First Report on Cultural

Attitudes to the Gluten Free

Diet

First Report on Cultural

Attitudes to the Gluten Free

Diet

Aydan Kansu

Ankara University Faculty of Medicine, Department of Pediatric Gastroenterology and

Hepatology, Turkey

Aydan Kansu

Ankara University Faculty of Medicine, Department of Pediatric Gastroenterology and

Hepatology, Turkey

TurkeyTurkey

Population: 72.561.312

Children: 18.859.334

CD prevalence (6-17 yr): 1:212 (Am J Gastroenterol 2011)

Population: 72.561.312

Children: 18.859.334

CD prevalence (6-17 yr): 1:212 (Am J Gastroenterol 2011)

Estimated childhood CD: 100.000 - 200.000

Diagnosed adult + childhood CD: ~12.000

Estimated childhood CD: 100.000 - 200.000

Diagnosed adult + childhood CD: ~12.000

Awareness about CD among doctors

and among people and availability of

testing is increasing in Turkey.

Awareness about CD among doctors

and among people and availability of

testing is increasing in Turkey.

National PolicyNational Policy

0-5 y 52.50 TL/month = 21 €/month

5-15 y 80 TL/month = 32 €/month

15 y 72.50 TL/month = 29 €/month

0-5 y 52.50 TL/month = 21 €/month

5-15 y 80 TL/month = 32 €/month

15 y 72.50 TL/month = 29 €/month

Flour: 10 €/kgPasta: 5 €/kgFlour: 10 €/kgPasta: 5 €/kg

Kinds of meals, ways of cooking and serving differ from nation to nation because of differences in climate, geographical setting, agriculture and economy.

Turkish cuisine is extremely diverse and includes a nearly global mixture of spices, and recipes from northern, southern, eastern and western communities.

In Turkey, nutrition is largely wheat-based. Wheat accounts for 60% of the daily caloric intake of a typical Turkish.

Our food tend to be spicy, oily (olive oil) with much sauce (tomato and red pepper paste).

Kinds of meals, ways of cooking and serving differ from nation to nation because of differences in climate, geographical setting, agriculture and economy.

Turkish cuisine is extremely diverse and includes a nearly global mixture of spices, and recipes from northern, southern, eastern and western communities.

In Turkey, nutrition is largely wheat-based. Wheat accounts for 60% of the daily caloric intake of a typical Turkish.

Our food tend to be spicy, oily (olive oil) with much sauce (tomato and red pepper paste).

Turkish FoodTurkish Food

Grains-dough-based food

Vegetables

Meat-fish

Fruits-dried food

Legumes

Desserts

Dairy products

Herbs-spices

Grains-dough-based food

Vegetables

Meat-fish

Fruits-dried food

Legumes

Desserts

Dairy products

Herbs-spices

GrainsGrains

Wheat is the basic of bread which is an extremely important food in Turkey.

In Turkish cooking, we use bread and other flour and dough-based foods. Bread holds an extremely important place at meals, some people eat bread even with pasta.

Bread is a central element of Turkish culture and is considered sacred and paid more respect than others. It is used synonymously with both “food” and “work”.

Wheat is the basic of bread which is an extremely important food in Turkey.

In Turkish cooking, we use bread and other flour and dough-based foods. Bread holds an extremely important place at meals, some people eat bread even with pasta.

Bread is a central element of Turkish culture and is considered sacred and paid more respect than others. It is used synonymously with both “food” and “work”.

We have various kinds of breads (wheat)We have various kinds of breads (wheat)

In villages, bread is baked daily, weekly or even monthly at home

In villages, bread is baked daily, weekly or even monthly at home

Regular breadRegular bread Pide (a thin flat bread)Pide (a thin flat bread) Yufka (paper thin bread)Yufka (paper thin bread)

Bazlama (a thick, flat bread)

Bazlama (a thick, flat bread)

Saç bread (cooked on a convex griddle)

Saç bread (cooked on a convex griddle)

Tandır bread (cooked on the walls of an oven that opens from the top)

Tandır bread (cooked on the walls of an oven that opens from the top)

Wheat-Dough-Based FoodsWheat-Dough-Based Foods

Bulgur is used to make pilaf, soup, köfte (wheat is washed and boiled, dried and beaten in a large mortar, or broken)

Pide (an open faced pizza-like dish)

Börek (pastry made from dough rolled to paper thinness, filled with vegetables, meat, cheese, potatoes or lentils)

Mantı (like ravioli, mostly made at home)

Erişte (home made noodles)

Gözleme

Bulgur is used to make pilaf, soup, köfte (wheat is washed and boiled, dried and beaten in a large mortar, or broken)

Pide (an open faced pizza-like dish)

Börek (pastry made from dough rolled to paper thinness, filled with vegetables, meat, cheese, potatoes or lentils)

Mantı (like ravioli, mostly made at home)

Erişte (home made noodles)

Gözleme

Wheat-Dough-Based FoodsWheat-Dough-Based Foods

On days where women get together, they prefer salty and sweet cookies and “börek”s prepared by the women of the house. Women like to display their skills as a cook. Women in Turkey generally learn to cook from their mothers and grandmothers, and not from books.

Corn flour-corn bread is regularly consumed in only east Black-Sea region. In general, fresh whole corn is boiled and eaten salted in summer time.

As income increases, the amount of bread and other wheat products decreases, and more rice is consumed.

On days where women get together, they prefer salty and sweet cookies and “börek”s prepared by the women of the house. Women like to display their skills as a cook. Women in Turkey generally learn to cook from their mothers and grandmothers, and not from books.

Corn flour-corn bread is regularly consumed in only east Black-Sea region. In general, fresh whole corn is boiled and eaten salted in summer time.

As income increases, the amount of bread and other wheat products decreases, and more rice is consumed.

VegetablesVegetables

Green beansGreen beans

CabbageCabbage

LeeksLeeks

OkraOkra

EggplantEggplant

Grape leavesGrape leaves

PeppersPeppers

CucumberCucumber

ParsleyParsley

MintMint

Green onionGreen onion

OnionOnion

GarlicGarlic

ZucchiniZucchini

SpinachSpinach

LettuceLettuce

PotatoesPotatoes

CauliflowerCauliflower

PeaPea

CarrotCarrot

CeleryCelery

TomatoesTomatoes

We have various types of vegetable meals

Soups

Main dish (vegetable meal with chopped meat)

Cold dish (vegetable meal with olive oil)

Musakka

Fried vegetables

We have various types of vegetable meals

Soups

Main dish (vegetable meal with chopped meat)

Cold dish (vegetable meal with olive oil)

Musakka

Fried vegetables

We have various types of vegetable meals

Dolma (eggplant, zucchini, green pepper, tomatoes) (stuffed with rice/bulgur/meat)

Sarma (wrapped from cabbage or grape leaves)

Paste (tomatoes – red peppers)

Dried vegetables

We have various types of vegetable meals

Dolma (eggplant, zucchini, green pepper, tomatoes) (stuffed with rice/bulgur/meat)

Sarma (wrapped from cabbage or grape leaves)

Paste (tomatoes – red peppers)

Dried vegetables

Meat and FishMeat and Fish

Meat and fish are not eaten very much frequently.

Chopped meat is commonly used.

Chicken is commonly consumed.

Meat and fish are not eaten very much frequently.

Chopped meat is commonly used.

Chicken is commonly consumed.

Köfte (chopped meat + bread/rice/bulgur + egg + spice)

Sucuk: spiced sausage

Pastırma: cured meat/pastrami

Köfte (chopped meat + bread/rice/bulgur + egg + spice)

Sucuk: spiced sausage

Pastırma: cured meat/pastrami

FruitsFruits Turkey is one of the richest countries in the world in terms of fruit production.Turkey is one of the richest countries in the world in terms of fruit production.

AlmondAlmond

AppleApple

ApricotApricot

BananaBanana

BlackberryBlackberry

CherryCherry

DatesDates

FigFig

GrapesGrapes

HazelnutHazelnut

LemonLemon

MandarinMandarin

OrangeOrange

MelonMelon

PearPear

PlumPlum PomegranatePomegranate QuinceQuince StrawberryStrawberry WatermelonWatermelon

FruitsFruits

Hundreds of varieties of a single fruit (e.g. pear, apple, grape, watermelon)Eaten fresh / compotes / sherbets / jamDried fruits and nuts (in some regions, staple food)Pekmez (sweet thick fluid made by boiling and concentrating fruit juice from grapes, plums, apples, pear, watermelon, pomegranates). It is the most important sweet food stuffs in our traditional diet.Pestil (fruit leather)

Hundreds of varieties of a single fruit (e.g. pear, apple, grape, watermelon)Eaten fresh / compotes / sherbets / jamDried fruits and nuts (in some regions, staple food)Pekmez (sweet thick fluid made by boiling and concentrating fruit juice from grapes, plums, apples, pear, watermelon, pomegranates). It is the most important sweet food stuffs in our traditional diet.Pestil (fruit leather)

LegumesLegumes

Beans Beans

ChickpeasChickpeas

Fava beans Fava beans

PeasPeas

Red lentilRed lentil

Green lentilGreen lentil

DessertsDesserts

Pastries (wheat flour + sugar + butter)Pastries (wheat flour + sugar + butter)

BaklavaBaklava RevaniRevani HelvaHelva

Milk desserts (milk + flour + butter ± rice + sugar)Milk desserts (milk + flour + butter ± rice + sugar)

Güllaç: made from wide thin starch wafers soaked in hot sweetened milk and layered with crushed nuts.Güllaç: made from wide thin starch wafers soaked in hot sweetened milk and layered with crushed nuts. Aşure (Noah’s pudding): wheat, beans,

chick peas, dried grape, dried apricot, orange, hazelnut, almond, walnut, sugar

Aşure (Noah’s pudding): wheat, beans, chick peas, dried grape, dried apricot, orange, hazelnut, almond, walnut, sugar

Dairy ProductsDairy ProductsMilkYoğurt: Fermented milk

Functional foodHolds an important place in our nutrition.Most people eat their own products.

– Is used to top vegetable and grain based dishes (frequently garlic infused yoğurt)

– Tarhana: Yoğurt + cracked wheat or flour + red pepper + onion + tomatoes

– Is used with pekmez or honey as a dessert– Is used as a cold drink (yoğurt + water ayran)– Like a salad (yoğurt + cucumber cacık)

Cheese– White cheese– Kaşar

Butter

MilkYoğurt: Fermented milk

Functional foodHolds an important place in our nutrition.Most people eat their own products.

– Is used to top vegetable and grain based dishes (frequently garlic infused yoğurt)

– Tarhana: Yoğurt + cracked wheat or flour + red pepper + onion + tomatoes

– Is used with pekmez or honey as a dessert– Is used as a cold drink (yoğurt + water ayran)– Like a salad (yoğurt + cucumber cacık)

Cheese– White cheese– Kaşar

ButterTarhanaTarhana

BreakfastBreakfast

Cheese

Olives (green & black)

Tomatoes

Honey

Pekmez

Jam

Tea

Cheese

Olives (green & black)

Tomatoes

Honey

Pekmez

Jam

Tea

BreadBread

Lunch – DinnerLunch – Dinner

Soup (wheat/rice)– Vegetable soup– Tarhana soup– Lentil soup– Yoğurt soup– Flour soup

Vegetable dish – beans/chickpeas

Köfte

Pilaf (bulgur or rice) / pasta / börek

Salad / cacık / ayran

Dessert (dough based pastry / milk based pastry)

Soup (wheat/rice)– Vegetable soup– Tarhana soup– Lentil soup– Yoğurt soup– Flour soup

Vegetable dish – beans/chickpeas

Köfte

Pilaf (bulgur or rice) / pasta / börek

Salad / cacık / ayran

Dessert (dough based pastry / milk based pastry)

BreadBread

One of the best summer food is bread + watermelon / grapes + white cheese

One of the best summer food is bread + watermelon / grapes + white cheese

Problems about gluten free diet in TurkeyProblems about gluten free diet in Turkey

Turkish cuisine is wheat based.

Bread is very important in Turkish meals.

Wheat is very commonly used in many soups and dishes.

Gluten free products are mainly imported products, and they are expensive.

Only gluten-free flour is produced in Turkey, other products are not produced.

There are problems about food labeling.

Turkish cuisine is wheat based.

Bread is very important in Turkish meals.

Wheat is very commonly used in many soups and dishes.

Gluten free products are mainly imported products, and they are expensive.

Only gluten-free flour is produced in Turkey, other products are not produced.

There are problems about food labeling.

Problems about gluten free diet in TurkeyProblems about gluten free diet in Turkey

There are no restaurants or cafes serving for Celiac patients.

No arrangements at school for lunch.

Social life of Celiac patients is a big problem in Turkey.

Celiac societies are working hard but they have limited financial sources.

Various kinds of vegetables, fruits and legumes are available and are consumed traditionally

Alternatives for wheat flour is mainly corn flour

There are no restaurants or cafes serving for Celiac patients.

No arrangements at school for lunch.

Social life of Celiac patients is a big problem in Turkey.

Celiac societies are working hard but they have limited financial sources.

Various kinds of vegetables, fruits and legumes are available and are consumed traditionally

Alternatives for wheat flour is mainly corn flour

Thank you…

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