Before Lisa Skelton opened the Wallflower Modern Diner three years ago, she frequently had lunch with a colleague who had celiac disease. It was difficult for them to dine out because her friend could not eat anything that contained gluten, a protein found in wheat, rye, and barley. This ruled out menu items like hamburgers, sandwiches, and pasta, as well as anything thickened with flour. Even soy sauce—which contains wheat—was taboo. “She ate a lot of salads,” Skelton remembers.
From her years working as a server at a variety of Vancouver chain and hotel restaurants, Skelton knew that people with dietary restrictions were often unpopular customers. “Chefs and servers would scoff at allergies,” she tells the Georgia Straight by phone. “There was a lot of insensitivity on what a pain-in-the-butt customer this was.” Moreover, she says, staff had no idea which items contained gluten and which were gluten-free.
When Skelton opened the Wallflower at 2420 Main Street, she offered an array of gluten-free options, which eventually evolved into a separate gluten-free menu. Hospitality drove her efforts to ensure that everyone from meat eaters to vegans to celiacs felt welcome. But she also acknowledges that “it was a bit of a business move.” She saw the challenge her friend faced trying to dine gluten-free and recognized that “it was an underserved market at the time.”
Today, though, as Skelton puts it, “the tables have really turned.” Many Vancouver restaurants now proudly tout gluten-free options. During the recent Dine Out Vancouver promotion, 77 out of the 230 participating restaurants offered gluten-free menus. In the past year, dedicated gluten-free stores and bakeries have popped up around the city, and it seems that every day a new product hits the supermarket shelf.
Last month, Vancouver’s first Gluten Free Expo was held at the Croatian Cultural Centre, offering gluten-free product samples and information. Organizer Margaret Dron told the Straight that she had expected a thousand people to trickle in during the course of the five-hour fair. Instead, 200 people crowded the hall in the first 20 minutes. By the end of that rainy Sunday, more than 3,000 people had passed through.
Dron thought the majority of those visitors would be those diagnosed with celiac disease, the autoimmune disorder for which the only treatment is a strict gluten-free diet for life. But she was surprised by the demand from nonceliacs. In a postfair survey, she learned that two-thirds of attendees weren’t celiac; they simply wanted to learn about avoiding gluten.
“I think that’s where we’re seeing a large shift,” Dron tells the Georgia Straight in a phone interview. “Most people didn’t even know what celiac was until two years ago. The only time you knew it was if you had it.” Now, awareness of gluten intolerances has gone mainstream. “Now when I say ‘gluten-free’, every single person says ‘Oh, my cousin’ or ‘Oh, my coworker’ or ‘Oh, there’s this girl in my building who has that.’ ”
Whole Foods Market regional grocery buyer Joe Kennedy confirms the interest in gluten-free products in Vancouver. “There’s been a huge increase in demand. Over the last five years it’s been steadily ramping up,” he says on the line from his Kitsilano office. “In the last year, 18 months, we’ve seen a lot more folks coming into the store and asking what we carry and lots more questions.” As well, producers have gotten more innovative. “There are a lot better products out there than five or six years ago.”
Restaurants, too, are paying gluten-free diets more respect. For example, Michael Knowlson, executive chef of the Donnelly Group, told the Straight that his pubs and restaurants used to stock generic gluten-free hamburger buns to offer customers “just in case”. But when he and chef Robert Belcham overhauled the group’s menus last November, they replaced these with locally made Panne Rizo rice buns and added a brown-rice-pasta spaghetti bolognaise to the menu as a regular item. “People were coming in and asking for it,” Knowlson says.
Clearly, many Vancouverites are eager to eat gluten-free. The question is, why?
“Part of it is a fad, definitely,” Arlene Kennedy says, chatting with the Straight in her cheery Mount Pleasant bakery. “Wheat is the new evil food.”
Kennedy’s candour might surprise some, given that her business depends on those who shun wheat. But she’s not targeting trendsetters. She opened mygoodness! gluten and wheat free kitchen last May to provide more palatable options to celiacs, who she estimates make up 70 percent of her customers. But in the past six months in her bakery, she’s seen a surge in people without a diagnosis, people vowing to cut wheat out of their diet.
She attributes part of this to the publicity surrounding the bestseller Wheat Belly: Lose the Wheat, Lose the Weight, and Find Your Path Back to Health, published last September. In it, American author and cardiologist William Davis argues that eliminating wheat from your diet can help all kinds of ailments, including diabetes, asthma, rheumatoid arthritis, irritable bowel syndrome, and mood swings. He posits that modern hybridization and cross-breeding of wheat have created a product that differs vastly from the wheat our ancestors ate, and it’s detrimental to our health. Cut it out and you’ll not only lose weight, he claims, but feel better.
But according to Kennedy, there is more driving the gluten-free trend than this book. There’s a growing general awareness of wheat sensitivities, and “doctors are becoming more aware of the fact that there is a thing called celiac disease.”
Kennedy’s adult daughter was diagnosed six years ago, and, as for many with celiac disease, her diagnosis was a long time coming. “The doctor kept on insisting it was everything else but [celiac disease],” she recalls. At first, she was told she had an ulcer, then irritable bowel syndrome, then “it was all in her head.”
The Canadian Celiac Association estimates that the disease affects one in 133 Canadians. It’s a genetic condition in which one has a permanent intolerance to gluten, which damages the absorptive surface of the small intestine so the body can’t absorb nutrients. It can appear at any point in the life of a person with a hereditary predisposition, and its initial appearance is triggered by factors such as stress, pregnancy, surgery, or an infection.
Symptoms vary widely by individual. They include abdominal pain, bloating, gas, diarrhea, weight loss, migraine, depression, and extreme fatigue. Because symptoms resemble those of other conditions—such as irritable bowel syndrome, lactose intolerance, and chronic fatigue syndrome—celiacs are often misdiagnosed. They are at greater risk for problems like osteoporosis, other autoimmune conditions, and some cancers.
Those who suspect celiac disease can be diagnosed with a blood test, followed by a biopsy to confirm damage to the intestines. However, many people never get that blood test, so they don’t know they carry the disease. Or they simply cut out gluten without a medical confirmation.
“A lot of people are self-diagnosing,” says Lorraine Didrikson, president of the Vancouver chapter of the Canadian Celiac Association. That’s what she concluded from staffing the association’s booth at January’s Gluten Free Expo. “People are just going on a gluten-free diet by choice because they know they feel better.” However, she urges people to be properly tested before cutting out gluten so they can accurately determine if they have celiac disease.
In a phone interview with the Straight, Didrikson relates how she was tested in 2003 after her three-year-old granddaughter was diagnosed as a celiac. “I’ve always had joint pains, but as you get older, they [the doctors] said, ‘Well, it’s arthritis.’ ”
Now 64 years old, she had been living for years with low iron, “brain fog”, and a hyperthyroid condition. Doctors attributed some of the symptoms to premenopause, others to overtraining.
Once diagnosed, she immediately cut out gluten. “Ten days later, I was feeling better,” she recalls. “It was like a light-bulb moment. I could go up and down the stairs better.” She no longer has joint pain and her energy has increased.
Since then, two additional granddaughters have tested positive for celiac disease, as well as her daughter and her 87-year-old mother, who was diagnosed four years ago. All have cut out gluten, as has her husband, who she says just feels better eating that way.
Meghan Moug, a 25-year-old Langara College student, went through two years of suffering before she got her celiac diagnosis last summer. Sitting down with the Straight on a study break, she recalls how she broke out in a persistent, itchy rash after a particularly stressful year. “There would be nights when my eyes were swollen shut,” she recalls. She also developed bad asthma and bloating. The unsightly rash, which doctors diagnosed as eczema, was affecting her social life and job as a restaurant server.
While waiting to see a dermatologist, she stretched her student budget to visit a naturopath. On the naturopath’s advice, she cut out wheat, dairy, and a host of other edibles. Her rash improved but didn’t clear up. “I was still cheating without even knowing I was cheating,” she explains. (Moug had yet to learn that gluten hides in myriad products, from burger patties to beer.) When she finally saw the specialist, he dismissed the naturopath’s advice out of hand. Instead, he treated her rash topically with betamethasone and with oral steroids.
Then one day when she was serving at the restaurant, a celiac diner asked that her gluten-free needs be relayed to the kitchen. Moug mentioned that she, too, had problems with wheat but said that she wasn’t celiac. The customer, Barbara Geroux, happened to be a volunteer with the Canadian Celiac Association and recognized Moug’s rash as dermatitis herpetiformis—celiac disease of the skin. She urged Moug to ask her doctor for a blood test.
Moug did and was diagnosed as a celiac. Immediately, she got serious about cutting out every speck of gluten. Her rash cleared up within weeks, the bloating stopped, and she is now virtually symptom-free. “She completely saved my life. I was on so much medication,” she remembers. “To have this relief and alternative, it changed my life.”
Moug tells the Straight that her mother was treated aggressively with pharmaceuticals her whole life for severe bloating, asthma, and eczema. She died of heart failure at the age of 52. Moug now believes that she was an undiagnosed celiac.
It’s estimated that celiac disease affects just one-half of a percent to one percent of the Canadian population. That’s according to Dr. Hugh Freeman, a gastroenterologist researching celiac disease at UBC.
In a phone interview with the Straight, Freeman says that a Mayo Clinic study comparing recent U.S. blood samples to those from the 1940s may indicate that the incidence of celiac disease has increased. Although there’s no reliable data in Canada, “the clinical impression is that it’s going up,” perhaps due to increased awareness and easier testing.
Then there are people who may be allergic to wheat or have an undefined sensitivity or “intolerance” for which there is no clear diagnosis.
“All the gastroenterologists in town see people who say, ‘I have a problem with gluten.’ Some of those people will have blood-testing done or a biopsy done to see if they have any evidence of celiac disease. Invariably, it’s negative. So they don’t have celiac disease but…they’re reporting a problem with gluten.”
Last March, the Wall Street Journal reported a study in the journal BMC Medicine that confirmed the existence of gluten sensitivity, which had until then been difficult to prove. “It shows gluten can set off a distinct reaction in the intestines and the immune system, even in people who don’t have celiac disease,” the article states. According to the article, six percent of the U.S. population is thought to have gluten sensitivity, and less than one percent of children have a wheat allergy, which most outgrow by age five.
According to UBC’s Freeman, there is no research showing that more people are becoming intolerant to gluten. He says marketing may be partially driving the trend toward gluten-free eating.
He advises those who suspect they might have gluten intolerances to ask their doctor for a celiac blood test—but before they start a gluten-free diet, because going off gluten first makes a correct diagnosis difficult.
After that, “If there’s something in your diet that seems to bother you, it’s reasonable to take it out,” he says. “The only problem is that a lot of people who start with gluten intolerance end up complaining of intolerances to a lot of other foods. They end up unnecessarily restricting their diet to a broader range of food, and that could potentially become a problem.”
Both student Moug and Didrikson have noticed a ripple effect of friends and family members eliminating gluten since they were diagnosed. “I have friends who aren’t celiac who just feel better cutting out wheat,” Moug says. “I think people are noticing their friends are doing something and it’s helping their health, so they’re saying ‘I’m going to do that as well.’ ”
Moug notes that she feels better partly because avoiding gluten means eating fewer processed and fast foods. “I eat out way less. I have to cook my own food,” she says. “Of course that’s going to improve my overall health.”
Dron, who organized the Gluten Free Expo, is a mortgage broker with a marketing background. She started eating gluten-free after a friend was diagnosed with celiac disease a year ago. After doing some reading (including Wheat Belly), she went on a two-week gluten-free trial. That left her with more energy, a better mood, and less bloating. She’s been eating “99 percent gluten-free” ever since.
“I realized that it is a healthier way for me to live. There’s no reason for me to consume wheat,” she explains. In her opinion, gluten-free eating isn’t a diet fad. “I think for a long time people knew, ‘Well, if I eat pasta, I’m going to be tired, but it’s good and it’s worth it.’ But now people are starting to understand, ‘Oh, every time I eat something with wheat, I feel that way and this is why.’ And they think, ‘Why do that to yourself if there’s an easy substitute?’
“Demand drives supply,” she notes. “More restaurants, more bakeries, more manufacturers are starting to not just provide these alternatives but really market these alternatives….As these things become more available and people start to see them, they’re also educating themselves more. It’s kind of like this really beautiful cycle.”
Over at the Wallflower, Skelton says that her restaurant is still attracting a loyal celiac clientele that appreciates that she takes their needs seriously. But she’s also seeing many people who aren’t on strict diets ordering gluten-free options. They say that “it doesn’t make them feel as heavy, or they like the taste of it better, or they’re trying to lessen the amount of gluten in their diet,” she reports. “More people with median-level health issues are seeking out different diets to see if they can fix themselves and feel healthier.”
And more people are happy to cater to them.
Follow Carolyn Ali on Twitter at twitter.com/carolynali