THE SPRUE-NIK PRESS

       Published by the Tri-County Celiac Sprue Support Group,
       a chapter of CSA/USA, Inc. serving southeastern Michigan

Volume 5, Number 1                                        January 1996
**********************************************************************

          ..................................................
          : What's Inside                       Search For :
          : -------------                       ---------- :
          : Miscellaneous Notes  . . . . . . . . .   -1-   :
          : Celiac-Friendly Restaurant Contacts  .   -2-   :
          : Gluten-Free Breads . . . . . . . . . .   -3-   :
          : Gluten-Free Pharmaceutical Guide . . .   -4-   :
          : Newsletter Roundup . . . . . . . . . .   -5-   :
          : Recipe Page  . . . . . . . . . . . . .   -6-   :
          :................................................:

Disclaimer
Miscellaneous Notes ---------1---------- Thank you to Tom Sullivan, who put together the Restaurant Contact form found elsewhere in this newsletter. You may find it of value to print this form and take it to the restaurants which you enjoy (or would enjoy) eating at. Once it is filled out, you could bring it to your next group meeting and share it with others. -=-=-=-=-=-=- Bread Machine Tips from Red Star Yeast: * When using a bread machine, never use water warmer than 85 degrees F. * You can use either active or rapid-rise yeast when you are using bread machine. * When using quick-rise yeast, use 1/2 tsp. per cup of flour. * When using active yeast, use 3/4 tsp. per cup of flour. -=-=-=-=-=-=- Celiac Cruise: Mar Go Travel is having a special Celiac Cruise of the Scandinavian capitals and St. Petersburg. This is a 12-day cruise that begins on June 8, 1996. Prices range from $4,641 to $13,236 (Canadian) per person, for double occupancy. Third/fourth passenger and single rates are also available. Special incentives include free air, prepaid gratuities, a cocktail party, shipboard credits, and more. For more information, call (604) 943-6141 or (800) 668-7022, or write to Mar Go Travel, 1133 56th Street, Twawwassen, BC V4L 2A2, CANADA. -=-=-=-=-=-=- Brown Rice--Better than White Rice: Milling is the primary difference between brown and white rice. Milling removes the outer hull, bran, germ, and endosperm from the rice grain. While milling increases the cooking convenience of rice, making it a 20 minute process instead of 40, the trade-off is a dramatic drop in nutrients. The outer layers that are milled off contain nutritionally important oils, fiber, vitamins, and minerals. Fiber is not only more filling, but has a probable role in preventing certain gastrointestinal diseases and heart disease. Brown rice contributes to health in a way that white rice can't, and is therefore well worth the wait.(1)

Return to the Table of Contents

Celiac-Friendly Restaurant Contacts -----------------2----------------- Hello, DATE:___________________ Celiac Disease is a medical condition caused by an intolerance to gluten. It can be controlled with diet by avoiding ALL sources of gluten. Gluten is found in products made from wheat, barley, rye, and oats. Bread and pasta are some of the more obvious sources of gluten. Soup bases, sauces, vinegars from the above grains (wine or cider are okay), deep-frying oil, and condiments are sometimes not-so-obvious sources of gluten. To protect themselves, celiacs must know the source of all food products and preparations. Celiacs enjoy eating out, but they must have information from a knowledgeable source at a restaurant as to both how their food will be prepared and what the labeled contents are of all products to be used in preparing their food. We would like to add your restaurant to our support group's list of celiac-friendly restaurants. This list is used by our support group's members, and would be shared with other support group members throughout the country who may be visiting in our area. To do so, we would ask you to help us with the following information. RESTAURANT NAME:______________________________________________________ ADDRESS:______________________________________________________________ PHONE NUMBER:_________________________________________________________ MANAGER - DAY:________________________________________________________ MANAGER - NIGHT:______________________________________________________ Do you currently have gluten-free meals available? YES___ NO___ Would you be able to serve a gluten-free meal to a customer if asked? YES___ NO___ To whom should celiacs talk with if they wish to dine here? NAME:_________________________________________________ DAY TITLE:________________________________________________ Before:____________ PM NAME:_________________________________________________ NIGHT TITLE:________________________________________________ Should they talk to this person... before they come in to dine? YES___ NO___ when they come in to dine? YES___ NO___ both before and when they come in to dine? YES___ NO___ Are there any suggestions you can offer for us to help you help us? ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________

Return to the Table of Contents

Gluten-Free Breads --------3--------- a talk by Sandra Leonard summarized by Lynn Samuel Sandra Leonard is the proprietor of the Gluten-Free Baker newsletter. She spoke at the 1995 CSA/USA conference on October 5, 1995, in San Francisco, California. Her talk was summarized by Lynn Samuel in the December 1995 newsletter published by the Midlands Chapter 13 Support Group, a chapter of CSA/USA. That summary is reprinted here. This was an EXCELLENT and entertaining presentation at the CSA conference, given by Sandra Leonard, proprietor of the Gluten-Free Baker newsletter in Fairborn, Ohio. This charming lady has a wonderful sense of humor and I thoroughly enjoyed her presentation, even though I felt I was out of my element. Owning a bread machine, I felt I was at the wrong place listening to tips on making bread from scratch manually! But, it was worth it. We were told that each brand of rice flour works differently. Betty Hagman's recipes call for Ener-G rice flour. Oriental rice flour is ground finer and requires less liquid. Sandra recommends cutting the liquid in half to start out. Following recipe directions, initially add 1/2 the amount required, then add more liquid gradually to form the proper consistency. All ingredients should be at room temperature. The latest bean flour available from Authentic Foods consists of broad beans and garbanzo beans. It is quite absorbent. She bakes with it. Sandra states that proofing the yeast is essential. To do this, take a pinch of sugar from the recipe, pour warm water (as stated earlier, using 1/2 the liquid to proof), sprinkle yeast on top of warm water, and stir to dissolve. Set aside. (It will get frothy and look like a shake). Salt inhibits yeast from rising, so add more sugar if there's lots of salt in the recipe. Mix the dry ingredients well, using a wire whisk rather than beating. Add the wet ingredients in stages: 1) eggs, 2) shortening, butter, or oil, 3) yeast and water mixture, 4) other liquids (dough may be sticky to the touch), 5) may add more liquid now. The dough should be the consistency of a thick batter, like a quick bread or thick muffin mix which is sticky, not kneadable. Place the bread dough into a greased loaf pan. Wet your hand or finger, then take the dough off. Using a wet finger, smooth the top across the dough and into the corners. It's best to use insulated bakeware that has a cushion of air between two layers. There is less chance of burning. To make rolls, use round cookie cutters and keep them on when baking. Grease a pan or cookie sheet, and spread dough with a wet hand. After using grease or Pam, put plastic wrap over the dough to rise. Let it rise about 45-90 minutes (or more if necessary, depending on the temperature), and then bake! Be sure to remove the plastic first. If the bread is browning too much, you can make a foil tent with the shiny side up. When the bread is done, remove it from the oven and place it on a wire rack to cool. Spray Pam on the knife if you plan to slice it while warm. If you prefer a softer crust, brush the top with butter or margarine before baking. If you add ingredients like raisins or nuts, dust them with rice flour and mix well. If you like, you can use parchment paper (using a clothespin to hold it to the side of the pan), or re-usable teflon paper. Sandra made delicious "Almost Cheese Nip Crackers" which she shared. The recipe is in one of the Gluten-Free Baker newsletters, and back issues were available to be purchased. She is obviously a very good cook and enjoys her job!

Return to the Table of Contents

Gluten-Free Pharmaceutical Guide ---------------4---------------- The following comes from the Lone Star chapter of CSA/USA. ................................................................ : : : GLUTEN-FREE PHARMACEUTICAL GUIDE : : : : I have Celiac Disease. I am intolerant to gluten, a mixture : : of grain proteins. Ingestion of gluten by celiac patients : : damages the mucosal lining of the intestinal tract. : : Symptoms may include nausea, vomiting, diarrhea, nutrient : : malabsorption, and increased risk for long term : : complications, including lymphomas. : : : : Any drug products I use MUST be gluten-free, as I may react : : to even the smallest amount of gluten. Gluten-containing : : products are not easily identified. I will need your : : : : assistance in identifying medications which are gluten free. : : : : Potential sources of gluten in medications, particularly : : drug excipients and binders, include: : : : : starch (corn, potato, or tapioca starch are allowed, : : wheat, oat, or barley starch is not) : : gluten peptides; grain vinegars; : : alcohol/ethanols/extracts; : : natural or artificial flavors; : : malt; maltodextrins; dextrins; : : natural or artificial flavors; : : hydrolyzed plant or vegetable proteins; : : monosodium glutamate; : : emulsifiers; stabilizers; : : lectins/lecithins; : : preservatives; and sweeteners : : : : It is necessary to contact the drug manufacturer to verify : : that a product is gluten-free. Excipient use may vary by : : lot number. Manufacturer's medical information personnel : : will be able to assist in determining if a product is : : gluten-free. Many drug companies have toll-free numbers. : : First try to obtain a toll-free listing by dialing : : 1-800-555-1212. : : : : I appreciate your kind attention to my health requirement. : : : : This card was produced by the : : Lone Star chapter of CSA/USA. : :..............................................................:

Return to the Table of Contents

Newsletter Roundup ---------5-------- Compiled by Jim Lyles We exchange newsletters with several other celiac groups. In this article I will summarize some of what we've learned from our newsletter swapping. ........................................................ : : : Excerpts from _The Celiac ActionLine_ : : ------------------------------------- : : Oct. 1995 (Vol. V, No. 4) Mike Jones, Publisher : : Celiacs of Orlando & GIG of Florida : : 12733 Newfield Drive : : Orlando, FL 32837 : :.....................................................: Bette Hagman's taping of GF Southwest cooking in Portales, New Mexico will be broadcast in three segments. Check with your local PBS station for availability of KENW-TV's show called "Creative Living". A tape of the show is available for $15. Write to KENW-TV, Attn: Sheryl Borden, 52 Broadcast Center, Portales, NM 88130. Are Oats Acceptable? An article in the New England Journal of Medicine (Oct. 19, 1995) refers to a recent study that suggests oats may be acceptable for a GF diet. This has stirred considerable discussion. There are many points to consider before adding oats to your GF diet: 1. Do oats have a low level of toxicity that will take years or require large quantities to show microscopic damage in the villi? 2. Cross contamination from other grains is a strong possibility. [This may occur as early as in the fields where the oats are grown, due to year-to-year crop rotation--ed.] 3. The medical/celiac community has not officially approved the inclusion of oats in the diet. [In particular, the study did not cover celiac children. Don't start feeding oats to your celiac child without seeing your gastroenterologist first!--ed.] Skin biopsies for DH: A skin biopsy in an affected area shows a specific diagnosis pattern of Dermatitis Herpetiformis (DH). This is typically obtained from the buttocks or other area where itching is observed. When a skin biopsy is needed and no blisters are available, then a DH outbreak can often be created by applying a 30% solution of iodine as a patch. Dapsone, a drug often used to treat DH blisters, decreases the average life span of red blood cells from 120 days to 30 days. Dapsone is known for possible hematological changes as a common side effect. Red Star has introduced another pamphlet for celiacs entitled "New Gluten-Free Recipes for your Bread Machine". To get a copy, call Red Star at (800) 4-CELIAC. Ibuprofen and DH: Ibuprofen types of pain relievers may not be desirable for DH patients, as they may cause an increase in DH problems.(2) Down's Syndrome and CD: The frequency of CD is 43 times greater in children with Down's Syndrome than in children without Down's Syndrome. It should be considered in all children with Down's Syndrome who have either persistent diarrhea or failure to thrive.(3) Epilepsy and CD: Several studies suggest a link between CD, brain calcifications, and seizures/epilepsy. Here is some information from two of these studies: * In a study of 783 patients with seizures nine were subsequently biopsy-diagnosed to have CD. In all these cases, symptoms of CD were either previously not taken into account or were very mild or completely absent. In a group of 36 patients with clinically manifest CD, regular follow-up, and good compliance to the GF diet, no seizures were reported.(4) * Of 31 patients (series A) with cerebral calcifications of unexplained origin and epilepsy, 24 were diagnosed as celiacs on the basis of a flat intestinal mucosa. Of 12 patients (series B) with both CD and epilepsy, five were found to have cerebral calcifications. This gave a total of 29 cases with the combination of CD, epilepsy, and cerebral calcifications (CEC). Only two of the series A patients had gastrointestinal symptoms at the time of intestinal biopsy. Most of the patients had diarrhea, anemia, and other symptoms of CD during the first three years of life. Unfortunately, a GF diet beneficially affected the course of epilepsy only when started shortly after the onset of epilepsy. The possibility of CD should be investigated in all cases of epilepsy and cerebral calcifications of unexplained origin.(5) ........................................................... : : : Excerpts from _Gluten-free Friends_ : : ----------------------------------- : : Summer 1995 (Vol. 1, No. 2) R. Jean Powell, editor : : Winter 1995 (Vol. 1, No. 4) Montana Celiac Society : : 1019 So. Bozeman Ave. #3 : : Bozeman, MT 59715 : :........................................................: Talking with a Medical Professional: First, learn all you can about CD, DH, and the GF diet. Make sure you have accurate information, and be willing to admit you are still learning. Be polite and respect the time pressures a professional works under. State facts, questions, and your purpose clearly; anger, hostility, or a "pity me" approach will not gain a professional's respect. Show respect for their professional knowledge even if they do not have much experience with CD. Dealing with Family and Friends: Family and friends often do not understand how important it is to be very strict about the GF diet. They may try to be helpful. However, you must do what is best for you; whether it is convenient for everyone or not; and whether they understand or not. If you eat "just a little" gluten one time, they will be confused when you try to decline the next time. (They won't know how you paid for your "politeness" the first time.) So BE CONSISTENT. As family and friends begin to see what a difference the GF diet makes, they tend to become more supportive. I'm glad I had a biopsy because: "First of all, it gave me a definite diagnosis from a medical source--pretty important when family members think it's 'all in your head.' Second, it gives me a definite reason to tell other family members that they and their offspring could be at risk for CD. Third, it helps keep me on the GF diet because I know I have it. Last but not least, medical personnel respect a diagnosis by a confirmed biopsy by a GI specialist."--Lily Patten A Frightful Tale: "I would like to introduce to you the wicked witch Gliadin and her cat Blacktoes. They lurk in the woods behind Sprue Village, a small community nestled in the valleys of Anywhere, USA, Earth (and other places) where peculiar people who can't eat cookies or gingerbread live. Gliadin, who is a luscious and tasty morsel, tries with all her many beguiling wares to tempt Sprue Villagers, evilly cackling when pizza and spaghetti make them writhe in pain! Blacktoes leaves cookies and slices of Velveeta on doorsteps to entice the children...and make them cry. Blacktoes is a bad cat. Gliadin is a bad witch. They will be appearing throughout your life, so--BEWARE!"--R. Jean Powell [I made some slight changes, based on comments from Dorothy Vaughan, our dietitian advisor--ed.] ................................................................ : : : Excerpts from the Houston Celiac-Sprue Support Group : : ---------------------------------------------------- : : newsletter: Jan./Feb. 1995 Janet Y. Rinehart, President : : 11011 Chevy Chase : : Houston, TX 77042-2606 : :.............................................................: The Incidence of Malignant Diseases and the survival rate in celiac patients were compared with those in the Finnish population. The five year survival rates of celiac patients did not differ from those in the general population. At least 85% of the celiac patients adhered strictly to the GF diet, which may explain the favorable outcome.(6) The Development of Respiratory Problems should be regarded as a potentially serious and life-threatening event in middle-aged celiac patients. Lung abscess should be added to the list of respiratory diseases associated with CD.(7) Adenovirus 12 and CD: Dr. Steven M. Best of Hudson, Wisconsin has examined research papers on Adenovirus 12 (Ad12) and CD. Some of the studies suggest that CD can be triggered by Ad12. However, there is conflicting evidence on this topic. In one study, researchers concluded that persistent Ad12 infection is not involved in the pathogenesis of adult or childhood CD. However, the study did not exclude the possibility that an acute, remote Ad12 infection (which does not integrate into host DNA) triggers the onset of CD.(8) ...................................................... : : : Excerpts from the Westchester CS Support Group : : ---------------------------------------------- : : newsletter: Oct. 1995 Sue Goldstein : : 9 Salem Place : : White Plains, NY 10605 : :...................................................: "A Passover Guide to Cosmetics and Medications" is written by Rabbi Gershon Bess and published by Kollel-Los Angeles. During Passover, some people of Jewish faith refrain from using items which are chometz, that is, which contain wheat, barley, rye, oats, or spelt. So you see, Rabbi Bess' annual research is useful for celiacs too. Last year's guide contained 25 pages of product names (in small type) organized into categories, with the chometz items marked by an "*". The 1996 guide will be ready in March. Write to Kollel - Los Angeles, 7466 Beverly Blvd. $204, Los Angeles, CA 90036. A donation is suggested. (This information comes from Mary Courtney, via the CELIAC e-mail list on the Internet.) References ---------- (1) "Brown Rice: Well Worth the Wait", Christine Negm, nutritionist, _Lundberg Rice Paper_, vol. 9, no. 1. (2) _The Merck Manual of Diagnosis and Therapy_, 16th ed., pg. 2445. (3) _European Journal of Pediatrics_, Nov. 1993. Authors: Hilhorst MI, Brink M, Wauters EA, Houwen RH., Dept. of Gastroenterology, Wilhelmina Children's Hospital, Utrecht, The Netherlands. (4) "Celiac Disease and Epilepsy in Pediatric Patients", Fois A, Vascotto M, Di Bartolo RM, Di Marco V, _Childs Nerv Syst_, Sept. 1994, 10(7), pgs. 450-454. (5) Coeliac Disease, Epilepsy, and Cerebral Calcifications", The Italian Working Group on Coeliac Diseasae and Epilepsy, Gobbi G, Bouquet F, Greco L, Lambertini A, Tassinari CA, Ventura A, Zaniboni MG, _Lancet_, Aug. 22 1992, 340 (8817), pgs. 439-443. (6) "Coeliac Disease -- Associated Disorders and Survival", _Gut_ 1994, 34:1215-1218. (7) "Lung Cavities in Patients with Coeliac Disease", _Digestion_ 1990; 46:72-80. (8) "Evaluation of Celiac Disease Biopsies for Adenovirus 12 DNA Using a Multiplex Polymerase Chain Reaction", _Modern Pathology_ 1993; 6(1):61-64

Return to the Table of Contents

Recipe Page -----6----- ********************************************************************** Ham 'n Cheese Supper Bread 1 cup GF flour mix** 1 egg 1 tsp. baking powder 1/3 cup milk 1/2 tsp. xanthan gum 1 Tbsp. salad oil 1/4 tsp. baking soda 1/4 tsp. prepared GF mustard 1/8 tsp. salt 1 cup shredded cheddar cheese 1/2 cup chopped cooked ham (about 4 ounces) 2 Tbsp. instant minced onion 1 Tbsp. sesame seed Combine the flour, baking powder, xanthan gum, baking soda, and salt and mix together well. Add the ham, onion, egg, milk, oil, mustard, and 2/3 cup of the cheese and mix well. Spread the mixture into a greased 1-quart casserole dish. Sprinkle the remaining cheese and sesame seeds on top. Bake at 350 degrees F until the top is golden brown, about 30 to 35 minutes. Serve warm. Makes 4 servings. This bread goes well with soup. Note: Wrap leftover bread in aluminum foil and refrigerate or freeze. To reheat, leave it in the foil wrapping for 10 minutes (if thawed) or 30 minutes (if frozen) at 400 degrees F. This recipe came from _Betty Crocker's Dinner for Two Cookbook_, published by Golden Press, New York, NY, in 1977. It was adapted to be gluten-free by Vicki Lyles. ********************************************************************** Crazy Crust Pizza 1 cup GF flour mix** 1 tsp. olive oil 1 egg, beaten 1-1/2 tsp. xanthan gum 1/4 to 1/2 tsp. salt GF cooking spray (such as Pam) 1/4 to 1/3 cup milk pizza sauce and toppings Mix all ingredients well. Pat out the dough in a greased 9" pizza pan. Make an edge. Spray top of dough with GF cooking spray. Bake for 10 minutes at 500 degrees F. Remove from the oven and top with pizza sauce and any other pizza toppings you want. Put it back in the oven for 7-10 minutes, or until the cheese melts. This recipe came from Joan Kulka. ********************************************************************** Light Apple Cobbler GF cooking spray (such as Pam) 1 cup GF flour mix** 6 cups apples, peeled & chopped 1/2 cup sugar 1/2 cup brown sugar, packed 1 tsp. baking powder 1 Tbsp. cornstarch 1 egg, beaten (or 2 egg whites) 1-1/2 tsp. cinnamon 1/2 tsp. vanilla 1/4 tsp. nutmeg 2 Tbsp oil (or applesauce) Spray a 9 inch baking dish with cooking spray. In a medium bowl, mix apples with brown sugar, cornstarch, cinnamon, and nutmeg. Place this mixture in the baking dish. Combine the flour, sugar, and baking powder. Add the egg and vanilla, stirring until well distributed. Dribble in the oil (or applesauce) and mix with a spoon until crumbly. Put this flour mixture on top of the apples and lightly press it into the apples. Bake uncovered at 350 degrees F for 40 minutes. This recipe came from Mary Guerriero. ********************************************************************** ** GF flour mix: 6 parts white rice flour 2 parts potato starch (NOT the same as potato flour) 1 part tapioca starch (also called tapioca flour) ********************************************************************** Tri-County Celiac Sprue Support Group Officials: ------------------------------------------------ Physician Advisor: Thomas Alexander, M.D. Dietitian Advisor: Dorothy Vaughan, R.D. President: Diane Morof Vice President: Mary Guerriero Past President: Kathy Davis Secretary: Denise Parsons Newsletter Editor: Jim Lyles (200-2214@mcimail.com) Contributing Editor: Judy Hafner (gpyp07a@prodigy.com) Disclaimer: ----------- All recommendations, information, dietary suggestions, menus, shopping guide suggestions, medical updates, miscellaneous articles, and recipes in this newsletter are intended for the benefit of our members, readers, and the general public. No liability is assumed by the Tri-County Celiac Sprue Support Group or any of its members. Information in _The Sprue-nik Press_ has not been submitted for approval to the CSA/USA medical board; however it has been approved by our physician and dietitian advisors. Individuals should consult with their physicians and dietitians before following any medical or dietary recommendations in _The Sprue-nik Press_. Original material used in _The Sprue-nik Press_ is placed in the public domain for the benefit of all celiacs. The information is not copyrighted to facilitate the easy exchange of celiac information. Feel free to reproduce any portion of this newsletter, unless it specifically states otherwise. All we ask is that you indicate where the information came from. _The Sprue-nik Press_ is published by the Tri-County Celiac Sprue Support Group (TCCSSG), a local chapter of CSA/USA located in southeast Michigan. Members receive this newsletter, a shopping guide, and a new member packet full of articles and useful information. Mail-in subscriptions are welcome. For subscription information, send a note to Jim Lyles, at (200-2214@mcimail.com).
Return to the Table of Contents