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Office of P-20 Education Policy
Child Nutrition Program Administration
89 Washington Avenue, Room 375 EBA, Albany, NY 12234
Phone: (518) 473-8781 Fax: (518) 473-0018

Food Service Managers/Directors
Frances N. O'Donnell, Coordinator
Sunday, October 1, 2006
Making Accommodations for Children with Celiac Disease

Making Accommodations for Children with Celiac Disease

            More school food service directors/managers are making dietary accommodations for children who have been diagnosed with celiac disease.  Since this diagnosis is increasing, it is helpful for you to have a basic understanding of this illness so you and your staff can provide appropriate meals for children in your school.

Celiac disease (CD) is an under-diagnosed genetic disorder that affects one out of 133 Americans. Only three percent of these cases have been diagnosed leaving 2.1 million Americans unidentified. This large number is the reason for a campaign to increase awareness of CD and provide supportive information for those living with it.

            The basis of the disease is the inability to digest gluten. Gluten is a protein commonly found in wheat, rye, barley and oats, among other foods. A typical person consumes 10-40 grams of gluten per day. However, only 0.1 gram is necessary to cause damage to a celiac. Gluten contains a particular sequence of amino acids, which when consumed by a person with celiac disease, sets off a response that causes damage to the small intestine. This damage then prevents the small intestine from absorbing essential nutrients into the body.

            Individuals with celiac disease differ from one another in the symptoms they incur. Some patients may have “latent” or no symptoms, while others could have extreme reactions. Regardless, in most instances, people who suffer from celiac disease are malnourished as a result of the small intestine’s inability to absorb nutrients from consumed foods. Other indicators of the disease include vomiting, gas, diarrhea, weight loss and abdominal pains. Delayed growth and puberty, along with skin rashes, infertility and osteoporosis are a few of the more severe symptoms associated with CD. A proper diagnosis is vital as untreated cases of the disease can potentially lead to cancer.

            It is recommended that patients who suffer from celiac disease engage in a life-long elimination of gluten products. This not only includes the digestion of these foods, but also preventative measures in food storage and preparation to ensure that no cross-contamination with gluten items has taken place. It is important to note that even after following a strict diet, some food sensitivities, such as lactose intolerance, may continue.

            School food authorities (SFAs) are required by law to provide substitutions to the school meals for children with celiac disease if their needs are supported by a statement signed by a licensed physician.

            SFAs should work closely with the child’s physician to clearly understand the foods that must be omitted from the child’s diet and the choices of foods and quantities to be substituted. Under no circumstances are school food service staff to revise or change a diet prescription or medical order.

            The physician’s order may require certain products to be purchased for the child. Schools may not charge children with disabilities, or with certified special dietary needs who require food substitutions or modifications, more than they charge other children for program meals or snacks. In other words, free children cannot incur any charges for their meals and full-priced children cannot be charged extra for the special foods the school has to purchase.

            Gluten can be found in a number of our favorite foods such as pasta, bread and cookies. However, it can also be hidden in a variety of processed foods. Therefore, reading labels may not always be the most sufficient way to remain healthy and symptom-free.

Examples of grains to avoid include gliadin (found in gluten of wheat), kamut (also found in wheat) and possibly edible and food starch, flour and grits, depending on content and cross-contamination. Some forbidden foods to a gluten-free diet are ice cream, salad dressings, frozen french fries, rice mixes and processed cheeses. On the other hand, items such as chestnuts, chickpeas, herbs, corn, masa flour, castor oil and flaked rice are just a few of the “safe” foods that are available on the market.

For more information about celiac disease visit and Gluten-free foods and products can be found at and If you have questions regarding your responsibilities for a child with celiac disease, contact Paula Tyner-Doyle at (518) 432-5066 or by email at PTYNERDO@MAIL.NYSED.GOV.


USDA Nondiscrimination Statement

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. 

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at:, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

(1)     mail: U.S. Department of Agriculture
         Office of the Assistant Secretary for Civil Rights
         1400 Independence Avenue, SW
         Washington, D.C. 20250-9410;

(2)     fax: (202) 690-7442; or

(3)     email:

This institution is an equal opportunity provider.


Click here for Nondiscrimination Statement translations.

Los demás programas de asistencia nutricional del FNS, las agencias estatales y locales, y sus beneficiarios secundarios, deben publicar el siguiente Aviso de No Discriminación:

De conformidad con la Ley Federal de Derechos Civiles y los reglamentos y políticas de derechos civiles del Departamento de Agricultura de los EE. UU. (USDA, por sus siglas en ingles), se prohíbe que el USDA, sus agencias, oficinas, empleados e instituciones que participan o administran programas del USDA discriminen sobre la base de raza, color, nacionalidad, sexo, discapacidad, edad, o en represalia o venganza por actividades previas de derechos civiles en algún programa o actividad realizados o financiados por el USDA.

Las personas con discapacidades que necesiten medios alternativos para la comunicación de la información del programa (por ejemplo, sistema Braille, letras grandes, cintas de audio, lenguaje de seas americano, etc.), deben ponerse en contacto con la agencia (estatal o local) en la que solicitaron los beneficios. Las personas sordas, con dificultades de audición o discapacidades del habla pueden comunicarse con el USDA por medio del Federal Relay Service [Servicio Federal de Retransmisión] al (800) 877-8339. Además, la información del programa se puede proporcionar en otros idiomas.

Para presentar una denuncia de discriminación, complete el Formulario de Denuncia de Discriminación del Programa del USDA, (AD-3027) que está disponible en linea en: y en cualquier oficina del USDA, o bien escriba una carta dirigida al USDA e incluya en la carta toda la información solicitada en el formulario. Para solicitar una copia del formulario de denuncia, llame al (866) 632-9992. Haga llegar su formulario lleno o carta al USDA por:

(1)     correo: U.S. Department of Agriculture
         Office of the Assistant Secretary for Civil Rights
         1400 Independence Avenue, SW
         Washington, D.C. 20250-9410;

(2)     fax: (202) 690-7442; o

(3)     correo electró

Esta institución es un proveedor que ofrece igualdad de oportunidades.