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To respond to a mounting public concern about allergies and other dietary issues, national chains like Starbucks, Dunkin' Donuts, California Pizza Kitchen, Papa John's, Subway, Shake Shack and others have modified their menus accordingly.

Over time, all have stepped up with alternatives to help customers sidestep certain food ingredients for an array of medical or philosophical reasons. 

Among Delaware restaurants, response to a growing consumer clamor for dietary alternatives covers a wide range.

A number of local establishments have tackled the issue aggressively, but in the end, those with special dietary needs find local dining options are limited.

"It is almost impossible for me to spontaneously go out with friends for a meal," said Sally Fintel, a Lewes resident who prefers a vegan diet.

Nationwide, some 15 million people have food allergies, including some that can be life-threatening, according to the Food Allergy Research & Education organization.

The most common allergies are to peanuts, tree nuts, milk, egg, wheat, soy, fish and shellfish.

And the problem seems to be growing: A Centers for Disease Control and Prevention study shows that food allergies among children have increased 50 percent since 1997.

While food intolerances are not usually life-threatening, certain allergies — like gluten for someone with celiac disease — can be fatal if untreated.

For example, a recent study showed 1.76 million people suffer from celiac disease, which is a life-altering disorder that is exacerbated by gluten, a common ingredient in everything from cakes to bread to pizza.

Interestingly, the study also found that another 2.7 million people have voluntarily stopped consuming foods containing gluten.

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Indeed, a voluntary avoidance of certain foods adds significantly to the percentage of people on restricted diets.

And that includes adults who choose not to eat certain foods for personal reasons. The most common would probably be those who favor a vegetarian or vegan diet.

In the end, that personal choice can present challenges.

"There are not many restaurants I know of that cater to vegetarians," said Jessica Clark of Georgetown.

In their defense, many local restaurants do offer vegetarian dishes.

And two getting high grades for their special diet offerings would be a(Muse.) in Rehoboth Beach and a sister establishment, Grandpa (MAC), a pasta restaurant in Rehoboth and Lewes.

"We are very mindful of people's eating habits and needs," said Hari Cameron, chef and owner of a(Muse.) and co-owner of Grandpa (MAC).

Indeed, for Cameron and several other local restaurateurs, there is a significant commitment to offering alternatives for diners.

"If you keep one person happy who is gluten-free, they will tell 10 of their friends," said Cameron.

And that attitude is appreciated by those on special diets.

Both Fintel and another vegan, Dorothy Greet, said Grandpa (MAC) is one of the few local restaurants they can patronize "without having to call ahead."

The Big Fish Restaurant Group, owner of at least eight Delaware restaurants and caterers, offers 11 separate menus for those with an array of allergies, including to  shellfish, dairy, egg and gluten. A separate vegan menu also is available.

The ambitious alternative menus were the result of "our management noticing a trend among diners and we decided we wanted to get ahead of the game," said Amy Polend, Big Fish director of dining operations.

And Polend said diners have responded to the availability of alternatives.

"Once we started, the popularity just skyrocketed," she said.

At Nectar Cafe and Juice Bar in Lewes, breakfast diners can order gluten-free pancakes. Or, at lunchtime, the restaurant offers sandwiches made with gluten-free bread — a rarity in southern Delaware.

"We try our best to cater to all kinds of diets and dietary restrictions," said Nectar owner Sarah McKeown.

Iron Hill Brewery, soon to open a restaurant in Rehoboth Beach, will have a special children's menu with gluten-free sandwiches.

For Italian food lovers, DiFebo's Restaurant in Bethany Beach, Rehoboth Beach and Berlin, Maryland, offers gluten free pasta.

"Gluten-free, dairy-free, no problem," said the DiFebo's website.

Touch of Italy, with restaurants in Lewes, Rehoboth Beach and Ocean City offers gluten-free pasta and a variety of vegetarian choices.

"We are super-sensitive to the many allergies out there and our focus is trying to make as many gluten-free and vegetarian options available to our guests as we can," said Lori Liguori Ewald, Touch of Italy brand awareness manager.  

Backyard, a restaurant and bakery in Milton, has gluten-free and vegetarian offerings in both operations.

"We do our best to alert customers to items that are gluten-free or vegetarian," said Backyard owner Ami Rae.

Though the Backyard menu reflects an array of choices, including a build-your-own sandwich or salad option, Rae said it reflects her desire to offer choices for all diners.

"We do not necessarily cater to people with dietary restrictions but try to do our best to give our customers enough information that they may find dishes that suit their particular dietary habits or needs," she said.

Perhaps the southern Delaware leader when it comes to providing information about dietary restrictions is the Grotto Pizza chain.

The website lists most everything on the Grotto Pizza menu and indicates if it contains milk, eggs, peanuts, tree nuts, fish, shellfish, soy or wheat or gluten.

The ambitious reference guide to food allergies is 12 pages long.

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Vinnie DiNatale, Grotto director of marketing, said the founder, Dominick Pulieri, instituted a host of dietary changes — including a gluten-free pizza — based on customer feedback.

"With his leadership, there is a culture of  doing 'whatever it takes' to make our guests happy," DiNatale said.

The response so far?

"We have received very positive feedback, especially about our gluten-free pizza," DiNatale said.

Though most restaurateurs are aware of the growing number of diners with special dietary needs, not all of them have attempted to accommodate those customers, beyond some cursory steps.

Several local restaurants, for example, claim to offer gluten-free sandwiches and burgers but, upon closer look, that simply means the meal is served without bread or a roll.

And at least one major local restaurant group doesn't promote its special needs offerings on their menu, but still accommodates customer requests. 

SoDel Concepts, operator of 10 upscale eateries in Sussex County including Bluecoast, Fish On and Matt's Fish Camp, does not mention allergies — or available alternatives — on its menus, either online or in the restaurant.

One reason, according to SoDel Vice President Doug Ruley, is because they are not convinced that food allergies are a widespread problem.

"The allergies and dietary restrictions only involve a handful" of our customers, Ruley said.

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But Ruley also said the restaurant will try and accommodate any diner with special dietary needs.

"If someone says they are allergic to something, we take it very seriously," he said.

Though the website reveals very little information, at least one SoDel restaurant — Lupo Italian Kitchen in Rehoboth — offers gluten-free pasta.

Ruley also said they have an internal gluten-free menu at each restaurant, although he admitted that many diners are unaware of the option.

"We don't publicize it," he said.

Cameron, a multiple James Beard Award nominee, said he understands why other restaurateurs might not embrace the same sympathetic philosophy toward special needs diners.

"I don't think every restaurant needs to be everything to everybody," he said.

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