After all, a trip to the emergency room isn’t the best way to end a dining experience. For people with celiac disease, also known as celiac sprue, that’s a real possibility.
First diagnosed in World War II, people with celiac are allergic to gluten, a protein most commonly found in wheat, flour, barley and oats. In recent years, restaurants have started offering gluten-free menus for patrons. It’s a trend that first developed in the Northeast and West and is now beginning to trickle South.
Approximately 10 years ago, Outback Steakhouse and the Gluten Intolerance Group formed a partnership to identify gluten-free menu items so individuals with Celiac could dine out without worrying about a reaction.
“The Outback/Carrabba’s/Bonefish chain has been the leading edge in the South,” said Jeannie Tyler, who runs the Ocala/Marion Gluten Free Group, which meets the second Tuesday of every month at the Ocala Regional Medical Center. “People can go out and not have to worry about getting sick.”
Lynn Richey, a registered dietitian at the Marion County Health Department, hasn’t seen an increase in celiac patients, though there has been an increase in children with food allergies. She hasn’t had any restaurants asking for advice on gluten-free menus, but they do have a manual that has a dining out section.
“It’s important for people, especially children,” Richey said. “We do have a handful of kids come in with gluten problems.”
According to the National Restaurant Association’s annual survey of menu trends, gluten-free/food allergy conscious meals are one the the Top 10 menu trends for 2010, illustrating that consumer interest in health and nutrition continues to grow and that restaurants are responding.
A GIG survey showed prevalence of celiac in the United States has increased from 1-in- 133 in 2003 to 1-in-100 in 2009, a 12 percent increase in the number of people using a gluten-free diet. Overall, requests for gluten-free menu options in restaurants is on the rise and more and more restaurants are striving to meet that demand, not only for health reasons, but because attracting the expanding base of consumers who must adhere to a gluten-free diet is a smart business decision.
“Absolutely,” said Mary Schluckebier, executive director of the Celiac Sprue Association, “because it means more money. If you’re a restaurant right now you want all the customers you can get. If you have people who are gluten-free, you want that person to keep coming back to your restaurant. The only way you keep people coming back is if you serve their needs. It’s a niche where if they know they can get good food and it’s not going to be an experiment, then instead of going to a new restaurant they’re going to go back to the one they know is going to do a good job for them.”
Schluckebier said gluten-free is part a larger movement toward healthier diets.
“Customers all over the United States want to know more about what they’re eating,” Schluckebier said. “We’re just getting to be better consumers. Sometimes when the economy takes a downturn we want to know more about what we’re getting into. We’ve had e-coli, salmonella, quite a few things that make people want to know more about their food.”
Tyler said learning more about what’s in restaurant food starts in the kitchen.
“Usually a restaurant that cooks from scratch that has a chef, they’ll do anything for you,” said Tyler, who was diagnosed with celiac disease four years ago. “They know you can substitute corn starch for flour and things like that. They’re used to being clean because you don’t need cross-contamination.”
For restaurants with a gluten-free menu, Schluckebier said food preparation becomes even more important.
“Some kitchens have the space for a dedicated area,” Schluckebier said. “Others, if they’re going to make a sandwich with gluten-free bread they have to roll out a piece of brown paper, use clean knives and gloves. Education and practice are big keys.”
Outback says it has implemented procedures and guidelines that servers and kitchen staff follow in addition to designated prep space and equipment that is used for making gluten- free menu items.
Restaurants also must have a knowledgeable and trained wait staff.
“Some restaurants have one person on staff to handle special diet requirements,” Schluckebier said. “Restaurants are doing things that make their customers feel happy so they will return and bring their family and friends.”
Tyler said if she’s uncomfortable with the wait staff, she’ll ask to see the chef.
“When a waiter or waitress acts really dumb, I’ve asked to see the manager or cook and a lot of the time the chef will come out and talk to us,” Tyler said. “It’s best to call ahead or go by the restaurant and talk to them ahead of time and not just show up at rush time.”
Tony Li owns Tony’s Sushi Japanese Steakhouse. He offers a gluten-free menu and though it requires some extra work in the kitchen such as keeping utensils separate, he says it’s all “part of the deal.”
“I have a lot of customers who can’t eat wheat,” Li said. “I try to do a healthy menu. Yes, it’s good for business. People are always coming back.”
Marge Felix, manager/owner of Felix’s, offers not only a gluten-free menu, but is prepared to meet other dietary needs.
“We have it written on the menu for special dieting needs, whether it be diabetes, gluten-free, vegetarian, whatever it may be,” Felix said. “Everything is made from scratch so we can work with that.”
Felix said gluten-free menus are another way to increase the bottom line.
“It can be a business opportunity if people know they can come and dine here and get what they need,” Felix said.
Felix believes gluten-free menus are a growing trend.
“In Ocala, I’ve noticed it more on the menus,” Felix said. “You have to appeal to the masses.”
Schluckebier also sees gluten-free menus continuing to gain popularity.
“About 1 percent of the population has celiac disease,” Schluckebier said. “Only about 80 percent of that group know they have it. People in their 50s, 60s and 70s are seeing an increase in symptoms. We have special diets but we still want to do what everybody else does.
“It’s a growing trend.”
Celiac disease is a genetic disease with an environmental trigger. In people with CD, eating gluten, sets off an autoimmune response that causes damage to the small intestine. This, in turn, causes the small intestine to lose the ability to absorb the nutrients found in food, leading to malnutrition and a variety of other complications. Gluten, is found in wheat, barley, rye, and to a lesser extent, oats. Related proteins are found in triticale, spelt, kamut. Other conditions, including non-celiac gluten intolerance, dermatitis herpetiformis, and wheat allergies, can require a gluten-free diet.
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