How to Order Gluten-Free at a Restaurant

You’ve probably heard that modern wheat is terrible for you. But you’ll never guess where gluten is hiding…

(Okay, here’s a hint: it could be in drugs, cosmetics, shampoo, lipstick, and even sushi rice!)

Now for the good news: once you know what to avoid, getting rid of wheat and gluten is easy as pie.

That’s exactly what we’ll teach you in this week’s show with Dr. Tom O’Bryan. Dr. Tom has over 30 years of experience researching Celiac disease and gluten sensitivity.

On this episode with Dr. Tom O’Bryan, you’re going to learn about hidden sources of gluten in your diet, autoimmune disease, and how to properly order at a restaurant without sacrificing your health.

In this show, you’ll learn:

  • What wheat does to your brain
  • How to address autoimmune issues with diet
  • The surprising places gluten is hiding
  • How to replace the grains in your diet with healthier options
  • How to order at a restaurant without getting glutened
  • And much more!

Let’s go hang out with Dr. O’Bryan…


Dr. Tom O’Bryan is an internationally recognized speaker and workshop leader specializing in the complications of Non-Celiac Gluten Sensitivity, Celiac Disease, and Autoimmune Disease. He’s also a personal friend and one heck of a hiking companion.

Let’s get straight to it:  How healthy are grains for us, across the board, especially wheat?

I have a catch phrase I usually start with to give you a quick overview:

Gluten is not bad for you. Bad gluten is bad for you. @theDr_com Click To Tweet

It’s the toxic gluten in wheat, rye, and barley that’s bad for all humans. In fact, a study out of Harvard in pediatric neurology looked at four different groups:

  • Celiac (where gluten affects your gut)
  • Non-Celiac Gluten Sensitivity (wherein gluten affects the brain, liver, kidney—anything other than the gut)
  • People on a gluten-free diet
  • And wheat-eaters

In all four groups, eating wheat turned on intestinal permeability for everyone. For everyone, gluten is the gateway to the development of autoimmune diseases like:

  • Alzheimer’s
  • Parkinson’s
  • MS
  • Rheumatoid arthritis
  • Alopecia
  • Psoriasis

The gateway is through a leaky gut. So, if you’re eating the type of grains that activate intestinal permeability—corn does it also in most people—you’re opening the gateway.  The fastest growing cells in the body are the inside lining of the stomach and intestine.  Every 3-4 days, you have a new stomach lining.

You eat toast for breakfast, you tear the lining, but it heals. You have a sandwich for lunch, you tear the lining and it heals. You have pasta for dinner, you tear the lining and it heals. You have croutons in your salad, you tear the lining. And this goes on day after day until one day you don’t heal.

When you cross that point, you get pathogenic intestinal permeability and you open the gateway to develop an autoimmune disease.

Is a gluten-free diet a lifelong necessity?

If you have the sensitivity to gluten—it’s a lifelong problem. You can’t be a little pregnant… it’s like that. The only grain we know of that’s lifelong is wheat. The immune system has memory b-cells and it makes them for wheat. We don’t know if the body makes them to any other grains, but with wheat we know it’s a slam dunk.  It’s lifelong.


Why is wheat so problematic now?

In the last 50 years, the gluten content of wheat has gone up by over 50%. Gluten means glue, so there’s more glue in the wheat. Why is that important? You want your dough to rise but not collapse and the more gluten the more it can stretch—the lighter the cakes and muffins and breads.

Scientists are very clear that’s not what’s caused the problem. And it’s not the GMO—American farmers spray crops with glyphosate two or three weeks before harvest to kill wheat and let it dry out so it doesn’t plug up the combines and there’s residue in most wheat products.  But that’s not why there’s so much more of a problem today.

In 1998 they found 9,700 blood samples from air force personnel from the 1950’s.  That’s really rare to have access to frozen blood samples from that long ago…  what did they find?

They looked at all the samples, which were almost all men, and they looked at the blood to see if they had any signs of celiac disease and didn’t know it. They found that some people had the markers for celiac.

Then they went to Humboldt county and took blood samples from 9,000 plus young men, healthy guys who came in for physicals. Did they have the markers?

“Four times more young men today have the markers for celiac than in the 1950’s, that’s a four-fold increase.”

They looked at the VA health records from the 1950’s samples, and they found that there’s a 4-fold increase in early death now compared to the men in the 1950’s. Four times more people are getting it today and they are dying much earlier than they did 60 years ago. Why?

Loss of oral tolerance. Here’s what that means: 70%-80% of your immune system is in your gut. Your immune system is there to protect you. Most of the threat is in the foods we choose to eat and beverages we choose to drink.

You eat a piece of celery. That celery goes into the sentries just inside the stomach. Those sentries say, oh that’s fine. Your body is always screening every forkful of what you put into your mouth. Every bite is either inflammatory or anti-inflammatory.  Except good water, that’s a neutral.

The diet we eat today with the colas, Twinkies, cupcakes, sliders, and fried foods… with all the garbage we’ve been eating, the immune system in the gut is fighting all the time. It’s hyper-vigilant, having to fight off invaders all the time. After a while, those sentries become trigger happy.

The gluten in wheat and rye is a mild toxin, but when you cross that imaginary threshold with a trigger happy immune system, the sentries fight the gluten. That loss of oral tolerance is why there’s such a huge increase in the number of people that recognize their sensitivity to gluten.

That’s why so many people feel better when they give up gluten. Their attention problems go away (yes, ADhD goes away). They feel better. Their migraines go away.  They have more energy.

This loss of oral tolerance is why it’s so much more prevalent now.

When you think back to the 1950s, you’re having a big beef roast, cabbage and maybe some coffee and pie at the diner. If you look back at the photos of people from then, they have a clear complexion and are relatively trim… being obese was not the norm as it is today.

But when you’re having cereal for breakfast, deep fried foods for lunch, and then eating dessert with gluten, you’re being exposed to it constantly and consistently and there’s a threshold you pass wherein your body gives up.

Yep, and everyone can hit that threshold at different times. It could be at two months, two years, twenty years, or older.

When you look at people who have had a diagnosed gluten sensitivity from a young age, there’s a difference in the way they age. They’re off of gluten and they have more energy and look better.

You’re right—I’m on the lecture circuit now talking about when you’ve had a gluten sensitivity unrecognized for so long. When that happens, your glutathione levels are low, even if you take the supplements, you’re sluggish in increasing glutathione because your whole system is worn out from having inflammation every day of your life.

Gluten is present in not just wheat, but other things. What about rye, barley, or spelt, teff, quinoa? How do you feel about those grains?

The family of wheat includes spelt, couscous, rye, and barley. That particular family—no human can digest them. They cause inflammation in everyone.

Quinoa, amaranth—here we may differ—my opinion is that some people do really well on a grain-free diet, they thrive over years. Especially people with blood type O. Other people will benefit from having a little bit of high quality nutrient-dense grains in their diets. Cultures have thrived on grains for centuries… but their immune systems weren’t fighting a barrage of other toxins.

Clearly, the vast majority of the emphasis in our food selection should be high quality proteins and vegetables.

The food pyramid is all politics. It's been disproven so many times now. But when you're trying to change politics in Washington, it's an uphill battle. - Dr. Tom O'Bryan abel james, gluten, gluten-free, fat-burning, celiac, alzheimer’s, antibodies, attention deficit disorder, brain health, cancer, disease, gluten sensitivity, gluten free, grain free, hidden gluten, inflammation, leaky gut, non-celiac, parkinson’s, processed foods, psoriasis,, tom o’bryan, restaurant, rheumatoid arthritis, success stories, toxins, transformations, wheat

“The food pyramid is all politics. It’s been disproven so many times now. But when you’re trying to change politics in Washington, it’s an uphill battle.”


I’ve had a few people on the showDr. Perlmutter, Dr. William Davis, lots of people who have spilled the beans on grains. What’s your perspective on how grains used to be processed or not processed? For example, fermenting on the chaff or making sourdough bread.

The more you alter a food, the less your body is able to use that food. @theDr_com Click To Tweet

We are supposed to eat food that grows on Planet Earth—you have to harvest and modify them a little bit, but the more they’re modified the harder they are to process.

I’ve not seen any hard science, but I take the opinion that some people will do well with whole grains on occasions. The immune system doesn’t get activated and no problem.  Other people will say you don’t need any grains, and that has a lot of science behind it.

I think the bulk of the diet should focus on high quality protein, high quality fats, and a ton of vegetables.

A guy just wrote a book called The Gluten Lie. It’s like, “Really man?”

What he says in his book, we actually don’t disagree very much. He says people shouldn’t go on fad diets. I agree with that.

When someone asks me, “How should I go on a gluten-free diet?” Get the blood test to find out if you have a sensitivity to gluten. There’s a ton of info on the website—I wrote a handout that explains what to take to your doctor to get the right blood test.

Here’s who should go gluten-free:

  • People whose immune systems are saying we’ve got a problem here.
  • People that aren’t feeling like a million bucks. Maybe they’re trying hard to be healthy, staying away from bad foods, but their body still isn’t giving them the performance they want it to.
  • People with sibling or first degree relatives with a sensitivity to gluten.
  • Those who have or have a family member with an autoimmune disease.

If you don’t want to get the blood test, and you fall into one of these categories (above) you should give a gluten-free diet a 3 week trial.

When you do find out you have a gluten problem, it’s kind of a gift in disguise. @fatburnman Click To Tweet

It took my mom a while to go gluten-free, and she’s an herbalist and a nurse practitionershe’s super healthy. It wasn’t until I interviewed Dr. Bill Davis that she tried it, and she had incredible results within weeks. 8 pounds came right off.  You could see it in her face.


How do you navigate a world with hidden gluten?

My sister and I were at J. Alexander’s in Detroit—it’s a national, upscale chain—and the waiter came over and we said “gluten-free” and he was like “no problem.” He was quick and trained and confident in what he was saying. She ordered a piece of fish, grilled with olive oil, garlic, and sea salt. How is that served? On a bed of rice with root vegetables.

I made sure to tell the waiter, “Tell the chef to make sure everything is gluten-free.” I was firm.

He comes back and he says, “Oh, I’m so sorry. The chef puts a scoop of flour in the rice.” So how would you know that?

I’ve asked at three of the last sushi restaurants, and all three chefs put flour in the sushi rice. Click To Tweet

You HAVE to be direct with the waiters. Make them ask the chef. Tell the chef everything HAS to be gluten-free. Don’t cow-tow. Lift your chest. Be direct. Look him in the eye.

Here’s the problem with all of that.

There was a study of 1,300 celiac patients, 3,300 of their first degree relatives, parents and siblings. The study followed them for over 20 years, every year they obtained copies of their blood tests, questionnaires, how often they cheat, whether or not they are strict?

They had all of this info for more than twenty years.

The standard mortality rate in celiac patients is 2:1. I am twice as likely to die at 63 or 32 than my brother is at that same age. That’s celiac with or without a gluten-free diet.  What did they find? Those that were really strict on following a gluten-free diet, their SMR (standard mortality rate) was almost equalized. Those that were not strict (defined as eating gluten as little as once per month), their SMR was 6:1.


Is gluten exposure dose-dependent?

There is no difference between a bagel and sushi rice with a scoop of flour in it.

When you get a measles vaccine—you get a really tiny dose of the measles. Now, you point at this one immune system cell and say, “You are General Measles.” General Measles builds an assembly line that builds soldiers to go after measles—these are called antibodies.

Now, those soldiers are going through the bloodstream looking for measles, firing their chemical bullets to destroy the measles. When all of the measles bugs from the vaccination are destroyed, he says, “Turn off the assembly line.” You shouldn’t have antibodies in your bloodstream now—but General Measles is vigilant for the rest of his life.

Now he just has to flip the switch, he doesn’t have to build the assembly lines when you’re exposed to measles.

That’s why if you go to Africa, you need vaccines months and months ahead of time for things like yellow fever, etc. But you go back 20 years later, you just need a booster shot a couple weeks ahead. You didn’t have to build the assembly line again, you just had to flip a switch.

So, if you have a sensitivity to gluten, you’ve got General Gluten—called memory b cells—they never go away and are there to protect you for the rest of your life. If you get one exposure (1/1000 of the dosage) that’s enough to activate General Gluten. If the antigen presenting cells in the small intestine say, “Oh that’s gluten,” then for 3-6 months you’ve got elevated antibodies.


As going gluten-free becomes more fashionable, people become more lax about it. At one end that’s great because restaurants have a gluten-free menu, but what are some other hidden sources of seemingly safe foods that might have gluten?

  • Vitamins
  • Drugs
  • Cosmetics
  • Shampoo
  • Lipstick
  • Gravies and Sauces

Just yesterday I had a filet that was going to be served with a wine reduction—I asked if there was flour in it? Yes. I had it just with sea salt and it was delicious.

We have a whole list on our website of hidden sources of gluten—there are hundreds of them. For some people, if they get an exposure they get tired, other people can be as bad as a peanut allergy. It can be really severe.

I spent years to come up with a digestive enzyme—something to save people’s’ lives.

What happens for most people is that they think maybe they have a problem, they check it out and they’re overwhelmed by the magnitude of this. How in the world can you be squeaky clean? It’s overwhelming.

I train health care practitioners on gluten sensitivity. We have about 450 in the country, well-trained to guide you how to dive into this new world to help your body be stronger and healthier long term.


What is a transformation you’ve seen from someone who may not have thought they had a problem?

I’m going to give you a couple of examples for that:

A 3 ½ year old girl was taken to an ophthalmologist and was diagnosed with a large tumor on the eye—Kaposi sarcoma—that’s HIV. That’s a tumor from AIDS. The child had been diagnosed two weeks earlier with celiac, as well. They did an endoscopy to make that diagnosis and she had a severe reaction to the anesthetic. They wanted to put her under a general anesthetic again to biopsy the tumor, but the parents wanted to wait since she had just had a reaction to the anesthetic.

In the meantime, she went on a gluten-free diet. She came back a month later and the tumor was smaller! She came back two months later and it was gone! You can see pictures of this in their research paper.

The ophthalmologist wrote they’d never seen anything like this, but they should be checking all conjunctival tumor patients for gluten sensitivity.

You pull a chain and it always breaks at the weakest link. @theDr_com Click To Tweet

Inflammation—all diseases are inflammation at the cellular level—inflammation is the pull on the chain. Maybe it’s your heart and you have a heart attack. Maybe it’s your kidneys or your brain. The more you pull, the more likely you are to have a problem.

Gluten is gasoline on the fire of inflammation. It roars up throughout the body, and where the weak link is, that's where it will blow up. abel james, gluten, gluten-free, fat-burning, celiac, alzheimer’s, antibodies, attention deficit disorder, brain health, cancer, disease, gluten sensitivity, gluten free, grain free, hidden gluten, inflammation, leaky gut, non-celiac, parkinson’s, processed foods, psoriasis,, tom o’bryan, restaurant, rheumatoid arthritis, success stories, toxins, transformations, wheat

“Gluten is gasoline on the fire of inflammation. It roars up throughout the body, and wherever the weak link is, that’s where it will blow up.”

They’re finding that things like Idiopathic Juvenile Rheumatoid Arthritis sometimes goes away on a gluten-free diet.

Another patient who had difficulty getting pregnant and suffered two miscarriages went gluten-free, got pregnant and gave birth to a healthy baby.

Another study focused on Attention Deficit Disorder—132 kids were tested and all of them improved in all 12 markers in six months on a gluten-free diet. Their brain was the weak link.

My godmother died of liver cancer, and we found it was from celiac disease.

If you eat a sandwich and feel fine, but you notice you’re getting a bird brain and not remembering the way you used to—you’re not firing on all eight cylinders—that might be your weak link.

I recently wrote a paper on non-celiac gluten sensitivity triggering neural inflammation and dementia. It identifies the mechanism linking gluten to Alzheimer’s.

Wherever your weak link is, that’s where it’s going to manifest.

So, you take gluten and wheat out of your diet, what do you put in? How do you crowd it out?

The Paleo world has come up with so many options now, there are so many Paleo cookbooks. I tell all of my patients, just take a look at the Paleo world. Some people would be exclusively Paleo, but there are so many great options there to go gluten-free. You don’t have to reinvent the wheel anymore.


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You can find Dr. Tom O’Bryan on his website, And if you’re interested in learning more about gluten sensitivity, check out The Gluten Summit

What did you think of this week’s show? Have a question? Leave a comment below!

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