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 9 December 1996
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: What's Inside Search For :
: ------------- ---------- :
: Miscellaneous Notes . . . . . . . . . -1- :
: Q & A with Dr. Murray . . . . . . . . -2- :
: Newsletter Roundup . . . . . . . . . . -3- :
: Recipe Page . . . . . . . . . . . . . -4- :
:................................................:
References
Disclaimer
Miscellaneous Notes:
---------1----------
Michigan now has a fourth support group! For many years Sandra
Cartwright has been a CSA Resource Unit in Traverse City, assisting
other celiacs in the area. Those celiacs have banded together to form
a new CSA chapter, covering a widespread area in the northwestern
lower peninsula. We wish them well, and are glad to see a center of
support for some of the northern Michiganians. (I still like
"Michiganders" better.)
-=-=-=-=-
Bite Not the Hand That Feeds: We have spent the last few years
cultivating a good relationship with a local health food store, the
Good Food Company West. We have come a long way--they have donated
baskets for us for some of our meetings, tried to do gluten-free (GF)
breakfasts for us, and carry a huge selection of GF items, including
items from Dietary Specialties. But there is a problem: We have had
a few complaints from them that our members are at times rude to the
store personnel when an item they wish to purchase is not available.
While I realize this can be very inconvenient, there are steps to take
to avoid this. Please call ahead to see if the item(s) you wish to
purchase are available. Try to realize if the store doesn't have the
item, they simply may not carry it, or are out of it. They have a
budget to follow when they order products, so please be aware of this.
We certainly don't want to ruin a good thing. The old saying "You can
catch more flies with honey than with vinegar" certainly holds true
here.--Mary Guerriero
-=-=-=-=-
Walnut Acres is a mail-order organic food grower and distributor.
They have available, on request, a three-page listing of gluten-free
(GF) items they sell. This GF list includes a dozen canned soups and
broths (including Cream of Mushroom and Carolina Clam Chowder), two
dry soup mixes, pancake mix, pasta, relish, and hot dogs. (Organic
hot dogs? That sounds like an oxymoron!) They do not sell any
products that contain MSG or HVP. They use only pure spices, and use
apple cider vinegar in all their processing. For more information,
call 1-800-433-3998, fax 1-717-837-1146, or visit their web page at
http://walnutacres.com.
| Return to the Table of Contents |
Q & A With Dr. Murray
----------2----------
summarized by Jim Lyles
Dr. Joseph Murray, one of the leading USA physicians in the diagnosis
of celiac disease (CD) and dermatitis herpetiformis (DH), spoke at our
October meeting. Dr. Murray originally came from Ireland and got his
medical degree and a doctorate from the National University of Ireland
in Galway. His residency was at the University of Dublin and he
completed his fellowship in gastroenterology at the University of Iowa
College of Medicine, where he has been since 1988. In our last
newsletter we gave some highlights from his talk.[1] In this article
we are including highlights of the question and answer session which
followed his talk.
Dr. Murray started off the questions and answer session with a
warning: All the information from his talk and from the question and
answer session is "general" information. It is NOT specific
information for you to go home and act on. Every celiac is unique,
with unique problems. Anything that requires medical intervention
needs to be discussed with your personal physician. Nutrition
questions should be discussed with your dietitian. It is important
that people do NOT go off and self-medicate, self-treat, or
self-diagnose.
It may seem simpler and cheaper to do without an official diagnosis.
You may think, "Why should I go see my doctor, when I'm feeling good?"
The answer is that it is important for your doctor to see you when
you're feeling good, because a year from now you may not be feeling
good.
Q: What is the latest on the oats question?
A: A lot of time was devoted to the oats question at the Tampere
conference.[2] As you know, there was a Finnish study published
in the New England Journal of Medicine doing a six-month follow-up
on patients with CD that had been eating oats. The study compared
their intestinal biopsies after six months with CD patients on a
regular GF diet. Note that in this case GF has a different
meaning, because they allow wheat starch as part of the GF diet
there, which is generally not recommended in this country. The
same percentage in both groups still had intestinal damage, and
the two groups had similar symptoms. There have also been a
couple of other studies in Sweden and Denmark, confirming these
findings.
However, we need to consider a couple of things. In the study
they used a batch of oats that was specifically grown for the
study. These oats were examined in the field and it was verified
that there were no contaminating grains such as barley or wheat
also growing there. These oats were then specially milled and
specially stored for the study. Finally, these oats were tested
using the most sensitive methods available for any wheat
contamination.
There were several presentations at the conference about testing
commercial sources of oats in different European countries. About
10% of commercial oats and wheat-free oat-containing foods were
found to have significant traces of wheat gluten in them. These
tests have not been done in the USA, so we don't know how pure the
oats would be in our country. Some of the largest cereal plants
in the world are in Cedar Rapids, my home. I know people who work
there and there is a lot of cross-contamination in that large
setting of wet-milling and dry-milling of oats and other grains.
So it is probably not safe for celiacs to consume oats that are
commercially available in the USA.
Oats, rye, and barley, and to some extent, wheat; are all grown in
the same fields, often in rotation one year after another. So
there will always be some "wild" shoots sprouting from the seeds
of the previous year's crop to contaminate the current crop. This
problem does not occur with rice because rice is cultivated in an
entirely different way.
Another point to consider: The studies that were done used 50
grams of oats per day, which is a little under two ounces. That
is not very much, and may not have been at a high enough level to
cause any significant intestinal damage in only six months.
So unless you can get a hold of a batch of oats as pure as that
used in the Finnish study, oats are probably not safe for celiacs.
Q: I have optic neuropathy, which has been attributed to my CD. Do
you see this very often?
A: There are several eye problems that can relate to CD in many ways.
Vitamin A deficiency is the most important factor. Other related
causes include autoimmune neuropathy, in which the body's immune
system attacks other tissues, and the optic nerve is one
possibility.
If Vitamin A is taken in very large quantities then eye problems
can develop as well as intercranial hypertension (high pressure in
the fluid surrounding the brain). This is another reason why you
should not go off and take massive amounts of vitamins without
professional advice.
Q: Is alcohol consumption a factor in causing, worsening, or
contributing to the development of CD?
A: Yes, if it is whiskey or beer, because these come from a gluten
grain. But alcohol itself probably does not bring on the damage
associated with CD, and may even suppress some of the symptoms by
making you feel "good" (i.e., intoxicated). For anybody to drink
more that two alcoholic drinks per day, five days a week, is
probably not a good idea. For women, that is just about the
threshold for causing liver damage, regardless of whether you are
a celiac or not.
Also, celiacs may be more sensitive to the effects of alcohol.
Q: Can you touch on the importance of being biopsied before going on
a GF diet?
A: Things get difficult when you come to a GI specialist after having
already been on a GF diet. At best, you will be facing a gluten
challenge, which may take some time to define it; and you may get
really sick. I'd say about half of the patients who come to me in
that situation cannot tolerate being on a gluten challenge.
If somebody who does not have a family history of CD comes to me
and says, "I think I have CD. Do I really need a biopsy?:" Well,
it may be important for their family. He may think he has CD and
has gotten better due to the GF diet, but he may not actually have
it.
Q: Please discuss intestinal complications associated with CD.
A: Lymphoma is one of the complications. It is a cancer of the
lymphocytes, which are the same cells that attack gluten and your
body, causing the intestinal damage. Those cells are growing and
dividing at an accelerated rate to fight off the gluten, and then
something triggers one to turn into a lymphoma. It is rare in
treated celiacs, but it does happen. It is like smoking and lung
cancer; the longer you've stopped smoking the less chance you have
of getting lung cancer. The longer a celiac has been GF with a
healed small intestine, the lower the chance of getting lymphoma.
After 20 years on a GF diet your chances of getting lymphoma are
very small. If a child is diagnosed with CD and sticks to a
lifelong GF diet, the odds of getting lymphoma are probably the
same as for the non-celiac population.
Q: Is the danger of intestinal cancer as high with DH if you are not
completely compliant to the GF diet?
A: It is probably not quite as high in DH as in CD, but it still
happens and there still is an excess of lymphomas in DH patients,
especially in middle-aged men.
Q: What causes ulcers?
A: Most duodenal ulcers are caused by a bacterium in the stomach. If
you treat that bacterium, the ulcer will disappear and not come
back about 90% of the time, except for patients on arthritis
drugs. But there is a smaller group of people who have duodenal
ulcers caused specifically by CD. These ulcers go away on a GF
diet.
Currently, duodenal ulcers are detected by performing an endoscopy
to see the ulcers and taking a stomach biopsy to find the culprit
bacterium. Once this has been done the ulcers are treated by
using antibiotics to combat the bacterium which is responsible for
the ulcer. I like to go farther and take a biopsy from the
duodenal area [which is the first section of the small
intestine--ed.] Also, because I've found that for some of our
patients the ulcer is not caused by the bacterium, but rather by
untreated CD.
Q: Can you have dermatitis herpetiformis (DH) without having CD?
A: If you have DH, then you have an intestinal sensitivity to gluten.
If you eat gluten, you will have some damage to your intestine.
That damage may become more significant as you get older. I've
seen patients that managed just fine for years using dapsone, who
then come in to see me, complaining of GI symptoms. The treatment
for both CD and DH is a GF diet. If you have DH you may also find
some relief from dapsone, which suppresses the symptoms until the
diet takes effect.
Q: Is there an association between Down's Syndrome and CD?
A: People with Down's Syndrome are much more prone to having CD.
Different studies suggest anywhere from 2-40% of Down's Syndrome
patients have CD. Down's Syndrome patients are prone to other
autoimmune problems such as thyroid disease. It is not known if
CD occurs in African-Americans or Asians with Down's Syndrome;
this just hasn't been studied.
Q: Is TPN (Total Parenteral Nutrition) GF?
A: It is pretty reliably GF. Another thing to consider is that you
can't get a gut reaction from it, because it bypasses the gut
entirely.
Q: Can you touch on bone pain?
A: The most common cause of severe bone pain with untreated CD is
osteomalacia, which is malformation of the bones due to lack of
Vitamin D and calcium. It affects mostly the hips, and sometimes
the shoulders and back. It usually gets better with specific
treatment, which includes the GF diet for celiacs and sometimes
includes Vitamin D supplementation and other interventions.
Another cause of bone pain is osteoporosis. It can often cause
pain in the back, due to vertebrae which have become shortened and
have begun squeezing the nerves. This condition is very painful
and is not going to get better; once the vertebrae have shortened
they are not going to stretch back up to their original size.
Muscle pain can also occur, due to Vitamin D deficiency. I have
seen some leg pains as the initial presentation of CD which
cleared up with the GF diet.
Q: Is there any kidney disease associated with CD?
A: Yes: IgA nephropathy, which is a common condition causing blood
in the urine (possibly in microscopic amounts that would not be
detected visually), may be caused by CD. This may be similar to
what happens in DH, where antibodies produced in the intestine get
deposited under the skin. In IgA nephropathy, you've got IgA that
was produced somewhere (we don't know where) getting deposited in
the kidneys, causing secondary damage to the kidneys.
Q: What is the treatment for arthralgia (joint pain)?
A: Celiacs with arthralgia at the time they are diagnosed often get
better on a GF diet. Sometimes anti-inflammatory drugs are
needed. Occasionally there are other dietary sensitivities which
cause arthralgia.
Q: Is there any research being done on finding something to
counteract gluten?
A: It is being "thought about", but there is no current research.
Researchers are thinking about how you can "turn off" the immune
system's response to gluten. The problem is, it may turn off more
than just the response to gluten, which would be a problem. What
we need is for the immune system to recognize foreign invaders,
but not recognize gluten. I think we are a long ways from coming
up with a safe, acceptable alternative to the GF diet.
Q: I have both lupus and CD. What studies have been done to
determine the frequency of CD in lupus patients?
A: There hasn't been very much research in this area. It is probably
a little bit more common than in the general population. CD is
also more common in scleroderma and Sjogren's patients. That is
because these diseases all come from the same autoimmune
tendencies.
Q: What can you say about the importance of having first-degree
relatives screened for CD?
A: I think it is important. We find a significant number of our
patients by looking at family members of celiacs. It is always
better to avoid illness. If someone has CD it is a whole lot
better to find out about it early, and to be on a GF diet. It is
still somewhat debatable in expert circles as to how you handle
the asymptomatic family member who has intestinal damage. Some
people say it is a greater hardship to impose a GF diet on them
when they are not symptomatic. I tend to think otherwise. I say
it is a whole lot better for them to avoid getting sick by
learning to avoid gluten from an earlier age.
Why isn't CD suspected by gastroenterologists more often? For one
thing, they are being taught in this country that it is very rare.
Many gastroenterologists, from very fine, world-class programs,
have never seen a case of CD. Why? Because many of those
programs are based in inner cities, where CD is not all that
common. Or they come from centers that are specialized.
30 years ago Inflammatory Bowel Disease (IBD), which collectively
refers to Crohn's disease and ulcerative colitis, was considered
to be a mystery. President Eisenhower had Crohn's disease and
people were amazed because it was thought to be so rare. More
recently, we learned that President Bush's son had either Crohn's
disease or ulcerative colitis, and there was not much of a public
reaction. So in 30 years public awareness of IBD has greatly
increased.
The Crohn's/Colitis Foundation (CCFA) is probably the single
best-organized support organization for furthering knowledge about
IBD. It funds research in most medical centers. There are GI
Fellows that are funded by the CCFA, some of whom go on to be
faculty in our medical schools where they teach about IBD. So
most gastroenterologists come out of medical school knowing a lot
about IBD. And a lot of it is due to the efforts of the CCFA.
Ulcer research has been funded mostly by drug companies, who are
trying to find better ways to treat ulcers. As a result, ulcers
are also in the public eye.
CD has been more "covert". However, that is changing. In Iowa,
many private practitioners that were not diagnosing any CD five
years ago are now diagnosing 10-12 new cases a year, simply
because they've become more aware of it. The efforts are
beginning to pay off: internet efforts, the various support
organizations getting hooked up with people like Dr. Alexander
[our group's physician advisor], spreading and exchanging
information.
But the pity is that all these efforts are not on the level of an
organization such as the CCFA. That sort of effort is what really
gets attention and gets built into the curriculum at medical
schools.
Q: Are Vitamin B-12 shots often given to celiacs?
A: Vitamin B-12 deficiency is usually caused by a malabsorption
problem. B-12 is important for nerve function and for making
blood cells. A B-12 deficiency can cause temporary problems with
making blood cells, but with nerve function the damage may be
permanent or only improve months or years later. So if a patient
is B-12 deficient then regular shots are generally used to ensure
that the levels of B-12 are adequate. The shots bypass the
intestine, so any malabsorption problem is avoided. The shots are
safe and cheap, whereas the tests for B-12 absorption are not; so
I will often put someone at risk for B-12 deficiency on B-12 shots
for the rest of their life. The problem with B-12 deficiency is
that the first symptom to show up may very well be a serious
neurological symptom that the patient may not recover from.
Q: Can a person who tests allergic to gluten also have CD?
A: When you speak of an allergy, you aren't talking about gluten.
Some people have a wheat allergy, with symptoms such as hives,
swelling, etc.. That doesn't mean they have CD; but like a celiac
they certainly should not eat wheat. Some celiacs develop other
allergies, probably because their gut is more permeable due to the
villi damage. They can get allergies to other things (not just
wheat) such as peanuts or shellfish.
Q: How important are periodic bone density tests?
A: I would tend to do a bone density test on most adult patients at
least once at the time of diagnosis. If the test comes back
normal, then I don't usually repeat it. If it is very low, then I
tend to repeat it 18-24 months later to see how much improvement
has occurred.
| Return to the Table of Contents |
Newsletter Roundup
---------3--------
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 _Gluten-free Friends_ :
: ----------------------------------- :
: Winter 1996 (Vol. 2, No. 4) R. Jean Powell, editor :
: Montana Celiac Society :
: 1019 So. Bozeman Ave. #3 :
: Bozeman, MT 59715 :
:........................................................:
A Little Won't Hurt...Will It? The body's primary defender in the
immune lymphatic system is the T-cell, which recognizes antigens
(foreign proteins) in the body and produces antibodies to neutralize
them. It has been suggested that a celiac's immune system may mistake
the gliadin protein from wheat [and similar proteins in rye, barley,
and possibly oats--ed.] for an invader such as a bacterium or virus.
According to Jerry Crabtree of Stanford University, when T-cells are
activated by an antigen, for the next two weeks they will proceed step
by step through a very precise pre-programmed sequence of events.
Some 200-500 genes will activate, one after another, ticking off like
soldiers standing up to be counted, and will do so the exact same way
each time, with each gene producing its own particular protein. To
make all of these proteins, the immune system needs about two weeks.
Once a cell has passed a critical point in the activation process
(which happens within an hour) it is committed to it. If you take
away the stimulus (the antigen) at that point, the cell would still
tick along through its two-week sequence.[3]
For celiacs, occasional accidental ingestion of a minuscule amount of
gliadin could presumably still lead to a two-week activation of
T-cells. If gliadin is consistently ingested, the immune system
theoretically might continue indefinitely on it endless rampage. Is
it any wonder that celiacs sometimes feel weary?
..........................................................
: :
: Excerpts from the Houston Celiac-Sprue Support Group :
: ---------------------------------------------------- :
: newsletter: Nov. 1996 Janet Y. Rinehart, President :
: 11011 Chevy Chase :
: Houston, TX 77042-2606 :
:........................................................:
Osteoporosis: Dr. Susan Mueller spoke to the Houston Celiac-Sprue
Support Group in September. She was the Assistant Chief of Medicine
at the University of Texas Medical School, and is now at the
Kelsey-Sebold Medical Center Clinic. Here are some excerpts from her
talk: [I've pared this down considerably. We had a detailed talk
about bone disease earlier this year which was written up in the
May/June 1996 issue of _The Sprue-nik Press_.--ed.]
A combination of genetic, dietary, hormonal, age-related, and
lifestyle factors all contribute to osteoporosis. It is a disease
that gradually weakens bones, and is not restricted to just the
elderly. The upper part of the spine (in the rib cage area) is the
most likely place for fractures, followed by the hips and wrists.
A typical portrait of a person at risk for developing osteoporosis
would include some of these factors:
small size or thin form
fair skin, Caucasian or Asian ancestry
family history of osteoporosis
postmenopausal women
surgical menopause
taking thyroid medication or cortisone-like drugs
diet low in dairy products and other sources of calcium
physically inactive lifestyle
Osteoporosis causes problems with other organs. It may compress lung
space (and fluid might develop around lungs). There may be loss of
height. Some clinical features of advanced postmenopausal
osteoporosis include back pain, multiple fractures in the wrists and
hips, kyphosis (dowager's hump), and abnormal jaw bone loss.
Certain lifestyle factors promote bone loss, including smoking,
drinking alcoholic beverages in excess (more than one or two a day),
and lack of exercise. Also, a balanced diet with enough Vitamin D and
calcium is important.
Some medications can contribute to bone loss:
certain antacids containing aluminum
anticonvulsants
some chemotherapy drugs
corticosteroids
coumadin
heparin
tetracycline
Routine X-rays can't detect osteoporosis until it is quite advanced.
The DXA (dual-energy X-ray absorptionometry) machine is FDA-approved
for measuring bone density in the lumbar spine region and hips, and
uses less radiation than a CAT scan.
Another new test, marketed as "Osteomark", provides an indication of
bone breakdown by detecting a specific component of bone breakdown in
a urine sample. With this test clinical labs can get results in about
two hours. This test can help physicians monitor treatment and
identify fast losers of bone for more aggressive treatment, but it can
not be used to actually diagnose osteoporosis.[4]
Your skeletal calcium "bank" has to last through old age. Frequent
"deposits" to this account should begin in youth and be maintained
throughout life to help minimize "withdrawals". Most adults get less
calcium than they need--as little as half. Calcium is critical, but
even a high intake won't fully protect you against bone loss caused by
estrogen deficiency, physical inactivity, alcohol abuse, smoking, or
medical disorders and treatments.
.................................................................
: :
: Excerpts from the San Antonio CS Support Group :
: ---------------------------------------------- :
: newsletter: Oct. 1996 Lynn Rainwater, Secretary/Treasurer :
: 1023 Cloverbrook :
: San Antonio, TX 78245-1604 :
:...............................................................:
Relations With Food Manufacturers: During the CSA Annual Conference
session on GF commercial foods, CSA Executive Director Leon Rottmann
stated that approximately 40% of all contacts by celiacs with food
manufacturers are harmful to our relations with them. Why? Because
of the intemperate language used. Several companies have become so
tired of the frequent angry tirades that they will no longer cooperate
with our attempt to determine the gluten status of their products.
Dr. Rottmann asks that we be courteous when we call or write for
information. The customer relations personnel who respond to our
calls or letters will appreciate our attitude, and we will have a
greater chance of obtaining the information we seek.
TX 78245-1604.
Return to the Table of Contents
References
----------
[1] See "The Widening Spectrum of Celiac Disease", _The Sprue-nik
Press_, Nov. 1996.
[2] Dr. Murray is referring to the 7th International Symposium on
Coeliac Disease held September 5-7 in Tampere Finland. See _The
Sprue-nik Press_, Sept. 1996, for a summary of this symposium.
[3] "Conversations in a Cell", Gary Taubes, _Discover_, Feb. 1996,
Vol. 17, No. 2.
[4] "Boning Up On Osteoporosis", _FDA Consumer_, Sept. 1996.
| Return to the Table of Contents |
Recipe Page
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Sea Shell Madeleines
2 eggs, separated 1 Tbsp. lemon rind
1/2 cup sugar 1/4 lb. (one stick) butter, melted
3/4 cup GF flour mix** 2 Tbsp. lemon juice
3/4 tsp. GF baking powder
Beat the egg yolks and sugar together until light. Fold in the flour,
baking powder, and lemon rind, then fold in the cooled butter and
lemon juice.
Beat the egg whites to soft peaks, and fold them into the yolk
mixture.
Coat the madeleine pan with GF cooking spray and fill each shell about
2/3 full. (Instead of a madeleine pan you may use a muffin pan, mini
muffin pan, muffin top pan, etc. filled about halfway. The batter
simply needs something to hold its shape.) Bake at 425 degrees F for
10-15 minutes until risen and firm.
This recipe comes to us from Joan Kulka. Note: For the rice flour in
the GF flour mix, Joan uses equal portions of sweet rice flour (like
Mochiko) and oriental rice flour.
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Chocolate Madeleines
2 eggs, separated 1 tsp. GF baking powder
1/2 cup sugar 1/4 lb. (one stick) butter, melted
1/2 cup cocoa 1 tsp. GF vanilla
1/2 cup GF flour mix**
Beat the egg yolks, sugar, and cocoa together until light. Fold in
the flour and baking powder, then add the butter and vanilla.
Beat the egg whites to soft peaks, and fold them into the yolk
mixture.
Coat the madeleine pan with GF cooking spray and fill each shell about
2/3 full. (Instead of a madeleine pan you may use a muffin pan, mini
muffin pan, muffin top pan, etc. filled about halfway. The batter
simply needs something to hold its shape.) Bake at 425 degrees F for
10-15 minutes until risen and firm.
This recipe comes to us from Joan Kulka. (See the note in the
previous recipe.)
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Peanut Butter Kiss Blossoms
1-3/4 cups GF flour mix** 1/2 cup sugar
1 tsp. GF baking soda 1/2 cup brown sugar, packed
1/2 tsp. salt 1 egg
1/2 tsp. xanthan gum 1 tsp. GF vanilla
1/2 cup butter 1 bag Hershey's chocolate candy
1/2 cup peanut butter kisses
Blend together the flour, baking soda, salt, and xanthan gum, and set
aside.
Cream together the butter and peanut butter. Gradually add the sugar
and brown sugar, creaming well. Add the egg and GF vanilla. Beat
well. Blend in the dry ingredients and mix thoroughly. Shape the
dough into balls, using a rounded teaspoon for each ball. Roll the
balls in sugar and place them on an ungreased cookie sheet. Bake at
375 degrees F for 8 minutes.
Remove the sheet from the oven and place a candy kiss on top of each
cookie, pressing down firmly so that the cookie cracks around the
edge. Return the cookies to the oven and bake 3-5 minutes longer,
until they are golden brown. Makes 3-4 dozen cookies.
This recipe came from Judy Haffner.
**********************************************************************
Potato Starch Sponge Cake
8 eggs, separated 1-1/2 tsp. grated lemon rind
3 Tbsp. lemon juice 1 cup potato starch, sifted
1-1/2 cups sifted sugar dash of salt
Beat egg yolks 2 minutes at high speed. Add the lemon juice, sugar,
and lemon rind, and mix for 2 minutes at medium speed. Gradually add
the potato starch and salt, and mix for two more minutes.
Beat the egg whites until they are stiff. Fold them into the egg yolk
mixture. Place in an ungreased 10" tube pan and bake at 350 degrees F
for 55-60 minutes. Invert the pan and cool thoroughly before removing
the cake from the pan.
This recipe came from a recent group meeting, author unknown.
**********************************************************************
** GF flour mix:
6 cups white rice flour
2 cups potato starch (NOT the same as potato flour)
1 cup 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: Jim Lyles
Secretary: Denise Parsons
Newsletter Editor: Jim Lyles
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 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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