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Apr 8, 2009 05:54 AM

gluten and gender

Purely anecdotal evidence, but it seems like out of the guests at this hotel, the majority of those who request gluten free food are women.

What's up with that? Does the condition not affect the sexes equally? Are women more sensitive or willing to address health issues while men are in denial and afraid to go to the doctor? Are women more likely to jump on the current in-the-news diet malady bandwagon? Or do we just have a skewed sampling so far and the numbers will even out over time?

Just curious if there is anything to my observation.

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  1. i am also in hospitality and anecdotally agree that women have far more special food requests than men -- gluten free now being the latest concern. before that it was lactose intolerance.

    please note: i am female and am not trying to make light of genuine health issues.

    however, approximately 2% of adult americans have food allergies. only 2%. celiac is genetic, and its prevalence is 1 in 133 -- so approximately 3 million americans have it, including those suffering yet remaining undiagnosed. there are nights when 4 or 5 women will claim to have gluten concerns. i'm sorry, but the math simply doesn't add up, but yes, we accommodate them.

    tossing out another unsupported anecdote: these requests only come from americans. we get plenty of europeans and south americans, and i have never had one claim a food allergy or intolerance as a concern.

    22 Replies
    1. re: hotoynoodle

      Just because you have gluten intolerance doesn't mean you have celiac disease. Currently the figures are about 1 in 133 have celiac. But there are more gluten intolerant people than that. DH and I both have gluten intolerances but do not have celiac (at least I know I don't as DH didn't get tested).

      Which will lead to the thing that the OP originally brought up -- women more sensitive and willing to address health issues than men. Working in the health field, I do find that to be generally the case. On the whole, women do visit doctors more often than men. That is one of the reasons why health insurance premiums for women tend to be higher than those for men.

      And I don't know about the South American thing, but celiac disease is certainly quite prevalent and well known in many European countries. I've heard the quality of gluten-free items is much higher than those in the States. So I think the reason you never encountered somebody is because of sample size -- I'm guessing you encounter a lot more Americans in your industry than Europeans.

      1. re: Miss Needle

        it's supposedly quite common in those of scandinavian and irish ancestry. living in boston, i know dozens of irish ex-pats. not one reports a gluten issue.

        1. re: hotoynoodle

          Just because you personally have not encountered any doesn't mean that it doesn't exist.

          1. re: hotoynoodle

            I've heard it's common in those of Irish descent, and I was told by a family friend with relatives in Ireland that you can find gluten free food everywhere because "lots of people have it and everyone knows about it." A non-GF friend attempted to test this theory out on my behalf in Dublin, and out of the 30 or so people he talked to, nobody had any idea where he could find gluten-free food.

          2. re: Miss Needle

            In my personal experience women are also for more likely to go see a naturopath - to help with vague complaints that their doctor can't/won't address, or even to help with weight loss. And it does seem that these praticioners are more likely to prescribe an elimination diet and suggest food intolerances.

            I do not mean to minimize the seriousness of celiac or even lesser intolerances, but there are trends to these things. 10 years ago it was the Candida diet - people were getting "diagnosed" by health food store cashiers based on the appearance of their tongues. Everyone I knew who went to a naturopath for any reason at all, got put on the Candida diet.

            1. re: julesrules

              And elimination diets turn out to be part of the problem in many (if not all) cases. The fad like popularity of elimination regimens would easily explain why mild intolerances become much more severe for increasing numbers of people.

              1. re: Karl S

                An elimination diet is a diagnostic tool, not a method of eating. One goes on an elimination diet to see what he or she has problems with. Then the protocol is to avoid these foods for some time and then reintroduce them slowly at a later stage. That's the original intention. Perhaps that's not what's going on in the States -- I don't know.

          3. re: hotoynoodle

            Oh...something else to consider, hotoynoodle: I'm not sure where you get the 2% number from, but if it's supposed to measure only those with *allergies*, but not intolerances, that might explain some of the discrepancy. A number of people I know, including me, have a wheat intolerance, which means that we develop skin conditions (hives, swollen lips, rashes, etc...) and have digestion issues (diarrhea) after eating wheat protein. Celiacs are allergic to all gluten, apparently have much more severe symptoms and can feel tired or weak for days after ingesting gluten. There are some technical distinctions between intolerances and allergies that I don't fully understand, but perhaps Miss Needle or others do.

            1. re: cimui

              the 2% figure is from the fda's website and can be found on numerous other reputable sites, like that of the mayo clinic. i didn't pull it out of my hat.

              i'm fully aware of the difference between an allergy and an intolerance -- an allergy involves the immune system and an intolerance means either a missing or malfunctioning enzyme that inhibits normal processing of a food.

              my frustration comes from somebody like miss needle's husband whom she admits is self-diagnosed. i have no doubt he suffers, but it could be any number of things.

              as i said above, my work observations are anecdotal and i don't intend to dismiss anybody's health. i have worked in fine-dining almost 20 years. 5 years ago, lactose intolerance was the thing everybody *had*. i can count on a few fingers how often that arises as a dining issue each month, whereas we now get dozens of gluten issues per week. i stand firm that the math simply doesn't add up.

              1. re: hotoynoodle

                I wasn't accusing you of pulling numbers out of a hat, htn, just trying to figure out what that 2% is supposed to represent. I'm almost certain that it only counts those with allergies rather than intolerances.

                This website notes that only 1/2% of people have wheat allergies, but a whopping 15% have wheat intolerance: Also, those with other intolerances:

                Dairy Intolerance (includes Lactose intolerance) ~75% 3 in 4 people
                Yeast sensitivity (eg. Candida infections) ~33% 1 in 3 people
                Gluten sensitivity (inc. Celiac and Wheat intolerance) ~15% 1 in 7 people
                Fructose or Sugar sensitivity ~35% 1 in 3 people

                [The same website actually estimates that only about 1% of people have true food allergies, which is even more conservative than your count.]

                I'm not sure whether you're making this assumption or not, but please do note that an intolerance does not mean the effects aren't sometimes very severe.

                Since (1) the technical distinctions between an allergy and intolerance are often lost on reservationists; (2) saying that you're "intolerant" doesn't sound nearly as bad as saying you're "allergic" (the former can just make you sound like a diva-type picky eater to those who don't know better); and (3) the consequences of eating wheat for a wheat intolerant person can be pretty darn ugly / uncomfortable, I'm sure a lot of people just find it easier to tell you they are allergic.

                I'm guessing that explains the discrepancy you're seeing.

                1. re: cimui

                  I do agree with you that the 2% figure is talking about allergies as opposed to intolerances. The figure for intolerances is a lot higher.

                  (Cimui, this isn't directed at you). I think the main reason why we're seeing more gluten intolerances/allergies in the recent years is that there is more awareness. Doctors are diagnosing them as opposed to dismissing them in the "psychosomatic" or "unknown diagnosis" category. The figure of 1 in 133 people affected with celiac is more of a recent one. It used to be like 1 in 200-300. And I'm sure as people are more aware of this, the numbers will change again.

                  Are there people who go to restaurants saying they've got gluten issues for other reasons like they need attention, want to feel "special," etc.? Perhaps. People can be funny. But as I said before women are more apt to see doctors as opposed to men. In addition to seeing doctors, women also tend to be more compliant. So I think that accounts for why some people may be seeing this more often from women.

                  And to answer hotoynoodle's question about my husband's gluten issues -- no, he did not receive a blood test or anything like that. But gluten intolerance can be diagnosed by an elimination diet done at home. I received tests to rule out celiac disease. I never received any tests to say that I had a gluten intolerance. When the doctor found out that I was negative for celiac, she just told me that I suffer from intolerance, and depending on my situation will be able to eat things like soy sauce depending on my tolerance level. She didn't give me any further tests to see whether or not I had gluten issues.

                  Lastly, when I go to restaurants, even though I have an intolerance, I don't go around making an issue out of it. I'll eat everything when I'm out as I generally eat at home most of the time. I've discovered that if I'm super good about ingesting any gluten, when I eat a tiny bit, I suffer from a lot of not-so-pretty issues. So I'd rather have gluten in moderation so my body doesn't freak out so much when I have gluten. I do, however, have a life-threatening allergy to one thing. If I ever see it on the menu, I've got to be super careful and sometimes probably go overboard making sure the waitstaff understands my dilemma. I would certainly be pissed off to no end if they didn't take my concern seriously because I was one of those gals who's got a control issue. I tell them I need an Epi-pen if I eat my allergic item. That seems to do the trick in having them take me seriously.

                  1. re: Miss Needle

                    >>I think the main reason why we're seeing more gluten intolerances/allergies in the recent years is that there is more awareness. Doctors are diagnosing them as opposed to dismissing them in the "psychosomatic" or "unknown diagnosis" category.

                    Agreed. I also don't think it's beyond the realm of possibility that gluten-related illnesses are actually just on the rise, period. A friend of mine who is a biochemist working in agriculture argues that it may be a side effect of widespread use of genetically modified wheat. I don't know if I believe this, but certainly it is true that genetically modified wheat from Monsanto and other sources has caused many unforeseen, undesireable side effects.

                    I did not develop my intolerance until very recently (in my 20s). My mother thinks it resulted from me eating too much pasta and bread when I was running cross country. An allergist I saw thought it might've been triggered by simultaneous exposure to other, new allergins in my environment. However it came about, the effects are very real.

                    Interesting what you say about continuous, low dosage exposure, Miss N. My intolerance has actually gotten a lot worse in the past few months and my allergist thinks it's because I'm not very careful about avoiding all wheat. (I eat nigiri brushed with soy sauce, stirfries, Thai noodle and other dishes that contain soy sauce, and sometimes eat a bite of bread or pastry so I know what it tastes like, to review food at a restaurant.)

                    1. re: cimui

                      "I also don't think it's beyond the realm of possibility that gluten-related illnesses are actually just on the rise, period."

                      I agree that your statement could definitely be a possibility. There could be many different reasons, whether it could be because of genetically modified wheat or because women are having children at a later age or because of the advances in medicine. Perhaps in the past, people with gluten-related illnesses wouldn't have survived (not that they would have died directly as a consequence of gluten intolerance). Who knows?

                      Sorry to hear that you're situation has bee getting worse because you're "cheating." Everybody's got different tolerances. If I have avoided gluten 100% for like a week or two and have a little bit, I feel like shit. But if I have a little bit here and there, I'm OK with it. If I regularly eat gluten in larger amounts (like two servings of pasta/bread on a daily basis), I end up feeling like crap in about three days -- which is probably why my body feels horrible at the end of vacations. Perhaps you need to be 100% wheat-free for a while (including things like soy sauce, etc.), and gradually work in wheat to see what your threshold is as Karl S has written below. If it turns out that even a bit of gluten is too much for you, you may need a total break from it for a period of time. I know it's really hard, especially where we live where we're tempted by a whole bunch of wonderful bakeries, great bread in restaurants, etc. But perhaps after a break, your system would readjust, allowing yourself to take in a bit of wheat now and then in the future.

                      1. re: Miss Needle

                        Cimui, I'd also like to add that my sister's boyfriend and my aunt are two people who had terrible food issues several years ago. The only thing my aunt was able to eat were sweet potatoes, vegetables, fish and grains. And no oil in any form. Otherwise she'd get really tired and break out into rashes all over her body. This went on for years. She probably would have been able to heal a lot faster if she was more compliant. Now she's able to eat everything with the exception of pork and oil that has been heated (cold oil is fine).

                        My sister's boyfriend also had terrible issues as well. Couldn't eat any sugar/sweetener, dairy. Only grain he could eat was quinoa. If he did, he would get explosive diarrhea. And I also believe he was a vegetarian as well. He was really good about following his diet, and now has been incorporating foods that used to give him problems in the past.

                        So don't give up hope! There are people out there who had very severe reactions to so many different foods. I know, a Chowhound's nightmare. But today they are much healthier and can eat these foods that gave them problems in the past because they avoided them for some time.

                        1. re: Miss Needle

                          thanks for these examples, miss needle! I think i need some stories like these to really inspire me to buckle down. i'm so glad i don't have to give up oil. i would really be said if i had to give up my fried latkes.

                2. re: hotoynoodle

                  I have self-diagnosed wheat and dairy intolerances. Both leave me with crippling stomach pains, nausea and diarrhea. As a child, I was in and out of family doctors dozens of times. However, doctors always just said, "Don't eat it if it makes you sick." As an adult I've gone to a few other doctors who have said the same thing. Nobody has ever offered to do testing, and when I have requested testing they have turned me down and said, "If you know it makes you sick, just stop eating it." I used to see a naturopath who said the same thing. Getting a referral to a specialist in Canada is pretty darn close to impossible, or so it would seem for me (I've been waiting since November for a different referral for a non-food issue). Today, I just don't eat wheat or dairy. And I don't get sick. After a long time without eating either, I can usually tolerate a very small amount with just mild discomfort, rather than full-blown torturous pain. It definitely could be any number of things, but the health system here is set up in a way that means I'll probably never know. I apologize if I frustrate you.

                  1. re: Jetgirly

                    Sounds like me. I know that I get hives and feel super hot if I have wheat, but as for getting a doctor to diagnose anything? nada. I also know that my insides hate me if I have dairy, but no doctor has ever found anything.

              2. re: hotoynoodle

                hotoy, I'm also in the industry and would say the ratio of women to men who complain of a gluten "allergy" is at least 20:1, perhaps more. I don't know if it's truly more common in women (not the case in the study mentioned below) or if some women aren't happy unless they're not happy.

                1. re: invinotheresverde

                  i'm more inclined to think that for those whom always seem to suffer from the latest thing, it's either an attention grab or a control strategy. either way, it diminishes the seriousness of those who truly have food issues rather than mental ones.

                  1. re: hotoynoodle

                    Well, no doubt that a higher number with active or previous EDs are women.

                2. re: hotoynoodle

                  It's really interesting that you encounter only Americans requesting GF, because there was just a thing in the NYT that mentions how much more and better European restaurants are doing for GF diners.


                  older but relevant article:

                  1. re: hotoynoodle

                    Well, let's see. There's a huge difference between someone who politely inquires and makes a menu choice or even special request, and someone who generates a scene at the outset.

                    Americans have a fairly high rate of some kinds of illnesses, and naturally there is more concern over the diet here given the high amount of food processing Americans are exposed to vs. many other areas.

                    And there's a world of discomfort not reflected in official numbers of who mainstream physicians think has an allergy or sensitivity, so I'm an advocate of tolerance. Maybe they're right.

                  2. The 2 people that I know that have Celiac disease are both women... interesting.

                    5 Replies
                    1. re: Squirrels

                      I have a wheat intolerance (rather than a generalized gluten intolerance or celiac disease) and I'm a woman. I work with at least four men that I know of with full blown celiac's disease and one man with a wheat intolerance like me. One celiac sufferer is in his fifties and was just diagnosed with it a few years ago. He'd suffered from the symptoms his entire life, as his mother had, but didn't realize his poor health was related to gluten ingestion until recently.

                      I am really curious whether these ailments are more common among people whose ancestors are from certain parts of the world. I am Asian American, as I think Miss Needle and her husband are. My celiac-suffering colleagues are all white (a mix of Eastern European, Jewish and Irish). I was very surprised to see how many gluten free products were on the shelves in supermarkets in Ireland when I visited last year.

                      1. re: cimui

                        Gluten intolerance is indeed more common in nations where gluten is widely consumed. Just as in Asia, rice intolerance is a lot more common than in the States.

                        1. re: Miss Needle

                          Yes, a lot of people in the West assume the rice is hypo-allergenic, but allergy rates for it are much higher in the East.

                          One exacerbating problem with allergies in the US as opposed to elsewhere has been the tendency to immediately recommend elimination diets rather than building tolerance through controlled exposure, as elimination in many cases tends to worsen the allergic response to inadvertent exposure, though this is *finally* becoming more recognized in the US.

                          1. re: Miss Needle

                            Ah, that makes sense. Just like how chicken allergies are common among dogs in the US, where it's often used in commercial kibble, but far less common in the UK where mutton is a more common allergen.

                        2. re: Squirrels

                          I have a neice and a nephew ( they are siblings) who have been diagnosed with celiac over the past year. Both are in their early 20's- and they were miserable for a while. They were told NOT to change their diet until the celiac diagnoses was confirmed with testing,because if they cut out the gluten, their symptoms would lessen! Their younger sister and their parents were both tested, and they tested negative. We are a large family of Irish descent, and so far, only two have celiac. They both have adjusted well to their diets, and we have all learned to prepare foods they can enjoy with the rest of us. This past Thanksgiving, I cooked two turkeys, to ensure one was gluten free- their stuffing was made with tapioca bread, and the gracy was thickened with corn starch.

                        3. Celiac disease is twice as common in males versus females according to a study released in Italy last month. The propensity for it to show up is increasing, too, so noted the authors of the study and there are various hypotheses as to why.

                          The genetic links are also being studied.

                          It is also suggested that gluten intolerance would be twice as high in women as men because there is some evidence that gluten intolerance is a kind of 'shadow' version of full-blown CF. This is not yet proven, but it does seem that there might be genetic markers for gluten-intolerance (really hard to prove this one because offspring of the gluten intolerant cannot remain unaffected by parental eating patterns and there is no simple test for gluten intolerance "except do you feel better when you avoid gluten?" which is subjective to a degree.

                          I am the mother of a young woman who was diagnosed with gluten intolerance after years of increasingly intrusive health problems. In the 3 months prior to going totally gluten free, she lost 22 pounds from a 120-lb frame. She was being tested for colon cancer and anything else they could think of to explain the unremitting GI problems.

                          Nobody is going to tell me gluten intolerance is not real and an increasing problem. But I am not convinced that there is not a connection to waht we are dousing our wheat in prior to turning it into flour that is the problem. What if gluten intolerance is pesticide intolerance?

                          Basically, we just don't know enough about either condition yet. But, by avoiding, ALL what products (and that is a huge deal), my daughter once again has roses in her cheeks, no dark circles under the eyes and is a healthy weight. Thank God!

                          1 Reply
                          1. re: LJS

                            Sorry about that first line in my original post. The Italian study found twice as many WOMEN as MEN...I later corrected but the furst line of my post it wrong. My bad.

                          2. Another thought to piggyback on LJS's observation that gluten intolerance might be twice as prevalent in women though celiac is twice as common among males:

                            It's possible that those with celiac or full blown allergies don't eat out at restaurants at all because even minute amounts of gluten can have such terrible effects. Those like me with intolerances do eat out. That might also explain why so many of your guests who request gluten free food are women.

                            I would really find it strange if people fixated on gluten intolerance as a glamorous malady, since I can't think of anything less glamorous. Who wants to admit they get the runs or swell up like a puff pastry when they eat wheat? And who would subject themselves to the horrible gluten free meals prepared for airplane passengers unless they really, really had to?

                            1. hey babette, i think you did a really good job of starting the discussion on neutral grounds. just curious about you and other chowhounds' clientelle. do you have more women diners in your hotel? to invoke another annoying, but unfortunately sometimes applicable, stereotype, could it be that women are dining in the hotel while their spouses are out having meals with clients or colleagues?

                              1 Reply
                              1. re: cimui

                                No, we are a vacation destination, not a business destination, so most guests are M/F couples, and most guests eat all of their meals with us.