<<Disclaimer: Verify this information before applying it to your situation.>>

Hello - I received such a wealth of information that I decided to break it up to make more meaningful summaries.  Some of the themes were very interesting in terms of approach to this disease and GF diet.  Everyone who wrote was great - no lectures, as requested :-)
 
My original post concerned balancing real life with the desire for health.  It also asked about calculated risks when eating out.....
 
(BTW, I have adjust a setting on my listserv settings so hopefully there will be less extra characters)  Beth
 
Here are excerpts from responses:
 
-- I'd agree with you that outside the home,  it's next to impossible to get gluten free  anything. I'm sensitive to dairy too, which makes it REALLY impossible. I have found that taking bentonite with a meal covers the "trace amount" issue. We used bentonite for clarifying beer, back when I made beer ... it gloms onto grain proteins.  It also inhibits mycotoxins in cattle feed.  I'm not sure what all it does for restaurant food, but it works.
Taking bentonite, I can eat out with no symptoms. Otherwise, I get migraines and other issues. In our house, we are very careful, and cook mostly from scratch, for a variety of reasons, but on the road it's much harder. Having a "deactivator" handy is very nice!

-- I usually look for balance in an opinion being expressed. Your post presents
a balanced argument against zero tolerance while searching for a reasonable
balance between dietary compliance and functioning in the real world where
commercial kitchens are not gluten-free and we are constantly risking
cross-contamination. I understand and can relate to most of what you say.
The diet can be such a pain in the neck that it is sometimes worth putting
up with a few pains elsewhere now and again just to be able to skip the
'fanatic' approach. Still, as time has progressed, I have become
increasingly more comfortable with my diet and with all the extra bother
involved. I have found work-around solutions that reduce my risk of
contamination. At the end of the day, I know that I am risking
cross-contamination whenever I eat away from home and whenever I rely one
someone else to read labels. 

The question implicit in your post, as I read it, is one that asks just how
careful we need to be. For that reason, I'd like to suggest that you read
some of Dr. Marios Hadjivassiliou's publications. They report that even tiny
traces of gluten can continue to cause neurological damage. You might also
be interested in looking at Dr. Rodney Ford's publications that suggest that
celiac disease begins with gluten-induced nerve damage. 

Just because we don't notice symptoms doesn't mean that gluten isn't causing
damage. I'm a big advocate of zero tolerance for these and other reasons but
there are some extremes that I will not go to in order to ensure that what I
am eating is gluten-free. Instead of insisting that a restaurant change its
food service policies and procedures, I will choose one that expresses a
willingness to accommodate me in order to get my business. I will risk
offending a host/hostess, I will trouble serving staff and kitchen staff, I
will badger pharmacists about non-medical ingredients, and I will forego a
meal or a snack that I consider suspect. However, I don't want to do battle
with drug companies, food manufacturers, or anyone else who chooses to
conduct their business ignoring the gluten-free market. While I am grateful
for those who have fought those battles, their zeal has sometimes caused
more harm than good. 
  
Reality seems to vary from one person to the next. The choices we each make
are informed by our individual perceptions of reality. As your post
suggests, there aren't any easy answers. Nonetheless, I am grateful for the
zero tolerance policy, and I'm a big fan of it. 
 
-- I agree that travel and staying gluten-free is challenging. I have to travel, and for the most part I feel that I'm safe. 

<They are, for the majority of us, gluten-reduced diets.  Cross contamination is everywhere.> True. We are probably exposed to some amount of gluten. Nobody exactly knows what that means, but it is probably measured in grams per day, not micro or milligrams. Dr. Gary Gray from Stanford University Hospital measured what happens to constant exposure of gluten. In his tests, he challenged the experimental subjects (small study, only 8 volunteers) to daily doses of gluten equivalent to 1-2 slices of bread. In three weeks, all subjects had evidence of malabsorption. But before that, they were all measuring normal. (for themselves. But Dr. Gray brings up a point that he thinks half of them could have better absorbtion.)  

I've found that good restaurants in the US and Europe can take good care of us that have gluten intolerance. I've never had a problem talking to either the wait people or the chef, him/herself. A large number of them say: "We do this all the time. I'll take good care of you." I was even at a buffet in London and the chef came out, took me on a tour of the food and said "too bad you can't have <whatever that is>. It is my best dish. I'll make a version you can have. You'll love it." ... and I did. In Las Vegas at the Wynn (on a company meeting) the chef prepared a GF version. At one point in another meal, the wait person came out and said "I'm sorry. The soup isn't gluten free. Can we bring you lobster consommé?" YES! 

Sometimes the unobvious is a problem. IHOP puts pancake batter into their omelettes. Why? Because it makes them special (and maybe pancake batter is less expensive than eggs, who knows). Tell the restaurant to not make your eggs on the griddle. Make them in a pan. When you get chicken soft tacos, tell them to NOT DIP THE TORTILLAS IN FAT. (I learned this the hard way. And yes, the gluten peptides in the fat did make me sick.) 

Good luck traveling. It is a challenge. I've never had a problem traveling, but I never get anything deep fried - ever.
 
-- That was a great post. I feel the same way - just tell me what the risk is so I can make an informed decision.  I faced this with Balance bars for my 12 year old son. Balance bars are manufactured on equipment that also processes wheat-containing ingredients.  Ok, but they must clean the machines between batches, right?  I called the company to ask, and the rep who answered told me, "I wouldn't risk it if it were my kid."  But when I emailed the company, the rep there said they understand about cross-contamination and are very careful about cleaning the machines. So how much gluten could really get into an individual bar? And how much matters? I emailed the U Chicago program about another question and was told that the amount of gluten needed to cause a reaction is the equivalent of 1/8 of a wheat thin. Anything less than that is digested in the stomach before it reaches the small intestines. But other places I've read that even a molecule of gluten can set off a
 reaction. I know it's different for different people, and yet, I wish there were some clearer guidelines. I want to be responsible, but not neurotic.  My son can live without balance bars, but if they're ok, they would be a convenient boost of protein and calories when he's on the run. It's hard to figure out how to be careful and still live a real life.  

-- My feeling is this; we must all find our own way through this and make decisions
only for ourselves.  We each have individual biochemistry and what works for me may not work for you.  I take some risks, I know that "accidents" happen in the kitchen that we can't see into.  Even when we have asked the server all the correct questions. For me when I have traveled on business I stick with tried and true, The Outback, for instance.  I have found most restaurants to be very kind and understanding but again if you can't see 
what is happening in the kitchen, you will be unsure. The current standing for part per million is less than 100 ppm. I support your questioning and you can only do for you and you will deal with the consequences of you decisions. Most of  us are so afraid of a gluten hit that our lives come to a stand still. You sould very intelligent, trust yourself.
I would say keep your risks to a minimum, all the foods you mentioned below
are foods that could be risky. They may not be either.  I have made lists, I have asked all the questions you  have asked, I take risks.

-- Finally, someone on this list who thinks like I do and is not a fanatic!  Thank you.  Every time I post I get all sorts of lectures and warnings, like I'm stupid.  We all know about cross contamination but this diet is tough and sometimes you just gotta go for it! Thanks for giving me hope that I am not the only celiac who is not fanatical!  

--  I figure I eat to keep myself healthy and alive when I am at a restaurant and focus on the conversation and friendships.  Then I may supplement at home later.  Sometimes I do need a full meal when at a restaurant and then I will explain to the staff that it is not only what I am eating but how the food is prepared.  Almost everyone is very accomodating.

-- You pretty much summed up how I feel about eating out these days.  I tend to go for things that I think are safe without going crazy interrogating staff.  Mainly because I've learned that no matter how careful I am in my questions, I'm going to forget or overlook something.  Did I remember to check that the grilled chicken breast wasn't injected with something beforehand (that's the newest one that knocked out many of my fast food options).  Yeah, I've messed up many times in the 4 years I've been doing this diet.  And I learn and adjust.  One of the new things I've learned is that chefs are tossing flour into mashed potatoes so they last better under the heat lamps - both at buffets and regular restaurants.  You're right, though.  It comes down to comfort level.  In theory, all gluten is attacking us, even if we don't see outward signs of it.  But it's hard to stay away from and short of eating whole foods prepared in our own homes that contain no processed foods, then
 we're all at risk.
 
-- I understand all your questions and concerns.  I am one that is not highly sensative - so when I travel I make the best decisions I can.  I really work on not stressing - because that makes everything worse! Trust yourself and be prepared for gluten - becuase
you are right nothing is 100% safe.
 
-- I know how frustrating it is to travel.  When we travel, we generally try to find out what's in the area and try to create a game plan before going.  For example, we'll see if there are any GIG-approved chain restaurants in the area like Outback.  We put our faith in McDonald's to have GF meat patties, hashbrowns/fries, etc, so we'll look for one of those.  Then, if there are specific restaurants we know we'll want to visit, we'll call first and see if we can educate them.  We've been pleasantly surprised to find that some places have cooks/chefs who've been educated about the diet either because of customers or family member.

Restaurants we look for before traveling:
Outback
Carrabas (not the best reputation for cross contamination, but we've had success)
PF Chang's China Bistro
Bonefish Grill
Bahama Breeze
McDonald's
Wendy's
Boston Market (used to have a GF menu online, but not sure if still does)

With all of these, we check the website for GF info and speak with the manager/server to make sure they understand the issue and ask for the GF menu if available.  Also, check and see if there are any health food stores/ Whole Foods in that area where you can stock up on GF snacks.  Not sure if this is what you were looking for, but it's worked for us.  Takes a little work up front, but then again, so does complying with this diet in the first place.  Good luck and safe travels,



*Support summarization of posts, reply to the SENDER not the Celiac List*
Archives are at: Http://Listserv.icors.org/SCRIPTS/WA-ICORS.EXE?LIST=CELIAC