(Cassandra Bent photo for boston.com)
When Alan Caparella's great-grandmother opened her restaurant in the North End 70 years ago, she served patrons heaping plates of home-cooked Italian food, rich in wheat-spun pasta.
Today, Caparella still serves hefty portions and his share of pasta-rich dishes at Mother Anna's on Hanover Street. But his customers also can order plates such as pollo venezia, served with gluten-free pasta for the gluten-intolerant diner.
My great-grandmother "made you what she made you and you’d like it or don’t come in," Caparella says with a smile. "But those times have changed, so we are definitely trying to conform."
Alan says he and his two brothers, Michael and John, have recently made changes to the meals they serve because of a “high demand” for gluten-free options, one that's even reached the gluten-rich North End mecca of pasta, breads and pastry.
Quietly, North End restaurants such as Marco, Benevento’s and Terramia Ristorante also are beginning to cater to a new crowd, customers with gluten allergies or just a desire to eat what they consider to be healthier foods. The restaurants are adding gluten-free dishes though sometimes these plates don't even appear on the menus.
Gluten is a protein found in barley, wheat, and rye that some people cannot tolerate, according the Celiac Disease Foundation, a non-profit organization striving to educate people who have the gluten-intolerant celiac disease.
Some with celiac disease exhibit no symptoms if they eat gluten, but have what Beth Israel Deaconess Celiac Center nutrition coordinator Melinda Dennis calls “silent symptoms,” such as the inability to absorb the calcium needed to keep bones healthy. This can later lead to osteoporosis, or brittle bones. Still others experience immediate and painful effects, such as getting sick to their stomach.
“Celiac disease can affect multiple parts of the body,” said Dennis, who is one of the authors of “Real Life with Celiac Disease” and one of what the Beth Israel Celiac Center estimates to be 200,000 Americans currently diagnosed with the disease.
Dennis gives the skin as one example of how the body can be affected by the disease. Because celiac disease is an inflammatory disease, she says, some who have it suffer from Dermatitis Herpetiformis, an “itchy, blistering skin rash that is closely related to celiac disease and responds well to the gluten-free diet.”
Members of the gluten-intolerant population can even be affected by sloppy kitchen practices. For example, chefs cooking for those on a gluten-free diet should not use a spoon in regular pasta and then stir gluten-free pasta without washing the utensil.
“It’s still [not easy] to do right,” said Scott Adams, the founder of celiac.com, a site that provides information about celiac disease and the gluten-free diet.
When Adams was diagnosed with celiac disease in the mid-nineties, he says he was able to find only two pages of information about the disease on the Internet.
Today, Adams says, doctors are testing more patients and patients are asking to be tested more because of the vast amount of information and media coverage of the disease.
Although awareness has spread, statistics show that more education is still needed. Rita Hopkins, executive director of the Celiac Disease Foundation, estimated that 3 million Americans actually have celiac disease, which means roughly 95 percent of those with the disease “are going undiagnosed.”
But a growing awareness of the disease can be measured today in the number of signs in restaurant windows and on menus of “gluten-free dishes.” Even in the North End, Alan Caparella notices this growing demand.
“It went from once a month to once a week to two times a night,” Caparella said of the requests for gluten-free dishes over less than a year’s time.
And so he makes sure to cook all gluten-free entrées in separate pans in order to prevent cross-contamination, cooking roughly one gluten-free meal for every 350 traditional meals.
As people try to consume fewer processed foods in hopes of staying healthier and losing weight, some of this heightened gluten-free demand is coming from more awareness of healthy eating rather than greater awareness and diagnosis of the disease itself. Dennis of the Beth Israel Celiac Center estimated that some 16 million people are following a gluten-free diet.
Though Caparella occasionally cooked a meal for those with the allergy before, it’s only since August has he stocked his kitchen with gluten-free pasta.
Other North End restaurants also order gluten-free items to cook with due to the growing demand. Just a couple streets over from Mother Anna’s, Benevento’s on Salem Street offers such gluten-free items as pizza, pasta and beer. It has recently added gluten-free breads and even gluten-free croutons, atop salads.
“It’s something people need and not many restaurants have,” said Benevento’s owner, Joe Bono.
Bono said he likes to accommodate people even though there are a few minor challenges, such as properly training staff members.
“It’s not that hard that we can’t adapt,” he said.
Also located on Salem Street, Terramia Ristorante serves gluten-free options as well.
“It’s not super difficult for us to do,” said waiter Andy Goaga. He said that most of the time, the only item that needs to be substituted in dishes is the pasta itself.
“It’s an easy remedy,” he said.
That remedy, head waiter Gabriel Goaga says, helps the restaurant “attract more customers.”
Down the street from Mother Anna’s, Marco on Hanover Street is another restaurant that caters to people on a gluten-free diet.
Celiac-friendly pastry is also making its way into this neighborhood. Just a few weeks ago, Terramia Ristorante began offering customers a sweet ending to their meal: gluten-free chocolate cake. Modern Pastry on Hanover Street also features a gluten-free and dairy-free whoopie pie.
Gluten-free customers should expect most restaurants to charge a bit more for their meals. The reason: Gluten-free pasta typically costs more than double the amount of a regular box of pasta, and gluten-free pizza crust is far more costly as well. At Mother Anna’s, for example, a plate with gluten-free pasta costs two dollars more.
Mother Anna’s chef, Caparella, said on a busy night it can be challenging to cook for someone who’s gluten-free because some of his dishes are prepared earlier in the day. There are always a few items, such as chicken parmesan, that he will not replicate.
“I try to limit it to where it’s not going to change the food and flavor that much,” Caparella said. “When it comes down to it, we still want the food to taste good.”
These days, after reading Robb Wolf’s “The Paleo Solution,” a book about eating healthier and avoiding illnesses, Caparella has decided to cut the pasta and bread out of his diet, too. He now eats more fruits and vegetables as the diet stipulates.
“The first two weeks were brutal,” said Caparella. “I used to eat pasta seven days a week, sometimes twice a day.”
A month later, Caparella says he feels better, has more energy and has lost more than 8 pounds.
And what would his great-grandmother have thought? Caparella says she wouldn’t understand because there weren’t many allergies back then. But, he ads, gluten-free items on his menu are here to stay.
This article is being published under an arrangement between the Boston Globe and Emerson College.