Avoiding gluten and dairy in Japan – handling it practically and culturally

The other day I was speaking with a client, making plans for the seminar I will be doing one morning next week at their office in Yokohama. “After the session, can you stay longer? It would be good to debrief about the seminar over lunch.” I replied that of course I would be delighted, and that I appreciated the invitation. But just one thing, about lunch…

So here was the awkward part. I had to explain that due to a health reason, I can’t eat gluten (a protein found in wheat and barley) and dairy products. That rules out most common lunch options in Japan like sandwiches (no bread!) or bento boxes (because they usually have tempura or breaded items, and soy sauce is made with wheat).

I hate to seem like a prima donna and to cause trouble for people. Really life would be so much easier if I could eat the same things as everyone else. So why is it that I am so fussy about what I eat?

In 2018 I was diagnosed with the autoimmune disease Grave’s Disease, also known as hyperthyroid. In some ways it’s fitting for me, as it’s said to be the disease of Type A personalities. I did some research and discovered the NY Times bestselling book The Autoimmune Solution by Dr. Amy Myers. In it she explains something that is still cutting-edge in the U.S. and seems not to be well-known in Japan — that autoimmune diseases have as their root cause an inflammatory response to irritants to the gut, and that gluten and casein (the protein in dairy products) are particular culprits. I later took a specialized test that showed conclusively that I have a negative reaction to eating gluten (there is not a similar test for dairy, but I experimented with avoiding it and eating it, and my thyroid antibodies doubled when I ate it, so it became clear that I need to avoid it too).

So since then I have cut gluten and dairy out of my diet. That means no bread, noodles, cakes or cookies made from wheat, no soy sauce except special gluten-free versions, no barley (including no barley tea), and no milk or cheese or yogurt. Although this is rather restrictive (I particularly miss gyoza dumplings, pizza, and goat cheese), it seems to be working, as my system has now calmed down. I also have been getting western medical treatment (a medication called methimazole) for my condition since 2019, but recently the thyroid specialist I see in Tokyo told me that I can “graduate” from treatment and stop taking the medicine as my thyroid hormones have stabilized and my antibodies have fallen to normal levels. Avoiding gluten and dairy has reduced the irritants to my system and supported the effect of the medication. This is exciting progress, but it makes me even more committed to continuing to avoid gluten and dairy so that I don’t sabotage these results and have to go back on the medicine.

Some people in Japan may be familiar with the concept of a gluten-free diet, as that is what tennis player Novak Djokovic follows, and he credits it with supporting his performance. Generally, however, I find that many people in Japan are not familiar with what gluten is. This is because the biggest group of people who must avoid gluten are those with Celiac disease, but genetically Japanese are not pre-disposed to it, whereas many Caucasians are. There also seems to be a higher prevalence and general awareness of gluten sensitivities and allergies, including the role in autoimmune disease, outside of Japan. I’ve seen statistics estimating that between 8-12% of people in the U.S. and Europe follow a gluten-free diet, and it’s relatively easy to find restaurants offering gluten-free foods there. (Restaurants in Japan that want to attract or better serve their non-Japanese customers should consider offering gluten-free options – those few gluten-free restaurants in Japan tend to be packed!)

In a country that loves wheat and dairy, what do I do? Fortunately, I like to cook, so I make many of my meals at home. For lunches at clients where everyone is having a bento, sometimes I’ll just bring my own lunch to make things easier for everyone.

It may sound restrictive to not be able to eat wheat, barley or dairy, but there are many things I can eat, such as:

• Meat and fish
• Tofu and beans
• Eggs
• Rice, corn, buckwheat and quinoa
• Fruits and vegetables
• Nuts and seeds
• Although I generally avoid dairy products, I am fine with butter, as it has almost no casein
• Chocolate, as long as it doesn’t contain milk

I would also like to make clear that although they are both food preferences that are written in katakana and that non-Japanese tend to ask for, “gluten-free” is something completely different than “vegan” (avoidance of all animal products). Unfortunately I find that people in Japan often confuse these. For example, at a recent business dinner, the hotel apparently misunderstood the advance instructions and thought I was vegan. So while the people sitting around me all had delicious looking pieces of steak for their main course, I was served one teeny portobello mushroom. Which was hardly enough to stop my stomach from growling. I would have been fine with the steak if they had left the sauce off of it!

There are some restaurants in Japan that offer gluten-free meals, and there are even bento delivery services that offer gluten-free options. Typing “gluten-free” in Google or Google maps will often turn up options. And some restaurants upon request will kindly make gluten- and dairy-free food if they have advance notice—thank you so much for the effort!

Also, there are some types of restaurants that are naturally easier for me to eat at:

• Yakitori, as long as it’s prepared with salt, not tare (sauce) (since tare contains soy sauce)
• Yakiniku, without tare
• Steak, without any steak sauce
• Plain grilled fish, without soy sauce in the marinade
• Sashimi (without any soy sauce – I will use just some wasabi, or ask for a little sesame oil for dipping)
• Shabu-shabu or other hotpots, as long as the base broth doesn’t contain wheat
• 100% buckwheat soba noodles, as long as they are not cooked together with soba noodles that contain gluten
• Salad, as long as there are no croutons and no cheese sprinkled on it, and the dressing doesn’t have dairy or soy sauce in it.
• Most izakaya will typically have something on the menu that I can eat! Which is good because I love izakayas.
• Thai, Vietnamese, Korean, Spanish and Mexican restaurants often have many gluten-free and dairy-free options. Also, if you avoid the pizza and pasta and cheese, many dishes at Italian restaurants are gluten- and dairy-free.
• Sometimes Indian restaurants will have dishes that don’t contain gluten, if they are making their curries from scratch. Japanese style curry however almost always contains gluten, unfortunately.
• International hotel chains such as Hilton are very good about offering gluten-free options, as they are used to serving customers who require gluten-free food.
• Vegan or health food restaurants sometimes, but not always, offer gluten-free options.
• If nothing else is available, I’m very happy to have just a raw egg on a bowl of hot rice!

Often restaurants will mention that they can’t guarantee that there is no cross-contamination. I’m fine taking that risk. People with Celiac disease can end up with strong reactions and intense pain if they eat even the slightest amount of gluten, but that is not the situation for me. Also, I am not going to go into anaphylactic shock and die if I have a teeny bit of gluten, which seems to be the concern of many restaurants when they hear the word “allergy.” My system is now stable enough that I can tolerate some very small amounts of gluten or dairy that might accidentally make it into my food. However, if I ingest foods that contain either gluten or dairy as one of the main ingredients, my immune system reactions will build up and I will have a flareup of my autoimmune condition, so I want to avoid that.

Japan is not an easy country to have special dietary needs. There is culturally a strong preference for going with the flow, not standing out, and not causing inconvenience for others. Once I met a Japanese person who needs to avoid wheat for health reasons. I asked them what they did when dining out with colleagues on business occasions. They replied “I just go ahead and eat the wheat anyway, even though I know it’s not good for me. I just don’t feel comfortable asking for special treatment.” I can see how that might feel like the most convenient option from a Japanese cultural perspective. However, I’m not Japanese, and I just can’t see taking that path, as I don’t want to do something that I know will negatively impact my health.

Personally, I see the issues of dietary preferences as yet another aspect of diversity. As there are more and more non-Japanese living in or visiting Japan, there will be more people requiring special diets, whether it’s gluten-free, vegan, Halal or other. As stated above, I really wish that I didn’t have to eat a special diet, but I can’t change my genetics so I have to change what I eat. So I hope everyone doesn’t think I’m being selfish, and I appreciate very much any efforts to help me in avoiding things I should not be eating.