TRAVERSE CITY — Sandy Cartwright remembers the first ice cream cone she ate in 15 years.
Cartwright, 77, was diagnosed with celiac disease in 1991 and told to start eating a gluten-free diet. If she wanted to buy groceries or eat out back then, the choices were slim and none.
"They told me to eat Kellogg's Corn Flakes, Rice Krispies, which you'd think would be gluten-free, but they have malt in them," she said.
Gluten is found in wheat, barley and rye. People with celiac disease have gluten intolerance; symptoms can range from an upset stomach to neurological disorders. About one in 130 people are thought to have celiac disease, but 90 percent of celiacs aren't diagnosed, Cartwright said. And as many as 8 to 10 percent of people may have gluten intolerance without full-blown celiac disease.
Once diagnosed and following a gluten-free diet, most celiacs ended up eating at home. Restaurants don't feel safe, because food can easily be contaminated. Flour stays in the air for 24 hours, Cartwright said. Oil in fryers may have been used for other products. Even a plain hamburger can be suspect, if it has fillers.
"I know one lady who went across the country going from Outback to Outback because she thought it was the only safe place her daughter could eat," Cartwright said.
Laura McCain, registered dietitian at Munson Healthcare, said gluten-free food is more prevalent now because diagnoses of celiac are more common.
"Ten to 15 years ago, nobody knew what celiac disease was," she said. Gluten itself isn't a bad thing, she said, and doesn't need to be avoided unless you know you have a sensitivity.
But dining out can still be "running a little on the shotgun side," she said. Simply removing croutons from a salad doesn't count; the salad can still be contaminated.
She suggests calling ahead and talking to someone at the restaurant. If they've heard of celiac disease and are familiar with gluten-free diets, that's a good sign.
"The ideal is, 'We know what you're talking about because someone on our staff has it,'" she said.
And try to get a peek at the kitchen, McCain said. Look to see how separate things are, how big the kitchen is, whether the cooks change gloves or make an effort to keep gluten-free food off surfaces where other food is prepared.
Restaurants owned by Magnum Hospitality -- Pearl's New Orleans Kitchen in Elk Rapids, Red Mesa Grill in Traverse City and Cafe Santé in Boyne City -- were among the first to develop gluten-free menus -- and it wasn't easy, said Colleen Thomas, manager at Pearl's.
"We had to research spices, Worcestershire sauce, call companies, ask about ingredients that aren't listed," she said.
The move has paid off, she said. They get requests at least daily for the gluten-free menu, lots of phone calls and lots of customers who thank them.
"Now we have gluten-free from cocktails to desserts," she said.
Pangea's Pizza in downtown Traverse City started offering a gluten-free crust after several people started asking about it, said Katie Aschim, front of house manager.
"It's pretty good, light and crispy," she said of the rice-based crust they get from Sysco. "A lot of people are ordering it even if they don't have celiac."
The crust comes in a 12-inch frozen round that the chef tops and bakes to order, she said, and the restaurant gets at least one request a day.
Tips
These are among the tips offered by the Traverse Area Gluten Free Support Group for dining out:
• Pick a restaurant where food is apt to be made from scratch.
• Explain your diet to your server; inquire about the method of preparation.
• Unless you know the food is OK, order a plain meal, such as broiled fish or meat without seasoning or added ingredients.
• Let the chef know it's necessary your food be prepared with separate utensils.
• Eat only foods when all the ingredients are known.
• Don't accept a plate that has a bread product on it.
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