Free to be gluten-free

There was a fun little piece on boston.com last week on the diet fad that is gluten free which, as rages go, is to this decade (the 20-teens?) what the Atkins Diet was the the 1970’s and 1980’s.

Books such as “Wheat Belly” and “Grain Brain” would make you think that gluten is the monstrous enemy of a healthy and successful life.Elisabeth Hasselbeck decided to jump on the gluten-free train too, and while she claims a gluten-free diet helped alleviate her gluten sensitivity symptoms, in the book Hasselbeck puts a gluten-free diet on a pedestal as the key to losing weight, increasing energy, and “alleviating the conditions of autism.” (Source: boston.com)

Well, right there, even if I were the type to jump on the gluten-free bandwagon, the thought of Elisabeth Hasselbeck raising her baton would give me pause.

But I’m not the type.

Having experienced the celiac life at one remove, I have to wonder who would voluntarily give up good-tasting bread and good-tasting pasta.

Yet I have at least two friends – intelligent, sensible, people to be trusted – who claim that they feel better when off gluten. (I suspect that they may suffer from gluten sensitivity, which is not as severe as celiac disease. So they probably do really feel better when they’re not wolfing down tortellini and grilled-cheese on rye.)

But gluten-free is not a miracle cure. It’s not (necessary) for everybody. And a doctor at MGH who directs the Center for Celiac Research can’t for the life of him understand why anyone who doesn’t need to would voluntarily forego the joys of gluten.

I’m with Dr. Alessio Fasano, who tells this story:

…He tried to live gluten-free for Lent. Especially as a European who loves pasta, he found it discouraging, annoying, and ultimately couldn’t understand why anyone would choose to live gluten-free if they didn’t have celiac disease or a gluten sensitivity.

He said the diet was simply expensive and inconvenient. “I would not call it a healthier diet, or something you should be on to lose weight,” said Dr. Fasano. “Because if you consume the alternate food options, they can often be higher in fats.”

My personal involvement with gluten-free began when my husband, at some point in his medical odyssey, was diagnosed with celiac disease, with the diagnosis confirmed through a biopsy. Although Jim had never suffered the symptoms that many do – he never had intense pain when ingesting anything containing gluten – it did explain why he had trouble absorbing iron. And it may have contributed to the development of the esophageal cancer that eventually killed him.

So celiac disease/gluten sensitivity is serious stuff, and those who automatically scoff at those on a gluten-free diet as faddists are mistaken if they think the whole thing is a farce.

Occasionally going gluten-free is not a colossal drag or burden.

Jim and I sought out restaurants that had gluten-free options, and we often ordered both our meals gluten-free, as we always liked to switch plates. There are plenty of wonderful things to eat that don’t contain gluten, including wonderfully starchy fare like risotto and potato gnocchi.

But there were some things that Jim really enjoyed that he had to live without, including hacked chicken from Shun Lee Palace in New York, which, sadly, used soy-sauce that contained something wheat-ish.

However, Jim was never a big bread and pasta junky, so he didn’t have as much trouble adapting to a gluten-free life as I would have.

Still, he did like sandwiches, and gluten-free bread was both expensive and pretty awful. We tried every brand available, before settling on Udi, which Jim found to be okay when toasted, but which – weirdly – always developed big holes in it after a few days, which made putting sandwich ingredients on it a drag.

While the Udi bread was nasty, their cookies and muffins were very tasty. Jim wasn’t a big sweet-eater, but he did like an occasional dessert-ish thing, especially when he was on a high-calorie diet. 

As for other gluten-free foods. Jim found a pretzel (Glutino brand) that was pretty good. (I still have the last bag sitting in the kitchen.) But the pastas were all pretty much ghastly. And even at the restaurants that specialized in gluten-free, we never found a pizza that was anything other than nasty-tasting. Nor did Jim ever find a tasty gluten-free beer.

One thing we did find out along the way is that Italy – of all places – is an excellent country for those with celiac disease.

Sure, you might think that the land of pasta and pizza would be no country for old men with celiac, but our gluten-free trip to Rome was a breeze.

It turns out that a lot of Italians have celiac disease. Pharmacies all sell gluten-free foods, and in every restaurant we went into, we found the staff aware of celiac disease, and ordering gluten-free was no problem. I had printed out some information sheets on “senza glutine”, but we never really needed them.

(The awareness level and responsiveness in Italy was far greater than you’d find in the U.S., that’s for sure, even though it has gotten better of late. We never got to find out, but rumor has it that France is terrible for those with celiac disease.)

Anyway, there is now a:

… billion-dollar industry that’s benefiting off of this trend. Analysts from the market research company NPD Group said in the The New York Times article “A Big Bet On Gluten-Free” that approximately 30 percent of consumers say they would like to cut back on the gluten in their diets. Another research company Mintel projected that this industry will reach more than $15 billion in sales annually by 2016.

While gluten-free is not for everybody:

“We really have a problem when we call this medical treatment a fad diet,” said Dr. Fasano. “The estimated prevalence of people who need to be on a gluten-free diet is 10 percent, but this industry and books like “Grain Brain” would rather estimate it’s at 100 percent.”

Jim was one of the 10-percenters, and he followed the diet very carefully. Until he neared the end.

On the day we found out that Jim wasn’t going to make it, we were (needless to say) pretty all-round sad. While the news wasn’t surprising, it was disheartening. Especially after all Jim had endured, we had been hoping that the pay-off would be something other than an early death.

We walked home from MGH, and Jim decided that, what the hell, at this point it didn’t seem to matter all that much whether he was absorbing the right amount of iron. Having a bit of gluten in his diet wasn’t going to kill him.

One of the things Jim had missed was having a beer. Another thing was having a hot dog. (For some reason, GF hot dog buns were even worse than the bread.)

So we went to the Cheers bar and the condemned man ate a hearty meal of a hot dog and a beer.

Bliss!

The look on his face confirmed to me that nobody in his right mind would deliberately go off gluten unless they absolutely had to.