources.

Do it yourself

A home-cooked meal is a popular option for graduation parties. You know everything will be gluten free, and it is probably the most budget-friendly choice. But it is also the most time consuming. Food preparation before the party with shopping, cooking, freezing and reheating—not to mention house cleaning—can take days or weeks.

And during the party you’re also in charge of replenishing food and making sure the hot and cold foods stay at safe temperatures.

Easy at-home gluten-free menu options include grilled steak, chicken or kabobs. A taco bar with corn shells or a baked potato bar are not only gluten free but can easily include vegetarian options. 

Check out our gluten-free recipes here.

Call the caterer

Nate Benkofske, who was diagnosed with celiac disease as a toddler, will graduated from high school in Minnesota in 2015. His party menu included assorted appetizers, catered food from Chipotle Mexican Grill, a specially made gluten-free cake for him and a regular cake for the other attendees.

“I know I can’t make all of the food myself because of time,” his mom, Lynda, said. “Nate loves Chipotle so it was an easy decision.”

Chipotle Mexican Grill is one of the most popular fast-casual restaurant chains in the country. Everything on the menu is gluten free except the flour tortillas. “While we don’t have a [special] gluten-free menu, there are plenty of options for people who maintain gluten-free diets. You can certainly order only items that are gluten free,” said Chris Arnold, communications director for Chipotle.

For his part, Benkofske had a laid-back attitude about what was served at his party. “I don’t dwell on the fact that just because I need to eat gluten free, that everyone at the party needs to eat gluten free. There is so much more to life than food,” he said.

Jennifer North, vice president of the National Foundation for Celiac Awareness, also turned to a caterer when her daughter Molly graduated from college several years ago. But she wanted everything served at the party to be gluten free to avoid cross-contamination for her daughter and 7-year-old niece, both of whom have celiac disease.

North is acutely aware of the complexity of managing gluten-free food in restaurants because the NFCA has a gluten-free education program for restaurants.

“I know what can happen when restaurants get busy and things get rushed,” North said. She tried to reduce the chance for error by asking the caterer to make her gluten-free order first thing in the morning. Then she planned to reheat it later for the party.

But the caterer insisted the meal could be made safely later in the day, and the food would be better if it arrived fresh and hot.

North finally agreed, but she was not home when the food was delivered and it turned out one dish mistakenly contained gluten. Unfortunately North’s niece had already eaten some of it by the time the error was noticed.  

North said she learned a valuable lesson. While she would order catered food again, she would stick to her original plan to have the food made and delivered at the start of the day.

Read Questions to Ask Before Hiring a Gluten-Free Caterer. 

 “I would follow my instinct to have them make the food when it is not so busy,” she said. And she would make sure she was there when the food arrived to double check the order.

If you are thinking of having your child’s graduation party catered, make sure the chef understands your gluten-free needs, including preparing the food in a way that prevents cross-contamination. Go over the menu thoroughly and ask questions about ingredients and food handling. On the day of the party, review all the food one more time to make sure your directions are followed.

Truck in the food

Food trucks are a growing trend, and many are available for on-site catering. You might be surprised to find that food trucks often offer cuisines that are naturally gluten free.

Bonnie Handke of Mahtomedi, Minnesota, hired the Tot Boss food truck for her daughter’s high school graduation party in 2014. Handke is also gluten sensitive and had vegan and vegetarian needs in the family.

“I liked the food truck option because the food was cooked to order, and the individual could specify what they wanted. This was so simple and there was no mess in the kitchen and no leftovers you get tired of,” she said.

Dan Docken of Tot Boss, based in Maplewood, Minnesota, has a niece with celiac disease and understands the gluten-free diet. While his regular menu, filled with what he describes as “tater tot concoctions,” has a few gluten-containing items, nearly everything is gluten free. Customers can request a completely gluten-free menu for a private party.

Easy cleanup is another plus. “One customer told me the mess just drives away at the end of the party,” Docken said.

Party prep

Although hiring a caterer or food truck will likely cost more, it will save a lot of time and effort.

Laura Ursini Marroquin, community relations and project manager for the Rib Company in Costa Mesa and Long Beach, California, began serving gluten-free options at the family-owned BBQ restaurants 12 years ago when her son was diagnosed with autism. “I couldn’t take my son to eat out at our own restaurant,” she said. Now the restaurant has many gluten-free menu items.

Based on her experience in the restaurant business, Marroquin said a caterer typically needs at least two weeks to plan and execute an order. But you should start planning even further ahead if you have a specific restaurant or food truck in mind.             

Marroquin said you should specifically tell the caterer that getting safe gluten-free food is the most important consideration to you. Make sure the caterer really understands gluten-free foods and preparation.  

“Ask about contamination in the fryer and special cooking techniques,” Marroquin said. “When we have a client who is actively asking those questions, we are more on top of those cooks creating the gluten-free meal.”

Docken recommends visiting a food truck and asking about truck cleaning procedures, noting that you should confirm that there will be no gluten-containing items in the truck during the party to eliminate any chance of contamination.

What about the cake?

A cake, complete with school colors and sometimes even a picture of the graduate, is often the centerpiece dessert at graduation parties. There are many bakeries, some exclusively gluten-free, that create gluten-free cakes for graduations, as well as other events.  

Click here for our list of gluten-free bakeries in the U.S.

If you have one in your area, be sure to put in your order far enough in advance. Some bakeries also offer online ordering. The sugar or icing sheets often used to put photographs on cakes are made from a layer of frosting and are usually gluten free.

It’s also easy to make a homemade cake using one of the many gluten-free mixes or recipes that are readily available. You may want to experiment with making a larger cake than usual if you are planning a big party. Cooking times will vary, and you want to be sure your cake is baked all the way through on the big day. A gluten-free sundae bar or a selection of gluten-free cookies and brownies are also popular options. 

Find gluten-free dessert recipes here.

In the end, it is important to consider what you realistically can do and what your child wants when planning a graduation party. Ask your graduate if he or she wants an exclusively gluten-free party. What kind of food does your child prefer? Maybe your graduate will surprise you, forgo the party, and ask to use the money for a plane ticket to backpack through Europe for the summer instead. It could happen.

The fun and excitement of a good old-fashioned sleepover never seems to go out of style. Between staying up late, watching movies or playing video games, talking, taking pictures and eating all kinds of food, what’s not to like? Children’s sleepovers are a rite of passage, and the upcoming spring break is a popular time for youngsters to spend the night away from home.

Usually parents are concerned their child might not make it through the sleepover and come home in the middle of the night. But for parents with a gluten-free child, that first sleepover away from home can lead to a whole new set of worries.

Sometimes parents of gluten-free kids put the first sleepover off as long as possible. We don’t want our kids to get sick from accidental gluten ingestion. We may feel we are burdening the host parent with gluten-free demands, such as worrying about cross-contamination and making sure to buy the right brand and flavor of chips or ice cream.

However, we all know that at some point we need to let go and finally say “yes” when our child asks to spend the night at a friend’s house. Here are some tips to prepare your child, the hosts and yourselves for the big overnight outing.

The first sleepover

“Aurora and her friend came running into the house, as 8-year-olds do, saying ‘Mommy, can I please go to [my friend’s] slumber party [for her birthday] on Saturday,’” Elizabeth Roach of Eagan, Minnesota, recalls about her daughter’s excitement about her first sleepover a few months ago. Aurora was diagnosed with celiac disease three years ago, and Roach had many concerns about the overnight adventure. “They both looked at me with those big, innocent eyes full of excitement. I couldn’t say no,” she explains.

I, too, remember those days and the looks from the kids who desperately want to stay over at a friend’s house. It is hard to say “no.”

Teagan Ott, a 10-year-old from Saint Paul, Minnesota, has both celiac disease and Type 1 diabetes, which adds another layer of complexity. “Teagan has to give herself insulin for any carbohydrates she eats. So knowing exactly how much she eats is super important,” says Michelle Ott, Teagan’s mom. If Teagan doesn’t get enough insulin or gets too much, her blood glucose level could be too high or too low and lead to serious consequences, Ott explains.

Still Teagan had her first sleepover at the age of 9. Concerns about her daughter managing two conditions dependent on diet “have led to sleepless nights for us when she is at a sleepover,” her mom says.

Preparation and communication

Managing expectations of everyone involved in the slumber party is an important first step. “I told Aurora and her friend that I would have to speak to her mom because Aurora has to have special food,” Roach recalls. The two moms discussed Aurora’s celiac disease, gluten-free diet and cross-contamination.

Roach was nervous because she wasn’t sure if the mom would really get the importance of the gluten-free diet. But it turns out, she did. “[The other mom] was just as interested in keeping Aurora safe as I was. It made me a little bit more comfortable with the whole thing,” she says.

After discussing the party, the moms agreed Roach would make gluten-free birthday cupcakes for all of the kids. “I also sent along frosting and a dozen different types of fun gluten-free sprinkles and decorations for each girl to top her cupcake with,” Roach says. “They had a decorating contest, and no one knew the cupcakes were gluten free.”

When Teagan had her sleepover, Ott sent the host parents instructions for dealing with Type 1 diabetes and list of a gluten-free foods. She also asked the parents what they were having for dinner, snack and breakfast.

“I sent the gluten-free equivalent and labeled the number of carbs on the foods when I could,” Ott says. Teagan’s parents also require her to keep in contact with them when she tests her blood glucose, including right before bed. “I don’t like it when I have to text my parents,” Teagan says. But her parents say this is non-negotiable.

Looking back on it, Ott says she didn’t need to be as detailed with instructions for the parents. A text or call from them would have been just fine, she realized. She says labeling the food does seem to help, however.

Whatever you work out with the host parents, fill your child in on the plan. This can help manage expectations at the sleepover and reduce any anxiety, even if your child does not seem to be worried.

Both Aurora and Teagan had their first sleepovers with families they knew pretty well. It’s a little scarier for parents when the child is going to a new friend’s house. In that case, you might need to have a more thorough discussion about your child’s dietary needs. And sending along gluten-free snacks and a breakfast option will make things easier for everyone.

It’s also a good idea to try having sleepovers at your house first. You will get a feel for how they go, what children like to do and what kinds of foods they like. This may better equip you for when you send your child elsewhere for the first time.

Sometimes children head to the friend’s house before dinner, which is often pizza, tacos, burgers or another kid-friendly, but not necessarily gluten-free, choice. If you can’t work out the details for making sure your child can eat dinner safely, you can send him or her over after dinner. But I would only make this choice if it was absolutely necessary, since it could result in your child feeling less a part of the entire sleepover experience.

Even now, my 17-year-old daughter Emma, who has celiac disease, sleeps over at her friends’ houses. By the time she was in middle school, she was deciding what food she was going to take along. She always grabbed some cereal from the pantry for breakfast and packed a bag of chips. As she has gotten older, she has simplified this process even more. Now she just takes a bag of microwave popcorn and comes home in the morning to eat breakfast.

Best-laid plans

Parents do need to prepare gluten-free children for the possibility that things won’t go as planned.

For example the host parents might have said they would take the children to a pizza place that has gluten-free pizza but end up going somewhere else that’s not as accommodating. The snack the parent thought was gluten free might not be, or another child might have brought an unexpected treat for everyone that’s not gluten free.

“I recommend having a conversation with your son or daughter [so he or she knows] it is OK to say ‘no thank you’ to something they should not eat or are unsure about,” Ott says. You can discuss the risk that if they eat something with gluten they could get sick and have to come home, something no child wants to have to do.

Sometimes a phone call from the host parent can help straighten things out if they are not going as planned, though this is probably best used when a child is young and won’t be embarrassed. You have to trust older children to handle this kind of situation on their own by simply telling a host parent when they can’t have something.

You might run into a parent who is reluctant to invite your child to a sleepover because of the gluten-free diet. The best thing you can do is assure the parent that your child will come prepared with safe food.

If you communicate that you and your child are comfortable with the plan, the parents will likely be more comfortable, too. At the other end of the spectrum are parents who really go out of their way to make your child feel welcome and included, making sure to get gluten-free foods and taking care to prepare them safely. These parents are always appreciated.

Ultimately communication is the key ingredient to making a sleepover successful for your child and the parents playing host. Once all of the food questions are answered, the kids can focus on being up all night and having fun. GF

Amy Leger is the family editor of Gluten-Free Living. She blogs about the gluten-free lifestyle at thesavyceliac.com.

Making School Cooking Class Safe for Gluten-Free Students

I will never forget the day—open house at my gluten-free daughter Emma’s school before the beginning of seventh grade. We went to the middle school, picked up her schedule, and then came the news: FACS class would begin in the fall, with the cooking segment. FACS is short for family and consumer sciences. Back in the day, we called it home economics, or home ec.

If you haven’t encountered this class with your gluten-free child and your school system offers it, it usually is part of the middle school curriculum or offered as an elective in high school. The goal is to give children a base knowledge of the kitchen—utensils, measurements and how to follow a recipe, make some basic foods, and clean up afterward.

As you can imagine, immersing your gluten-free child into this situation can be a little nerve-wracking for parents and even more difficult for the child. With a little extra legwork, FACS class can be made educational, fun and safe.

Cooking up gluten free in class

Eleven-year-old McKenna Juhnke of Fargo, North Dakota, was diagnosed with celiac disease six years ago. She just finished her first FACS class. Her brother, Austin, 15, also has celiac disease and went through FACS class—both did it successfully.

Their teacher provided a gluten-free alternative (flour or another ingredient) to make each recipe. “I always have an open line of communication with all teachers,” the kids’ mother, Stacey Juhnke, said about working with her children’s schools. She tells the teachers her children have celiac disease and have to eat a gluten-free diet. Juhnke made an arrangement with the FACS teacher. “If they couldn’t get the gluten-free ingredients they needed, then I would buy them. But [the school] had no problem buying them.”

The Juhnke children were able to have a successful gluten-free experience in FACS class because the teacher assigned one of the kitchens to be strictly gluten free. A few other kids in the class would cook with them and make only gluten-free foods. McKenna said she always tried the food she cooked and felt safe eating it.

Our experience was very different. When I emailed Emma’s teacher after open house (we were unable to reach her during the event), I explained Emma’s needs. The teacher suggested Emma sit in the library during the first lab, which involved baking cookies. While I didn’t like that idea, it was so early in the year I acquiesced, and Emma made her gluten-free cookies at home.

At the same time, I started working with the school’s 504 Plan coordinator to put a 504 Plan in place for Emma as soon as possible. According to the U.S. Department of Education, Section 504 of the Rehabilitation Act of 1973 “prohibits discrimination on the basis of disability in programs or activities that receive federal financial assistance from the Department of Education.” If your child’s school receives federal funds, the 504 Plan will allow a child with special needs to have generally the same experience in class as everyone else. In Emma’s case, that meant having access to gluten-free ingredients in FACS class.

The 504 Plan was finalized after Emma’s first cookie-baking lab. In the plan, I requested the teacher talk to me about the recipes before every cooking experience so we could figure out how to make them gluten free. It also mentioned not using wooden utensils or used cutting boards, or sharing colanders and toasters, to prevent cross-contamination.

I also offered to buy ingredients for the teacher and made her aware our district nutrition department had access to gluten-free ingredients and said it was willing to help.

Unfortunately, the teacher didn’t contact me to prepare for any of the cooking labs. Inevitably, I would always call when Emma came home from school and told me she had a cooking lab the next day. The teacher didn’t buy ingredients for her, never asked me to supply any, and was fine with Emma cooking gluten-filled meals and “just not eating it.” I tried to make it better, but the entire experience was less than successful.

In the end, Emma decided she would not take any more FACS classes.

Making gluten free happen in class

FACS class doesn’t have to be a negative experience for gluten-free students. But it does take good communication between student, parent and teacher, said Kim Graybill of McAlisterville, Pennsylvania, who has taught FACS for 27 years. Her website, familyconsumersciences.com, offers ideas and advice for other FACS teachers.

Graybill has had two gluten-free students over the years, plus another with a wheat allergy. She says student safety is a priority.

When she learns about a student’s health issue, Graybill said, she meets with the parents, student and nurse to fully understand it. “Obviously, you want to know what they can and can’t eat,” Graybill said. She looks for recipes that are easy to make with a gluten-free substitution, and she usually will pick up the gluten-free ingredients.

Parents also should be available to talk about the class and any gluten-free needs that might arise, Graybill said. A good working relationship with the family helps in case the teacher has questions. If it is not an easy gluten-free recipe fix, she works with the parents to figure out how to make it work. “I consider parents to be the experts,” she said. In the past, parents have provided both advice and certain ingredients when needed.

Graybill said having a gluten-free student in class also offers the opportunity to teach all students about managing food allergies. Even if the students don’t know anyone with a food allergy, they could encounter food allergies themselves, or those of a loved one, later in life.

While Graybill does what she can to make the class work for gluten-free students, what if your child’s teacher isn’t so accommodating? Juhnke said, “I would go to the principal and see about getting the child into another class. Come up with some alternative so your child can have the full FACS experience.”

Other considerations include getting the nurse involved to explain to the teacher why this is medically necessary. If you already have a 504 Plan for your child, make sure it is up to date and covers cooking in FACS class. If you don’t have one, start one, and involve the plan coordinator in working with the FACS teacher.

“Sitting out of class has never been an option in my classroom,” Graybill said. But if the food allergy is severe, “I think I would err on the side of caution and have the student sit out if there were no other way around it.”

Whether parents and teachers agree on the full class experience, doing some labs at home or a different option, in the end it is about making sure your child receives a good education. “I want kids to have basic skills,” said Graybill. “The process is more important than the tasting.” Deciphering ingredient labels, learning how to substitute ingredients, and understanding cross-contamination also are vital.

These skills might be even more important for someone who is gluten free, she said. “If these kids need to make their own food, they are going to have to learn their way around the kitchen.” GF

Amy Leger is the family editor for Gluten-Free Living. Her website is thesavvyceliac.com. She recently moved from Minnesota to Colorado with her husband and two daughters. 

Testing is the key to getting a definitive answer.

I’ll never forget when my daughter was officially diagnosed with celiac disease. The entire journey, from the onset of symptoms to the final confirmation from Emma’s gastroenterologist, is seared into my mind. Fifteen years ago I didn’t even know how to spell “celiac.”

The day you hear your child’s doctor say the words “celiac disease,” “tests” and “endoscopy” can be daunting as you face the prospect of dealing with a lifelong, chronic condition.

And then there’s the restrictive and unfamiliar diet that’s the only treatment. Even as it begins to sink in, your head is likely to be spinning with questions. What is involved in celiac disease testing? Does my child really need to go through all this? What are the long-term prospects for a normal, healthy life?

Testing is the place to start.

What’s wrong?

Emma started getting sick in 2000, around her first birthday. For months she had a cold she couldn’t shake. She had diarrhea and was vomiting and losing weight. At the same time, her belly was distended.

Despite the fact that Emma had classic gastrointestinal symptoms of celiac disease, it took four months and three doctors to get a final diagnosis.

Alessio Fasano, M.D., chief of the division of pediatric gastroenterology and nutrition at MassGeneral Hospital for Children in Boston and director of the Center for Celiac Research and Treatment there, says it is sometimes still hard to get a diagnosis of celiac disease because the common symptoms are just that…common.

“These are symptoms that every child at some point in his or her first years of life will experience,” Fasano says.

That might explain why our first doctor responded to my concerns about Emma’s bouts with vomiting by saying, “You know kids throw up, right?”

Extra-intestinal symptoms such as anemia, short stature and discoloration of teeth can also indicate celiac disease. Fasano says whether a child is suffering from classic gastrointestinal or extra-intestinal symptoms, when they are prolonged and start to affect the child’s lifestyle, doctors should begin looking for answers.

How celiac disease is diagnosed

Diagnosis of celiac disease begins with a blood test, which you might also hear called serology. The simple test can be done at your pediatrician’s office, and you get the results in a few days. The test looks for specific biomarkers, known as anti-tissue transglutaminase (tTG) antibodies, indicative of celiac disease.

Tasha Miller of Naperville, Illinois, was shocked when her then 14-year-old son Ryan’s bloodwork came back positive for celiac disease. He was tested along with his older and younger brothers in 2014 because Miller’s husband was concerned their youngest son, Adam, had symptoms that might be celiac disease. But Adam’s test came back negative, and Ryan was the only one who had positive results.

Ryan then went through the traditional second step. He had an endoscopy to confirm his diagnosis. During an endoscopy the child is put under anesthesia, and doctors insert a tube through the mouth and into the small intestine to biopsy a few samples of the intestinal lining. After the procedure, doctors might have some idea how likely celiac disease is based on what they’ve observed, but they cannot confirm the diagnosis until the biopsy sample is analyzed by a pathologist. That procedure usually takes a few days.

Some gastroenterologists wonder whether children still need to undergo the endoscopy to confirm celiac disease. Fasano says the European Society for Pediatric Gastroenterology, Hepatology and Nutrition supports the idea that if a child has symptoms, a positive blood test, carries the HLA DQ2 and/or DQ8 gene found in people with celiac disease and has resolution of symptoms on the gluten-free diet, the endoscopy is unnecessary.

But Fasano always recommends the endoscopy to confirm the final diagnosis. “The information you gain from this really overcomes the possible risk of putting your kids through a procedure like an endoscopy,” he notes.

When Ryan had his endoscopy, Miller says doctors explained what they were going to do before the procedure started. “He came out of the procedure slowly but fine,” Miller recalls. “It took him about an hour or so to wake up and readjust to the world.” Since the throat can be a bit tender after having the tube inserted, Miller says Ryan had a gluten-free milkshake on the way home.

Asymptomatic children

Unlike Emma, Ryan had no symptoms of celiac disease. But his mother says it was good fortune that he was diagnosed. “I am glad we discovered it,” Miller says, adding that Ryan took charge of his gluten-free diet and does not cheat. And he has grown several inches since his diagnosis.

Fasano is often asked whether an asymptomatic child really needs to go gluten free. He says asymptomatic children who have been diagnosed should go on the gluten-free diet to help prevent future, and potentially worse, symptoms, such as diabetes. “Then it is too late, there is nothing you can do about it,” Fasano says. Additionally lack of symptoms does not mean that damage is not being done to the absorbing lining of the intestine.

Young children are more likely to have classic gastrointestinal symptoms, making them easier to diagnose than teenagers, Fasano says. Teens’ symptoms tend to be more random. And they are more independent and more focused on their friends and fitting in. As a result they might not share information with their parents.

“In general parents’ IQs drop 100 points when a kid goes from childhood to being a teenager,” Fasano says. “Therefore they are not seeking their parents’ advice with the symptoms they may be experiencing.”

What parents need to know

If your child is having symptoms of celiac disease or you have a family history of the condition, Fasano says these are the things you need to know:

Get the blood test. It is simple, cheap and reliable.

Do not put your child on a gluten-free diet to see if he or she feels better before getting tested.

“Among all the mistakes that can be made, [taking your child off gluten before testing] is the most severe one you can imagine,” Fasano says. Test results may not be accurate if the gluten-free diet is being followed, and you will not be able to get a definitive diagnosis. “You would not do this with any other disease,” Fasano says. “Nobody would dare put their child on insulin just because he or she is urinating or drinking too much [even though these are common signs of diabetes].”

Follow the blood testing with an endoscopy and biopsy of the small intestine.

“In lieu of more solid data, I would suggest the endoscopy is still needed to confirm a celiac diagnosis,” Fasano says. “I am not disputing the fact that in the future we may get rid of the endoscopy, but I don’t think we are there yet.”

If your child does have celiac disease, other family members should also be tested because it is a genetic autoimmune disease.

You should also consider genetic testing for the family. This test, which is also done by collecting a blood sample, determines if you carry the genes necessary to have celiac disease. If someone has a negative test result, it rules out the possibility that celiac disease will develop and makes repeated antibody tests unnecessary. If the test is positive, it does not mean you or your child have celiac disease, only the potential to develop it, in which case antibody tests should be done periodically.

Armed with this information, you can prepare yourself and your child for testing for celiac disease, with the goal of getting the most accurate result possible.

Blood tests for celiac disease

• Anti-tissue transglutaminase antibody (tTG-IgA): This is the primary blood test used to diagnose celiac disease. It looks for the two types of antibodies found in the blood when someone has celiac disease: immunoglobulin A (IgA) and immunoglobulin G (IgG). The test is also used as a follow up to see how well a celiac disease patient is doing on a gluten-free diet. If gluten is getting into the diet, antibodies will show up.
• Total serum IgA: This tests for IgA deficiency, a condition that can cause a false IgA-anti-tTG or EMA result. This test is often done in conjunction with the tTg-IgA.
• Deamidated gliadin peptide (DGP IgA and IgG): This is a go-to test if the IgA levels are low and the anti-tTg test is negative. It is also a good test for celiac disease in children younger than 2 years old because their levels of IgA-anti-tTG can fluctuate at this age, Fasano says.
• IgA endomysial antibody (EMA): While very accurate, this test is not as sensitive as the IgA-anti-tTg. EMA is done by an indirect immunofluorescent assay, a more expensive and time-consuming process than the anti-tTG’s ELISA testing. It is often reserved for patients who are more difficult to diagnose.

Sources: Alessio Fasano, M.D. director of MassGeneral Hospital for Children’s Center for Celiac Research and Treatment, Celiac.org, LabTestsOnline.org and NIDDK.NIH.gov

Related articles

Development of Childhood Celiac Disease

The Basic Gluten-Free Diet

Boston Children’s Hospital Releases Videos for Kids with Celiac

Top 10 Ingredients You Really Don’t Need to Worry About

Amy Leger is the family editor for Gluten-Free Living. She lives in Minnesota with her husband and two daughters, one of whom has celiac disease. She also blogs about the gluten-free lifestyle on her website, thesavvyceliac.com.

You’ll need to plan well in advance to get your child the right food next fall

It’s spring. The flowers are blooming. The kids are going on field trips, to prom, competing in track meets and baseball games and taking their finals.

Even though the only thing you and your children may want to think about is the upcoming summer break, now is the time for parents to investigate a gluten-free school lunch menu for the new school year in the fall.

School districts across the country are making big changes to their gluten-free offerings. Many districts didn’t have any gluten-free options even five years ago. But now they have burgers (with or without a gluten-free bun), pizza, chicken nuggets and more.

This is the best time to find out what your child’s school has to offer. Even if you’ve done some checking in the past and been disappointed with limited choices, it’s worth trying again because of all the improvements in gluten-free school lunch offerings.

If your child was recently diagnosed with celiac disease or gluten sensitivity or is entering a new school in the fall, it’s particularly important to begin doing the legwork this spring. It can take up to six weeks to make arrangements for gluten-free meals. Steps you take now will lead to a smoother lunch experience, especially during that critical first week of school.

Getting a gluten-free lunch

The extent to which schools have gluten-free offerings runs the gamut. Some schools do not have a gluten-free menu yet, sometimes because no one has requested it. Others have staff who are fully trained, processes in place to minimize cross-contamination and gluten-free food orders coming in. You will not know what the situation is at your school until you ask.

First go to the school nutrition office for your district. Many parents make the mistake of starting at their child’s school, but that can result in misinformation. If the school cafeteria supervisor hasn’t already had a student with a gluten-free need, they may not know the district makes gluten-free accommodations at other schools. The district nutrition officer typically oversees all cafeterias and is the decision maker.

The U.S. Department of Agriculture (USDA), which oversees school nutrition services, requires basic information from the district nutrition office to get started, says Becky Domokos-Bays, director of school nutrition services for the Alexandria City Public Schools in Alexandria, Va., and vice president-elect for the School Nutrition Association.

“We have to have a letter written by a licensed medical authority that explains the medical condition and what the accommodation has to be,” says Domokos-Bays. “Since celiac disease falls under the Americans with Disabilities Act (ADA), when kids come through we are obligated by law to accommodate.”

The 1990 ADA defines a disability as a “physical or mental impairment that substantially limits one or more major life activities of such individual.” Major life activities include eating, learning, thinking and concentrating and can also affect bodily functions like the immune and digestive systems and bowel, according to the ADA.

A 504 plan, named for a section of law that describes how the ADA applies to public schools, protects students who have conditions that fall under these major life activities, according to the U.S. Department of Education. While a 504 plan is not required for a student to get gluten-free lunches at school, it may be helpful. A 504 plan will get all parties in the school on the same page about accommodating your child’s needs during the school year. Check with your school’s 504 coordinator, counselor or the special education department to start this process.

If your child needs a gluten-free diet for a reason not covered under the ADA, for example gluten sensitivity, more leeway is given to each school district in deciding whether to make lunch accommodations. A USDA guide for school food staff says each school has the discretion to accommodate a dietary allergy or intolerance that is not considered a disability but is medically certified as having special dietary requirements. The added cost of special diets may determine whether a district will allow dietary accommodations for someone not covered by the ADA.

The gluten-free lunch experience

Once you’ve determined that your child will get gluten-free lunches, the next step is to ensure that everyone who works with your child’s food is a part of a team aware of his or her needs. In addition to the cafeteria staff, the team can include the school principal, nurse, your child’s teachers and anyone who patrols the lunchroom.

“I like to meet with the parent and the lunch supervisor in May and then turn them over to the supervisor in the fall,” says Esther Motyka, a registered dietitian and site operations and safety manager for child nutrition programs for Anoka-Hennepin Schools in Anoka, Minn. About 50 of the school district’s 39,000 students use the gluten-free menu.

The students select items from the gluten-free menu ahead of time so their lunch is ready when they get to the cafeteria, Motyka says.

School districts usually order all food, including any gluten-free items, pretty far in advance, one of the reasons it’s a good idea to get in touch with the nutrition office before the end of the previous school year. It can take about three weeks to order specialty items and another few weeks for them to be delivered. To limit special orders, districts look for products that will serve a wide variety of students during their food bidding process.

“We try to look at our bids and choose something like a hamburger that can be served to every child,” Domokos-Bays explains.

It’s easy to see how all these steps take time. If you start the process this spring, you’ll be able to get the necessary letter from your physician and give the district enough of a heads-up to order food and supplies, set up a process and train staff (if they haven’t already done so).

If you wait until the very busy open house to bring this up with staff, you will end up scrambling to get the letter in time for school, which, Motyka says, could delay the whole process at the beginning of the year.

The big picture

Each year, the number of school districts with a gluten-free lunch menu grows, says Andrea Levario, executive director of the American Celiac Disease Alliance. The ACDA, a national celiac disease advocacy group, has made improved access to gluten-free school lunches one of its priorities.
Levario says schools are getting better at meeting gluten-free needs because parents of children with a medical need are asking for it. That is what Kelly Trouy and her 11-year-old son, Scott, who has celiac disease, did. They live in Frisco, Texas, and he is off to middle school in the fall.

Their district didn’t have a gluten-free menu when Kelly Trouy first asked three years ago. “We tried the school cafeteria first, and there was no level of comfort there. We went to the district and started working with a nutritionist,” Trouy says. It took them about a month to get the food, menu and training all in order. Scott Trouy’s favorite meal is a salad, burger (no bun), Baked Cheetos, bananas and frozen yogurt. The district has 46,000 students and currently serves at least 11 gluten-free students.

It took Shannon Stewart of Coon Rapids, Minn., about three months to set up her 12-year-old daughter Amissa’s gluten-free accommodations. Amissa has a wheat sensitivity and eats gluten free at a school in the Anoka-Hennepin district.

“When we went to the open house, I got Esther Motyka’s name from the lunch supervisor,” Stewart says. Because of some confusion over the physician’s letter required by the USDA, Stewart had to fill out the paperwork twice, which took extra time. Amissa’s gluten-free lunches started in December of 2013. “She can eat pizza at school. It is a dream come true for her,” Stewart says.

But sometimes planning ahead just isn’t in the cards. A gluten-free diagnosis can be made just before kindergarten, which is what happened to 5-year-old Lane Lovre of Brooklyn Park, Minn.

He started with gluten-free lunches right away in one school district, but moved to the Anoka-Hennepin district a few weeks later. Because the district serves so many gluten-free kids, his gluten-free needs were quickly met even though the school he attends hadn’t served a gluten-free student yet.

As districts get used to the idea of catering to gluten-free needs, they are also offering a greater variety of foods. For example, Chesterfield County Public Schools in Virginia has a gluten-free grilled cheese sandwich. The Scarborough School Department in Maine serves gluten-free pancakes as a breakfast alternative. Fargo Public Schools in Fargo, N.D., has gluten-free muffins and English muffins at breakfast as well as gluten-free peanut butter and jelly sandwiches and chicken noodle soup during lunch.

Communication is the key

One of the key components to successfully getting a safe gluten-free lunch at school is to have open communication between the parents, school and district. “I feel better knowing if I didn’t get the answer I was looking for with the supervisor at the school, I could take it to the district,” Beth Lovre, Lane’s mother, says.

Domokos-Bays agrees. “Start at the nutrition office, and if you have trouble, then you may just have to go up the chain.” But she also recommends that parents try to be polite and patient during the process.

Parents have very common concerns about daily kitchen operations including food preparation, cross-contamination, staff training and the steps their child needs to take to get their gluten-free lunch, with no mistakes.

“Their biggest concern is, ‘Is my child going to get sick by eating here?’” Domokos-Bays says. Her Virginia district, which serves about a dozen gluten-free students, hears parents’ concerns and helps ease fears by allowing the parents and kids to read labels at any time. Plus, the district purchases separate kitchen supplies such as pans and utensils and washes them separately to reduce the chance of cross-contamination.

Trouy, the Texas mom, recommends building a relationship with a school nurse and having a 504 plan for your child. “[The nurse] will be an advocate. The 504 plan helps open that door for her,” she explains. Domokos-Bays agrees that a 504 plan helps inform all staff regarding the expectations for the gluten-free accommodations.

This spring, Trouy says she plans to notify the nutrition department about her son’s upcoming transition to middle school. She will also ask what needs to be done to get the cafeteria ready, since she is unsure if that school has made gluten-free meals before.

Stewart will do the same when Amissa moves into a new building for middle school next year.

Creating a meal for a gluten-free child can be a challenge for a school, but school nutritionists say it is one they welcome and want to do correctly. With a little patience and planning, the school and the family can see great results.

Amy Leger is family editor for Gluten-Free Living. She also blogs about gluten-free topics at thesavvyceliac.com. Leger is married with two children. Her oldest daughter has celiac disease.

1. Make your kitchen gluten-free friendly

Buy a new toaster, cutting boards and colander to reserve for gluten-free use. You’ll worry less about cross-contamination. Purchase new containers of butter, peanut butter, jelly and any other products that could be cross-contaminated with crumbs. Either designate these as gluten free or teach the family never to double dip.

2. Create a space for gluten-free foods

It is easier to keep gluten-free foods all in one spot, perhaps in a basket or bin at a level your child can reach in the cabinet. Let your child know all the food in this area is safe.

3. Learn which ingredients you have to watch out for

Also learn which ingredients are safe. For help getting started, check out our Ingredients Index.

4. Learn which foods are naturally gluten free

This includes gluten-free flours such as rice, sorghum, quinoa, amaranth and teff; plain fruits, vegetables and meats; dairy products including real cheese, ice cream and yogurt that do not have gluten-containing add-ins; plain rice, quinoa, nuts, popcorn and potato chips; potatoes; and beans. For a more extensive list, see our Basic Diet Guide.

5. Stock up on necessary gluten-free products

These include gluten-free pasta, cereal, flour and baking mixes; xanthan gum (used in many gluten-free recipes); cereal and granola bars; bread mix or ready-made bread; frozen pizza crust or ready-made pizza; and snacks. More products than ever are labeled gluten free, making this job a little easier. You can also get apps for your phone that detail gluten-free products by brand name and category. (See our top 10 gluten-free apps.)

6. Keep backup gluten-free treats

Have frozen gluten-free cupcakes on hand if your child is in pre-school or elementary school where birthday or class parties may come up on short notice. If possible, keep them in a freezer at school just in case you have no notice. Teachers are also sometimes willing to keep treats like your child’s favorite candy or snack right in the classroom for those times when something that contains gluten is given to the other children.

7. Learn how to cook gluten free

This will save you money, and it’s not as hard as you might think. There are many baking mixes to make the job even easier. A number of the recipes you use may already be gluten free or easily adjusted to be. For example, rice crispy treats can be made gluten free simply by using Kellogg’s specialty gluten-free version of Rice Krispies. See our recipe section for more gluten-free cooking inspiration.

8. Tell coaches, parents of friends and other adults who care for your child about the diet

Anyone who is responsible for your child for any amount of time should know about the gluten-free diet. Don’t hesitate to bring it up. It’s helpful to give them a simple list of safe foods. But especially at first you might prefer to send your child with their own gluten-free items. Pack a sandwich, a snack or piece of pizza that simply has to be heated in foil, and you’ll be covered for most events.

Is your family going gluten free for the first time?

Going gluten-free isn’t easy at first, but once you learn the basics, it becomes much simpler to help your child live a happier, healthier gluten-free life. To help get started, consider signing up for our free e-newsletter to receive gluten-free recipes, news, articles and more delivered to your inbox each week.

University settlement could have broad impact

Students with celiac disease and their parents have long fought for the right to have safe, gluten-free options in college dining halls. Now they can point to the Americans with Disabilities Act (ADA) to back up their rights as the result of settlement between the U.S. Department of Justice and a Massachusetts university.

The settlement is expected to have a far-reaching effect for those with special diet needs.

It came after a complaint by gluten-free and allergic students to the Justice Department. The complaint alleged that Lesley University was violating Title III of the ADA by failing to provide “necessary reasonable modifications … to fully enjoy the privileges, advantages and accommodations of its food service and meal plan system.” The settlement, reached in December 2012, could be a game changer in making gluten-free food accessible at all schools. Some speculate its impact will be felt in a larger arena even though the settlement is specific to schools that require students to participate in a meal plan.

The settlement included the university’s agreement to provide:

1. A $50,000 payment to the student(s).
2. Ready-made gluten- and allergen-free food in dining halls.
3. Individualized meal plans.
4. A dedicated space in its main dining hall to store gluten-free and allergen-free foods.
5. Staff training.
6. Better signage indicating which foods are gluten-free and allergen-free and which contain gluten and allergens.

The university also agreed to create a process students can follow to have their dietary requirements met. And it agreed to work to retain vendors that include gluten- and allergen-free foods at dining sites accessed with prepaid meal cards.

Mary Pat Lohse, Lesley’s chief of staff and senior advisor to the president for strategic planning and initiatives, says the university took the Justice Department complaint very seriously and made the required changes. Lohse says it put a policy in place a few years ago to handle food allergies and gluten-free diets, but it needed updating.

“The policies in place today have evolved from where they were three years ago and reflect the concerted efforts the university has made to improve the quality and safety of the food that it provides to its students,” Lohse says.

While those who have celiac disease or gluten intolerance may not think of themselves as having a disability, the Justice Department’s decision to pursue resolution of the students’ complaint as a violation of the disabilities act sets a new precedent for gluten-free accommodations.

What this means for higher education

Dena Iverson of the Justice Department says the agreement with Lesley University “will serve as a model for other schools—particularly those that require students to participate in a meal plan.”

Lesley previously required all students living on campus to participate in, and pay for, its meal service plan-even if some students with severe allergies could not eat the food available through the plan without risk of illness, the Justice Department says in an online question and answer page it set up to explain the settlement. Under the agreement, Lesley has made modifications to its meal plan to allow students with food allergies to take advantage of its food services. The agreement also requires Lesley to consider exempting students from its mandatory plan if they cannot, because of disability, take full advantage of the university’s meal service plan. (The Q&A is available at ada.gov/q&a_lesley_university.htm)

Iverson says, “Food service plans are not one-size-fits-all, and each school should evaluate its food service plan to assess whether reasonable modifications for its students with disabilities are necessary to avoid discrimination.”

Scott Lissner, president of the Association on Higher Education Awareness and Disability (AHEAD) and ADA coordinator at Ohio State University, says colleges and universities have to take notice of the settlement. “It sets a pattern that I think will be useful for colleges, students and employees with celiac disease and food allergies,” he notes.

Lissner says he is not surprised celiac disease and some food allergies would be considered a disability. A disability is defined by the ADA as a “mental or physical impairment that substantially limits a major life activity.” The Justice Department settlement points to “eating” and “major bodily functions like the gastrointestinal system” as examples of “major life activities.”

Lissner says he believes the Justice Department was sending a clear message that you can’t discriminate against people with food allergies. He has personal experience with the issue because he has a wheat allergy and his wife has celiac disease. Lissner says universities are probably already discussing whether changes need to be made. “I think you’ll see some little [changes] quick. Next fall, with dining plans you’ll see more clear statements referencing dietary needs, clearer paths for making accommodations,” he explains.

Another consequence of the settlement may be that those with special dietary needs will be more inclined to rely on the disabilities act when they have difficulty getting adequate accommodations. Lissner says these students don’t think of themselves as disabled and previously might not have thought of the disabilities act as having any role in their lives. He expects that more will contact their disability service office as a result of the case.

Lissner also sees this settlement eventually impacting extra-curricular school activities. He believes that offering free pizza to get students to come to an event or program won’t be enough. “Those things would be covered the same way the dining services would be covered … a lot of these activities surround food,” Lissner says. “I now need [to order] a second box of gluten-free pizza.”

Impact in elementary and secondary schools

Even before the Lesley settlement, public schools were starting to take the idea of food allergies and gluten intolerances seriously. For example, the Green Bay School District in Green Bay, Wis., started offering an updated gluten-free menu this school year.

“We are a National School Lunch Program school district, and as such it is our responsibility to substitute foods for any child who has a disability,” Laura Rowell told the Green Bay Press Gazette last February. Although the district had been offering a few gluten-free choices for about five years, this year it came up with a full menu that includes gluten-free pasta, homemade mashed potatoes and a safe gluten-free preparation process. They worked very closely with their vendors because they wanted all gluten-free foods to be certified.

“We had to look into our responsibilities from the USDA and ADA guidelines,” Rowell recently told Gluten-Free Living. “I am saddened that other food service areas aren’t taking this seriously. This is our job, to be food and service. Why not be proactive and meet the federal regulations?”

Food manufacturers are also paying attention to the impact this settlement may have on schools. “As gluten free begins to be seen as a basic accessibility issue rather than simply a diet preference, it is increasingly important for food companies to develop more gluten-free options,” Lindsey Jahn, associate editor for Manufacturing.net, an online industry publication, says.

Impact on restaurants

The settlement could also put restaurants on notice—but only to a certain point.

Iverson says the ADA doesn’t require restaurants to serve gluten-free or allergen-free food. But it recommends a restaurant take “reasonable steps” to accommodate without completely changing the business operations. Examples from the Justice Department include “answering questions from diners about menu item ingredients … or omitting or substituting certain ingredients upon request if the restaurant normally does this for other customers.”

As awareness of the gluten-free diet grows and more customers seek gluten-free meals, more restaurants are voluntarily accommodating the diet. The Gluten Intolerance Group, the National Foundation for Celiac Awareness and the Celiac Sprue Association have programs to help restaurants safely prepare and serve gluten-free food. You can use websites and phone applications like GlutenFreeRegistry.com and FindMeGlutenFree.com to find restaurants that accommodate gluten-free diets. However, restaurants are not required to train their staff or offer a gluten-free menu.

The bottom line

College and university students are likely to feel the most immediate and widespread effects of the Lesley settlement. It was widely reported in the mainstream press as the first settlement of its kind, and the role of the Justice Department was seen as an indication of the seriousness of the disability claim. The damages awarded to the students and the specific steps the university agreed to are likely to be drawing serious consideration by other higher education institutions.

Elementary and secondary schools are also likely to take serious note because they, too, are bound by the ADA in providing accommodations to students. Restaurants may voluntarily try to improve the availability of gluten-free options, but they are not required to do so.

While the ripple effect of the settlement remains to be seen, it clearly is having an impact on awareness of gluten-free diets across the country. Overall, the settlement has been hailed as providing a roadmap for the way schools can meet the needs of their gluten-free and allergic students.

Tips for getting GF food in your school

Scott Lissner, president of the Association on Higher Education Awareness and Disability and Americans with Disabilities Act coordinator for Ohio State University, has these tips for getting accommodations for a gluten-free diet:

1. Go to your school/district/university’s dietitian first. Go to the school’s website for information on dining halls, residence halls or food service. If there is a way to contact a dietitian about your school’s food plan/options, take advantage of that.
2. If there is no option to talk to a dietitian or nutrition services, then check with disability services. At a large university it could be an entire office staff; at an elementary school it may be one person designated as the disability/ADA/504 Plan coordinator.

Amy Leger is the family editor for Gluten-Free Living and operates her own website, thesavvyceliac.com. She has a daughter with celiac disease. Leger and her family live in Minnesota.

It’s time for the grandkids to visit. Mom and Dad get a break. Grandpa and Grandma get a kid fix and the grandkids get love and attention. Ideally, it’s a win-win-win situation, right?

It can be for grandparents who understand their grandchild’s gluten-free lifestyle. But for grandparents new to the gluten-free diet, feelings can range from uneasy to downright scary.

One day your grandchild is like all the other kids, and the next day you have to take a crash course in all things gluten free so you can safely care for your grandson or granddaughter. It can seem like a daunting task, but simple steps will help ease the way.

Ask the parents for help

Many parents are happy to help with the gluten-free meals while their kids are at Grandma’s and Grandpa’s house. They send snacks, bread and cereal, or perhaps even everything needed for breakfast through dinner. Some provide a list of favorite safe foods listed by brand. If you would like any of these, be sure to ask the parents.

The parents are the best source of information on how they specifically handle the gluten-free diet. They can guide you on age-appropriate steps to make your grandchild feel welcome, loved and safe in your home. Even if you have a different opinion on how things should be done, it’s best to keep consistent with rules the child follows in his or her daily life. For example, if the parents only trust ready-made products that have been certified as gluten free, make sure that’s what you buy. These will have a symbol on the package from the certifying group.

Grandchildren shouldn’t feel strain between parents and grandparents over the gluten-free diet. If you have issues to discuss, make sure you do so privately before the child comes to your house. Don’t dismiss concerns about always being gluten free and never suggest that a little gluten won’t hurt or give in to any claims by the child that gluten is sometimes allowed.

Learn about what gluten free means

Gluten-free food is free of wheat, barley (malt) and rye. Regular oats that you buy in the supermarket, including Quaker Oats, are not gluten free. Only oats that are certified gluten free are safe.

You may not realize how many items have gluten in them until you start looking for products without it. Mainstream bread, crackers, pasta, cookies and other baked goods, and pizza are among the items that are likely to contain gluten. You will have to buy a gluten-free specialty version of any of these kinds of products.

But feel free to stock up on fresh fruits and vegetables. Plain meat, potatoes, rice and corn are also gluten free and can be used to make a safe lunch or dinner. If you are looking for a mainstream gluten-free treat, head for the ice cream freezer, where you will find many options. Always read labels looking for wheat or barley, and avoid any flavors with pieces of cookies, cake, pretzels, cookie dough, etc.

Read labels on any processed food you plan to give your grandchild. Look for wheat in the ingredients list or a statement that says, “Contains wheat.” A federal allergen labeling law requires that wheat always has to appear on the label when it is used in a food, either in the ingredients list or the “contains” statement. Also look for oats and barley, malt, malt extract or malt flavoring and avoid foods that contain any of these. In the beginning it might be easier to get a list of safe foods from the child’s parent or to buy only foods specifically labeled gluten free. Food labeled “wheat free” is not necessarily gluten free.

Linda Thielke, of Phillips, Wis., is learning to cook for her grandchild, 3-year-old Roxy. If an ingredient listing isn’t clear, Thielke takes it to the manufacturer. “Calls to the 800 numbers on food packages answer a lot of questions,” Thielke says.

Many supermarkets now have special sections where they stock all kinds of gluten-free products. Check with your grocer about where they put the gluten-free items. Some supermarkets do spread them throughout the store so you might find gluten-free pasta in the same aisle as the wheat pasta. If you have a smartphone, there are a number of apps you can download that will also help you find gluten-free items in the supermarket.

It’s natural to have a lot of questions when you are learning the basics of the gluten-free diet.

Linda Mensing of Beckemeyer, Ill., says it took time to learn what is safe and what is not for her 4-year-old gluten-free grandson Kasen. “How extreme do you go when you have (a grandchild) with celiac disease? Does your dish soap, laundry detergent, makeup all have to be checked?”

The best available scientific research says gluten cannot be absorbed through the skin and has to be eaten to be harmful. So it’s very unlikely any of these products pose harm to your visiting grandchild. Even if they kiss you, the amount of gluten they could ingest from lipstick or makeup would be far below levels that are considered safe for gluten-free food products.

When your grandchild visits

It’s likely you have been to your grandchild’s house since they were diagnosed with celiac disease or gluten intolerance, so you might generally know the drill. But it can be a different story when it’s your home and you don’t have the comfort of knowing the child’s parents have taken all the needed steps to keep things safe. Here are few simple tips to ensure your grandchild’s visit will be successful.

Have gluten-free food on hand.

Make sure you are already stocked with some gluten-free options when your grandchild comes to visit. Find a little space in a cupboard or on a shelf for his or her items so they always know where to look. This way they feel welcomed and accepted.

Ready-made products might be easier at first if you are not confident about cooking and baking gluten free. Donna Hoel of Cedar, Minn., grandmother of 8-year-old Isaac, says she struggles with preparing meals for him. “We all try to cook for [Isaac’s] needs, and mostly we waste our time and the expense of food,” she says.

Find out your grandchild’s favorite foods and treats. Consider buying single-serving, gluten-free foods to avoid waste. You can find frozen gluten-free pizza, chicken fingers and chicken nuggets, bagels, bread and other items that will make meal preparation easier.

If you like to bake and cook, there are numerous child-friendly gluten-free recipes available. And traditional recipes can be adapted to be gluten free. Sometimes all it takes is the substitution of one gluten-containing ingredient for one that is gluten free. You’ll find easy-to-make cake mixes from companies like Betty Crocker, Glutino, Wegmans, Wholesome Chow, 1-2-3 Gluten Free and many others. These are available in many supermarkets and in even in some Marshalls and Home Goods stores.

Think inclusively.

Always make sure your grandchild is included at meals. For example, if you are making spaghetti, it’s a simple matter of making some gluten-free pasta while being mindful of the potential for cross-contamination in cooking and serving utensils. Most spaghetti sauce is gluten free and many now have a gluten-free label.

If you are offering a treat or dessert, make sure to have something for your grandchild. It’s great if you can make something gluten-free that everyone can share, but if that’s not possible have a gluten-free equivalent. Even if it’s not exactly the same, the most important thing is making sure your grandchild does not feel left out.

If others might be visiting while your grandchild is there and bring unexpected goodies, use the same strategy that works in the classroom – have a backup supply of one of the child’s favorite treats in the cupboard.

Prevent cross-contamination.

It takes practice. “I have to think and concentrate when I am cooking for him,” Hoel says of Isaac. “Remember to clean all areas and don’t use the same serving spoon.”

Thorough washing by hand or in a dishwasher should be sufficient to make utensils, pots, pans and colanders safe, according to sanitation experts. But some grandparents and parents like the peace of mind they get by purchasing a separate colander, pot and cutting board that’s only used for gluten-free food.

Crumbs in a toaster can cross-contaminate gluten-free food, so it’s best not to share one. You can toast gluten-free bread, bagels and other products on a clean cookie sheet in your oven,  purchase special toaster bags that will prevent cross-contamination or have a separate toaster used only for gluten-free items.

Grand parenting is supposed to be fun. There is no reason the gluten-free diet should change that. By following these suggestions, you will understand the diet quickly, and it will be much easier to feed your gluten-free grandchild without worry. Then you will be free to enjoy your time together.

Resources

You can find a lot of information about celiac disease, gluten intolerance and the gluten-free diet online. Our website has details on the basic gluten-free diet, kids and the gluten-free diet, ingredients, recipes and more. You can also read our blog, which includes updated gluten-free news and other observations of the gluten-free world by our staff.
You can also go to the websites of support groups and celiac research centers like these:

• Celiac Disease Foundation celiac.org
• Gluten Intolerance Group gluten.net
• National Foundation for Celiac Awareness celiaccentral.org
• Celiac Center at Beth Israel Deaconess Medical Center celiacnow.org
• Celiac Disease Center at Columbia University celiacdiseasecenter.org
• Center for Celiac Research at Mass General celiaccenter.org
• University of Chicago Celiac Research Center cureceliacdisease.org

These are trusted sources of accurate information about the gluten-free diet. Be cautious of things you might read from less-reliable sources. There are also a number of books on celiac disease and the gluten-free diet or cookbooks with gluten-free recipes available at amazon.com and in bookstores.

Amy Leger writes regularly about family issues for Gluten-Free Living. She lives in Minnesota with her husband and two daughters. Her oldest daughter has celiac disease. Amy’s website, thesavvyceliac.com, covers news, cooking & shopping tips in the gluten-free world.

The first year away at college is usually filled with a whirl of emotions. Students are excited for this new part of their lives to begin — to get out from under their parents’ watch, take a chance, live on their own, and make the most of their own decisions.

And college is a whole new world.  The classes can be more challenging and parents aren’t there looking over a student’s shoulder. Plus there’s the excitement and worry about making new friends and fitting in, not to mention simply not getting lost on campus that first week or two.

When a student also needs a gluten-free diet, the transition presents even more challenges.

Physicians at Stanford University’s Lucile Packard Children’s Hospital have been taking note of these challenges and the way students on campus handle them. And the consensus is that first-year Stanford students don’t always stick to the gluten-free diet.

“We had some Stanford students not doing as well as they got away from the care of mom,” says K.T. Park, M.D., the hospital’s attending physician for pediatric gastroenterology. He says students become more “flexible” with their gluten-free diet than they should be.

“It is natural for them to explore … and try to have as similar an experience as possible to their dorm-mates, but they have to be gluten free,” Park says, noting that students have to realize the diet is “just as important as medication for someone with a chronic disease.”

Park and other researchers started surveying about two dozen first-year gluten-free Stanford students this past fall to find out how they adapted to school and their gluten-free lifestyle during their first semester. The students will have filled out three surveys by early 2013 regarding quality of life, availability of gluten-free food, compliance with the diet, and digestive health.

The researchers hope to use the survey results to create health policy models for students with chronic diseases.

Meanwhile, Gluten-Free Living talked to a few students to find out what the college experience is really like when you are gluten free.

Freshman year

None of the students we interviewed put gluten-free food at the top of their list in the search for a college or university. They all looked for a complete package of academic and social features, with the gluten-free diet added in.

Paul Roy, 18, a freshman at the University of Minnesota, in Minneapolis, was diagnosed with celiac disease six years ago. He says accommodating the gluten-free diet wasn’t his first priority when choosing a school, but the one he attends is accommodating his needs.

“When the chefs cook [my food] they have a designated section and tools just for gluten-free foods,” Roy says.  One concern is consistency between regular cafeteria staff and student workers. “Student workers aren’t up to par on gluten-free foods….so sometimes I am stuck with eating a hamburger with no bun and some soggy corn.”

Sam Lohse, a 20-year-old junior at Concordia College in Moorhead, Minn., has celiac disease, but gluten-free food was not a primary factor when she chose which school to attend.

When she was searching for colleges, she says she looked at the overall picture of the school instead of focusing on the gluten-free diet.  She and her parents met with the managers of the dining hallsafter she narrowed her choices to a few finalists.

Lohse says Concordia has been a good fit, meeting her educational needs while giving her several options to eat gluten free. “The first few weeks at Concordia were a little rough,” she says. “I remember not having a lot of variety.” Since then her options have been increasing.  The dining service has a gluten-free toaster, microwave and refrigerator for her gluten-free food.

Like Lohse, Andrea Wilhite, a 20-year-old junior at Mount Mercy University in Cedar Rapids, Iowa, did not give the gluten-free diet first priority in choosing a school. But she says she now wishes she had focused more on that aspect of her college life.

Wilhite was diagnosed with celiac disease and started following the gluten-free diet when she was 17, not long before she went to college. She describes her first few weeks at Mount Mercy as “very hard.”  “Transitioning into a new school and environment is hard enough, and adding a gluten-free diet on top of that can be very challenging,” Wilhite says.

She figured out which foods in the dining hall were gluten free by reading ingredient lists in a binder that detailed all the foods served. The school makes some foods gluten-free for Wilhite and recently purchased gluten-free buns and tortillas.

Her options have expanded, but perhaps not quite enough. “There are days when I know the cafeteria will hardly have any options for me, and I’d much rather just eat in my room or go out to eat and get something I know is gluten free,” she explains.

Universities making the grade

Gluten-free options have only recently been getting more priority in higher education as demand increases. The Wall Street Journal published a survey of 1,500 students done by food-service giant Aramark that showed 4 percent of students had a gluten intolerance and another 5 percent said they were gluten-free for other reasons.

Heather Stueven, residential dining supervisor at Concordia, admits choices used to be very limited.  But about two years ago she started seeing an increase in the number of students with celiac disease and in requests for gluten-free diets. As a result, she has been able to order more foods, including bread, bagels, brownies, pancakes, cereal and pasta.

Many other schools, including Pennsylvania State University, Boston University, University of Chicago, University of South Florida-Tampa, Southern Methodist University and Drexel University, have expanded gluten-free choices for students.

Maturing in the gluten-free lifestyle

Both Lohse and Wilhite have matured in their gluten-free lifestyle while in college.  Lohse has become more independent. “Before college, my mom always automatically checked everything for me, checked ahead if we were going somewhere … so becoming my own advocate was the biggest learning experience,” she says.

Wilhite says she started to recognize and deal with “emotional issues” over her difficulty eating gluten free at her school and turned to the Celiac Group of Eastern Iowa for help. “It really helps to be able to be around people who understand your frustrations and situations that you encounter when following a gluten-free diet,” Wilhite says.

Though still a freshman, Roy has been proactive about his diet right from the start of the first semester. He became a university dining adviser for a  gluten-free organization on campus and his residence hall so he can make sure cafeteria staff is educated and handles gluten-free diets correctly.

All three students recommend doing significant research before choosing your school. Wilhite suggests giving equal weight to your educational and dietary needs. And Lohse recommends being a little more flexible and not ruling out any school until you visit the dining hall and talk to the staff.

The challenges of going to college are part of growing up. But in order to meet them, students with celiac disease or gluten intolerance need to be able to follow a healthy gluten-free diet. The transition is much tougher if you don’t feel well, have enough energy or the ability to concentrate. Finding a school that works with you to meet your dietary needs will make the transition much easier.

Finding a college that’s gluten-free friendly

•  Check each school’s residential life or dining hall web page to find out how special dietary needs are handled.

•  Visit glutenfreetravelsite.com for reviews of colleges by students. The site also includes colleges and universities that have gone through the National Foundation for Celiac Awareness GREAT Kitchens Program, which provides a course for chefs and food service managers on safe gluten-free food handling and preparation. You’ll also find links to some campus dining web pages.

•  Get in touch with the school’s nutritionist or head of dining services and ask directly about gluten-free options. You can often do this by phone or email before visiting a campus. See if you can set up a meeting when you visit.

•   Go to the dining hall when you visit a campus. You’ll be able to see how accessible and well-maintained any areas set aside for gluten-free students really are.

•  If possible, eat in the dining hall on your visit. You will get a first-hand look at what it’s like to get a gluten-free meal. If you have talked to the school nutritionist or head of dining services, you will know if there is a specific dining hall that is designated for gluten-free students.

•  See if there is a gluten-free student group on campus and get in touch with members to ask about the reality of eating gluten-free on campus.

•  Find out if you will be required to pay the full fee for on-campus dining or if there may be other options depending on how well the school can meet your needs.

What to take

Gluten-free students who have already been through the experience of going away to college and living in the dorms say it will be much easier if you have the following items:

1. A microwave and mini refrigerator

Some schools require you to rent a combined micro-fridge, so check before you purchase either of these items. Others will let you bring your own. If so, buy a refrigerator with the largest freezer compartment you can find. In some cases these appliances are not allowed in dorm rooms and you may have to use the ones in a student lounge, not an ideal arrangement. Make sure you know in advance what the rules are. Toasters and hot plates are usually not allowed in dorm rooms, but check to see if special accommodations can be made. Many gluten-free students bring a toaster, which they use discretely and safely, but it can be a violation of dorm rules.

2. Plate, bowl and utensils

Like any college student, if you are going to prepare food in your room, you will need these basics. Disposables may be a good idea if it’s difficult to clean these items, for example, if you don’t have a sink in your room.

3. Gluten-free staples

Bring non-perishable items including cereal, energy bars, crackers, peanut butter and snacks. If you have access to a microwave, bring things like gluten-free instant oatmeal, soup, popcorn and ready-to-heat entrees.

If you have refrigerator, bring frozen gluten-free bread, rolls, bagels, waffles, pizza, chicken tenders and pasta dishes like lasagna and macaroni and cheese. (Now you know why the bigger freezer is important.) Start the year with fresh fruit and vegetables like mini carrots in an amount you can eat before it spoils, then replenish from the dining hall or a local grocery.

All these will come in handy when the dining hall options are getting repetitive or you want to grab something quickly in your room.

Amy Leger is the mother of a gluten-free teenager.  She writes regularly for Gluten-Free Living about family issues. She also blogs at www.thesavvyceliac.com. Amy lives in Minnesota with her husband and two daughters.