Going gluten-free not without costs
Arturo Chilelli offers gluten-free ravioli and pizza at his Calabria Pizza and Italian Grill in Absecon. The items cost 20 percent more than their counterparts with gluten.

ABSECON - What kind of Italian restaurateur advertises chewy pasta and pre-made, frozen pizza crust?

An accommodating one, it seems.

Yellow signs advertise gluten-free pizza and ravioli on the front doors of Calabria Pizza Italian Grill in Absecon. After learning a customer could not eat wheat, owner Arturo Chilelli expanded the menu at the end of the summer.

"People who ... are allergic to gluten, sometimes they don't go out to eat or they're limited when they go out," he said. "By offering gluten-free products, you're giving people more options."

The rice flour swapped for the typical wheat stuff does not alter the flavor of the sauce and cheese-laden food at Calabria. It does, however, create a chewier texture.

Local restaurants have started to add gluten-free food to their menus in response to learning about clients or co-workers with celiac disease or other disorders marked by intolerance for gluten, a mixture of proteins found in products that contain wheat, barley or rye.

It seems like a smart move. People living with gluten intolerance often suffer health problems through several misdiagnoses before figuring out they have to stop eating the ubiquitous proteins. Experts estimate the 3 million people who know they have celiac disease represent one third of the actual affected population. As awareness spreads and more are diagnosed, the market for gluten-free products grows. Gluten-free is expected to become a $2.6 billion industry by 2012, according to the National Foundation for Celiac Awareness.

The special food is more expensive: Rice flour, for example, is at least triple the price of wheat flour.

People whose medical conditions prevent them from eating gluten can claim tax-exemption from the added expense for groceries as long as the added costs combined with all other medical expenses exceed 7.5 percent of their income, they document it properly and eat that way under doctors orders, according to Martin H. Abo, a Voorhees-based accountant.

"In order to claim a deduction for this special, medically required food, you would need to carefully document the increased expenses," Abo wrote in an email. "I suspect most restaurants would ordinarily not provide their patrons with such information. If they can reasonably provide you with such incremental costs, you'd have a pretty good shot."

Chilelli marks up those items by 20 percent, about half the increase at another Calabria's restaurant - no relation - in Livingston, Essex County.

Those operations are small compared to Harrah's Casino in Atlantic City, where guests pay nothing additional for staff to whip up the gluten-free versions of their favorite dishes at four of seven restaurants or from the buffet and room service menus, according executive chef James Harris.

Harris started to roll out the program there two years ago and gets about 50 requests per month for gluten-free preparation.

Buffet items are marked; the steakhouse menu naturally lends itself to a wheatless diet, and chefs at the casino's Italian restaurant simply swap pastas.

At a 24-hour cafe there, guests seeking gluten-free fare must alert staff, who will get the chef to talk about options with the guest. Same goes for room service.

"You can make almost anything gluten free, but you have to know how to prepare it," Harris said. "You can make barbecue chicken wings gluten free as long as you have a dedicated fryer for it."

Harris does not have any food allergies, but learned about the limitations that accompany celiac disease when he noticed a co-worker at his former job in St. Louis could not eat the meals prepared for staff at the restaurant. The 41-year-old met more people affected by the disease since moving to New Jersey four years ago.

"This affects one in 23 Americans," he said. "The disease manifests itself in heart burn, diarrhea and migraines, so it's often misdiagnosed by doctors, but once someone goes gluten-free, ... it basically changes their life. In two weeks, symptoms start disappearing."

Harris trained through a program created by Nancy Sherry Baker, who runs The Celiac Site. She created the Web site to spread information about and awareness of the disease and living gluten-free. Baker learned she suffers from celiac disease after years of poor health and misdiagnoses.

About a year ago, Baker partnered with the Delaware-based National Foundation for Celiac Awareness.

Since then, about 25 restaurants, predominantly in the tri-state area, have paid $150 for the digital Gluten-Free Resource Education Awareness Training program.

Chilelli did not go through a formal training program. But he did his homework and keeps a letter behind the front counter that shows the cheese he uses is gluten-free. He also stashes a spare nutrition label from the packages for ravioli and pizza shells, which Vineland-based Conte's Pasta Co. manufactures.

Chilelli and his staff make most other menu items from scratch. He said he has no plans to start stocking the rice flour needed for gluten-free versions of the homemade stuff.

"If it becomes big, then yes," he said. "It's a possibility, I really don't know, that's why I started with this. My feeling is, in a few years, this is going to take off like whole wheat."

But unlike the fat-free, sugar-free, caffeine-free and whole wheat foods already embraced en masse, gluten-free fare requires extra care during preparation.

Rice-flour pastas and ravioli get a clean pot with fresh water separate from the regular stuff; pizzas and anything else entering the oven are baked in a separate chamber with fresh, clean racks.

About a dozen people have taken advantage of Calabria's extended menu.

"I make sure people get what they ask for," he said.

Contact Emily Previti:


Gluten-free diets

What: Cut out gluten, a mixture of proteins contained in foods that contain rye, wheat or barley such as bread, pasta, cookies and pizza.

Who: People with celiac disease and dermatitis herpetiformis, or DH, and other conditions characterized by gluten intolerance. It's also reportedly helped people lose weight and manage autism.

Why: Gluten triggers an allergic reaction that can damage the surface of the small intestine and the ability to absorb nutrients in people who suffer from celiac disease. Ultimately, they might suffer malnutrition and vitamin deficiencies that stunt growth in children and adversely affect brain, nervous system, skeletal and organ damage.

The substance prompts an immune system response in people with DH, which is a chronic, hereditary condition associated with celiac disease and manifests itself in watery, itchy blisters on the skin, particularly near pressure points like elbows, knees and scalp. While people with DH also are gluten intolerant, the protein does not wreak as much havoc on their digestive systems as it does those with celiac disease, although DH patients' symptoms disappear more slowly after cutting gluten out of their diet and might require reducing or eliminating iodine as well.

DH is associated with thyroid disease, type 1 diabetes, Addison's disease, scleroderma, lupus and other skin conditions.

FYI: FDA has proposed guidelines regarding gluten content in foods that purport to be free of gluten, but has not yet adopted them, nor are they enforced.

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