Gluten-free foods gaining popularity [Highlands Today, Sebring, Fla.]

Aug. 19--SEBRING -- Until about 20 years ago, if one heard the word gluten one might have pictured a covered can to keep some glue in.

While it's not glue, it is a protein found in certain grains that helps hold together baked goods and pastas.

Gluten-free products were once unheard of, but Mintel, a market research company, reported sales of gluten-free items exceeded $6 billion in 2011.

In fact, since 2009, sales of gluten-free products grew by 27 percent, Mintel stated in a news release.

At the heart of the gluten-free popularity is celiac (SEE-lee-ak) disease and wheat-intolerance or allergy.

Celiac disease is a digestive condition triggered by consumption of gluten, which is primarily found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye, according to the Mayo Clinic.

People with wheat allergy who don't necessarily have celiac disease may also benefit from a gluten-free diet, although such an allergy can be caused by other proteins found in wheat.

Greg Cleveland, who works at Food For Thought, a health food store at 301 U.S. 27 N. in Sebring, said Thursday that he's noticed an increase in the sale of gluten-free products.

"It's definitely picking up steam based on the fact we've got people each day asking about it," he said. "I'd say it's becoming more popular with a good portion of the clientele."

There are lists of gluten-free restaurants available online. Many list broiled meat and fish dishes, steamed vegetables and crouton-free salads on their gluten-free menus.

Here in Highlands County, various gluten-free items are available at local restaurants.

Olive Garden offers gluten-free pasta and several other dishes.

Red Lobster's website suggests, "When dining at Red Lobster, please make your server aware of your allergies. Our expert crew members and managers can provide you our allergen menu that will help you select a dish that meets your individual needs and answer any questions you may have.

"Since all of our dishes are prepared-to-order at Red Lobster, our normal kitchen operations may involve shared cooking and preparation areas. Therefore, we cannot guarantee that any menu item can be completely free of allergens."

Zeno's makes gluten-free dishes, some from scratch -- such as gluten-free pizza, gluten-free bread crumbs for frying on chicken parmesan, garlic rolls, bread and desserts, including brownies, plus it serves gluten-free pasta, owner Basil Makris said Wednesday.

"The whole thing with the gluten-free items is we like to have customers preorder," he said, so he's in at 9 a.m. Tuesday through Saturday preparing for the day.

The issue is with the rice flour Makris uses; the yeast needs to proof for two hours, and then his gluten-free pizza needs to be par-baked before the toppings go on and it is reheated. "Otherwise it falls apart in the oven," he said.

So advance notice is important in order to make enough dough to bake enough pies. In the busy season, unless people call ahead, the restaurant tends to sell out, Makris said.

"We average about 10 a week in the summer and 20 to 30 during the season," he said.

Zeno's offers gluten-free pizzas in three sizes: personal, 12-inch and 16-inch. The price is $1 more than the regular item for gluten-free, whether it's a pizza, an order of garlic rolls, pasta dishes or chicken parmesan.

"We're trying to accommodate as much as we can with their diet," Makris said. "For chicken and pastas they need to call in the morning and we'll have it ready for dinner. We don't bread our stuff and freeze it."

He said since the gluten-free rice flour used in pizza dough needs some zing, he adds tasty herbs, seasonings and oil that won't affect a celiac's diet.

Most who come in for his gluten-free pizzas are vegetarians. He even offers them a vegan cheese.

Some people are eating gluten-free food as part of what they consider a healthier diet, Makris said.

Many are Seventh-day Adventists from the hospital, he said.

"A lady came in last year who hadn't had pizza since she was diagnosed with celiac disease," he said. "She was so happy to have pizza again. ... I enjoy pleasing people, and it's been fun for me."

He and his cooks have to exercise caution to make sure the products are not contaminated with regular flour.

"We wash our hands after we make a regular pizza before we start a gluten-free, and we wipe down the counter," he said.

Food For Thought co-owner Barbara Snapp said Thursday that many people with celiac disease, including her son Tripp, have been misdiagnosed for years.

Unfortunately, he was only properly diagnosed after he had his gallbladder removed, and it was the wheat, barley and rye in his diet that was making him sick, she said.

Not everyone who is eating gluten-free is a true celiac, she said.

"You have to be tested for that," she said. "You can have chronic sinus infections and it's the wheat. You can be everything from wheat-intolerant to a celiac."

Tripp must follow a special diet and carefully read the labels. He got sick just from drinking a sports drink that contained modified food starch, his mother said. "That's gluten," Snapp said. Why it was put in a sports drink, she couldn't fathom. "Cornstarch is OK," she said.

"When he comes over we only use gluten-free products, and I make everybody eat it," she said. "I'm not going to boil spaghetti for everybody else and make his separate; although on Thanksgiving I'll make him gluten-free pie, gluten-free dressing, everything else, because he's got to eat."

There is just about anything one could want these days in gluten-free form, Snapp said.

"There's cereal, bread, crackers, chips; there's condiments, candy, candy bars, protein bars, makeup, vitamins," she said. "People who are gluten-sensitive have to be completely gluten-free.

"Gluten is a cheap filler, so they put it in everything: canned foods, soups, you name it," she said. She said gluten was only in a popular sports drink "to bulk it up."

Gluten can cause mild stomach irritation all the way up to anaphylactic shock, Snapp said."We had one girl who gave her dog a new dog food; that dog licked her face and she's in the hospital due to that gluten transfer," she said. "You can be wheat intolerant all the way to horrible. So now the really drastic people, severe people won't eat anything that doesn't say gluten-free on it."

That's why gluten-free makeup is available.

"They even make empty gluten-free (gel) capsules," said Paul Travers, who works in the store.

The other issue people with severe allergies must be aware of is cross-contamination. Everything must be separate when preparing foods: pans, surfaces, utensils, Snapp said.

Wheat intolerance masks itself as other things; that's why without a test it takes a true celiac years to figure out what's wrong, she said.

While Snapp thought getting the blood test for celiac disease was all right, she thought it was crazy to go to the next step -- a biopsy of the small intestine -- if you tested positive.

"I think if you go on a gluten-free diet for two or three weeks, you'll know if you're wheat-intolerant or not," she said. "It will change your life."

Five years ago, if you were diagnosed as having to live gluten-free you'd have lived a miserable existence, she said. "Now there are plenty of things you can eat," she said.

Despite the increase in popularity and product development of gluten-free items, celiac disease and gluten intolerance could be widely undiagnosed, Mintel's research revealed.

"The prevailing problem is that many Americans simply may not realize they are gluten intolerant, sensitive, or they may be ignoring signs and symptoms," said David Browne, senior analyst at Mintel.

"While food companies may be overdoing it unnecessarily with gluten-free label claims that are appearing on everything from tomato sauce to scallops, the message is getting out ..., both for foods eaten at home and at restaurants."

Although celiac disease can affect anyone, it tends to be more common in people who have type-1 diabetes, autoimmune thyroid disease, Down syndrome or microscopic colitis, the Mayo Clinic stated.

"People with celiac disease who eat foods containing gluten experience an immune reaction in their small intestines, causing damage to the inner surface of the small intestine and an inability to absorb certain nutrients," Mayo Clinic staff stated.

"Celiac disease can cause abdominal pain and diarrhea. Eventually, the decreased absorption of nutrients that occurs with celiac disease can cause vitamin deficiencies that deprive your brain, peripheral nervous system, bones, liver and other organs of vital nourishment. No treatment can cure celiac disease. However, you can effectively manage celiac disease by changing your diet."

The Mayo Clinic estimated that about 1 percent of U.S. adults have celiac disease -- which would be close to 2 million Americans -- and that it is about four times as common as it was 50 years ago.

There are no typical signs and symptoms of celiac disease. Most people with the disease have general complaints, such as intermittent diarrhea, abdominal pain or bloating, the Mayo Clinic stated.

"Sometimes people with celiac disease may have no gastrointestinal symptoms at all," it said. "Celiac disease symptoms can also mimic those of other conditions, such as irritable bowel syndrome, gastric ulcers, Crohn's disease, parasite infections and anemia."

There are tests for celiac disease.

Ask to have a blood test done that measures blood levels of gluten-related antibodies, said Melissa Diane Smith, author of "Going Against the Grain" and a nutritionist specializing in therapeutic gluten-free diets.

"If those indicators come back positive, a doctor typically recommends an intestinal biopsy to confirm a diagnosis of celiac disease," she said.

"A small percentage of gastroenterologists now use capsule endoscopy, also known as pill-cam or EndoCapsule. This is a newer procedure in which the patient swallows a camera that is the size and shape of a pill to take pictures inside the small intestine that the doctor can analyze."

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