Did you know that coeliac disease – an autoimmune disease which is triggered by the consumption of gluten – affects roughly one out of every 100 people in Ireland?
“And if someone in your family has it, the likelihood of you having it yourself increases to one in 10,” says Frances Buckley, the technical food advisor for the Coeliac Society of Ireland. Her work includes advising food businesses on how best to cater to the coeliac dining segment – one which has grown rapidly in recent years.
May is Coeliac Awareness Month and when it comes to the Irish food and the hospitality industry, despite increased awareness of coeliac disease and the many ways it affects those who live with it, we are still drastically under-educated on how to cater to these diners. While the options for those with gluten intolerance – which is less serious – have improved in recent years, the same cannot be said for those with coeliac disease.
Coeliac disease is widely under-diagnosed, and also often misdiagnosed as something like irritable bowel syndrome. Unlike the milder gluten intolerance, coeliac disease causes serious internal damage to your digestive system when gluten is consumed. The only way to treat it is to avoid gluten in all its forms.
“If you have any symptoms at all, you need to ask your doctor for a blood test,” Frances says. “The blood test for coeliac disease is not done in routine blood work, so you need to request it specifically. We often see that males are more reluctant to get tested than females.”
Frances also says that if you have tested negative for coeliac disease in the past and now have symptoms, you could have developed it since the last negative test. If a number of years have passed, it is worth getting re-tested.
Frances Buckley, MSc, is the technical food advisor for the Coeliac Society of Ireland.
“We recently met a lady who said she’d been tested years ago, but started having problems. She thought, because her coeliac test was negative 20 years ago, it would still be negative today – but that is not the case.”
Vague symptoms
Some people who have coeliac disease have no symptoms at all, or their symptoms are vague, says Frances. This was the case for Cavan-based permaculture student and Kepak environmental health and safety officer, Cait Galligan, when she was diagnosed with coeliac disease.
“I had serious fatigue,” she recalls. “I was so tired I was falling asleep in the middle of the day. It took ages to figure out what was wrong with me.”
Looking back, and knowing what she knows now, Cait realises she had other symptoms of coeliac disease at the time including a skin rash, upset stomach and gassiness.
“I finally went to the GP complaining about how much I was burping,” she says. “He told me I should get tested for coeliac disease, and when the test came back positive, I couldn’t believe it. Such a simple, random symptom and it led to a full coeliac diagnosis.”
Adjusting to a new diet was upsetting for Cait, at first. As she awaited her scope test, she gorged on her favourite snacks knowing she might not get to eat them again. Once she received the confirmation that she was, in fact, living with coeliac disease, she focused on adjusting to her new normal: dining out with strict dietary restrictions.
“Whenever I went out for food, I had to ask the server if they had any coeliac-friendly options,” she says. “Most didn’t know what I was talking about, and some just thought I was being a picky eater.”
Developing a thick skin as a diner is one thing everyone living with coeliac disease needs to do. It’s not just about having gluten-free options on the menu; cross-contamination with anything containing gluten has the potential to make a coeliac diner extremely sick. This means, for a restaurant kitchen to ensure coeliac diners can enjoy their meal, they need to prepare all gluten-free items in a separate area of the kitchen. For things like chips, they need to use a separate deep-fat fryer.
Cait Galligan has been on a strict gluten-free diet for the past 2.5 years and has seen much improvement in her overall health and wellbeing.
“Before I dine out now, we need to look up the restaurant and ring ahead to make a plan,” Cait explains. “I always ask if they can do anything coeliac-friendly and most restaurants say ‘we can try, but there could still be cross-contamination.’
“My partner and I went to Athlone recently and the server said they had just cleaned out the fryer, so I could have chips – but cleaning out the fryer wasn’t enough, because I got sick after [even though the food there was lovely]. You really need separate areas for coeliac-friendly food.”
The Coeliac Society of Ireland runs a programme called The Coeliac Circle, which is for upskilling hospitality professionals in areas around coeliac-friendly dining. Frances says the programme runs online, but they also offer in-person training for restaurants and food businesses who are serious about catering to this growing segment of diners.
“This programme first centres around the front-of-house [the servers and greeters at a restaurant],” she explains. “This is because they are the first people to come into contact with a coeliac diner. No matter how good the offering from the kitchen is, if a diner gets the wrong kind of body language, attitude or information from their server, they completely lose confidence in the establishment.
“The second part of the programme is for back-of-house [chefs, cooks, dishwashers, etc] and management,” she continues. “The restaurants who commit to this training see the value in offering quality coeliac-friendly menu items. Coeliac diners often feel nervous in restaurants. They will choose to dine somewhere they know they will get looked after, but the enjoyment of going out to eat is always accompanied by a certain amount of anxiousness.”
A particular area of concern for Frances are the people living with coeliac disease who are regularly on the road for work. The Coeliac Society encourages Irish service stations to provide better options for coeliacs. “It’s virtually impossible [to find safe food on the road],” Frances says. “We’ve had meetings with Supermacs, and they now have some coeliac-friendly options in the Plaza at Loughrea [Co Galway] and Kinnegad [Co Westmeath]. For these larger service stations, catering to coeliacs brings other forms of income. They’re going to be stopping here for diesel, for coffee. It’s a bit of extra work, and I’ll often hear from businesses that there’s not much demand, but that’s because coeliacs just don’t expect to be catered for.”
The Coeliac Society offers membership for the over 500,000 people living with coeliac disease or gluten sensitivities, but they also have corporate options for those working in food and hospitality. This membership includes food and ingredients lists and options for training.
“Some foods are gluten-free, even though sometimes they’re not labelled as gluten-free, so our ingredients list is comprehensive and comes in handy,” Frances says. “We also manage the Crossed Grain licence, which is a trademark that food producers can put on their gluten-free products. When it comes to gluten, you always think about breads and pasta, but there is gluten in lots of foods – herb and spice blends, chips, sausages, malted vinegars.”
Coeliac Awareness Day was this past week, on 18 May. The society had a campaign entitled “Ask Away on 18 May”, because if coeliac diners don’t ask, restaurants and food service operations will continue to be slow to make changes that will help.
“If you don’t ask, they are never going to see the need for change,” Frances says.
For most coeliacs, symptoms will improve just weeks after going gluten-free.
Symptoms can vary in severity and frequency and can include fatigue, headaches, skin rash or dizziness.
There is a genetic pre-disposition to coeliac disease.
If you have Down’s Syndrome, Type 1 Diabetes, Turner’s Syndrome or autoimmune thyroid disease, you are more likely to develop coeliac disease.
See coeliac.ie
Read more
Women have key roles ‘feeding and nurturing rural communities’
‘Community and family supported me on Inis Mór’
Did you know that coeliac disease – an autoimmune disease which is triggered by the consumption of gluten – affects roughly one out of every 100 people in Ireland?
“And if someone in your family has it, the likelihood of you having it yourself increases to one in 10,” says Frances Buckley, the technical food advisor for the Coeliac Society of Ireland. Her work includes advising food businesses on how best to cater to the coeliac dining segment – one which has grown rapidly in recent years.
May is Coeliac Awareness Month and when it comes to the Irish food and the hospitality industry, despite increased awareness of coeliac disease and the many ways it affects those who live with it, we are still drastically under-educated on how to cater to these diners. While the options for those with gluten intolerance – which is less serious – have improved in recent years, the same cannot be said for those with coeliac disease.
Coeliac disease is widely under-diagnosed, and also often misdiagnosed as something like irritable bowel syndrome. Unlike the milder gluten intolerance, coeliac disease causes serious internal damage to your digestive system when gluten is consumed. The only way to treat it is to avoid gluten in all its forms.
“If you have any symptoms at all, you need to ask your doctor for a blood test,” Frances says. “The blood test for coeliac disease is not done in routine blood work, so you need to request it specifically. We often see that males are more reluctant to get tested than females.”
Frances also says that if you have tested negative for coeliac disease in the past and now have symptoms, you could have developed it since the last negative test. If a number of years have passed, it is worth getting re-tested.
Frances Buckley, MSc, is the technical food advisor for the Coeliac Society of Ireland.
“We recently met a lady who said she’d been tested years ago, but started having problems. She thought, because her coeliac test was negative 20 years ago, it would still be negative today – but that is not the case.”
Vague symptoms
Some people who have coeliac disease have no symptoms at all, or their symptoms are vague, says Frances. This was the case for Cavan-based permaculture student and Kepak environmental health and safety officer, Cait Galligan, when she was diagnosed with coeliac disease.
“I had serious fatigue,” she recalls. “I was so tired I was falling asleep in the middle of the day. It took ages to figure out what was wrong with me.”
Looking back, and knowing what she knows now, Cait realises she had other symptoms of coeliac disease at the time including a skin rash, upset stomach and gassiness.
“I finally went to the GP complaining about how much I was burping,” she says. “He told me I should get tested for coeliac disease, and when the test came back positive, I couldn’t believe it. Such a simple, random symptom and it led to a full coeliac diagnosis.”
Adjusting to a new diet was upsetting for Cait, at first. As she awaited her scope test, she gorged on her favourite snacks knowing she might not get to eat them again. Once she received the confirmation that she was, in fact, living with coeliac disease, she focused on adjusting to her new normal: dining out with strict dietary restrictions.
“Whenever I went out for food, I had to ask the server if they had any coeliac-friendly options,” she says. “Most didn’t know what I was talking about, and some just thought I was being a picky eater.”
Developing a thick skin as a diner is one thing everyone living with coeliac disease needs to do. It’s not just about having gluten-free options on the menu; cross-contamination with anything containing gluten has the potential to make a coeliac diner extremely sick. This means, for a restaurant kitchen to ensure coeliac diners can enjoy their meal, they need to prepare all gluten-free items in a separate area of the kitchen. For things like chips, they need to use a separate deep-fat fryer.
Cait Galligan has been on a strict gluten-free diet for the past 2.5 years and has seen much improvement in her overall health and wellbeing.
“Before I dine out now, we need to look up the restaurant and ring ahead to make a plan,” Cait explains. “I always ask if they can do anything coeliac-friendly and most restaurants say ‘we can try, but there could still be cross-contamination.’
“My partner and I went to Athlone recently and the server said they had just cleaned out the fryer, so I could have chips – but cleaning out the fryer wasn’t enough, because I got sick after [even though the food there was lovely]. You really need separate areas for coeliac-friendly food.”
The Coeliac Society of Ireland runs a programme called The Coeliac Circle, which is for upskilling hospitality professionals in areas around coeliac-friendly dining. Frances says the programme runs online, but they also offer in-person training for restaurants and food businesses who are serious about catering to this growing segment of diners.
“This programme first centres around the front-of-house [the servers and greeters at a restaurant],” she explains. “This is because they are the first people to come into contact with a coeliac diner. No matter how good the offering from the kitchen is, if a diner gets the wrong kind of body language, attitude or information from their server, they completely lose confidence in the establishment.
“The second part of the programme is for back-of-house [chefs, cooks, dishwashers, etc] and management,” she continues. “The restaurants who commit to this training see the value in offering quality coeliac-friendly menu items. Coeliac diners often feel nervous in restaurants. They will choose to dine somewhere they know they will get looked after, but the enjoyment of going out to eat is always accompanied by a certain amount of anxiousness.”
A particular area of concern for Frances are the people living with coeliac disease who are regularly on the road for work. The Coeliac Society encourages Irish service stations to provide better options for coeliacs. “It’s virtually impossible [to find safe food on the road],” Frances says. “We’ve had meetings with Supermacs, and they now have some coeliac-friendly options in the Plaza at Loughrea [Co Galway] and Kinnegad [Co Westmeath]. For these larger service stations, catering to coeliacs brings other forms of income. They’re going to be stopping here for diesel, for coffee. It’s a bit of extra work, and I’ll often hear from businesses that there’s not much demand, but that’s because coeliacs just don’t expect to be catered for.”
The Coeliac Society offers membership for the over 500,000 people living with coeliac disease or gluten sensitivities, but they also have corporate options for those working in food and hospitality. This membership includes food and ingredients lists and options for training.
“Some foods are gluten-free, even though sometimes they’re not labelled as gluten-free, so our ingredients list is comprehensive and comes in handy,” Frances says. “We also manage the Crossed Grain licence, which is a trademark that food producers can put on their gluten-free products. When it comes to gluten, you always think about breads and pasta, but there is gluten in lots of foods – herb and spice blends, chips, sausages, malted vinegars.”
Coeliac Awareness Day was this past week, on 18 May. The society had a campaign entitled “Ask Away on 18 May”, because if coeliac diners don’t ask, restaurants and food service operations will continue to be slow to make changes that will help.
“If you don’t ask, they are never going to see the need for change,” Frances says.
For most coeliacs, symptoms will improve just weeks after going gluten-free.
Symptoms can vary in severity and frequency and can include fatigue, headaches, skin rash or dizziness.
There is a genetic pre-disposition to coeliac disease.
If you have Down’s Syndrome, Type 1 Diabetes, Turner’s Syndrome or autoimmune thyroid disease, you are more likely to develop coeliac disease.
See coeliac.ie
Read more
Women have key roles ‘feeding and nurturing rural communities’
‘Community and family supported me on Inis Mór’
SHARING OPTIONS