THE SPRUE-NIK PRESS

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

Volume 6, Number 5                                      June/July 1997
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          : What's Inside                       Search For :
          : -------------                       ---------- :
          : Miscellaneous Notes  . . . . . . . . .  -1-    :
          : Refractory Celiac Disease  . . . . . .  -2-    :
          : Newsletter Roundup . . . . . . . . . .  -3-    :
          :................................................:

References Disclaimer
Miscellaneous Notes: ---------1---------- Look Beyond Celiac Disease: Sometimes we become so focused on celiac disease, that we assume all problems are related to it. But that is often not the case. We are saddened to report that Judy Fearncombe, a former member of our group who moved to Georgia, died a few months ago of colon cancer. I'd like to share the following information, condensed from a note from Doris Fearncombe, Judy's mother: If there is one lesson to be learned by Judy's illness and death, it is to not overlook other causes for problems just because you have celiac disease. They say Judy must have had cancer in the colon for over a year before she had surgery--and all the time the thoughts were on celiac disease. Her colon was completely filled in one area, and six of fourteen lymph nodes were malignant when they did the surgery last August. Eventually it spread to the liver and all of the abdomen. The problem is they didn't do a colonoscopy early on because everything was focused on celiac disease. So the message is: Keep an open mind, don't assume that every problem is due to celiac disease. -=-=-=-=-=-=- Don't Miss This Magazine: The July 1997 issue of _Taste of Home_ magazine has a lot of recipes that are gluten-free (GF), or can be very easily adapted to be GF. There are many summer salads and desserts. It comes out every two months, so this issue should be available for a while. Check at your local grocery store, or if you miss it you can always try looking for it at the library.--Vicki Lyles Here is a list of the recipes which are either GF or easily adapted to be GF: Strawberry Lemonade Summertime Main-Dish Salad Yogurt Fruit Dip Meat Loaf Hamburgers (with a GF Lemon Pudding Cake (for two!) bun, of course) Superstar Spinach Salad Chicken Salad on Cantaloupe Rings Fruity Summer Cooler Roast Beef and Potato Salad Banana Custard Pudding Chocolate Chip Pie Brown Cow Punch Grilled Turkey Tenderloin Potato Pockets That Good Salad (without the Cucumbers with Dressing croutons) Cheesy Potato Bake Homemade Ice Cream Cattleman's Spread Anytime Cucumber Slices Dilled Pork Roast Zucchini with Dill Onions au Gratin Fried Onions and Apples Roasted Tomato Soup Red Potato Bundles Catfish Jambalaya Italian-Style Walleye Wild Berry Freezer Jam Mozzarella Dip Kookie Cookies Blueberry Sauce Supreme Stars and Stripes Parfait -=-=-=-=-=-=- What's in a Name? Life is full of little ironies. Did you know that Phyllis Brogden, chairperson of the Greater Philadelphia Celiac-Sprue Support Group, lives in Flourtown? Do you think celiacs would be welcome in Wheaton, Illinois (pop. 57,000)? -=-=-=-=-=-=- New Cookbooks: The Houston Celiac-Sprue Support Group announces a new cookbook by Carol Fenster, Ph.D., entitled _Special Diet Solutions: Healthy Cooking Without Wheat, Gluten, Dairy, Eggs, Yeast, or Refined Sugar_. It is available from Savory Palate, Inc., (800) 741-5418. Single copies are $19.95 plus $3 shipping. Discounted group orders are available. This new cookbook (190 pages) is extremely suitable for all celiacs and celiac diabetics. We recommend you first read thoroughly the Glossary of Ingredients and the appendices, which address baking with alternative sweeteners, dairy substitutes, egg substitutes, and wheat-free flours; hidden sources of dairy products, corn, soy, and yeast; and food exchanges.--Janet Rinehart and Karen Tipton in Houston[1] _Great Gluten Free Goodies_ was written by Rebecca Riley, a professional chef with a recently diagnosed celiac son. The index gives some insight into the recipe selection of items that are initially removed from our diet, as it includes items such as quickbreads, coffee cakes, muffins, pies, quiches, tarts, cookies, cakes, and desserts. Write to Promo Works, Recipes from Rebecca's Kitchen, PO Box 372, Yarmouth, ME 04096. The cost is $5.95 plus $1.00 for postage.--Michael Jones[2] -=-=-=-=-=-=- Boar's Head Products: So you can't find Boar's Head Products? (They have several gluten-free items.) Then call Bruce, their distributor, at (248) 414-9998. He will tell you what stores in your area carry their products.--Ruth Clarey -=-=-=-=-=-=- The University of Utah is recruiting participants for a study to detect genes that may predispose individuals to celiac disease. They request that sibling pairs (brothers/sisters) and extended family members--cousins, aunts, etc. (even distant cousins) volunteer for the study. The previous requirement to be biopsy-proven has been relaxed. They now desire samples from any pairs that are confident that they are gluten intolerant. They will pay to have the blood drawn. Note that their address has changed slightly. If you are willing to contribute a blood sample and answer a short questionnaire, please contact Jeff Black, University of Utah, Genetic Epidemiology, 391 Chipeta, Suite D, Salt Lake City, UT 84108; phone: (800) 444-8638, Extension 15075; fax: (801) 581-6052.[3] -=-=-=-=-=-=- Shopping Guide Reminders: The next edition of our shopping guide will come out this fall. As in the past, it will be automatically sent to all current members of TCCSSG. Non-members who want to buy an updated copy should send in their request in October. The anticipated cost is $10, postage included. Checks should be made payable to TCCSSG and mailed to TCCSSG Shopping Guide, 34638 Beechwood, Farmington Hills, MI 48335. The next edition of the CSA shopping guide is due out in July. The cost is $8, postage included. Make your check payable to CSA/USA, and request the Cooperative Gluten-Free Commercial Products Listing #3. Mail your request to CSA/USA, Inc., PO Box 31700, Omaha, NE 68131-0700.
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Refractory Celiac Disease[4] -------------2-------------- by Dr. Joseph Murray A recent poster asked about refractory celiac disease. This is a highly complex area and is the most challenging in dealing with celiac disease. While refractory celiac disease can be defined as a patient with celiac disease whose symptoms do not respond to a gluten-free diet, there are several important questions and issues in coming to the determination that the patient is really suffering from truly refractory disease. To make the diagnosis conclusive first one must be satisfied that there is not another cause of the problem. Though rare there are other conditions that can mimic or coexist with celiac disease and cause continued problems. The second issue is whether the patient is truly gluten free and have they been so for long enough to conclude that there has been a failure? To make this determination I have the patient keep a complete and detailed dietary record for 3-4 weeks listing every single item they ate and have them save the wrapper or carton for review. If the dietitian or I feel that there is any possibility of contamination then we exclude that item and wait longer. Sometimes the patient is exposed to a higher risk of gluten contamination by eating out a lot where they do not have true control over the food preparation. We check medications that the patient takes regularly. I also check the endomysial antibodies and gliadin antibodies. These should be negative if the patient has been gluten free for at least six months. The gliadin IgG may persist longer but usually its levels drop. If these are positive then that makes me think that they have had significant gluten in the diet in the recent past. (Note : there still may be gluten in the diet if the test is negative) The original and follow up biopsies should be compared to see if there has been any improvement. Assuming that these criteria are met then one can proceed to consider the patient to have refractory disease. At that point it is important to check for complications such as lymphoma, lymphocyctic colitis and possibly pancreatic insufficiency. I treat the patient with a course of antibiotics and consider adding in pancreatic supplements to see if that will help the patient's symptoms. It is only at this point that I consider some suppression of the immune system such as with steroids or some other agent. Rarely, the patient may be so ill that one must accelerate the decision to treat with steroids. Steroids are powerful medicines that can be very helpful and even lifesaving in many diseases but also have risks that should be discussed prior to use. This is not medical advice and should not be used as such.--Joe Murray
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Newsletter Roundup ---------3-------- Compiled by Jim Lyles This section contains excerpts from newsletters produced by other celiac groups. ........................................................... : : : Excerpts from _The Celiac ActionLine_ : : ------------------------------------- : : Spring 1997 (Vol. VII, No. 1) Mike Jones, Publisher : : Celiacs of Orlando & GIG of Florida : : 12733 Newfield Drive : : Orlando, FL 32837 : :.........................................................: Incorrect Use of the Term "Gluten": A new cookbook, _My Kid's Allergic to Everything Dessert_, incorrectly lists these items as containing gluten: buckwheat, chickpea flour, garbanzo flour, potato starch, and potato flour. [There is disagreement between the various celiac groups as to whether or not buckwheat contains gluten--ed.] Pat Cassady Redjou, author of _The No-Gluten Solution_ and _The No-Gluten Solution's Children's Cookbook_, died in mid-September. Send memorial donations to the University of Iowa Foundation, Celiac Disease Research Foundation, c/o Dr. Joseph Murray, PO Box 4550, Iowa City, IA 52242. Free Information from registered Dietitians is available by calling 1-800-366-1655. They may not be experts on the gluten-free diet, but this is an excellent resource for general nutrition. Bacterial Overgrowth: Dr. Betty Wedman is a celiac and nutritionist in St. Petersburg. She recently made a reference to the fact that six of her seven celiacs had bacterial overgrowth in the small intestines. Therefore, it would be prudent for celiacs to consider this possibility if they have symptoms such as abdominal cramps, bloating, gas, diarrhea, weight loss, and Vitamin B12 malabsorption. [This assumes that these celiacs are on a strict GF diet; otherwise these symptoms could be due to villi damage--ed.] Dietary Specialties is offering a wonderful cracker from Bi-Aglut. Also, they have a free recipe booklet of ways to prepare Bi-Aglut pasta. They are also shipping their unique gluten-free living newsletter "Recipe for Better Health" with each order. Dietary Specialties, PO Box 227, Rochester, NY 14601, 1-800-544-0099, http://colorwheel.com/ds/index.html. The GF Cookie Jar produces a wonderful line of 50 fresh baked products. Ten of these items are also available dairy and egg free. A good way to sample their products is to order the Cookie Jar Sampler: bread, rolls, bagels, donuts, pretzels, brownies, and cookies. The GF Cookie Jar, PO Box 52, Trevose, PA 19053, 1-215-355-9403. Ener-G Foods has made several additions to their product line: Crackers, Chocolate Cake, Rainbow Pasta, and Authentic Foods Bean Flour Mix (from Bette Hagman's new cookbook). Ener-G Foods, PO Box 84487, Seattle, WA 98124-5787, 1-800-331-5222, http://www.ener-g.com. Miss Roben's is now charging $4.95 for shipping on any order in the continental USA. Some of the new products include: European Dark Bread, White Cake Mix, and a Pie Crust Mix. Miss Roben's, PO Box 1434, Frederick, MD 21702, 1-800-891-003, http://www.jagunet.com/~msrobens. Gluten-Free Delights is a new line of GF products produced by a sensitive celiac in Iowa. The product line includes: Snickerdoodle, Chocolate Chip, Peanut Butter, Lemon Love Notes, Caramel Corn, Popcorn Candy Balls, plain and Cinnamon donut holes. Gluten-Free Delights, 700 W. Ridgeway, Lot #604, Cedar Falls, IA 50613, 1-319-277-0963, ZEJG11A@prodigy.com. Natural Feast built a following through their line of fresh pies. Several new additions may be of interest to vegetarians or those with a dairy problem: Bread Mix, English Muffins, Walnut Torte to name a few. There is also a Sponge Cake, Butterscotch Brownies, Chocolate Mousse, Chocolate Brownies, Raisin Bread, Energy Bar, and a Protein bar. They no longer ship by mail, but the products can be found in many local health food stores. Natural Feast Corp., PO Box 5018, New Bedford, MA 02745, 1-508-984-4230. The Gluten-Free Pantry has added several new items to their product line: Hot dog roll form, Coconut Macaroon Mix, White Rice Flour, Brown Rice Flour, Potato Starch, Jowar Flour, Tapioca Flour, Tart Dried Cherries, Wild Rice Flour, Chickpea Flour, and Powdered Cheddar Cheese. The instant soups are tasty and easy to prepare at work. The Gluten-Free Pantry, PO Box 840, Glastonbury, CT 06033, orders 1-800-291-8386, http://www.pantry.glutenfree.com. Stevia is a leaf from the rain forests of Paraguay and Brazil. It is gaining popularity in the USA as a sweetener, since it is several hundred times sweeter than sugar. Some reports state that it is not disruptive to blood sugar levels. Diabetic celiacs may desire to talk with their physician about the use of Stevia. It comes in various forms. One source is Stevia Co., 7650 US Hwy. 287 #100, Arlington, TX 76017, 1-888-783-8422, www.fastlane/~petro/stevia.html. A New Fat Substitute made from prunes and apple is available from SunSweet. It is designed as a fat replacer in soft baked goods (cakes and brownies). Recipes and information are available by calling SunSweet at 1-800-418-2253. La Choy Soy Sauce: If the label on La Choy Regular and Light reads hydrolyzed soy protein, the company states that it is GF. For additional information: Hunt-Wesson, PO Box 4800, Fullerton, CA 92634, 1-714-680-1000. French Toast Cereal from General Mills appears to be GF when reading the ingredients. When the company is called at 1-800-328-1144, the old answer is received that none of their products are GF. The company is not willing to make a commitment due to the volume of wheat products in the plant. Tips for Baking with Jowar Flour: * Add 1/2 to 1 Tbsp. of corn starch for every cup of Jowar flour. * 1/2 tsp. xanthan or guar gum is required for cookies for each cup of Jowar flour. Double this for breads. * A little oil may be added for recipes that are dry. * An extra egg or egg white will improve the smoothness and crumb structure. Bread Machine Recipes for Regal and Toastmaster are now available in two pamphlets produced in cooperation with Red Star Yeast: * "GF Recipes for Your Toastmaster Bread Machine", Toastmaster, 1801 N. Stadium Blvd., Columbia, MO 65205 * "GF Recipes for your Regal Breadmaker", Regal Ware, 1675 Regal Dr., Kewaskum, WI 53404, 1-800-998-8809. (Available in English or French.) ............................................ : : : Excerpts from _Celiac Connections_ : : ---------------------------------- : : April 1997 Katie Marschilok, editor : : 4 Fairlawn Lane : : Troy, NY 12180 : :..........................................: Senior Citizens recently diagnosed with Celiac Disease (CD) should... * ...have a bone density test done as soon as possible. * ...encourage your children, grandchildren, and siblings to be tested for CD. * ...take vitamin and mineral supplements if your doctor makes that recommendation, but first check to make sure they are gluten- free (GF). * ...make sure any medicines you take are also GF. * ...make sure every doctor you see is aware of your diagnosis and the need for all medication to be GF. * ...check out the availability of a safe GF diet prior to starting any hospital stay, and if you have any doubt then have a family member bring you food. ........................................................... : : : Excerpts from _Gluten-Free News_ : : -------------------------------- : : March 1997 Michigan Capitol Celiac/DH Support Group : : April 1997 PO Box 1482 : : East Lansing, MI 48826 : :.........................................................: Thyroid Disease: Celiacs who also suffer from thyroid problems may wish to contact the Thyroid Foundation of America, Ruth Sleeper Hall, 350 Parkman St., Boston, MA 02114-2698, 1-617-726-8500. Pasta Machine: Creative Technologies Corp. makes the Takka X1000 Pasta & Dough Machine. They will sell it to individuals for $79 plus $14 shipping charges. Takka Products Div., 170 53rd St., Brooklyn, NY 11232, 1-800-282-5240. .......................................................... : : : Excerpts from the Gluten Free Gang Support Group : : ------------------------------------------------ : : newsletter: Apr. 1997 Mary Kay Sharrett, co-editor : : Children's Hospital : : 700 Children's Drive : : Columbus, OH 43205 : :........................................................: The 9th Annual Celiac Program for children and adults will be on Saturday, December 6th, in Columbus Ohio. The guest speaker will be Dr. Joseph Murray of the University of Iowa. ................................................................. : : : Excerpts from _Derby City Celiac_ : : --------------------------------- : : Spring 1997 Marge Johannemann, President : : Summer 1997 Greater Louisville Celiac Sprue Support Group : : PO Box 7194 : : Louisville, KY 40257-0194 : :...............................................................: From the Children's Hospital Conference held in Columbus, Ohio last fall, come these highlights of a talk by Steve Plogsted, PharmD. Steve said that there are now over 300,000 drugs. 15 years ago many drugs had gluten in them, but over the last 10-15 years most drugs have become gluten-free (GF). It costs about 2-3 million dollars to develop a single new drug and takes 5-7 years to get it on the market. Steve offered to answer questions about medications; he can be called at (614) 722-2195. -=-=- -=-=- GF Fat Replacer: Sunsweet has a new product called Lighter Bake, which can be used to replace butter, margarine, oil, and/or shortening in your favorite recipes and packaged mixes. A phone call to the manufacturer revealed that this product is GF. Simply eliminate the fat from the recipe and replace it with Lighter Bake at half the amount called for. [For example, replace 4 oz. of butter with 2 oz. of Lighter Bake.] This product gives a moistness to cakes and chewiness to cookies that can not be achieved with traditional ingredients. It can be found in most grocery stores in the same section as shortening or in the health foods/produce section. -=-=- -=-=- Fast Fuel Gels for Runners: If you're a gluten-free (GF) runner, triathlete, or bicyclist, there are two brands of GF fast fuel gels: * Power Fast Fuel Gel, from the makers of PowerBar (1-800-500-5634), comes in vanilla, lemon lime, and strawberry banana flavors. * GU Fast Food for Athletes comes in several flavors including orange burst. For more information call Sports Street Marketing (1-800-400-1995). These gel packs contain complex carbohydrates that metabolize quickly and are easy to digest. They should always be taken with plenty of water. -=-=- -=-=- Simply Potatoes can be found in your grocer's refrigerator case. These shredded hash browns are delicious and quick to prepare. They can also be used to make potato pancakes. According to the Northern Star (1-800-259-7335), this item (plain hash browns only) is GF. Hidden Wheat Alert! According to Kroger (1-800-632-6900), Kroger brand dark brown sugar contains wheat, and should not be used by celiacs. However, Kroger brand light brown sugar does not contain wheat and is safe for celiacs. [For Domino's light brown and dark brown sugar, it states right on the package that it is Kosher for Passover, and since it does not contain matzoh, that means it is also gluten-free.--ed.] Centrum and Centrum Silver are NOT GF according to Lederle Pharmaceutical (1-800-762-4672). Both have traces of gluten due to cross-contamination during processing. Tums 500 is GF according to Smith/Klein Beecham (1-800-456-6670). Premarin is GF according to URL Pharmaceutical (1-800-666-7248). ............................................................. : : : Excerpts from the _CSA/GC Newsletter_ : : ------------------------------------- : : June 1997 Lois Walter, editor : : Celiac Sprue Association of Greater Chicago : : 124 Newton Ave. : : Glen Ellyn, IL 60137 : :...........................................................: Amy's Kitchen has six gluten-free (GF) products: Whole Meal Enchilada Dinner, Shepherd's Pie, Black Bean & Vegetable Enchilada, Cheese Enchilada, Veggie Loaf Dinner, and Mexican Tamale Pie. Amy's Kitchen, Inc., PO Box 7868, Santa Rosa, CA 95407, 1-707-578-7188, Fax 1-707-578-7996. Taj Gourmet Foods makes cooking sauces and frozen dinners, all of which are GF according to the company. In a letter they state that their products are "...all natural, free of any chemicals or artificial colors, flavors, and additives of any kind. Taj products are sold through more than 400 natural food stores and supermarkets throughout the [USA]." Taj Gourmet Foods, 190 Fountain St., Framingham, MA 01702, 1-508-875-6212, Fax 1-508-875-6457. ..................................................... : : : Excerpts from the Westchester CS Support Group : : ---------------------------------------------- : : newsletter: June 1997 Sue Goldstein : : 9 Salem Place : : White Plains, NY 10605 : :...................................................: Dr. Peter Green, Westchester's medical advisor, is co-author of some abstracts on celiac disease (CD) that were presented at Digestive Diseases Week in May. Some excerpts: * "Celiac Disease: A Physician Survey"[5]: New York City gastroenterologists were surveyed. They averaged only six celiacs each, but diagnosis in recent years appears to be increasing. Most do not perform bone mineral densitometry or give Pneumovax [Merck Labs' pneumonia vaccine[6]], suggesting a lack of awareness of the high rate of osteoporosis or hyposplenism among celiacs. Also, only about half refer their patients to celiac support groups. * "The Endoscopic and Biopsy Appearance of Treated Adult Celiac Disease"[7]: In the study, adult celiacs rarely had normal appearing duodenal mucosa, with reduced folds and subtotal villous atrophy. This may be the norm for adults. Refractory patients have more marked changes including scalloping. Mucosal fissures are seen both before and after commencement of the diet. ........................................................ : : : Excerpts from the Healthy Villi Celiac Support Group : : ---------------------------------------------------- : : newsletter: Spring 1997 Melinda Dennis, editor : : 95 Orchard St., #2 : : Somerville, MA 02144 : :......................................................: Product Information: * Bristol Myers, (800) 468-7746. According to Pam Polis, these products are gluten-free (GF): Comtrex (caplets, tablets, liquid), Nuprin tablets, Bufferin Extra Strength, Excedrin Extra Strength (tablets and caplets), No Doze, and Theragram vitamins. Pam said the starch in these products is from corn; the gelatin is from animal sources; and that there are no incidental ingredients in these products. * Pillsbury, (800) 767-4466. Their GF product list is outdated and they do NOT plan on updating it. They will check the status of specific products but will not send anything in writing. Current GF products: Green Giant vegetables (plain without seasonings) and Pillsbury Frosting (French Vanilla and all chocolate flavors; but NOT the plain Vanilla flavor). ...................................................... : : : Excerpts from the Midwest Gluten Intolerance Group : : -------------------------------------------------- : : newsletter: May 1997 Lillian Stich, editor : : 62 12th Ave. NE : : St. Cloud, MN 56304 : :....................................................: Tips for Successful Baking: * Add an extra egg to recipes for lightness and moistness. Beating egg yolks and whites separately before adding to the batter also lightens the product. * Use white rice flour for lighter texture and brown rice flour for added nutrition. * Some cooks combine the liquids in a recipe with the rice flour, bring the mixture to a boil, and then let it cool before adding it to the other recipe ingredients. This can reduce rice flour's grainy texture. * Buttermilk used in place of regular milk will lighten baked goods and reduce crumbly texture. * Baked goods made with gluten-free flours dry out fast. Frosting them and keeping them in airtight containers will help preserve moistness. * A mashed banana or 1/4 cup of applesauce in muffins or quick breads will help preserve moisture. ........................................................... : : : Excerpts from the Greater Philadelphia CS Support Group : : ------------------------------------------------------- : : newsletter: June 1997 Phyllis J. Brogden : : 6318 Farmar Lane : : Flourtown, PA 19031 : :.........................................................: Pretzels: A new (and apparently very tasty) gluten-free (GF) pretzel is available. They are called "Glutano". The cost is about $3 per bag. These can be ordered from a Canadian company called De-Ro-Ma. De-Ro-Ma carries nearly 400 GF products so be sure to request their product list. The only drawback is that there can be some hefty shipping charges for orders from the USA. For more information write to De-Ro-Ma, 910 Jarry Blvd., Laval, QC H7W 2W6, CANADA; call (800) 363-3438; or visit their web page.
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References ---------- [1] From the CELIAC Listserv archives, on the Internet, Janet Rinehart, posted June 25, 1997. [2] From the CELIAC Listserv archives, on the Internet, Michael Jones, posted May 26, 1997. [3] Michael Jones, CELIAC Listserv archives (on the internet), Oct. 16, 1996. [4] From the CELIAC Listserv archives, on the Internet, Dr. Joseph Murray, posted June 2, 1997. [5] J Poneros, S Stavropoulos, L Das, F Byfield, D McMahon, P Green, Dept. of Medicine, Columbia University College of Physicians and Surgeons, New York, NY. [6] Canada NewsWire, "Merck Frosst Partners in Ontario Health Prevention Program", from the internet: http://www.newswire.ca/releases/July1996/16/c1939.html, obtained June 26, 1997. [7] P Green, H Rotterdam, J Poneros, F Byfield, Depts. of Medicine and Pathology, Columbia University College of Physicians and Surgeons, New York, NY.
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Tri-County Celiac Sprue Support Group Officials: ------------------------------------------------ Physician Advisor: Thomas Alexander, M.D. Pediatric Advisor: Robert Truding, M.D. Dietitian Advisor: Dorothy Vaughan, R.D. President: Mary Guerriero Vice President: Sue Gentilia Past President: Diane Morof Finance Committee: Maria Montie 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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