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    "Free-From" Peanut Butter Cookies (Gluten-Free)


    Jules Shepard

    Ok, I know these cookies aren't free from peanuts, but they are peanut butter cookies, after all!  If you can do almonds, but not peanuts, definitely try this recipe with almond butter – yum!


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    For the rest of us with other dietary restrictions, take heart! These cookies fit the bill! They're delicious, and still gluten-free, dairy-free, egg-free, soy-free, and sugar-free! Yes, they even have a low glycemic index! Enjoy these cookies on their own, or add chocolate chips (dairy-free chips are great too!) for a change of pace. High protein, loads of vitamins and minerals, dietary fiber – it's all there, and in a cookie!!!  Maybe I should have called these “Guilt-Free Cookies”!!!

    Don't be daunted by some of the unusual flour ingredients. Try them if you will, or just use my all purpose blend instead, for a quick and easy recipe substitution.

    Ingredients:
    1 ½ cups peanut butter (natural or no sugar added)
    ¾ cup agave nectar (light or dark)
    1 Tbs. gluten-free vanilla extract
    ¼ cup unsweetened applesauce
    ½ tsp. salt
    1 cup Nearly Normal All Purpose Flour*
    ¾ cup buckwheat flour (or Nearly Normal All Purpose Flour)
    2 Tbs. mesquite flour (or Nearly Normal All Purpose Flour)
    2 Tbs. almond meal (or Nearly Normal All Purpose Flour)
    ½ cup+ chocolate chips (optional)
    Cinnamon and sugar (or granulated splenda) mixture (or cinnamon only) for tops of cookies

    *Nearly Normal All Purpose Flour may be made using the recipe found in my cookbook, Nearly Normal Cooking for Gluten-Free Eating, or on my Web site.

    Directions:
    Preheat oven to 350 F.

    Blend peanut butter and all liquid ingredients together, then add in the dry ingredients, mixing until fully incorporated.

    Prepare a cookie sheet lined with parchment paper. Roll balls of dough approximately the size of ping pong balls in your hands and place on the prepared cookie sheet. Dip a fork in the cinnamon-sugar mixture and press into each cookie to flatten with a criss-cross design.


    Bake for 10-12 minutes and remove to cool on the pan.

    Peanut Butter Cookies
    Finished "Free-From" Peanut Butter Cookies

     

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    Great recipe, but you should be promoting this as free of all of the top 8 allergens except for peanuts. You left out the fact that it is milk free, and milk is one of the most common allergens in the top 8!

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    Guest Mary

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    I have actually made almost all of Jules' recipes without milk (even if the recipe calls for it, the substitutions are very easy and she usually lets you know what's best to add in its place). That's why I use her recipes - because with her flour, you know what you're baking is going to turn great even if you have to make substitutions. These cookies are great, just like everything else I've made using Jule's recipes.

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  • Related Articles

    Wendy Cohan
    Celiac.com 11/12/2008 - It's not as hard as you might think!  It's easy to start with the big items—a gluten-free turkey, gluten-free stuffing, gluten-free pumpkin pie, and of course, gluten-free gravy.  All are easily achievable by the average home cook, and no one will be able to tell anything is different or unusual—just a lovingly prepared meal full of flavor.
    Order an organic turkey from New Seasons or Whole Foods in plenty of time, or choose a less expensive option such as Norbest, Riverside, or Honeysuckle White (my favorite).  Some commercially produced turkeys contain gluten in the broth used to inject them full of flavorings, salt, and fat.  It is important to avoid eating gluten with your conscientiously prepared meal by choosing a gluten-free turkey as your centerpiece.  Check the label and it should say no MSG and no gluten on the front or under the nutrition label on the back.  Season turkey with high quality herbs like sage, thyme, and rosemary, or go Latin with cumin, chilies, and lime, but forgo additional salt.  Most turkeys are pre-salted—some excessively so.  The turkeys I surveyed at my discount grocer ranged in Sodium Content/Serving from 160 mg. to 325 mg.  Honeysuckle White, which I cooked at my Thanksgiving Prep class, had 200 mg. and I did not need to add any salt when cooking.  It was moist, flavorful, and delicious.
    Gluten-free stuffing is easy, just buy or make the best gluten-free bread, cube it and dry in a low temperature oven.  Angeline's bread, available locally here in the Pacific Northwest, makes excellent stuffing (it does contain milk powder).  You can also make a wild rice/brown rice and dried cranberry pilaf style stuffing, which can be cooked separately, or used to stuff the bird.  You can make terrific stuffing using my recipe for focaccia bread, available in my Thanksgiving Planner (see below).
    Use sweet rice flour to replace the traditional wheat flour in thickening gravy.  If it's not quite thick enough you can add a little tapioca or potato starch.
    I’ll inject a note of caution here, for those folks with gluten-related bladder problems. If you still have a sensitive bladder, take it easy on the cranberry sauce.  I know, it’s recommended to prevent bladder problems, but in reality, it is quite harsh on the bladders of those who already have them.  You may be able to tolerate a little apple cider, though, and herb tea is a good option, especially some nettle leaf tea before you have dinner, whether it’s one you’re preparing or not—nettle leaf can help to minimize any food sensitivity reactions you may have, although it can’t prevent a reaction to gluten, so do maintain your gluten-free diet, and don’t be afraid to ask your host or hostess about ingredients.  It’s best to do it before-hand rather than at the dinner table.  Think about how relaxed you’ll be if you already have your game plan when you get to the table, and know exactly what you can eat, and which dishes you’ll need to politely pass on to the next guest.
    For pumpkin pie, all you really need to do is make a killer pie crust and make sure your filling is dairy free if necessary.  You can substitute Earth Balance for regular margarine—it's gluten-free and dairy-free, or if you tolerate dairy products, use butter.  Or, you can use oil to make pie crust.  I’ll include recipes for both crusts, and the pies, here.  To replace milk in your pumpkin custard for the pie, there are many options to choose from:  rice, soy, almond, hazelnut, or hemp, but for extra richness, try coconut milk—it has a very mild taste and won't overwhelm the pumpkin flavor.  I'm very happy with the recipe I included in my Thanksgiving Planner & Recipe Guide.
    Poached pears or other fruit make a lovely alternative to pie, especially when prepared with the finest ingredients and served in an attractive dessert bowl.  I use my Mom’s retro 1940’s curvy glass bowl, which always brings back happy memories.  No, I wasn’t actually around yet when she got the bowl!
    Here’s the menu for my 2008 Thanksgiving dinner:

    Sangria with Cranberries Yeasted Pumpkin Bread Traditional Roasted Thanksgiving Turkey Traditional Tukey-Sage Stuffing (Made with Focaccia Bread) Traditional Turkey Gravy Mashed Yukon Gold Potatoes Yam Gratin with Spiced Pecans Green Salad with Satsumas, Avocados, And Lime Dressing Wild-Rice-Cranberry-Pecan Pilaf (Alternate Stuffing) Oven Roasted Green Beans or Asparagus Cranberry Pineapple Salsa Pumpkin Pie with Coconut Whipped Cream (Optional)
    To view my Thanksgiving menu, or order my Thanksgiving Planner & Recipe Guide, go to my Gluten-Free Choice Web site (see the link in my biography on the upper-right), and look under the “Gluten Free Resource Guide” tab.  At the bottom of the page, below the Thanksgiving Menu, you’ll see how to order the guide.
    TWO GLUTEN-FREE PIE CRUSTS
    Tender Gluten-Free Pie Crust
    (Adapted from Karen Robertson)
    Ingredients:
    1 ¼  cup gluten-free flour blend (+ up to 1 tablespoon more as needed)
    ¼ cup tapioca starch
    ¼ cup potato starch
    1 ½ teaspoon guar gum or 1 ¼ teaspoon xanthan gum, not both
    2 teaspoons fructose
    9 tablespoons Earth Balance Vegan margarine or shortening*
    1 large egg + 1 egg yolk
    1 ½ tablespoons apple cider vinegar or cold water
    (if using shortening, add ½ teaspoon salt)
    Directions:

    Mix together dry ingredients, then cut in margarine or shortening carefully until there are no lumps larger than pea-size. Beat together the eggs, and water or vinegar. Make a well in dry ingredients and add egg and liquid mixture, stirring carefully with fork to combine. When dough is just barely beginning to hold together, turn out onto a floured surface and flatten and fold, and flatten and fold again.  Do not overwork dough. Roll out carefully between wax paper. Remove top sheet of wax paper, and invert crust into pan.  Using wax paper, press crust into pan and form, then remove wax paper.  Use a similar technique for top crust if using.

    SOY-FREE, EGG-FREE OIL-BASED PIE CRUST
    (Adapted from Betty Hagman’s recipe)Ingredients:
    1 cup gluten-free flour blend
    ½ cup potato starch
    ½ cup sweet rice flour
    3 teaspoons xanthan gum
    1 teaspoon salt
    2 teaspoons fructose
    3 tablespoons cold rice milk
    2/3 cup vegetable oil
    Directions:

    Mix together all dry ingredients, then mix together rice milk and oil. Make well in dry ingredients and add rice milk/oil mixture, stirring gently with fork to combine. Proceed as directed in previous recipe. PUMKIN PIE (Gluten-Free)
    Choose either one of the pie crust dough and make as directed.  Place in pie plate, and carefully cover inside of crust with foil.  Fill pie crust with dried beans or rice, and pre-bake crust about 10 minutes at 350.  When edges are set, remove foil and beans, and bake another 5 minutes, or until bottom crust is beginning to crisp slightly.
    Here’s the filling:
    This makes enough for two 8 inch pies, so if you’re only doing one, cut it in half.
    Filling Ingredients:
    2 15-ounce cans of pumpkin, not pumpkin pie filling, or 1 29-ounce can of pumpkin
    4 whole eggs
    2 tablespoons gluten-free flour blend
    1 teasoon sea salt
    1 teasoon cinnamon
    ¼ teasoon cloves
    ½ teasoon allspice
    1 teasoon ginger
    ½ cup fructose
    1/3 cup dark agave syrup
    2 teasoons vanilla extract
    2/3 cup full fat (not light) coconut milk
    2/3 cup unsweetened rice or almond milk
    Directions:
    If making only half the recipe, you can make this in the blender, which is very quick and easy, and also makes it easier to pour into the crust.  The full recipe will exceed the capacity of most blenders.

    Mix all ingredients together in large mixing bowl, in approximately the order they are listed.  Blend until thoroughly mixed. Pour into pre-baked pie shell, and bake for fifty minutes at 325.  Remember to reduce oven temperature after pre-baking the pie shells.  Check for doneness every 5 minutes thereafter, by inserting a paring knife into the pie; it should come out clean.
    FOCACCIA BREAD WITH CARAMELIZED ONIONS

    Prepare liquid ingredients in a small bowl:

    1 teaspoon apple cider vinegar 1 tablespoon fructose 1 tablespoon agave syrup 1/3 cup vegetable oil (light tasting olive oil works well) 2 eggs + 1 egg white at room temperature, or equivalent egg substitute (Ener-G foods, or flax seed & boiling water – beaten with fork until foamy) 1 ¾ cups warm milk substitute (rice milk etc.) (110-115 degrees)
    …and prepare dry ingredients in separate bowl, combining with whisk
    1 package active dry yeast (equiv. to 1 tablespoon) + 1 teaspoon yeast 1 teaspoon fructose 3 ¼ cups all purpose baking mix (2 parts brown rice flour, 1 part sorghum flour, 1 part tapioca starch, ½ part potato starch) ¼ cup teff flour ¾ cup amaranth flour 4 teaspoons guar gum 1 ½ teaspoons salt ¾ teaspoon garlic powder
    Directions:
    Combine all wet ingredients and beat together with whisk.  Add flour mixture all at once, stirring on low until combined.  Increase speed to medium and beat for 3 full minutes.  Let dough rest in bowl, covered with towel for 10 minutes, and it will firm up slightly.  Wash and dry hands, then coat with gluten-free cooking spray.  Scoop 2 equal portions of dough onto prepared pizza pans, sprayed lightly with cooking spray.  Pat dough into smooth round, and begin to work dough out into a round about ½” thick and about 10 inches in diameter.  When dough begins to stick to hands, rinse hands in warm water, shake it off, then continue to spread dough.  When dough reaches desired shape and size, use fingers to lightly dimple dough, and sprinkle lightly with granulated garlic. Cover with towel, and place in warm, draft-free place to rise for 40 minutes. Preheat oven to 375F and bake for 8-10 minutes.  Remove bread from oven and brush with olive oil - add caramelized* onions and return to oven for an additional 10-15 minutes.
    *To caramelize onions, place 1 tablespoon olive oil over medium heat, Add 2 cups sliced sweet onions; cook slowly, stirring often until softened and taking on dark caramel color.  This cooking process basically released the sugars from the onions.  You can add a little water, wine, or chicken broth to prevent sticking to bottom of pan.  Also be sure to scrape bottom of pan well each time you stir during cooking.


    Jefferson Adams
    Celiac.com 12/24/2012 - Like many people, I associate the holidays with delicious desserts and yummy baked goods. As a child, holidays meant ovens warming the house, delicious smells filling the rooms, counter tops brimming with wonderful treats. Homemade desserts and baked goods bring these things and more to the holidays. They bring smiles to the faces of friends and guests and family. They bring joy to the heart.
    However, for people with gluten-sensitivity or celiac disease, making tasty desserts and baked goods comes with extra challenges. Not only do they need to avoid wheat and flour, they need to find recipes that match the taste and texture and goodness of favorites that are now off-limits.
    In fact, these challenges have inspired us to include links to some of our best loved and most delicious gluten-free holiday recipes. To help you bring delicious desserts and baked goods to your holiday table, here is a recipe for a delicious gluten-free apple pie, followed by links to some of our best loved gluten-free desserts and baked goods.
    This pie crust recipe comes from King Arthur Flour
     
    Great Gluten-free Apple Pie
    Gluten-free Pie Crust Ingredients (Makes 1 crust):
    1¼ cups King Arthur Gluten-Free Multipurpose Flour 1 tablespoon sugar ½ teaspoon xanthan gum ½ teaspoon salt 6 tablespoons cold butter 1 large egg 2 teaspoons lemon juice or vinegar Apple Pie Filling Ingredients:
    6 cups thinly sliced, peeled apples (6 medium) ¾ cup sugar 2 tablespoons King Arthur Gluten-Free Multipurpose Flour ¾ teaspoon ground cinnamon ¼ teaspoon salt 1 tablespoon lemon juice Directions:
    Heat oven to 425F. Be sure to double crust ingredients for a 2 crust pie.
    Cut the cold butter into pats. Then, in a large mixing bowl, work the pats into the flour mixture till it's crumbly, with some larger, pea-sized chunks of butter remaining.
    Whisk the egg and vinegar or lemon juice together till very foamy. Mix egg and vinegar mixture into the dry ingredients. Stir until the mixture holds together, adding 1 to 3 additional tablespoons cold water if necessary.
    Shape into a ball and chill for an hour, or up to overnight.
    Allow the dough to rest at room temperature for 10 to 15 minutes before rolling.
    Roll out on a cutting board clean table that is heavily sprinkled with gluten-free flour.
    Invert the crust into the un-greased 9-inch glass pie plate. Press firmly against side and bottom.
    Tip: The egg yolk makes this crust vulnerable to burned edges, so always shield the edges of the crust, with aluminum foil or a pie shield, to protect them while baking.
    Tips for Better Baking:
    Baking on high heat at the beginning will help prevent sogginess on the bottom of the crust. For best results, use a metal pie pan. Aluminum works best. Bake at 425°F on the bottom rack of your oven for 20 minutes, then reduce the heat to 350°F, move your pie to the middle rack, and continue to bake until the crust is golden and the filling is bubbly (40-45 minutes total baking time). Brushing the crust lightly with milk and sprinkling it with sugar will help the crust to brown better, and will also give a nice sparkle and sweet crunch to your finished pie. Here are links to some of our best loved gluten-free desserts and baked goods (Note: King Arthur Gluten-Free Multi-Purpose Flour will work well in place of regular wheat flour most of these recipes, so feel free to substitute as you like):
    Holiday Pumpkin Bread (Gluten-Free) Orange Walnut Bread (Gluten-Free) Pumpkin Pie Banana Nut Bread #3 (Gluten-Free) Gingerbread #2 (Gluten-Free) Decadent Gluten-Free Triple Chocolate Chunk Cookies Quick Cranberry Coconut Cookies (Gluten-Free) Molasses Spice Cookies (Gluten-Free) Snickerdoodles (Gluten-Free) Pumpkin Chocolate Chip Cookies (Gluten-Free) Soft Sugar Cookies (Gluten-Free) Frosted Pumpkin Bars (Gluten-Free) Sugar & Spice Madeleines (Gluten-Free) Lebkuchen (German Ginger Cookies - Gluten-Free) Three Ingredient Gluten-Free Pie Crust Danish (Gluten-Free) Pumpkin Cheesecake with Butter Pecan Crust (Gluten-Free) Apple Crisp #2 (Gluten-Free)  Tasty Apple Crisp (Gluten-Free)

    Connie Sarros
    This article originally appeared in the Autumn 2003 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 09/17/2014 - The traditional food pyramid of the past shows breads, pasta, rice, cereals (all high in carbohydrates) at the base of the pyramid, the ‘staple’ of the diet.  Recently, this assumption has come under attack.  Experts are telling us that a diet high in carbohydrates is bad for us (Why is it that the things we love to eat are bad for us?).
    We consume carbohydrates primarily from grains, fruits, vegetables (including ‘root’ crops such as potatoes), beer, wine, desserts, candies, most milk products (except cheese), and ‘…ose’ foods, such as sucrose, fructose, maltose, etc.  Eating an excessive amount of carbohydrates will increase total caloric intake, which may lead to obesity, heart disease and higher blood sugar levels.  Consuming too few carbohydrates may lead to an increase in our intake of fats to make up the calories (which also leads to obesity, heart disease and higher blood sugar levels), or malnutrition.
    Right now, it is considered the “in” thing to be on a low carbohydrate diet.  Dr. Atkins has become a household word.  The term “fad diet” refers to a diet that will yield rapid weight loss and is like a quick fix for a particular problem.  It sells the dream that this time you WILL lose weight and your life will be better.  Most diets fail to yield the anticipated results because we set unrealistic expectations of what our bodies can do.  The claim of the low carbohydrate diet is that you should adapt this regimen as a permanent way of life, thereby preventing weight-gain in the future.
    If carbohydrates are totally eliminated from your diet for a prolonged period of time, your body will become deficient in major nutrients.  Fortunately, it is nearly impossible to retain a 100% carbohydrate-free diet, because carbohydrates are found in fruits, vegetables, legumes––nearly everywhere.
    Some who follow the Atkins diet feel that it is permissible to consume large quantities of meat and eggs each day, both high in protein, and ignore their cholesterol intake.  Over a period of time, this may create other health risks.
    That being said, a sensible low-carbohydrate diet has been deemed a healthy one.  Americans consume way too much starch and sugar.  Diabetics must, of necessity, restrict their sugar and carb intake; the rest of us should follow suit.  
    Complex carbohydrates provide calories, vitamins, minerals, fiber, and improve your energy level.  Therefore, it is wise to replace processed carbohydrates (like bread, pasta, crackers, cereal) with complex carbs, such as the following:
    Apple Apricot Asparagus Broccoli Brussels sprouts Cauliflower Celery Cherries Cucumber Grapefruit Green beans Green pepper Lettuce Mushrooms Onions Plums Spinach Strawberries Tomatoes Zucchini The complex carbohydrates that should be limited if you are following a low- carbohydrate diet are:
    Acorn squash Baked beans Butternut squash Cooked dried beans Corn Grains Hummus Peas Plantain Popcorn Potato Rice Sweet potato Yam So what does a low-carbohydrate diet look like?  In the sample menu below, you will notice that ‘toast’ is listed.  One slice of ‘healthy’ toast (with flaxseed or sesame seed or other form of fiber) may be beneficial, even on a low-carbohydrate diet.
    Breakfast:  
    1 cup sliced strawberries (sweetened with ½ teaspoon honey) with 1 cup 0.5% milk.
    1 hard-boiled egg.
    1 slice toast with 1 teaspoon all-fruit jelly.
    Lunch:  
    Salad made with ½ cup shredded lettuce, ¼ cup diced tomato, ¼ cup diced green pepper, ¼ cup diced cucumber, ½ cup broccoli florets, 3 Tablespoons water-packed tuna (drained), 1 Tablespoon gluten-free lowfat Italian dressing.
    1 cup fresh cherries for dessert.
    Dinner:  
    4 oz. broiled salmon topped with 1 teaspoon gluten-free low-fat mayonnaise mixed with 1 teaspoon gluten-free Parmesan cheese.
    Sliced beets and onion salad.
    Zucchini, mushrooms and red peppers sautéed in 1 teaspoon olive oil with Italian seasoning.
    Juice-packed diced peaches folded into gluten-free sugar-free orange gelatin for dessert.
    A few final hints:
    Limit your intake of ‘white’ processed foods, including rice, breads and pastas.  If you need a sugar rush, get it from natural sugars—eat an orange or broil half a grapefruit.
    Use herbs and shredded cheeses to liven up entrees and vegetable dishes.  Read labels, not just for gluten ingredients, but for fat, sugar, sodium, and carbohydrate counts; the lower the numbers, the better it is for you.
    Buy foods in their natural state, eliminating processed foods, and vary your menu.  If you prepare bland foods or foods you don’t like, you won’t stick to any diet.

  • Recent Articles

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
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    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics