When I was first diagnosed with celiac disease, I went to my best friend’s place in Montreal for dinner. She is Italian, and her lovely family were used to feeding me pasta without issue. When I explained my disease to her parents, her father looked appalled. Solemnly and slowly he said, “Jodi, this is a fate worse than death.”
While many celiacs feel the same way upon hearing their diagnosis, the reality is that the world is a safer place for our stomachs than it ever has been. And there are plenty of wonderful, naturally gluten free grains out there for experimenting and enjoying.
Given his reaction, however, I was worried about my trip to Italy. I did not know if there would be any food for me, or if I would need to bring snacks of my own. I was surprised to find that my fears were very misplaced.
Italy was one of the easiest places to enjoy food as a celiac during my 8+ years of world travel.
Gluten Free Italy: Table of Contents
Overview of Italy and Celiac Disease
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: “oh Italy must be accommodating its tourists!” Not the case. It was obvious that the dietary changes were not rooted in tourism. Even tiny towns had knowledge of the disease, and had been exposed to it sufficiently that they made adjustments in what they offered.
I reached out to Letizia Mattiacci, who runs a B&B with a cooking school in Italy. 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.
The exposure goes much deeper than that. Children are routinely screened for celiac disease in Italy, and celiacs receive 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.)
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 addition, there is the fact that food is central to Italian life and community. Per a New York Times piece on celiacs in Italy:
In Italy, not being able to stomach wheat is more than an inconvenience or fad diet.
“It’s a tragedy for Italians,” said Susanna Neuhold, the AiC’s manager of food programs. “Food in Italy is the center of social life and relationships with people. For someone who can’t go out with their friends or to a work meeting at a restaurant, it’s a very big problem, psychologically and socially.”
That resonance has translated to an institutional empathy that might shock Americans.
In addition, alternative flours are prevalent in Italy as well. 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.
A Tailored Gluten-Free Translation Card for Italy
As with the other gluten free cards in this series, this was written in detail in English, then translated into Italian by native speakers. It includes not only wheat, barley, and rye, but also the other grains with gluten (kamut or farro) used in Italian food. And it aims to help celiacs travel safely, and with comfort that their needs are going to be explained to native Italian speakers even if they don’t speak the language.
The English version: I have celiac disease, and I cannot eat gluten, which is found in wheat, barley, rye, orzo, farro, and often in oats. I will become very ill if I eat food, marinades, soup or sauces containing wheat, barley, rye, semolina, or oats. This disease affects me if I eat these ingredients, but also if the food is fried in the same oil used to fry unsafe foods. In those cases, the cross-contamination will also make me sick. Even a sprinkle of flour on the grill pan, or in the sauce or soup will make me ill. I cannot eat soup that has bread blended into it, or meat/sausages with bread as an ingredient (such as meatballs or some sausages). Can you please help me choose something that does not include any wheat, rye, barley, oats, bread or pasta? I can eat food containing rice, chickpeas, tapioca, cassava, potatoes, corn, beans, lentils, vegetables, cheese, fruit, eggs, meat, chicken, or fish – as long as they are not cooked with wheat flour or breadcrumbs. This means I also cannot eat battered or breaded dishes, unless they are breaded in only rice flour, corn flour, chickpea flour or tapioca flour, and fried in separate uncontaminated oil. Thank you for your help. I am sorry for any inconvenience this may cause you, but I have to be very careful when I eat.
A big thanks to Alanna Tyler and Letizia Mattiacci for their help in translating this card.
Foods to eat in Italy for celiacs
For the most part, the following suggestions are for you to be able to walk into restaurants that are not specifically gluten-free, but that have options for you on the menu.
As with the other gluten free guides I’ve written, I find it far more satisfying to eat safely where I can, versus sequester myself in GF restaurants all the time. Yes, it’s great to know things are safe to eat in those dedicated GF kitchens but the point of travel is to connect with other humans and learn about their culture and food — to me this is best done in general restaurants to the extent possible.
- Gluten free pizza, usually corn, chickpea and/or rice flour based. Confirm that shared pizza pans will not be an issue, and that this dough is not made on the same surface as the floured doughs — pizza shops often have quite a bit of flour being tossed around their kitchens!
- Gluten free pasta
- Grilled meat and fish, including arrosticini (meat skewers from Abruzzo, typically sheep). Confirm no breaded/dredged flour on fish prior to cooking.
- Risotto and risi e bisi – confirm broth is gluten-free.
- Plain rice.
- Insalata Caprese.
- Farinata or cecina or panelle– chickpea flour flatbread. Confirm 100% chickpea flour.
- Ragu – Bolognese sauce.
- Salsiccia fresca (storebought sausages may contain flour in the casing), mortadella ham and Bologna sausage (again, care with store-bought products), Bresaola cured beef, and prosciutto and Parma ham.
- Stracciatella soup – confirm broth is gluten-free, and no flour, pasta or breadcrumbs are added.
- Porchetta pork cuts (not breaded).
- Beans and lentils – confirm that if broth is used it is gluten-free, and no flour or pasta or breadcrumbs are added.
- Caponata, an eggplant dish — confirm oil is not contaminated.
- Panna cotta and semifreddo desserts. Confirm no flour is added.
- Torta Caprese – flourless chocolate cake
- Zabaglione – confirm it is not served with cookies.
- Granita fruit drinks
- Gelato IF gluten free, as many flavors do have gluten.
- Almost all cheeses (including parmesan and ricotta) — HUZZAH!
Fresh vegetables and Meat Always an Option!
Even when not on the menu, most restaurants will have a simple dish of steamed vegetables served with lemon. In the event you cannot find a side dish that works for your stomach, the chef will almost always oblige. Type of vegetables will vary depending on the season, but have in my experience always tasted better than at home.
Many of the meals at lunchtime that I enjoyed were a version of whatever meat they had that day alongside some delicious steamed vegetables and a salad.
Foods to avoid in Italy for Celiacs
Gluten is a huge part of Italian cuisine, and while there are some wonderful options that are naturally gluten free — and some great celiac-friendly modifications available — the reality is that most of the food has something we can’t eat.
I wanted to list out a bunch of those dishes, just to make sure you have them in mind when you travel there.
- Pasta (most of the 600+ varieties, including ravioli, gnocchi (potato dumplings but are also always made with wheat flour, tortellini, passatelli and Pizzoccheri – which is often named buckwheat pasta, but also contains wheat).
- Pizza unless specifically labeled gluten free, and varieties of pizza like the folded calzone option.
- Breaded meats like cotoletta and cacciatore.
- Breaded and fried vegetables.
- Battered or breaded fish or calamari (squid).
- Arancini – rice balls coated with bread crumbs.
- Salami, which often has wheat. Some store-bought salamis will be marked as gluten-free but the customary way to prepare them does include gluten.
- Meatballs, and sausages like cotechino.
- Involtini (known in US as braciole), a way to pan fry meat that often uses a coating of breadcrumbs and cheese.
- Osso buco, a veal stew/casserole (meat is dredged in flour during preparation)
- Soups such as minestrone, pasta e fagioli, and acquacotta (bread soup). Ribollita, a Tuscan soup, may be made without wheat occasionally but it is rare.
- Panzanella — a bread salad.
- Cannoli — a Sicilian dessert.
- Crostata — a baked tart
- Pandoro, panettone, panforte, and Zuppa Inglese — all cakes / sponge desserts.
- Tiramisu (SO SADS)
- Most types of bread including Piadina (flatbread) and pastries like Sfogliatella.
- Most types of gelato – unless clearly marked as gluten-free, I would avoid.
Further reading for celiacs traveling to Italy
1) The Gluten-Free Guide to Italy by Maria Ann Roglieri (paperback guidebook)
4) A searchable database of restaurants for celiacs in Italy, where you can browse by region.
5) For those craving Italian at home, two really great cookbooks for Italian food:
- Gluten-Free Italian: Over 150 Irresistible Recipes without Wheat — from Crostini to Tiramisu, by Jacqueline Mallorca. Covers the basics with easy substitutions, and lovely photography to accompany the recipes.
- The Gluten Free Italian Cookbook: Classic Cuisine from the Italian Countryside, by Mary Capone, which is a great compliment and focuses on rustic Italian cuisine. It’s delightful!
6) Sara Rosso’s gluten-free suggestions for Italy.
8) The New York Times covers Italian options for gluten-free dining.