Thought for Food

Sherry McGarrah was down to 80 pounds. Her energy had been evaporating as steadily as her weight recently, and her severe fatigue was just one symptom of a medical battle whose cause she couldn’t identify.  Several of her doctors believed she was anorexic; one ran tests to be sure she ingested fat. Only then did she have her diagnosis.

Celiac disease. That was the unfamiliar diagnosis McGarrah received in May 2005 and the same one that has since been given to several of her family members. The disease is an inherited autoimmune condition in which the small intestine cannot tolerate gluten, a type of protein found in wheat, barley and rye that also appears in commonplace products ranging from medicine to lip balm to envelope sealant. The condition is commonly misdiagnosed, as its symptoms — including depression, constipation, joint pain and a tendency to bruise — can be misinterpreted as other health problems, stress or something “all in the patient’s head.” And, like food allergies, the condition seems to be showing up — or simply being recognized — in more and more Americans today. There is no medication available, only diet adjustment.

“I knew I was going to change my lifestyle right then and there,” McGarrah says. Besides buying  cookbooks with recipes based on safe ingredients like rice flour, buckwheat and sorghum, she took her lifestyle changes one step further by opening her own gluten-free bakery, Kneaded Specialties. The Lee’s Summit shop offers a selection of baked goods, including sandwich bread, honey-butter biscuits and “ooey-gooey” fudge  brownies.

Another local gluten-free bakery entrepreneur, Carreen Blankenship, knows that taste is a large factor in selecting foods that also meet health standards. Blankenship opened Olivia’s Oven after her daughter Olivia was diagnosed with celiac disease just before her first birthday. Blankenship, too, found out she has the disease, as do her mother and younger daughter, Layla. Modifying family recipes, she makes basics like birthday cake and burger buns. One of her major clients is Waldo Pizza, which uses her gluten-free crust.

Although dining out can be a challenge for those with food sensitivities, a number of area restaurants cater to those with specific needs: Succotash at the River Market offers a selection of gluten-free foods and vegan menu items; Blue Bird Bistro ensures that staffers know exactly which ingredients are in each item and how to modify; and Daniel’s Bar-B-Q serves gluten-free barbecue in Shawnee.

Considered an autoimmune disorder, celiac disease is not specifically a food allergy, but those with allergies can face similar struggles in safe-proofing their diets. Cross-contamination is a major concern. The salad bars, grills and cutting boards in restaurants can allow “safe” foods to touch allergy triggers, and packaged foods sometimes are manufactured in plants where trigger foods are produced. Even at home, problem foods stored or prepared near allergy-safe foods can introduce risk. For six months after her diagnosis, McGarrah kept all her food in her own refrigerator drawer until her husband also started eating gluten-free.

Food sensitivities are pervasive. About 4 million adults and children in the U.S. suffer from a food allergy, according to the Greater Kansas City Chapter of the Asthma and Allergy Foundation of America (AAFA). In people with allergies, the immune system mistakenly pinpoints specific substances as harmful then releases antibodies to fight the perceived culprit. Chemicals released into the blood can cause symptoms ranging from itchy eyes to nausea to the severe condition known as anaphylactic shock. Life-threatening reactions are most common in people with asthma.

AAFA’s metro chapter estimates that 8 percent of U.S. children and 3 percent of adults might have reactions to some foods, which emphasizes the point that some children can grow out of their conditions. Interestingly, 90 percent of all food-allergy reactions are caused by eight foods: milk, soy, eggs, wheat, peanuts, tree nuts, fish and shellfish.

“There has been a rising incidence of allergic and immune disorders during the 20th century,” explains Dr. Khaled Girgis, an asthma and allergy specialist who serves on AAFA’s local board of directors. “One theory suggests that the increase is because of improvements in hygiene during the last century.” Some scientists believe in a “hygiene hypothesis,” meaning that as society has become more antiseptic (more hand sanitizers and antibacterial soaps), we have eliminated or reduced dangerous bugs and left our immune systems to fight less serious threats, such as the molecules in cat dander or dust mites.

The key to reducing the impact of allergy and immune system disorders, Blankenship believes, is education. Through her own research, she learned that many individuals with celiac disease also are lactose-intolerant. Now all her bakery items are also dairy-free. “This isn’t a fad diet. This is not the low-carb rage. We’ve watched this make a difference with our girls,” she says.

*Below, read an exclusive interview with local chef Renee Kelly, whose upcoming book, “Crap, I Forgot How to Eat,” discusses food’s role in poor health.

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Chef Renee Kelly works in a castle — yes, a real castle — but her culinary life wasn’t exactly fit for a queen when she found herself suffering from a mystery illness that left 30 doctors across the country baffled. Finally, she discovered that food played a large role in her poor health, and she’s coming out with a new book called Crap, I Forgot How to Eat to explain why the modern diet is anything but body-wise. The resident chef at Kansas City’s Caenen Castle — and the victim of at least 11 allergies and intolerances — shares her thoughts on allergy-friendly meals out.

As a chef, what are some common concerns you hear from people with food allergies?
The most common concern is the selection. Rarely there is something on the menu patrons can just order without having to modify it. Then, once the special order is placed, the service staff projects a very negative vibe like it is going to be an act of Congress to get the kitchen to make the order. Flavor is not really an issue because there are flavoring agents, like vinegars, sea salts and house-made broth, which brings both flavor and texture to the plate.

The other complaint I hear is still there is a lack of general knowledge about how important food allergies are (by the chefs and wait staff). Understandably, if they don’t have them and never have experienced a horrible reaction to food, they won’t understand the utter importance of proper food preparation. Most, if not all, of my colleagues in the small restaurants around Kansas City do have a great knowledge of food allergies, and I completely trust them to cook for me, as should other patrons.

How do you modify recipes to meet allergy needs? Are there any allergies or modifications you have to plan for more often than others?
Recipe modification sometimes can be difficult, especially when it comes to baked goods for a gluten-free client. The elasticity of gluten gives the baked goods their texture and structure. Often, the all-purpose flour blend ingredients shift to potato starches, rice flours and a bean flour, such as fava bean or sorghum flour, to give the bread a little browning effect. 

On the fly in the kitchen, the trick is not to reinvent the wheel. There are plenty of things in a kitchen that the client can eat; it just might take some creativity.  Knowledge is power in this case. Knowing the different food sources and the chemical make-up of the products helps to understand what the client can and cannot have on his or her plate. The creativity of the chef gives it a signature and helps to pull the products together for a tasty treat.

Most kitchens have, on hand, brown rice, corn meal, quinoa, almond milk and more.  The most common request is for a gluten-free meal, followed by dairy-free then vegan. In a given night, we will have around four special requests.

How long have you been a chef?
11 years.

In that time, have you seen the amount of allergy concerns increase, decrease or stay the same?
During culinary school, we didn’t even learn about food allergies. This is to show you how fast the epidemic has spread. While at my internship, the only request we got was for vegetarian meals. I didn’t even know what a celiac was. About six years ago, my friend was having problems with food allergies, and I thought she was crazy, but I did some research for her and we created some recipes to suite her cravings for cakes and breads.

Do you personally have any food allergies on intolerances?
Oh my gosh, yes! It’s funny how life plays games. Here I am a chef who can’t eat “normal” food. I think this makes me a bit more eccentric and possibly endearing, rather than a freak. Some people have called me a sadist for staying in the profession, but it has been a blessing in disguise.