As a longtime chef in four-star restaurants, Joseph Pace had seen appreciative customers before. But nothing prepared him for the day that a well-dressed man walked into his Greenwich Village restaurant, ordered a pizza and a beer, and broke into tears.
That man, Pace recalls, had been diagnosed 10 years earlier with celiac disease, an incurable affliction that makes the body unable to take anything containing gluten, a protein found in wheat, barley and rye.
The pizza and beer that Pace serves in his restaurant Risotteria, like many other items on his menu, are formulated with substitutes for wheat and barley, making his place a magnet for people who have celiac disease. The customer told Pace he hadn't been able to enjoy a pizza and beer for a decade.
"This is what the restaurant business is _ making people happy," Pace said.
Not every customer may be as effusive as that one, but Pace says he gets tremendous amounts of feedback from customers, which also helps him try out new recipes. His latest experiment is a pasta made from white beans. Rice, the main ingredient in risotto, is naturally gluten-free.
Founded just five years ago, Pace's restaurant quickly became known among people with celiac disease, who make heavy use of the Internet and e-mail to share restaurant recommendations.
Several major restaurant chains also are reaching out to the celiac community. Outback Steakhouse, P.F. Chang's and other restaurant companies offer menus of gluten-free dishes, and more are joining them.
Recently, Mitchell's Fish Market, a 13-restaurant chain with headquarters in Columbus, Ohio, introduced gluten-free menus, and several months ago Legal Sea Foods of Boston did the same in its 31 restaurants. Richard Vellante, the executive chef for Legal Sea Foods, said his company adopted a gluten-free menu after hearing requests from customers and noticing that competing restaurants were doing it.
Many people with celiac disease miss the textures that come with eating foods that contain wheat, such as crusty bread, croutons in salads and crispy fried foods, which often contain bread crumbs or flour, Vellante said.
So Legal Sea Foods worked on making substitutes: chick pea croutons for salads, corn meal for frying and chick pea crumbs for baking instead of flour. Many items, they found, unexpectedly contained gluten and had to be excluded from the celiac-safe menu, including cocktail sauce, balsamic vinegar and blue cheese. Gluten is often added to foods as a stabilizing agent.
The response from diners has been strong, Vellante said, though he has yet to report an instance of a grown man openly weeping.
"A lot of restaurants don't appreciate this," Vellante said. "I was surprised by it. I did not realize how many people are gluten-sensitive."
Until recently, celiac disease was mistakenly thought to be a rare affliction and had been severely underdiagnosed. Symptoms, including gastric pain and diarrhea, are similar to other ailments including irritable bowel syndrome and Crohn's disease.
Awareness of the disease has been growing rapidly in recent years. In 2003, a major study found that one in 133 people in the United States may have the disease, far more than previously thought.
For people with the disease, dining out can become a source of anxiety because of the risk of unintentionally eating something that contains gluten.
Many consult pocket-size Clan Thompson food guides published by a Maine family with six members living with the disease. The Thompsons started making the guides in 1997 and now sell nearly 5,000 a year. Mother Lani K. Thompson, who does not have celiac disease, says she has seen a "huge jump" in awareness of the disease in the past year-and-a-half.
Kevin Seplowitz, a former computer security expert who developed the first commercially produced gluten-free beer, Bard's Tale, was diagnosed with celiac disease almost four years ago. He quit going out to dinner, fearful of inadvertently eating something with gluten in it.
"I think the most underappreciated aspect of being diagnosed with a chronic disease is the psychological impact," Seplowitz said. "You have to be very diligent about it. If we order something and say, a barbecue sauce had beer in it and they say it didn't, we get sick."
Outback Steakhouse, a major casual dining chain with 760 restaurants, has offered a gluten-free menu since 1998, and its Tampa parent company Outback Steakhouse Inc. has adopted gluten-free menus at two of its other chains, Carrabba's Italian Grill and Bonefish Grill.
"They're a very loyal following," Ben Novello, president of Outback Steakhouse, said of celiac patients. "The return goes beyond the sales that we generate from the loyal customers we get. It goes to goodwill."