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 5 July/August 1996
**********************************************************************
..................................................
: What's Inside Search For :
: ------------- ---------- :
: Miscellaneous Notes . . . . . . . . . -1- :
: Pre-School and CD . . . . . . . . . . -2- :
: Cheap, Tasty GF Food . . . . . . . . . -3- :
: Newsletter Roundup . . . . . . . . . . -4- :
: Recipe Page . . . . . . . . . . . . . -5- :
:................................................:
References
Disclaimer
Miscellaneous Notes:
---------1----------
From the Editor: It seems forever since I last put together a
newsletter, though I know it has been only a few months. As you'll
see, a large part of this newsletter comes from other newsletters.
We've been swapping newsletters with other groups for eight months.
These reciprocating agreements have helped us a lot; since then we
have included 2-5 pages of information from other groups in all but
one issue of _The Sprue-nik Press_. Altogether, 20 different groups
have helped to fill the pages of this newsletter at one time or
another.
Other groups have benefitted from our newsletter as well. I've found
information from _The Sprue-nik Press_ in newsletters from 12 other
groups since last fall. I think newsletter swapping is a prime
example of "celiacs helping celiacs", and I look forward to more
exchanges of information with other groups in the future.
Return to the Table of Contents
Pre-School and Celiac Disease[1]
---------------2----------------
by Tracy Keegan
President, Celiac Support Group, Boston Children's Hospital
As September approaches I wanted to talk about how to make the
pre-school experience both physically safe and emotionally positive
for the celiac child. As a parent, your first mission is to secure a
gluten free environment for your child. The typical pre-school
classroom holds several hidden dangers to beware of.
Start by sitting down with the teacher before the beginning of the
school year. Give her some literature about Celiac Disease (GIG
prints a brochure for teachers). Ask her to have every adult who will
be serving as an instructor or an aide read this information before
school starts. Have her post a notice about your child's food
intolerance's for any substitutes who might be in the class room
during the year. Talk about the various OK snacks and offer to supply
GF snack or ingredient substitutions.
Request that on occasion GF snacks be offered to all of the students
instead of constantly singling out your child as different by giving
him a separate snack from the rest of the class. I think this issue
is incredibly important to children with celiac disease. Their first
preschool experience is a chance for our children to develop their own
identities and a sense of self confidence. Our job as parents should
be to make this experience as emotionally secure and positive as
possible. We should attempt to minimize the isolation our toddler
must feel at being singled out as different from his peers during one
of the most social periods in his day.
True, our children will always have to think before they eat but the
preschool experience can also reassure them that they can eat the same
things as all the other children too. There must be a balance between
the differences and the similarities. My personal solution to the
issue was to supply a GF snack which could be enjoyed by the entire
class once or twice a week.
The following list of GF snacks may be served to the typical preschool
class:
1. fresh fruit slices together or separately
2. most canned fruit
3. cheddar cheese cubes
4. raisins
5. pumpkin or sunflower seeds
6. nuts (but other children might have allergies)
7. Popcorn
8. Corn chips and corn nuts (If kids are over 3 yrs)
9. peanut butter on rice crackers or with carrot sticks as a dip
10. GF yogurt
11. Cinnamon apple rice chips (Hain's)
12. Fruit popsicles (always check to see if still GF )
13. My daughter loves Bi-Aglut Swedish cracker bread, sold by Dietary
Specialties*
14. Dietary Specialties sells a "saltine"-like cracker called
Wel-Plan Crackers*
15. Health Valley fat-free crisp rice bars in three flavors (Orange
Date, Raisin Apple & Tropical Fruit) are currently GF*
16. Bette Hagman's Mock Graham Crackers are a huge hit with my
daughter and anyone else who can get their hands on them--the
recipe is found in _More From the Gluten Free Gourmet_. I
sprinkle them with a little cinnamon sugar
17. Mini muffins from any GF mix
Most of the time the school will provide juice for all the children .
Ask the teacher to purchase only 100% fruit juice and recommend
several Gluten Free brands. It is also possible to send in a safe
bottle of juice for your child's drink.
The other major gluten minefields in preschool are birthday cupcakes
and holiday treats. The best technique I've worked out is to bake
chocolate and vanilla cupcakes at the beginning of the year and freeze
them in individual Ziploc bags; then I can quickly defrost the
appropriate flavor and either mix up homemade frosting or use some
Duncan Hines Homestyle frosting* in the same flavor as the birthday
child's cake. Don't forget to put a few sprinkles on top just in case
the birthday cupcakes have them too. As your child matures this exact
matching game will become less important. There will come a day when
they realize a cupcake is a cupcake whatever the color/flavor.
Have your child's teacher supply you with a list of birthdays at the
beginning of the year so that if a parent has not given you warning
before they plan to bring in a treat you can give them a quick call to
see if they were planning anything special.
Finally, give the teacher a box of 'just in case' cookies at the
beginning of the school year. This way your child won't be the only
one without a special treat "just in case" Sarah's grandmother bakes
some valentine cookies for the class or "just in case" Jack's brings
in treats to celebrate Groundhog day.
One play area in most classrooms is the sensory table into which sand,
water, beans, etc. are placed for the children to play with. Request
that the teachers do NOT use wheat, rye, oats or barley in the sensory
table. It should be obvious that little fingers often find their way
into little mouths. Recommend cornmeal, rice, beans, sand, or water
as safe alternatives.
Stickers and envelopes are often used in classroom play. Ask that the
teachers use only peel-n-stick varieties wherever possible. If
envelopes are being used have a damp sponge available for sealing
them. The reason for this is that some envelope companies do not
confirm that the gum Arabic used to create the seal is gluten free.
(My source for this information is _The Gluten Free Gourmet_, by Bette
Hagman.)
A popular pre-school project these days is stringing cereal into
necklaces, usually a gluten containing brand . Unfortunately I have
not come across a gluten free alternative to this type of cereal. As
not all cereal always ends up on the string you should consult the
teacher about skipping this activity altogether. A safer alternative
to the stringing project would be to supply the classroom with GF
pasta in the shape of tubes so that the class could paint the noodles
as well as string them. This type of pasta is available through
Dietary Specialties (800) 544-0099.
Playdoh is a standard item in every preschool. Playdoh is made from
wheat flour base. Request that the "Play Dough" in your child's room
be made from a cornstarch base instead. The following recipe is from
Tim Meadows:
1/2 cup rice flour 1 cup water
1/2 cup corn starch 1 tsp. cooking oil
1/2 cup salt food coloring
Cook and stir on low heat for 3 minutes until it forms a ball.
(If your child is older or can remember NEVER to put his hand in his
mouth than you can tell the teachers to let him use the regular
Playdoh; however, always ask that the teacher have your child wash his
hands right after playing with it.)
If the preschool does any cooking projects Play Dough is a fun recipe
to cook up.
On the subject of cooking, my experience is that every pre-school uses
baking as a basic part of its curriculum. In order to incorporate
your child into his activity go over the general baking projects at
the beginning of the school year and suggest or supply a GF
alternative.
For example: If the class is going to make blueberry muffins replace
the recipe with a package of GF blueberry muffin mix. (Dietary
Specialties has a great one). Go the next step and actually supply a
list of GF baking ingredients for the teacher (i.e.: GF butter or
margarine, GF food colorings, GF vanilla extract, GF chocolate chips,
whatever ingredients are required). Now your child can roll up his
sleeves and lick the batter off his fingers with the rest of the kids.
In addition to supplying the class with a variety of GF muffin mixes
(The Really Great Food Company [ 516-593-5587] is a good source of
both muffin mixes and a pizza crust mix which doubles as a bread stick
recipe fun for the kids to make as they can roll their own bread
sticks.) There are a lot of other fun GF cooking projects the class
can do and here are a few suggestions to share with your child's
teachers:
1. Fruit Kabobs or fruit boats
2. raisin and nut and sunflower seed gorp
3. peanut butter on celery sticks or rice crackers (be sure to
supply your own jar to be used only for GF snacks)
4. applesauce
5. popcorn from a dried corn stalk
6. home made fruit popsicles
7. cheese cubes on sticks with fruit
8. Bette Hagman's peanut butter cookies (ingredients include only
peanut butter, sugar and eggs--see _The Gluten-Free Gourmet_)
9. Meringue cookies (Egg whites, sugar, & cream of tartar--see _The
Gluten-Free Gourmet_)
A note to parents of school-aged children. My daughter is now in
kindergarten and old enough to go to the Cafeteria for lunch. At
first glance it would appear that no foods could be considered safe at
a school cafeteria. However, with a little research, your child may
be able to purchase at least part of her lunch just like everyone
else. I went directly to the cafeteria at the beginning of the school
year and actually read the labels of the juice, milk, & popsicles
offered for purchase. After calling the companies I was able to let
my daughter pick out a drink and a piece of fruit or an Italian ice
for desert . Due to the nature of kid friendly foods it would be very
unlikely that any main course would be safe for consumption on a GF
diet.
These precautionary measures should go a long way to insure an
emotionally successful school year for your child. We must be
diligent in training our children to be on guard for that hidden
enemy, gluten. The pre-school environment, however, should be a safe
haven in which to grow and explore the world unencumbered by the
social restrictions a GF diet will always demand.
*Please call any brand name manufacturer to confirm current gluten
free status of any of the products I have suggested here. I know it
is difficult and time consuming to continually research product safety
but I cannot guarantee the gluten-free status of any of the
aforementioned commercial products beyond October 25th l995.
Return to the Table of Contents
Cheap, Tasty GF Food[2]
-----------3-----------
by Laura Johnson-Kelly
My mother-in-law's best friend loves it when I visit my in-laws so she
can gripe with me about the "bland" GF diet, as I am the only other
celiac she knows. I realize that for those of you who for some reason
must consume institutional food all the time, it must be difficult to
come up with interesting, safe, GF food. However, I cannot understand
how someone can possibly refer to our diet as "bland", especially if
one cooks for oneself (and it is never too early to learn!).
The people I know who like traditional American food tend to be wary
when they eat at my house, since they always suspect that I will
introduce them to something a bit more tasty than they are used to.
My husband and I (as well as our 2-1/2 year old) all prefer highly
spiced, flavorful foods. As I am the cook and also the celiac,
everything I make (barring the occasional commercial product, usually
purchased for guests) is gluten-free. In addition to the usual GF
constraints, I cannot tolerate whole grain corn (maize), and my
daughter has at times had to eat dairy (casein) free, so I really do
know that one can cook fun, interesting, cheap food while maintaining
a restrictive diet. Here is how I manage to eat fun and flavorful
food on a budget:
1. Cook the real thing, rather than substitutes. Though I sometimes
buy rice pasta (the 99 cents/pound stuff from the Chinese market,
not the $3.50/pound Pastariso, Ener-G, etc.), I prefer serving
the things that one might serve over pasta over rice instead.
Even the most expensive varieties of exotic brown rice are
usually less than one third the price of name brand GF pasta
substitutes, and the cheap, generic rice in 20 lb. bags (we eat
a lot of rice, so I buy in bulk for convenience) go for about 35
cents (US Dollars)/pound here. And we enjoy the flavor of "real"
rice! For more zip, try adding a splash of olive oil and some
garlic to your rice before cooking--this is a Peruvian trick that
subtly flavors the rice. By avoiding the processed foods and
cooking real rice rather than some mix, there is no chance of
gluten contamination.
2. Use herbs and spices liberally. If you are leery of trusting
major brands like McCormick saying that their spices are GF, then
use whole leaf spices only. If you don't like dried spices, then
use fresh, either grown yourself in pots on the windowsill or in
the garden, or bought in the store. There seems to be a terrible
misconception that just because the word "spices" on a list of
ingredients for a commercial sauce may be suspect for us, that we
need to avoid all spices in our own cooking. This isn't true!
3. Try ethnic foods. Before going GF, I had never really eaten
Indian food, and now the Indian food aisle is one of my regular
stops. Our supermarket has a dizzying array of GF Indian sauce
concentrates, a spoonful of which mixed with some yogurt or
coconut milk and poured over chicken, lamb, fish, or vegetables
makes a very tasty meal when served with rice. Tomato-based
"Italian"-style sauces are quick, easy, and cheap, and can easily
be made dairy free. Start with a can of pureed tomatoes and add
your favorite flavorings (meat, mushrooms, peppers, garlic,
olives, etc.). Try eating Cajun flavored foods, or Chinese (with
GF soy sauce, of course), or Greek--the possibilities are
endless! If you need inspiration, check out the cookbook section
of your local library. Good ethnic cookbooks won't use lots of
prepackaged, gluten-containing foods, and if your Arabic cookbook
tells you to serve some dish with couscous, try using rice
instead and you still have something new and interesting (and
safe!) to try .
4. Use flavorful vegetables, fruits, and condiments to enhance your
meals. I love using peppers of all kinds, onions, various
homemade and (GF) commercial relishes, etc.--either to add to
sauces or just to eat along with a main dish. The other day I
served Peruvian-style chicken with peanut sauce (made from GF
peanut butter, hot peppers, onions, garlic) served over potatoes.
I dare anyone to call this dish "bland".
5. Look up old traditional American favorites. My friends think
that I am odd for bringing things like tapioca or rice pudding to
a potluck. I don't know anybody else my age who makes rice
pudding on a regular basis, but there is a reason why this
dessert has been popular for years! It can be made deliciously
dairy free by using coconut milk instead of regular milk. I'm
viewed as eccentric for whipping my own cream instead of using
the frozen stuff, but not only do I not have to worry about
hidden gluten, it tastes much better and is cheaper to boot!
Recent research at Cornell University has indicated that a rice-based
diet appears to lower both serum triglycerides and cholesterol levels,
and both have continued to drop for me as well as my non-celiac
husband, even though we eat red meat and other foods not on the heart
smart lists. I won't use "diet" products--most aren't GF anyway--and
it appears that one can consume things like eggs (omelets are cheap GF
food) and not have one's cholesterol automatically skyrocket.
About baked goods--OK, here I think it is unavoidable that we pay more
than someone who isn't on a GF diet. This isn't true, though, if you
compare the cost of homemade GF muffins, breads, pancakes, etc. with
commercial gluten-containing baked goods. I buy my xanthan gum
through Miss Roben's (the cheapest source I've found), my tapioca
starch and potato starch at the Chinese market, and my rice flour in
the Indian food aisle. I save at least 50% over the cost of mail
ordering from someplace like Ener-G. I don't use commercial GF mixes
(Bette Hagman's books are a great source of basic recipes). My food
bills are lower than most people's (eating regular gluten diets)
because I am not tempted to use mixes or convenience foods. If you
cook from scratch it doesn't really take much more time (muffins from
a mix preparation time can't be much less than the 5 minutes it takes
to whip up a batch from scratch), you can control the ingredients,
things taste better/fresher, and they cost less!
I hope that some of these hints help some of you to broaden your diets
and bring joy to mealtimes again.--Laura (whose mouth is watering at
the prospect of grilling the cheap chuck steak marinating in a
homemade Italian-style dressing as soon as she gets home!)
Return to the Table of Contents
Newsletter Roundup
---------4--------
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 Gluten Intolerance Group of North America :
: ----------------------------------------------------------- :
: newsletter: June 1996 Cynthia Rolette, editor :
: PO Box 23053 :
: Seattle, WA 98102-0353 :
:.............................................................:
Marvelous Marinades: Marinades are a wonderful means of adding flavor
to many dishes, and are useful in tenderizing meat. DowBrands has a
nice booklet of marinades for many purposes. Write to: Marvelous
Marinades, DowBrands L.P., PO Box 68511, Indianapolis, IN 46268. Ask
for Form #218-971-94.
.........................................................
: :
: Excerpts from _The Celiac ActionLine_ :
: ------------------------------------- :
: April 1996 (Vol. VI, No. 2) Mike Jones, Publisher :
: Celiacs of Orlando & GIG of Florida :
: 12733 Newfield Drive :
: Orlando, FL 32837 :
:.......................................................:
Mysterious Neurological Ailments such as lack of coordination or
muscle weakness may be diet related. Dr. Marios Hadjivassiliou and
colleagues at the Royal Hallamshire Hospital in Sheffield decided to
test people with undiagnosed neurological symptoms to see if they had
a sensitivity to gluten. They found that 57 percent of those with
neurological problems of unknown cause also had antibodies to gliadin,
a component of gluten. 16% of them had CD, a much higher level than
normally found. Most of the patients with antigliadin antibodies did
not have other symptoms of CD. Dr. Hadjivassiliou speculated that
antigliadin antibodies may mistakenly attack neural tissue. This
could explain why some celiacs do not get better on a GF
diet--sometimes the nerve damage could be permanent. Dr.
Hadjivassiliou recommends that patients with unexplained neurological
problems be screened for CD.[3]
-=-=-=-=-=-=-
Diamond Crystal Specialty Foods produces a tasty, GF, fortified
pudding. These ready-to-use, 4.25 oz, single-serve containers are
available in Vanilla, Chocolate, and Butterscotch. Currently they are
only available through health care channels, but if you are admitted
to the hospital they are a wonderful GF supplement. Contact
information: 10 Burlington Ave, Willington, MA 01887; (800) 225-0592.
-=-=-=-=-=-=-
Colonial Gardens Kitchens has a Teflon-coated donut baker which works
well with GF flours (add 1 tsp. xanthan gum to recipes). It makes
great-tasting donuts that are less fattening because they are baked.
In three minutes you get six mini-donuts. The donut baker is like a
waffle iron with depressions on both sides. To order one, call (800)
245-3399.
......................................................
: :
: Excerpts from _Derby City Celiac_ :
: --------------------------------- :
: Summer 1996 Marge Johannemann, President :
: Greater Louisville Celiac Sprue Support Group :
: PO Box 7194 :
: Louisville, KY 40257-0194 :
:....................................................:
Dr. Joseph Murray gave a talk at the University of Louisville on March
21, 1996. Here are some excerpts from the talk:
* Typical symptoms of CD include diarrhea, steatorrhea, anemia,
vitamin deficiency, and weight loss.
* Frequent atypical symptoms of CD include fatigue, depression,
milk intolerance, osteomalacia, and osteoporosis.
* Less frequently recognized atypical symptoms of CD include
constipation, osteopenia, arthralgias, short stature,
neurological disorders, and dental enamel defects.
* CD affects people throughout Europe, the Near East, and North
Africa. Cases have also been reported in Cuba, Kuwait, Sudan,
and India. CD is very rare among African-Americans and
Orientals.
* From country to country, the rate of diagnosis seems to
correspond to the level of suspicion of its prevalence.
* Dr. Murray has 10 principles for treating CD:
1. Explain the condition; expect grief reactions.
2. Give up-to-date professional dietary advice on achieving a
GF lifestyle.
3. Encourage the patient to join both local and national
support groups as an essential part of treatment.
4. Prescribe nutritional supplementation to correct
deficiencies.
5. Perform baseline bone density measurements.
6. Consider screening at-risk family members.
7. Provide intensive nutritional support and fluid replacement,
if needed, for very ill patients.
8. Consider co-existing malignancy/autoimmune disease in very
ill patients.
9. Follow-up with patients to ensure response and compliance to
the GF diet.
10. To quote Elaine Hartsook: "Send the patient off with
champagne and encouragement, not pessimism."
* Dr. Murray does not consider the following to be helpful in
managing the a GF diet: home testing kits for gluten, large
listings of GF commercially-available processed foods, and
self-challenges to test a food's safety.
-=-=-=-=-=-=-
Have My Bread and Travel Too: LaVaughan Will took a 3-1/2 week trip
recently, and wondered how she might have bread with her. Ener-G's
individually packaged slices provided one alternative, but LaVaughan
has gotten used to home made bread from her breadmaker. Her solution?
She took the breadmaker with her, stored in a large canvas bag. She
also took several bags of pre-mixed dry ingredients, with a list of
the needed wet ingredients listed on each bag. When she needed bread
she would stop at a local grocery store and buy a half-dozen eggs.
Then she would carry the bread machine into the hotel, add the yeast,
dry ingredients, and wet ingredients, push the start button, and go to
bed. The next morning she had fresh bread to eat with her coffee.
She used a small hot pot to soft-boil the remaining eggs. Because it
spoils fast, her husband helped her eat the bread and found it to be a
real treat.
...........................................................
: :
: Excerpts from the Greater Philadelphia CS Support Group :
: ------------------------------------------------------- :
: newsletter: July 1996 Phyllis J. Brogden :
: 6318 Farmar Lane :
: Flourtown, PA 19031 :
:.........................................................:
Thomas Mace & Associates is going out of business. This is a
mail-order company that provided Basco products in the US, as well as
some bean flour products from Authentic Foods. Tom Mace still has 35
cases of Basco bread mix left. A bread machine is not required. The
ingredients are: Maize [corn] starch, rice flour, skim milk powder,
glucono delta lactone (rising agent), sugar, baking powder, salt, and
xanthan gum. The cost is $3.55 per package plus delivery. Write to
Thomas Mace & Associates, PO Box 1498, Monument, CO 80132-1498; or
call (800) 692-7323.
-=-=-=-=-=-=-
Authentic Foods products can be ordered directly from the company.
This includes the light bean flour Bette Hagman refers to in her
latest cook book, _The Gluten-Free Gourmet Cooks Fast and Healthy_.
Authentic Foods carries flours (bean, brown rice), pancake & muffin
mix, falafel (vegetarian burger) mix, cake mixes (chocolate, lemon),
vanilla powder, maple sugar, xanthan gum, bread mixes (regular,
cinnamon), and tapioca flour. The tapioca flour is $.75 per pound.
Shipping and handling is $6.50, no matter how much you order. Write
to Authentic Foods, 1850 W. 169th St., Suite B, Gardena, CA 90247;
call (800) 806-4737; or fax (310) 366-6938.
-=-=-=-=-=-=-
A Coloring Activity Book for celiac children is available. Nancy
Patin Falini, the dietitian advisor for the Philadelphia group, is the
author of the book, which is entitled Celiac Disease: Me and the
Right Food Choices. It is aimed for children ages 5-7. It comes with
an instructional guide for parents and contains a great deal of
helpful information in dealing with your child's celiac problems. The
cost for one coloring-activity book with one instructional guide is
$14.75 including postage; quantity discounts are available. To order,
send a check or money order to: Mrs. Nancy Patin Falini, M.A., R.D.,
437 Sharpless St., West Chester, PA 19382. Please include your
address, phone number, and support group affiliation.
-=-=-=-=-=-=-
_Gluten-Free Living_ is a newsletter that began publication in
January. The July-August issue includes an article from Jax Peters
Lowell, author of _Against the Grain_, a popular and entertaining book
about dealing with celiac disease. The article is entitled "Talking
To Your Doctor (so he or she will take you seriously)". Like her
book, the article is both helpful and entertaining. All the material
in _Gluten-Free Living_ is cleared by four doctors, including Drs.
Joseph Murray and Alessio Fasano. All four doctors also contribute to
it. This newsletter has more than lived up to expectations. It comes
out every two months. Subscriptions are $29 for one year, or $49 for
two years. To order, mail a check payable to Gluten-Free Living, PO
Box 105, Hastings-on-Hudson, NY 10706. [Editor's note--we also get
this newsletter, and have found it well worth the cost.]
-=-=-=-=-=-=-
Dr. Alessio Fasano spoke to the Philadelphia group on March 24, 1996.
Here are some notes from that meeting, as recorded by Nancy Patin
Falini:
* Glucose tolerance, fecal fat, and D-xylose tests are not specific
indicators for celiac disease (CD). [In other words,
abnormalities detected by these tests might be caused by
something unrelated to CD.]
* Once a sibling of a celiac reaches 4-5 years of age, Dr. Fasano
recommends that they be screened for CD.
* In the USA, from 1991 to 1995 there have been only eight
scientific papers published on CD. Only two of these were
epidemiological (community/population) studies.
* Approximately 20% of children diagnosed with short stature from
an unknown cause have CD. During prepuberty often the only
symptom of CD is short stature. Growth hormone treatment will
not be effective if the cause of short stature is CD.
Consequently, endocrinologists need to be more aware of CD.
* Untreated CD during pregnancy can result in a neurological defect
in the unborn child, possibly resulting in a shorter [and lower
quality] life span.
-=-=-=-=-=-=-
Testing for CD: Dr. Karoly Horvath of Pediatric Gastroenterology &
Nutrition Laboratory in Baltimore answers questions about CD testing.
Here are some excerpts from this article:
* Celiacs on a gluten-free (GF) diet that ingest 0.3 grams/kg body
weight of gluten as a single dose show immunological changes
(cellular immunity) in the small intestine within five hours.[4]
However, to detect serological changes in the blood takes more
time. If you have not been diagnosed with CD, are on GF diet,
and are going to have serological tests to see whether you have
CD; then Dr. Horvath's lab recommends ingesting 5-20 grams of
gluten per day for at least two months prior to the tests. Note
that a single slice of bread has about 2-3 grams of gluten.
* There are several advantages in using a laboratory experienced
with the celiac serological tests. Technically the tests are
more reliable, and the internal and external controls of the
tests are better established. Also, labs that specialize in CD
serological testing have larger numbers of positive and negative
samples to validate their tests.
* Dr. Horvath's lab recommends that first degree relatives
(parents, siblings, and children) of celiac patients undergo
serological screening tests for CD. Since CD can manifest
(become active) at any period of life, they recommend that these
tests be repeated every 2-3 years for first degree relatives, or
sooner if gastrointestinal symptoms consistent with CD are
observed.
* A biopsy may be inconclusive in a *small percentage of patients*,
due to so-called "patchy lesions" in the duodenum. What this
means is there are both normal-looking spots with finger-like
villi and pathologic spots showing flattened mucosa. When CD is
suspected, the gastroenterologist should obtain several biopsies
from different spots of the whole duodenum. The examination of a
single biopsy specimen may increase the risk of false negative
diagnosis.
* The experience of the pathologist in the interpretation of
specimens is important. In centers specializing in CD the
gastroenterologist routinely reviews the specimen slides with the
pathologist.
* It is still possible for inconclusive results even with multiple
biopsies and interpretation of the specimens by an experience
pathologist and gastroenterologist. It takes time for the
changes to the mucosa to be evident. If a biopsy is done before
the changes are noticeable then the results may not be
conclusive. Such cases are rare, but may require a repeat biopsy
after a period on a higher-gluten diet.
* Serology (blood) tests may be inconclusive if the sample handling
was inappropriate (e.g., shipped for several days at room
temperature). Also, if a CD patient is IgA-deficient then only
the IgG antibody test will be positive. Dr. Horvath's lab
recommends further absorptive tests and/or an intestinal biopsy
for patients that are IgA deficient and have a positive IgG test.
.........................................................
: :
: Excerpts from the Gluten Free Gang Support Group :
: ------------------------------------------------ :
: newsletter: May 1996 Mary Kay Sharrett, co-editor :
: Children's Hospital :
: 700 Children's Drive :
: Columbus, OH 43205 :
:.......................................................:
8th Annual Workshop: The Gluten-Free Gang's 8th annual celiac
workshop will be on Saturday, November 16th. This year's special
guest will be Jax Peters Lowell, the author of _Against the Grain_.
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References
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[1] From the CELIAC Listserv archives, on the Internet, October 29,
1995.
[2] From the CELIAC Listserv archives, on the Internet, May 6, 1996.
[3] From the CELIAC Listserv archives, on the Internet, February 8,
1996.
[4] _Journal of Pediatric Gastroenterology and Nutrition_, 198l;
9:176-180.
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Recipe Page
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Cocoa-Cola Cake
2 cups sugar 1 cup cola (not diet)
2 cups GF flour mix** 1-1/2 cups GF miniature marshmallows
1-1/2 tsp. xanthan gum 1/2 cup buttermilk
1/2 cup vegetable oil 1 tsp. baking soda
1/2 cup butter or margarine 2 eggs, slightly beaten
1/3 cup Hershey's Cocoa 1 tsp. GF vanilla extract
Preheat the oven to 350 degrees F, and grease a 13x9x2" rectangular
pan.
In a large mixing bowl combine the sugar, flour, and xanthan gum. Set
aside.
In a medium saucepan combine the oil butter, cocoa, and cola. Bring
the mixture to a boil over medium heat, stirring constantly.
Add the chocolate mixture to the sugar mixture. Beat until smooth.
Stir in the marshmallows. Add the buttermilk, baking soda, eggs, and
vanilla; blend well.
Pour the batter into the greased pan. Bake 40-45 minutes or until a
toothpick inserted in the center comes out clean. Makes 12-15
servings.
A mixture of 1-1/2 tsp. of vinegar plus a scant 1/2 cup of milk can
be used instead of buttermilk.
This cake is similar to a Texas sheet cake. It comes from Vicki
Lyles, who adapted it from the cookbook _Hershey's Make it Chocolate_.
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Old Fashioned Soy Grits Muffins
3/4 cup Soy Quik, divided 4 eggs, beaten
1-1/2 cup warm water 1/4 cup brown sugar
1 cup soy grits 1/2 cup raisins
2 Tbsp. butter 1/2 cup nuts
Dissolve 1/2 cup Soy Quik in the water. Add the mixture to the soy
grits and let them soak for 20 minutes. Add in the butter.
Add the sugar to the eggs and beat.
Mix the remaining 1/4 cup Soy Quik with the raisins and nuts.
Add the soy grits mixture to the egg mixture. Combine with the raisin
mixture. Pour into a muffin pan that has been sprayed with
butter-flavored GF cooking spray. Bake at 350 degrees F for 30
minutes. Makes 12 muffins or 6 bundt muffins that are great for
travel.
This recipe comes to us from Elizabeth Calcagno.
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Lily's GF Pie Crust
1/3 cup brown or white rice flour 1 tsp. xanthan gum
1/3 cup tapioca flour 1 Tbsp. sugar
1/3 cup potato starch 1/3 cup (5 Tbsp.) butter
1-1/2 Tbsp corn starch 1 egg, beaten
1/3 tsp. salt 1/2 to 1 tsp. apple cider vinegar
Have eggs and butter cold for best results. Combine flours, starches,
salt, xanthan gum, and sugar into a mixing bowl. Cut cold butter into
slices and then work it into the flour mixture with hands or a pastry
cutter until the dough feels slightly moist and begins to hold
together.
Add the beaten egg and vinegar to the flour mixture and stir with a
spoon or fork until it begins to stiffen. The dough will be quite
soft at first but will firm up. Is it firms up, form it into a ball
and work it a little with your hands. Use a little tapioca flour if
necessary to keep your hands from getting sticky.
Roll the dough out between two pieces of wax paper, turning and
peeling off paper as necessary to smooth out wrinkles. Leave the
paper on the pie dough to turn it. When it is ready for a pie pan,
peel the top layer of paper off, hold the lightly greased pan over the
dough, and slip your other hand under the bottom paper and dough.
Lift it into the pan as you flip it all over.
Smooth the dough into the pan before removing the wax paper. Again
peel it off; don't lift it off. Crimp edges as desired. Prick with a
fork if a baked pie shell is desired and bake at 350 degrees F for
12-15 minutes.
Double the ingredients for a two-crust pie. Don't attempt to fold the
top pie crust. A two-crust pie will bake one hour or a bit longer.
This recipe comes from _Lifeline_, Summer 1996, pg. 5. It is Lily
Mae Patten's recipe.
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**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)
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Tri-County Celiac Sprue Support Group Officials:
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Physician Advisor: Thomas Alexander, M.D.
Dietitian Advisor: Dorothy Vaughan, R.D.
President: Diane Morof
Vice President: Mary Guerriero
Past President: Jim Lyles
Secretary: Denise Parsons
Newsletter Editor: Jim Lyles
Disclaimer:
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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 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.
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