While at a late-night diner with friends recently, the server brought plates of steaming fries covered in gravy and grilled cheese and Monte Cristo sandwiches on buttered toast. And then he brought my plate: a skimpy house salad sans croutons. Everyone nibbled off of everyone else’s meal— except for mine, which my friends dismissed with a wave of their forks. After all, who’s itching for a bite of iceberg lettuce?
Rabbit food isn’t my first choice for appeasing late-night cravings, either. But this past year, I was diagnosed with celiac disease, also known as the permanent intolerance to gluten, and since then, I’ve had to change my eating ways. Gluten is a protein found in wheat, barley and rye— scan the ingredient lists of most consumables and you’ll find it’s a main component. Unfortunately, there’s no pill that provides an invisible shield to protect me from gluten. The only way to treat celiac disease is to adhere to a strict gluten-free diet.
Initially, a gluten-free diet seemed like a death sentence, or at least a recipe for a joyless life. I love to eat. I eat when I’m anxiety- ridden or mellow, caffeine-jolted or sleepy, elated or depressed. Learning that I’d need to steer clear of gnocchi, mozzarella sticks, glazed doughnuts with chocolate icing and Chinese take-out— forever— was literally hard to swallow.
And yet, the diagnosis nevertheless brought relief, ending the mysterious health problems I’d suffered for years. On some days during my undergraduate years, I’d lie in bed drenched in sweat from waves of nausea and searing, debilitating abdominal attacks, literally unable to get out. Then there were days that blurred into nights then back into days when I’d drift into narcoleptic comas, sleeping for more than 24 hours straight.
While doctors labored to diagnose me, I played the role of a scientific experiment. At the ripe age of 22, I became intimate with X-ray machines, needles and suction tubes. Colonoscopies? Let’s just say that I’ve undergone more than the average 75-year-old.
At the end of it all, I learned I was joining the one in 133 Americans with celiac disease. That’s a pretty sizable group, and many experts actually think this figure is low since Americans are not routinely tested for the disease. But with more and more information circulating, our ranks are growing every day. It’s not a club anyone would rush to join, that’s for sure. But, as I’ve learned, the diagnosis doesn’t have to mean an end to enjoyable eating. It just means a different way of eating.
Not too long after my diagnosis, I ventured on my first gluten-free grocery trip. I dawdled in the aisles, hoping against hope to discover that Texas toast was not, in fact, made out of bread, or that my favorite frozen pizzas had miraculously turned gluten-free overnight. But when I looked at the ingredient lists, I had to admit I was dreaming. Gluten was gluten and, unfortunately, it didn’t vaporize from the array of cake and brownie mixes, pretzels and oatmeal pies that used to comprise my favorite foods.
So I wandered over to the frozen foods section and opened the freezer doors to skim the ingredient lists of my least favorite items: frozen diet meals. I almost fainted when I saw that most microwaveable, low-calorie meals are doused in sauces or gravies containing gluten as a thickening agent. Not only could I no longer eat my favorite foods, I couldn’t even eat my least favorite foods. It was obviously time for a radical change.
My grocery purchases now include fresh or frozen fruits and vegetables, plain meats and gluten-free grains such as rice. I make my own sauces and gravies with cornstarch that are much healthier and cheaper than prepared sauces. I also plan my meals according to a weekly agenda and include leeway for snacks, including almonds and apple slices with peanut butter. On the days that I work all day and attend graduate school at night, I tote a hefty supply of food in my backpack to ensure I’m not tempted to grab something out of the vending machine.
Grocery shopping is still strenuous and time-consuming, because I have to analyze the ingredients of every item not marked “gluten-free.” I can’t assume that foods will maintain consistency, because manufacturers constantly change them from one batch to another. Still, there are times when a visit to the food store feels similar to winning the lottery, like the day when Chex cereal first boasted the label “gluten-free” in big, bold letters. When I realized I didn’t have to drive a half-hour to purchase specially made cereal and could stock up at my local store, I called my mother to inform her. Fifteen purchased boxes later, I felt like a millionaire worth my weight in Chex squares.
Shopping at specialty grocery stores like Whole Foods, Wegmans and Trader Joe’s is now a true delight. Such stores offer gluten-free foods in substitution for most common items and the gluten-free foods are either clearly labeled with signs or are housed in particular aisles. Each individual item also bears a prominent gluten-free label or notation on its packaging. In a wave of carefree gluttony, I’m able to toss gluten-free lasagnas, frozen chocolate chip cookie dough, pretzels and pizza crusts into my shopping cart. I’ll decline to comment on my receipt, but for me, the cost is well worth the safety, convenience and taste.
Sure, not all gluten-free items are top-notch, five-star quality foods. As I discovered, one brand of gluten-free rice bread is equivalent to (well, worse than) gnawing through a cardboard box, so I’ve since transitioned to making sandwiches and paninis with gluten-free waffles, which I actually prefer to the average loaf of white bread. And let’s not forget my recent discovery of lemon-glazed, gluten-free doughnuts, which are far superior to the average glutinous doughnut.
Sadly, dining out can be a challenging experience for the gal who has to avoid gluten. First of all, it’s mainly chain restaurants that go out of their way to accommodate the growing numbers of diners with gluten intolerances. Uno Chicago Grill offers gluten-free pizza and beer. Although it does not offer the signature deep-dish crust, the crusts of its gluten-free pizzas are nevertheless light and flaky— and one of the best pizzas I’ve ever tasted. P.F. Chang’s offers gluten-free soy sauces. And the menu at Bonefish Grill politely reminds consumers to request the Bonefish Caesar salad without croutons and also lists gluten-free desserts, like its fudgey, macadamia nut brownie. These restaurants readily distribute ingredient information to inquiring consumers, and they also offer nutritional information on their Web sites.
When I first arrive at Bonefish in Bel Air, prepared both to dine and chat with operating partner Eriksson Hill, I notify the host that I would like a gluten-free entrée list. She hands me a hard copy menu, similar to those distributed to other patrons, tailored to my dietary concerns. I have no need to question if there’s flour in my soup or a bread crumb rub on my chicken. Instead, I simply skim the menu and select from a wide variety of meals containing the “GF” notation, everything from filet mignon to salmon salad with citrus vinaigrette to a list of wines and cocktails that also bear the GF notation. I decide on the chicken garnished with goat cheese and spinach.
When Hill sits down with me, he proceeds to detail the food allergy and gluten intolerance training given to each new employee. Servers communicate to kitchen staff that a diner has ordered a gluten-free meal by way of a computer prompt, and cooks are knowledgeable that gluten-free food must be prepared in fresh pans with clean cooking utensils. “Gluten-free menus take the guesswork out,” he says. “Rather than be afraid of it and ignore it, we under- stand that people have it.”
Independently owned restaurants are beginning to acknowledge the need for awareness as well. Brian Greene, executive chef at Gertrude’s at the Baltimore Museum of Art, is knowledgeable of every ingredient in a meal. “We’re a ‘scratch house’— we make all of the food ourselves,” he states. So when a customer asks for an ingredient list, the server can communicate with Greene or with owner and chef John Shields, both of whom can cite ingredient lists from memory. Greene explains that he receives eight to 12 requests from food-allergic customers per day, with those requests rising on a regular basis.
“Food allergies shouldn’t preclude you from going to dinner with your best friends. It’s a physical ailment that has to be accommodated,” says Greene, who personally prepares meals for those with special needs. He carefully avoids cross-contamination, selecting a fresh plate directly from the dishwasher and re-sterilizing food preparation surfaces and cooking utensils prior to cooking a gluten-free dish. Greene may lead diners through certain dishes listed on the menu that are gluten-free or, time permitting, create a custom plate. The restaurant encourages patrons with allergies or intolerances to call ahead.
Donna Crivello, owner and executive chef of Donna’s Restaurants, explains that her staff is educated about dietary restrictions, since many of them have various ones as well, but stresses the importance that consumers voice their particular needs. “Not every item is listed on the menu,” she states, and she further explains that her kitchen staff will custom prepare items for regular customers with gluten intolerances or food allergies. Customers may substitute side dishes of pasta with gluten-free rice, risotto, potatoes or polenta. If a chicken dish has bread crumbs in the crust, staff will either grill or roast the chicken, instead. Or, diners may choose from dishes already gluten-free, including the chicken and steak salads.
On the other end of the spectrum, some restaurants that offer gluten-free menus do not properly inform or train staff members about food handling and preparation methods. On one occasion while dining out with my mom, I ordered an entrée from a gluten-free menu, only to find that a breadstick had been added to the side of my salad. I sent the salad back— the addition of a breadstick had cross-contaminated my plate, defeating the overall purpose of a gluten-free menu.
In my year or so of eating gluten-free, I’ve also found it’s risky to trust most fast-food restaurants that offer allergen information. I asked one drive-thru attendee at Wendy’s if she knew of the gluten-free foods for individuals with celiac disease as listed on the online menu. Ready to order a bowl of chili and hamburger patty (no bun), I was slightly surprised when she couldn’t provide the requested information. “I’m not sure what you mean,” she said. “We just offer what’s there.” Then she scowled at me as if I were a carrier of the Black Plague, unaware that my disease is not contagious.
Things are improving for gluten-intolerant diners, but the fact is that people with celiac disease still have to dine out mostly at restaurants that do not offer gluten-free menus— and that’s not always the easiest or most elegant experience. “When I go to a restaurant that does not have a gluten-free menu, the waiter or waitress gives me a hard time, usually thinking that I am being a picky eater,” says Nottingham resident Samantha Warm, who was diagnosed with celiac disease in April 2007. “At times, I do feel obnoxious. But my problem is that I do not know if a meal contains gluten or not, so I have to be extra careful.”
I share Warm’s concern— I know it’s a pain, but I have to ask. If I unknowingly ingest gluten, I experience extreme fatigue one to two days later, as if I’m blanketed in a thick, mental haze. I may also experience severe gastrointestinal pains and, worse, may eventually suffer from long-term consequences such as infertility and cancer.
There are no current state-mandated programs for restaurants that offer gluten-free foods to consumers. Instead, independent organizations, such as the Gluten Intolerance Group of North America, certify restaurants like Bonefish Grill that seek to be labeled as gluten-free. Specifically, the organization sponsors the Gluten-Free Restaurant Awareness Program, which provides volunteer representatives to establish an ongoing relationship with both restaurants and staff members. Organizations like the National Foundation for Celiac Awareness also offer courses to certify local restaurants as gluten-free. Lebanese Taverna and Roy’s, both in Harbor East, are certified as GREAT Kitchens by the Gluten-Free Resource Education and Awareness Training (GREAT) program of the NFCA.
Legislation to protect consumers with food-related allergies is slowly developing. Ming’s Law of Massachusetts recently set a precedent for states across the country by requiring restaurants to educate workers about food allergies and necessary measures to take if serving customers with special needs. Maryland does not require such intensive, allergen-specific training, nor does it require that restaurants be state-certified to serve gluten-free food. But the state is gradually joining national trends to publicize the disease, and recently declared May Celiac Awareness Month.
Restaurant owners may balk at accommodating gluten-free diets— it requires extra effort and some extra expense at the start, after all— but it’s savvy business sense considering celiac disease is one of the most common genetic diseases to date. I know when I dine out with friends, the primary question is not, “What is everyone in the mood for?” but rather, “Lisa, where can you eat?” I influence where my money and the money of my friends and family are spent.
For now, I follow the rules and simply daydream of the day when I can show up at a diner with friends after a night out on the town and order gluten-free fries dripping with cornstarch-based gravy and gluten-free grilled cheese or baked meatloaf void of bread crumbs. Then, when the food arrives, steaming and golden and smelling so good, my friends will reach to eat off of my plate. That will be pure, gluten-free, heaven.
Lisa Cleary is a writer and production editor who lives in Baltimore.
Visit the following Web sites for more information on gluten-free dining in the Baltimore and Maryland region:
>Gluten Free in Baltimore at Glutenfreebaltimore.blogspot.com
>Maryland Gluten-Free Restaurant Guide at Celicachandbook.com
>Urbanspoon Baltimore at Urbanspoon.com Gluten Free Restaurants
>Gluten Free Registry at glutenfreeregistry.com