August 2013 - Canadian Celiac Association

Transcription

August 2013
Volume 1 Issue 126
Charitable Registration #
CCA -VC 855544896 RR0001
CCA 119218766RR001
August 2013 ~ Vancouver Celiac News
Canadian Celiac Association
1
L’Association canadienne de la maladie coeliaque
2013 Board of Directors
President
Lorraine Didrikson
Vice President - Vacant
Treasurer
Val Vaartnou
Membership Director
Lorraine Didrikson
Secretary
Darien Cope
Website
Val Vaartnou
CONTENTS:
Email: [email protected]
Page:
3
14
24
28
36
39
President’s Message
Celiac in the Kitchen
Kids Corner
Odds & Ends
Schedule of Events
Calendar of Events
NEXT ISSUE:
If you have any recipes, restaurant reviews/articles
for the October issue, please have them submitted
by September 15, 2013.
Communications
Facebook / Twitter / Yahoo
Vacant
If you have any comments, praises or criticisms,
quips or questions, please send them in (see
below).
Member at Large - Vacant
Newsletter Contributors
Please submit to:
Newsletter Editor- Lorraine Didrikson
Publication Design - Diane Lee
CCA Mission Statement:
The Canadian Celiac Association is the national voice
for people who are adversely affected by gluten, and is
dedicated to improving diagnosis and quality of life.
°
[email protected]
°
604-736-2229 / 877-736-2240
°
CCA - Vancouver Chapter
Letters to the Editor
360-1385 West 8th, Vancouver, BC V6H 3V9
CCA Vision Statement:
The gluten problem: Found. Treated. Cured.
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NEWSLETTER SUBMISSION DEADLINES
The Vancouver Celiac News will now be distributed 6 times per year.
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June 1st - Travel & Summer
August 1st - BBQs & Back to School
October 1st - Halloween & Thanksgiving
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December 1st - Christmas & Holidays
February 1st - Valentine’s Day
April 1st - Easter & Mother’s Day
Please submit your content to us a minimum of 3 weekends prior to the edition you’d like to be featured in. We will also accept early submissions for
upcoming editions as well, just let us know which issue you’d like to be in. You can submit your stories, recipes, photos, etc. in a variety of ways,
and if you have any questions: EMAIL: [email protected] or [email protected]
DISCLAIMER AND EXCLUSION OF LIABILITY:
The contents of this publication, provided in good faith for information purposes only and in using the most current information available subject to
amendment, should not be used as a substitute for the advice of a qualified health professional. The Professional Advisory Board of the Canadian
Celiac Association (the “CCA”) has not reviewed this publication. Use of the information in this publication is at your own risk. The CCA does not
endorse any product referenced in this publication. To the fullest extent permitted by law, the CCA its local Chapters, and all persons involved in
compiling this publication disclaim any responsibility for, and make no representations or warranties regarding the information provided in this
publication. In no event will the CCA, its Chapters, or those persons involved in compiling this newsletter be liable for any damages of any kind
resulting from the use of the information in this publication. Please review the CCA’s disclaimer policy on its website at http://www.celiac.ca/.
2
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Summer, yes, thought we would never see it. All this beautiful weather just encourages the growth and
flavor of the fresh berries and vegetables available during this season. The Farmers Markets are in full
swing. Summer holidays are upon us, so have fun and be safe.
Mississauga, Ontario did a good job on the National CCA Conference. As I said the weather was nasty but
we all survived and enjoyed the stay. Thank you to Marilyn Mahnke and the Halton Peel Chapter for hosting
the conference. Thank you to all those volunteers who worked behind the scene and you never got to see
them. You did a great job, THANK YOU.
Congratulation to Ann Wraggett of Victoria who is now our New President of the CCA National Board.
NEWS Flash – Tim Horton's now has gluten free chocolate macaroons.
http://www.newswire.ca/en/story/1196719/tim-hortons-introduces-first-certified-gluten-free-menu-item
Family Physicians Conference - June 8 - 9, 2013. Thank you to Val Vaartnou and the volunteers who
helped her (Mavis Friesen and Pauline Skipper).
Eat Fraser Valley October 4 - 6, 2013 at the Tradex in Abbotsford is having a Gluten Free Living Segment
for the first time at their show. We, the Chapter, are attending. We would like you to attend. If anyone is
interested in helping please email: [email protected] or [email protected]
This is a 2 ½ day event, so we will need a few volunteers. www.gluten-freeliving.ca
Members Event - October 27th, 2013 at the Royal City Mall (Community Room) – Speaker Dr. Jean Layton
will make a return engagement. Mark your calendar.
Membership Dues: Thank you to all who have paid their dues. Many have not and we do not want to see
you leave and we will miss you. Please renew. Donations to the Vancouver Chapter are appreciated. Val
will only be too happy to issue you a tax receipt.
Newsletter – Many of the Chapters that publish a newsletter are trying to go completely green. As you know
the cost of sending out a hardcopy is becoming more expensive and the Chapter does not receive enough
from National to cover the operation of the office and put out 6 issues of the newsletter. We are hoping by
the fall of 2014 we might be able to go completely green with your help. Please think about providing us
with an email address. Thank you.
Toronto – I did take some extra days to do some visiting. On my list was to visit a restaurant called Aprepa
Cafe at 490 Queens Street West. This is a Venezuelan restaurant that has many GF options
(www.arepacafe.ca ). My travels to Brantford found a dedicated GF bakery called Sophia’s Bakery & Cafe
at 60 Colborne Street (www.sophiasbkery.ca). Nates Bagels & Gluten Free Foods, 60 Rayette Road #12,
Concord. Ontario. You must try the products. This is the closest I have seen anything look and taste like
European baked goods (www.natesbagels.com). Their Facebook page shows you the pictures of their
breads. They really do look like that and taste good. Shipments to Vancouver would cost around $400 for a
$300 order of product. Just a little expensive!
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3
4
Regional Director’s Report
Submitted by Kathleen Shoemaker
National Office Staff has changed from 4 positions to 3 ½, as well as personnel changes.
Phone: 905-507-6208 Toll Free: 1-800-363-7296 Fax: 905-507-4673
Facebook: canadianceliacassociation
Twitter: @CCAceliac
Governance: The Federal government’s new “Not for Profit Act” comes into force in October 2014. The interim Bylaws are in place
and are expected to be completed by the National Conference next year. The role of Regional Directors will be replaced by a Council
of Presidents. Bill Shank will work with the current Presidents to organize and co-ordinate the group.
Direct Communication to Members – The Awareness Committee proposed a brief monthly report be produced from National to the
membership to keep everyone informed of operational updates on work at CCA National.
Online Modular Educational Program is in the developmental stages for a food handler’s module.
Treasurer’s Report – The Board continues to pay serious attention to finances and has assigned a special committee to focus on
future financial goals. Cost cutting efforts have shown results. A report will follow.
Fundraising – Chapters are encouraged to make plans in September for next May’s Celiac Awareness Month 2014. Green Shields
Funding Program – we received a $25,000 grant. The CCA also received a $10,000 grant as seed money for the purpose of
broadening sources of income. Therefore a temporary contract for someone with experience in soliciting funds from corporate
sponsors will be hired.
Gluten free Certification Program - Currently 15 companies are certified. Check the CCA website: www.celaic.ca The CCA holds
the proprietary ownership of the GFCP trade-marks, ACG will be solely responsible for the administration and management of the
Program
New National Board Members Volunteers as of July 1st, 2013
Past President: Brian Benwell
President: Anne Wraggett
Executive Vice President: Bill Shank
Treasurer: Leo Turner
Secretary: Mark Johnson
Regional Director for BC: Kathleen Shoemaker
Regional Director for Alberta: Carolanne Nelson
Members at Large: Lori Alexander and Serge Buy
National Conference 2014
Host – Calgary
May 30 – June 1, 2014
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Dermatitis Herpetiformis
Dermatitis Herpetiformis (DH) a skin manifestation of celiac
disease. It is an intense itching, burning sensation of a
cluster of small blisters that persistently break out on the
elbows, knees, buttocks, back or scalp. DH affects 15 to
25 percent of people with celiac. Disease and these people
typically have no digestive symptom of the disease.
One such person is Rory Jones. Although plagued with
celiac-related ailments including joint pain, thyroid disease,
and early-onset osteoporosis, she never experienced
intestinal symptoms and had no idea she had celiac
disease. Then came the increasingly frequent appearance
of itchy sores on her hands, which eventually spread to her
face and arms. “The itching would wake me up at night”,
said Jones, who sometimes bled from scratching in her
sleep. “I wanted to scratch my bones”.
Dermatologists, allergists, and other specialists couldn’t
determine the cause of her skin outbreaks and other
symptoms. Another 4 years passed before she was
diagnosed with DH and celiac disease.
Celiac and the Skin
How does a disorder that damages the intestines show up
on the skin? When a person with celiac disease consumes
gluten, the mucosal immune system in the intestine
responds by producing a type of antibody called
immunoglobulin A (IgA), explains John Zone, M.D.,
Chairman of the Department of Dermatology at the
University of Utah School of Medicine. As IgA enters the
bloodstream, it can collect in small blood vessels under the
skin, triggering further immune reactions that result in the
blistering rash of DH.
Telltale Signs
The first clue that a skin eruption may be DH is that “it
itches like crazy” said Zone. “People are digging at
themselves”. As a result, the blisters are almost always
broken open by the time a DH sufferer seeks medical help.
The second characteristic sign of DH is its location on the
body. Lesions most often appear on the extensor
surfaces—the forearms near the elbows, the knees, and
the buttocks. The outbreak of lesions also tends to be
bilateral, meaning it appears on both sides of the body.
The grouping of the lesions provides a final clue. Although
DH is not caused by the herpes virus, its lesions resemble
those of herpes, hence the word “herpetiformis”. In both
conditions, lesions form in small groups.
Still, DH is often confused with eczema, a common
inflammatory skin disorder that, like DH, results in an itchy
rash that is often scratched raw.
A Selective Disorder
DH can affect people of all ages but most often appears for
the first time between the ages of 30 and 40. People of
northern European descent are more likely than those of
African or Asian heritage to develop DH. The condition is
somewhat more common in men than women. And men
are more likely to have atypical oral or genital lesions.
The unusual outbreaks of DH on Rory Hones’ forehead and
eyelids may have led her dermatologists down the wrong
path.
Diagnosing DH
For Jones, the diagnosis of DH came about in an
unexpected way. An endocrinologist became suspicious of
the unusual severity and early onset of her osteoporosis.
In an effort to find a cause, her doctor sent a blood sample
to Peter Green, M.D., Director of the Celiac Disease Center
at Columbia University, who was conducting a random
screening for celiac disease in osteoporosis patients.
Jones tested positive for the presence of antibodies that
often indicate the presence of celiac disease and was
scheduled to undergo an endoscopy to confirm the
diagnosis. “At the hospital, while Dr. Green explained the
procedure, he saw me scratching my hands and face”, said
Jones. Green suggested she have a skin biopsy for DH.
The endoscopy results were inconclusive but the skin
biopsy was not. She had DH—and an answer to the
source of her bone, joint and thyroid problems.
A skin biopsy is the key tool in confirming a diagnosis of
DH. Doctors take a skin sample from the area next to a
lesion and, using a fluorescent dye that highlights
antibodies, look for the presence of IgA deposits. Skin biopsies of people with DH are almost always positive for IgA.
Blood tests for other antibodies commonly found in people
with celiac disease—antiendomysial and anti-tissue
transglutaminase antibodies—supplement the diagnostic
process. If the antibody tests are positive and the skin biopsy has the typical findings of DH, patients do not need an
intestinal biopsy to confirm the diagnosis of celiac disease.
Treatment
The rashes caused by DH can be controlled with antibiotics
such as dapsone. “What’s most interesting about DH is
that the rash itself responds dramatically to dapsone,
usually in 48 to 72 hours”, said Zone. This dramatic
response—another hallmark of the disease—was once the
basis for diagnosis, before skin biopsies became the norm.
People who can’t tolerate dapsone may be give
sulfapyridine or sulfamethoxypyridazine instead, although
these drugs are less effective.
A strict gluten free diet is the only treatment for the
underlying celiac disease. Even with a gluten-free diet,
dapsone or sulfapyridine therapy may need to be continued
for 1-2 years to prevent further DH outbreaks. For people
like Jones, who elected not to use dapsone, relief comes
gradually as the diet does its job.
Jones’ circuitous path to a diagnosis is a common one for
people with celiac disease. According to Zone, more than
95 percent of DH cases are misdiagnosed as eczema.
Thankfully, once diagnosed, relief for most people with DH
will come through treatment and strict adherence to a
gluten-free diet. www.celiac.nih.gov/articlearchives.aspx.
All of the articles are copyright-free and can be reproduced
for newsletters, websites, and other educational purposes.
Page last updated February 14, 2013.
6
Welcome New Members
Darlene Burritt
Leah Bettger
Dragana Vasic
Help Us Keep Up To Date!
The Canadian Celiac Association website has a new "Member Log-in" feature where members can update their contact
information, renew their membership, purchase items through the online store, and much more! Go to the Canadian
Celiac Association's website at www.celiac.ca and click on the "Member Log-in" link. You will be asked to create a user
ID and password that will allow you to access your membership account.
Members are encouraged to use this function to keep their contact information up-to-date to ensure they get newsletters,
food alerts and other important information that the Chapter sends out.
Membership Report
Membership has its Benefits
We need your support. We value your membership.
If you have received your renewal from National, we encourage you to renew your membership.
You can renew it on line at www.celiac.ca Call the National Office at 1-800-363-7296
By mail: 5025 Orbitor Dr., Bldg. 1 – Suite 400, Mississauga, ON L4W 4Y5
Renewal fee is $50.
New Membership is $65 which includes a new member package.
Your membership helps support our National Office (3 National Celiac News),
Brings Celiac Awareness to all Communities, and helps run the Chapter Offices.
The portion the chapters receive helps to provide local celiac awareness, attend various Trade Shows,
organize member’s events and publish 6 yearly chapter newsletters.
If you have any questions about your membership please email:
Lorraine Didrikson, [email protected] or call our National Office at 1-800-363-7296
NOT A MEMBER? WANT TO SUBSCRIBE TO THE NEWSLETTER?
If you are not a member but would like to subscribe to our newsletter:
Current newsletters can be purchased at $5/copy or a 6 copies subscription for $25.00
(annual subscription as newsletters are created bi-monthly).
Copies will only be sent via email. Send your request for copies to our office:
Canadian Celiac Association - Vancouver Chapter
360 - 1385 8th Avenue, Vancouver, BC V6H 3V9
Please make cheques payable to the Canadian Celiac Association - Vancouver Chapter and provide:
Email address that the copies should be sent to
Identify the month/year of the newsletter that you would like a copy of
or state when you would like your subscription to start, if you wish an annual subscription.
7
Canadian Celiac Association National Conference
Submitted by Lorraine Didrikson
The 2013 National Canadian Celiac Association Conference “Envision.....The Gluten Problem: Found. Treated. Cured” was held on
June 7 - 9, 2013 at the International Centre, Mississauga, Ontario. The weather was cold, windy and raining. Shuttle buses
transported us daily from the Holiday Inn to the International Centre. Approximately 200 registered attendees, 66 gluten free
exhibitors and 10 special guests. The Trade Show was open to the public on Saturday. Friday evening was a Welcome Reception
and a time to visit with attendees and vendors to sample and purchase products. Saturday the Gala Evening was a Hawaiian Luau
with entertainment by the Hula San Village Dance Troupe. It was an evening to be enjoyed by all who attended. A very well planned
children’s program. Thank You.
The Speakers at the conference were:
Dr. Stefano Guandalini
Dr. Connie Switzer
Dr. Don Duerksen
Dr. Mohsin Rashid
Shirley Braden
Shelley Case RD
Jackie Gates RD
Alexandra Anca RD
Dr. Elena Verdu
Dr. Valentina Discepolo
Sue Newell has done a very good job summarizing the Conference. Full report is on the National website at www.celiac.ca
http://www.celiac.ca/index.php/cca-national-conference-wrap-up/ A Pdf is available for download and covers topics: Celiac Disease
and Gluten Sensitivity by Dr. Stefano Guandalini;” Celiac Disease Through the Kaleidoscope” by Dr. Connie Switzer, Dr. Don
Duerksen & Dr. Moshin Rashid; Emotions in Motion-Psychosocial Challenges of Gluten Problem by Shirley Braden; Beyond the
Gluten Free Diet: Searching for Other Treatments and Advancing our Understanding of Celiac Disease to Lead to a Cure and more.
Gluten Free Expo had 66 vendors exhibiting their products and services. Saturday, June 8, 2013 was open to the public and was well
attended. I went in around 11am at a break time. There were too many people for me. Some of the vendors were sold out of product
by then. It was good to see many local vendors, products we could not get in BC. If visiting Ontario, you may want to keep an eye
open for them.
List of Vendors:
Coco Mira
All But Gluten
Tag Vodka
O’Dough’s
PatsyPie
GlutenFreeFine.com
Voila! Gluten-Free Bakeree
Gluten-Free Ontario
Glutenfree Garage
Cream Hill Estates
Antipastos Kitchen
Nates Gluten Free Foods
Glutenpro
GAGA for Gluten-Free
U-Be-Livin-smart
Organic Works
Green Beaver
Marc Angelo
Nutri Health
Avena Foods (Only Oats)
El Peto Products
P.F. Chang’s
Super Squeezies
Celiac Choice
Allergic Solution
2Go Energy
Aidan’s Gluten Free Inc
Alexandra Anca
Arbonne International
Bakery on Main
Back 2 the Garden Inc.
Bix Bakery
Boreal Berry Bar Inc.
CheeCha Pufffs
Canbrands Speciality Foods Inc.
Celebrity Cruises
Crossing Cultures Cuisine
Dendy & Co
Enerjive Inc.
Epicure Selections
Expedia CruiseShip Centers
Gluten Tox
Goodbye Gluten
Healthful Organics International
Holy Crap
Hot Mamas Foods Inc.
Jamestown Mills
Kinnikinnick Foods
Jody Leigh for Gluten-free
La Maison Cannelle ans Gluten Inc.
Molly B’s Gluten Free Kitchen
Natura
Newton’s No Gluten
Organic Oven
Original Kettlecorn
Protein Bake
Queen B Pastry Inc.
Rizopia
Sunrise Soy Foods
Sweet Temptations Cupcakery
Tia’s Bakery
Tootsi Impex Inc. – Elan product
Udis
Gluten Free & Glutino
Victoria’s Gluten Free Bistro
Wellness Foods
Winnie’s Gluten free Foods
Wrap It Up-Raw
Bob &Ruth’s Gluten-Free Dinning &
Travel
JK Gourmet
8
Conference - continued
New Organic GF Beer Brunehaut was introduced
at the Conference Banquet .
http://www.glutenfreebeer.org/gluten-free-beerreview-brunehaut-gold-medal-winner-amber-ale/
The Youth Program – “Surviving Gluten Free” was
two full days of fun, activities and gluten free food
for the Kids. They played in the pool, had a pizza
party, GF cooking program and good memories and
friendships. Great Job.
NEXT YEAR THE CANADIAN
CELIAC ASSOCIATION
CONFERENCE IS
MAY 30 - JUNE 1, 2014.
CALGARY, ALBERTA WILL BE
HOSTING
“THE CELIAC STOMP”
AT THE
TELUS CONVENTION
CENTER.
9
10
Dental Enamel Defects and Celiac Disease
Celiac disease manifestations can extend beyond the classic gastrointestinal
problems, affecting any organ or body system. One manifestation—dental
enamel defects—can help dentists and other health care providers identify
people who may have celiac disease and refer them to a gastroenterologist.
Ironically, for some people with celiac disease, a dental visit, rather than a trip
to the gastroenterologist, was the first step toward discovering their illness.
Not all dental enamel defects are caused by celiac disease, although the
problem is fairly common among people with the condition, particularly
children, according to Alessio Fasano, M.D., medical director at the University of Maryland Center for Celiac
Research. And dental enamel defects might be the only presenting manifestations of celiac disease.
Dental enamel problems stemming from celiac disease involve permanent dentition and include tooth
discoloration—white, yellow, or brown spots on the teeth—poor enamel formation, pitting or banding of teeth,
and mottled or translucent-looking teeth. The imperfections are symmetrical and often appear on the incisors
and molars.
Tooth defects resulting from celiac disease are permanent and do not improve after adopting a gluten-free
diet—the primary treatment for celiac disease. But dentists may use bonding, veneers, and other cosmetic
solutions to cover dental enamel defects in older children and adults.
Similar Symptoms, Different Problem
Tooth defects that result from celiac disease may resemble those caused by too much fluoride or a maternal
or early childhood illness.
“Dentists mostly say it’s from fluoride, that the mother took tetracycline, or that there was an illness early on,”
said Peter H.R. Green, M.D., director of the Celiac Disease Center at Columbia University. “Celiac disease
isn’t on the radar screen of dentists in this country. Dentists should be made aware of these manifestations to
help them identify people and get them to see their doctors so they can exclude celiac disease.”
Green just completed a U.S. study with his dental colleague, Ted Malahias, D.D.S., that demonstrates celiac
disease is highly associated with dental enamel defects in childhood - most likely due to the onset of celiac
disease during enamel formation. The study, which did not identify a similar association in adults, concluded
that all physician education about celiac disease should include information about the significance of dental
enamel defects.
Other Oral Symptoms
Checking a patient’s mouth is something primary care physicians also can do
to help identify people who might have celiac disease. While dental enamel
defects are the most prominent, a number of other oral problems are related
to celiac disease, according to Green. These include recurrent aphthous
stomatitis or canker sores or ulcers that recur inside the mouth atrophic
glossitis, a condition characterized by a red, smooth, shiny tongue dry mouth
syndrome squamous cell carcinoma—a type of cancer—of the pharynx and
mouth.
Additional feature articles about celiac disease are available at the National
Institutes of Health Celiac Disease Awareness Campaign (CDAC) website,
www.celiac.nih.gov/articlearchives.aspx. All of the articles are copyright-free
and can be reproduced for newsletters, websites, and other educational
purposes. (Source: GIG of North Texas Communicator)
11
Yogurts – Are they gluten free?
Submitted by Val Vaartnou
As we know, not all yogurts are gluten free!
Plain yogurt is made with milk that's been fermented with friendly
bacteria until it thickens and develops a tangy taste. In its pure form,
yogurt is gluten-free, and you can enjoy it on a gluten-free diet as long
as you are not lactose intolerant. Many celiac’s are sensitive to milk
products. Flavorings and sweeteners used in commercially available
yogurt are not always gluten free.
Darien Cope contacted a few yogurt companies and the following
were their responses. Good news for yogurt fans!
Response from: IÖGO (Reference no. CAS-19675-R3W7)
CRM:0008333
France Ainsley, a Consumer Service Agent for IOGO responded: “Please be advised that we carefully analyze all of our
ingredients (presence of wheat, rye, barley, triticale, spelt, oats and malt) and can assure you that all iögo products are
gluten-free. Therefore, they can be safely consumed by people who suffer from celiac disease.”
Darien also contacted Astro and was advised that “none of the Astro yogurts were safe.”
Response from: Parmalat Canada # 272544
“In response to your inquiry, at this time we cannot confirm if any other products than the ones listed below can or
cannot be declared as gluten free as we are awaiting a response from our suppliers, which in turn are awaiting a
response from their suppliers. This is a lengthy and complex process and unfortunately we do not know when we will
have an answer. Therefore we do not recommend consuming any other products if you are allergic to gluten.
The gluten-free list:
•
Beatrice Skimmed Milk
•
Beatrice 1% Partly Skimmed Milk
•
Beatrice 2% Partly Skimmed Milk
•
Beatrice Homogenized Milk
•
Lactantia Pur Filtre Skimmed Milk
•
Lactantia Pur Filtre 1% Partly Skimmed Milk
•
Lactantia Pur Filtre 2% Partly Skimmed Milk
•
Lactantia Pur Filtre Homogenized Milk
•
Sensational Soy Beverages
•
Sensational Soy Smoothies”
Jane Anderson, on about.com’s Celiac Disease site, says the company making Dannon yogurt does not consider its
products to be gluten-free, since "the natural system for stabilizing flavor might contain ingredients derived from gluten
sources." The same statement applies to Oikos Greek yogurt, since it's made by Dannon.
Likewise, she indicates that Yoplait yogurt, part of General Mills, features an extensive gluten-free list on the General
Mills site http://www.livebetteramerica.com/health/gluten-free/articles/gluten-free-resources
A spokesperson said the gluten-free list includes most — but not all — Yoplait products. Notably, the gluten-free parfaits
with granola are not gluten-free (they contain regular oats and barley malt). Yoplait products are tested to 20 parts per
million. If you have kids, GoGurt and Trix both are Yoplait products, and there are many of both on the GlutenFreely
gluten-free list.
12
Namaste Foods is doing a test run with the
Northwest Region Costco Stores (Washington,
Oregon and Coeur d’Alene, ID) with the Perfect
Flour Blend in 5 lb re-sealable bags. Namaste is in
competition with another gluten free company.
Whichever company sells the most during the trial
period will have their product brought in on a
permanent basis. The goal is to have the product in
all the stores in the USA and Canada but it is up to
Costco and each region has their own separate
buyers. We need you to buy the product from the
Bellingham Costco when in the area and this will
show the store there is a demand for this GF
Product. Namaste would like you to write to their
Facebook page if you see their product in your local
stores. www.namastefoods.com
The flour blend ingredients are: sweet brown rice
flour, tapioca flour, arrowroot flour, sorghum flour
and xanthan gum. The product does not contain any
wheat, gluten, soy, corn, potato, dairy, casein,
peanuts or tree nuts. It is non-GMO, all natural and
no preservatives.
13
Bucatini All'Amatriciana
There are photos of the steps on how to make it at an Italian
Directions:
site, ricette.giallozafferano.it/Spaghetti-all-Amatriciana.html as
1. Remove the hard rind and cut the pancetta into cubes or
well as how to make the basic tomato sauce. (Adapted from
strips, put it in a pan to fry with oil, and add the crushed
recipe at [email protected] )
red pepper.
2. As soon as the fat part of the pancetta becomes
transparent, pour the white wine in and let it evaporate.
When the wine has evaporated, drain and remove the
pancetta from the pan and set aside, keeping it warm.
3. Peel and chop the tomatoes and remove the seeds. Add
to the pan, cooking the sauce in the same sauce as the
pancetta. Cook the tomatoes until they come apart.
4. Meanwhile, cook spaghetti, drain and add directly into the
pan, add the pancetta, and toss a few seconds to blend
well.
5. Finish with freshly ground black pepper and a healthy
amount of grated pecorino cheese. (I chopped up some
Ingredients:
Italian parsley to top)
•
400 gr/ just under 1 lb. Spaghetti (we have several
Interesting facts: When Spaghetti Amatriciana was invented
brands but Costco has just brought out a new one made
from rice, corn, & quinoa called Giovanni Panzani made in in the region of Abruzzo, originally without the tomatoes, it
was the shepherds' main meal, "Gricia". Every year in the
Italy)
town of Amatrice in the province of Rieti, not too far from
•
1 chili pepper
Rome, the Spaghetti Amatriciana festival is held on the last
•
1 tablespoon extra virgin olive oil
weekend of August.
•
1 cup dry white wine
•
black pepper as you like
•
75 gr/3 oz pecorino cheese
•
350 gr/12 oz peeled tomatoes (you can use seeded
canned tomatoes)
•
100 gr/4 oz pancetta if you can't find guanciale
(unsmoked Italian bacon prepared from a pig’s jowl or
cheeks)
Picnics are great
ways to spend lazy
summer days with
family or friends. Go
to a beach. Go to a
park. Just get out and
enjoy the company
and the food!
14
Carnivale Caprese Salad
Posted on June 25, 2013 by Nick Church (http://www.plumdeluxe.com/
carnivale-caprese-salad#sthash.6MRqwQ4y.dpuf)
Directions:
1.
One of my favorite spring/summer time recipes is the basic
“caprese salad.” A little mozzarella cheese, heirloom tomato, and
large basil leaves, slap them together on a plate, throw on a little
bit of balsamic vinegar and run to the dining room table as quickly
as you can: it’s a delightful combination.
Recently, while planning dinner, I realized that I had some great
ingredients to add a little variety to my basic caprese recipe: I had
some tropical mangos and some avocado, I couldn’t think of
anything better, so, direct from the Plum Deluxe Kitchen, here’s
my Carnivale Caprese Salad.
Ingredients:
•
•
•
•
•
•
•
Two mangos
Two avocados
Two large handfuls of
fresh basil (use fresh
from garden
One package
Bocconcini (bitesized) mozzarella
One pack cherry tomatoes (or use your fresh ones from
the garden)
Salt and pepper to taste
Everything from the garden will make this salad so much
better
Reduction:
One and a half cups balsamic
One tablespoon honey
One quarter teaspoon salt
•
•
•
2.
3.
4.
5.
6.
Start with the balsamic reduction. For the balsamic, you
want some mid-range tasty balsamic; if you don’t like the
taste of it by itself, you definitely won’t like it when it’s
reduced. In this recipe, I like mixing some regular
balsamic with a raspberry–infused balsamic, but it’s up to
you. Pour your vinegar into a small saucepan, and place
on your stove on medium to medium-low temp, bring to a
soft simmer; one trick is to leave the pan half on, and half
off the burner, so the reduction doesn’t get too hot and
scorch. If any film forms on your balsamic, scoop it off
before serving. (Don’t lean directly over simmering
vinegar or you’ll get a deep breath of vinegar — it’ll knock
your socks off. Or so I’ve heard.) You’ll want your
balsamic to reduce by about half by the end.
Peel your mangoes – the peels aren’t edible. Do your best
not to cut too much into the flesh or you’ll lose out on
some yummy goodness, but mangoes have a really hard
center seed that can be difficult to cut around. Feel free to
cut large strips, and then cut those strips into bite-sized
chunks. Important: for this recipe, you don’t want the
mangoes to be overripe or you’ll end up with mango mush
in your delicious salad.
Peel and seed the avocados, then chop into bite-sized
pieces. You don’t want everything to be the same size
and cut, the size variety adds depth & texture.
For the basil, I like to cut the basil into strips, but feel free
to have a little liberty here, if you like rough tear, have at
it, if you like small strips, do it.
Cut the mozzarella and cherry tomatoes in half.
In a large bowl, add the mangoes, avocados, basil,
mozzarella, and tomatoes, and toss gently – you don’t
want to mash anything. Add salt and pepper to taste. Add
a small drizzle of your reduction to each individual
serving, just prior to placing at the table.
Serves 4.
Fresh this Spring: Pineapple Pomegranate Salsa
Posted on March 19, 2013
by Pamela MacNaughtan : http://www.plumdeluxe.com/fresh-this-springpineapple-pomegranate-salsa#sthash.nkZX8kh4.dpuf
•
Looking for a quick, simple dish to freshen up your meals this
spring? What if I told you it was healthy and tasted great? It
may sound impossible, but I’ve got just the little treat to get
you going.
•
•
Ingredients:
•
•
•
•
1/2 Pineapple chopped into bite size pieces (must be
fresh, not canned)
1 Pomegranate
1 Large Tomato diced
1 Med White Onion diced
1-2 Serrano chili diced (you
can use a jalapeño, but it
won’t be as spicy)
2-3 Garlic cloves, diced
Juice of 1 lime
Directions:
In a bowl mix pineapple pieces,
tomato, onion, chilies, and garlic together. Add lime juice, and
then the seeds from one pomegranate. Mix well and serve as
a salsa with tortilla chips, or as a topper for tacos or tostadas.
Remember: leftovers may be spicier the next day as flavors
tend to mix and strengthen overnight. Remember flavors will
be different if you use fresh summer ingredients vs winter.
15
Ice Creams
(floridajuice.com 01/04/2013)
Pineapple-Coconut Ice Cream
(from the Taste for Life test kitchen) July 13, 2013
www.tasteforlife.com
Servings: 6
Ingredients:
•
•
•
•
•
2 c. Pineapple chunks
1 (13.5) can coconut milk
¾ c. Agave nectar
½ c. Coconut milk beverage
1 tsp. Vanilla extract
Roasted Strawberries with Balsamic
Vinegar
Ingredients:
•
•
•
•
•
Directions:
1.
2.
3.
4.
Place all ingredients in a high-speed blender. Blend until
smooth and well combined
Chill mixture at least 3 hours in the fridge.
Freeze in an ice cream maker according to
manufacturer’s instructions.
I decided to bring out my ice cream machine that has
never been used. I used So-Delicious unsweetened
coconut milk beverage. The grandkids loved the ice
cream. I let it sit overnight.
Roasted Strawberry-Buttermilk Sherbet
(www.bonappetit.com July 2013)
Servings: 6
Ingredients:
•
•
•
•
•
•
2 pints strawberries, hulled and quartered
2 tbsp. honey
¼ cup balsamic vinegar
1 tbsp Crema Balsamic - first time I made this, I used the
dark crema, visual not so nice, but the white crema is
perfect. I used Italissima. There are other brands. Check
the ingredients.
1 tbsp Butter (optional) I have done it both ways. Prefer
without butter. If you like to serve it cold over things, you
have that cold butter texture. Not good. If you are using it
hot/warm that is different.
Directions:
1.
2.
3.
4.
Preheat oven to 375F
Combine strawberries, honey, and balsamic vinegar in a
large baking dish and mix together.
Bake for 30-35 minutes until soft and bubbling
Remove from the oven and serve warm, room
temperature, cold. You can use it over Greek Yogurt
(plus add gf granola); topping for ice cream; over gf
cereal; really good over gf crostini with goat cheese; over
pancakes, toast, waffles, even as a dressing on your
salad. Use it cold or as warm dressing on your salad; add
to a smoothie, top your favorite cakes: angel food, pound,
Pavlova, etc. This is a very versatile topping. Enjoy.
4 cups strawberries (about 1 lb.) hulled, halved
1 cup sugar
½ vanilla bean, split lengthwise
1 ½ cups buttermilk
1/3 cup sour cream
Pinch of kosher salt
Directions:
1.
2.
Preheat oven 425F. Combine strawberries and sugar in a
13 x 9x2” baking pan. Scrape in seeds from vanilla bean
and add pod: toss to combine. Roast berries, stirring
occasionally, until juices are bubbling, 15-20 minutes. Let
cool
Discard the vanilla pod. Puree berries, buttermilk, sour
cream and salt in a blender until smooth. Process mixture
in an ice cream maker according to the manufacturer’s
instructions. Transfer sherbet to an airtight container and
freeze until ready to serve. Can be made 1 week ahead.
Let soften at room temperature for a few minutes before
serving. If you have not had roasted strawberries, you
must try.
16
Vinaigrettes
Raspberry Vinaigrette
(Source: Cafe Tecumseh Vol 3, issue 2)
Blackberry Vinaigrette
www.cafetecumseh.com
(source: delicious living July 2013)
www.deliciousliving.com
Ingredients:
Ingredients:
•
•
•
•
•
•
•
½ cup fresh raspberries
½ cup olive oil
2 tbsp red wine vinegar
2 tbsp fresh lemon juice
1 tsp minced shallots
1 tsp honey
Salt & Pepper to taste
Directions:
1.
In a blender, puree
raspberries, oil,
vinegar, lemon juice,
shallot, and honey.
Season dressing to
taste with salt and
pepper.
•
•
•
•
•
•
•
1 cup fresh
blackberries
¼ cup balsamic
vinegar
1 tbsp honey
2 tsp minced shallots
1 tsp stone-ground
mustard
½ cup extra-virgin olive
oil
Salt & Pepper to taste
Directions:
1.
In blender, puree blackberries; press through a fine sieve
to remove seeds (optional). Add remaining ingredients.
Drizzle oil slowly as motor is running. Blend until
emulsified. Season with salt and pepper. Makes 1 cup.
Gluten Free Frozen S’Mores
source: http://simplygluten-free.com/blog/2013/06/gluten-free-frozen-smores-recipe.html
Yields – 6 Recipe can be double or tripled easily.
Ingredients:
•
•
•
•
Gluten Free, non-stick cooking spray or vegetable oil
1 ½ pints gf rocky road or chocolate ice cream (or
dairy-free ice cream)
1 ¼ cups gf graham style crumbs (Kinnikinnick works
well)
2 tbsp melted unsalted
butter or dairy-free
butter substitute
8 tsp Mini semisweet
chocolate chips (or
dairy-free)
½ cup heavy cream or
dairy-free chipped
topping (equal to 1 cup
whipped)
Directions:
1. Spray a 6 p (1/2 cup each) silicone muffin pan with gf
cooking spray or brush lightly with oil. (This recipe works
best with a silicone baking pan as it makes it easier to
remove the s’mores, but if all you have is a metal muffin
tin just line it with paper cupcake liners).
2. Let the ice cream soften at room temperature for about 10
minutes (it should be easy to scoop) or microwave on
high power for 30 seconds.
3. Combine the gluten-free graham style crumbs and melted
butter until fully mixed. Place a heaping tablespoon into
each of the 6 cups of the muffin pan and press down
firmly. Reserve the remaining crumbs for garnish.
Sprinkle 1 tsp. of chocolate chips into the bottom of each
cup on top of the crust. Reserve the remaining chips for
garish. Scoop ½ cup of ice cream into each cup and
press down firmly with the bottom of a glass. Freeze until
firm, 1-2 hours.
4. Whip the cream until stiff peaks form. Remove the
s’mores from the muffin pan by pushing on the bottom of
each muffin cup and popping them. Top with the whipped
cream and garnish with the remaining crumbs and
chocolate chips.
17
Gluten-Free Mug “Pancake”
(Shirley Braden-www.glutenfreeeasily.com/gluten-free-mug-pancake)
Please visit Shirley’s other sites: http://glutenfreeeasily.com and http://
allglutenfreedesserts.com (reprinted with permission)
Ingredients
•
2-3 tbsp butter (dairy or non-dairy)
•
2 tbsp certified gluten-free oat flour
•
2 tbsp gluten-free all purpose flour
•
Heaping ¼ tsp. baking soda
•
3 tbsp maple syrup, plus additional for topping
•
1 large (or extra large) egg
•
3 tbsp milk (dairy or non-dairy)
Directions:
1.
2.
3.
4.
5.
6.
7.
Add butter to large mug. Microwave on HIGH for 20-30
seconds until melted.
Remove mug and let butter cool slightly
Add oat flour, gluten-free all purpose flour, and baking
soda. Stir Well
Add maple syrup, egg and milk. Stir well.
Cook on HIGH for 3 minutes
Let sit in microwave for another minute or two
Drizzle some additional syrup over your mug pancake
before eating.
TIPS:
If you have certified gf oats, you can process them into oat
flour using your food processor or spice/coffee grinder.
Mug Pancake will rise very high while baking, some batter
may possibly run over the side of the mug but then the batter
will settle back down.
Flour Blend:
3 parts Asian White Rice Flour (very finely ground)
3 lbs. Rice flour
2 parts cornstarch or tapioca or potato starch
•
2 lbs cornstarch
•
•
Mix in large bowl and
store in airtight
containers. It’s an economical mix that works
well in most recipes. No
refrigeration is needed for
this flour mix.
If you have an allergy to
corn, you can use tapioca
or potato starch in place
of corn.
Streusel Cake by Shelly
source: www.glutenfreemom.com http://glutenfreemom.typepad.com/
gluten_free_mom/2009/09/two-thumbs-up-to-betty-crocker-gluten-freemix-and-a-streusel-cake-you-will-love-plus-a-giveaway.html
http://foodallergyinfo.org/wiki/index.php?title=Shelly%E2%80%
99s_Streusel_Cake&action=edit Shelly Carpenter
Directions:
1.
2.
3.
Ingredients:
•
•
•
•
•
•
•
2 tbsp brown sugar
2 tsp cinnamon
1 pkg Betty Crocker Yellow GF cake mix
½ cup sugar
2/3 cup oil
4 eggs
1 cup gf buttermilk
(dairy free used 1
cup soy milk with 1
tbsp lemon juice
2 tsp vanilla
4.
5.
6.
7.
8.
Mix together the brown sugar and cinnamon and set
aside.
Grease and flour a bundt pan
Combine remaining ingredients well and pour a little more
than half into the bundt pan.
Add the brown sugar/cinnamon mix in a complete circle,
careful not to touch the inside/outside of pan or it will
burn.
Cover with the remaining batter.
Bake at 350F for about 55 minutes or until light golden
brown on top
Remove from pan and let cool
Top with cream cheese frosting:
Frosting:
1 pkg 8oz cream cheese
1 Tbsp. Milk
1 tsp. Vanilla
4 cups icing sugar sifted.
•
•
•
•
18
Gluten Free Pizza
Submitted by Lily
To celebrate a close friend's move to Toronto, I took him out for
dinner and he suggested the restaurant SKP in my neighbourhood
because of the gluten-free options. The Italian Restaurant in
Vancouver Point Grey has gluten-free pizza dough and gluten-free fusilli pasta.
We arrived at the restaurant at 8:30pm and were the only table seated in the
dining area. The bar area was busy with guys hanging out who had come to
watch a basketball game and were having drinks.
While we looked over the menu, I noticed that the restaurant had two floors. One
which is perfect for private parties and large groups. The downstairs, where we
were seated had a comfortable atmosphere which is inviting for a first date.
The owner, Travis Davidson came by to say hi and was very helpful at explaining the menu and telling us what was
popular. I love a basic Margherita pizza and wanted to try their gluten-free crust. So I ordered one with a glass of
Pinot Grigio.
Our food arrived quite quickly as we were the only table in the restaurant. The pizza crust was thin and a bit chewier than
a regular crust. The toppings were very fresh and the pizza was delicious. For $13 the pizza was a good deal as I ate 4
pieces and my friend ate 2 with his starter.
All in all, I had a surprisingly great experience at a neighbourhood restaurant that I had not tried before. The service was
good and staff was very friendly plus the food was delicious. I will definitely go there again with friends who are glutenfree or when I feel like a Margherita pizza. SKP restaurant is on 4409 West 10th Avenue Vancouver, BC V6R 2H9,
(T) 604-222-0220.
http://corianderkitchen.ca/2013/06/25/gluten-free-pizza
19
Gluten-Free Eating on a Budget
Submitted by Sondi Bruner
We’re living in tough economic times, when every dollar counts.
If you have celiac disease or are gluten-intolerant, you may find yourself sighing as
you empty your wallet for gluten-free specialty products. You may feel green with
envy while the ‘regular’ folk dine without blowing their entire paycheque at once.
There’s no question that gluten-free stuff is pricey. Baking mixes, crackers, breads,
flours, cereals, granola bars all cost way more for than their gluten-filled
counterparts, and often you’ll receive far smaller portion sizes.
So it is even possible to eat gluten-free on a budget?
Absolutely. You can eat a healthy, gluten-free diet without spending a fortune.
Here are my top four tips for saving money on a gluten-free diet. They’ll not only increase your savings at the grocery store, they’ll
make you healthier, too. And that will save money in the long-term, because you won’t lose income due to illness or pay through
the nose for health premiums due to chronic diseases.
1. Focus on eating real, fresh, unprocessed food.
When companies put food into a package, there are additional costs for manufacturing, processing, marketing, advertising,
staffing, transportation – and as consumers, we're paying for all of that. When companies produce gluten-free packaged products,
they have to use dedicated gluten-free facilities and certified ingredients, which spikes the price.
Naturally gluten-free things like fruits, vegetables, gluten-free whole grains, beans, legumes, nuts, seeds, fish and eggs don't have
all of those costs, so they are way less expensive. Eating real food also saves you money because of what you’re not buying,
which is all the pre-packaged, junky stuff.
2. Choose real food that also happens to be cheap.
I’m not naïve. There are expensive gluten-free, healthy foods out there.
If you spend your days relishing spoonful's of creamy avocado, slicing juicy pineapples and mangos, sampling tangy berries and
gorging on fancy superfoods from South America, then your food bill is going to skyrocket.
But I’m talking about the inexpensive whole foods. Generally, carrots, celery, onions, garlic, spinach, apples, cabbage, bananas,
sweet potatoes, eggs, beans, lentils, brown rice, zucchini, cucumber, squash, sunflower seeds, pumpkin seeds, green peas and
lettuce are all inexpensive options.
Focusing on those foods, instead of pricier items, will allow you to create a lot of delicious gluten-free meals for a fraction of the
price.
3. Cook food from scratch.
We’re fortunate to be living in a time when awareness about gluten-free living is growing. That means there are an increasing
number of gluten-free options at restaurants, grocery stores, bakeries and farmers markets.
The problem? The price of that gluten-free muffin is exorbitant compared to what you’d spend if you made the same thing at home.
The same goes for soup, salads, hamburgers, bread, or any other gluten-free food you buy instead of creating in your very own
kitchen.
Homemade meals are always less expensive than eating out or buying pre-made gluten-free foods. With packaged meals, you
often only get enough food for one meal. When you make food yourself, for the same price you can cook enough to last you for
several days.
When you cook at home, you can control exactly what goes into your food. That means you won't be adding chemicals or
preservatives, you'll be using ingredients you can pronounce, and you’ll lower your chances of being accidentally ‘glutened’.
4. Focus on a plant-based diet.
Animal products are incredibly expensive compared to plant products. Think about it: how much would you save if you cut down on
meat and cheese?
Increase your consumption of vegetables, fruits, beans, legumes, whole grains, nuts and seeds. When you plan meals that focus
on these foods, your grocery bills will go down, I promise.
I’m not suggesting that you become vegan or vegetarian. I’m simply reminding you that meat is expensive, and you’ll save money
by eating less of it. If reducing the amount of meat you consume seems overwhelming, try eating vegetarian for one day a week.
The Meatless Monday movement offers tons of tips and suggestions for how to do this.
Sondi Bruner is a holistic nutritionist, freelance writer and food blogger who can’t stop dreaming about what to create in the
kitchen. She educates people who follow allergen-friendly diets about how to eat simply, deliciously and safely, allowing them to
rediscover the pleasure of food.
Learn more about her services and peruse gluten-free recipes at www.sondibruner.com
20
21
Living and Eating Gluten Free
Submitted by Alyce Feindel
Preface by Dr. John Feindel
•
Neuropathies producing sharp or
burning pain, numbness, “pins and
needles” sensations.
The current incidence of celiac disease
•
Mental changes including confusion,
is 1 in 100 persons in the population.
depression and schizophrenia.
This represents 1% of the population in
•
Dental changes such as poor
Canada and the United States.
development of the dental enamel
Therefore there are approximately
and chronic periodontal disease.
330,000 persons in Canada who are
The recent medical literature has
affected adversely by the presence of
focused on the condition termed “gluten
gluten-containing foods in their diet.
sensitivity”. Researchers now believe
Gluten is a protein that is present in
that individuals can suffer the
three common grains: wheat, rye, and
consequences of gluten sensitivity for
barley. Wheat is the most common grain variable lengths of time before they
in the average North American diet. It is, actually develop overt celiac disease.
therefore, difficult for everyone to avoid
The usual blood tests for celiac disease
ingesting it as part of their daily food
cannot detect gluten sensitivity.
intake.
However, there are usually anti-gliadin
antibodies (aga) in the gastrointestinal
Just think about it! Wheat is in breads,
tract which can be detected in the saliva
rolls, muffins, pastry, pasta, cakes,
and the stool of the sensitive individual.
cookies, cereals, hamburger buns, hot
dog rolls, pizza, doughnuts, pancakes,
It is very important for the disease to be
subs, sandwiches, sauces and gravies.
diagnosed as early as possible because
This is why persons with celiac disease lymphoma and other gastrointestinal
must read content labels on all canned
cancers are known to occur if the
and packaged foods. Susceptibility to
disease is not treated as soon as
celiac disease is inherited and is a form possible by commencing a gluten-free
of auto-immune disease. Gliadin, a
diet. It is now known that gluten can
protein present in gluten, produces an
produce effects in many parts of the
inflammatory response in the wall and
body other than the small intestine.
lining of the intestine. Villi, which are
Dermatitis herpetiformis was found to be
finger-like projections into the lumen of
associated with gluten sensitivity in
the small bowel, become atrophied and
1967. This condition produces small
flattened. This reduces the surface area,
groups of itchy blisters on red plaques
and impairs the small bowel’s ability to
located on the backs of the elbows and
absorb vital nutrients from ingested food.
knees. They can also occur on the face,
As a result of these changes, fat from
scalp and trunk. This condition
ingested food is not well absorbed.
disappears on a gf diet. It has also
Therefore, the fat-soluble vitamins A, D, been reported that about 16% of
E, and K are not well absorbed, resulting persons with psoriasis have antibodies
in a deficiency of these essential
to gluten and that their skin condition is
vitamins. Vitamin B12, iron and calcium less severe on a gf diet. In a study
are also not properly absorbed.
performed in 2005, it was found that 5%
of children with chronic hives also had
These changes result in a cascade of
gluten sensitivity.
atypical symptoms including the
following:
Osteopenia, osteoporosis, and
osteomalacia can develop as a result of
•
Chronic fatty diarrhea with bulky
gluten sensitivity and can be reversed on
“foul smelling” stools.
a gf diet.
•
Anemia which is cause by the poor
Systemic Lupus Erythematosis is an
absorption of iron, folic acid and
auto-immune disease which affects the
vitamin B12.
joints, skin, kidneys, heart, lungs, blood
•
Abdominal pain and cramps.
vessels, and brain. It is stated that one
•
Fatigue and weakness.
in five persons with this lupus is gluten
•
Osteopenia resulting from poor
sensitive.
calcium absorption. May cause
shortness of stature.
Arthritis is an inflammation in the joints
and it is one of 100 rheumatic diseases
•
Myositis or fibromyalgia.
which affect one in five adults. These
diseases produce inflammation or pain in
muscles, joints and fibrous tissue. One
report noted that 68% of persons with
celiac disease suffer this kind of
inflammation. A gf diet can reduce or
eliminate the symptoms of rheumatoid
arthritis. The diet may also help those
with osteorarthritis.
Celiac disease is 10 to 20 times more
common in type 1 diabetes. They have
gluten sensitivity but have not developed
celiac disease. All diabetics with gluten
sensitivity can be helped by a gf diet.
Thyroiditis and Hyperthyroidism show a
greater prevalence of gluten sensitivity.
There are other diseases of the digestive
tract other than celiac disease which are
related to gluten sensitivity. The irritable
bowel syndrome (ibs) and crohn’s
disease are particularly related. Persons
affected by these conditions should be
tested for gluten sensitivity.
Gastroesophageal reflux disease (gerd)
produces burning sensations in the chest
and throat and pain behind the sternum.
It has been noted that a gluten-free diet
controls these symptoms. Ophthous
ulcers in the mouth may be caused by
gluten sensitivity. Many of the persons
afflicted by these distressing ailments
have been helped by a gf diet.
Chronic Fatigue Syndrome (CFS) and
fibromyalgia are very similar. Both of
these conditions are associated with
gluten sensitivity.
Iron deficiency anemia can be caused by
celiac disease and it is one of the
important signs in the differential
diagnosis.
Approximately 5% of the population
suffer the distress of asthma which can
be defined as an allergic reaction to
factors in the environment. It seems that
some of these reactions will disappear
on the diet.
Celiac disease leads to malnutrition
which results in weight loss. Studies
clearly show that if you experience
unintentional weight loss, it could be
caused by gluten sensitivity accompanied by other identifying symptoms.
Dilated cardiomyopathy, a form of
congestive heart failure is a recognized
atypical symptom of celiac disease.
22
Living and Eating Gluten Free - Continued
disorders can be facilitated by better
immunological laboratory tests which are
Chronic infections such as sore throat,
currently available. The proteins in the
colds, ear infections, urinary tract
gluten fraction of grains cause antibodies
infections may be connected because of
to form in the blood and tissues of
an interaction of the immune system with
persons who are sensitive. The best
gluten sensitivity.
individual test seems to be that for iga
It is estimated that 29% of the population ema. In adult studies, ema was only
found in persons with active celiac
may have gluten sensitivity. Celiac
disease. The test is less powerful in childisease is the end result of gluten
dren as ema’s have been found in other
sensitivity.
childhood diseases.
In many of the books and articles I read
pertaining to human nutrition, the axiom A more recent tests used for screening is
for tissue transglutaminase antibodies
that “we are what we eat”, is stated. In
(ttg). High levels are positive for celiac
other words, our feeling of well-being is
determined by the nutritional value of the disease. The human iga (ttg) test is
highly reliable for the diagnosis and
food that we ingest. We all required a
follow up of celiac persons without iga
balanced diet which includes 40% of
deficiency. However, the test is less
calories from carbohydrates, 30% from
accurate for the diagnosis of persons
fat and 30% from proteins in our diet.
with iga deficiency.
Most of our carbohydrates should be
those with a low-glycemic index.
Persons with positive antibody tests
must still undergo a small intestinal
We need to have foods that do not
biopsy to assess and confirm the amount
cause a sudden rise in our blood
glucose levels. For example, it we select of mucosal involvement.
foods such as carbohydrates which have
Recent new knowledge suggests that
a high glycemic index, this can put a
the increased ingestion of wheat and
strain on the blood glucose, insulin,
wheat-containing products by Europeans
glucogon hormonal system resulting in
and North Americans contributes to an
the onset of type 2 Diabetes.
increased incidence of celiac disease.
A sudden rise in the blood glucose level
A newly diagnosed celiac may have
can cause a dramatic rise in the blood
temporary lactose intolerance due to
insulin level. The insulin causes the
damage caused to the small intestine.
excess glucose to be stored as fat in the
The lactose intolerance should
fat cells. Excess can also contribute to
disappear once the intestine heals.
the development of insulin resistance.
The elevated insulin level causes an
Celica disease is a condition which lasts
increase in appetite and cravings for
throughout the affected person’s
more carbohydrates. Normally glucogon lifespan.
functions to release the fat from storage
Treatment and management
to produce energy for physical activity.
However, this does not occur in the
The simple answer to the management
presence of an elevated insulin level.
of celiac disease is to eliminate gluten
from the affected person’s diet. You
To reiterate, Increase insulin levels
must begin to read the list of ingredients
cause:
in all processed and packaged foods.
Elevated cholesterol
The good news is that if the elimination
Elevated blood pressure
of gluten can be accomplished, the
Increased appetite, increased craving for persons afflicted with celiac disease will
food
see a gradual disappearance of their
Increased rate of aging
symptoms and will return to a normal
Increased growth of cancer cells
state of health. A section of this book is
Osteoporosis
devoted to the beginning and
The development of type 2 diabetes
maintaining of this diet.
Obesity
SUMMARY
A gf diet can help you avoid wheat, rye
It is now recognized that gluten
and barley grains in your diet and thus
sensitivity is much more common than
reduce a food source which is high in
previously appreciated. It is believed to
carbohydrate.
be a cause or a significant factor in a
Diagnosis
wide range of medical conditions.
Diagnosis of gluten sensitivity in all
Sensitivity to gluten affects 29% of the
population.
Celiac disease is now considered to be
the final result of untreated gluten
sensitivity. It is a permanent conditions
which affects genetically predisposed
individuals who are exposed to gluten in
wheat and related products from rye,
and barley. Once the diagnosis is
confirmed by means of a small bowel
biopsy, you must continue on a gf diet
for life.
We hope that you will benefit from our
knowledge and experience so that you
can successfully eliminate gluten from
your dietary intake in a manner that will
enable you to enjoy the taste of good
food which is attractive, flavourful and
nourishing. Just think about it! Although
you will be denied the common grains
such as wheat, you will be able to enjoy
all the lean meat, dairy products, poultry,
fish, lobster, scallops, oysters, mussels,
clams and shrimp as well as all the fresh
vegetables, fruits and berries. In
addition, you will be able to eat meals
which include products made from rice,
corn, cornstarch, arrowroot flour,
buckwheat, potato flour and tapioca.
For those of you who are trying to control
being overweight, you should be aware
of the role played by carbohydrates and
the effects of a diet high in grains,
especially wheat. You should read the
book called, “The NO-Grain Diet” by Dr.
Joseph Mercola. The information
contained in his book is well researched
and supported by other scientific articles.
For a broader view on “gluten sensitivity”
and the related subjects, I suggest you
read the “Gluten Connection” by Dr.
Sheri Lieberman. Dr. Lieberman was an
expert clinical nutritionist who came in
contact with many persons with gluten
sensitivity.
Dr. John Feindel is a graduate of Acadia
University with a B. A. in biology. He
received his MD.C.M Degree from McGill
University, Montreal, Quebec. He later
became a specialist in Anesthesiology.
Dr. Feindel was Associate Professor of
Anesthesia at Dalhousie University and
Chief of Anesthesiology at the Halifax
Infirmary for twelve years. He also
served as president of the Canadian
Anesthesiologists’ Society. (Reprinted
with permission from Alyce Feindel)
www.glutenfreeforlife.com
23
Kids Corner
5 Great End of Summer
Activities for Bored Kids
in order to celebrate? Get a hold of all the kids and
parents and organize a "catch up get-to-together"
before the daily grind starts again in fall. You can go
pot-luck or pick out a fun theme such as in How to
Throw a Western Themed Dinner Party (Old Fashioned
Cowboy Barbecue) For some extra fun food ideas check
out How to Serve a Cheese Plate for a great way to
serve a classic or How to Make Plastic Spoon Trays for
a unique twist on some appetizer favorites.
Stay Inside and Be Creative: On rainy days, or just
the final lazy dog days of summer, the same board
games and other indoor activities can get old fast. Here
are some great new game and craft ideas that can be
made at home: How to Make a Reading Board Game is
good to get even the smallest children geared up for
Kids are always so excited when summertime comes. No
learning before the 1st day of school, How to Make
more teachers, no more books...until they realize that
Your Own House Barbie Games is neat if you have a
day after day with nothing to do but lay around gets
little girl who loves her dolls, How to Make a Photo
boring real fast. The trick is to turn seemingly everyday
Puzzle Collage is great if you are looking for a creative
activities into adventures. Here are 5 great end of
present to give someone or would just like a new twist
summer activities for bored kids that the whole family
on the classic group puzzles and How to Do Picture
can take part in. Enjoy the rest of the season while it
Collages is another great way to preserve vacation
lasts and create some great memories!
memories.
Head Outdoors: Take the kids outdoors for a picnic on
the park (Read How to Have a Fun Family Day at the
Park for some great ideas) last minute overnight
camping trip or just to simply enjoy your own backyard.
Kid-Friendly Summer Landscaping Projects offers some
great activities that you and your children can do to
spend quality time together and spruce up your yard
while you are at it.
Have a New Experience: Have the family pile in the
car to try out a whole new variety of cuisine at an
ethnic restaurant that no one has tried. Read How to
Build Restaurant Games for Free for some neat ideas to
keep even the youngest of your clan busy.
Do Something for Someone Else: One of the great
end of summer activities for bored kids is to spend the
last few weeks of vacation doing something for your
neighborhood or local charity. If you are really up to a
worthwhile challenge, read How to Organize a
Community Walk Event and have everyone pitch in. It's
a great way to reconnect with old friends before school
starts, as well as meet some new ones.
Throw an End of Summer Party: Who needs a holiday
24
Kids Corner
As a parent of a celiac child and as a member of the Victoria Chapter of the CCA, Cheryl McKinnon knew that providing a
gluten-free environment for her 3 year old was just as important as providing a gluten-free diet. To that end, Cheryl and
business partner, Colleen Irwin, became determined to make ‘play safe for everyone,’ from celiacs to children with multiple
allergies.
Cheryl’s personal experience with her daughter and her further diagnosis of multiple allergies helped them recognize that this
was a common occurrence. Further research was done to ensure that their formula was the safest it could be. As a result of
their two years of research and product development, they created a version of ‘play dough’ that is free of gluten, dairy, nuts,
corn, soy, artificial colors, dyes, perfumes and preservatives.
"The gluten free are susceptible to gluten not only in their food, but in their immediate environment. Celiac experts assure us
that while gluten cannot be absorbed through the skin, traces of gluten on hands can make their way onto lips and into mouths.
Curious children may even 'taste' the substances that they play with despite parents' best efforts to discourage them! Gluten in
quantities as small as 10 mg (a dime weighs 2200 mg) are considered sufficient by the Canadian Celiac Association to trigger
an immune response/intestinal damage." ~ Ellen Bayens The Celiac Scene™
Check out their website (www.GigglesFunDough.com) for more details on where you can purchase Giggles Fun
Dough.
25
Ontario Health Insurance
TESTING FOR CELIAC DISEASE TO BE COVERED Celiac disease can be detected with a simple blood
test and controlled by diet. With early detection,
BY THE ONTARIO HEALTH INSURANCE PLAN.
By Jefferson Adams
people with celiac disease can live "a long and
Published on 07/05/2013
healthy life,” Mauro said.
On the Canadian gluten-free front, a local lawmaker
Source:
has introduced a bill to have testing for celiac disease
http://www.tbnewswatch.com/news/282116/Maurocovered by the Ontario Health Insurance Plan.
introduces-private-member%E2%80%99s-bill by Jodi
Bill Mauro (Lib., Thunder Bay-Atikokan) introduced a
private member’s bill Tuesday afternoon in Queen’s
Park asking for an amendment to the Health
Insurance Act to include serological testing for celiac
disease.
Lundmark and by Jefferson Adams
http://celiac.com/articles/233251/1/Canadian-LawmakerPushes-for-Early-Celiac-Detection/Page1.html
Photo: CC--palindrome6996
Mauro cited statistics indicating that about one per
cent of Canadians are currently affected by celiac
disease, but that 90 per cent of them are
undiagnosed.
The longer those people remain undiagnosed, the
more severe the potential health impact. The
long-term impacts of celiac disease can include
vitamin deficiencies and higher rates of type 1
diabetes, arthritis, depression, neuropathy, infertility
and osteoporosis, among other factors.
26
Educational Brochures
Canadian Celiac Association Educational
Brochures
The brochures listed below are available as free
downloads. You can print them or save them to your
computer or mobile device for later reference
www.vancouverceliac.ca or www.celiac.ca
Blood Testing for Celiac Disease (PDF ~165KB)
Celiac Disease - What is it? (PDF ~190KB)
Celiac Disease - Myths and Facts (PDF ~200KB)
Celiac Disease - Teachers' Info (PDF ~185KB)
Celiac Disease - Seniors Living with Celiac (PDF
~175KB)
Dermatitis Herpetiformis: A Skin Disorder (PDF
~250KB)
Go Gluten Free...Your Key to Better Health (PDF
~235KB)
Hidden and Dangerous (PDF ~50KB)
Contamination Guidelines - For Restaurants (PDF ~ 240
KB)
Dental and Oral Manifestations of Celiac Disease (PDF)
French
La maladie coeliaque - sournoise et dangereuse (PDF)
La maladie coeliaque: La lien au gluten (PDF)
Punjabi
Celiac Disease: Myths and Facts
Celiac Disease: What is it?
Chinese
Celiac Disease: Myths and Facts
Celiac Disease: What is it?
27
Odds and Ends
Celebrity Chef Jamie Oliver fined over $12,000 after a customer with CD was sickened by eating regular pasta
instead of gf which she was supposed to receive. Read article for details at:
http://www.celiac.com/articles/23315/1/Jamies-Italian-Pays-12000-Fine-for-Seving-Regular-Pasta-To-Customer-WithCeliac-Disease/page1.html
Robin Hood Nutri Flour Blend – Gluten Free
New Nutri Flour Blend is gluten free all purpose flour blend made from rice flour with
sugar beet fibre and potato and tapioca starches. Comes in a convenient resealable
bag. Recommended for making cookies, muffins, biscuits, quick breads, breads, rolls,
pies & pastries, brownies, cakes, cupcakes except cakes with a delicate texture like
chiffon and angel food. Store in a clean dry area at room temperature (sounds like it
doesn’t have to go into the fridge). Shelf life is 12 months from the date of
manufacturing. The flour has been seen at a number of stores on the lower mainland.
http://www.robinhood.ca/product-details.aspx?pid=436&prodcid=44
Back to School and Summer Trivia
The Eiffel Tower grows in summer. This
historic structure is made of iron. Metal
expands with heat. As a result, the Eiffel
Tower can grow more than six inches in
hot weather.
Scientific experiments have
established that on average a
single scoop ice cream cone
takes 50 licks to eat.
In 1776, the first
ice cream parlor
opened in New
York City.
According to Discover
magazine, the pencil can
actually write about 45,000
words and could draw a line
about 35
miles long.
Did You Know?
Watermelon is a
vegetable. As the
air heats up, so
does the
consumption of
watermelon. This
vegetable is part of
the cucumber, squash and
pumpkin family. Americans eat 15
pounds each year.
Pencils can
actually write in
outer space (or
any place with
zero gravity),
upside down and
under water.
Pretty handy!
According to Crayola, the first box of
crayons sold in 1903 for five cents. It
included the same eight colors that are
in a box today.
Did you know that?
28
Odds and Ends
Fast Facts
Razzis Pizzeria – 8523 Greenwood Ave. N. Seattle, WA 206-782-9005 - Eat in, Take Out, or Order on Line. They
have a huge gluten-free menu. www.razzispizza.com This was a great find, as my daughter and granddaughter were
down for a ball tournament. Gluten free food is limited. On the way home another pickup for a 3 days camping trip with
the school. GF food was suppose to be provided but did not turn out that way. As I said a great find. Put on your list
when traveling/camping south and you need gf items.
Trader Joe’s – New Gluten Free Product Chocolate Cupcakes. Also check out their gf waffles, gf pizzas, gf oats and
coarse almond meal. For many traveling south, Trader Joe’s is a regular stop for celiac.
Support group Community - this site was created a couple of years ago by Carol Kicinski of Simply gluten-free. If
traveling this may help you do some research in the area of interest. http://simplygluten-free.com/celiac-support-groupscommunity
Sobeys Inc. Acquired Safeway’s Canadian assets in Western Canada (213 stores). This will make Sobeys the largest
grocer in Alberta and a leading grocer in Western Canada. www.huffingtonpost.ca/2013/06/12/sobeys-safewaydeal_n_3430389.html (14/06/2013)
Pigs fed genetically modified grain have more stomach inflammation. Researchers said there were no differences
seen between pigs fed the GM and non-GM diets for feed intake, weight gain, mortality and routine blood-bio-chemistry
measurements. The pigs that ate the GM diet had a higher rate of severe stomach inflammation – 32% of GM-fed pigs
compared to 12% of non-GM-fed pigs. The inflammation was worse in the GM-fed males and females. GM-fed pigs
had uteruses that were 25% heavier than the non-GM fed pigs. More research is needed. My question: is this also
happening to humans? (Globe & Mail (Globe Life & Arts Section-L6) 06/12/20134
Gluten Free Take Out Orders – up 60% since April 2012 while 4% of US restaurants offer gluten-free options
according to the digital food ordering service GrubHub. Diners in the Pacific Northwest lead the demand for gluten-free
with Seattle, Portland, & Eugene, Oregon, topping the list of cities with the highest percentage of gf orders. The next
biggest gf cities were San Jose, Chicago, Raleigh, Denver, Minneapolis, Los Angeles and Albany. The city that is
ahead when offering gf menu items is Detroit the clear winner with almost 18% of the restaurants featuring gf items.
The most popular ordered gf dishes are: pizza, salad, burgers, wraps, sandwiches, Pad Thai, pasta, bread, cakes and
paninis. Full report at: www.bakeryandsnacks.com/content/view/print/786428 Elaine Watson 25/06/2013 related
topics: Markets, gluten-free & Allergens
Label Clutter – means consumers don’t pay attention to nutrition information, say researchers. The density and design
of nutritional information on food and beverage packaging plays a vital role in whether consumers pay attention. I know
the more I have to read, the less I want that product. I want simplicity.
www.foodnavigator.com/content/view/print/782444 Nathan Gray – 11/06/2013 Related topics: Science & Nutrition.
Afterglow Cosmetics – the first makeup line to be certified gf by the Gluten-Free Certification Organization(GFCO)
Visit their website www.afterglowcosmetics.com. Here are a few things you may not know about makeup:
1.The cosmetic industry is not regulated
2. Due to the lack of regulations, the words “natural, pure, and organic” do not guarantee the products have these
characteristics.
3. Cosmetic companies are now manufacturing products with particle sizes so small (micronized and nano sized) they
can penetrate the layers of the skin and settle into the fatty tissues of the body.
4. The average woman ingests an average of 4 pounds of lipstick over a lifetime.
5. Many products contain the ingredient carmine which is the red pigment obtained from the exoskeleton of a beetle.
Check their web site.
29
30
Growing Market in Gluten Free Foods
Growing Market in Gluten-Free Foods Does Not Match Prevalence of Gluten Sensitivity
By Ted Bosworth
Las Vegas - The reported growth in the market for
gluten-free foods is difficult to understand in the
context of recent estimates of the prevalence of gluten
sensitivity, according to reports. In one food industry
report, the annual market for gluten-free foods in the
United States was placed at more than $4 billion. Yet,
gluten sensitivity, including celiac disease and other
causes, is estimated to affect less than 2% of the U.S.
population.
The increase in marketing for gluten-free foods has
increased awareness of gluten hypersensitivity, but a
team of Columbia University investigators who
presented data at last year’s annual meeting of the
American College of Gastroenterology (ACG) was
unable to detect a corresponding increase in the prevalence of problems with gluten digestion.
Although there is some evidence that the prevalence of celiac disease is increasing, one recent estimate reported a
prevalence of only 0.71% (Rubio-Tapia A et al. Am J Gastroenterol 2012;107:1538-1544). The relatively low incidence
of celiac disease “leads to the inference” that the large increase in the market for gluten-free products is being driven by
gluten sensitivity among people without celiac disease, reported Daniel V. DiGiacomo, MPH, and Peter H. Green, MD,
researchers at Columbia University College of Physicians and Surgeons who presented the data at the ACG meeting.
However, the article by Rubio-Tapia et al, which was based on data from the National Health and Nutrition Examination
Survey 2009-2010, found that non-celiac gluten sensitivity remains uncommon, and that “most persons who were following a gluten-free diet did not have a diagnosis of celiac disease.”
The estimated prevalence of non-celiac gluten sensitivity in the United States is 0.55%, which is approximately half that
of celiac disease,” reported the investigators of the ACG study. With both figures combined, the prevalence of gluten
hypersensitivity would be less than 2%, or no more than 7 million individuals. Therefore, each of these individuals would
need to spend an average of more than $500 per year on gluten-free products in order to sustain a $4 billion market.
Consequently, it appears likely that either non-celiac gluten sensitivity is being under-estimated, or gluten-free food
marketing appeals to individuals without gluten sensitivity.
Future studies are merited in order to understand the true population burden of non-celiac gluten sensitivity,” the authors
suggested.
Asked to comment, Rupa Mukherjee, MD, of the Division of Gastroenterology, Beth Israel Deaconess Medical Center,
Boston, reported that the disparity between the prevalence of celiac disease and the growth in gluten-free foods has
attracted her attention. She cited a report from Reuters that predicted the gluten-free market would grow another 22%
by 2015.
Those with celiac disease, non-celiac gluten sensitivity and gluten-sensitive irritable bowel syndrome are unlikely to
account for this degree of consumption,” said Dr. Mukherjee, who recently authored a review article on non-dietary
therapies for celiac disease (Gastrointest Endosc Clin N Am 2012;22:811-831).
There is certainly substantial public interest in the gluten-free diet, which is likely fueling … consumption by patients with
gluten hypersensitivity. Further data on the use of a gluten-free diet among the general public would be revealing.”
Permission granted to reprint article by Gastroenterology & Endoscopy News “Non-Celiac Gluten Sensitivity:
Gastrointestinal Hip or Hype?” By Brigid Duffy. Gastroenterology & Endoscopy News June 2013;64:1,16-17.
http://www.gastroendonews.com/ViewArticle.aspx?d=In%2bthe%
2bNews&d_id=187&i=June+2013&i_id=961&a_id=23375
Drs. DiGiacomo, Green and Mukherjee reported no conflicts of interest.
31
Non-Celiac Gluten Sensitivity
Non-Celiac Gluten Sensitivity: Gastrointestinal Hip or Hype?
by Brigid Duffy
In recent years, “gluten-free” has become a ubiquitous term in the public’s on going conversation about what constitutes a
healthy diet. From celebrities touting the evils of wheat, to food companies cashing in on gluten-free versions of cookies,
Pop-Tarts and donuts, to books and blogs dedicated to the “chic and gluten-free lifestyle,” there is no denying the anti-gluten
zeal in American culture.
It is therefore no wonder that far more than the approximately 1% of Americans who are diagnosed with celiac disease are
swearing off bread, pizza and other staples of American cuisine, all in the name of a self-diagnosed gluten allergy. The recent
spike in reported gluten sensitivity leaves a lot of gastroenterologists scratching their heads and asking, “Is non-celiac gluten
sensitivity a mere fad, or does the condition warrant more serious consideration?”
At the first-ever Intestinal Immune-Based Inflammatory Diseases Symposium held at Columbia University Medical Center in
March, a host of physicians, scientists, nutritionists and other clinicians from Columbia University Medical Center and Weill
Cornell Medical College, both in New York City, addressed the growing prevalence of non-celiac gluten sensitivity and shared
methods by which doctors can diagnose and treat patients who claim, “I just can’t eat wheat.”
Three Types of Gluten-related Autoimmune Conditions
In a lecture entitled, “Celiac Disease vs. Gluten Sensitivity: How Common?” Peter Green, MD, director of the Celiac Disease
Center at Columbia University, explained that although there is a spectrum of gluten-related disorders with different definitions
and proliferations of guidelines, specialists typically place gluten-related autoimmune conditions into three categories: wheat
allergy, celiac disease and non-celiac gluten sensitivity.
Wheat allergy is mainly a pediatric disorder that tends to peak and then subside by the age of 1 year. However, there are an
increasing number of cases of exercise-induced wheat allergy among non-pediatric patients, as well as cases of contact
urticaria among food handlers, bakers and restaurant personnel who are in frequent contact with uncooked wheat. Although
some specialists are baffled by the recent rise in wheat allergy, some speculate that it is because wheat grown today contains
higher levels of gluten, as it helps to provide the sticky, chewy texture desirable in bread and baked goods. Blame it on the
bagel.
The second and perhaps most well-known category of gluten-related autoimmune conditions is celiac disease, which affects
roughly 1% of people worldwide, with children, adults and the elderly among them. People with celiac disease have one or two
genetic mutations that cause the immune system to attack the walls of the intestine as gliadin proteins travel through the
gastrointestinal tract. That, in turn, causes the finger-like villi that absorb nutrients in the small bowel to atrophy, rendering the
intestine permeable.
Dr. Green noted that like wheat allergy, the incidence of celiac disease has increased over the past 50 years, a phenomenon
that continues to bewilder specialists in the field. Notably, many of these cases remain undiagnosed. According to a 2012
study, about 0.7% of the individuals who participated in the National Health and Nutrition Examination Survey 2009-2010
tested positive for celiac disease, but of that group, only 17% were aware that they had celiac disease (Rubio-Tapia A et al.
Am J Gastroenterol 2012;107:1538-1544). The vast majority of individuals with celiac disease could be consuming gluten,
putting them at a greater risk for complications, including mortality. The same report found that nearly an equivalent number of
people—roughly 0.6% of the U.S. population—followed a gluten-free diet but did not have celiac disease (see “Growing
Market in Gluten-Free Foods Does Not Match Prevalence of Gluten Sensitivity”).
Specialists generally have treated the third category of gluten-related disorders, described as non-celiac gluten sensitivity, with
some degree of skepticism over the past several years. Even the definition of the category is less of a diagnosis than it is a
catchall description: patients who do not have wheat allergy or celiac disease, but whose health appears to improve in
response to a gluten-free diet. Further frustrating specialists is the conditions’ myriad symptoms that manifest differently from
patient to patient, leading some specialists to believe that there is more than one type of illness at play.
Initially, Dr. Green had some degree of confusion about the illusive non-celiac gluten sensitivity.
“Seeing all these patients, I didn’t really know what it was. I found it very hard to grasp hold of this condition in which patients,
when you tested them, were normal, but some had this profound effect [when they were] off gluten. I just didn’t understand it.”
Many specialists have asked themselves: Is gluten sensitivity all in patients’ heads?
Views started to shift in 2011 when The American Journal of Gastroenterology published a study led by Peter Gibson, MD, at
the Eastern Health Clinical School in Melbourne, Australia (Biesiekierski JR et al. 2011;106:508-514). In this double-blind
study of 34 patients, those who suffered from irritable bowel syndrome (IBS), did not have celiac disease and were on a gluten
-free diet were given bread and muffins to eat for up to six weeks. Some of the participants were given gluten-free bread and
muffins, whereas others got baked goods and bread containing gluten. Those who ate the gluten-based products reported that
they suffered significantly worse abdominal pain, bloating, fatigue, nausea and gas. In these patients with IBS, it appeared that
a gluten-free diet was much more than a placebo effect.
“While it’s nowhere near as common as we thought, it’s an iceberg phenomenon, and IBS is a very big part of the iceberg,” Dr.
Green said.
32
Non-Celiac Gluten Sensitivity - continued
Diagnosing Patients
There are up to 130 different symptoms associated with gluten sensitivity, and virtually every tissue in the body can be
affected, which makes the prospect of successfully diagnosing a patient’s condition all the more difficult for
gastroenterologists. But although experts do not yet know the mechanism behind gluten sensitivity, there are some steps
that doctors should keep in mind when dealing with patients who think they have a wheat allergy.
Christina Tennyson, MD, assistant professor of clinical medicine at Columbia University noted that the most important step
when treating a patient with suspected gluten sensitivity is to rule out celiac disease. Patients with celiac disease have an
increased risk for neurologic problems and certain cancers compared with patients with non-celiac gluten sensitivity, which
makes diagnosing the disease all the more critical.
After establishing if a patient is on a gluten-free diet, the tissue transglutaminase (tTG) immunoglobulin (Ig) A antibody test is
the single best test to determine if a patient has celiac disease. Although in theory the test is only revealing if the patient is
presently eating gluten, Dr. Tennyson noted that in most patients with celiac disease, tTG antibody levels usually return to
normal within six to twelve months. Therefore, it is often still worthwhile to screen even patients who are following a gluten-free
diet.
After celiac disease has been ruled out, patients should be directed to a dietician and followed over time. Dr. Tennyson noted
that long-term check-ups are crucial because many patients initially respond to a gluten-free diet, but may find that symptoms
come back over time.
Specialists also should keep in mind that the culprit is not always gluten. Dr. Green stressed that there is always a possibility
that other allergies are at play.
“When we see these patients, we often find something else that accounts for these symptoms, like bacterial overgrowth, or
fructose intolerance,” he said. “It’s worthwhile evaluating these patients because sometimes you can offer an alternative
diagnosis and they can go back to eating gluten.”
Treating Patients
A common theme throughout many of the presentations at the symposium was the issue of “gluten contamination.” Even the
most conscientious of patients who follow a gluten-free diet may be unknowingly ingesting the prohibited protein composite.
In 2002, researchers from Mayo Clinic, Rochester, Minn., reported that gluten contamination is the single biggest culprit in
patients who have a poor response to a gluten-free diet (Abdulkarim AS et al. Am J Gastroenterol 2002;97:2016-2021). One of
the chief reasons is that an increasing number of food manufacturers and fast-food companies are using microbial tTG, or
“meat glue,” as a means to cross-link proteins and give processed meat its desired shape. Even products as seemingly
innocuous as turkey bacon might contain this gluten trigger. Moreover, the FDA does not require food companies to list tTG on
its labels because the agent is considered a “processing aid.” In these cases, even patients with celiac disease or gluten
sensitivity who are the most committed to a gluten-free diet don’t stand a chance.
Considering that 7% to 30% of patients report continued symptoms when maintaining a gluten-free diet and many more
patients find it extremely difficult to adhere to a gluten-free diet, some specialists are seeking out nondietary therapies for
patients.
In her presentation, “Non-Dietary Treatment of Celiac Disease, Fact or fiction,” Dr. Tennyson noted that many patients with
celiac disease are aching for an alternative, and although experts do not yet know enough about non-celiac gluten-sensitive
patients, some of these therapies might be available to them as well.
A few methods involve ways to minimize gluten exposure in the small intestine. For example, there is increasing potential to
genetically modify different varieties of wheat to contain lower amounts of the immune-stimulating prolamin proteins—good
news for patients who prefer non-chewy bread to no bread at all. Additionally, recent studies have shown promise for an
enzymatic oral supplement that promotes gluten degradation in the stomach before it reaches the small intestine where it can
cause damage.
Another breakthrough in celiac disease therapy is a new medication called larazotide (Alba Therapeutics), a first-in-class oral
peptide. This protein targets the junctions of intestinal cells and has been shown to prevent gluten entry into the lamina
propria. Last year, Daniel Leffler, MD, of Beth Israel Deaconess Medical Center in Boston, and his colleagues published a
randomized, double-blind study of larazotide (Am J Gastroenterol 2012;107:1554-1562). The researchers showed that some
lower doses of larazotide acetate reduced gluten-induced immune reactivity and symptoms in patients with celiac disease
undergoing a gluten challenge and was generally well tolerated.
Other researchers are studying ways to reduce immune activation with the use of probiotics or vaccines that target tTG
inhibition, the modulation of cytokine secretion or the blockage of HLA DQ2 and DQ8 serotypes.
Although many of these new therapies will be welcome news for patients with celiac disease and gluten sensitivity, for many
doctors, figuring out why celiac disease and gluten sensitivity are on the rise is often the most baffling aspect of gluten-related
autoimmune diseases. As Dr. Green noted in his final remarks, “There’s so much more to learn.” Reprinted with permission:
“Growing Market in Gluten-Free Foods Does Not Match Prevalence of Gluten Sensitivity” By Ted Bosworth. Gastroenterology
& Endoscopy News June 2013;64:16-17. http://www.gastroendonews.com/ViewArticle.aspx?d=In%2bthe%
2bNews&d_id=187&i=June+2013&i_id=961&a_id=23417
33
Celiac Related Articles
Celiac Related Articles - I have been giving you celiac articles to read and I just noticed the ones from www.medscape.com you will
have to create an account. My apologies. Some of these articles are long but very interesting.
Increased Risk of End-stage Renal Disease in Individuals with Coeliac Disease – Adina Welander, Karl-Goran Prutz, Michael
Fored, Jonas F Ludvigsson Gut.2012;61(1):64-68
Objective: The prevalence of end-stage renal disease (ESRD) is increasing worldwide. Although increased levels of celiac
disease (CD) autoantibodies are often seen in renal disease, the importance of biopsy-verified CD for the risk of future ESRD is
unclear. The aim of this study was therefore to investigate the risk of future ESRD in individuals with CD.
Conclusion: This study indicates that individuals with biopsy-verified CD suffered increased risk of subsequent ESRD.
Full story www.medscape.com/viewarticle/755103 28/12/2012
Moderately Increased Risk of Urinary stone Disease in Patients with Biopsy-verified Coeliac Disease – J.F. Ludvigsson, F.
Zingone, M. Fored, C. Ciacci, M. Cirillo – Aliment Parmacol Ther. 2012;35(4):477-484
Background: Urinary stone disease is a mal-absorptive disorder that is a significant problem because of its high prevalence and
incidence. However, there are few population-based studies on the risk of urinary stone disease in patients with CD.
Aim: To examine the risk of urinary stone disease in CD
Conclusion: In this study, CD was associated with a moderately increased risk of urinary stone disease both before and after CD
diagnosis. Full story www.medscape.com/viewarticle/757844 (28/12/2012)
Gluten in Makeup: New Debate on Celiac Safety – posted by Lisa Fitterman on 2013/06/12
www.allergicliving.com/index.php/2013/06/12/gluten-in-makeup-new-debate-on-celiac-safety (14/06/2013)
Gluten free Cosmetics – Samantha Miller published 04/04/2011 Say Goodbye to your gluten filled makeup bag. For full story visit
www.glutenfreern.com/gluten-free-cosmetics 12/02/2013
Baking substitution for Gluten Free and More – by Karina this is a great site to get information and recipes from.
http://glutenfreegoddess.blogspot.com For Gluten Free Tips & Help go ¾ way down on left side and you will find the Baking
Substitutions and GF Baking Tips.
What if I have Villous Atrophy but Negative Celiac Blood Tests? – By Jefferson Adams – published 06/27/2013
www.celiac.com/articles/23321/1/What-if-I-Have-Villous-Atrophy-but-NegativeSelected Skin Diseases With Systemic Involvement- by M.Ruiz M.D;P.Valdes M.D; & K. Tomecki M.D.
www.medscape.com/viewarticle/805515_print 22/06/2013
34
Kids Corner
35
Mark Your Calendar!
UPCOMING VANCOUVER CHAPTERS MEETING - October 27, 2013
Royal City Centre, 610 Sixth Street, New Westminster, BC (Community Room) – 2:00pm
Dr. Jean Layton –Naturopathic Physician, Chef, Cookbook Author and Bellingham Rock
Leader for Celiac Kids.
Dr. Jean shares her naturopathic practice with her husband, acupuncturist Ed at Layton Health
Clinic in Bellingham’s Fountain District. Dr. Jean’s specialities are speaking and teaching
“How to Live Gluten-Free”. Her passion for teaching motivates her to make time for both Kids
and Adult classes. She says “Teaching is a joy for me”. She loves to work with kids because
they are fun, curious and love to show off their knowledge. As a mom of 14 year old twin girls,
she is well experienced. She just finished a summer cooking series at the Bellingham Co-op
for kids.
Her first cookbook, Gluten-Free Baking for dummies, co-authored with
Linda Larsen, became available in November. You can follow Dr. Jean’s
blog at www.GFDoctor.com. She also shares information on Facebook,
Pinterest, and Twitter. Dr. Jean is one busy lady who “loves to help
people eliminate the negatives from life and thrive”.
Healthy Gluten-Free Kids – http://www.facebook.com/ages/HealthyGluten-Free-Kids/110199554101
Gluten Free Doctor- http://www.facebook.com/pages/GFDoctor/129746488603
Tweets at - www.twitter.com/gfdoctor
Schedule of Events
Chicago 2013 - 15th International Celiac Disease Symposium
September 22-25, 2013 www.ICDS2013.org
If you are a physician or investigator, this is the event to find out about the latest treatments, scientific initiative, and
cutting-edge research aimed at finding a cure for celiac disease and gluten-related disorders. More than 300 scientific
presentations by contributors from 40+ countries.
If you are a dietician, clinician, care giver or celiac patient, come hear from the world's foremost experts and participate
in 3 days of seminars, discussions and education featuring news on improvements in gf. Living, progress on alternative
treatments and the very latest research on CD and gluten-related disorders. Enjoy the best gf products and services
from around the globe. For more information or to register, visit: www.ICDS2013.org
University of Chicago - Celiac Disease Center www.cureceliacdisease.org
Fraser Valley Food Show 2013 – October 4-6 at the Tradex Exposition Center in Abbotsford. New is the
GLUTEN FREE LIVING SHOW portion . There will be several vendors and a Celebrity Chef or two. We the Chapter
will be participating. Our booth is near the Food Network Celebrity Stage. Mark your Calendar. If you would like to
volunteer(we will need help for the 2 ½ day event) please email [email protected] or
[email protected]
Members Event – October 27, 2013 at the New Westminster Library. Dr. Jean Layton, Naturopathic Physician,
Chef, Cookbook Author, and Bellingham Rock Kids Group Leader. Dr. Jean’s speciality is speaking and teaching on
how to live gluten-free. Her last presentation was well attended and thoroughly enjoyed by all. Had several requests for
her to return. Please mark your calendar and come and hear Dr. Jean and enjoy. Coffee and treats will be provided. If
you would like to share a gf treat, please do so.
36
37
Drop-In Groups
Please RSVP to Leaders if you can so they can be
prepared to expect you!
Drop-In Groups Check the Vancouver Chapter website,
www.vancouverceliac.ca for updates, events, and changes.
You can also phone the office at 604-736-2229.
North Shore Celiac Meet-up
First Monday of each month except for July & August - cancelled
Roastmastir's - 1902 Lonsdale Avenue, North Vancouver
Time: 7 - 8:30pm Come and join us for coffee and chat.
Call Eugenia Mooney at 604-985-0719 or email: Andria Stutzer at
[email protected]
Vancouver Drop-In - Second Thursday of each month.
2013 schedule: August 8th and September 12th. The Gluten
free Epicurean (voted best Vancouver Bakery-2012 Gluten Free
Awards)- 633 East 15th Avenue, Vancouver, BC RSVP: Val at
[email protected] Check our website for updates:
www.vancouverceliac.ca Coffee and goodies are available for
purchase. Lots of fun, laughter and great information.
POWELL RIVER DROP-IN - Last Monday of each month.
The Community Health Unit Office, 7:30pm
Contact: Liz Kennedy: [email protected]
CHILLIWACK DROP-IN - First Saturday of each month.
Location changes each month. Contact: Geraldine David
604-792-2119 or [email protected]
ABBOTSFORD COFFEE DROP-IN ***Venue and day change ***
Meetings will be on the first Tuesday of every month 12 noon.
Contact: Ute Tindorf at [email protected]
Congratulation Pamela’s (1988)
for 25 years in business!
Thank you for your passion, dedication &
creativity of many award winning delicious
GF foods and products.
Read the full story at
www.pamelasproducts.com and sign up for
their excellent newsletter!
38
August 2013
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September 2nd – Labor Day
•
September 3rd – Abbotsford Drop-in
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September 7th – Chilliwack Drop-in
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September 12th – Vancouver Drop-in
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September 30th – Powell River Drop-in
OCTOBER 2013
•
October 4th to 6th - Eat Fraser Valley –
Gluten Free Living Show
•
October 27th – Members Event – Dr.
Jean Layton Presentation
August 3rd – Chilliwack Drop-in
•
August 5th – BC Day
•
August 6th – Abbotsford Drop-in
•
August 8th – Vancouver Drop-in
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August 26th – Powell River Drop-in
September 2013
Schedule of Events
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August 2013 - Canadian Celiac Association

Transcription

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