Imagine how much food you eat in a day that contains bread, noodles or other wheat products. These foods are almost impossible to avoid. But for many people, they are off limits. Sometimes this avoidance is not a choice.

Gluten is a protein found in many foods, most often products made with wheat, semolina, kasha and many food bindings. Holly Herrington, registered dietitian at the Center for Lifestyle Medicine at Northwestern Memorial Physicians Group, said finding products without gluten can be difficult for people who can’t tolerate it.

“These ingredients are found in so many foods in our society,” Herrington said. “It’s kind of tricky to avoid all gluten products because gluten is basically a protein.”

Gluten–free products have increased in popularity since the idea of going gluten-free became a trendy dietary choice several years ago. Before that, the products were used mainly by people with celiac disease, a gluten-triggered autoimmune disorder that affects the digestive system.

“Sometimes people will go gluten-free if they suspect they have any issues with gluten,” Herrington said. “Some people can be gluten-intolerant or possibly have celiac disease. Some people also go gluten-free because it’s a fad.”

Kathryn Lipps, 22, sits at a table in a sushi restaurant with her friends. She pours soy sauce into a bowl and puts an ice cube in it, letting it melt to lessen the amount of gluten in the product. Lipps, a graduate student at DePaul University, is in the early stages of celiac disease and feels discomfort when she eats food containing gluten.

“It’s like being punched in the stomach,” Lipps said. “Just thinking about eating gluten and knowing the effects makes me feel sick.”

Lipps began having problems with her diet when she was 18 years old, but she found out about celiac disease at age 15 when her grandmother was diagnosed with it. Her mother began having the same symptoms two years later and began eating a gluten–free diet. The stomach pains and other symptoms then went away.

“I really did not want to come to terms with not eating gluten anymore,” Lipp said. “My favorite food was doughnuts before realizing my diet had

to change.”

With the dietary, Lipps said her biggest challenge was cooking on a gluten–free diet. She said this was important because she could control what was going into her body. Her favorite meal now is a gluten–free sandwich.

“It is always so rare to find good gluten–free bread to make a sandwich with,” Lipps said. “If you can make a sandwich, it’s the best thing ever.”

Herrington’s biggest caution with gluten–free food is the fat content. She said foods like pretzels, crackers and other snack items may lack gluten but have additional fat to improve the taste.

“Personally, I don’t think there is that big of a taste difference,” Herrington said. “But once again, they will add things to them, like fat.”

Cynthia Kupper, executive director of the Gluten Intolerance Group and a licensed dietitian in Auburn, Wash., was diagnosed with celiac disease 18 years ago. Since then, she has maintained a diet with little or no gluten.

“When I started eating a gluten–free diet, it was akin to eating cardboard and Styrofoam,” Kupper said. “Today, there are so many gluten–free products you wouldn’t know are gluten-free unless someone told you.”

GIG is a nonprofit group that supports people with celiac disease and other forms of gluten intolerance. It aims to educate the public and help those who suffer from the conditions.

“There is a difference between having gluten intolerance and having celiac disease,” Kupper said. “It’s really important to know the difference because as the science of these two conditions progresses, you can understand what will happen for you.”

Kupper said GIG has support groups for those following a gluten–free diet for medical reasons. In Chicago, groups are very active through cooking classes and meetings. The group also provides a listing of restaurants that offer gluten–free options. John Sola, senior vice president of culinary at Grill Concepts, said various restaurant chains in the U.S. , including his, are listed through GIG offering gluten–free services.

In Chicago, Grill Concepts owns Grill On the Alley, 909 N. Michigan Ave. Its gluten–free menu ranges from side dishes, such as hummus and shrimp cocktails to full entrees, like a charbroiled chicken Caesar salad and New York steak.

“We are able to adapt to [the menu],” Sola said. “If certain dishes come with pasta, we will serve them without pasta.”

Grill Concept’s decision to add a gluten–free menu came about four years ago, after company officials attended seminars and noticed an increasing trend of dieters requesting gluten–free foods, according to Sola. He said the most important thing about the menu change was the necessary training.

“It’s not as much about the food or the menu, to be honest,” Sola said. “It’s more about the training and how the food is made. You can’t cross-contaminate.”

Herrington said in many sensitive cases, cross contamination between gluten–free foods and food containing gluten can give someone with a gluten intolerance or celiac disease the same pain he or she would get if eating a regular diet.

“There’s always risk of cross contamination,” Herrington said. “For something as little as using the same spatula to flip a sandwich in a skillet. If I were to flip regular bread and then gluten–free bread with the same spatula, it can contaminate the gluten–free food.”

Sola said the staff goes through intensive training to maintain the seal of approval it gets from GIG.

“We have our ‘gluten box’ in the kitchen when an order comes in,” Sola said. “Every bowl, every spatula, every cooking surface is sterilized. It’s really just the education of the kitchen staff and understanding what gluten is all about.”

Other gluten–free restaurants in Chicago include The Melting Pot, 609 N. Dearborn St., and Karyn’s Cooked, 738 N. Wells St. Lipps said Swirlz Cupcakes, 705 W. Belden Ave., is a good place for those on a gluten–free diet to get their cupcake fix.

As this condition gets better known, Kupper hopes the public becomes more educated on the subject, especially those in food service.

“Get to know what it is about and what it really requires for a restaurant to be gluten-free,” Kupper said. “Because then you appreciate it, and if you appreciate it, you are doing it because you want to do it.”

Lipps knows she is not alone in her diet choices because gluten–free is becoming more popular, and she hopes to see awareness grow in the future.

“It’s a growing issue a surprisingly large amount of people are now dealing with. But understand it is not anything you can choose,” she said. “I do miss wheat, but the benefits of my diet outweigh my love for doughnuts.”