Which Country Appears to have more than its share of people with Celiac/Coeliac Disease?

If I were still working in restaurants and I had a difficult time with all this buzz about Gluten-Free customer needs, I would probably be even more miserable if I worked in one in Finland.

According to the "Food from Finland" Website:

"“Finland is like a tourist paradise for people with coeliac disease on a special diet,” suggests Antti Sierla, Finnish Ambassador to Brussels, in the latest issue of the Keliakia magazine. The Embassy in Brussels arranged an event in April where Finland was marketed as a model country in coping with coeliac disease."

"An exceptional number of coeliac patients in Finland."

"Finland’s extensive knowledge of coeliac disease stems in part from the country’s exceptionally high proportion of coeliac patients, around 1 per cent of the adult population. A study published in the Journal of Clinical Gastroenterology in 2007 measured the prevalence of coeliac disease at 0.45 per cent, which according to Keliakia is probably the world’s highest rate of diagnosed coeliac patients."

Tonight's Gluten-Free Menu Item Choice: Is It Celiac SAFE; or Is It Simply Gluten?

By William T. Beverly, Ph.D., L.C.S.W.

This is the question that a typical person with Gluten intolerance is possibly asking her/his self from the time they know which restaurant they are going to be eating in tonight, to the time that they leave that establishment.

When a place has a "Gluten-Free Menu" or items that they advertise as "Gluten-Free", a person with such a medical condition is still going to probably be a bit cautious. That is, until they know with whom they are dealing and just what they are getting.

With whom are you dealing?

Well, there are big chains that are beginning massive advertising campaigns claiming that they serve some "Gluten-Free items" and that is all well and good. At the same time, one can sometimes get a pretty scary feeling when entering such an establishment and asking a question about such an item, and the server is not at all versed on the terms "Gluten" or "Celiac".

I guess in cases where the item is fully automated and totally hands off from the time it leaves the corporate big house to the time it is served to you, then perhaps it can be assumed to be truly "gluten-free". But then who really wants to eat something that mechanized. I mean, even at the fastest, fast-food joints, the folks in the back at least bless your entree with a pickle or something prior to serving it.

And then there is the problem that one often encounters in massive chain operations where the consumer gets an item that is supposedly "Gluten-Free", yet the item is served with a brand of ketchup or mayo or dressing that is known to contain gluten. Then one nudges up to the counter-server to ask about this and is met with an "I don't know" or "If you cannot eat wheat, can you eat white bread instead?"

In fact I was at one of those "Have it your way" burger chains the other day and ordered a Double _____ "with everything except the bun"; and the counter guy, savvy as he was -- and polite -- whistled back, "One Double ______, Low Carb!" OK... so I didn't say a word. I was delighted that at least he was trying.... but does "Low Carb" necessarily mean "Gluten-Free"... I don't think soooooooooo.

Part II of With Whom are You Dealing?

OK, so then there are those wonderful mom-and-pop places that just seem to be perfect, and they are trying their best to serve their Gluten-Free-Needy customers a wonderful item and they do..... Except, they get a little touchy when one asks... nicely, "Hey, this steak is like.... mulllahhhh wonderful!!! But can you tell me.... is it marinated?" (yes)... "OK... and I love it tooo....... but how bout... , Does that marinate include any items that might contain gluten???"
Their first defense (and unfortunately it is often a defense -- which it does not need to be) is. "Well that's Jenny's Secret Recipe and I cannot divulge..." So you explain to the waiter about the Gluten-Free thingee, while at the same time, he is wondering why his establishment actually cares about such "food preferences" and he goes back to consult with the Chef... Jenny.... or Jenny's daughter or somebody close enough to know the secret.

Of course she gives him a list of the ingredients in the marinate because as the Chef, she is somewhat aware that the Gluten thing is in her face more and more every day now...
The Waiter returns to the table and says, "The ingredients are some herbs and spices, vinegar, mayo, beer (cannot tell you what kind), sugar, a (not-to-be-named) steak sauce, an anonymous fruit juice, and tomato paste." "Nope, nothing in there could contain Gluten.. so, you are home free". "

Now can you cut into your steak and tell me if it is done to your liking?"
At this point, it is kind of hard to tell the guy....... the waiter about how almost every ingredient he mentioned could contain gluten, depending on which brand they use etc... (e.g., Gluten can be in some brands of vinegar, mayo, beer, confectioners sugar, some steak sauces, some fruit juices, and in tomato paste).

I'm Backing Off Now...

So with tons of years in food service under my belt, I say with some firmness that in every establishment, there should be at least one person who cares about this "Gluten issue". Food service people are people too and they are typically underpaid, overworked and they have to deal constantly with social situations where they clothes smell more like their fryer grease than like the cologne that they splashed on this morning. This is a hard life. So some slack is warranted.

At the same time, as an over-educated person with years of Celiac Disease under my belt (literally un-der my-belt), I can say that this life too is difficult and unfair and some slack is definitely warranted.

So How can We Meet In the Middle?

I am not sure what the solution is going to be.

I am certain that there are two things that cannot be helpful:

1. I do not think that half-hearted "Gluten-Free" menu and advertising overhauls in corporate America are going to do anything but aggravate the situation UNLESS... and I said, "UNLESS!!!", those same corporate bosses are willing to also act consistently in terms of training ALL involved staff and also sincerely analyzing recipes and inventoried product brands to see that only "Gluten-Free" product makes its way to the consumer's table. This is an expensive undertaking and I would be surprised if even the majority of those touting "Our New Gluten-Free Menu" are taking it as seriously as all this.
2. and, at the same time: I am certain that nothing really gets solved when a person in need of a Gluten-Free meal gets visibly angry about what she/he is served and then takes out 100% of that anger on the extremely low-level staff-person who served it to them. Yes, I think ALL staff are or should be responsible in such cases, but if a person is a teenager making minimum wage and has not ever even been reasonably briefed on the "New Gluten-Free Items" thingee... then I think it is management who is in the wrong; not the line worker.

So this morning, I was going to write up a list of what kinds of dishes on restaurant menus that say they are "Gluten-Free" are likely to be safe, versus which ones are probably not. I could not write that yet because I think these types of problems -- as listed above -- are much grander and much more significant at this time.

Surely, I will put together a list of "probably" and "possibly not" Gluten-Free "safe" menu items soon. And I will publish it. But for now, I think the "Safe" thing to do would be for America's Corporate Bosses to wax sincerely about the "Gluten-Free" issue or NOT wax at all. And I think that those of us who sometimes have emotional rants in our empty dining enjoyment quests that sometimes lead to "Gluten-Free" starvation -- oh... and I have been there many times too.. -- should also think next time before we blast an unsuspecting cashier the local "Minute Burger Joint".

What do you think?

Read what others have said about this issue:

• Gluten-Free Dining Out: Is It Safe?
• Gluten-Free Restaurant Dining: Tips for Safe Gluten-Free Restaurant Meals
• How to Tell if a "Gluten-Free Menu" is Truly Gluten-Free
• Keeping Celiac Guests Safe: Gluten-Free Food Guidelines
• Safe and Unsafe Gluten-Free Food Lists

Can You Trust a Waiter/Waitress about Gluten-Free Issues?

Quoting a post about Gluten-Free dining (GF) from Rhonda on Celiac Forums.com back in 2006:

"Is there a salad dressing that will pretty much always be GF if you are going to a restaurant? See, I don't really trust the waiters because if they don't know what gluten is or mistake it for just not being able to have bread then they will of course tell you it's okay. But I'm just curious if there is one that's safe to choose at most places. Did that make sense? Click here to read the discussion.

This is probably a good question that contains some valid issues. If you are a waiter/waitress and you are conscientious and as a professional, have made yourself aware of the seriousness of Gluten-related issues and Celiac Disease as it relates to eating out, then please do not be offended.
On the other hand, if you are in that profession and you have yet to educate yourself about this, then Rhonda's concerns should ring true -- though they may be uncomfortable at this time.
If you would like to learn more about Celiac Disease and Gluten-Free living, there are many reliable resources. One can start with Gluten-Free Simplicity.com, in particular, here is an article about the necessity of avoiding Gluten at ALL times for people with this disease.
Either way, we are each responsible for the products that we deliver/serve to the public. Agreed?

Gluten-Free Hassles

"Why Would Anyone Go on A Gluten-Free Diet if She/He Did Not Have To?

Think about it.

There are some hassles involved are there not? High Prices, Aches, Pains, Social Awkwardness, more Headaches, Totally De-calibrated Nutrition Balance (i.e., Fats-to-Proteins-to-Carbs), Monotony, Moods, etc……….. "

Read the article. This link is to a previous article from December 23, 2008.

Consulting Services are Available

Consulting, training, Gluten-Free menu design, research, and authoring services are available.

For more information, please feel free to write to Dr. William Beverly, at nepeht@hotmail.com, or send U.S. mail to P.O. Box 1271 Edinburg, TX 78540.

Your queries will be answered in a timely manner.

Also, if you are interested in other related topics, please view the affiliated sites at:

Gluten-Free Simplicity.com

Gluten-Free Simplicity at Wordpress.com

Gluten-Free Simplicity IQ Building Site

Gluten-Free Simplicity for Food Service Professionals

Are all the Cleansing Chemicals Gluten-Free?

Are the Dishwasher Chemicals, Table cleansers, and Hand Soaps all "Gluten-Free"?

Are Possible Surface Cross-Contaminations Prevented?

Are the fryers, Grill spots, and cutting boards where "Gluten-Free" items are prepared totally free of Gluten? (Why: Grills and Cutting Boards can be cleaned, but a batch of fry grease that has been used to cook breaded vegetables has gluten in it and cannot be used to prepare "Gluten-Free" French fries.)

See these articles: "What is Gluten Cross-Contamination?" and "A Gluten Free Guide: Cross-Contamination".

Are all of the Ready-Mixes Gluten-Free?

Are all Ready-Mixes used for “Gluten-Free” items actually “Gluten-Free” (e.g. Hollandaise Mix, Salad Dressings, and Brown Sauce)?

Are the Bread-Substitute type Items Gluten-Free?

Is there Gluten in items like Corn Bread, Corn Bread Stuffing, Corn Meal Fry or Bake Coatings, Nacho Chips or Corn Tortillas?

Are the Cheeses, Cold Cuts and other Menu Items Offered really Gluten-Free?

Are the cheeses and Cold cuts offered on the "Gluten-Free" menu actually "Gluten-Free"? (Why: The original plan could have been to offer hot dogs that are "Gluten-Free", but the the manager decided to get the others instead because they are about 1/2 the cost and in his opinion they taste the same.)

Has Gluten been Ruled Out among the Non-Suspected Pre-Made Items?

Has Gluten been ruled out as an ingredient in certain non-suspected Pre-made items such as pop corn, pop corn seasoning, potato chips, mints, bacon bits, condiments, candies, cold salads, desserts, cheesecakes and pre-portioned extras like ketchup, mayonnaise, mustard, tarter sauce, cocktail sauce etc.? (Why: It could be that the Chef uses the prescribed "Gluten-Free" brand of ketchup in cooking, but the little packages of ketchup given to customers on to go orders are not"Gluten-Free".)

What about the possibility of Gluten with non-typical Items?

Are any of the items being used that are NOT prescribed among the Consultant or Corporate Brands possibly Gluten Coated (i.e., Rice, Frozen Foods and Marinated items etc.)?

Are All Possible Risks of Cross-Contamination in Check?

Is there possible Cross-Contamination of pre-shelled, pre-cut, pre-formed, pre-grated or milled items such as nuts, corn meal, canned fruits, cheese toppings, or prepped frozen potato items such as hash browns? If so, do any Staff members actually think it is acceptable to simply rinse off this item before serving in order to make it Gluten-Free?

Are the Brands of Prepared Cooking Seasonings Used in Gluten-Free Items actually Gluten-Free?

Are brands of prepared Cooking seasonings used on "Gluten-Free" items, actually "Gluten-Free" and MSG free? (i.e., Soy Sauce, Teriyaki Sauce, BBQ Sauce, Marination, Wine, Sherry, Alcohol, Juices, Stocks, Consumes, Sprinkled Taste Boosters and Seasoning Salts). (Why, It could be that the Chef likes to use a dash of his homemade meat tenderizer combination on ALL grilled and roasted entrees and this tiny dash has just enough Gluten to make it unsafe.)

Are Staff using Gluten-Free Brands of Prepared Items?

Are the brands of prepared sauces used in food preparation of "Gluten-Free" items known to be "Gluten-Free"? (i.e., Vinegar, Ketchup, Tomato Sauce, Jelly, Syrup, Yogurt, Sour Cream, and Peanut Butter etc.). (Why: Because even though the corporate recipe might call for a certain "Gluten-Free" brand of ketchup and mayonnaise used to make that Thousand Island Dressing, the Chef might have decided to use a different brand because it is less expensive -- and possibly Gluten-Contaminated.)

Are Prep and Line Staff using Prescribed Gluten-Free Products and Methods?

Are preparation and line staff using the prescribed "Gluten-Free" methods and ingredients for thickening Gluten-Free sauces, gravies, soups, puddings, ice creams, shakes, icings, and toppings etc? (Why: Perhaps the Chef has decided that flour-made Rouxs make richer cream soups than do those using Corn Starch.)

Have Staff been Trained to handle Gluten-Free needs Safely?

Have Staff been trained to leave Gluten-Contaminated off of plates upon request? Have they been trained to offer non-Gluten substitutes? (i.e., Can they leave off the toast and substitute it with grits; or how about some fresh fruit instead of pudding?)

Are Key Staff Aware of the Seriousness of the Effects of Gluten Exposure?

Are key Staff (i.e., Managers, Chefs, Bartenders, Waitrons and Buyers) aware of the possible adverse and long-term effects of Gluten-Exposure? (Why: Because staff who are aware of the seriousness of Gluten exposure may be more conscientious about serving Gluten-Free food.)

Can Key Staff Distinguish Gluten-Free from other Products?

Have key Staff (i.e., Managers, Chefs, Bartenders, Waitrons and Buyers) been oriented to the differences between Gluten-Free items and ingredients versus those with Gluten?

Dedicated to Using Gluten-Free Brands?

If you have a G-F menu, did the consultant or who ever designed it specify certain brand names for various items such as Vinegar, Rice, Pepperoni, Sauces etc. to use regardless of cost or convenience? Are Buyer & Chef aware of these requirements and either committed or required to use these brands? (Why: Because certain brands of various ingredients are Gluten-Free and Certain brands are not.)

How to Tell if a "Gluten-Free Menu" is Truly Gluten-Free By William T. Beverly, Ph.D.

First, it is important for me to acknowledge the efforts of Food Service People. For one, I am very grateful for their sincere attempts at constructively addressing the important consumer need -- "Gluten-Free".

As a person with Celiac Disease who spent many years (about 20) working in food service, prior to just as many years in higher education, I have closely examined "Gluten-Free" Menus whenever I have been afforded the opportunity. Following a brief period of wonder and gratitude, I could not help but start to notice the potential for misunderstandings that can lead to big problems.

By all means, please keep the "Gluten-Free" Menus. But at the same time, please consider these areas that may call for closer attention.

I can see for myself the various ways in which a food-service menu item advertised as "Gluten-Free" by well-meaning food-service planners and menu designers could be slightly altered by well-meaning restaurant staff to become Gluten-Contaminated.

Then I started thinking about how (given my experience) such maladies could fall between the cracks and become tragedies for both unsuspecting Celiac Disease or otherwise Gluten-Sensitive persons as well as for well-meaning restaurateurs.

I have constructed a list which if used wisely, can help both consumers and sincere food-service persons to rule out sources of potential Gluten Contamination in the best of "Gluten-Free Menu" -offering food-service establishments. Please feel free to print this list and offer a copy to the managers of your favorite dining establishments. And if anyone needs further clarification or could use some more focused help with this, I will be glad to accommodate. My contact information is at the bottom of the list.

In additional pages of this blog, I offer various things to consider and look out for when creating Gluten-Free menus.

For additional information, please feel free to browse my other related pages at G-F S.com, G-F S at Wordpress, and the G-F S IQ Building Site.

Gluten-Free Menu for Food Service Professionals

My mission here is to provide resources for food service professionals and consumers as we all move toward valid Gluten-Free Menus for those who need them.