Wellness

In this article:

• Know where gluten hides. Learn which traditional Thanksgiving dishes and unexpected ingredients may contain gluten.

• Prevent cross-contamination. Get practical tips for preparing, cooking and serving gluten-free foods safely.

• Enjoy holiday favorites. Explore gluten-free Thanksgiving recipes and simple ways to adapt classic dishes for people with celiac disease.

   

Making room for gluten-free traditions

Thanksgiving is a time to gather around the table, share favorite recipes and enjoy a meal with family and friends. But for people with celiac disease, the holiday can also bring questions about what's safe to eat.

From traditional stuffing and gravy to unexpected sources of gluten in family recipes, navigating a holiday meal takes more than skipping the dinner rolls.

November is gluten-free diet awareness month, making it a good time to learn how to prepare a Thanksgiving meal that everyone can enjoy. Amanda Cartee, MD, director of the newly launched UC Health Celiac Disease Center, and Jessica Kuiper, nutritionist, share tips on identifying hidden gluten, preventing cross-contamination and preparing gluten-free versions of favorite holiday dishes.

What is celiac disease?

Celiac disease is a chronic condition in which the body cannot tolerate gluten which can lead to other serious long-term health issues.

"Celiac disease is something that impacts people for the rest of their lives after diagnosis. Their symptoms can change, or they can develop health issues later in life," said Dr. Cartee.

For people with celiac disease, following a strict gluten-free diet is essential to managing the condition and preventing intestinal damage. Even small amounts of gluten can cause harm, including when gluten-free foods come into contact with foods or surfaces that contain gluten.

Unlike a food preference or sensitivity, celiac disease requires careful attention to ingredients, food preparation and cross contamination.

Common Thanksgiving foods that may contain gluten

Some holiday dishes are obvious sources of gluten, while others may contain ingredients people don't expect.

Traditional stuffing, dinner rolls, pie crusts and flour-thickened gravy often contain wheat. But gluten can also show up in less obvious places, including

• Gravy and sauces—Wheat flour is commonly used as a thickener
• Stuffing and casseroles—Bread, seasoned breadcrumbs and some packaged ingredients may contain gluten
• Marinades and seasoning blends—Some products contain wheat-based ingredients or additives that require a closer look at the label
• Processed meats—Certain prepared or seasoned turkey products may contain gluten
• Desserts—Pie crusts, cakes and cookies traditionally rely on wheat flour
• Shared serving utensils—A serving spoon used in traditional stuffing or gravy can transfer gluten to an otherwise gluten-free dish

Reading ingredient labels and checking product packaging each time you shop can help identify potential sources of gluten. When in doubt, check with the manufacturer or choose a product clearly labeled gluten free.

How to make Thanksgiving gluten-free

A gluten-free holiday meal doesn't have to mean giving up the dishes that make Thanksgiving special. With a few ingredient swaps and some planning, many traditional favorites can be adapted.

Consider these alternatives

• Stuffing—Use gluten-free bread or a rice-based recipe. Several boxed gluten-free stuffing options are available, including products from Mom's Place and Aleia's
• Gravy—Thicken gravy with cornstarch or a gluten-free flour blend, making sure the other ingredients are also gluten-free. Gluten-free gravy mixes, including options from Pioneer and McCormick, may also be available
• Bread—Look for certified or clearly labeled gluten-free options. Red Lobster-style cheddar biscuits also have gluten-free alternatives available. Check specialty grocery stores and local markets for additional options
• Casseroles—Substitute gluten-free flour, breadcrumbs or other appropriate ingredients in recipes that call for wheat. Pay special attention to condensed soups, which are often used in casseroles. Check labels for gluten-free cream of mushroom soup and other canned ingredients
• Turkey: If you're preparing turkey in an oven bag, check the flour or seasoning ingredients. Use a gluten-free flour blend or a combination of gluten-free flour and cornstarch when needed. Options include products from Pillsbury, King Arthur Baking, Bob's Red Mill and Cup4Cup
• Desserts—Try a gluten-free pie crust or a naturally gluten-free dessert made with ingredients such as fruit, rice or chocolate, after checking labels
• Baking spray: Some baking sprays contain flour. Choose a product specifically labeled gluten-free, such as this Chosen Foods option, and check the ingredient list before using it

Pay attention to shared ingredients, too. Butter is an easy place for cross-contamination to happen when someone spreads butter onto regular bread and returns the knife to the container. Use a separate butter dish or individual portions for gluten-free guests.

Product ingredients and formulations can change, so always read labels each time you shop, even if you've purchased the same product before. When in doubt, contact the manufacturer to confirm that an item is safe for someone with celiac disease.

How to avoid cross-contamination

Even when a dish contains gluten-free ingredients, the way it's prepared and served can make a difference.

Cross contamination happens when gluten comes into contact with food that would otherwise be gluten free. This can occur in the kitchen, during cooking or when guests serve themselves.

To help reduce the risk

• Clean preparation surfaces—Wash countertops, cutting boards, utensils and cookware before preparing gluten-free foods
• Use separate utensils—Keep separate serving spoons for gluten-free dishes especially when food is served buffet style
• Choose safe cookware: Avoid using wooden utensils and cutting boards, which can hold gluten residue in scratches and porous surfaces. If using cast-iron cookware, line the pan with aluminum foil to create a barrier and avoid direct contact with the surface
• Prepare gluten-free dishes first—When possible, prepare and cover gluten-free foods before handling ingredients that contain gluten
• Check shared equipment—Toasters, colanders and other kitchen tools can be difficult to clean thoroughly and may retain gluten-containing food particles
• Use fresh frying oil: Do not reuse oil that has been used to fry foods containing gluten. Use a separate fryer or fresh oil for gluten-free foods
• Keep foods separate—Place gluten-free dishes away from bread, stuffing and other foods that contain gluten
• Communicate with your host—If you're attending someone else's Thanksgiving dinner, discuss ingredients and preparation ahead of time

When hosting, consider setting aside a separate area for gluten-free foods and clearly labeling dishes so guests know which options are safe for them.

For buffet-style meals, place gluten-free dishes at the beginning of the serving line and foods containing gluten at the end. This allows guests who need to avoid gluten to serve themselves first, before serving utensils or food are more likely to come into contact with gluten. Provide separate serving utensils for each dish.

Gluten-Free green bean casserole

Looking for gluten-free Thanksgiving inspiration? UC Health nutritionist Jessica Kuiper shares a recipe to help you create a delicious holiday meal that people with celiac disease can enjoy.

A Thanksgiving classic gets a gluten-free update with green beans, creamy mushroom soup and crispy onions.

Ingredients

• 6-ounce container gluten-free French-fried onions or crispy onions, divided

• 24 ounces frozen cut green beans, thawed

• 10.5-ounce can gluten-free condensed cream of mushroom soup

• ¾ cup whole milk

• ¼ teaspoon ground black pepper

Instructions

1. Preheat the oven to 350°F.

2. In a large bowl, mix the condensed cream of mushroom soup, milk and black pepper until combined.

3. Fold in the green beans and 1 cup of French-fried onions.

4. Pour the mixture into a 1½-quart baking dish.

5. Bake for 35 minutes or until hot. During the last 5 minutes of baking, sprinkle the remaining French-fried onions over the top. Bake until the onions are golden brown.

6. Serve immediately and enjoy!

Celiac disease food safety note: Check ingredient labels to confirm that the condensed soup and crispy onions are gluten-free. Prepare the casserole with clean cookware and utensils, and avoid cross-contact with foods containing gluten.

Specialized care for celiac disease

The UC Health Celiac Disease Center provides specialized care, helping you understand celiac disease and manage the dietary changes that come with it. Working with our knowledgeable clinicians and nutrition professionals, you can make informed food choices and maintain a balanced diet while avoiding gluten.

We provide specialized care for adults, including

• Diagnostic evaluation
• Nutrition support
• Ongoing monitoring to help you protect your long-term health

Learn more about the UC Health Celiac Disease Center.