Do no harm, eat no gluten?

Food allergies plague only a small percentage of people, leaving them to perform almost superhuman feats of discipline to make sure they don't get sick.

Until a few years ago, I loved oysters. Then, one day, they stopped loving me back. The first time I got sick was after inhaling a dozen plump, briny Wellfleets on a pier. Afterwards, I sat in the car, clutching my midsection and delirious with pain, certain that I'd been the victim of a bad seed. That winter, at a celebratory dinner, I washed down two dozen sweet Kumamotos with some raw clams, then dashed to the airport, where I missed my flight, having spent the greater part of the evening shivering in foetal position in a bathroom stall just a few strides from my gate. Certain that the clams had been the culprit, I attended an oyster tasting the following summer in Vancouver, BC. Later, when the emergency room doctor examined my chart, his eyes widened. "You ate how many oysters?" he asked, figuring, I'm sure, that I was either the biggest dimwit or the greatest glutton he'd ever met. "You're allergic to oysters and you've survived four dozen of them. You," he cautioned, "are a very lucky girl."

Reflecting on my lordly reluctance to accept an allergy developed in adulthood makes me cringe. That I perceived it as a form of weakness makes me wonder. Unfortunately, it was only a taste of things to come. One month after the Vancouver incident, I finished graduate school and moved to Dubai, where within a matter of weeks, I developed chronic allergic rhinitis and adult onset asthma that launched a dietary hot war against an unknown host. And my relationship with my body, and with food, has not been the same since.

There's no denying that all allergies, including food allergies, are on the rise. Nearly four per cent of adults (and eight per cent of toddlers) have them, with shellfish, other seafood, peanuts, tree nuts and eggs, soy, wheat and dairy, making up what is called The Big Eight. The Mediterranean diet, with its antioxidant-rich foods, has been linked to the prevention of asthma and allergy symptoms, but the people of the Mediterranean have not been spared. Indeed, we have an elevated rate of non-allergic diseases being managed similarly to allergies, including favism, which is a type of anaemia that results from exposure to fava beans (and may be one reason for the use of garbanzo beans in the Levant), and Coeliac disease, an autoimmune disorder of the small intestine that can occur in anyone with a genetic predisposition, and for which the only known treatment is a lifelong gluten-free diet.

I don't have Coeliac disease, but I know a few people who do. Far greater is the number of people I've known who have lauded cutting gluten out of their diets simply because it makes them feel better, then self-diagnosing as gluten intolerant; a slippery slope, to be sure, since there is no way to assess the efficacy of the placebo against the impalpable changes people make in their lives and their diets concurrently.

To see if it helped my allergies and asthma, I underwent an adventure in gluten-free living; a challenge whose magnitude seemed manageable after I realised that I had nothing to lose. In fact, I was looking forward to the challenge of preparing and eating gluten-free meals without feeling as though I was missing out. As the prevalence of legitimate food intolerances has increased manyfold, so has the prevalence of professed food intolerances, which can create some interesting challenges for a commercial kitchen. At restaurants, I caught - or perhaps imagined? - glances of irritation from servers as I micromanaged my meals with gluten-free specifications - and I felt bad about it. How many times had I mocked or resented picky eaters in my own mind? How many times had I doubted the validity of others' purported sensitivities, such as tap water or table salt, believing them instead to be an attempt to justify certain preferences without wishing to defend them? A lot.

And there were other issues burning on my mind. For instance, though I welcome the chance to cook without discrimination for friends with all kinds of nutritional philosophies, I don't think it's necessarily fair to expect a restaurant to adjust to the same modifications or compromise to the same degree. Would I have to forfeit the joys of dining out in favour of the sterile comforts of a home kitchen? And most disconcerting: could I trust the kitchen staff to serve me a gluten-free meal, when gluten, it seemed, was in just about everything?

Gluten dominates kitchen, pantry and supermarket shelves, but knowing where to look for it is not entirely intuitive. It can be veiled with vagueness, partly because the term "gluten-free" has not yet been fully regulated. It can appear in labels as "edible starch", "flavourings", "seasonings", "hydrolysed plant protein", "stabiliser", "vegetable gum", "malt", "binder" and "emulsifier". When the amount used is considered negligible, ingredients like flour and modified starch are not always listed. They are also used to stop bagged grated cheese from clumping and by confectionery manufacturers to stop sweets sticking to the conveyor belt.

There's likely to be gluten in your ice cream, yogurt and cheese, and particularly in low-fat versions of dairy products, because it acts as a thickener. It also may be in your vitamins, lip gloss, sausages, burgers, prescription drugs and coffee. Avoiding wheat, kamut, rye, spelt, barley, triticale and oats is no walk in the park. On the other hand, corn, potatoes, chickpea flour, rice, buckwheat and tapioca can be had ad nauseam, as well as millet, amaranth, quinoa, arrowroot, sorghum, taro, teff, sweet potato and yam.

Ah gluten: the tie that binds. I had assumed there would be a substantial payoff in place in order to get so many people to sacrifice chocolate chip cookies. Going off gluten, and later dairy, didn't help my allergies, but it nurtured my compassion and admiration for those who live with food allergies: real, imagined, and everything in between.

Updated: June 03, 2009, 12:00 AM