Travelling Overseas with Coeliac Disease
Travelling should be fun. For most people it’s relaxing, but this isn’t true for everyone. Eating with coeliac disease requires a vigilance that many people won’t understand, but with a bit of research and flexibility, you can reduce your risks and have amazing adventures. So here’s our guide to travelling, in four easy stages.
- Pre-trip planning
If you get this right then everything else should be easier. Choose your trip and accommodation based on how comfortable you are with travelling and finding appropriate food. Many coeliacs travel extensively and thrive; others may need to start in easier countries or with a specialist gluten free tour. Do your research and find the right travel plans for you.
When booking travel, order your meals. Notify the airline, cruise line, bus, train or tour company. Ask for coeliac meals, but understand that they are not always available. If flying, remember to check directly with the airline at least 48 hours before your flight and when reconfirming return flights. You may wish to ask for extra baggage allowance. Some airlines will allow it for medically required food.
Organise a letter from your doctor stating any medication being taken, as well as advising of your medical condition and requirements for a special diet.
Shop around for insurance. Some companies charge extra for clients with coeliac disease, but most don’t. Check yours before committing.
Make communication easier. Download apps to translate information, but also print off translation cards. There are many websites offering coeliac information in a myriad of languages. Phone apps are easy, but cards can be passed on to people in the kitchen and can be used without Wi-Fi. Make a few copies of the cards and have 1 with you at all times. They can be given to airline staff, tour directors and restaurant staff.
If you belong to Coeliac Australia, they have excellent travel fact sheets for over 100 countries. You can also contact the local coeliac or celiac association of your destination. Research traditional foods and learn the names of foods and ingredients which are not gluten free.
- Packing
As well as your normal travel requirements and translation cards, there are a few extra things to think about carrying:
Snap lock bags and an air tight container for leftovers and to keep opened food fresh.
Small cutting knife and vegetable peeler (not in hand luggage when flying), unbreakable picnic sets and napkins.
Reusable toastie bags to avoid cross contamination in hotel toasters.
Enough medication (in original packaging) to get you through the trip. Finding a gluten knowledgeable pharmacist may not be easy, and a gluten free equivalent of your medication may not be available.
Ginger to help reduce travel sickness symptoms, or travel sickness wrist bands.
Vitamins and supplements to help if you do get glutened or run down.
Hand luggage snacks might include; fresh fruit and vegetable sticks, cheese sticks, popcorn, chocolate for cool countries; non-melting snacks for warm countries; fava beans, pretzels, biscuits, chips and crackers, snack bars, dried fruits and nuts, fruit strips, lollies, grab n go wafers or snaps.
Add extra snacks in your luggage, as well as foods for more substantial meals. Take pimp my salad sachets to add to the most boring salad, crostini or crisp breads, breakfast biscuits, protein shakes, vegetable stock cubes and vegetable soup mixes. You may even like to take a box of cereal or bread for the first morning in a new place, salt and pepper sachets, rice cakes and perhaps soy sauce if you are going to Asia.
- Travelling between countries.
Always carry your contingency snacks in your hand luggage. Ordered meals may not eventuate; delays can be lengthy and shops may be closed when you arrive. Emergency food will help you stay focused and patient. No one likes to be hungry!
When flying, check your liquid allowance. Usually it’s only 100ml per container in a separate clear bag but it does vary. On board, make yourself known to staff to improve your chances of being served the correct meal. If it does not turn up, explain your situation using your translation cards or medical letter. Staff may be able to provide fresh fruit platters, extra drinks, nuts or other snacks.
Many overnight trains will have a food car. Once again, make yourself known to staff. On shorter journeys, don’t expect gluten free snacks to always be available. For coaches and tours reconfirm your requirements close to the departure date and then with staff on boarding. When you can’t book special meals, eat before boarding.
Cruise companies may require special meals be requested 45 to 90 days pre sailing, due to the way they purchase their dry stores. If you ordered when booking, you may still like to reconfirm.
To avoid any troubles, always make sure you declare food at customs. Some countries will ask you to throw out fresh food and foods containing meat or seafood (fresh or processed). Most will not have a problem with dry foods in sealed original packaging.
- The destination
Once at your destination, keep researching, stay vigilante and enjoy yourself!
For self-catering, there are often fruit and vegetable markets around the corner; you just need to find them. Stock up on gluten free breads when you see them and buy fruit, tomatoes, cheeses, local dips or delicacies as you go. Picnicking in the park is easy and something both tourists and locals do.
Be aware that labelling laws differ. In Australia a product must have no detectable gluten to be considered gluten free. In most other countries products labelled as gluten free may contain oats or small levels of gluten below 20ppm. Global food brands can have different ingredients in different countries. If you read labels and prepare meals with as few ingredients as possible, self catering will be easier.
When eating out, normal eating and travel precautions must be taken. You may end up eating salads, but be cautious if the vegetables aren’t washed in clean water, and wash your own fruit.
Often local foods are naturally gluten free, and eating fresh, rather than processed foods, may help you avoid gluten. Vietnamese, Thai and Indian cuisines are usually good, as well as sticking to simple foods. Again, the fewer ingredients, the better. Order boiled eggs with grilled tomatoes and a juice for breakfast; and grilled meats with rice and vegetables, but not exotic sauces, for dinner.
Speak to chefs and restaurant managers; then follow your instincts. Use your translation cards and apps and only order if you feel understood. Don’t assume that items on the menu are prepared in the same way as those at home. Check cooking methods and ingredients each time. Buffets are not always safe, so ask the chefs if they can cook your food separately.
Street stalls are good. You can see what goes into meals, there are fewer ingredients and you can ask for things not to be included. Just remember to check for general hygiene, refrigeration and clean water.
In non-Western countries, gluten free products might be found in expat supermarkets, and often western restaurants will be able to accommodate basic requirements.
European cuisines can be challenging, but many Europeans understand coeliac disease. In some countries it’s quite common to offer gluten free alternatives; even the land of pizza and pasta is great. Italy has a large proportion of coeliacs so education on dietary requirements has been extensive and alternatives can be plentiful. In Europe, always double check condiments.
In Asia, coeliac disease is relatively uncommon and many countries don’t have a coeliac association. Be careful of sauces such as soy, hoisin and oyster. Ask for stir fries without sauce and add your own soy from home. Rice, chickpeas, curries, fish sauce, and coconut-based foods are normally gluten free. Rice porridge is available all over Asia and is often eaten for breakfast. Ask for no toppings. Rice noodles are naturally gluten free but avoid wheat based udon or ramen.
In Africa, gluten free staples include corn, teff, rice, sorghum, and cassava (tapioca) but it may be a good idea to take your own supply of cereals, breads and rice cakes if you can.
In South America, rice, beans, corn, and tapioca products are the norm. You might also enjoy salty popcorn, peanuts and cooked maize.
In the Middle East, wheat is used in breads, couscous and tabouleh. Meat dishes may be prepared with burghul (cracked wheat) but falafels and dolmades are usually safe.
On many Pacific islands, processed gluten free products probably won’t be available, but there should be plenty of fresh foods.
In North America you will need to read labels carefully. In Canada, wheat, rye, barley, oats or anything derived from these grains must be declared on labels, however the USA only requires wheat to be declared as an allergen. Other gluten containing grains do not need to be singled out. You still need to look for rye, oats and barley as ingredients but they won’t be highlighted or may be under a different name. Some less obvious but common gluten containing ingredients to avoid are emulsifiers, stabilisers, cereal additives, vegetable gums, brown rice syrup, modified food starch, hydrolysed or textured vegetable proteins, textured plant protein, vinegar and malt. If the label says ‘starch’ by itself, then it is corn starch and OK. Starch from other sources will have the source next to it.
When ordering, know that foods can be cooked differently. Ask that your grilled fish not be covered in batter and your salads to come without croutons or dressings. A simple vinegar and oil on the side is more reliable. Soups are often thickened with flour, and fries can be dusted with it.
If you are off to a theme park, request a list of special dietary foods in advance. Carry your doctor’s letter and snacks just in case, but rules differ so check before going.
With all this in mind, use your best judgement, keep emergency snacks and if in doubt, leave it out. Remember that no matter how hard you try, some people will not understand your requests. If you are still polite and understanding, the next coeliac to visit may have a better experience and options will continue to improve as education does.
Good luck and enjoy the sights, the sounds, the people and the entertainment. There are so many ways to experience the world, food is just one of them so enjoy all the other things around you.