When I was first diagnosed with celiac disease, I went to my best friend’s place in Montreal for dinner. She is Italian, and her lovely family were used to feeding me pasta without issue. When I explained my disease to her parents, her father looked appalled. Solemnly and slowly he said, “Jodi, this is a fate worse than death.”

While many celiacs feel the same way upon hearing their diagnosis, the reality is that the world is a safer place for our stomachs than it ever has been. And there are plenty of wonderful, naturally gluten free grains out there for experimenting and enjoying.

Given his reaction, however, I was worried about my trip to Italy. I did not know if there would be any food for me, or if I would need to bring snacks of my own. I was surprised to find that my fears were very misplaced.

Italy was one of the easiest places to enjoy food as a celiac.

This page was last updated: JUNE 2020

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Upon my return from Italy, I waxed poetic about how much I could eat. The first reaction from every single person was precisely the same: “oh Italy must be accommodating its tourists!” Not the case. It was obvious that the dietary changes were not rooted in tourism. Even tiny towns had knowledge of the disease, and had been exposed to it sufficiently that they made adjustments in what they offered.

I reached out to Letizia Mattiacci, who runs a B&B with a cooking school in Italy. Letizia responded quickly :

I recall seeing a Dutch study time ago stating that modern wheat varieties have higher toxic gluten content than traditional varieties. Then there’s the problem of overexposure. Wheat and modified starch are everywhere, so Italians are certainly more exposure than others as we are big pasta and bread eaters. According to the Italian celiac association, about 1% of Italians are celiac. As a consequence, is not surprising that you find lots of gluten free options in Italy. In Perugia we even have a gluten free restaurant and we’ll have a Gluten-Free Festival at the beginning of June.

In a 2019 report entitled “, the Italian government noted that celiac disease diagnoses in Italy increased by 57,899 from 2012 to 2017, with an average of 10,000 new cases diagnosed per year.

The knowledge and care goes much deeper than that. Children are routinely screened for celiac disease in Italy once they begin to show any symptoms that may be correlatable, something doctors missed for me when I was a child. I spent many years sick to my stomach with no suggestions to screen for celiac. As with some other countries, in Italy celiacs also receive a government subsidy to compensate them for the higher cost of gluten-free foods.

Furthermore, Maria Ann Roglier, the author of The Gluten-Free Guide to Italy, notes that Italian law requires that gluten-free food be available in schools, hospitals, and public places. And that you can study for a masters in celiac disease, from diagnosis to management thereof.

But one thing still nagged: the country didn’t just know about celiac disease, they accepted it. They embraced that this was an issue and moved around it to accommodate their meals, and did so with gusto. I asked Letizia and she gave a thoughtful response: that Italians are very conscious of the connection between health and food.

In addition, there is the fact that food is central to Italian life and community. Per a New York Times piece on celiacs in Italy:

In Italy, not being able to stomach wheat is more than an inconvenience or fad diet. “It’s a tragedy for Italians,” said Susanna Neuhold, the AiC’s manager of food programs. “Food in Italy is the center of social life and relationships with people. For someone who can’t go out with their friends or to a work meeting at a restaurant, it’s a very big problem, psychologically and socially.” That resonance has translated to an institutional empathy that might shock Americans.

In addition, alternative flours are prevalent in Italy as well. Chickpea and chestnut flours have been part of Italian cuisine for centuries. In the nineteenth century, an Italian agronomist noted about Tuscany that “the fruit of the chestnut tree is practically the sole subsistence of our highlanders” (Targioni-Tozzetti, pub. 1802, Volume 3: 154). And in the twentieth century, Adam Maurizio, who wrote a seminal book on the history of edible vegetables in 1932 (called L’histoire de l’alimentation végétale depuis la préhistoire jusqu’à nos jours, for those inclined) discussed chestnut trees as being available not just for the fruit of the tree, but also for making into bread when grinding that fruit into flour.

Unlike in North America, where these new flours are trendy but not firmly braided into our history, Italians have been using ground corn, chestnuts and chickpeas as substitutes for hundreds of years.