The Celiac ActionLine
Celiacs Helping Celiacs
Vol. VII, Num. 1 from Spring 1997
Celiacs of Orlando
Gluten Intolerance Group of Florida
Publisher/Writer: Mike Jones, 12733 Newfield Drive, Orlando, FL 32837,
(407) 856-3754, Internet: mjones@digital.net
Editor: Mary Kump, 3190 Village Park Drive, Melbourne, FL
32934,(407) 254-2034
Hospital Liaison: Patricia A. Gillen, Cape Canaveral Hospital, PO Box
69, Cocoa Beach, FL 32931, (407) 799-7187
Definition: Celiac disease (CD) is used to reference the general requirement
to avoid gluten in the diet. The terms replaced are: celiac sprue, coeliac
disease, dermatitis herpetiformis (DH), and gluten sensitive enteropathy
(GSE). Except for direct quotations and medical reference to a disease, CD
will be the universal term used in this newsletter.
This issue of The Celiac ActionLine is extremely late for several reasons.
We appreciate your patience. A few items from the original publication date
were changed to reflect their status of March 97. The last issue of 1996 was
canceled. The good news is that the next issue is almost ready for printing.
Subscriptions: As The Celiac ActionLine enters its seventh year, a few
changes are required . Mary Alice Warren would be pleased with the
international standing that we obtained. This growth in responding to
requests for assistance and mailing costs have reached a new level.
Therefore, we must change the scope of our outreach.
Request for assistance outside of the local Florida area will be through the
Internet. Currently, we are using the Internet for limited distribution of
the newsletter and our support of the Celiac List and its reference files.
The only noticeable impact of this change will be the loss of a hard copy of
the newsletter being mailed to our distant readers. Our goal will be to
provide information in easy to obtain files.
A very large number of our subscribers have made generous donations to offset
printing and mailing costs. Everyone's donation has been exceptional and
reflects your appreciation for the information, but the volume has grown to
the point where it is hard to justify printing costs as part of the
hospital's outreach programs for mailings outside of the local area.
Therefore, we must establish an annual subscription requirement to
newsletters mailed outside of the local support group area. A standard used
with most newsletters is $20.00. We will continue to work with those on a
tight budget in obtaining the newsletter.
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: Inside This Issue Search For :
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: News Highlights . . . . . . . . . . . =1= :
: Internet . . . . . . . . . . . . . . =2= :
: Medical Information . . . . . . . . . =3= :
: Product Information . . . . . . . . . =4= :
: Hidden Gluten . . . . . . . . . . . . =5= :
: Cooking . . . . . . . . . . . . . . . =6= :
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============1============ News Highlights
1. Celiac Cruise: The Celiac Disease Foundation is inviting all celiacs to
join aboard the Superliner, IMAGINATION, August 23 - 30, 1997. Departure
will be from Miami, Florida. The ports of call in the Western Caribbean are:
Cozumel, Grand Cayman, and Ocho Rios, Jamaica.
For additional details contact: Classic Cruise & Travel, 1920 Ventura Blvd.,
#A, Woodland, CA 91364, (818) 346-8747, (800) 767-7447 or
e-mail:classic@CyberEsc.net Classic Cruise & Travel reports that special
foods will be prepared in accordance to the Celiac Disease Foundation
guidelines.
2. Celiac Genetics Study: The University of Utah is recruiting participants
for a study to detect genes that may predispose individuals to celiac disease.
They request sib pairs (brothers/sisters) and extended family members -
cousins, aunts, etc. (even distant cousins to volunteer for the study).
The previous requirement to be biopsy proven has been relaxed. They now
desire samples from pairs that are confidant that they are gluten
intolerant. They pay for the blood draw. If you are willing to contribute a
blood sample and a short questionnaire, please contact:
Jeff Black, University of Utah, Genetic Epideminology, 420 Chipea Way, #180,
Salt Lake City, UT 84101, (800) 444-8638 ext. 15075, FAX (801) 581-6052, E-
mail: jeff@episun5.med.utah.edu.
3. Incorrect use of the term, Gluten: A new cookbook incorrectly lists these
grains as containing gluten: buckwheat, chickpea flour, garbanzo flour,
potato starch, and potato flour. The book is My Kid's Allergic to Everything
Dessert, by Mart Harris and Wilma Nachsin from Chicago Review Press, Inc.
4. Have you had your gluten today? Several celiac newsletters recently had
articles on celiacs who believe that a little non-gf bread would have no
adverse effect. Their logic is that they cannot live without the non-gf
selections. Additionally, they feel that everyone cheats on this lousy
diet, and being on the diet does not improve their quality of life.
Luckily, several of these celiacs were able to find a knowledgeable celiac
who convinced them how a strict GF diet leads to excellent health and a great
feeling of wellness. This feeling of wellness is second in consideration to
the increased long-tern risks associated with not adhering to a strict GF
diet. We can never downplay how hard it is to eliminate all of the hidden
glutens, but some diseases are much harder.
5. Pat Cassady Redjou author of the No-Gluten Solution and The No-Gluten
Solution's Children's Cookbook died in mid-September. Send memorial
donations to the University of Iowa Foundation, Celiac Disease Research
Foundation, c/o Dr Joseph Murray, PO Box 4550, Iowa City, IA 52242.
============2============ Internet
1. Conference files: The Celiac List has started collecting summaries from
important celiac meetings. The reports are prepared by volunteers desiring
to spread conference information. These files are available by e-mail. If
you need assistance in obtaining a copy, send a message to:
mjones@digital.net. In 1996, these conferences were covered:
Seventh International Symposium on Coeliac Disease in Tampere, Findland
CSA/USA Annual Conference, Dallas, TX
Mystery Golden Key (Early Diagnosis of celiac Disease), Mount Sinai medical
center, New York, NY
2. The Mayo Clinic sponsors an on-line health network and newsletter. The
graphics are virtual, but the information provided can help you improve your
health. The page links to the most recent newsletter. There is also the
ability to search back issues: http://healthnet.iviv.com.
3. The MERCK Manual is available on the World Wide Web. The URL for the
section on celiac sprue is
http://www.merck.com/!!Pf_o30jNrPg8C00nA/pubs/mmanual/html/pilldgb.htm.
============3============ Medical Information
Much medical information is of no interest to celiacs, but articles are a
simple way to explain an issue to a medical professional. These extracts are
handy references to show your physician, in his technical language, what
research has been documented throughout the world. When you encounter a
similar problem, or, if you have a physician willing to learn from a patient,
share these articles for the benefit of all concerned.
1. Initial Assessment and Follow-up Care of Celiac Patients by Peter Green,
M.D.
Dr. Green sees a lot of patients who, either through their own frustration or
because of physician advice, have started a gluten-free diet without
obtaining a biopsy-proven diagnosis of Celiac Disease. However, the need for
a biopsy to establish a diagnosis of Celiac Disease must be emphasized.
Celiac Disease is a lifelong illness with serious potential implications. In
addition, sensitivity to gluten doesn't go away, and a radical lifestyle
change is involved. You also need to be certain of the diagnosis because
Celiac patients' families should be screened. The initial biopsy is also
needed to serve as a baseline because one doesn't know what the future may
involve.
Basic blood work is also included in the initial assessment. Such things as
anemia and liver function need to be looked for. But it's very important to
go further than that, and knowledge of the physiology of the small intestine
should lead a physician to measure those nutrients that could be malabsorbed.
Celiac Disease involves the small intestine, where iron, folic acid, calcium,
fat soluble vitamins (Vitamins K, A, D, and E) and zinc are absorbed. These
nutrients should be measured in the initial assessment and also during the
course of the illness. Physicians will see patients who present with
malabsorption of just one of these nutrients. If they are aware of the
consequences of all these nutrient deficiencies, it will help them consider
Celiac Disease as a possible diagnosis.
The patient should also have the Celiac antibodies blood testing, but the
diagnosis is still established on the biopsy pathology. In Dr. Green's
experience, about 30% of Celiacs have negative antibodies at diagnosis, so
positive antibodies are not required to make the diagnosis. Antibodies
testing often helps establish the need for a biopsy, but their great value is
also in establishing a baseline so that an assessment can be made on how the
patient is doing later on. All the antibodies should normalize, in time,
when gluten is eliminated from the diet.
What about the patient who seeks a diagnosis, but has already eliminated
gluten from the diet? It is very difficult for many patients to go back on a
gluten-containing diet to secure a biopsy-proven diagnosis. This can often
take three to six months or longer. Columbia-Presbyterian has been talking
about setting up alternative means of securing a diagnosis, such as a rectal
challenge. The physician can take a biopsy of rectal tissue, and then
instill gliadin extract into the rectum and do a repeat biopsy a certain
number of hours afterward to demonstrate an inflammatory response similar to
that in the small bowel. However, interpreting the results of the gluten
challenge would require a pathologist who is very experienced, and
sophisticated immunology on the cells of the rectal biopsy may be needed.
Soon after diagnosis and adhering to a gluten-free diet, patients will often
report an increased feeling of well-being. How well they feel - and how
quickly -will also depend on what the manifestations of their disease were.
For example, if the patient was iron deficient, it will take time for the
iron stores to be repleted.
An assessment of vitamin and mineral levels should be part of the follow-up
care. Specific deficiencies need to be addressed, treated, and monitored.
Patients have been seen who have been ingesting too much of the fat-soluble
vitamins, with resulting problems such as liver disease (Vitamin A toxicity),
and hypercalcemia (Vitamin D toxicity), which can cause confusion,
constipation, and kidney problems. Certain vitamins and minerals may need to
be administered, but the patient should be under a physician's guidance as to
how much should be taken.
After a diagnosis of Celiac Disease, a bone mineral density should be
performed to assess the condition of the bones. Reports have shown that
between 50-100% of people at initial diagnosis of CD will have osteopenia or
osteoporosis. Ostopenia is thinner bones, usually less than 2 standard
deviations from normal. Osteoporosis involves an even greater deviation from
normal.. In Dr. Green's experience, nearly 100% of the Celiac patients at
diagnosis will have osteoporosis. Surveys of Celiac patients have shown an
increased incidence of fractures prior to diagnosis and after diagnosis. If
the bone mineral density is low, the patient should be referred to a bone
mineral expert for assessment and specific individual treatment. For
example, calcium and Vitamin D needs will be addressed and monitored, and
exercise and hormone replacement (in post-menopausal women) will be
considered.
At diagnosis, patients should get a Pneumovax, because it is very common for
Celiacs to have poor splenic function, which puts them at risk of developing
certain bacterial infections such as pneumoccal pneumonia and meningitis.
Since there is a genetic predisposition to Celiac Disease, another important
issue in the follow-up is screening family members for CD. Children and
other first-degree relatives should have their antibodies status measured.
About 10-15% of first-degree relatives have positive antibodies, and the bulk
of the people with positive antibodies will have the disease, even though 50%
of those people will be asymptomatic, even with a flat biopsy.
What annual follow-up care should the Celiac patient be getting? The most
important thing is a good physical examination. Blood work, x-rays, CAT
scans, mammograms and PSA tests, while valuable, do not replace a physical
examination. The physical exam should include a breast exam for women,
prostate exam for men, and a rectal exam for everyone. Blood work should
include measurements of folic acid, calcium, and iron, and antibodies
testing, Bone mineral density testing should be repeated annually for those
with abnormal results, and every several years for those with normal results.
Finally, patients with Celiac Disease should have at least one follow-up
biopsy to confirm response - normalization of the biopsy sample. Patients
who are non-responders, or whose clinical situation is somewhat confusing,
may need more repeated biopsies at intervals.
What about the non-responders or people who relapse? The first thing is to
check the diet with antibodies testing. People may be ingesting gluten, such
as in medications, and not be aware of it. They may be getting gluten from
licking stamps or envelopes. They may have misinformation from food labels
or manufacturers.
However, the antibodies can normalize and the biopsy still look quite flat,
so once again, the antibodies have only a limited value - but they are still
important to measure. It is also important to check the original biopsy to
make sure of the diagnosis. Not all pathologists are experienced enough to
properly diagnose Celiac Disease. Pathology departments, by law, have to
keep the biopsies for a lengthy period of time - some keep them for 50 years.
So it is important for the physician to review the biopsy sample with a
pathologist who understands the spectrum of Celiac Disease. The pathologist
needs to know, for example, how to identify latent Celiac Disease and
different subtle aspects of the biopsy, such as increased intraepithelial
lymphocytes.
A problem that comes up in non-responders is other food sensitivities. It's
very rare for people with CD to also have sensitivities to other foods that
result in the abnormal biopsy. There are, however, reports of ingestion of
soy protein or egg or some kind of meats that cause the biopsy not to
normalize.There are other conditions that can co-exist with Celiac Disease
and confuse physicians. For example, pancreatic insufficiency can cause
diarrhea, steathorrhea, and malabsorption of fat, and bacterial overgrowth
can affect absorption of nutrients. Patients may have colonic pathology.
Having one disease doesn't mean you can't have another disease, and other
conditions need to be investigated in the CD patient who isn't doing well.
If there is no improvement in the biopsies, patients remain at the risk of
developing or maintaining bone disease and vitamin deficiencies, and they are
at a higher risk for malignancy. Patients who are refractory may need other
therapies such as corticosteroids or immunosuppressent drugs such as
cyclosporin. One doesn't engage these therapies lightly (for example,
steroids will thin the bones); being closely evaluated while on these drugs
is important.
The studies that have indicated increased mortality in CD are from other
countries where people have different smoking and dietary habits. It is hard
to extrapolate these studies to our patient population.
The existing studies indicate that the mortality rate among adult Celiacs is
about two to three times that of the general population, and the increased
mortality is found mainly in the first five years after diagnosis. After
that, the mortality rate approaches that of the normal population. That
tends to suggest that it is the continued ingestion of gluten that is
responsible for the increased mortality. This is especially so in regard to
malignancies, where the risk of diagnosis of malignancy such as lymphoma is
usually highest in the first year after diagnosis, and then decreases in
instance downward until it equals that of the normal population after about
five years. There is certainly the suggestion that adhering to a gluten-free
diet reduces the risk of developing a malignancy.
Traditionally, the incidence of Celiac Disease in this country, based upon
epidemiological work, suggests that CD occurs in about 1 in 4,600 people.
Certainly it's much more common that that. Serology testing of blood donors
by Dr. Fasano suggests the same prevalence as in European countries, about 1
in 300 people. Dr. Green, who does a lot of endoscopies, has found an
incidence of Celiac Disease in about 1 in 280 patients who were having
endoscopies for reasons other than suspicion of Celiac Disease. It is
important, therefore, for the gastroenterologist to have a higher suspicion
for the possibility of Celiac Disease, and for physicians to screen for
Celiac Disease, particularly among their patients who have associated
diseases such as Insulin Dependent Diabetes, Sjogren's, and Autoimmune
Thyroid Disease.
2. Free Information from registered Dietitians is available by calling
(800) 366-1655. They may not be experts in the GF diet. This is an
excellent source on general nutrition.
3. IMMCO Diagnostics is one of the four US companies with an excellent
understanding of the requirements for conducting serological diagnosis of CD.
They may be contacted for specimen collection kits: IMMCO Diagnostic, 963
Kenmore Ave., Buffalo, NY 14223, (800) 537-TEST, e-mail IMMTEST@AOL.COM.
4. Bacterial Overgrowth: Dr Betty Wedman is a celiac and nutritionist in St
Petersburg. She recently made a reference to the fact that six of her seven
celiacs had bacterial overgrowth in the small intestines. Therefore, it
would be prudent for celiacs to consider this possibility if they have
symptoms like abdominal cramps, bloating, gas, diarrhea, weight loss, and
Vitamin B12 malabsorption.
5. Bone Density has always been a critical problem associated with women.
It is a problem that affects all celiacs according to Dr Elliott Schwartz,
Director, Foundation for Osteoporosis.
A recent issue of Gluten-Free Living has a comprehensive article: "A
Practical Look at Celiac Bones" for those desiring an in-depth discussion
on celiac and bone problems. Subscriptions available by writing to: PO Box
105, Hastings-on-Hudson, NY 10706 for $29.00. One of the keys for living with
this problem is identification of the condition. For this reason, the
following information can be used to convince your physician of the
requirements of a bone density test. Since celiac is a GI related condition,
the indicators associated with the intestinal track are excellent reasons for
investigating the current status of your bones.
Osteoporosis is now felt to be both preventable and treatable; but to
apply the present strategies bone density testing is invaluable.
Studies have show that clinical risk factors, such as thinness, blonde
hair, blue eyes are not discriminating enough in individual patients to
enable one to prescribe medication. However, bone density testing is a
very precise way to predict the risk of fractures while an x-ray is
used to diagnose a current acute fracture. This is comparable to using
a cholesterol test to predict the risk of future heart attack and an
ECG to diagnose an acute event. In the same way that treatment is
applied to lower cholesterol to prevent future heart attack, so
treatment to prevent loss of bone should now be applied to prevent
future fracture. (1)
The National Osteoporosis Foundation suggest four indications for tests: (2)
(1) estrogen deficiency (e.g., menopause, primary and secondary;
amenorrhea, such as from eating disorders)
(2) vertebral abnormalities and radiographic osteopenia
(3) long term glucocorticoid therapy
(4) primary asymptomatic hyperparathyrodism
Other indications can include:
(1) monitoring response to treatment
(2) early glucorticoid therapy
(3) renal disease
(4) onset of first fracture as adult over 50 years of age
(5) states of secondary hyperparathyrodism
(6) disease causing malabsorption
(7) treatment with medications known to cause bone disease, e.g.
chemotherapy, thyroid
(8) patients at risk for rapid bone loss of any cause
(9) multiple risk factors. e.g. small, thin frame, family history of
osteoporosis, smoking, excessive alcohol
Insurance reimbursement is a critical question to consider:
On January 1, 1994, a national CPT code (76075) was adopted for bone
density testing and Medicare began to formally pay for these tests. . .
. Thus, all patients with some form of insurance should be covered
completely or in part. Some insurances may require preauthorization or
have other restrictions. (3)
6. Ask-A-Nurse allows registered nurses to provide general non emergency
information by phone. The program is available at many local hospitals.
there is now a toll-free number, (800) 535-1111, for finding the phone number
of a local Ask-A-Nurse program.
============4============ Product Information
1. TCCSSG Shopping Guide was updated by this Michigan support group and
reflects information from March 1995 and later. You can obtain a copy by
mailing a $10.00 check, payable to TCCSSG to: Maria Campbell, TCCSSG
Shopping Guide, 34638 Beechwood, Farmingron Hills, MI 48335.
2. GF Products in Local Stores: Several of the national GF vendors
expanded the availability of their products to local stores. When mail
ordering, ask if the company has a local outlet. these companies have a
local dealer in some areas: Dietary Specialties, Ener-G Foods, GF Pantry,
and Miss Roben's.
The Tampa Palms Public, near Community Hospital in Tampa, is carrying several
Dietary Specialties products. They are part of the PKU program (low protein
but all brands are not GF). The hospital arranged this program because of a
need for low protein products.
Missy's on Highway 41 in Flora City, has a wide variety of GF products,
including items from GF Pantry.
3. Dietary Specialties is offering a wonderful cracker from Bi-Aglut. Also,
they have a free recipe booklet of ways to prepare Bi-Aglut pasta. They are
also shipping their unique gluten-free Living newsletter "Recipe for Better
health" with each order. Dietary Specialties, PO Box 227, Rochester, NY
14601, (800) 544-0099, http://colorwheel.com/ds/index.html.
4. The GF Cookie Jar produces a wonderful line of 50 fresh baked products.
Ten of these items are also available dairy and egg free. A neat way to
sample their products, is to order the Cookie jar Sampler: bread, rolls,
bagels, donuts, pretzels, brownies, and cookies. The GF Cookie Jar, PO Box
52, Trevose, PA 19053, (215) 355-9403.
5. Ener-G Foods has made several additions to their product line: Crackers,
Chocolate Cake, Rainbow Pasta, and Authentic Foods Bean Flour Mix (from Bette
Hagman's new cookbook). Ener-G Foods, PO Box 84487, Seattle, WA 98124-5787,
(800) 331-5222, http://www.ener-g.com.
6. Miss Roben's is now charging $4.95 for shipping on any order in the
continental US. Some of the new products include: European Dark Bread, White
Cake Mix, and a Pie Crust Mix, Miss Roben's, PO Box 1434, Frederick, MD
21702, (800) 891-003, http://www.jagunet.com/~msrobens.
7. Jowar Foods produces an alternate flour for celiacs made from sorghum.
Jowar Foods, 113 Hickory St., Hereford, TX 79045, (806) 363-9070,
http://www.jowar.com.
8. Gluten-Free Delights is a new line of GF products produced by a sensitive
celiac in Iowa. The product lines includes: Snickerdoodle, Chocolate Chip,
Peanut Butter, Lemon Love Notes, Caramel Corn, Popcorn Candy Balls, plain and
Cinnamon donut holes. Gluten-Free delights, 700 W. Ridgeway. Lot #604, Cedar
Falls, IA 50613, (319) 277-0963, ZEJG11A@prodigy.com.
9. Natural Feast built a following through their line of fresh pies. Several
new additions may be of interest to vegetarians or those with a diary
problem: Bread Mix, English Muffins, Walnut Torte to name a few. There is
also a Sponge Cake, Butterscotch Brownies, Chocolate Mousse, Chocolate
Brownies, Raisin Bread, Energy Bar, and a Protein bar. They no longer ship
by mail, but the products can be found in many local health food stores.
Natural Feast Corp., PO Box 5018, New Bedford, MA 02745, (508) 984-4230.
10. The Gluten-Free Pantry has added several new items to their product line:
Hot dog roll form, Coconut Macaroon Mix, White Rice Flour, Brown Rice Flour,
Potato Starch, Jowar Flour, Tapioca Flour, Tart Dried Cherries, Wild Rice
Flour, Chickpea Flour, and Powdered Cheddar Cheese. A unique product is
their Instant Concentrates in vegetables and Wild Mushroom. The instant
soups are tasty and easy to prepare at work. The Gluten-Free Pantry, PO Box
840, Glastonbury, CT 06033, orders (800) 291-8386, www.pantry.glutenfree.com.
11. De-Ro-Ma is a GF Bakery and distributor in Quebec Canada. They offer
fresh baked items and a very impressive list of the GF products from
overseas. These include: Rite-Diet, Junela, Orgran, Aproten, Polial, Glutafin,
Agutella, Bi-Agulut, and Hammer Muhle. Their price list shows additional
information for items free of eggs, soya, corn, sugar, milk, lactose. De-Ro-
Ma, 910 Jarry Blvd., Quebec H7W 2W6 Canada, (514) 687-2287, (800) 363-DIET.
12. A Unique Cracker is available from Glutafin, made in England, it is also
available from these Canadian mail order sources: De-Ro-Ma, (800) 363-DIET,
Kinnikinnicki Foods, (800) 891-0083.
13. Stevia is a leaf from the rain forest of Paraguay and Brazil. It is
gaining popularity in the US as a sweetener, since it is several hundred times
sweeter than sugar. Some reports state that it is not disruptive to blood
sugar levels. Diabetic celiacs may desire to talk with their physician about
the use of Stevia. It comes in various forms: Tablestop (85% maltodextrin
(ground maniok) and 15% Stevia, teacut Leaves (especially cut for teas). One
source is Stevia Co., 7650 US Hwy 287 #100, Arlington, TX 76017, (888) 783-
8422, www.fastlane/~petro/stevia.html.
14. Sunflakes are available directly from Ralston Purina (800) RALSTON.
Their recent product survey made reference to the GF diet.
15. Fat Substitute made from prunes and apple is a new product from SunSweet.
It is designed as a fat replacer in soft baked goods (cakes and brownies).
Recipe and information is available by calling SunSweet at (800) 418-XXXX.
16. Red Star Bread Machine was available again for the holidays. It was
labeled as the Magic Chef and is not available once the limited supplies
were sold. Occasionally it is being offered on Home Shopping Network.
17. La Choy Soy Sauce: If the label on La Choy Regular and Light reads
hydrolyzed soy protein, the company states that it is GF. For additional
information: Hunt-Wesson, PO Box 4800, Fullerton, CA 92634, (714) 680-1000.
18. Celiac Disease: Me and the Right Food Choices is a coloring book and
instructional guide for explaining the GF diet to children (age 5-7). It was
prepared by Nancy Falani, R.D., R.N. it is available for $14.85 from Nancy
Falani, 437 Sharpless St, West Chester, PA 19382.
19. French Toast Cereal from General Mills appears to be GF when reading the
ingredients. When the company is called at (800) 328-1144, the old answer is
received that none of their products are GF. The company is not willing to
make a commitment due to the volume of wheat products in the plant.
There are many products produced in mixed plants. When care is taken by the
company, then the risks to celiacs are reduced and we each must make our own
choice.
============5============ Hidden Gluten
Whenever a product or ingredient is identified as a possible source of
gluten-contamination it will be highlighted in this section. Some products
contain a minute amount of gluten and may not have a noticeable physical
affect, but may cause internal damage. NO GLUTEN is the ActionLine's goal.
Medical research has established one standard for damage to the gut, but it
is still unknown how much gluten or if repeated exposure to small amounts of
gluten will increase a celiacs' chance of certain cancers or cause subtle
changes, such as lassitude and depression.
Nebulous terms must be researched until a satisfactory answer is obtained
that the item is free of any toxic protein. When those terms are found on a
label, we must routinely verify that it has not changed. If adequate
information is obtained and fellow celiacs do not report any adverse
reactions, those products should not be left out of your diet. Some celiacs
limit labels with nebulous terms to only a few products, in order to reduce
the amount of time spent on routine verification. When in doubt leave it
out, is the best course of action.
Gluten can be added to a product as an ingredient, through cross
contamination, or as a result of the manufacturing process. When all gluten
is kept out of a celiac's diet, the best quality of life is enjoyed. Each
person must determine their preferred life style and how careful they will be
in avoiding hidden toxic proteins.
1. Contandina Italian Paste contains hydrolyze vegetable protein (HVP) from
wheat. Nestles may be contacted at (800) 637-8537.
2. Contandina Pasta Ready-Mushroom Sauce contains soy sauce from wheat.
============6============ Cooking
Each person must evaluate all recipes prior to use. Many inappropriate
products are included in cookbooks. The inappropriate products may be the
result of a local brand that is GF, the product may be homemade, or the GF
status may have changed.
1. Wheat-Free Recipes & Menus by Carol Fenster, Ph.D. This cookbook, ISBN
1-57502049-1, is being praised by everyone who has read the book. The
author avoids many of the grains normally found in wheat-free recipes
(barley, kamut, spelt, and rye). The book has 100 various recipes and
numerous information on tips, using different ingredients and time savers.
This is not a low-fat cookbook but reduced fat is seen in many of the
recipes. it is available form Savory Plate, 8174 South Holly, Ste 404,
Littleton, CO 80122, (303) 741-5408 or orders (800) 742-0339 at $19.95 plus
$3.00 postage. Health food stores can order from the NutriBook catalog,
#T1878.
2. Gluten-Free Anytime and Gluten-Free Special by Joyce Friesan and Donna
Wall.
Anytime contains recipes such as muffins, bread, biscuits, crackers, waffles,
and more. "Special" is a collection of recipes such as: sausage rolls,
fortune cookies, fruitcake, Christmas mints. each is available from Donna
Wall, 583 Cottonwood Ave., Sherwood Park, Alberta Canada T8A 1Y5, (403) 464-
7604 for $14.05 Can plus $3.00 postage.
3. Use of Jowar Flour in baked goods. Here are some tips for using Jowar
flour in baked products (cookies, cakes, breads, coating for fish and
poultry). The flour is a little dry in baked goods and needs rising help in
breads.
Add 1/2 to 1 Tbsp. of corn starch to every cup of Jowar flour.
1/2 tsp. xanthan or guar gum is required for cookies for each cup of
flour. Double this for breads.
A little oil may be added for recipes that are dry.
An extra egg or egg white will improve the smoothness and crumb
structure.
4. Breadmachine Recipes for Regal and Toastmaster are now available in
two small pamphlets. They were produced in cooperation with Red Star Yeast.
GF Recipes for your Toastmaster Bread Machine from Toastmaster, 1801 N.
Stadium Blvd., Columbia, MO 65202
GF Recipes for your Regal Breadmaker from Regal Ware, 1675 Regal Dr.,
Kewaskum, WI 53404, (800) 998-8809. Available in English or French.
========================= Disclaimer
All recommendations, information, dietary suggestions, menus, and
recipes promulgated by this newsletter are intended for the benefit of
our readers and the general public. No liability is assumed for the
use of this information by GIG of Florida or Celiacs of Orlando.
Individuals should consult with their personal physician before
following any medical recommendations mentioned in this newsletter.
Opinions expressed are those of the authors and are not necessarily
endorsed by GIG of Florida or Celiacs of Orlando. Products mentioned
or omitted do not constitute endorsement.
If you find a grammatical error in this publication, please consider
that it is there as a result of a typing error or to make people happy
who are always looking for mistakes. If you find a technical mistake,
please report that information so that the correction may be passed
along to the readers. Original material used in The ActionLine is
placed in the public domain for the benefit of all celiacs. The
information is not copyrighted to facilitate exchange of celiac
information and thoughts.
_________
1 http://www.FORE.org
2 http://www.FORE.org
3 http://www.FORE.org
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