THE SPRUE-NIK PRESS
Published by the Tri-County Celiac Sprue Support Group,
a chapter of CSA/USA, Inc. serving southeastern Michigan
Volume 8, Number 3 March 1999
**********************************************************************
...........................................
: What's Inside :
: ------------- :
: Miscellaneous Notes :
: Product Information :
: 9th Int'l Symposium on CD :
: GF Trips from Bob & Ruth :
: CD: An Under-Recognized Disease :
: Definition of CD :
: Prevalence :
: Pathogenesis :
: Diagnosis :
: Laboratory Studies :
: Complications :
: Associated Disorders :
: Latent CD :
: Treatment :
: Post-Diagnosis Management :
: Q & A :
: Recipe Page :
: Apple Bavarian Torte :
: High on the Hog Ham Bone Stew :
: Party Mix :
: Fig Honey Cookies :
: Cherry Jello Dessert :
:.........................................:
References
Disclaimer
Miscellaneous Notes:
--------------------
Product Information:
* Pamela's is switching to safflower oil. The canola oil in all
products is being replaced with high oleic safflower oil. Watch
the ingredient panels for this change. [Note: both canola and
safflower oil are gluten-free, so for most celiacs this is not an
issue. However, some people seem to have a sensitivity to canola
oil, so if you are in this category then this will be a welcome
change.-ed.]
* Brand 365 is making a list of their gluten-free (GF) items.
Right now we have a partial list, that is accurate as of Feb.
16, 1999; more items will likely be added in the future. At this
point, the following Brand 365 items are listed as being GF:
100% fruit juices
balsamic vinegar 5 years old
canned tomatoes
Everyday energy bars
expeller pressed canola oil
frozen fruits
frozen orange juice
frozen vegetables (EXCEPT potato products)
fruit spreads
Italian extra virgin olive oil
natural spring water
NFC orange juice
soft drinks
solid white albacore tuna
tongol tuna
Brand 365 products can be found at Merchant of Vino. For more
information, call Dennis Ring at 925-299-1365. (Thank you to Pat
Michael for this information.)
* Whole Foods has a list of gluten-free (GF) products, dated Jan.
1999:
apple butter
bagged tea
beans in glass
bread dipping oil
bread spreads
dessert sauce
dry rubs
fire roasted salsa
fruit essence
honey
Italian-style pasta sauce
jam
juices
maple syrup
mayonnaise
organic applesauce
organic balsamic vinegar
organic chocolate bar
organic mustard
organic nut butter
organic olive oil
organic olives
organic pasta sauce
organic roasted red piquillo peppers
organic tomatoes in glass
pear and plum butter
sparkling cider
vinegar
Whole Foods products can also be found at Merchant of Vino. For
more information, contact Annie Smith, 919-286-0145 ext. 372,
718 Iredell St., Durham, NC 27705. (Thank you again to Pat
Michael for this information.)
-=-=- -=-=-
JCAHCO Address Correction: In the February newsletter we listed an
address you could write to with complaints regarding poor health care
service (such as failing to provide a GF diet during a hospital stay
or uncooperative pharmacists). Unfortunately, we didn't get the
address right. The correct address is: Division of Accreditation
Operations, Accreditation Service Specialist, Joint Commission on
Accreditation of Healthcare Organizations, One Renaissance Blvd.,
Oakbrook Terrace, IL 60181.<1>
-=-=- -=-=-
The Cookie Recipe Web Page has a listing of about 40 gluten-free
cookie recipes, along with some basic information about celiacs and
their need for a gluten-free diet. The URL is
http://www.CookieRecipe.com. Scroll down to the bottom of the "All
Kinds O' Cookies!" section and click on "Gluten-free Cookies".<2>
-=-=- -=-=-
GIG's Annual Conference will be on Saturday, April 17th, 1999, at the
Highline Community Hospital, near the Sea-Tac Airport in Washington
State. There is also a pre-conference dinner Friday evening. For
non-GIG members the cost is $70 for the conference ($80 if after March
26th), and $25 for the pre-conference dinner. Speakers include Peggy
A. Wagener, president of Sully's Living Without magazine; Jay Berger,
owner of Miss Roben's, a GF mail-order vendor; and Dr. Michael
Schuffler, GIG's medical advisor. The conference includes a
continental breakfast and lunch. For more information or to make
reservations, write to Gluten Intolerance Group, 15110 10th Ave. SW,
Suite A, Seattle, WA 98166; call 206-246-6652; fax 206-246-6531; or
send e-mail to gig@accessone.com.
-=-=- -=-=-
The 9th International Symposium On Celiac Disease will be held in the
United States, August 10-13, 2000. This is the "Super Bowl" of all
celiac conferences, last held in Finland a few years ago, and to be
held this year in Italy. It has never before been held in our
country, so plan now to set aside some time in August next year to
attend.
A large turnout is expected, and it is likely that the hotel will be
completely filled with attendees to the conference. Therefore,
special arrangements are being made now to take early hotel
reservations. The following is for HOTEL ACCOMMODATIONS ONLY. The
symposium program and registration fees will be released as soon as
they are available (probably not until June or July, 1999).
Marriott Hotels International Reservations System cannot accept
reservations more than a year in advance, so special arrangements have
been made to accommodate your early reservation requests.
Dates: August 10-13, 2000
Accommodations: Marriott's Hunt Valley Inn, Hunt Valley, Maryland
Rates per night: Single or Double $115; Triple $135; Quad $155
(These rates are available 2 days prior and 2
days after the dates of the conference, based
upon availability.)
We recommend that reservations be made by mail prior to September 1,
1999 to ensure availability. All reservations must be made by July
20, 2000 and are available on a first-come, first-serve basis. To
make your reservations by mail prior to September 1, 1999, simply
complete the form below and mail it to: Bob & Ruth's Gluten-free
Dining & Travel Club, 22 Breton Hill Rd., Suite 1B, Baltimore, MD
21208.
Written requests will be confirmed by letter upon receipt; and, then
reconfirmed with a confirmation number after September 1, 1999.
Reservations after that date must be made by calling 1-800-228-9290.
(Prior to Sept. 1, 1999, telephone reservations will NOT be accepted
by either Bob & Ruth's OR Marriott's Hunt Valley Inn).
Name: _____________________________ Tele #: ______- ______- _________
Address: _____________________________________________________________
City: ________________ ST: ____ Zip __________ Country: ___________
# in Party: ____ Arrival Date: __________ Departure Date: __________
Room Type Requests: (Circle your choices)
Smoking/Non-Smoking One King Bed/Two Double Beds
Credit Card #: ________________________ Expiration Date ____________
(A credit card is required to confirm reservation only)
Type (Visa, MC, Amex, etc.): _________________________
Signature: ___________________________________ Date: _______________
-=-=- -=-=-
Bob & Ruth's Gluten-free Dining & Travel Club has set up two trips you
may find of interest. The first trip is coming up quickly, so act now
if you are interested. (Club members have priority and receive a
discounted rate):
* Gluten-Free Family Getaway To Jamaica: Join us on August 2-8,
1999, at the SuperClubs Boscobel Beach All-Inclusive Family
Resort in Ocho Rios, Jamaica. One child per each paying adult in
the same room is FREE. Comprehensive SuperKids programs are
available at 4 age levels. There is an adult-only complex as
well. Gluten-free food is the best part of all. From the time
your plane lands in Jamaica (airfare not included) until you
takeoff for home, ALL of your family's food, drink, and
activities are paid for. All deposits for reservations must be
in by April 8, 1999.
* Gluten-Free Getaway To The Bahamas: Join us November 15-21,
1999, at the SuperClubs Adult Only All-Inclusive Breezes Bahamas
Resort Hotel at Cable Beach, Nassau. We will be wined, dined
(gluten-free and regular) and entertained in casual elegance.
Every meal will include a gluten-free selection of food
specialties and baked goods. From the time your plane lands in
Nassau, Jamaica (airfare not included) until you takeoff for
home, your food, drink, and activities are paid for (with few
exceptions). Tipping is not even allowed. Last year's trip was
enjoyed by 46 of us and we had to turn away another 16, so please
make your reservations early as we have only been allotted 25
rooms this year.
If you are interested in costs and additional information for either
of these trips, send e-mail to bobolevy@erols.com or call
410-486-0292.
-=-=- -=-=-
Brown Rice--Better than White Rice: Milling is the primary difference
between brown and white rice. Milling removes the outer hull, bran,
germ, and endosperm from the rice grain. While milling increases the
cooking convenience of rice, making it a 20 minute process instead of
40, the trade-off is a dramatic drop in nutrients. The outer layers
that are milled off contain nutritionally important oils, fiber,
vitamins, and minerals. Fiber is not only more filling, but has a
probable role in preventing certain gastrointestinal diseases and
heart disease. Brown rice contributes to health in a way that white
rice can't, and is therefore well worth the wait.<3>
-=-=- -=-=-
Are You Out of Baking Powder? Or are you not sure if the commercial
baking powders are GF? You can mix your own using 1 part baking soda,
2 parts cream of tartar, and 2 parts arrowroot powder. Mix well.
Store in a sealed container, at room temperature.<4>
Return to the Table of Contents
Celiac Disease: An Under-Recognized Disorder
----------------------2----------------------
by Thomas Alexander, MD
summarized by Tom and Carolyn Sullivan
The speaker for our Feb. 8 general meeting was our physician advisor,
Thomas J. Alexander, M.D. He presented an overview of the current
thinking on clinical presentation of celiac disease and then handled
questions and answers. A summary is provided here for those who were
unable to attend.
Definition
----------
Celiac disease (CD) is a life-long autoimmune disorder of the
intestinal tract which can have its onset anytime during childhood or
adulthood. It varies in severity, with classic symptoms of
malabsorption noted in some patients while others remain completely
asymptomatic.
Prevalence
----------
It is more common in the European population with more recent studies
suggesting an incidence as high as 1:250. There is a 2:1 female
preponderance. It is felt that the disease is grossly
under-diagnosed, perhaps in large part due to the relatively recent
understanding of the disease and the wide spectrum of symptoms which
are increasingly recognized. In one study, the number of patients
diagnosed over three successive five-year periods increased seven-fold
when the disease was considered in less severe or atypical cases.
Pathogenesis
------------
In a genetically predisposed individual, the intestinal immune system
is abnormally activated by gliadin, a specific portion of the
predominant wheat protein molecule, gluten. As a result, an
inflammatory reaction takes place resulting in the destruction of the
villi, with the first portion of the small intestine generally the
most severely damaged. This damage then limits the small intestine's
ability to absorb nutrients.
95% of patients with CD have the HLA-DQA1 0501 and HLA-DQB1 0201 genes
encoded for the HLA-DQ protein. The remaining 5% have the DR4 and DQ8
genes. But there is more than just genetics involved, as only 30% of
siblings with the identical haplotype will also have CD. Even in
identical twins, when one has CD only about 75% of the time will the
other twin also have CD. Clearly something else is involved in
"triggering" the onset of CD in individuals that are genetically
predisposed to it.
Diagnosis
---------
There are three important syndromes which occur in CD with the degree
of severity varying greatly.
1. Malabsorption with diarrhea, foul-smelling gas, and weight loss.
2. Iron deficiency without blood loss. These patients frequently
present with chronic or even life-long anemia with
hemoccult-negative stools, without any significant symptoms of
malabsorption such as diarrhea or weight loss.
3. A common presentation noted in children is that of unexplained
diarrhea and/or growth retardation often associated with
irritability. The onset may occur in infancy when gluten is
introduced into the diet, or at a later age.
Other non-classic presentations may include osteoporosis,
oligoarthritis, hypertransaminasemia, atypical Sturge-Weber syndrome
(epilepsy with cerebral calcifications), and dental enamel defects
(horizontal grooves).
Laboratory Studies
------------------
Laboratory studies which would suggest malabsorption and CD would
include iron deficiency anemia, hypocarotenemia, hypoalbuminemia,
elevated prothrombin time, and decreased D-Xylose absorption.
Serologic studies which would suggest CD include the anti-gliadin,
anti-endomysial and anti-reticulin antibodies (typically ordered as a
celiac panel) which are about 85-90% accurate. These tests are used
for screening purposes; they cannot be used to make a firm diagnosis.
More recently, autoantibodies to tissue transglutaminase have been
shown to be 95% accurate in predicting CD. Small bowel x-rays are
abnormal in less than 50% of celiac patients.
In time, the tissue transglutaminase autoantibody tests may prove to
be accurate enough to be the single screening blood test for CD. The
only way to definitively diagnose CD is through a small intestinal
biopsy followed by clinical response to a gluten-free (GF) diet.
Pathologic features of the disease may include shortened or absent
villi with crypt hyperplasia. However, these findings may also be
present in a variety of other conditions. Features which are more
specific for CD include increased numbers of lymphocytes (type of
immune cells) mixed in with and below the cells of the villi
(enterocytes).
Complications
-------------
These include the complications of malabsorption such as weight loss,
vitamin and mineral deficiencies, coagulopathy, osteopenia, bone
fractures, lymphocytic gastritis, and lymphocytic colitis. Intestinal
strictures and ulcerations may occur. Other complications include
refractory and collagenous sprue as well as malignancy. There is a
3-4 fold increased incidence of all malignancies, half of which occur
in the intestinal tract. The risk of malignancy returns to that of
the general population after 5 years on the GF diet.
Untreated CD may also negatively affect pregnancy outcome with
relative incidences of spontaneous abortion and low birth weight being
nearly 9 and 6 times higher respectively. These improve markedly in
treated celiac patients.
Other major complications include osteoporosis, short stature, delayed
puberty, infertility, and lactose intolerance. CD may be present in
up to 20% of patients with unexplained neurologic dysfunction.
Associated Disorders
--------------------
CD occurs with greater incidence in patients with other autoimmune
disorders. It is present in about 90% of those individuals with
dermatitis herpetiformis (DH). It has also been seen with increased
frequency in insulin dependent (Type 1) diabetes, autoimmune thyroid
disease, and liver disease.
Latent Celiac Disease
---------------------
This is an ill-defined syndrome where there are positive serologies
with otherwise normal biopsies. These patients have increased gamma
delta T cell receptor lymphocytes. 25% develop histologic features of
CD at 5 years.
Treatment
---------
Life long adherence to a strict GF diet is mandatory. This includes
avoidance of all products made from grains in the wheat family such as
wheat, rye, barley, triticale, and spelt. Pure oats have been shown
to be safe for periods up to 1 year. However, commercially available
oat products are typically grown in fields or milled in plants where
there is wheat contamination.
All food products must be constantly and carefully examined for the
presence of any "hidden glutens" which are often used as food
additives or in processing.
Adherence to the diet can be confusing and overwhelming, particularly
in the newly diagnosed patient. Patient support groups at the
national and particularly the local level have been invaluable in
helping these patients adjust to their restrictions.
Most patients achieve symptomatic improvement within 2-3 weeks of
beginning the diet. Histologic improvement occurs 4-6 months later.
If there is no improvement, it is usually because of noncompliance to
the diet although other causes include refractory sprue, collagenous
sprue, and small bowel lymphoma.
There is often a "honeymoon" period during the teen years when celiac
patients who ingest gluten may be relatively symptom-free. However,
the disease does NOT disappear and their symptoms typically recur in
their twenties.
Post-Diagnosis Management
-------------------------
While most patients will improve with careful attention to the diet,
it is still advisable to obtain an annual CBC, biochemical panel, iron
levels, B12, folic acid, and vitamin D-250H.
A one-year post-treatment biopsy is important in establishing a new
baseline as all patients do not heal completely in spite of strict
adherence to the diet.
Bone densitometry at the time of diagnosis and periodically thereafter
is important particularly in female patients.
Celiac antibodies may be helpful in monitoring some patients,
particularly those in whom noncompliance with the diet is suspected.
Q & A
-----
Q: Is there any connection between arthritis and CD?
A: I don't know of any even though arthritis is sometimes the only
presentation.
Q: If a patient has positive blood tests but a normal biopsy, do they
have CD?
A: This may describe latent CD. Symptoms alone will not tell if CD
is present. Testing must be done for a certain type of
lymphocyte. Within 5 years a typical CD biopsy may develop.
Q: Does a negative blood test always mean no CD?
A: No. Family history and symptoms consistent with CD are also
factors in determining if a biopsy is necessary.
Q: If all tests for CD are negative but a patient has CD symptoms and
a family history of CD, should they have a biopsy?
A: Absolutely yes.
Q: If one has anemia, negative blood tests, but a flat small
intestine biopsy, is there a possibility of mixed up test samples
and is a second opinion necessary or does one have CD?
A: Mixed-up blood test samples is not the problem here. If you see
the disease in the biopsy, you have it. If you don't see it, you
don't have it. A second opinion in this case is unnecessary.
Q: What does one look for to diagnose CD in young children?
A: The most common presentations in young children are diarrhea
and/or a drop in the growth curve.
Q: What does one look for to diagnose CD if there are no symptoms?
A: Blood tests such as gliadin, endomysial, and tissue
transglutaminase antibodies are the first clinical tests. If
there is any suspicion from these tests or from other symptoms,
then the biopsy should be done.
Q: A patient was diagnosed 7 years ago and has been OK on the GF diet
until about 3 months ago when bloating, diarrhea and other
symptoms started appearing. Why?
A: Several things are possible. First, it need not be CD. There are
various other diseases that have similar symptoms such as spastic
or irritable bowel which would require other treatment. There may
be inadvertent gluten ingestion or the CD could have progressed to
the refractory stage where it doesn't respond to treatment in
which case a new biopsy would be required. Or lymphocytic colitis
could be a possibility to consider.
Q: A patient was recently diagnosed with CD but the follow-up biopsy
showed no change. Why?
A: It may take time for any improvement to show. The patient usually
requires about 3 or 4 months to figure out the diet and then the
body requires another several months to heal. The European
practice is to re-biopsy in 3 to 6 months but I consider that too
soon. It might be valid if the symptoms are very minor.
Q: What about vitamin and mineral supplements?
A: Take a standard "One-A-Day" type of vitamin. Vitamins are
important, you have been deficient in them for a long time, and
the one-a-day variety can't hurt. B12 deficiency, for example,
can cause a nerve deficiency. The megavitamin regime- NO! But
the regular one-a-day, yes.
Q: After the initial diagnosis of CD and being placed on the GF diet,
what follow-up should be done?
A: Each year there should be a physical exam and blood tests. (This
would be prudent even if the patient has no symptoms.) At the
initial diagnosis a bone density test should be taken. Depending
upon the age, sex (women should be tested more often) and symptoms
of the patient, bone density tests should be taken probably every
5 to 15 years. After the first year there should be a follow-up
biopsy.
Q: Should blood tests be used with children for follow-up?
A: Blood tests could be used for every patient. They are helpful for
monitoring purposes. They can check for inadvertent gluten in
children and/or adults.
Q: Does CD cause headaches and migraines?
A: The symptoms are listed but the connection is not known. If one
is diagnosed with CD and the headaches still persist, look for
another cause.
Q: How does all this apply to dermatitis herpetiformis (DH)?
A: DH is a very itchy skin condition usually found symmetrically on
the body extensions, elbows, buttocks, etc. 90% of DH patients
also have CD but many have no gastrointestinal symptoms. When DH
patients are put on a GF diet, the majority respond. For DH
patients it is recommended that they be tested for CD and usually
they should have a biopsy too.
NOTE: A member suggested that a change to 100% cotton sheets, no
polyester, helped her skin irritation problems.
Q: How is the absorption of medications, and in particular thyroid,
affected by CD?
A: Untreated or newly-diagnosed celiac patients can have problems
with drugs. The absorptive capacity is severely restricted
because drugs are processed into the body via enzymes on the tips
of the villi.
Q: Why isn't the medical profession more aware of CD?
A: The history of CD is one of a slow learning process. It wasn't
until after World War II that a connection was made between the
disease and wheat. Then the gluten portion of wheat was found to
be the problem for celiacs, and finally the gliadin portion in
wheat gluten. In the last 5 years, the publication of information
in journals has just exploded. Doctors are now checking for the
disease earlier, they are recognizing that it doesn't have to be
accompanied by diarrhea and weight loss. Each celiac can help the
learning process by providing information to their own personal
doctor.
Q: What about a partial GF diet?
A: It is not good and is definitely NOT recommended. The lower
limits of tolerable gluten intake are not known. If cancer
develops, it is extremely difficult to treat.
Q: Are there different standards for the GF diet?
A: Yes. In the United States, we espouse a zero tolerance standard.
In England, for example, they allow wheat starch. A celiac must
read labels and be aware of the differences between countries when
using imported products.
Q: Is alcohol OK?
A: There is no one answer. Alcohol is simply an OH radical at the
end of a chemical name. If you are referring to alcoholic drinks,
then wine, potato vodka, tequila, and rum would generally be
acceptable. Wine coolers are generally not acceptable because
malt is usually added to them.
If you are referring to a pharmaceutical, you would need to talk
to the company. If you are talking about distilled alcohol with a
food chemist, then the answer would be that gluten can't transfer
through the distillation process even though gliadin is the
alcohol-soluble portion of the gluten molecule.
[Editor's note: Distillation involves evaporating the liquid,
capturing the vapor it forms, and then allowing the vapor to
condense back into a liquid in another container. Any impurities
in the liquid are left behind, unless these impurities evaporate
as well. Gliadin is a protein, and proteins don't evaporate.
Therefore, the process of distilling alcohol or vinegar should
remove any gluten proteins from the liquid. In theory, the only
way you could still have gliadin in distilled alcohol or vinegar
is if there is some environmental cross contamination between the
original gluten grains and the distilled end product.]
Q: How does one handle the diet in a hospital?
A: You must be very emphatic. This is your health that is in danger.
NOTE: Ron De Cicco, who spent time in the hospital for knee
replacement surgery (see "Total Knee Replacement", _The Sprue-nik
Press_, April 1997, pg. 3), stated that you should get the doctor
to write it on the orders. Then it must be followed; you have
your doctor's orders to point to if it isn't.
Q: After a patient has been on the GF diet for a long time, what are
the results of inadvertent intake of gluten?
A: There is no answer. The longer one is on the GF diet, usually the
better control of the diet one has. However, individual responses
to inadvertent gluten intake are just that, individual.
Q: Is there any correlation between an allergic reaction to sulfites
in wine and CD?
A: No. Allergic reactions and celiac reactions are caused by two
different mechanisms in the body.
Q: What is the time lag between ingesting gluten and having a gluten
reaction?
A: It can vary anywhere from almost immediate to taking years.
Everybody is different, but usually an individual will react
within 24 hours.
Q: Are oats, buckwheat, and millet OK?
A: Oats are not recommended because of the high probability of
cross-contamination in the products commercially available to
celiacs. The one study done on oats was conducted for only one
year and was done with specially-grown and handled pure
oats-something not commercially available in the United States.
Buckwheat and millet are not a problem themselves, but again, you
may have trouble finding a source that does not have
cross-contamination issues.
Return to the Table of Contents
References
----------
<1> "JACHO", by Greta De Wolf, from the CELIAC Listserv archives on
the Internet, posted Feb. 6, 1999. To obtain a copy on the
internet, go to
http://maelstrom.stjohns.edu/archives/celiac.html and click on
"February 1999, week 1."
<2> "cookie recipe web site", by Marian Narodowiec, from the CELIAC
Listserv archives on the Internet, posted June 9, 1998. To obtain
a copy on the internet, go to
http://maelstrom.stjohns.edu/archives/celiac.html and click on
"June 1998, week 2."
<3> "Brown Rice: Well Worth the Wait", Christine Negm, nutritionist,
_Lundberg Rice Paper_, vol. 9, no. 1
<4> _Cooperative Gluten-Free Commercial Products Listing_, edited by
Leon H. Rottmann, CSA/USA, printed Jan. 1995, pgs. 2-3.
Return to the Table of Contents
Recipe Page
-----3-----
**********************************************************************
Apple Bavarian Torte
Crust:
1 cup GF flour mix**
1/3 cup sugar
1/2 tsp. GF vanilla
1/2 cup butter
Preheat the oven to 350 degrees F.
Combine the flour, sugar, and vanilla. Cut in the butter until the
mixture looks like coarse meal. Press the mixture into the bottom and
sides of a 10" springform pan. Bake until golden, about 5 minutes.
Cool to room temperature.
Filling:
2 8-oz. pkgs. GF cream cheese, room temperature
1/2 cup sugar
1 tsp. GF vanilla
2 eggs, room temperature
Beat the cream cheese, sugar, and vanilla with a mixer until smooth.
Beat in the eggs. Spoon the mixture into the crust.
Topping:
2 large tart apples, peeled, cored, and thinly sliced
1/4 cup sugar
1/2 tsp. cinnamon
1/2 tsp. GF vanilla
Preheat the oven to 425-450 degrees F.
Mix the apples, sugar, cinnamon, and vanilla. Spoon the mixture over
the cream cheese layer, spreading it evenly. Bake 15 minutes. Reduce
the temperature to 350 degrees F and bake another 45 minutes, or until
the tester comes out clean.
This recipe comes to us from Julie Trescott.
**********************************************************************
High on the Hog Ham Bone Stew
1 ham bone
6 cups water
4 medium potatoes, diced
2 cups chopped cabbage
1 lb. frozen corn
1 large onion, diced
salt and pepper to taste
Don't throw away the ham bone after your Easter meal. You can cook it
with beans or you can make this tasty stew.
In a large pan, bring the water to a boil. Add in the salt, pepper,
and ham bone. Reduce heat to a slow simmer. Cook the ham bone for
several hours, until the meat comes off the bone. Add the vegetables.
You may need to add additional water during cooking. You can thicken
the broth with rice flour or cornstarch if desired.
This recipe comes to us from Bruce Richardson, chef of St. Charles
Seminary in Wynnewood, Pennsylvania.
**********************************************************************
Party Mix
6 Tbsp. butter
2 Tbsp. GF worchestershire sauce
1 tsp. salt
1/4 tsp. garlic powder
1/2 tsp. onion powder
2 cups popped popcorn
2 cups Health Valley Rice Crunch 'Ems cereal
1 cup peanuts
1 cup Dietary Specialties GF pretzels
Melt the butter. Add the seasonings. Add the other ingredients,
stirring well to coat. Microwave the mixture 4-6 minutes on High,
stirring every 2 minutes. Spread the mixture on paper towels to cool.
Store in an airtight container.
This recipe came from a recent meeting. If the author will identify
him/herself, I'll give credit in a future issue of the newsletter.
**********************************************************************
Fig Honey Cookies
1 cup dried figs
3/4 cup sugar
1/2 cup shortening
1/2 cup honey
2 eggs, well-beaten
2 Tbsp. milk
2-3/4 cups GF flour mix**
1 tsp. xanthan gum
3 Tbsp. GF baking powder
1/2 tsp. salt
1/2 cup coconut
1 tsp. GF lemon or vanilla flavoring
3 Tbsp. chopped orange rind
Cover the figs with cold water, simmer 10 minutes, and drain. Cut the
figs into pieces.
Cream the sugar and shortening together. Add in the honey, eggs, and
milk, and mix thoroughly. Sift together the flour, xanthan gum,
baking powder, and salt. Add the flour mixture to the
sugar/shortening mixture. Add in the figs, coconut, and flavoring.
Add in the orange rind and mix thoroughly.
Drop by the teaspoonful onto an oiled baking sheet. Bake at 375
degrees F for 12-15 minutes.
This recipe came from a recent meeting. If the author will identify
him/herself, I'll give credit in a future issue of the newsletter.
**********************************************************************
Cherry Jello Dessert
Jello:
1 large package of GF cherry-flavored gelatin mix
2 cups boiling water
1 can GF cherry pie filling
Dissolve the gelatin mix in the water. Add the cherry pie filling.
Place the mixture in the refrigerator until firm (about 40 minutes).
Topping:
1 8-oz. container of Cool Whip
1 8-oz. pkg. GF cream cheese
1/4 cup sugar
Beat the Cool Whip, cream cheese, and sugar together. Spread the
mixture on top of the chilled gelatin mixture. Chill until firm.
This recipe comes to us from Beth Coderre.
**********************************************************************
** 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:
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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: Pam Murphy
Newsletter Editor: Jim Lyles
Contributing Editors: Tom & Carolyn Sullivan
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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