Great Gluten-Free Eats in St. Pete

While you might think only think of Orlando or Miami as a Florida destination, the St. Petersburg/Clearwater region offers fun and sun—and delicious gluten-free food!—for everyone.

clearwater beachSports fans flock to the area for the Outback Bowl and the spring training homes of the Toronto Blue Jays, New York Yankees and Philadelphia Phillies. Those who visit between April and September can watch regular-season Tampa Bay Rays games at Tropicana Field, which features a live stingray tank. The Firestone Grand Prix, an exciting Indy car street race through the streets of St. Petersburg’s downtown, draws crowds from around the world. Tampa Bay’s professional soccer team, the Rowdies, also play here. And if you’d rather exert a little energy of your own, hit the links at one of several award-winning golf courses.

Little-known gem

St. Pete is rich in cultural diversity and a delight for art lovers. From museums like the Salvador Dali Museum and the Museum of Fine Arts to the Chihuly glass exhibit and powerful Florida Holocaust Museum, visitors can cool off indoors while they immerse themselves in art and history. Nearby Lowry Park Zoo, Great Explorations Children’s Museum, and Busch Gardens and Adventure Island offer more active destinations for families with children to entertain. If you visit between late June and early August, be sure to take advantage of Summer Nights at Busch Gardens, which features extended hours and special live entertainment.

The seasonal home to dolphin tours, fishing excursions, pirate festivals, chalk art festivals and lovely, meandering farmers markets, St. Petersburg features miles of award-winning beaches. It is also a treasure trove of vintage and handmade furniture, crafts, clothing and art.

Gluten-free fun

But what you really want to know about is the food in St. Petersburg/Clearwater. The seafood is, of course, outstanding. But there is an eclectic range of choices here that can match that of just about any big city while satisfying any preference, sensitivity or allergy.

When you arrive in this quaint small-town/big-city hybrid, you’ll have plenty to keep you going from morning till night. The moment you wake up, head straight to Craft Kafé, a dreamy little hot spot specializing in “gluten-free artisan fare.” You’ll have trouble believing that every flaky, warm, gooey or savory baked good is free of gluten and made with in-house stone-milled flours. Order a muffin, a cupcake, a fluffy slice of quiche or a savory flatbread. Try a latte with house-made almond milk or a locally grown salad, grilled cheese sandwich, hazelnut cake or plate of pancakes. Or let loose and order one of each. New York native and owner Teddy Skiadiotis dreamed of opening a gluten-free restaurant for years, and his baked goods have been such a hit with locals that he is planning a relocation/expansion in 2017.

When you want something different, head to Alesia Restaurant, a delightful rustic-modern spot serving French-Vietnamese fusion. While the designated gluten-free menu is limited (be sure to tell your server about food allergies), all you really need to order is a hearty bowl of pho, the traditional rice noodle soup. If you like, ask to replace the noodles with bok choy. I truly have never found a pho to match the one at Alesia. Now, just thinking about that healing and heavenly dish has this Florida native, since transplanted to the northeast, ready for a road trip! True story: I was once fighting a killer cold with a looming wedding to photograph. I called Alesia on the way, explained my plight and flat-out begged for a to-go order of pho. Asked if I had a few minutes to spare, I arrived to find a corner table set for me and my business partner/husband. Within seconds, two piping-hot bowls of soup were brought out, filling our bellies and priming us for a long day of work.

Whether you soak up some sunshine, hunt for vintage treasures, history or fine art, or relax to live music while tucking into crab legs and a fruity drink at a rooftop bar, St. Petersburg/Clearwater is a culinary and cultural Florida paradise for the young, the young-at-heart and families of all ages.

-Written and Photographed by Angela Sackett

Taking gluten free on the road

 Having celiac disease and living a gluten-free lifestyle can feel overwhelming at times, even in your own home. Imagine managing the demands of eating gluten free with the logistics and complexities of traveling away from your comfort zone, whether for business or pleasure. How can you safely avoid gluten in an unfamiliar place—especially if you don’t speak the language? Some people think that traveling while gluten free is nearly impossible. Thankfully, solutions do exist that make it not only possible but enjoyable to go wherever you want without constantly worrying about cross-contamination.

Plan ahead

Planning a safely gluten-free trip goes beyond scotravelping out the best hotel and other attractions. Perform a quick internet search for supermarkets in the area you will be visiting. Even if you won’t have gluten-free eateries close by, having access to safe groceries enables you to plan your meals and snacks. When booking your hotel, choose a room with a refrigerator where you can store vegetables, fruits and other safe but perishable items. Of course, it’s always a good idea to have nonperishable foods such as granola, protein bars and crackers on hand in case you get stuck somewhere on a day trip with no gluten-free options.

Snacking on the plane

If you’re taking a long flight to your destination, you’re bound to get hungry. Ask your doctor ahead of time for a doctor’s note to give to the Transportation Security Administration (TSA) at the airport. The note will allow you to pack “medical food” snacks such as soups, shakes, yogurt, hummus and peanut butter.

Before booking your flight, call the airline to ask whether they provide a gluten-free menu. Many airlines are catching on and adding safe options. If this is the case, check in with them a week or so before your flight to ensure that they will have it ready for you. If your airline does not provide gluten-free options, pack some vegetables, fruit, cheese, dry cereal or protein bars in your carry-on bag.

Driving to your destination

If traveling by car, you have the benefit of stopping to eat at restaurants along the way. Even so, it’s best to map out your route and meals ahead of time. Call ahead to any restaurants you are considering to inquire about their gluten-free menu items so that you already know the gluten-free status and don’t have to worry about it in the moment, already starving after spending hours in the car.

Eating at a restaurant

Enjoying a top-notch meal at a restaurant should be one of the treats of traveling away from home. Whether you have crossed state lines or an entire ocean, you can still enjoy this luxury. As with every other aspect of your trip, planning and calling ahead will help save time and stress. If you are lucky enough to find a dedicated gluten-free restaurant (or more!), then check out the menu and decide on the meal that you are going to sit down and take stress-free delight in, knowing it’s absolutely safe for you.

If you are not this lucky, but rather find eateries with separate gluten-free menus or specific gluten-free items, still inquire about the precautions the staff takes to keep the meal safe from kitchen to table. As you well know, but the staff may or may not, just because a dish contains all gluten-free items does not mean it is safe from possible cross-contamination. Even the smallest amount of gluten can send a person with celiac disease or gluten intolerance into a whirlwind of pain. Asking these types of questions before even setting foot into an establishment can help you determine which restaurants understand what it means to keep food safely gluten free for their patrons.

Although you are doing your homework ahead of time, you should still befriend your server and ask questions. Never feel embarrassed by asking how the food is prepared or whether the same utensils or fryers are used for both gluten-containing and gluten-free items.

Traveling with a gluten sensitivity or full-blown wheat allergy doesn’t have to make your vacation stressful. Planning ahead and knowing what to expect can allow you to enjoy your vacation to the fullest and make lasting memories.

Heather Burdo is a health content writer from New York. Visit her at heatherburdo.com.

 

Special Occasions and the Gluten-Free Diet

Amy Jones, M.S., R.D., L.D., is a dietitian and celiac disease support group leader from Bellefontaine, Ohio.

Q: My best friend is getting married this summer, and they are having a served sit-down dinner at the reception. I’m in the wedding and very excited, but the dinner has me worried. How can I get a safe meal without bothering my friend? She’s already so busy with everything else.

A: Weddings can be exciting, but they can also be stressful for guests following a gluten-free diet. Because you are in the wedding, I think it’s OK to have a conversation with the bride about your meal at the reception. You might be surprised—maybe she already thought about having a gluten-free meal available for you! If she hasn’t, you can offer to contact the caterer to ask what options might be available. Most catering companies are used to dealing with special diet requests, including gluten free. If the bride and groom have already set a menu, ask the caterer what will be served and how it might be modified to be gluten free. For example, will the entrée have a breading or sauce? If so, could a plain piece be set aside for you and cooked in a clean pan? If there is a cocktail hour before the reception, will there be veggies, shrimp or cheese available to nibble?

If the meal absolutely cannot be made gluten free, or if you don’t feel comfortable after speaking with the caterer, plan to eat a larger meal beforehand, and then bring along snacks to tide you over. If you think you’ll feel left out when it’s time for cake, also plan to bring along a sweet treat to enjoy!

Q: My daughter is going on an eighth-grade field trip for three days to Washington, D.C., this spring. It’s the longest she’s been away from me since her celiac disease diagnosis five years ago. She’s very comfortable with the gluten-free diet and will speak up for herself, but I’m still a little worried. Are there any steps I can take to help make sure she has a fun, safe experience?

A: School field trips, especially ones that involve overnights and meals away from home, can be worrisome for any parent. If a tour company is managing the trip, give them a call to see which restaurants the students will visit on the trip, as well as which hotel they are staying in. If the restaurants have gluten-free options, ask if students will be allowed to order from the menu. If there will be opportunities to eat in local restaurants, consider contacting the local celiac support groups for recommendations.

Ask whether your daughter can bring an extra carry-on bag with snacks and shelf-stable meals; these present a good option when a gluten-free menu isn’t available. Gluten-free pretzels, energy bars, popcorn, fruit cups, tuna packets and peanut butter are all easy and portable. If she has access to a microwave in the hotel, little cups of gluten-free macaroni and cheese will also work. Don’t forget to send plastic spoons and napkins, too!

If breakfast will be eaten at the hotel, there may be gluten-free bread or bagels available, but she still should bring toaster bags because the toaster in the breakfast area will likely be shared with regular bread and bagels. Yogurt, fruit, boiled eggs, cheese and gluten-free cereal with milk are a great way to start a day of sightseeing. Also consider sending packets of instant gluten-free oatmeal or grits that can be mixed with hot water.

Q: My new co-workers invited me to a cookout. I would love to go, but this is my first summer on the gluten-free diet, and I’m a little bit nervous. What kind of things should I watch out for?

A: A summer cookout can be a lot of fun, and you can eat safely with a little planning. If you choose to disclose that you are on the gluten-free diet before the cookout, it may help open a dialogue with your hosts about basic cross-contamination prevention. For example, you can ask about squeeze bottles of condiments or making sure there are enough serving utensils, so they don’t get moved around from dish to dish.

Be sure to bring a gluten-free dish to enjoy; salad, chips and salsa, or even a dessert are all good choices. That way, if you are uncertain about other foods, you will have something to eat. If at all possible, stick to meat that is plain. Chicken, beef and many (but not all) hot dogs are gluten free. If you don’t know what ingredients the marinade contains, it’s best to steer clear as some contain soy sauce or beer. Some seasoning blends also contain wheat, so try to get a piece of meat that has not been preseasoned.

Take foil with you and ask the host to wrap your meat or veggies before cooking on a shared grill so you’ll enjoy all that grilled flavor without the risk of cross-contamination. Bring a gluten-free bun or tortilla, or wrap your sandwich in lettuce. Be cautious with side dishes like baked beans or salads that may contain hidden croutons. Avoid veggie burgers as many contain wheat. Ketchup, mustard and mayonnaise in squeeze bottles are safe choices. If adult beverages are being served, bring along a safe choice like gluten-free beer or hard cider. 

-By Amy Jones 

Share Your Gluten-Free Horror Story

Do you have a gluten-free horror story? Let’s face it—from ignorance to misinformation to cross-contamination, people who have to avoid gluten also face daily obstacles to stay healthy and eat safely. But you are NOT alone! In fact, for every nightmarish experience you’ve had to endure, there is another person out there who’s gone through something similar. And we want to hear from all of you! Below, read a horror story from Kaitlin Kiely, Brand and Communications Marketing Associate for Bakery On Main, who took every step to ensure a safe meal out for her husband’s birthday, only to be unapologetically glutened and—even worse—humiliated and disrespected.

If you have your own horror story to share for possible inclusion in a future Gluten-Free Living article, email it to [email protected]—be sure to include your first name and state.

Kaitlin’s story

My husband and I had traveled to a local casino for a weekend to celebrate his birthday. Saturday morning we were doing research (as we always do when eating away from home) on where we could go for lunch that had safe gluten-free options to avoid my being contaminated and getting sick. We found a restaurant that seemed to have an esteemed gluten-free menu from all of the reviews we saw online. We went to the restaurant for lunch that day and I realized quickly that the menu was fairly vague. I felt so terrible having to send the waitress back to the kitchen with questions about five or so times but after all the answers that I received, I felt comfortable placing my order. Lunch arrived and as we were eating, my husband and I both noticed that something didn’t seem right with the rice included as a side with my meal (and that was on the menu as a side for most of the gluten-free dishes). It looked like it had various grains besides just rice. With a quick Google image search, we learned that it was a wild barley rice, which was not disclosed on the menu or in any of the numerous conversations I had with the waitress.

I became instantly upset and called the waitress over and asked her to go to the kitchen to double check the rice. When she returned from the kitchen, she did confirm that it was, in fact, a barley rice that had been served with my “gluten-free” meal. She left the table and out came her manager. This is where things took a very ugly turn. I had started to cry because I knew what I was about to deal with, despite trying to be so careful—the sickness, the incredible pain, the brain fog, the exhaustion…the ruined birthday weekend for my husband. Upon seeing how upset I was, the manager made no effort to be apologetic or comforting but instead laughed directly at me and then nonchalantly said she had called an ambulance. An AMBULANCE!!

I immediately told her that my reaction did not call for an ambulance and since it was not necessary, to not bring in the paramedics. I also let her know that after already feeling embarrassed enough at being a spectacle in front of everyone in the restaurant because I was upset and crying, and now having management lurking over our table, the last thing I needed was a table-side visit from paramedics on top of everything else. She walked away for a few minutes and the next thing I see is her allowing the paramedics to walk right into the dining room, directly toward our table with a wheelchair. Infuriated and mortified, I told her to get them out and reminded her how I had, just moments earlier, told her that they were not needed. She could have intercepted them but she made the choice to go against what I had requested and caused a scene, making me even more of a spectacle to an entire restaurant.

She then made no effort to have any other contact with me. Her manager simply approached my husband and I as we were walking toward the exit to offer us a lackluster apology and tell us that our meal was free—as if that was what we cared about in that situation.

It was the worst feeling I have ever been made to feel, being so disrespected and mocked due to a condition I have no control over. This story is a shining example of not only the lack of knowledge about gluten and how it affects certain people but also how this ignorance can lead people to be incredibly insensitive, causing the pain already felt in this type of situation to go far beyond just the physical.

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Staples of the Community

These companies have been around for decades, but they don’t rest on their laurels, as they continue to develop fun, new and delicious gluten-free products.

marketThe gluten-free marketplace is constantly changing. Each trip to the grocery store offers an opportunity to discover new gluten-free brands and products. However, for those newly diagnosed with celiac disease or gluten sensitivity and just starting out on the gluten-free diet, every gluten-free item on shelves—whether new to the market or celebrating two decades on it—is new for them.

A number of companies have a long history of serving the gluten-free community, many of which were founded in the 1980s and 1990s, when gluten-free consumers had far fewer options available to them. At that time, they filled a very important void, which they continue to do in 2017.

One of those early companies, Pamela’s Products, was founded in 1988 after Pamela, who does not have gluten intolerance but had experience with the gluten-free diet through her family’s natural food bakery, saw a need for gluten-free products and focused on providing them. Almost 30 years later, the company now offers a wide selection of cookies, baking mixes and bars, including Figgies & Jammies for those craving a fig cookie. Three of Pamela’s Products—the Baking & Pancake Mix, Ginger Cookies with Sliced Almonds and the Peanut Butter Cookies—have been on the market since the very beginning.

Like Pamela’s, the brand Glutino has been around for decades. Founded in 1983, the company has been providing a range of products to the gluten-free community for more than 30 years and today offers everything from toaster pastries and pretzels to crackers, pizzas and cookies. One of its product lines, Glutino Gluten Free Pantry Baking Mixes, has deep roots of its own. Beth Hillson founded Gluten-Free Pantry in 1993 and joined Glutino in 2005. The mixes cover the gluten-free gamut, starting with an all-purpose flour mix and a favorite sandwich bread mix as well as a double chocolate brownie mix.

Foods by George products have been made with love since 1991. The company was founded by a husband and wife, George and Ceil Chookazian, after Ceil was diagnosed with celiac disease. The Chookazians were the first to offer gluten-free ravioli and manicotti on the market, then branched out into new products that they are still well-known for today, including their Plain English muffins, which are so versatile you can have one for breakfast or use it as a burger bun, brownies, and cinnamon and currant English muffins. Foods by George also offers a pecan tart, crumb cake, pound cake and cheese pizza.

Kinnikinnick Foods Inc. recently celebrated its 25th anniversary. The company has come a long way since its small beginnings, when one of the founders realized the difficulty of finding gluten-free products. From that encounter, Kinnikinnick was born, beginning with two types of bread and English muffins. Since 2000, the company has been making donuts, a harder-to-find gluten-free treat, in such mouthwatering flavors as cinnamon sugar, chocolate, vanilla, maple and pumpkin spice. Kinnikinnick also started producing new Soft Donuts with Vanilla Icing.

Tinkyada brought lots of gluten-free pasta to the late 1990s. The company that introduced brown rice pasta in 1997 today offers 18 pasta products in either brown rice or organic brown. The pastas are available in a variety of shapes and sizes, including spaghetti, penne, spirals, shells, fusilli and elbows. Two of their products, Vegetable Brown Rice Spirals and Spinach Brown Rice Spaghetti, incorporate the vegetables and colors that make a bowl of pasta exciting, fun and full of possibilities.

The dawn of the millennium brought with it Enjoy Life Foods. Since 2001, the company has filled a crucial need in the gluten-free marketplace. Not only are the company’s products gluten free, they are also free of dairy, peanuts, tree nuts, eggs, soy, fish and shellfish. Given the number of individuals on the gluten-free diet who have additional allergies and sensitives, this company’s entrance to the marketplace affected the lives and taste buds of thousands. While Enjoy Life no longer offers its original products, its cookies, bars and baking mixes reflect the benefits of the knowledge base built up over 15 years of providing gluten-free and allergen-free products.

While not a completely gluten-free company, Nature’s Path has a longstanding commitment to the gluten-free community. The company was founded in the mid-1980s and is known for its organic cereals and snacks. A number of the company’s cereals, including Mesa Sunrise Flakes, Whole O’s, Crispy Rice and Honey’d Corn Flakes, were formulated to be gluten free from the start. Nature’s Path also produces an extensive line of kids’ cereals called EnviroKidz. With a nod to the environment and taking care of the planet, these cereals capture flavors that kids crave, such as Lightly Frosted Amazon Flakes, Chocolate Koala Crisp and Peanut Butter Panda Puffs.

With so many of these staple companies continuing to grow and expand—not to mention countless more developing quality gluten-free food—this is an exciting time to be gluten free. GF

Susan Cohen is a New York freelance writer. She contributes regularly to Gluten-Free Living.

Gluten-free labels and disclaimers

Jones2013-166

Amy Jones, M.S., R.D., L.D., is a dietitian and
celiac disease support group leader from
Bellefontaine, Ohio.

 I’m confused about statements like “made on shared equipment” or “made in a shared facility.” Does this mean that the product is contaminated with gluten? Are the food companies just trying to cover themselves in case I get sick? How can they label such products gluten free?

Allergen advisory statements like these certainly can be confusing. However, products with such a statement on their packaging do not necessarily contain gluten. Remember that food manufacturers are not required to put allergen advisory statements on packaging. Some manufacturers may choose to, but others may not. This differs from food allergy labeling (i.e., contains eggs or peanuts), which is required.

The FDA’s gluten-free labeling rule states that as long as the final product contains
less than 20 parts per million of gluten, the product may be labeled gluten free.
The FDA also states that allergen advisory statements are not meant to take the place of cleaning equipment or other cross-contamination prevention. In short, a company can’t be lax in its procedures and just put an allergen advisory statement on the label to protect itself.

I read online that sourdough bread might be safe for those with celiac disease. Is this true?  

Unfortunately, this is not true.  Sourdough bread (or any other bread made from fermented wheat flour) is not safe for those with celiac disease or non-celiac gluten sensitivity. You might have come across information about a 2011 study involving two people who ate sourdough bread. While they didn’t experience digestive symptoms after eating the bread, it is important to note that they still suffered intestinal damage.

The fermentation process used to make sourdough may reduce gluten content, but not to a safe level. In fact, testing shows that some of these breads contain extremely high levels of gluten. Those with celiac disease or non-celiac gluten sensitivity should avoid sourdough products.

I bought a box of a new brand of gluten-free granola bars yesterday, but when I got it home I noticed that the ingredients list includes “barley malt extract.” I thought barley wasn’t allowed on the gluten-free diet.  

First of all, great job double checking the ingredients list even though the product was labeled gluten free. It’s always a good idea to look at the ingredients a product contains, especially one you’ve never purchased before. Some manufacturers believe that barley and malt are allowed in products labeled gluten free as long as final testing indicates less than 20 parts per million of gluten. However, the FDA has stated that barley and malt are not allowed in a product labeled gluten free. Your granola bars are mislabeled and should be reported to the FDA. Go to fda.gov/safety/reportaproblem/consumercomplaintcoordinators/default.htm to find contact information for your state’s FDA consumer complaint coordinator.

Last week my sister brought over a bag of buckwheat flour that she found at a discount store. I know that buckwheat is a naturally gluten-free grain, but I don’t see “gluten free” anywhere on the label.
Is this safe to eat?

You are correct that buckwheat is a naturally gluten-free grain, but I would not recommend that you use this particular bag of buckwheat flour. A 2010 study showed that some naturally gluten-free grains are at risk for contamination with gluten. This may happen in fields, on trucks or in processing plants. In light of that study, experts recommend purchasing grains and flours specifically labeled gluten free. Even if it’s a naturally gluten-free flour like buckwheat, you should still look for the gluten-free label.

I went to my favorite Italian restaurant last night and was surprised to see they had a gluten-free menu! I was just about to order when I saw the disclaimer that they could not guarantee that there would be no cross-contamination with gluten in the kitchen. I was so upset. Does that mean this gluten-free menu is useless for me?

I can understand your worry, especially in an Italian restaurant where there would be a higher risk of contact with gluten. However, many restaurants have procedures in place to prevent cross-contamination. It’s a good idea to ask questions. For example, are they using separate containers of sauce and toppings for gluten-free pizza? Do they prepare the gluten-free pizza on a separate countertop or clean baking sheet? How do they separate the gluten-free pizza from other pizzas in the oven? Do they use a separate pizza cutter? Do they use a separate pot with clean water to boil gluten-free pasta? Do they drain the noodles in a separate colander? Are their cream-style sauces thickened with flour? If the restaurant offers gluten-free bread, is it heated separately from the regular bread? Is the finished pizza or pasta served on a different color plate or
in some other way to indicate that it is gluten free?

Asking questions will allow you to decide if you feel comfortable ordering from the gluten-free menu. 

Bone Symptoms of Celiac Disease

Celiac disease can manifest in many different ways. While symptoms can affect the whole body, those involving the gastrointestinal system receive greater attention. However, for some individuals, the state of their bones holds the key to diagnosis.

“Patients with celiac disease very frequently have osteoporosis and fractures,” explains endocrinologist Emily Stein, M.D., associate research scientist and associate attending physician at Hospital for Special Surgery in New York City. “These are often the first signs of celiac that bring a patient to diagnosis. Patients with celiac may not have any gastrointestinal complaints but come to seek medical attention because of a low-trauma fracture.”

bonesFor patients with undiagnosed celiac disease, fractures, osteopenia and osteoporosis develop as a result of nutrient deficiencies. “People with untreated celiac disease are pre­disposed to malabsorption of both calcium and vitamin D,” says endocrinologist Jessica R. Starr, M.D., assistant professor of medicine at Columbia University Medical Center. Calcium and vitamin D are essential for healthy bones, and when they are not absorbed, deficiencies can attack the bones.

When it comes to the skeleton, celiac bone symptoms overlap with other conditions. As a result, undiagnosed celiac may not be considered, because in some instances “people are presumed to have osteopenia due to vitamin D deficiency or osteoporosis due to aging/menopause, but celiac disease should definitely be considered as well, especially if the
patient has anemia or any relatives with autoimmune disease,” notes Starr.

The structure of the medical field itself plays a part in compounding the celiac bone story. “In our super-specialized world of medicine, people with bone pain or fractures may be seen by orthopedists or pain management doctors. They may follow with rheumatology or even endocrinology,” explains Starr. “A lot of specialists are good at managing their area of expertise but are not necessarily trained to think ‘outside the box’ and think of other possible pathology that may be causing the bone issues [that the patient is experiencing].”

Physicians should consider testing for celiac disease based on factors such as age, family history or the inability to
explain deteriorating bone health. Stein points out that “it is important to think about celiac in patients with unexplained osteoporosis and fractures, especially younger patients.” Starr says screening should also take place for “anyone with severe vitamin D deficiency or unexplained anemia and osteoporosis.”

Following a diagnosis, keeping an eye on a patient’s bone health remains important. Starr recommends that “gastroenterologists seeing celiac patients send them for bone density screening at time of diagnosis and follow up the bone density testing every few years, especially if it is abnormal.”

Even though bone health is impacted prior to a celiac diagnosis, Stein says the damage  actually can get better once on a gluten-free diet. “Interestingly, the bone disease in patients with celiac disease improves dramatically in just one year of following a gluten-free diet.”

— Susan Cohen

Gluten in Supplements, Probiotics and Medications

Plogsted HiRes[1]Steve Plogsted, a pharmacist at Columbus Children’s Hospital, is an expert on gluten in medications. His website, glutenfreedrugs.com, is widely recognized as the most reliable source of information on prescription and over-the-counter drugs. Have a question about gluten and medications? Send it to [email protected].

Q: I was interested in a gummy vitamin supplement, and during my search I came across a product that listed wheat as one of the ingredients. I was under the impression that gummy vitamins are generally gluten free. Can you explain this issue?

A: Vitamin E is a potential source of gluten in any gummy vitamin because it can be made from wheat germ, a potential source of gluten contamination. Unfortunately, some manufacturers label their product as containing wheat because the glucose used to give the product that gummy texture could have been derived from a wheat source and because of The Food Allergen Labeling and Consumer Protection Act. Glucose produced from a wheat source is considered safe for people with celiac disease, but manufacturers are trying to protect themselves. A simple call to the manufacturer should provide you with the answer. If the manufacturer says that the wheat is derived from vitamin E, it is best to avoid that product unless they can explain to you how the vitamin E was produced.

Q: I was reading all of the controversy surrounding gluten in probiotics, and I just don’t know what to do or who to believe. Do you know of any probiotic that I can really trust?

A: I recently attended a professional meeting and had the opportunity to speak with the manufacturer of the probiotic Florajen3. The product contains rice maltodextrin and is free of all allergens and dairy. The company does extensive testing for the presence of gluten and other contaminants. I am not recommending the product but providing you a gluten-free option to consider if you choose to take a probiotic.

Q: I have been taking Cytomel for my thyroid condition. I recently called the company that manufacturers it and was told that it could contain gluten. I can’t do without this medication. Can you help me?

A: Several manufacturers make a generic substitute for Cytomel. Ask your physician if switching to one of the generics is a viable option for you. Interestingly, although the manufacturer of Cytomel is telling people that it won’t disclose the source of the starch in Cytomel, it publishes a Material Safety Data Sheet, a document mandated by the Federal Occupational Safety and Health Administration that lists the ingredients of its product. This document, last revised on May 16, 2016, includes sugar, cornstarch, calcium sulfate, stearic acid and gelatin in the list of ingredients, with no mention of wheat.

Q: Can you tell me what the ingredient sodium starch glycolate is and whether it is safe for people with celiac disease?

A: Sodium starch glycolate (SSG) helps medications dissolve upon exposure to water by swelling, which helps break the tablet or capsule apart. There are basically three types of SSG: Type A, Type B and Type C, with Type A the one most commonly used in medications. SSG Type A is primarily manufactured using potato starch, with a small percentage coming from a corn source. Theoretically SSG can be made from any starchy source, however, I have not found a manufacturer who uses a starch other than potato or corn to make SSG.  Several manufacturers produce SSG. Three of the most popular brands, Vivastar®, Explotab® and Primojel®, use potato starch. Sodium starch glycolate is considered generally safe for people with celiac disease although it may cause an issue in those who experience symptoms when exposed to corn-derived products.  Still, it is wise to call the drug manufacturer to find out what type of SSG they use.

Into West Africa

Kate McNamara had just started her dream job when she received a diagnosis of celiac disease. It would have been a challenge for anyone, but McNamara faced an additional complication. She had to figure out how to eat gluten free in West Africa.

McNamara, who lives in New York City, works for a foundation that does charitable investing around the world, and her job requires her to travel to urban and rural areas of West Africa every month or two.

Although she describes celiac disease as “overwhelming for all aspects of your life,” McNamara was determined not to let it interfere with her career.

 “[Celiac disease] isn’t a thing that is going to stop me from doing what I’ve dreamt of,” she says. When she accepted her job, she made a point to learn about the local cuisine in the areas she would visit, including whether there were any gluten-free options.

West AfricaMcNamara discovered that wheat flour is not commonly used in West African cooking, good news when you’re gluten free. But Maggi bouillon cubes, which contain wheat, are a recipe staple there, so gluten-free options can be hard to come by. McNamara realized she’d have to bring gluten-free items in her suitcase.

Now seasoned at traveling to West Africa, McNamara has a routine before and during each trip. She packs plenty of food for the 12- to 20-hour flights, which often include getting on multiple planes. Her go-to staples focus on foods high in protein and include StarKist tuna packets, Krave jerky and EPIC protein bars. Over time she has developed relationships with local restaurants and has begun dining out.

“I have restaurants that I got to know, and they will cook me plantains in new oil [that’s not cross-contaminated] and a clean pan, or grill me a piece of fish on foil,” McNamara explains. She makes sure to spell out her exact needs when eating in a restaurant.

 “I physically write out a note each time, just to make sure I am safe,” McNamara says. She has high praise for Zane “Zato” Abraw, a server at the Coconut Grove Regency Hotel in Accra, Ghana, who “goes above and beyond to make me safe meals,” she explains.

Like many who are diagnosed with celiac disease, McNamara relies on and credits her support system. “I have amazing family and a great medical team and a really supportive employer,” she says.

McNamara hopes that her story can help others who might think celiac disease limits what they can do. “I think you have to not be afraid, to be willing to hustle and fight each minute of every day to do your dream job,” she says. Then she was off to West Africa again.

—Susan Cohen 

Day in the Life: Lindsey Schnitt on Working and Eating Gluten Free During the Rio Olympics

Photo courtesy of Lindsey Schnitt
Photo courtesy of Lindsey Schnitt

Long before many of the athletes had even qualified to compete at the 2016 Olympic Games, Lindsey Schnitt knew she was Rio bound. In fact, when Schnitt interviewed to be a coordinator in the events department at NBCUniversal, she found out the position would mean a chance to be part of the Olympic experience. “When I interviewed for my job about a year and a half ago, I remember my future boss asking me, ‘Are you ready to go to Rio?’ I remember smiling and being so excited because that would be an opportunity of a lifetime in the work world,” she said.

Photo courtesy of Lindsey Schnitt
Photo courtesy of Lindsey Schnitt

Schnitt, who has celiac disease, approached traveling to Rio the way she does all her trips—by doing her due diligence. Having already studied abroad and being comfortable traveling with celiac disease, she knew what to do. After consulting with her gastroenterologist, Dr. Peter Green of the Celiac Disease Center at Columbia University, about what to look out for in Brazil, she began to prepare for the trip. She researched the gluten-free offerings in Rio, printed translation cards stating that she is gluten-free and packed plenty of gluten-free food for her month-long stay, which would begin before the games began and continue through the duration. “I couldn’t live without my chocolate chip cookie dough LÄRABAR. I brought five boxes with me,” Schnitt says. She also packed small protein balls, pretzels, popcorn, packets of Nutella and other items that she could eat on the go.

Schnitt worked on the NBCUniversal hospitality program in Rio. Her days were spent overseeing daily trips provided for clients to Rio’s famous sites—Samba City, for a behind-the-scenes look at Rio’s Samba Schools involved in the annual Carnival celebration, and Sugarloaf Mountain, where visitors can ascend a mountain peak that provides magnificent views of Rio. Schnitt worked the tours and joined clients for the lunches that followed. During her month in Rio, Schnitt worked long days between tours and meetings. But her time in Rio was not all work, as she had the opportunity to immerse herself in the Olympic culture and attend some of the events.

After returning from Rio, Schnitt shared what an average day was like during the 2016 games.

Photo courtesy of Lindsey Schnitt
Photo courtesy of Lindsey Schnitt

What time did you wake up?
I would wake up around 5:45 a.m. and just kind of spent some time in my room reading the news, and then by 6:45–7:00 a.m., I would leave for the office.

What was for breakfast?
For breakfast, if I had time, I would eat at the hotel. I would have an omelet with peppers, onions and tomatoes and then I would have delicious fruit. I never really was a mango eater and I was obsessed with mango there. I became very friendly with the woman who made the omelets—she’s a
sweet lady.

What was an average day like for you?
I was at the office by 7:30 a.m. at the latest. I was usually in before that doing some research. I would leave for my tour at 8:45 or 9:00 a.m. It could be 10 people or it could be 58 people. I would be in charge of getting them from point A to point B and telling them exactly what our meetings times were and explaining the day to them.

What was for lunch?
For lunch, because I was working the tours I would join the guests at a restaurant. We had translators with us and I would say the translators were key. I felt is that there are a ton of gluten-free options like you wouldn’t believe, but it’s the language barrier for cross-contamination that becomes the tricky part. It did take a little learning, a little help with the language, but eventually they got it and made me what I wanted. And what I also think is really cool about the Brazilian culture: Everything there is labeled ‘Não contém glúten’ if it doesn’t contain it.

I think that was my favorite part about any time I would have something that was in a bag or a can or bottle it had proper labeling. The olive oil was labeled gluten free. The balsamic vinegar. Those things that sometimes can be so tricky. You could Google it a hundred times, but the answer was just there for you.

Did you try any of the gluten-free products you found?
I tried the gluten-free cheese bread, which we had at our hotel, and I’m not really a cheese eater, but I lived on that. There’s nothing out of the ordinary that I tried that I was surprised to see.

What was for dinner?
Dinner we had at the hotel most of the time and it was a buffet. They had labels for what was gluten free and what wasn’t.

Photo courtesy of Lindsey Schnitt
Photo courtesy of Lindsey Schnitt

Did you have the chance to attend any of the sporting events?
Yes, I was fortunate enough to go to Opening Ceremony. I also went to beach volleyball two times, including the bronze match for the women, which was really something very special. I saw Michael Phelps’ swim his last race, and my favorite part about that was we were on TV during the gold medal ceremony waving the American flag. It was a very special moment in history. I also went to the men’s basketball gold medal match. It’s different because you’re still working so if anything pops up, you’re hopping out of your chair.

What was your favorite part of the day?
My favorite part was being with the clients and seeing them have a good time. At the end of the day, when everyone got off the bus with a smile on their face, I knew we’d done well that day.

What did you take away from the experience in Rio?
There’s so much that I took away from it. I took away the fact that, number one, it’s amazing, as cliché as it sounds, to see the world come together. I was on the phone with my boss the other day and I said to her, ‘I just want to let you know that I know this is work, but really as a young kid, I thought having a career like this wouldn’t be attainable, not because I’m not hardworking, but you just kind of think of the world, and these things just seem so far out of reach—even if you reach for the stars.’ It was really special. I just don’t take these opportunities for granted.

Photo courtesy of Lindsey Schnitt
Photo courtesy of Lindsey Schnitt

I like that I was also a go-to person for guests with food allergies. Since I understand the severity of allergies I was able to ensure an enjoyable dining experience.

Has this experience in Rio changed your thoughts on traveling with celiac disease?
I’ve never wanted to be held back by celiac because it’s not my choice to have it. I think that this allowed me to see once again that anything is possible anywhere. Of course, certain things are difficult and there are little bumps you have to get over, but I would say it just reminded to never say no to an opportunity based on the food. I could live out of a suitcase, honestly.

[This interview has been edited for clarity]