THE SPRUE-NIK PRESS

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

Volume 7, Number 4                                       May/June 1998
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: What's Inside                  :
: -------------                  :
: Miscellaneous Notes            :
: NIH Meeting on CD Held         :
: If Not For the Biopsy          :
: A View From College            :
: Newsletter Roundup             :
: Recipe Page                    :
:................................:

References Disclaimer
Miscellaneous Notes: -------------------- From the Editor: _The Sprue-nik Press_ got its start in November 1992, under the guidance of Jeanne Boldt. Since then it has blossomed and grown, with articles and short pieces from many group members. In the last few years we've included items from many other newsletters and from the Celiac e-mail list on the internet. Items from our newsletter have found their way into dozens of other newsletters around the country, and an online version of our newsletter has appeared in the reference files of the Celiac e-mail list since February of 1995. This cooperation and sharing between so many US and Canadian groups is a fine example of our motto, "Celiacs Helping Celiacs." This is the 48th issue of this newsletter, marking over 600 pages of articles, recipes, conference talk summaries, reports from the four presidents we've had over those years, poems, cartoons, and many other tidbits. All of you make this possible with your contributions, along with the 40 other US and Canadian support groups with whom we share newsletters. Each of you has a story to tell, or some hints to pass on. We share these ideas verbally at meetings. Why not take a few minutes and jot your ideas down? Whether you send a finished article or a set of notes, we can use the material for the benefit of other group members, and all the other celiacs that see our newsletter. E-mail your ideas to lyles@tir.com--Jim Lyles -=-=- -=-=- _Sully's Living Without_ is a new magazine meant to be a lifestyle guide for people with food and chemical sensitivities. The premiere issue (Spring 1998, 60 pages) focused mostly on celiac disease and the gluten-free diet. This is not surprising, as the publisher (Peggy A. Wagener) herself is gluten-intolerant, and Dr. Joseph Murray is one of the medical advisors for the magazine. Also, Carol Fenster (author of _Special Diet Solutions: Healthy Cooking Without Wheat, Gluten, Dairy, Eggs, Yeast, or Refined Sugar_) is a contributing food editor for the magazine, and Janet Rinehart (CSA/USA president) and Elaine Monarch (Celiac Disease Foundation executive director) are on the magazine's advisory board. So it looks like articles of benefit to celiacs will continue to appear in future issues. The magazine is published quarterly. The subscription rate is $12 for one year or $20 for two years. To subscribe, write to Sully's Living Without, Inc., 1840 Industrial Drive, Suite 200, Libertyville, IL 60048-9400; call 6 30-415-3378; or fax 630-493-9511. -=-=- -=-=- Recipe Hint: Some recipes call for chow mein noodles, which are NOT gluten-free (GF). You can usually substitute GF potato sticks in place of the chow mein noodles. Depending on the brand you use, you may have to cut back on the salt used in the recipe. For example, in a no-bake cookie recipe I recently made, I used unsalted peanuts to compensate for the extra salt in the potato sticks.--Vicki Lyles -=-=- -=-=- _Vegetarian Times_ Magazine has an article on allergies in their May issue, which includes information on gluten intolerance. They even included a few recipes: New Fashioned Pot Pie (the crust for this looked like a good one), Kale Soup with Black Eyed Peas (the name does not do it justice), and Cranana-Nut Bread (this one looked like a good twist on the tired old banana nut breads we've been eating). The newstand price is $2.99, which is well worth it for this issue.[1] -=-=- -=-=- You know you're a celiac if... ...you've ever been caught licking a discarded Twinkie wrapper. ...at Christmas, visions of guar gum dance in your head. ...you've ever had to give a doctor a crash course in Celiac 101. ...you weep at picnics, parties, receptions and fast food joints. ...you weep at breakfast, lunch, and dinner. ...you've ever "brown bagged it" to an elegant dinner engagement. ...a 7 Course Meal is a 1 Course Meal for you. Lettuce. --Diane Wright
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NIH Meeting on Celiac Disease Held ---------------------------------- by Ann Whelan, editor/publisher of Gluten-Free Living reprinted from the April 1998 newsletter of the Westchester Celiac Sprue Support Group, White Plains, NY On March 10th, more than 20 members of the celiac community and celiac disease (CD) specialists attended a meeting of the Digestive Diseases Intragency Coordinating Committee, a part of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The meeting, held to update the current status of CD, was chaired by Jay Hoofnagle, MD, Director of the Division of Digestive Diseases and Nutrition at the NIDDK. At the meeting, presentations were made by Martin Kagnoff, MD, Joseph Murray, MD, Alessio Fasano, MD, and Frank Hamilton, MD. Dr. Kagnoff is a gastroenterologist and Professor of Medicine at the University of California, San Diego. He spoke about his research into the genetics of CD, focusing on the pathogenesis. Dr. Kagnoff is well known for his research into the genetics of CD, and several of his studies have been funded by the National Institute of Health (NIH). Dr. Murray, Associate Professor of Medicine and clinician at the University of Iowa Hospitals and Clinics, described his experience with CD both in Iowa and in Ireland, noting that his interest in CD is clinical. He emphasized what he called the "Classic II" symptoms, meaning the actual symptoms patients have today and the "Classic" symptoms many doctors may be familiar with. He said, "The rate of diagnosis is proportional to suspicion." Dr. Murray described the CD experience at the University of Iowa from 1985 to 1997, presenting statistics that indicated a steep increase in diagnosis. "At our institution, CD is an adult disease," he said, "and is now seen as frequently as Crohn's Disease." Anticipating the question, "Why look for CD?", Dr. Murray gave his reasons: preventing lymphoma and osteoporosis, as well as resolving fatigue and nonspecific symptoms and shortening the current significant delays in diagnosis. Dr. Fasano's presentation was called "Where Have All the American Celiacs Gone?" He described what has happened in the field of CD in various parts of the world, including some parts of the United States, but emphasized the European experience. Dr. Fasano noted that plans are already underway in Italy to screen all seven-year-olds in 1999. Dr. Fasano explained why an epidemiology study is critically needed in this country. He pointed out the benefits of such a study for four groups: * The American health care community: lower health care costs, increased awareness of CD, and more knowledge of its "protean manifestations in the US". * Participating physicians: publications, more patients, and increased credibility. * The American people: the prevalence will be established and CD will be diagnosed more quickly. * Celiac patients: free screening of first-degree relatives, federal support for dietary and drug regulations, an improved food supply, stronger local supports groups, and more funding for celiac research. Dr. Fasano added that such a study, whatever its findings, would end in a win-win situation for everyone. If the study shows that CD is underestimated in this country, patients will benefit as physicians begin looking for the problem with the knowledge that they might well find it. If the study shows CD is indeed rare in the United States, "it's even more exciting because we will be able to figure out why." Dr. Hamilton, chief of the Digestive Diseases Program Branch at the NIDDK, briefly described the CD research, to date, that has already been funded by the NIH. He said $1.4 million has been granted for such research, adding that over the last five years, "we have seen growth in the funding of CD." He said he was pleased funding has increased, and felt a lot of work has to be done. Dr. Hamilton ended by saying, "Today's meeting will serve as an impetus for a partnership between the NIH, academe, and the lay groups to foster more research." He added that it was important for the investigators and support group representatives present at the meeting to get the word out, referring to information about CD. These talks were followed by a round table discussion, between the members of the committee and the presenters. Later, audience comment was invited. The committee showed an interest in the current adult nature of the disease, the changing symptoms, current testing methods, and identification of the most critical research needs. Patients who spoke were anxious to let the committee know what they felt were the important concerns in the real world. At the end of the meeting, Dr. Hoofnagle said his division will prepare a short, pithy plan, then present it to Drs. Kagnoff, Murray, and Fasano. He noted that the important issues are pathogenesis, delivering the message to physicians, clinical research issues, and pediatric health concern. Some quotes from the meeting: * Elaine Monarch: "There is a general lack of knowledge, awareness, and interest in CD among the medical profession. We celiacs can go for years with substantial symptoms but not diagnosis....The cost to the medical community is enormous." * Joseph Murray, MD: "There is more than one gene involved in CD. Most Europeans are homogenous. Here we have a mongrelized population. What happens when you mix? How much does it change? Our mongrelized population may be at risk at a later age." * Martin Kagnoff, MD: "The issue of other genes is not at all clear. Like Joe [Dr. Murray], I see adult celiacs. Their time delay to diagnosis is not exaggerated, but what is striking is the lack of knowledge of doctors, even at the University of California. They really are not aware of this disease." * Alessio Fasano, MD: "We receive 10-15 calls a day. The vast majority are self-diagnosed. They say, 'I know more than my gastroenterologist.'" * Peter Green, MD: "We need to emphasize education of gastroenterologists. At my institution [Columbia-Presbyterian Medical Center in New York City], doctors are not used to looking at the duodenum....We need to educate many levels of the medical community and tell them, 'If you don't recognize something, take a biopsy.'" * Sue Goldstein: "I'm concerned about the people who have not yet been diagnosed and the reasons why a physician won't consider CD. It all boils down to: 'it's rare and you can't have it.'" In addition to the speakers, the following were among those who attended: Phyllis Brogden, celiac, founder and chairperson of the Greater Philadelphia Celiac Sprue Support Group. Winnie Feldman, celiac, Celiac Disease Foundation [Los Angeles]. Kenneth Fine, MD, gastroenterologist/ researcher at Baylor University Medical Center in Dallas. Al Fornace, MD, celiac, National Cancer Institute. Sue Goldstein, celiac, founder, and advisor, Westchester Celiac Sprue Support Group. Peter Green, MD, clinician/researcher at Columbia-Presbyterian Medical Center in New York City. Joanne Hameister, celiac, former chairperson, Western New York Gluten-Free Support Group. Ivor Hill, MD, clinician/researcher at Bowman Gray School of Medicine, Winston-Salem, North Carolina. Beth Hillson, celiac and proprietor of the Gluten-Free Pantry. Karoly Horvath, MD, clinician/researcher at the University of Maryland School of Medicine in Baltimore. Marge Johanneman, celiac, CSA Kentucky state coordinator. Pam King, University of Maryland. Bob Levy, celiac in the Washington, DC area, and Ruth Levy, spouse. Jax Lowell, celiac and author of Against the Grain. Elaine Monarch, celiac, founder and executive director of the Celiac Disease Foundation. Selwyn J. Monarch, board of directors, Celiac Disease Foundation. Diane Paley, celiac, governing board of CSA/USA. Michelle Pietzak, MD, pediatric gastroenterologist at Children's Hospital, Los Angeles. Connie Tur, celiac, president of Greater Louisville Celiac Sprue Support Group. Ann Whelan, celiac and editor/publisher of Gluten-Free Living. [_Gluten-Free Living_ is a national newsletter published to provide help and information for those with CD or Dermatitis Herpetiformis and the professionals who treat them. Subscriptions are $29 for one year and $49 for two years. Write to Gluten-Free Living, PO Box 105, Hastings-on-Hudson, New York, NY 10706.]
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If Not For the Biopsy...[2] --------------------------- by Christine Duncan My child is a biopsy-proven celiac, but he never had any of the obvious celiac symptoms. No diarrhea, no gas and bloating, no constipation--none of that stuff. His behavior was terrible. He was constantly irrationally angry. You never knew what would set him off. Someone getting between him and the TV set could set off a storm that would last hours. His only complaint was that he felt that he couldn't swallow well. He refused pills, meat or anything with a tougher consistency than yogurt or cooked noodles. I discussed this with both his pediatrician and his allergist and they felt the problem was psychological. This seemed reasonable as he had had several episodes where his throat closed due to an allergic reaction. But over the years his behavior worsened. Our other children were afraid of him as was I. He was constantly being suspended from school. His grades were in the dust. We tried counselors, who sent us to psychologists who sent the child to a psychiatrist. My son was put (involuntarily) in a mental hospital. He returned home and we were told not to waste any more money on counseling. He was not engaged in treatment. We became our city's coordinators of Tough Love in order to cope. Tough Love's policy is to call the police when the child is violently out of control--so we did. The police came to know us only too well. They advised us to get the child out of the home for the sake of our other children. Meanwhile, I still felt that food was the problem. Allergy testing revealed nothing, but my son was constantly hungry. And the words that I most dreaded to hear out of his mouth were "I'm starving." Those words presaged some of his worst problem times. I went back to the pediatrician without my son, and told the doctor that I wanted a swallow test. Previously, I hadn't known that could be done, but a friend had had his daughter tested and it gave me the idea. The doctor told me she would do it but that she felt my son had a true genetic mental illness. This would not solve the problem. The test revealed that my son had a severe stricture of the esophagus. He was sent immediately to a pediatric gastroenterologist. And when he did a biopsy in the course of stretching the esophagus, he found classic signs of celiac disease. Even then, the gastroenterologist did not believe it. My son showed no signs of celiac disease, he said. He was thin, but he was not terribly short. And as I mentioned he had none of the usual gastrointestinal signs. There were signs that my son had gastroesophageal reflux, but the child never felt anything. His receptors had evidently been burned out. The gastroenterologist ordered tests. My child was negative on every thing but the IgG. Because of that, the gastroenterologist hesitated again. But he talked with my husband and me, and decided on a trial period of the GF diet. Thank God he did. My son's behavior changed within a very short period of time. At first I didn't dare to believe it. Then other people made comments. They noticed too. His grades went up. He had the follow-up biopsy after three months and it showed vast improvement. The gastroenterologist was convinced too. There is a reason that the biopsy is the gold standard for diagnosis. If the blood test results are in any way equivocal, and you have doubts, please get the biopsy. Trust yourself. No one knows you or your child like you do. If the biopsy is also negative, you can breathe a sigh of relief. It won't do any lasting damage. If the biopsy is positive, you have the satisfaction that you caught it as early as you could.
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A View From College ------------------- by Josh Marks reprinted from the Dec. 1997 newsletter of the Westchester Celiac Sprue Support Group When I was diagnosed with Celiac Disease, I didn't understand exactly what that meant. I was told, like so many other celiacs, "Oh, you just have to eliminate gluten from your diet." The doctor made it sound as if it was no big deal. However, I soon realized that my assumption was wrong. I had just turned twenty-one and it was at the beginning of my sophomore year of college when I found out I had Celiac Disease. As most college students do, I lived on pizza, bagels, muffins, and sandwiches. Also, I frequently attended a number of parties where I enjoyed the beer and grain alcohol. I didn't even realize the extent to which I had to change my life. The only cooking I ever did was making eggs on Sunday mornings. Once I found out that everything I ate contained gluten, I knew that I needed to make some major adjustments. First, I had to learn how to cook, which turned out to be pretty easy. The major adjustment I faced was social situations. At parties and formal dinners, I found that there was nothing I could eat and no alcohol I could drink. Now, my mother didn't have too much sympathy for my inability to digest alcohol, but most college students will tell you that drinking is a major part of college life. I would feel very awkward at parties when I had to explain why I had to turn down a beer. When going to a restaurant on a date, I hated explaining that I couldn't eat anything on the menu. I became very self conscious and as a result, I rarely attended any social gatherings. I felt so bad, that I barely went out at all. In addition, before my disease, I was accustomed to grabbing a bagel or slice of pizza between classes. However, after I was diagnosed I wasn't able to do that anymore. In fact, I would not eat anything all day and just wait until I got back to my apartment to broil a chicken breast so I could e at something. My not eating and self-pity lifestyle made things in school much worse. I would get annoyed and irritated by people and events that never bothered me before. I became very short tempered and didn't want to deal with anything or anybody. My grades and class work were affected. Every time I sat down to study, all I could think about was how angry I felt. I even stopped attending class because I couldn't learn anything. The only thing that entered my mind was how hungry I was and the food I could eat. It was definitely no way to live and required a change. My routine of starving myself all day and not going out lasted about two depressing months. When I was close to going insane, I was forced to make a decision. I could let this lifelong disease control me or I could get my act together and control my disease. I made the decision to get my act together and kick my disease's butt. I learned how to cook food that I could eat. Also, I would prepare gluten-free sandwiches and bring them with me to school. When I went to restaurants, I boldly brought my own bread and cookies. My attendance at social functions increased and I even found several items that I could eat or drink. Sometimes, I would even bring my own potato vodka and share it with everyone. If a lot of my friends were going out, I would eat something at home first to subside my hunger. Then, with my friends, I would order something simple like fries or potato skins. [Make sure there is no cross-contamination in the frying oil from breaded items--ed.] My situation started to get a lot better. As a result of my new control over my disease, I became much more confident. I didn't mind answering questions like "You can't have bread! What can you possibly eat?" I learned to laugh at these questions and give a friendly reply. I even realized some positive things about my situation. Becoming a celiac made me more aware of nutrition. Ironically, my disease has made me become a healthier person. Now, when I am faced with questions about my disease, I answer them and change the subject. I don't insist on explaining how difficult it is, and how lucky everyone else is that they can eat all kinds of good foods. This disease affects a person's everyday life. No one realizes the role that food plays in his/her life until it is taken away. I could let myself get depressed over the situation, or I could accept it and think about other aspects in my life. I decided a long time ago that in order for me to be happy, I need to face my circumstances with a positive attitude. When I start getting down about my disease, I try and concentrate on the good aspects of my life and, thank God, there always are. If I don't, then my disease will pollute my life and will make me a bitter person. I definitely don't want that to happen. Adjusting has been and still is very hard. Fortunately, as my everyday routine continues, things get much easier. Recently, I have stopped desiring food I used to enjoy. Bakery goo ds never enter my mind. Even pizza doesn't seem so good anymore. Occasionally, I get frustrated and annoyed. When that happens, I just think that I am a normal human being who has been dealt a certain hand and I am living with it. Actually, if I may say so, I am doing a damn good job. My good friends know that I can't have certain foods, so they have stopped offering them to me. Sometimes, they even look out for my diet restrictions, which I take as a sign that they care. Now, when I go out on a date or even with some friends, I find it to be no big deal to explain what I can't eat. Actually, I turn things around and emphasize the food I can eat. I make my situation sound positive which makes everyone, including myself, feel more comfortable. That is the most important, for me to be at ease with my situation. A year ago when I was diagnosed, I never imagined that I could be handling things the way I do. Now, I see no other way to approach my situation. I feel a hundred times better than I have in the past four years. I was able to cure myself from constant episodes of pain and fatigue and replace them with humor and rice crackers. I know what I can and can't have and because of it, I feel great. I love living without pain, and I have so much energy that I sometimes don't know what to do with all of it. The way I see it, CD all depends on how a person looks at it. I am able to view it on a positive note only because I choose it that way. I can't imagine living any other way. [Josh Marks is an active board member of the Westchester Celiac Sprue Support Group, and has served as an invaluable source of information and support to other celiacs, especially those of college age. We thank Josh for his very honest article.--the Westchester CSSG editors.]
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Newsletter Roundup ------------------ Compiled by Jim Lyles This section contains excerpts from newsletters produced by other celiac groups. ........................................................ : : : Excerpts from _Celiac Connections_ : : ---------------------------------- : : March 1998 Katie Marschilok, editor : : April 1998 Capital District Celiac Support Group : : 4 Fairlawn Lane : : Troy, NY 12180 : :......................................................: Congratulations to Dr. Peter Green and his colleagues. Six of their abstracts were accepted for presentation at Digestive Disease Week in New Orleans this May. This is the world's largest international meeting of gastroenterologists and related specialists. The accepted abstracts are: "Screening of First-Degree Relatives for Celiac Disease in the US" "Bone Mineral Density in Patients with Celiac Disease--a US Study" "Celiac Disease in the Elderly--Experience in the US" "Small Intestinal Malignancy and Celiac Disease" "Refractory Celiac Disease is Due to Celiac Disease" "All that Scallops is not Celiac Disease" The first abstract refers to a study involving first degree relatives of people who attended a celiac support group meeting. The subjects included 47 parents, 35 children, and 26 siblings of celiacs (one was both parent and daughter), 107 subjects altogether. All claimed to be clinically asymptomatic. Blood samples from the subjects were tested for EMA, IgG AGA, and IgA AGA. 33 subjects had elevated IgG and/or IgA AGA levels. Of these, another 7 also had positive EMA. 4 of these 7 had biopsies that were abnormal and consistent with the diagnosis of celiac disease (CD). Also, one of the EMA-negative subjects with elevated IgG AGA was biopsied and found to have partial villous atrophy. These findings are similar to data reported from Europe, suggesting that CD is underestimated in the USA. -=-=- -=-=- Boston Market recently sent a "Food Allergy Information" sheet, which included this list of gluten-free (GF) products: butternut squash rotisserie chicken cranberry relish creamed spinach fruit salad jumpin juice squares mashed potatoes steamed vegetables zucchini marinara For more information, call 800-356-7000. -=-=- -=-=- Hillshire Farms 97% Fat Free Sausage and Hot Dog products should be AVOIDED by celiacs. The remaining Hillshire Farm Smoked Sausage, Deli Select, Hot Dog, Bacon, and Ham products are GF. For more information, call 800-328-2426. ............................................................... : : : Excerpts from the Gluten Intolerance Group of North America : : ----------------------------------------------------------- : : newsletter: May 1997 Cynthia Kupper, editor : : newsletter: 3rd Quarter 1997 PO Box 23053 : : newsletter: 1st Quarter 1998 Seattle, WA 98102-0353 : :.............................................................: Gluten-Free Stickers are available for marking GF in your pantry. The stickers are 3/4-inch in diameter, fluorescent green, and have "GF" printed on them. The cost is $2 for a sheet of 120 stickers, including postage. Write to Gluten Intolerance Group of North America, PO Box 23053, Seattle, WA 98102-0353. -=-=- -=-=- Product Information: * Nupro (R) Prophylaxis Paste is free of gluten and soy, according to Dentsply International Preventative Care (as of June 1997, call 800-989-8825 to verify). All grit textures are gluten-free. Many dentists use this dental care product. * Arby's Restaurants: A letter from Triarc Restaurant Group, dated Jan. 26, 1998, indicates that Arby's signature roast beef is gluten-free (GF), as are the "natural" baked potatoes and cheddar cheese sauce. (The modified food starch in the cheddar cheese sauce is from corn.) For more information, call 954-351-5100. * Cascade Fresh(r) Yogurt: A letter dated Feb. 3, 1998, states no preservative, refined sugars, artificial sweeteners, colors, flavors, or additives are used. This yogurt is sweetened with fruit juice concentrate. The "natural flavors" include only concentrates of the fruit listed on the label. Cascade Fresh yogurt is GF, as are the fruit juice concentrates added to it. -=-=- -=-=- Ask the Professionals: Question: Does a person with celiac disease (CD) need to be concerned about antibiotic therapy for any reasons? Short term course or long term course? The type used? Dr. Joseph Murray (University of Iowa) answers: Most antibiotics are gluten-free (GF) but not all. Ask the pharmacist to check for you. If they are needed, then antibiotics should be taken. Antibiotics have gastrointestinal (GI) side effects but they are no more or less common in celiacs than in "glutons" (those eating gluten). Diarrhea is the most common side effect. Question: Why do some listings for foods to avoid on a GF diet include canola oil and others don't? Is there a problem with guar gum? Cynthia Kupper, CRD, CDE answers: Canola oil is made from rapeseed. Rapeseed is GF; however, some people have GI symptoms because of using products, such as canola oil, due to sensitivity (an allergic type reaction) to the food. Sometimes it will appear on a "to avoid list" for people with CD. This may have been done to help decrease confusion in knowing what is a "gluten contamination" reaction and what is a "general sensitivity" to foods. When you see information that is conflicting like this, it is always best to ask for a clarification. Guar gum is GF. It is ground from the endosperm of the Cyanopois tetragonoloba plant. It is primarily a carbohydrate that is soluble in hot or cold liquids, but insoluble in oil and greases. It is tasteless and odorless. It has 5-8 times the thickening power of starch. It is used like xanthan gum in products to thicken, stabilize, emulsify, and bind or "glue" together baked goods and frozen desserts such as ice cream. In medications it is used as a binder. Guar gum does have a natural laxative effect. In some individuals, the appearance of loose stools or diarrhea may be confused with a reaction to gluten. Other ingredients, such as sorbitol and mannitol (commonly found in sugar-free foods), also can induce diarrhea. In some medical situations sorbitol is prescribed to ease constipation. The gas, stomach aches, and diarrhea are a result of the ingredient, not gluten ingestion. The amounts of these ingredients that will cause diarrhea vary with each person. Some may react as the result of eating one small muffin made with guar gum or a couple of pieces of candy made with sorbitol; others may need to eat larger quantities for the same effect. When using products containing guar gum, sorbitol, or mannitol, remember that a change in stools and GI symptoms may only be a result of this additive, meaning simply that you are sensitive to small quantities of these ingredients and should be careful about the amount you use. ......................................................... : : : Excerpts from _K.C. Gluten-Free Advocate_ : : ----------------------------------------- : : April 1998 Joe & Janna Denison, editors : : Greater Kansas City Chapter of CSA/USA : : 7911 Little Lane : : Pleasant Valley, MO 64068-9187 : :.......................................................: A Psychological Aspect of CD: Diet maintenance is not the only aspect of celiac disease (CD) that needs addressing. Those with CD also deal with a grief process common with any life-changing event. The feelings do not necessarily go in order and not everyone experiences all of them. First, denial about having the disease and the all-encompassing changes that take place is common. During the denial phase, those with CD continue eating whatever they want because the ramifications have not set in. The thinking is, "I'm already sick, what is one cookie or slice of pizza going to hurt?" Next, anger and depression about the situation sets in. "Why did this happen to me?" runs through the mind of the celiac. There are many frustrations associated with CD that add to the anger and depression. Eating out, in a restaurant or someone else's home, triggers anxiety over having to explain once again the foods that are acceptable and not. Finally, there is acceptance that this is not really a bad disease to have, if you are going to have one. There are no needles, no pills, and no hospital treatments; only a diet to control the symptoms. Frankly, the alternative to the diet (diarrhea, skin rash, cramps) is incentive enough to do everything possible to keep toxic gluten from contaminating your diet.--Kristina Dilks ........................................................ : : : Excerpts from the Healthy Villi Celiac Support Group : : ---------------------------------------------------- : : newsletter: Spring 1998 Melinda Dennis, editor : : 95 Orchard St., #2 : : Somerville, MA 02144 : :......................................................: Caines: The following Caines products are gluten-free (GF), as of Dec. 9, 1997: All Natural Mayonnaise, Light Reduced Calorie Mayonnaise, Reduced Fat Mayonnaise Dressing, Fat Free Mayonnaise Dressing, Tartar Sauce, Sweet Relish, Kosher Dill Pickles (whole, chips, spears, sandwich cuts), and Sweet Cucumber Pickles (chips, sandwich cuts). The distilled vinegar and modified food starch used in Caines products are both derived from corn. For more information, call 508-772-0300. -=-=- -=-=- Rice Facts: For some fun online rice facts, try this website: http://www.usarice.com. ........................................................... : : : Excerpts from _Lifeline_ : : ------------------------ : : Spring 1998 (Vol. XVI, No. 2) Leon Rottmann, editor : : CSA/USA, Inc. : : PO Box 31700 : : Omaha, NE 68131-0700 : :.........................................................: Hypothyroidism: Individuals are at a higher level of risk for hypothyroidism if they have another autoimmune condition such as celiac disease (CD), type I diabetes, or rheumatoid arthritis. Symptoms include lethargy, forgetfulness, sluggishness, loss of interest in normal daily activities, feeling cold or tired, hair growing slowly or becoming dry and brittle, wounds taking longer to heal, itchy skin or dryness not helped by oils and lotions, constipation, muscle cramps, and, in women, increased menstrual flow. Mild hypothyroidism may not cause any symptoms. The treatment is synthetic thyroid hormones, taken as a daily pill for the rest of your life. Thyroid failure can be progressive; as time goes on the dosage may need to be increased, so a yearly checkup is important.
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References ---------- [1] "Good Article in Vegetarian Times Magazine", Lynda Swink, from the CELIAC Listserv archives on the Internet, posted April 22, 1998. To obtain a copy, go to http://maelstrom.stjohns.edu/archives/celiac.html and click on "April 1998, week 4." [2] "Re: Testing 1st deg relatives, irritable Celiac children", from the CELIAC Listserv archives on the Internet, posted March 22, 1998. To obtain a copy, go to http://maelstrom.stjohns.edu/archives/celiac.html and click on "March 1998, week 4."
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Recipe Page ----------- ********************************************************************** Lily's GF Pie Crust 1/3 cup brown or white rice flour 1/3 cup tapioca flour 1/3 cup potato starch 1-1/2 Tbsp corn starch 1/3 tsp. salt 1 tsp. xanthan gum 1 Tbsp. sugar 1/3 cup (5 Tbsp.) butter 1 egg, beaten 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. As 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 longer. This recipe came from _Lifeline_, Summer 1996, pg. 5, and was previously printed in the July/Aug. 1996 issue of _The Sprue-nik Press_. It is Lily Mae Patten's recipe. ********************************************************************** Joan's Pie Crust 1-1/2 cups GF flour mix** 1/4 tsp. cream of tartar 1/2 tsp. salt 1/2 cup butter-flavored Crisco 1/3 cup plus 1 Tbsp. milk 1 egg Mix the flour, cream of tartar, and salt. Cut the Crisco with the flour mixture. Beat the egg in the milk. Add the milk mixture to the flour mixture and shape into a ball. Divide the ball in half and roll out each half to fit the pie pan. This recipe comes to us from Joan Kulka. ********************************************************************** Pecan Pie 1 cup white corn syrup 1 cup brown sugar 1/3 tsp. salt 1 cup melted butter or margarine 1 tsp. GF vanilla 3 eggs, beaten 1 9-inch unbaked GF pie shell 1 heaping cup pecans or walnuts Mix the syrup, sugar, salt, butter, and vanilla together. Mix in the beaten eggs. Pour the mixture into the pie shell. Put the nuts on top of the filling. Bake at 350 degrees F for 45 minutes. This recipe comes to us from Joan Kulka. ********************************************************************** Pineapple Pie 1 20 oz. can crushed pineapple 1/2 cup sugar 2 tsp. corn starch 1/2 tsp. lemon juice 1 Tbsp. butter 2 unbaked GF pie shells (one for the top) Prepare the bottom pie shell. In a pan mix all the ingredients except the pie shell. Cook for about 7 minutes. Pour the mixture into the bottom pie shell. Dot with butter. Put on the top crust. Brush the top with milk and sprinkle lightly with sugar. Bake at 375 degrees F (350 degrees for a glass pie pan) for 30 minutes or until golden brown. To make a pineapple sauce, stop cooking after 7 minutes and add butter. The resulting sauce can be served on cake or ice cream. This recipe comes to us from Joan Kulka. ********************************************************************** Libby's Pumpkin Pie 1 unbaked GF pie shell 2 eggs 1 16 oz. can solid pack pumpkin 3/4 cup sugar 1/2 tsp. salt 1 tsp. ground cinnamon 1/2 tsp. ground ginger 1/4 tsp. ground cloves 1 12 oz. can evaporated milk Prepare the pie shell. Preheat the oven to 425 degrees F (or 400 degrees F for a glass pie pan). Beat the eggs in a large bowl. Stir in the remaining ingredients in the order given. Pour the mixture into the pie shell. Bake for 15 minutes. Reduce the temperature to 350 degrees F (325 degrees F for a glass pie pan) and bake for another 40-50 minutes or until a knife in the pie center comes out clean. Cool on a wire rack. This recipe comes to us from Joan Kulka. ********************************************************************** Meringue Cookies 2 egg whites 1 tsp. GF vanilla dash salt 1/2 cup sugar 1 6-oz. pkg. Nestle Morsels Beat the egg whites until foamy. Gradually add the vanilla and salt, then sugar, beating until egg whites are stiff and shiny. Fold in the chocolate chips. Drop by the teaspoonful onto a greased cookie sheet. Bake at 300 degrees F for 30 minutes. This recipe comes to us from Judy Phelps. ********************************************************************** ** 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) **********************************************************************
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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: Tom Sullivan 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 Mary Guerriero.
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