It’s the day we all anticipate as we invite friends and family, set the table and plan a menu of favorite foods. But for my patients with celiac disease and their parents, the Thanksgiving table presents a dilemma — which Thanksgiving foods are safe? The answers may not be obvious, as gluten, found in wheat, barley or rye, is a hidden ingredient in some Thanksgiving standbys: soy sauce and cream of mushroom soup in the traditional green bean casserole both contain wheat, as can the seasoning packet that comes with a turkey.
Gluten-free diets and menu items are commonplace these days and are often part of trendy diets, but celiac disease, a permanent condition in which the immune system reacts to gluten, is no fad. Up to one percent of the population may have celiac disease, an immune reaction that, if left undiagnosed and untreated, causes damaging inflammation to the small intestine and interferes with the body’s ability to digest and absorb nutrients.
The good news is, the symptoms caused by celiac disease — including gastrointestinal upset, constipation, diarrhea and abdominal pain — will be resolved in patients who adopt a strict gluten-free diet. However, many kids with celiac disease will not have symptoms immediately after eating gluten, but are still at risk of long-term side effects if they don’t follow their diet or if they have accidental contaminations. Awareness and advance planning will help kids with celiac disease enjoy Thanksgiving as it should be — surrounded by loved ones and enjoying a great meal.
Tips to help kids with celiac disease enjoy Thanksgiving
Here are a few tips to help families of those with celiac disease enjoy Thanksgiving safely and deliciously:
- Do it yourself. Hosting Thanksgiving means you’ll have control and oversight of everything you prepare. If guests want to contribute, ask them to bring non-food items such as a beverages, flowers or ice.
- Oven safety. Prepare gluten-free foods in a separate, pre-cleaned area and in fresh dishes. If you’re keeping dishes warm in the oven or reheating foods, be sure to cover them with aluminum foil or lids to avoid cross contamination.
- On the road. If you’re visiting family for Thanksgiving, offer to help cook the meal when you arrive to be sure plenty of gluten-free dishes are available. Ask your host in advance to help you identify a grocery store that offers gluten-free products. You can also bring prepared dishes so you know there will be a few safe foods.
- Buffet know-how. When serving buffet style, place gluten-free dishes in a separate area and have one serving spoon for each dish to avoid cross-contamination. If you are on a gluten-free diet, it’s also a good idea to serve yourself first.
- Dining out. Find a restaurant that accommodates gluten-free diners. Call ahead and speak with the chef, and explain your situation to your server when you arrive. It may be helpful to explain it as an allergy to wheat, rye, and barley so that they understand the importance of preparing the food properly. If the meal is buffet style, ask that your plate be served directly from the kitchen to avoid cross-contamination.
- Awareness. Your child may be tempted by all the delicious foods or offered tastes by another adult. Make sure that your child and other adults are aware that even one bite of the wrong food is bad for their disease.
- Be prepared. You must be prepared for the accidental contamination of food when the gravy packet explodes on your gluten-free food or when the spoon from the stuffing is placed in the potatoes. You should always have a plan B.
Gathering around the Thanksgiving table can also provide a great opportunity to talk with family members about what living gluten-free means, especially if your child is newly diagnosed. Take the time to share your experience with loved ones in a positive way.
Specialists within the Gastroenterology, Liver and Nutrition Program at Children’s Hospital of Wisconsin have expertise in managing diverse GI issues found in infants, adolescents and teenagers. Our specialists take a holistic approach and always consider growth, physical and emotional development, and age-related social issues when developing treatment plans with families.
Learn more about Douglas Zabrowski, MD.