Molten mozzarella, cherry tomatoes and yeast are the aromas that punctuate summer in Rome.

On a recent day, 7-year-old Filippo Virgo has a hankering for pizza — a classic of the Eternal City.

The problem is that Filippo has celiac disease. This means he gets sick from eating gluten — a protein found in wheat and other grains. Pizza is usually out of bounds. And, for a second-grader, that's a travesty.

Filippo's family heads inside Il Tulipano Nero, a classic Italian restaurant — right down to the checkered tablecloth.

The menu reads like a gluten minefield: linguine, penne, macaroni. But just when we fear Filippo is doomed to dine on pea soup, dinner is saved. The waiter comes by to tell him the food is gluten-free.

Tulipano Nero is one of nearly 4,000 gluten-free restaurants officially recognized by the Italian Celiac Association (AIC).

Tulipano Nero is one of nearly 4,000 gluten-free restaurants officially recognized by the Italian Celiac Association (AIC).

Chris Livesay for NPR

There's a great deal of public awareness in Italy about celiac disease. The Italian government offers celiac patients vouchers to buy gluten-free food — up to 140 euros per month.

Dr. Marco Silano, who chairs the scientific board of the Italian Celiac Association, explains why gluten is so central to Italian cooking.

"In fact, gluten is like a dietary glue that makes pasta very good because gluten has the properties to make bread good to catch — in Italy we say to catch — the sauce in the plate, or pasta to have the sauce," he says.

It's not that there's a greater prevalence of celiac disease — 1 percent of Italians have it, on par with the rest of the world. Rather, it's that gluten is everywhere you look. And in a country where the dinner table is at the center of social life, not being able to enjoy gluten is like having a beach allergy in Hawaii.

"Maybe this is the reason the gluten-free market and the gluten-free products in Italy are so large," Silano says. "There is no city or town where there aren't gluten-free restaurants."

Il Tulipano Nero is one of nearly 4,000 gluten-free restaurants in Italy that the Italian Celiac Association has recognized.

Filippo's dad, Paul Virgo, says this means his son can eat whatever everyone else is eating and doesn't feel left out.

"I think that the fact that people are very food-aware does make your life a bit easier," Virgo says. "You wouldn't expect the land of pasta and pizza to be so welcoming, but it is, actually. In many ways, it's a good place to be."

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Transcript

RACHEL MARTIN, HOST:

Italian cuisine put the carb in carbonara. So in the homeland of pasta, you might think a typical meal would be a gastrointestinal minefield for people who cannot tolerate gluten. As reporter Christopher Livesay discovered, you would be wrong.

CHRISTOPHER LIVESAY, BYLINE: Molten mozzarella, cherry tomatoes and yeast. These are the aromas that punctuate the summer in Rome. And 7-year-old Filippo Virgo is hankering for a classic of the eternal city.

FILIPPO VIRGO: Pizza.

LIVESAY: The problem is Filippo has celiac disease. That means he gets sick from eating gluten, a protein found in wheat and other grains. So pizza is usually out of bounds. And for a second-grader, that's a travesty.

FILIPPO: (Speaking Italian).

UNIDENTIFIED WOMAN: (Speaking Italian).

FILIPPO: (Speaking Italian).

LIVESAY: His family heads inside Il Tulipano Nero, a classic Italian restaurant right down to the checkered tablecloth.

ANGELO SCIOTTI: Buonasera signori. My name is Angelo. I am your waiter tonight.

LIVESAY: The menu reads like a gluten minefield, linguine, penne, macaroni. And just when we fear Filippo is doomed to dine on pea soup...

SCIOTTI: This food is without gluten.

LIVESAY: Dinner is saved. There's a great deal of public awareness in Italy about celiac disease. All Italian children are tested for it by the age of 6. That's how Filippo learned he had the disease.

FILIPPO: (Speaking Italian).

LIVESAY: If they test positive, the government offers considerable benefits into adulthood. Celiac patients receive extra time off work to prepare gluten-free food. They also get vouchers to buy it, up to 140 euros per month. Dr. Marco Silano chairs the scientific board of the Italian Celiac Association. He explains why gluten is so central to Italian cooking.

MARCO SILANO: In fact, gluten is like a dietary glue. That makes pasta very good because glue then has the properties to make bread good to catch - in Italy, we say to catch - the sauce in the plate, or pasta to have the sauce.

LIVESAY: It's not that there's a greater prevalence of celiac disease. One percent of Italians have it, on a par with the rest of the world. Rather, it's that gluten is everywhere you look. And in a country where the dinner table is at the center of social life, not being able to enjoy gluten is like having a beach allergy in Hawaii.

SILANO: But maybe this is the reason the gluten-free market and the gluten-free products in Italy are so large. There is no city or town where there aren't gluten free restaurants.

LIVESAY: Like in Rome.

SCIOTTI: Voila’, Pizza margherita.

PAUL VIRGO: OK, grazie.

FILIPPO: The best pizza in the world.

LIVESAY: Il Tulipano Nero is one of nearly 4,000 gluten-free restaurants nationwide recognize by the Italian Celiac Association. Filippo's dad, Paul Virgo, says that means his son can eat whatever everyone else is eating and doesn't feel left out.

VIRGO: I think that, you know, the fact that people are very food-aware does makes your life a bit easier. And you wouldn't expect the land of pasta and pizza to be so welcoming. But it is, actually. In many ways, it's a good place to be.

LIVESAY: That's something they can all eat and drink to.

FILIPPO: Cheers.

VIRGO: Cheers, Fil, to your good health.

LIVESAY: For NPR News, I'm Christopher Livesay in Rome. [POST-BROADCAST CORRECTION: The audio for this story, as did a previous Web version, incorrectly states that the Italian government allows people with celiac disease to take extra time off work to prepare gluten-free food and that Italian children are routinely tested for celiac disease. Neither is the case.] Transcript provided by NPR, Copyright NPR.

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