IN PRAISE OF CHAINS

Chains can be liberating--at least for people on the gluten-free diet. Knowing that Outback Steakhouse, Carrabba's Italian Grill, Bonefish Grill, Legal Sea Foods, P.F. Chang's and a slew of fast-food establishments offer gluten-free menus can ease trip planning as well as ordinary and business dining. It's especially reassuring to know that a restaurant has developed its gluten-free menu by working with a reputable outside organization, as is the case with the Gluten Intolerance Group and Outback, Carrabba's, and Bonefish Grill.

When I saw that the July 2006 Consumer Reports ranked dozens of chain restaurants according to reader surveys, I thought I'd share the results for restaurants with gluten-free menus. The highest score is an 88; the lowest is a 65. (See the magazine for more details.)

Carrabba's Italian Grill
Score: 86
Taste: 5 out of 5
Service: 5 out of 5
Approximate Price: $20-24
Note: Carrabba's got special notice for takeout.

Bonefish Grill
Score: 85
Taste: 5 out of 5
Service: 5 out of 5
Approximate Price: $25-$29
Note: Bonefish Grill got special notice for "special occasions."

P.F. Chang's China Bistro
Score: 84
Taste: 5 out of 5
Service: 4 out of 5
Approximate Price: $20-$24
Note: P.F. Chang's got special notice for takeout but a "black eye" for crowds.

Legal Sea Foods
Score: 82
Taste: 4 out of 5
Service: 4 out of 5
Approximate Price: $25-$29

Outback Steakhouse
Score: 80
Taste: 4 out of 5
Service: 3 out of 5
Approximate Price: $20-$24
Note: Outback got special notice for takeout but a "black eye" for long waits.

So far Outback is the only one of the above five chains to establish a presence in New York City. However, among the magazine's top-ranked chains, several are already in The Big Apple. Even though they're not cheap, wouldn't it be great if they'd adopt gluten-free menus?

GFNYC's List of Chains Ripe for Gluten-Free Menus
(All got top marks in Taste and Service)

The Capital Grille (Score: 88; $40 plus) already in NYC
Ruth's Chris Steak House (Score: 87; $40 plus) already in NYC
J. Alexander's (Score: 86; $20-$24)
Houston's (Score: 86; $25-$29) already in NYC
McCormick & Schmick's (Score: 85; $30-$39) already in NYC
Pappadeux Seafood Kitchen (Score: 84; $20-$24)
Morton's, The Steakhouse (Score: 84; $40 plus) already in NYC

If you're aware of other celiac-friendly chains (those with gf menus), feel free to note them in the comments.


ADDENDA

Two more cents....

First, I want to take note of the numbers. According to Consumer Reports, there are 779 Outbacks, 209 Carrabba's, 133 P.F. Chang's, and 108 Bonefish Grills. According to its website, Legal Sea Foods has more than 30 restaurants. So the effort to hammer out five gf chain restaurant menus yielded more than 1259 celiac-friendly restaurants--an average of about 252 restaurants per menu!

Second, because I'm budget conscious, I'll also take note of the seven "good food at a good price" restaurants listed by Consumer Reports--even though none has a New York City location at present:

Abuelo's Mexican Food Embassy (Score: 84; $15-$19)
Red Hot & Blue (Score: 82; $15-19)
Famous Dave's (Score: 82; $15-$19)
Claim Jumper (Score: 82; $15-$19)
Romano's Macaroni Grill (Score: 82; $15-$19)
Johnny Carino's Country Italian (Score: 81; $15-$19)
Texas Roadhouse (Score: 81; $15-$19)

WELCOME, MUG READERS!

ADDENDUM MARCH 7, 2009 Please note that some of the information in this post is now out-of-date. Babycakes NYC still makes a number of items using spelt, but the bakery appears to have taken some measures to help ensure the safety of its gluten-free and wheat-free customers. Josefs Gluten Free is not open to the public. And the Gluten Free Bread Basket in upstate New York has closed.

Today's Manhattan User's Guide included the following:

From blogger David Fischer of Gluten-Free NYC (as well as Blog About Town):

Your item on Babycakes calls it "a gluten-free bakery" but that's misleading. At least one Babycakes cupcake contains spelt, which is forbidden to people on medical gluten-free diets.

In case you're interested, here's more context.

First, some background information:

People on medical gluten-free diets (due to celiac disease or dermatitis herpetiformus) must not eat products made with wheat, barley, rye, and, possibly, oats. If they ingest a particular molecule associated with the gluten in those grains, they risk getting an autoimmune reaction that can be very damaging to their systems, especially over the long run.

People with classic wheat allergies run the risk of having a very severe and possibly fatal reaction, such as anaphylactic shock, if they eat wheat.

The current estimate is that about 1% of the population should be gluten-free or wheat-free, though most of the population is undiagnosed.

Spelt, which is related to wheat, is forbidden to people on medical wheat-free and gluten-free diets. However, some food marketers have made scientifically unsupported claims to the contrary.

There used to be a completely gluten-free bakery in Manhattan and another in Staten Island, but both closed. In Williamsburg, Josefs Gluten Free continues to operate as a kosher gluten-free bakery. Slightly upstate in Chester, New York, Gluten Free Bread Basket produces a line of gluten-free baked goods as a participant in the Gluten-Free Restaurant Awareness Program (GFRAP), which helps restaurants serve people on gluten-free diets.

There are other gluten-free bakeries around the globe, though they are rare. Many other friendly eateries (but not enough!) include wheat-free/gluten-free products among the foods they serve, while taking pains to ensure that their labels are accurate and that no cross-contamination occurs. Still other places, including some that have great intentions, are not that scrupulous about accuracy and ingredients. And spelt marketers have added to the confusion.

I've been excited that Babycakes has gotten excellent reviews for making cupcakes with "alternative" ingredients and I've wanted to support Babycakes in any attempt to make confections that are safe for people on wheat-free and gluten-free diets.

But, when I've read about Babycakes in the media, I've been worried about the confused reporting that spelt is wheat-free. That's why I was concerned in March, when I was told that Babycakes labeled its spelt cupcakes as wheat-free and I took note of New York's inaccurate reporting on the bakery. And that's why I sent a note to MUG about its own slip-up on June 16. On both occasions I first called Babycakes and checked its website to confirm my information.

In a post dated just yesterday, the Celiac Chicks blog posted an interview with Erin McKenna of Babycakes.

[Celiac Chick] Kelly: What types of flours do you use in your gluten-free goods?

Erin: Rice flour, potato starch, and garbanzo/fava bean combo.

Kelly: Are any customers fearful of cross-contamination with the spelt items? And have you considered going totally gluten-free?

Erin: Yes, some people have been concerned. However, we are hyper neurotic about preventing cross-contamination. As far as going totally gluten-free, we are working on plans for a wholesale facility with a storefront in the San Diego area within the next year.

However, the interview did not cover the question of how the spelt products are labeled. So today I phoned Babycakes and asked to speak with Erin. I didn't get through to her, but I asked two other employees whether the spelt products are labeled "wheat-free." From the first employee I got a disappointing "yes," but from the second employee I got an encouraging "no"--plus a thank you for my "good work" and advice to go after a major chain that, she said, persists in calling spelt products "wheat-free." She said that the company is "really putting people in danger." I'll be sure to look into that.

In the meantime, I do hope that everyone at Babycakes will indeed stop calling spelt products "wheat-free" and I continue to wish it well in serving the needs of people on medical diets. I also hope it will consider changing its website to be clearer about its ingredients. I don't see the harm in changing

Created with the delicate nature of toddlers young tummies in mind, Babycakes are free of wheat, gluten, dairy, casein, eggs, soy, nuts and refined sugar.

to include the word "many" in front of "Babycakes." (And, while they're at it, "toddler tummies" would eliminate a possessive problem, reduce redundancy and add assonance!)

TEEN SUMMER EVENT

Burgers, volleyball, and croquet are among the attractions of the second session of the Teen Workshop Series of the Celiac Disease Center at Columbia University.

The event, for kids 13-18, is scheduled for Sunday, July 9, 2006 from 11 am to 3 pm.

$20 registration (online only and non-refundable) ends July 5.

BEST DOCTORS 2006

New York just released its Best Doctors update, a tie-in to the Top Doctors books published by Castle Connolly.

The Best/Top Doctors lists reflect a poll of doctors (not patients) in the metropolitan area. The list in New York is shorter and more selective (and currently more up-to-date) than the one in the book.

How reliable are the lists? At Slate, physician Ken Seplowitz prescribes taking them with a grain of a salt. "To my expert eye," he writes, "every year the New York survey gets it about half right: Half of the selections are first-rate doctors, no doubt about it. Another 25 percent are people whom I don't know well (though I have my doubts), and 25 percent are certifiable duds--doctors who (hopefully) haven't seen a patient in years but have risen to the lofty realm of high society and semi-celebrityhood."

I haven't charted my own experience with the list, but that sounds about right. I think that, when searching for a physician in the medically populous metropolitan area, it's good to seek and consider the advice of doctors you already trust, support group members, and friends in addition to the Best Doctor/Top Doctor guides. It's not easy to sort through all of that, but the method might give you the best odds of getting optimal results.

That said, searching at the new New York list yields six gastroenterologists under the keyword celiac. All but Peter Green are identified as pediatric gastroenterologists.

Half of the recommended celiac specialists are affiliated with the popular Celiac Disease Center at Columbia University: founder Peter Green, Joseph Levy, and Philip Kazlow, who is also affiliated with Valley Hospital in Ridgewood, New Jersey.

In New York City as well as Englewood, New Jersey, there's Keith Benkov of Mount Sinai Medical Center/Englewood Hospital and Medical Center.

In Westchester, there's Leonard Newman of the Westchester Medical Center/Our Lady of Mercy Medical Center.

And on Long Island, there's Michael Pettei of Schneider Children's Hospital/North Shore University Hospital at Manhasset.

GLUTEN-FREE VENDOR FAIR!

Congratulations to Suffolk County Celiacs for a successful Gluten-Free Vendor Fair!

At yesterday's event, throngs of celiacs grazed food samples inside a Long Island warehouse made available by generous host Comfy Cuisine.

At the booths, I was glad to see the familiar faces of the Celiac Chicks, Ann Whelan of Gluten-Free Living, Rory Jones (co-author of Celiac Disease: A Hidden Epidemic), and nutritionist Anne Roland Lee (who earlier in the week got raves from folks at the New York City Celiac Disease Meetup) as well as folks from the Ramapo Valley Brewery, Philadelphia's Mr. Ritts Bakery, The Silly Yak Shirt Co., Gluten Free Bread Basket, Inc., Plainview's Dr. B. Well Naturally (a.k.a. Safe Harbor Foods), and Whole Foods, which is about to introduce hearty nutmeal-raisin cookies and some new breads to its gluten-free inventory.

I wasn't able to sample everything at the fair. But I enjoyed the LifeField Buckwheat as well as the baguettes of Everybody Eats and the bagels of the East Meadow bakery Joan's GF Great Bakes (gfgreatbakes at yahoo dot com). Outstanding crusts in both cases--no wonder they were popular!

Meet Pedro Arroba and Bruce Bassman of Everybody Eats.
















Here's Joan (third from left) with some of the posse from Joan's GF Great Bakes.
















And here's the energetic and enterprising Suffolk County Celiac Michael Thorn. He says he doesn't photograph well, but I think that might just be a result of the bolts of inspiration forever shooting through his brain. Looks like he's just come up with another brilliant idea!















Photos: David Marc Fischer

DR. ALESSIO FASANO ON CELIAC DISEASE

In the aftermath of Digestive Disease Week (DDW), here are some highlights of Dr. Alessio Fasano's Medscape report, "Celiac Disease in the Clinical Spotlight -- What's New and What's the Path Forward?"

The general perception that celiac disease is rare in some countries, such as the United States, was unsubstantiated by any large epidemiologic study.... This controversy has been put to rest by a series of recent reports suggesting that this disorder is as frequent in the United States (prevalence in the general population of 1:133) as in Europe. This observation has been expanded to other regional areas, including North Africa, Asia, Oceania, and South America, where celiac disease is now recognized as a frequent condition affecting approximately 0.5% to 1% of the general population. Furthermore, the total prevalence of celiac disease seems to also be on the rise, as suggested by a study from Finland in which the prevalence of the disease doubled during the last 2 decades, a trend similar to that observed for other autoimmune diseases...

Given the low level of suspicion among healthcare professionals, particularly when the disease presents in an atypical manner, many cases of celiac disease remain undiagnosed and carry the risk for long-term complications, including osteoporosis, infertility, psychiatric and behavioral disorders, or cancer. One controversial topic addressed by 2 studies during this year's DDW meeting concerned the association between celiac disease and irritable bowel syndrome (IBS). A prospective multicenter study conducted in the United States suggested that more than 7% of IBS subjects enrolled tested positive for celiac disease antibodies. Whether all of these patients were indeed affected by celiac disease remains to be established, as only a small number had the diagnosis confirmed by upper endoscopy. Conversely, a prospective observational study performed in The Netherlands established that screening patients with IBS for celiac disease is not cost-effective....

Currently, total and lifelong abstinence from gluten ingestion remains the cornerstone of treatment for the disease. This diet requires an ongoing education of patients and their families, by both physicians and dieticians....

The article goes on to identify the usual assortment of serological tests as playing a "definitive role in the diagnostic process" and calls the upper endoscopy the "mainstay for establishing the diagnosis of celiac disease." It says that positive genetic testing for the DQ2 and/or DQ8 haplotypes is not diagnostic, and it doesn't mention any stool tests. This is consistent with the conventional wisdom that diagnosis involves two basic types of testing: a panel of blood tests (during a period when the patient is still ingesting gluten) and an endoscopic biopsy of the upper intestine.

Fasano wraps up by noting research into the possibility that a gene involving intestinal permeability may be directly linked to celiac disease. I believe that both Fasano and the doctor behind this new genetic research will offer presentations at November's International Celiac Symposium in New York City.

REGISTRATION OPEN FOR INTERNATIONAL CELIAC SYMPOSIUM

Celiacs in the Greater New York metropolitan area won't have to travel very far to attend the XII International Celiac Disease Symposium. It'll be held November 9-11, 2006 at the New York Hilton in midtown Manhattan and hosted by the Celiac Disease Center at Columbia University. All foods and beverages will be gluten-free.

Registration details are here. The key date for many will be August 1, after which the early registration discounts will cease to apply.

The event involves three types of programs:

Program: International Symposium
Audience: Physicians and scientists
Cost: $495-695
Credits available

Program: Clinical Forum
Audience: Patients, dietitians, nurse practitioners, nurses, physician’s assistants, etc.
Cost: $195-395
Credits available

Program: Connecting Teens with Celiac
Audience: Teenagers
Cost: $195-295
Credits not available

In recent years, the Celiac Disease Center has hosted annual Information Days, but this year the International Symposium replaces that event. Cynthia Beckman of the Celiac Disease Center informs me that the biannual Symposium will not be held again in the United States for at least another 14 years, so this can be a rare opportunity for many of us.

At the time of this posting, some details (such as lodging information) have not yet been posted at the Symposium website.