I didn’t expect to be suffering for lack of food in Italy. I visited in the past, before I decided to listen to my doctors and my body and cut out wheat and gluten entirely. I was diagnosed with celiac over a decade ago, but stubbornly ignored it for years, hoping that the diagnosis was a mistake, or perhaps an intolerance instead of an allergy. I avoided gluten when it suited, casually indulging in pizza or sandwiches while I was working in NY. Though I was often sick after eating as a child, I didn’t want to believe it had to do with wheat. That would require a full overhaul of my eating world, and while I discovered the joy and variety of spices around the time of my diagnosis I still loved dumplings too much.
Eventually I got sick enough that I smartened up, getting to a point where almost everything – gluten or otherwise – made me ill. But first I went to Italy and I willfully, stupidly, ignored the pain in my stomach. I ate pasta, but I also ate prosciutto and melon, pillowy soft burrata cheese, illicitly delicious in its raw milk wonder. There were paninis but also piles of roasted pork and salumi, packed with flavour and texture. And thus when planning my return to Italy this year, I expected to be drooling with envy over the pizzas and wheat-laden dishes – but I also knew that there would be plenty to choose from in Umbria, even for a celiac.
However, while I anticipated some memorable meals, I did not realize how thoroughly Italy accommodated those with celiac disease. Not only was there a wide variety of pizzas, pastas and breads on offer that were entirely gluten-free, but everyone knew what it meant to have celiac. From the tiniest of Umbrian towns to the family-owned farms, the minute I would smile nervously and say “sono celiaca” people would nod and say “ah! Senza glutine!” and find me something else to eat.
I was flabbergasted.
In England and in North America, people are generally attuned to food allergies and in most bigger towns, gluten-free options exist. It is undeniably much more popular to be gluten-free these days. Not all of those who advocate the diet are diagnosed celiac; some follow stricter paleo diets, others simply feel healthier without gluten. I’m not knocking it either way – the trendiness of cutting out gluten has meant that I have much more to choose from when I grocery shop. However the public knowledge of ceiliac disease – what it is and what it does for those whose bodies reject wheat – is a lot lower than I realized. This is obviously the case in many less-developed countries where food diets and allergies take the back seat to deeply entrenched culinary traditions. But even in returning to visit my parents in Quebec, I’ve found many are not aware of the disease, or they think it’s only bread not also barley and rye. When I do eat out, I find myself apologizing profusely to my waiter or waitress for asking after ingredients; I’m one of those people, the ones I used to make fun of when I was waiting tables years ago.
Imagine my astonishment: at every single turn in Italy, everyone knew what celiac was. Moreover, they were cheerful about it. “Ah yes! One of those! No problem, here’s what we’ll give you instead.” I was anxious leading up to my time in Umbria, worried that I’d be annoying to travel with on the post-conference press trips or forced to send back a meal once it arrived. Not so. For example, the talented chef (aka the family’s nonna) at I Mandorli had prepared a series of simple but exquisite dishes – mountain lentil soup, fresh ricotta and egg plates, salumi, grilled vegetables and more, piled high. Many were gluten-free, in part because it was a meal of staples and disparate pieces, but in part because they were advised I was in the group. They took me by the hand and showed me exactly what was safe on the table.
For dessert, she made her own impromptu gluten-free dish – a thin egg crepe filled with spiced rice (cinnamon, ground nuts, a little bit of sweet wine), folded in half and topped with strawberries. Delicious and incredibly accommodating. She noted that she wanted to make something easy from scratch instead of substituting flours, and it turned out great. It was also the size of my head, and I ferried it around the room, feeding tastes to the rest of the group.
This wasn’t the first or last of the specially-prepared meals from my short Umbrian visit. The conference venue had a staggering variety of gluten-free options regardless of meal. The waitstaff would spot me, pop a gluten-free loaf of bread into the oven and in 10 minutes, I’d have a huge plate of food. Of course, a little more starch than I was used to:
And my hosts for the Feast of St. George made sure that I wasn’t given a porchetta sandwich, but instead allocated a big plate of freshly cut pork and a thick handful of complimentary fava beans to gnaw on. When the rest of the table had their sandwiches in hand, Teresa from Lungarotti pushed me to the front of the queue, telling the carvers that I had celiac. In the middle of teeny Torgiano, wise nods – ah, no problem. “More pork for you, if you don’t have bread!”
The gluten-free options extended even to the airport on my flight out of Florence. They too had frozen pastas available in lieu of the more traditional wheat-filled fare. (Never mind that it tasted terrible – it was a coup that the meal was an option; we can’t have everything.)
So why is Italy so celiac-friendly?
Upon my return from Italy, I waxed poetic about how much I could eat. The first reaction from every single person was precisely the same: that Italy was accommodating the tourists.
I disagreed; it was obvious that the dietary changes were not rooted in tourism. Too many tinier towns had deep knowledge of the disease, and had been exposed to it sufficiently that they made adjustments in what they offered.
I decided to reach out to Rebecca from Umbria on the Blog to ask her if my suspicions were correct. She directed me to Letizia Mattiacci, who – among other posts – blogs about her own struggles to avoid wheat. Letizia responded quickly :
I recall seeing a Dutch study time ago stating that modern wheat varieties have higher toxic gluten content than traditional varieties. Then there’s the problem of overexposure. Wheat and modified starch are everywhere, so Italians are certainly more exposure than others as we are big pasta and bread eaters. According to the Italian celiac association, about 1% of Italians are celiac. As a consequence, is not surprising that you find lots of gluten free options in Italy. In Perugia we even have a gluten free restaurant and we’ll have a Gluten-Free Festival at the beginning of June.
And as Rebecca noted in a blog post of her own, the exposure goes much deeper than that. Children are routinely screened for celiac disease, and celiacs even get a state subsidy to compensate them for the higher cost of gluten-free foods. Furthermore, Maria Ann Roglier, the author of The Gluten-Free Guide to Italy, notes that Italian law requires that gluten-free food be available in schools, hospitals, and public places. (And that you can study for a masters in celiac disease, from diagnosis to management thereof.)
Well, that explains the Florence airport.
But one thing still nagged: the country didn’t just know about celiac disease, they accepted it. They embraced that this was an issue and moved around it to accommodate their meals, and did so with gusto. I asked Letizia and she gave a thoughtful response: that Italians are very conscious of the connection between health and food. In her opinion, that is why food cooked at home is lighter and more balanced than the restaurant fare. And that is also why they don’t think it unreasonable to eliminate a certain food if it makes them ill. In fact, she noted, “they probably do this easier than renouncing a cigarette (sigh).”
Add to this that alternative flours are trendy as well, products like spelt and kamut (which contain gluten), but also rice, buckwheat and soy. In addition, chickpea and chestnut flours have been part of Italian cuisine for centuries. In the nineteenth century, an Italian agronomist noted about Tuscany that “the fruit of the chestnut tree is practically the sole subsistence of our highlanders” (Targioni-Tozzetti, pub. 1802, Volume 3: 154). And in the twentieth century, Adam Maurizio, who wrote a seminal book on the history of edible vegetables in 1932 (called L’histoire de l’alimentation végétale depuis la préhistoire jusqu’à nos jours, for those inclined) discussed chestnut trees as being available not just for the fruit of the tree, but also for making into bread when grinding that fruit into flour.
Unlike in North America, where these new flours are trendy but not firmly braided into our history, Italians have been using ground corn, chestnuts and chickpeas as substitutes for hundreds of years.
When I was first diagnosed with celiac, I went to my best friend’s place in Montreal for dinner. Her family is Italian and were used to me eating their pasta without issue. I mentioned to them that I’d be unable to eat any wheat, or rye or barely and her father, completely serious with a slow shake of his head, said “Jodi, this is a fate worse than death.”
It’s no surprise, then, that I expected Italy to react the same way. But instead, it was the easiest place I’ve travelled with this disease. And instead of a food roundup, I wanted to touch upon this curious, seemingly paradoxical fact because I don’t believe many of us who avoid gluten are aware of how great a place it is to visit.
1) The Gluten-Free Guide to Italy by Maria Ann Roglieri (paperback guidebook)
4) For those craving Italian at home: my favourite of the GF Italian cookbooks, by Jacqueline Mallorca. Another option is the 100 Best Gluten-Free Recipes book by Carol Fenster, but I was trying to stay to theme ;)
6) Brigolante’s gluten-free resources page for Umbria.
7) Sara Rosso’s gluten-free suggestions for Italy.
8) Gluten-free Rome (recent, from Feb 2012) from Aglio, Olio e Peperoncino.
9) Update as of June 2014: New York Times covers Italian options for gluten-free dining.