Blame it on Gwyneth, or Miley, or Victoria Beckham, or even Chelsea Clinton’s wedding cake. Or on the Paleo diet or the best-selling book “Wheat Belly.’’ Or on improved awareness and diagnoses, or diets centered around processed foods, or changes in wheat itself.
Whether fact or fad, or a bit of both, gluten avoidance has become a way of life for millions of Americans. According to a study by the Center for Celiac Research at Massachusetts General Hospital, nearly one out of 133 Americans suffers from celiac disease, a genetic autoimmune disorder, in which all foods with gluten, found in wheat and other grains, must be avoided. According to the center’s figures, another 18 million people, or 6 percent of the population, have gluten sensitivity; symptoms may range from gastrointestinal issues to behavioral problems to joint pain and osteoporosis. And then there are countless people avoiding gluten because they think it’s simply a healthier way to eat, or because they believe it will result in weight loss.
“It’s a real thing, not a fad,’’ says Melinda Dennis, nutrition coordinator at Beth Israel Deaconess Medical Center’s Celiac Center. Both celiac disease and gluten sensitivity have increased dramatically, and not just because testing has improved, she says. “People are being diagnosed more — and it’s more prevalent.’’
There are a number of possible explanations for the increase. One theory holds that the wheat we eat today is different from yesteryear. Says Dennis, “There is now a controversy on how wheat has changed or not changed. The controversy is: Has it really changed? But what we can say is that we’re eating more of it — more than 100 years ago or even 50 years ago.’’
In addition, gluten is hidden in a number of condiments and prepared foods, so gluten-free shoppers have become dedicated label-readers.
Dennis herself was diagnosed with celiac disease 20 years ago. Still, she acknowledges that some people may be avoiding gluten unnecessarily, and that they could be putting themselves at risk. Anyone who goes on a gluten-free diet, she says, should seek the guidance of a nutritionist, lest they end up with deficiencies in nutrients and fiber that could leave them feeling even worse.
Popular diet doctors certainly haven’t failed to pick up on the trend. The newest book from Arthur Agatston, creator of the South Beach Diet, is “The South Beach Diet Gluten Solution.’’ And William Davis’s best-selling “Wheat Belly’’ promises in its subtitle to “Lose the Wheat, Lose the Weight.’’ But a gluten-free diet isn’t a weight-loss regimen per se; after all, that gluten-free brownie can still be loaded with fat, sugar, and calories.
Chefs, restaurateurs, and food manufacturers aren’t in a position to know — or care — why customers are demanding gluten-free choices. In a field where sensitivity to customer need is paramount, they realize that having gluten-free options available just makes good business sense.
While some chefs hinted off the record at their personal skepticism about gluten-free diets, most are in the business of accommodating diners. “I learned a while back that it’s not my job to tell people what to eat or how to enjoy it,’’ says Dave Becker, chef and owner of Sweet Basil in Needham. Lydia Shire, chef and owner of Scampo, adds, “We have done everything we can to please [customers who avoid gluten]. There’s nothing I wouldn’t stop at doing.’’
For diners with celiac disease, it’s not sufficient that the food is free of gluten; if it’s prepared in a kitchen where wheat products are used, there’s the risk of cross contamination. The measures sometimes seem extreme, but no restaurant wants to run the risk of a lawsuit or negative publicity that might result if a customer were to accidentally ingest gluten.
At Back Deck restaurant, burgers and sandwiches can be ordered on gluten-free buns made by Curtis Street Bakers, a Somerville wholesaler of gluten-free baked goods that supplies area coffee shops and Tufts University. But Back Deck chef and owner Paul Sussman goes a step further, making sure that the burger itself is cooked on a grill that’s never used for items that might contain gluten. “And nothing goes in our fryolater except potatoes,’’ says Sussman, who explains that frying a breaded item could contaminate the oil.
Nebo restaurant, which is in the midst of a move from the North End to Atlantic Avenue, also goes the distance. “We’re not just serving a piece of steak and salad, which is naturally gluten-free,’’ says Carla Pallotta, co-owner with sister Christina. “We’re doing zucchini lasagna, eggplant Parmesan, pizza, pasta, a whole fried seafood platter.’’
Many restaurants that offer gluten-free pasta rely on dried commercial versions. But at Rialto (which also has menus that cater to nut, dairy, and alcohol allergies), Jody Adams has literally taken matters into her own hands by creating a house-made gluten-free pasta, served with peppers, eggplant, and chickpeas. “We make it with a designated KitchenAid machine that never sees gluten,’’ says the chef. Developing the recipe was a little tricky: “It took me a couple of days to get it right, and it’s not like pasta with gluten, that’s for sure. But people seem to really like it, and for the most part I’m pretty proud of it.’’
Legal Sea Foods was an early adopter. “We’ve had a gluten-free menu implemented for seven years or so,’’ says executive chef and vice-president Richard Vellante. Legal’s also takes the step of making sure that the gluten-free menu “looks just like the regular menu,’’ says Vellante. “We don’t want customers to feel uncomfortable.’’
Mainstream food manufacturers are getting into the act. When gluten-free practices first came to the fore, niche manufacturers began to fill the demand for specialty products. But now even major players such as General Mills are jumping in, with a line of gluten-free Betty Crocker mixes and gluten-free Bisquick. Robert Dircks, marketing manager for Betty Crocker and Bisquick, acknowledges that some sales may be trend driven — “Any time you get a lot of celebrities doing something, folks will naturally give it a try,’’ he says — but the category is strong and growing.
King Arthur Flour might seem an unlikely entrant in the gluten-free derby, but products are actually a fit for the company’s core mission, says spokesperson Terri Rosenstock. “We are about baking for everyone, whether they can tolerate gluten or not,’’ she says. The company has a line of certified gluten-free products and a dedicated gluten-free blogger who creates suitable recipes for the website.
Consumers who rely on gluten-free products and dining options are grateful for the recent proliferation — up to a point. Skye Stewart, an Arlington resident whose now 7-year-old daughter was diagnosed with celiac disease three years ago, says that when her family first went gluten-free, “there were two things we were grappling with: figuring out what was safe, and then, once we did, figuring out what tasted good. There is some not-tasty gluten-free food out there, and now we know we don’t have to eat it just because it’s gluten-free.’’ Gluten-free food, she notes, isn’t de facto healthy: “A product might be safe, but that doesn’t mean it has fiber or is low in sugar or fat.’’ But quality and variety have improved, she says, in the years her family’s been off gluten.
Vicki Rowland, of Watertown, who reluctantly stopped eating gluten a few months ago to see if it might help her stomach troubles, recently met a friend for lunch at Pizzeria Uno. “They tout their gluten-free pizza, but I learned it’s better to have something else,’’ she says. But she’s been pleased with gluten-free cookies and rice pasta from Trader Joe’s, and Udi’s bread, one of the more ubiquitous gluten-free brands, “seems to be the best out there.’’
The demand for gluten-free food isn’t going away any time soon. Most chefs report that customers seeking such meals represent a small portion of their business — but it’s a portion they must accommodate. And it’s not necessarily the quantity of gluten-averse customers that matters. “It’s interesting,’’ says Vellante. “It’s a small number of people who come in, but they have a loud voice.’’