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Gluten-free has its day, and restaurants respond

A gluten-free stand at Citi Field in New York.

Eating gluten-free was once the domain of people with actual allergies -- people with celiac disease, for whom a bit of gluten can spell all sorts of unpleasant problems. But today, going gluten-free is all the rage for a whole lot of us.

And restaurants are piling on board.

One of the very early adopters of a gluten-free menu is Fresh Brothers Pizza in Southern California.  It's been serving gluten-free pizza since 2008, the year Adam Goldberg started the business with his wife, Debbie. “It’s funny,” says Debbie, “when we first started offering the gluten-free menu, people were like, ‘what’s gluten’?”

(For those of you wondering the same thing, gluten is a protein found in wheat and other grains. So eating gluten-free means no flour or regular crust.)

A gluten-free pizza is an idea that strikes some pizza fans as a little off. “They just can’t comprehend the concept of a pizza without flour,” says Adam. But flourless pizza is, every day, a little less incomprehensible, even when it costs a few bucks more than regular pizza. “Since 2008,” says Adam, “we’ve seen gluten free sales literally grow on a weekly to monthly basis.” 

And more and more restaurants are catching on. Going gluten-free is going mainstream. Domino's has a gluten-free pizza. Dunkin Donuts is testing gluten-free baked goods.

“What we’ve seen from a trend perspective is that some Hollywood stars had decided to cut gluten or even wheat out of their diet and they’ve lost weight,” says Joy Dubost, the director of nutrition at the National Restaurant Association, “and it has sort of become a buzz as a way to lose weight.”

The gluten-free “diet” is hot. On the list of top restaurant trends, “gluten free items” is number one with the fast food industry. “People are equating gluten-free with being nutritious,” says Dubost, “and I’m a registered dietician and I do not advocate for a gluten-free diet unless you have a reason to be on that diet.”

But Dubost’s advice doesn’t seem to be stopping much of anyone. “In our latest data, which takes us up to the end of January, we have 30 percent of all adults saying they are trying to cut out or remove gluten from their diet,” says Harry Balzer, chief industry analyst at the consumer research firm NPD Group.

That’s one in three of us. 

Balzer stresses that doesn’t mean that all those people are actually eating gluten-free. But, he says, “their interest in this has been growing.”

All that flirting with gluten-free makes it attractive for restaurants.

But it can be a bit of a rub for people like Amy Phillips, who has celiac disease, and has to avoid gluten for medical reasons. “It’s mostly a blessing that it’s more popular,” says Phillips. More trendy means more choices.

But not everyone takes it quite as seriously as Fresh Brother Pizza does, where Amy is sharing a gluten-free pizza with her son. When she tells waiters at some other restaurants that she has to eat gluten free, she can sense skepticism, she says. “Sometimes you can tell they really think it’s something like a low-carb diet, that it’s kind of a trend.  And I have to stress that I’m very allergic.”

Domino's “gluten-free” free pizza for example -- is for the trend followers. Not Amy. The company makes clear that people with celiac disease NOT chow down. It is cashing in on the fad, rather than any allergy need.


Have you changed how you eat? If so, which lifestyle choice made/makes you feel your best? Vote in our poll here.

About the author

Adriene Hill is a senior multimedia reporter for the Marketplace sustainability desk, with a focus on consumer issues and the individual relationship to sustainability and the environment.
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Adriene needs to be better versed about GF foods. The mistake many make when first talking about GF foods is they say, for example, pizza without flour. You obviously didn't do your research. GF pizza and other GF foods DO have flour, they just don't use wheat flour. And for many this is not a fad. My husband was diagnosed with celiac disease and we decided to make everything in our house GF, it would be heathier for the two of us. I think there are many people undiagnosed but having digestion problems that are feeling better eating a GF diet. Please do not treat this lightly, it is a very serious 'switch' many have to make from eating all foods to only eating GF foods.

In The Healthy Villi Newsletter (summer 2012) there is an excellent explanation of the impact of "faddish" gluten free diets on people with celiac disease in the column TWENTYSOMETHING CELIAC. The article is called
"Amid the ‘Gluten-Free’ Fad, Our Stakes Are Higher." (http://lindagscomm.com/wp-content/uploads/newsletter-summer-12.pdf)
When Marketplace takes on a topic of this nature related to a serious health issue, you need to do real research on the topic and not skim the surface treating it like a "fluff" piece.

I suspect that registered dietitian, Joy Dubost, the director of nutrition at the National Restaurant Association, had a lot more to say on the topic than what was reported. As a registered dietitian/licensed nutritionist myself, I'm sure she would have made the distinction that people following a true gluten free diet do not avoid all flour, but rather those made from wheat, barley, rye, and some need to avoid oats, as well. There are many other types of flours that they can have including rice flour, corn flour, tapioca flour, amaranth flour. Often many gluten free flours will be combined together and to enhance the overall flavor and texture of GF baked products. To add some elasticity to the dough, xanthan or guar gum is often added to the mixture.

It would have been more important for Ms. Dubost to have been asked about the training that goes into teaching restaurant staff exactly how to ensure the safety of the food served under the label "gluten-free," and perhaps from a Marketplace point of view, the cost of training restaurant employees and the interesting dilemmas that arise when employees make a mistake and need to decide whether to fear for their performance reviews by admitting to the mistake or just ignore this "serious" mistake at serious risk to their customer. The cost of these mistakes may ultimately impact the restaurant employee, the customer, and /or the restaurant in the form of damaged reputation or the cost of vouchers for free meals should the customer dare to give the restaurant another chance.

In the future, Marketplace might want to explore the topics of new investment opportunities in gluten free products or issues of college food services reliably ensuring the availability of appetizing gluten free meals for their GF students required to eat on the meal plan and whether they are legally obligated to guarantee the safety of these meals for these students, especially given the high cost of college paid by students and their families .

It's sad that GF diets are seen as a mere celebrity-driven fad, because there is a very real problem underlying the sharp rise in GF adoption: allergy and intolerance to the wheat gluten itself. Our wheat is not the same wheat we ate as kids- it's been hybridized to a degree that has created proteins that our bodies cannot process. Since the wheat is a hybrid and not a "GMO", attention has not been paid to its effect on digestive and physical health. But studies have started, and people are starting to realize that this staple is no longer our friend. And in a wheat-wrapped, breaded, gravy-covered, pasta happy world, this is really bad news.

Since I gave up wheat and wheat gluten, I feel much better. No more bloaty belly, IBS, migraines, joint pains... and yes, the weight has stayed off. I am very adamant about keeping it out of my diet, and will closely question every restaurant I visit, and gently educate, if needed.

I'm so tired of hearing that human changes to wheat are the reason this happens.

While celiac disease has been around forever, only the most serious cases were identified prior to WWII--people who lost their villi when they were small children. It wasn't until WWII that people found out that wheat was the problem! During WWII, children with celiac disease "miraculously" improved during periods of wheat rationing and wheat unavailability. This led scientists to discover the link between wheat and gluten and celiac disease.

Adult/adolescent-onset celiac disease largely went unidentified until very recently and was rarely diagnosed except when a child with the early-onset form was born and the whole family improved after eliminating gluten for the house, or other members; eventually doctors learned to test family members when a child turned up celiac.

Because I was adopted, I went until my mid-adult years before being diagnosed and was diagnosed at my own insistence after learning about the disease. (I do have doctor-diagnosed celiac disease.) Until I found out that it was celiac disease, I didn't know what was wrong with me. Most people who are celiacs have no idea that they are celiac. About 1 in 133 people has celiac disease. Many more people have gluten sensitivity. Most people with non-celiac gluten sensitivity are related to celiacs. Dr Alessio Fasano's research has shown that there are specific genes associated with celiac disease and gluten sensitivity.

Anyhow, when celiac disease manifests later in life due to slow destruction of the villi over time, people don't know what is wrong with them. I didn't. People who have untreated celiac disease usually end up with unexplained fatigue, depression, chronic pain, weakness, skin rashes, and many other non-intestinal symptoms that are the result of the damaged intestine's inability to absorb nutrients. While "classical" celiacs who manifest it in early childhood are thin before going gluten-free, adult celiacs are often obese due to the fact that you can eat 3000 calories a day and still feel hungry with celiac disease, because your food doesn't do you much good.

Before we knew what celiac disease and gluten sensitivity actually were, all the people who are going gluten-free and getting better today were still sick. Many of them suffered from infertility or other autoimmune disorders that were reactions to the constant onslaught of dietary gluten and the inability to process nutrients. People who are now being diagnosed as celiac or gluten-sensitive were called "malingerers" or "sickly" or "neurasthenic" a generation ago, and often were blamed for their own problems or told that it was all in their heads. They still are. I lost a LOT of weight when I went gluten-free and have taken great delight in reminding my doctors that the weight they insisted was the CAUSE of many of my problems was actually a SYMPTOM of celiac disease. At the time I was diagnosed, I insisted they test me because the only other diagnosis left was fibromyalgia, which is not nearly so easy to treat...I was so relieved that it was celiac disease.

It's not the wheat. There are NO MORE celiacs and gluten-sensitive people than there were 50 years ago. The same number of people were gluten-sensitive; we just had no idea what was wrong with them. If they were lucky they had a single symptom bad enough that they were taken seriously (intestinal symptoms were often misdiagnosed as IBS or Crohn's disease); otherwise they were regarded as people with mysterious and possibly illusionary problems who just couldn't get it together and would be JUST FINE if they'd only lose weight, go vegetarian, take supplements, exercise more, sleep more, or just "get it together" and "try harder". Celiac disease and gluten sensitivity can cause joint pain, chronic muscle pain, intestinal problems of every kind, brain fog, depression, osteoporosis, infertility, rashes, sweats, migraines, and a load of other problems that doctors don't immediately associate with a food intolerance/allergy.

I'm sure high-gluten wheat helps more people get diagnosed because their symptoms are more obvious. Once your villi are gone it's very difficult to pinpoint the cause of your malaise because you ALWAYS feel rotten; however, if you eat something like seitan (fake meat made of wheat gluten) and you immediately get MUCH WORSE than usual (this happened to me while out with my vegan cousin) it can be a big cluebat to the head.

But the cause is genetic and these problems have always been with us; the rise in awareness and diagnosis is due to the fact that we actually now know what the cause IS, and people who would just have been regarded as sickly or psychosomatic (I got a LOT of that over the years) are now being identified as people with a real problem that can be fixed by removing gluten from their diets.

Appreciated the attention to gluten-free issues. A factual error in the piece about gluten-free pizza not containing "flour" needs to be addressed. Gluten-free pizza will contain flour, which is ground grain, but a grain which does not contain the offending protein contained in wheat, rye, barley and is often in oats, which don't contain gluten but are frequently cross-contaminated in the supply chain unless specially handled. This misinformation leads to often confusion at restaurants, who don't understand that flour is often short hand for bleached white wheat flour. I have had numerous conversations with servers that sound like, no, there is no wheat in that dish, we only use flour, the the follow up question, what exactly is the flour made from?

I always remember being a cook at a camp for 120 people. With such a position comes responsibility to cook some special meals for those who have certain restrictions. The one that I always remember was when I was asked to make sure the food for one of the campers could not have any food coloring in it. That had a lot of restrictions. Things such as pie filling I see, as lots of coloring is used there, but also cheese that is not white has food coloring. So we had to make special meals on the side for her and it was an interesting time learning how to please all people according to what is best for them.

This is a once-over-lightly story, an opinion piece posing as an investigative study. I suggest you hire someone who knows how to research a story. When it comes to gluten, practitioners of standard, or what some call allopathic medicine, and I call pharmaceutical medicine, are out of their element when talking about gluten, ciliac disease, or related food sensitivities. It has yet to pay their rent, and practitioners who understand ciliac disease tend not to get free golf vacations to Hawaii, Hilton Head, or the Caymans.

As a result of taking a pharmaceutical (simvastatin [Zocor]), I developed a number of symptoms, diagnosed as poymyalgia rheumatica, with an accompanying condition known as rhabdomyolysis - a breakdown of muscle cells. My "provider" and subsequent specialists were unable to treat the condition with anything other than prednisone, a steroid. They quickly gave up.

I went to a naturopath, who didn't diagnose, but read a number of tests, and among other things recommended that I give up gluten, dairy, soy, sugar, yeast and nightshades (tomatoes, potatoes, etc.). I'm not perfect at giving these things up, but the less of them I consume, the better I feel.

Marketplace, thankfully, is not my preferred source for health information. The best thing on radio in this regard is People's Pharmacy, also on public radio. In the future, I suggest that when you delve into health matters that you either find someone who knows what they are talking about, or someone who knows how to find someone who knows what they are talking about.

The end statement - that restaurants are cashing in on the fad rather than the allergy-need should be in bold, bright, 50 pt font. This is the story. For people with legitimate gluten-free (and other food allergy/intolerance issues) eating out is a tricky feat.

Oftentimes, restaurants aren't well versed in what it means to serve a gluten-free meal. If you cook my gluten-free pasta in the same pasta water as regular pasta, you're serving me glutened pasta and I will get sick. I may not need an Epi pen at the table, but I also won't ever be going back (and I will be sick for the next few weeks).

If you serve me a salad that I've asked not have croutons on it, I will have to send it back. Those croutons just made out with my lettuce leaves. I will get sick; I am not high maintenance.

Gluten-free isn't a weight-loss diet. For people with celiac disease, it often means it is the first time they can gain enough weight to be healthy. And the fact is, if you swap out a gluten-free scone for a regular scone it is a simple carb-for-carb switch. You're not actually making a healthy change, but you might be getting more fat and carbs in the gluten-free one because it takes different ingredients to make it "like" a regular one.

Whether you are gluten-free due to celiac disease or intolerance, or because you are doing it to support someone in your household who is gfree, or you've found significant health benefits from removing gluten, your need/choice to be gluten-free is valid. Restaurants have no right to undermine that because they want to make a dollar.

I hope you'll dig more into restaurants and gluten-free practices. Restaurants looking to cash in on the fad should consider that they're playing with the health of potential customers and that's dangerous.

If your celiac disease isn't identified until adulthood, you may very well get fat and then lose weight on a gluten-free diet. It happened to me and it happened to Shauna Ahern (Gluten-Free Girl). When your villi are badly damaged and you don't know what's causing it, you can get very hungry due to lack of nutrient absorption, and in your effort to get enough food to provide vitamins and minerals, you can get an awful lot of calories--an inexplicable weight loss often starts when the villi are completely gone, but in the intermediate stage getting fat is a real possibility and by the time you're diagnosed you may still be fat, even if you're losing weight.

I'm sorry, but I really think this is a poorly done piece. I got skeptical when the word "diet" was put in quotation marks, as if going gluten free isn't a diet at all but instead is a trendy Hollywood vanity project. And it just got worse every paragraph. There's been a growing body of research that spans the better part of a century on the cognitive and digestive effects that gluten has on at least a segment of the non-Celiac population. Dismissing it on the grounds of "it's just popular because some movie star vouches for it" seems pretty irresponsible. Even if it was your source, and not you personally, who made the claim, not following up on it strikes me as irresponsible. If you had, you'd have found that that explanation is at very best grossly incomplete, and at worse untrue.

Further, it looks like your one professional source for this piece is a nutritionist. That's fine, because when you're talking diet, you want to talk nutrition. Definitely. But it doesn't take much footwork to find that most of the reasons people go on/stick with/advocate for gluten free eating aren't strictly nutritional. They fall into the physiological, particularly for those who have trouble digesting gluten, find themselves addicted to it, or overeat when they consume it.

There's a wealth of information on this subject, and people willing to talk about it. That you either missed it, or didn't feel it was worth bringing up in the first place, is disappointing, and disheartening. I'd really recommend that if you want to wright about gluten-free eating, you do so more responsibly in the future.

-A disappointed reader

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