Egypt is home to one of the world's great ‘food is love’ cultures. Just ask anyone with an Egyptian mama, biological or adopted. Heaven help you if you don't eat all the food on your plate: Mama will think you hate her cooking. Heaven help you if you do eat all the food on your plate: she'll refill it and then insist you take all three kinds of dessert. You need the stomach capacity of an elephant and the metabolism of a shrew to keep up.
Now imagine trying to keep up when your body cannot tolerate gluten, an ingredient in many foods. For people with celiac disease, gluten inflames the lining of the small intestine, which consequently prevents nutrients from being digested. The immediate symptoms include persistent digestive problems ranging from abdominal pain, nausea, vomiting, constipation or diarrhea. Over the long term, the lack of nutrients can cause numbness or tingling in the extremities, hair loss, nosebleeds, joint pain and many other problems. The only treatment is a lifetime gluten-free diet.
Sounds simple, until you realize what that means: nothing made with any type of wheat, barley, rye or even oats, which are prepared in the same facilities as wheat products. In places like the US or Europe, major food manufacturers such as General Mills now offer gluten-free versions of breads, pastas, cake mixes, snacks and other items, so it's possible to load up the suitcase with treats while traveling. In Egypt, however, a gluten-free kitchen is a mostly a do-it-yourself project. As an experiment, I made the rounds of large supermarkets in Maadi, an area known for its availability of imported food appealing to the expatriate population.
Beans, sesame, meats, eggs, fruits and vegetables and most dairy are all allowed on a gluten-free diet, so no problems there. But head over to the bakery section, and it's all made from wheat in one form or another. All those glorious Ramadan treats like baklava or konafa are off the table. Not even basboussa is allowed, because its base ingredient semolina is a wheat product.
That wall of packaged pasta also held no gluten-free options. The breakfast cereal section, the cookies and snack sections – all of it is off limits. Products with cream sauces usually use flour as a thickening agent, so you can't buy those. Barley is an ingredient of malt vinegars and soy sauce, so you even have to check the labels in the condiment section closely.
As a last resort, I stopped by an organic food store, thinking a health- and-environment-conscious outlet might have a gluten-free section. No such luck: While the store had local and imported products such as muesli and noodles, they were still made with wheat, albeit organically grown. The man at the counter seemed sympathetic but said they have never carried gluten-free products.
There is still some hope for people with celiac disease in Egypt, especially if they like to experiment in the kitchen. I was pleasantly surprised to find in several supermarkets that the locally made brand King M has corn meal and rice flour, both gluten-free substitutes for wheat flour. They're not perfect substitutes, as I discovered when I tried to adapt my favorite cake for my cousin, who has celiac disease — you have to tweak the recipe to come close to the original.
Egypt's food-oriented social life also presents a challenge, as Katrina Morsi found out when she started a gluten-free diet about three months ago. A British woman who has lived in Cairo for 12 years, she'd suffered from digestive problems and tingling fingers for years, but it wasn't until she saw an episode of the Dr. Oz Show on celiac disease that she recognized her symptoms. Thinking she had nothing to lose, she put herself on a gluten-free diet.
As someone who loves carbohydrates, Morsi feared the new diet would be boring. “But when you take into consideration you can eat rice and things made with corn, you can kind of balance it out a little,” says Morsi. “There are a lot of cuisines that are rice-based, if you think of Japanese [or] Indian, and there's risotto if you go for Italian.”
“The biggest problem is if you go to any kind of coffeeshop — they have sandwiches, they have pastries, they have cakes,” she continues. “They don't have anything that you can eat, apart from cheesecake if you avoid the bottom.”
According to Morsi, who is married to an Egyptian, Egyptian cuisine has a lot of foods you can eat. “The problem [is] a lot of [dishes] are designed to be eaten with bread, and you can't have that,” she explains. “I mean, you've got hummus and ful and tahina. But I've never eaten ful by itself, I've always dipped bread in it and the same with hummus.”
In addition to avoiding obvious things like bread, she also has to be aware of how dishes are made. “There are lots of things […] you think would be fine but aren't because of the hidden [ingredients] like anything made with milk sauce or cream because it's thickened with flour.”
While others dig into the breads and dips, she contents herself with eating the meats and vegetables. It does attract questions, and Morsi says many people have this idea that if someone is eating funny foods, she must be on some kind of miracle weight loss diet. “Most people are very interested […] but they also think it's a bit extreme that you can't any bread or [any] form of bread,” she notes. “They don't think it’s a lifestyle, they don't think it’s a health thing.”
For Morsi and others with celiac disease, though, it is very much a health thing. After she went gluten-free, her chronic digestion problems ended. “ The results are amazing. Amazing,” she says.
So when people do ask about her eating habits, Morsi takes the easiest path: “It's easier to say I'm on a no-carb diet, because most people have heard of that.” et
Celiac disease can be diagnosed through a series of blood tests. If you have chronic digestive problems, consult your physician about getting tested. A number of websites offer resources for people with celiac disease, including the US-based http://celiac.org/index.php and the UK-based http://www.coeliac.org.uk/.