They seem like such small numbers — one in 133 Americans — but that translates to up to 2.5 million people in the United States who have celiac disease, and one percent of the Western world, according to the Celiac Disease Foundation. An estimated 30 percent of those remain undiagnosed.
Celiac is an autoimmune disease. People who have it have to avoid certain grains that are omnipresent in the American diet: notably, wheat, but also barley, rye, spelt, and for two percent of those suffering from celiac, even oats.
Those particular grains contain gluten, according to …
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They seem like such small numbers — one in 133 Americans — but that translates to up to 2.5 million people in the United States who have celiac disease, and one percent of the Western world, according to the Celiac Disease Foundation. An estimated 30 percent of those remain undiagnosed.
Celiac is an autoimmune disease. People who have it have to avoid certain grains that are omnipresent in the American diet: notably, wheat, but also barley, rye, spelt, and for two percent of those suffering from celiac, even oats.
Those particular grains contain gluten, according to expert Dr. Zachary Reichenbach, director of the Translational Research Program in Gastroenterology and assistant professor of medicine at Temple University.
“Gluten is a protein, and part of that gluten, specifically something called gliadin, can generate an immune or inflammatory response in the small intestine,” Dr. Reichenbach explained. “That response can cause a localized inflammation, which damages the small intestine and leads to the symptoms of celiac disease.”
Celiac impedes absorption of nutrients and triggers symptoms such as abdominal bloating, pain, diarrhea, and weight loss, he says. It can also lead to other symptoms, including iron deficiency, anemia, abnormal liver tests, weak bones, and even symptoms you may not anticipate, such as neuropsychiatric changes and infertility. Even worse, the Celiac Disease Foundation notes on its website, celiac patients are at higher risk for multiple gastrointestinal cancers if they do not adhere to a gluten-free diet.
A blood test for certain antibodies can help pinpoint a celiac diagnosis, but it is confirmed by an endoscopy. In other words, a tube with a camera is channeled through your esophagus — under anesthesia, of course — and down into your small intestine to check for damage and to snip a small tissue sample.
There is no pill or shot for celiac. However, symptoms can be alleviated and damage reversed by modifying one’s diet and avoiding foods made with those grains.
Still, giving up gluten doesn’t mean giving up good eating.
Savory and safe
A growing number of eateries, including many in the Chestnut Hill area, are adapting to the needs of those with celiac and others who are gluten sensitive, and the results are often incredibly tasty.
Of course, it’s difficult in one story to list all the restaurants, pubs, bakeries, and other food establishments in our area that have made efforts to cater to those who have celiac or who are gluten-sensitive. But some efforts are notable.
If you are craving something savory, your local options are abundant.
One of the best examples?
The gluten-free pizza at Cosimo’s, 8624 Germantown Ave., Chestnut Hill.
Many pizza shops selling gluten-free pizza use a hard crust that comes out of a box. It’s like eating melted cheese and sauce on a Ritz Cracker. Not so at Cosimo’s, says Francesco Mandarano, son of owner Vincenzo Mandarano.
“The product we get is a higher-end gluten-free dough, topped with high-quality sauce and cheese,” Mandarano said. The result is as close as you can get to a regular pizza in gluten-free. The crust, unlike the Ritz Cracker variety, is floppy and foldable. Just like a regular pizza.
They also bake their gluten-free pie on a sheet of aluminum foil to avoid cross contamination with their other pizzas, a thoughtful touch.
Cosimo’s has been serving gluten-free pies for about 10 years, Mandarano said. “Once celiac became more of an issue, people started asking for gluten-free,” he explained. “We looked around and found the best product for the dough and we found this one made with rice flour. It’s really good.”
Cosimo’s also serves gluten-free penne, and any of their sauces can be made gluten-free.
Head to Germantown and you’ll find a gluten-free paradise at Salam Café, 5532 Greene Street, where the air is infused with the scent of berbere, an Ethiopian spice mix of red chili pepper, cumin, cardamom, cayenne, ginger, and garlic. There, owner Hayat Ali promises a tasty Ethiopian dining experience for celiac sufferers or those with gluten sensitivity. (And even you don’t have gluten issues.)
“Ethiopian food,” Ali quipped, “you can smell it from a distance.”
Most of the entrees, from the spicy chicken to the chicken kabob to the baked lamb, are gluten-free, as are all of the side dishes. Even the bread, called injera, is gluten-free because it is made with teff, a gluten-free grain. Many dishes are also vegetarian and dairy free, and everything is nut-free. All the meat is halal.
According to Ali, who employs recipes she learned from her mother, most Ethiopian food is naturally gluten-free and vegetarian.
“People come in here because they know the food is not highly processed,” she said, “and they love the vegetarian and gluten-free options. They come because of the flavor.”
If you’re craving chicken wings — a dish sometimes breaded or coated and therefore off-limits to those avoiding wheat flour — look no further than Tavern on the Hill, 8636 Germantown Ave., Chestnut Hill. Their gluten-free wings come in medium, mild, hot, and buffalo. They’re some of the tastiest wings outside the city from which the dish gets its name. They might even be better than Buffalo’s.
Chef Gerard Strenger uses an elaborate three-step process to produce his wings, including his own special marinade, according to Kathlyn Egan, restaurant co-owner with husband John. The result is messy fingers, and multiple napkin deliciousness.
The ribs, Egan said, are also gluten-free. “They melt in your mouth, and they are served with a delicious apple coleslaw,” Egan said. And most any of the sandwiches or burgers can be made gluten-free, she adds. Tavern on the Hill stocks gluten-free rolls.
More savory options
For those who crave sweet treats but have to avoid wheat-based cookies, cakes and the like, the options are also many.
All the sweets you can eat
Turns out you can have your cake and eat it, too. Ask Amy Edelman, owner of the beloved Chestnut Hill bakery The Night Kitchen, 7725 Germantown Ave. Those who have sampled the flourless chocolate cake — rich, dense, fudgy and decadent — swear by it. And that includes the loyal many who don’t have issues with gluten.
Eggs, butter, sugar, and high-quality chocolate. That’s all that goes into a Night Kitchen flourless chocolate cake, Edelman said, but the results are magical.
“We started having a lot of requests for flourless items about 15 years ago,” she said. “So, it took a long time to develop recipes, and we have a few items now because we do get requests for flourless items almost daily.”
In addition to the flourless chocolate cake, Night Kitchen offers gluten-free coconut and almond macaroons, and a mouthwatering clementine almond cake on a seasonal basis.
More sweet treats
