Guide: coeliac disease and eating out

Coeliac disease (celiachia) is a permanent inflammation of the lining of the duodenum, a part of the small intestine, caused by gluten in genetically predisposed people. Both are needed, gluten in the diet and the genetic predisposition: according to the ISS, only 3% of people who have the predisposition and eat gluten develop the disease. It is not a passing disorder: Law 123 of 2005 recognises it as a social disease (malattia sociale).

In Italy, as of 31 December 2024, there were 279,512 people diagnosed with coeliac disease, 19,123 of them in Piedmont (figures from the Italian Ministry of Health's annual report to Parliament). The only treatment available today is a strict gluten-free diet, to be followed for life. Gluten is only harmful if it is swallowed: cosmetics and detergents are not a problem.

Symptoms, in general

Coeliac disease can cause very different problems from one person to another. Among the most common signs, the Italian Ministry of Health and the ISS list chronic bowel problems (abdominal pain and bloating, diarrhoea or constipation), chronic tiredness, anaemia, mouth ulcers and hair loss. The most common form, called atypical, often appears in adulthood and especially in women; none of these signs, on its own, is enough for a diagnosis.

If you suspect you have it, the first step is to talk to your GP or paediatrician, who will decide which blood tests you need and, if necessary, refer you to a specialist centre of the Italian National Health Service (SSN). One important rule: do not cut out gluten ‘to see what happens’ before being tested, because the tests would come back negative and a diagnosis would become impossible. Always consult your doctor or a dietitian before changing what you eat.

1. Choose a well-informed place. Places in the AFC programme have taken a course on coeliac disease and the gluten-free diet, organised by AIC, by the local health authorities or by partner organisations, and they accept regular inspections, with a thorough on-site visit at least once a year. The official list is on AIC's website and app; on the Where to eat page you will find a selection of addresses in Turin. Joining is voluntary: there are also places outside the programme that offer gluten-free dishes.
2. Book in advance and say that you have coeliac disease when you phone: the kitchen will have time to get organised.
3. When you arrive, tell them you have coeliac disease before you order and ask for the gluten-free contact person (referente), the person responsible for the gluten-free service. In AFC places the kitchen follows precise rules, including:
   • dedicated shelves and fridges, surfaces used exclusively for gluten-free preparation or cleaned and used only for it, clean utensils and ovens;
   • never reusing cooking water or frying oil already used for foods containing gluten;
   • no multi-portion cooking baskets and no cooking in the oven at the same time as foods that contain gluten;
   • in pizzerias, for AFC places in Piedmont, two ovens and two sets of topping trays are compulsory.
4. Take your time ordering and, if you are not sure about a dish, ask for the list of ingredients and allergens: as the video below points out, it is worth asking at the slightest doubt.
5. Check how the dish arrives. The gluten-free dish must be recognisable by a distinctive mark and must not be brought out together with dishes containing gluten; there must be no crumbs on the table.
6. If in doubt, go without. If the answers are vague or nobody can tell you how a dish was prepared, choose something simpler or go somewhere else.
7. After the meal, let people know how it went. If an AFC place does not follow the rules, you can report it to AIC Piemonte by writing to segreteria@aicpiemonte.it with the subject ‘segnalazione AFC – inosservanza’ (‘AFC report – non-compliance’): reports are handled anonymously. If instead you have found a place that deserves a mention, tell us about it with the form.

In Turin: free courses for restaurants

In Piedmont, courses on coeliac disease and gluten-free food for restaurateurs, hoteliers and artisan food producers are free and taken online: they are funded by Law 123 of 2005, as part of the Piedmont Region's Progetto Celiachia (Coeliac Disease Project). After the course come 2-3 training sessions directly on the premises, followed by refresher audits every six months or every year.

In 2024, 143 courses for food business operators were held in Piedmont, with 1,690 participants: the second-highest number of courses in Italy after Abruzzo. More trained people in kitchens means more places able to welcome you safely.

There is nothing to be embarrassed about: a well-prepared place is used to these questions. You can ask them on the phone when you book or at the table before you order, and note down the answers for next time.

Keep the list to hand, on your phone too. Precise, consistent answers are a good sign; if the staff hesitate on several points, go back to step 6 of the list above.

1. Do you have gluten-free dishes or a gluten-free menu? Ask whether they are made specially or adapted on the spot from a regular dish.
2. Are you part of AIC's AFC programme? In Piedmont the places in the network receive the AFC window sticker for the current year every year: ask to see it or check the official list on AIC's website or app.
3. Is there a gluten-free contact person? In AFC places this is the person responsible for the gluten-free service: they are the one to ask the other questions.
4. How do you avoid contamination in the kitchen? Listen to what they say about surfaces, utensils, cooking water and frying oil; in a pizzeria, ask about the dedicated oven and toppings.
5. Can I see the list of ingredients and allergens? This is especially useful for sauces, breaded and fried foods, which may contain gluten or be cooked in the same oil as other foods.

Sources (in Italian): AIC, Programma Alimentazione Fuori Casa; AIC, Regole fondamentali AFC; AIC Piemonte, Programma AFC; AUSL Ferrara, video in the next section.

The video plays when the site is published online or opened from a local server. If an error message appears instead of the video, watch it directly on YouTube (video in Italian).

We explain why we chose this particular video on the Sources and credits page.

What the video says

This is a summary we wrote, not a full transcript: the video subtitles are generated automatically by YouTube and may contain mistakes.

Ambra Tonioli, coordinator of the provincial dietetics service of the Ferrara health authorities, explains how to follow a balanced gluten-free diet based on the Mediterranean model: naturally gluten-free cereals such as rice, quinoa and buckwheat, pulses, fruit and vegetables, fish, lean meat and eggs, attention to portion sizes, without relying only on substitute products.

Giusy Carrozza, prevention technician at the Ferrara AUSL, then describes how places that prepare and serve gluten-free food are inspected: notification to the health authority, documented procedures against contamination and a compulsory specific training course for anyone starting the business, to be refreshed regularly.

To close, she urges people with coeliac disease to ask the place for the list of ingredients and allergens, even at the slightest doubt, and to read labels carefully when shopping, where allergens are highlighted, usually in bold.