Accommodating Celiac Disease in Higher Education: Evidence-Informed National Recommendations

Objectives: We aimed to develop expert-informed recommendations for colleges and universities to support students with celiac disease (CeD) managing a gluten-free (GF) diet. Methods: A multidisciplinary panel of 40 stakeholders, including physicians, dietitians, a disability rights attorney, university staff, and students, was convened by the Celiac Disease Foundation to create expert-based and experience-informed recommendations. Over a 6-month period, the group conducted literature reviews, stakeholder interviews, and expert consensus discussions to identify common barriers and accommodations aligned with federal disability law. The expert panel collaboratively developed and revised an initial set of recommendations. Two rounds of structured voting were held during which panelists provided feedback to refine content and ensure clarity. All final recommendations were adopted with at least 90% of panelists voting in support. Results: The panel identified 24 accommodations across four domains: academics, housing, dining, and campus life. Academic recommendations include flexibility for illness-related absences, support for remote learning, and classroom modifications. Housing recommendations emphasize access to priority placement, appropriate appliances, and proximity to safe dining. Dining accommodations address GF food availability, ingredient transparency, staff training, and meal plan flexibility. Campus life recommendations ensure full participation in athletics, study abroad, social events, and internships, with supports for psychosocial well-being. Conclusions: This manuscript presents the first expert-informed recommendations focused specifically on the needs of college students with CeD. These recommendations are intended to support institutions as they develop strategies to enhance access to GF food, quality of life, educational supports, and student experience for those living with this chronic autoimmune condition.