by Anita Cheung
Who doesn’t enjoy eating their favourite pizza covered in cheese and accompanied by a full-bodied red such as an Argentinian Malbec, French Bordeaux, Spanish Ribera del Duero or something a little earthier like a New Zealand Pinot Noir? Fair enough, it may be a hot day and your preference is a Sauvignon Blanc bursting with citrus fruits or a chilled Pinot Noir rosé that is the perfect balance between summer fruits and dried apricots. But I am getting distracted… back to the subject of pizza! Whether it is a shared meal or enjoyed alone, pizza is one of the most popular foods in the world as it lends itself to shared moments with friends whilst watching a film or a game, a quick snack when time is limited or a light meal when accompanied by a favourite salad and bottle of wine. Go to an Italian restaurant and the majority of dishes offered are pasta and pizza. Walk along the street looking for a snack and 90% of what can be found will either be made out of pastry or bread. Sandwiches, baguettes, bagels, burritos, kebabs, pastries, cakes and desserts predominantly contain an ingredient known as gluten. Whilst this will not affect those who do not suffer from any form of gluten-intolerance, those who have a gluten-intolerance or are coeliacs will be familiar with the situation of walking and walking and searching and searching for a light bite that does not contain gluten.
For those who do suffer from any form of gluten intolerance or who are coeliacs, the subject of gluten is not a mystery. However, for those who neither suffer from an intolerance nor have family members or friends who suffer from either an intolerance or an allergy, perhaps the whole subject of eating gluten or being gluten-free is an anomaly. So what do the words 'gluten-intolerance’ and ‘coeliac disease’ actually mean?
Firstly, it is important to understand what gluten is. The word gluten refers to a group of seed storage proteins found in wheat (such as durum, spelt, bary, rye, oats and common wheat amongst others) and grain proteins and accounts for 75-85% of the total protein in the wheat found in bread. It is a common staple in many countries as a result of the facility of growing grains and the multiplicity of edible delights (bread, pizza, pasta, pastries, cakes, biscuits, pies, tarts etc) that can be produced from these grains. There are 40 countries in the world which currently produce more than 2 million metric tonnes of wheat per year. Given that wheat is a common staple product in many cultures and countries, the numbers of those who are gluten-free, have a gluten-intolerance or coeliac disease, has been on the rise for the last few decades
So gluten-intolerance or coeliac disease? What is the difference? On the extreme end of the scale and affecting around 1-2% of the population are the coeliacs. For this unfortunate group, the digestion of gluten results in an inflammatory reaction in the small intestine and may include shortening of the villi which lines the small intestine. Nutrients are not absorbed so easily and this often leads to anaemia. Other symptoms include gastrointestinal complaints, pale, loose and greasy stools, weight loss or an inability to gain weight, abdominal pain, cramping, bloating as well as abdominal distension. In extreme cases where not diagnosed or treated (by a gluten-free diet), the symptoms can lead to lymphoma of the small bowel and cancer. Being a coeliac is often genetic and hereditary.
Gluten-intolerance refers to a group of people who suffer from more or less the same symptoms as a coeliac with the exception that gluten does not damage the small intestine. Often those who are gluten intolerant present with symptoms similar to Irritable Bowel Syndrome and their condition is often diagnosed as the more common IBT, should they choose to consult their doctor. However, many people discover - through trial and error - that gluten is the culprit for their discomfort and of their own free will, choose to pursue a gluten-free diet.
Within my family, I have one aunt, two cousins (plus one husband), my sister and myself who are all gluten-intolerant. Only one of the six family members has been to the doctor for a diagnosis and the rest of us have all discovered - through trial and error - that life is a lot simpler when there is no gluten (or reduced gluten) in our diets. I started having gluten-intolerance symptoms around ten years ago and by this time, my aunt and sister had already been confirmed gluten-intolerant. I had a fair idea what was coming my way and so I decided to reduce the gluten intake in my diet to once a day instead of three times per day in the hope that I could avoid being completely intolerant. To date, my plan has worked fairly well and I can enjoy a small amount of gluten without suffering too much. However, there are occasions when I am presented with something that I want to eat, but shouldn’t, such as a shared piece of cake with friends or bread in a restaurant and there are also moments when I simply lose track of how much gluten I have had in the day. On those days, my body is very good at reminding me that I have passed my limit! Those moments serve to remind me that the limits must be respected and that there are consequences for non-compliance!
On the whole, a lot of gluten can be easily avoided by purchasing gluten-free pasta or preparing meals with rice instead of pasta. Gluten-free bread is readily available as are gluten-free crackers. It’s not too difficult to make changes to one’s diet at home and nowadays it is possible to buy cookbooks specifically created for a gluten-free diet. The range of recipes and quality of options has been increasing over the last 10 - 20 years and now it is very difficult to tell apart an item containing gluten and one that does not. I have had a gluten-free brownie that I am happy to say, tasted no different to a normal brownie! Although it requires some thought and adjustment, achieving a gluten-free diet at home is relatively straight-forward. Many products do not contain gluten such as fruit and vegetables, meat, fish, eggs, rice, yoghurt and other dairy products. Standard flour can be replaced with either corn four or rice flour, gluten-free pasta options can be chosen and there is generally a supply of gluten-free biscuits for those who have a sweet tooth. Lovejoy´s Bloody Mary Mix is an excellent example of a gluten-free option and more and more producers are not only aware of the various health benefits, but also ensuring that customers are aware that their products are gluten-free. Many products will boast this on their labels, but perhaps the area of temptation that is the most difficult to redress is the area of snacks and quick options. Think about it. Crisps, burritos, pizzas and tortitas all contain gluten unless they are corn-based or rice-based. In order to find out, all packets must be examined thoroughly in the junk food aisle which really makes one feel like a food nerd trying to discover if a popular packet of crisps contains gluten or not. However, this examination will take place happily by the coeliacs and the gluten intolerant and is a necessity!
The biggest challenge, however, lies in finding gluten-free options whilst out and about with friends. If one is alone, it doesn’t matter if it takes another twenty minutes to find a place that offers gluten-free options, but if one is with a group of friends, then it is almost impossible to guide the group to a gluten-free restaurant. What usually happens is that the group ends up in a fairly standard restaurant where the gluten-free friend peruses the menu for anything at all that does not contain gluten. There are usually one or two options plus salads, but the quality of the gluten-free food will differ according to the restaurant and whether the establishment has any interest in catering for those with various diet restrictions.
So what if you aren’t gluten intolerant, but are considering a gluten-free diet for various health benefits? Are there any health benefits to avoiding gluten? I know many people who would not identify themselves as being gluten-intolerant and yet who have chosen to eliminate gluten from their diets. In their words, they define their new diet as leaving them less bloated and with less stomach discomfort after eating. Surely less of both of those symptoms is a good thing, but the true benefits are part of a personal journey and someone else’s experience may or may not mirror your own. It is to be tried, for without personal experience being gluten-free will just remain an anomaly, a confusing concoction of words used at certain restaurants with no specific point of reference.
Today’s temperature is currently 26°C, four degrees less than yesterday, but it is still warm enough for me to turn my thoughts to views of the Mediterranean and a shared gluten-free Quattro Stagiones pizza (traditional Italian ‘Four Seasons’ pizza). This will obviously be accompanied by a chilled Rosé d’Anjou (Anjou is my favourite French rosé-producing region), which is the colour of dried apricots and perfectly balanced on the palate and topped off with a couple of hours with a good friend. Being gluten-free does not mean missing out on the good things in life, but like the best things in life, we need to sometimes change our habits, know where to find them and to make time for them. ¡Buen provecho!