When Cynthia Kupper was diagnosed with celiac disease, a condition marked by intolerance to gluten, she didn't go out to eat for six months. Staying healthy meant a change in diet — eliminating wheat, rye, barley and oats and all related products.
She knew that would be a tall order for most restaurants.
Eventually Kupper, 50, a Seattle resident, mustered the courage to head to a local restaurant, even though she had to ask a long list of questions before ordering to make sure that she wouldn't get sick from any of the ingredients.
"They brought me a five-gallon tub to read the label on the salad dressing," she said. "People were looking at me, and I swore I'd never eat out again. They were trying to be helpful, but it was so embarrassing."
Twelve years later, awareness of celiac disease is on the rise, and so is the number of restaurants willing to cater to people with the condition and other special dietary needs.
Pushed by the work of advocacy groups and the spread of information about food allergies and related issues, Kupper's restaurant options nationwide now include entire chains like Outback Steakhouse and PF Chang's China Bistro, which offer gluten-free menus, as well as an array of restaurants in the Seattle area. Some even provide separate food preparation areas; one Seattle restaurant markets itself as completely gluten free.
The past five years have seen a spike in gluten awareness. In 2002, several studies addressed celiac disease, which can be set off by an environmental trigger at any point in a person's life. Long thought to be rare, studies found it to be fairly common and often under-diagnosed.
Roughly one in every 133 Americans, or about 3 million people, are affected, according to the 2003 Archives of Internal Medicine. Congress passed a bill last August calling on the Food and Drug Administration to regulate which foods may be labeled "gluten free" by 2008.
Restaurants have been getting the message.
"More and more restaurants are calling us, saying, 'How do we do this, what do I have to do?'" said Kupper, executive director of the Gluten Intolerance Group of North America, an organization with a membership of more than 5,000. "Restaurant managers are paying attention."
Part of it is just good business practice, says Mary Schluckebier, a former wheat farmer and executive director of Celiac Sprue Association in Omaha, Neb. "Restaurateurs who've been creative about serving their customers find this a new frontier and really enjoy serving their people with special diets," she said. "It's all good business, and it shows that you care."
Years ago, in her small Nebraska town, Schluckebier was the only customer with celiac disease at the local restaurant. "They used to have a fry baby with oil in it just for me," she recounts. When she ordered fries, the cook microwaved a potato, chopped it up, and made it into french fries because the other fryer had traces of wheat flour in it.
For Peter Zakakis, owner of Peters' Gourmet Diner in New York, it just looked like a niche that had to be filled. Zakakis, who has been in the restaurant business for 30 years, started researching the disease as a favor to a longtime loyal customer.
"He thought he was allergic to garlic, and he'd drive me nuts calling me to say, 'Peter, did you put garlic in the chicken soup?' and I'd say, 'No, Harold, there's no garlic in the chicken soup.'" Then he found out he had celiac disease. Unlike food allergies that trigger immediate reactions, the disorder is marked by delayed reactions and potential long-term damage to the small intestine.
"He can open up the menu now and have anything he wants, including pancakes and breaded things," said Zakakis, who opened the diner five months ago with a separate area and separate fryers for preparing gluten-free foods. Zakakis also uses rice flour instead of regular flour in all his sauces and gravies, and serves up everything from gluten-free pasta to sandwiches on gluten-free bread. "Ninety-five percent of my menu can be gluten free," he said.
Restaurants like Zakakis' train their waiters and chefs to make sure they know the rules. But when Mike Lodico, from Buffalo, N.Y., goes to restaurants for the first time, he's always sure to bring them his gluten-free cooking tips sheet. It lists safe and unsafe foods and also lists specific ways cooks can make sure they're not cross-contaminating the food.
"When you have celiac disease, one of the most difficult things is not the food they're preparing but what they're preparing it with," he said. "Are they going to use a clean ladle, a clean spatula?"
Not all restaurants are hopping on the bandwagon. Mary Wikle, 45, of Tualatin, Ore., had been sick most of her life until she was diagnosed four and a half years ago with celiac disease. She had to give up eating at some restaurants, like the restaurant that refused to show her the ingredient list unless she brought in a note from her doctor.
She and her family, including a daughter who also has the disease, have been known to drive three hours to Seattle just to eat at Kalli's Kitchen, a wholly gluten-free restaurant, where "we know we can eat whatever we want and not have to worry about it."
Web sites like www.glutenfreerestaurants.org and others list restaurants that promise gluten-free options. The Web site, created by the Westchester Celiac Sprue Support Group, expanded the site beyond New York in 2003. The group works with volunteers like Danielle Smith, 29, of New York, who goes out and tells restaurant managers and owners how to provide gluten-free appetizers, entrees and desserts.
Recently, food offerings have expanded to include special soy sauce, breading, pasta and even gluten-free beer, which otherwise diners with celiac disease would never dare ingest.
"They're carrying a lot of specialty products," Smith said, "not just preparing a gluten-free meal, but they go above and beyond what's necessary for us to dine in their restaurants."
By KAREN SCHWARTZ, Columbia News Service
May 18, 2005