Today, about one percent of Americans suffer from celiac disease, an inherited autoimmune digestive disorder that interferes with the absorption of nutrients in food. The protein gluten, found in all forms of wheat, rye and barley, triggers the immune system to attack the villi (tiny finger-like projections that enable absorption) of the small intestine. Undiagnosed and untreated, celiac disease can lead to the development of other autoimmune disorders, as well as osteoporosis, infertility, neurological conditions or cancer (The University of Chicago Celiac Disease Center). Adherence to a gluten-free diet is the only treatment for celiac disease, but avoiding these ubiquitous grains can be a trial for celiacs dining out.
With an estimated 3 million people--97 percent of them undiagnosed--living with celiac disease and awareness of the condition growing, restaurateurs and chefs are beginning to grasp that increasing numbers of their guests need safe, gluten-free options.
Michael Savett, an attorney in Philadelphia who makes his home in Cherry Hill, NJ, started the blog Gluten-Free Philly after his son Aden was diagnosed with celiac disease at the age of three. Now that his son is nearly nine and the family dines out more often, Savett shared his experience of keeping his son’s food safe.
"The most important concern is whether the staff is aware of what celiac disease is," he says. "They must understand the importance of separate pots and pans to prevent cross-contamination."
Savett explained that for gluten-intolerant folks, a few crumbs of conventional flour bread could be tolerated, but for true celiacs having their GF bread toasted in the same toaster could lead to days of illness.
"The next step is inquiring about the ingredients in the food itself--salad dressings and sauces, for example. It's really a two-step process and there are certainly restaurants that are gluten-free friendly."
Training chefs and restaurant staffs in celiac awareness is the Ambler, Montgomery County-based National Foundation for Celiac Awareness (NFCA). This not-for-profit organization's mission is to raise awareness of celiac disease among the general public and healthcare community. Part of this mission is the GREAT Kitchens program, which "trains the trainers"--chefs and food service managers--in safe practices preparing gluten-free food alongside conventional items in restaurants, sports and entertainment venues and cafeterias. The NFCAs Web site lists more than 30 businesses in PA that have completed their course, as well as restaurants in locations as far-flung as the Bahamas and California. Locally, Iron Hill Brewery & Restaurant has taken gluten-free training to the next level in response to consumer demand.
The Pennsylvania-based regional chain, which currently operates eight locations in PA, Delaware and New Jersy, has recently developed a separate gluten-free menu, a process spearheaded by director of culinary training Dave Anderson.
"We had a lot of guests asking for gluten-free modifications to the menu," says Anderson. “It started to become a noticeable trend, so rather than shoot from the hip, we wanted to have a structured, proper way to handle it. 'There’s no bread in it' is not the right answer."
Anderson admitted that training kitchen staff to prevent cross-contamination was the biggest hurdle to instituting the GF menu in August. "If a cook puts a burger on a bun that’s not supposed to be on the plate, you can't just take it off the bun and serve it. Our menu has a GF button. When a gluten-free house salad comes up, the cooks know to question this, to think about it now. It modifies what needs to happen to that item so the process can become automatic."
Chains stand to benefit the most from such institutionalized training and menus, since their investment--in training and advertising--can reap profits from multiple outlets. Smaller restaurants are embracing celiac education as well, to better attract gluten-free guests, who are known to be appreciative and loyal to eateries that go out of their way to accommodate serious food allergies.
Michael Savett notes the potential gluten-free menus have for ensuring return business, "It's an absolute growth market from a business standpoint. As a family, if you have a choice between places who know what they are doing and those who are not even aware of gluten intolerance. I'm going to choose a GF menu for my son, rather than roll the dice and ask a lot of questions. I don’t want to spend time doing that when we go out to eat."
Savett maintains a page dedicated to listing gluten-free friendly restaurants in Southeastern PA, south Jersey and Delaware on his blog, noting restaurants who have completed NFCA’s GREAT Kitchens training or the Gluten-Free Restaurant Awareness Program (GFRAP), offered by the Gluten Intolerance Group of North America. The thirst for more information, including recipes for traditionally flour-based recipes like cookies, pie crust, pizza and bread, is evident in the comments on gluten-free blogs and newspaper articles. This is a vocal and interested population that is seeking restaurants who will take celiac disease seriously and serve up delicious food at the same time. Accommodations for food allergies, once scorned by "serious" chefs, are being made in the kitchens of well-known chefs (Jose Garces’ Amada and Tinto), intimate Parisian bistros (Bistrot La Minette) and casual, family-oriented brucheries (Café Estelle).
With one in 133 Americans suffering from celiac disease, investment in education and safe practices in commerical kitchens is on its way to becoming the norm rather than the exception. Food Network, are you listening?
Felicia D''mbrosio is co-editor of Philadelphia City Paper's new food and drink blog, Meal Ticket. She can be seen about town cycling through traffic at breakneck speed, holding forth at the finest, cheapest gin mills, and consuming as much raw fish as a small killer whale. Send feedback here.
Photos:
Chef Dave Peterson at Iron Hill's Media location
Michael Savett
Iron Hill's Char Grilled Angus NY Strip
Iron Hill's Cochon Mussels
All Photographs by Michael Persico