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      Frequently Asked Questions About Celiac Disease   04/07/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    GLUTEN-FREE THANKSGIVING PLANNER


    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.


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    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:

    1. Mix together dry ingredients, then cut in margarine or shortening carefully until there are no lumps larger than pea-size.
    2. Beat together the eggs, and water or vinegar.
    3. Make a well in dry ingredients and add egg and liquid mixture, stirring carefully with fork to combine.
    4. 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.
    5. Roll out carefully between wax paper.
    6. 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:

    1. Mix together all dry ingredients, then mix together rice milk and oil.
    2. Make well in dry ingredients and add rice milk/oil mixture, stirring gently with fork to combine.
    3. 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.

    1. Mix all ingredients together in large mixing bowl, in approximately the order they are listed.  Blend until thoroughly mixed.
    2. 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.




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    Guest Kathleen Taylor

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    I am so happy to finally find a decent pie crust recipe. Regardless, I was going to have baked pumpkin pie filling! Thanks

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    admin

    When I started eating gluten-free food I discovered a flour mix in a book called Living Healthy with Celiac Disease, Wendy Wark (AnAffect, 1998). In addition to the standard gluten-free flour mix of tapioca starch flour, potato starch flour and rice flour she added cornstarch and sweet rice flour. The addition of these two flours make a huge difference in the texture, flavor, and moisture content in gluten-free baking. I couldnt understand why more people werent using this superior flour mix so I made it my mission to distribute this recipe around. (If you cant tolerate corn, just substitute the cornstarch with equal parts of sweet rice flour and tapioca starch flour.)
    While Wendy gave me permission to use the flour mix and many of her recipes I failed to tell her I was naming the flour mix after her in my book. She has since told me that she found it on the internet and doesnt know the source of the recipe, she doesnt feel that she should take credit for the mix.
    Recently Authentic Foods decided to mix these flours in their factory and sell it as the Multi Blend Gluten-Free Flour, now available at The Gluten-Free Mall.
    Multi Blend Gluten-Free Flour (Wendy Warks Gluten-Free Flour Mix)
    1 cup brown rice flour (requires refrigeration)
    1¼ cup white rice flour
    ¼ cup potato starch flour
    2/3 cup tapioca starch flour
    ¾ cup sweet rice flour
    1/3 cup cornstarch
    2 teaspoons xanthan or guar gum
    I often use only brown rice flour in the mix as it is healthier and better tasting. I buy at least 5 pounds every time I order (from manufacturers that sell a lot of brown rice flour). I keep it refrigerated and highly recommend it over white rice flour. This flour mix is the basis of many of my sweets, breadsticks, tortillas, waffles etc. I also like to use pure buckwheat, amaranth, and quinoa flour to increase the flavor and healthfulness of certain items. It is important to buy these alternative flours from pure, gluten-free sources. Pure in the sense that they are grown in fields that are not adjacent to wheat fields and that they are processed in a 100% gluten-free environment from the field to your table.
    Triple this flour mix recipe and keep it on hand for all of your baking needs. Once you have the flour mix together you are ready for about a months worth of gluten-free baking.
    The Multi Blend Gluten-Free Flour mix is used cup for cup in recipes such as tortillas, pancakes/waffles, and cookies. If you plan to use this flour mix for cakes, sweet breads or brownies add an additional ½ teaspoon of xanthan gum per cup flour mix. I dont use this flour mix for bread, pizza crust, breadsticks, etc. as they require specific flour combinations for the best results (see Cooking Gluten-Free! A Food Lovers Collection of Chef and Family Recipes Without Gluten or Wheat Celiac Publishing, 2002).

    admin

    Cinnamon rolls are an occasional indulgence that we all deserve. In our home we dont make them often so they are very special. It is challenging to recreate the exact texture of a cinnamon roll but these come close. Substitutions:
    I like to substitute ½ the flour in the recipe with light buckwheat flour for an even better texture. The first time you make cinnamon rolls follow the recipe exactly and then begin to make your own substitutions. This way you will know what the dough is supposed to feel like before you begin to customize.
    Though I havent tried it, I believe that a dairy-free version would include substituting the dry milk powder with ground almonds in the Workable Wonder Dough recipe. Water could substitute for the milk in the Cinnamon Roll recipe (butter could be substituted with a non-dairy margarine).
    Tips:
    Whenever you make gluten-free bread or dough, take humidity into consideration. Always hold back a little of the water until you can see how wet the dough will be. Gluten-free flour absorbs moisture from the air and too much water can ruin a recipe. The dough needs to be firm enough to roll out with a rolling pin without sticking. It is important to tightly pack the cinnamon rolls into the pan, otherwise, they may become too firm. A warm towel placed over the pan during the rise phase is important. A good way to warm a towel is to place a wet, cotton dishtowel into the microwave for 40 seconds. Place the towel over the pan of cinnamon rolls and then cover with another towel or a piece of foil. This will allow for a nice rise. Good luck.
    Karen Robertson
    Cinnamon Rolls
    Makes nine 2-inch rollsEvery now and then you must treat yourself to a cinnamon roll! Packing them tightly into a baking dish helps to keep them moist throughout. Adapted from Wendy Warks Living Healthy with Celiac Disease (An Affect, 1998).
    1 recipe Workable Wonder Dough
    3 tablespoons butter, melted
    2/3 cup brown sugar
    3 tablespoons ground cinnamon
    ½ cup raisins
    1 1/3 cups confectioners sugar
    3-4 tablespoons milk
    Butter an 8-inch round cake pan.
    Roll out dough to a 9 x 18-inch rectangle, approximately ½-inch in thickness. Brush dough with 3 tablespoons melted butter. Sprinkle sugar, cinnamon, and raisins evenly over the dough. Beginning at one of the 9-inch sides, roll dough into a log shape. Using a sharp, clean knife, cut log into 9 equal pieces. Arrange rolls in prepared pan, packing tightly together and keeping the swirl side up. Cover with a warm, wet towel and let rise one hour. Bake at 400F. for 15-20 minutes. While cinnamon rolls are baking, whisk together confectioners sugar and milk in a small bowl. Drizzle mixture over hot, baked cinnamon rolls.

    Hallie Davis
    Celiac.com 10/16/2008 - Having gone gluten-free I, like many of you,have been struggling with gluten-free baking challenges. I began withpancakes. My first pancakes, made with a popular mix, were not thelight, fluffy things that I remembered. My son compared them to hockeypucks. They got eaten, but were not a favorite. The next time I tried apopular author's gluten-free pancake recipe. These were a hit, and didnot have the sourness of the popular mix (which were bean-based)! Theauthor's recipe was also based on sorghum flour, so I have becomeconvinced that sorghum holds the greatest potential for gluten-freebaking. I also tried the author's recipe for bread, which is based onher same sorghum flour mix as her pancakes. The bread, however, was adisaster, and it collapsed as soon as it was taken from the pan. Ithink possibly that the problem was that by the time you take hersorghum flour mix, and add the additional potato starch called for inmaking the bread mix, you end up with a mix that is overwhelminglystarch rather than flour. There is actually very little sorghum flourin it by that point. I repeated these problems when trying to use yetanother popular sorghum-based gluten-free bread mix.
    Meanwhile,in my search for a good sorghum bread recipe I kept coming across ablurb by the Agricultural Research Service to the effect that they haddiscovered that sour dough fermentation improved the quality of sorghumbread. Well, I have never been fond of the sourness of sourdough bread,but I was interested to know that the ARS was trying to find goodrecipes for sorghum bread. Apparently they are convinced, as I am, thatit holds the highest promise for good gluten-free bread.
    Well,heck, the Agricultural Research Service was my old stomping ground! Fora couple summers during college I worked at the ARS in Beltsville,Maryland, and at least one of them was spent in the Human NuitritionResearch Division. I worked as a biochemical technician. While I wasworking with test tubes and distillation apparatus, the wonderfularomas from the nearby test kitchens would waft by me and I would envythe taste testers. I decided to contact those sorghum researchers whohave been involved in the search for a good gluten-free bread recipe. Iemailed them requesting to know if they had developed any goodnon-sourdough recipes, and I received the following replies (the replyfrom Tilman Schober was particularly valuable):



    Dear Hallie Davis,
    Thereare a couple of things which could help you to get the desiredgluten-free sorghum bread. Sourdough is not imperative, it justadditionally helps to stabilize the bread structure. But we know thatmany people object to the flavor. So, besides sourdough, the followingthings may help:
    1) Add the hydrocolloid HPMC (hydroxypropyl methylcellulose).It tremendously helps to get a good crumb. It is a food additive, andsome people object to it because they regard it as not natural.However, it is available in a food grade version designed for humanconsumption, and we simply know nothing that works better. Xanthan gum,probably the second best hydrocolloid, is much inferior in gluten-freebread making. There are various slightly different versions of HPMCcommercially available. As US government employees, we cannot endorse aspecific product. However, I would like to let you know that we hadgood success with Methocel K4M, food grade, which is available fromretailers like Ener-G Foods. The larger your bread pan the more likely the bread willcollapse. Try to use small pans, and just bake more loaves. This alsohelps to keep them fresh (just freeze the loaves which you do not eatfresh immediately after cooling). A good pan size might be e.g. 6inches by 2-3 inches and 2-3 inches high. Mix sorghum flour with starch. A recipe that has worked for usis described in the attached article (wHPMC, p. 5138). It is as follows: 105g water, 70 g sorghum flour, 30 g potato starch, 1.75 g salt, 1 gsugar, 2 g dry yeast, and 2 g HPMC. Highest accuracy in weighing theseingredients is not required, but I would prepare a larger amount ofdough (e.g. all ingredients multiplied by 10), so that it is easier toweigh. Mix all dry ingredients first in a large bowl (make sure thatthe HPMC is well mixed with the rest, it tends to form lumps withwater). Then add the water, mix (electric mixer) until a smooth batterresults, and pour (or spoon) the batter in the greased bread pans. Letthe dough rise for about 30-45 min (depends on temperature, observe howit increases in volume) and bake at 355 oF for about 30 min (depends onpan size, you will need to find out for your pan size and oven type).
    Another source for sorghum recipes you can find here:
    http://www.twinvalleymills.com/
    They sell a celiac disease with recipes (it is copyrighted, so I cannot send it to you).
    If you have success, we would love to hear about it. If you need further assistance, please let us know.
    Kind regards
    Tilman


    Tilmanthen wrote again, enclosing a copy of the referenced article, andasking that I cite it. The article was published in the "Journal ofAgricultural and Food Chemistry", 2007, 55, 5137-5146, and is entitled,"Gluten-Free Sorghum Bread Improved by Sourdough Fermentation:Biochemical, Rheological, and Microstructural Background." The Authorswere Tilman J. Schober, Scott R. Bean, and Daniel L. Boyle. They areworking in the Manhattan, Kansas Grain Marketing and ProductionResearch Center of the Agricultural Research Center. The otherperson who responded to my inquiry was Scott R. Bean. He sent me anearlier but related article, entitled, "Use of Sorghum Flour in BakeryProducts." This article was published in the "AIB InternationalTechnical Bulletin" in Volume XXVIII, issue 3, May/June 2006. Theauthors here were:

    T.J. Schober and S.R. Bean, USDA-ARS, GMPRC, Manhattan, KS 66502 E.K. Arendt, University College Cork, Cork, Ireland C. Fenster, Savory Palate Inc., Centennial, CO 80122
    This article had the formulas for two sorghum flour blends:Sorghum-Corn Flour Blend and Sorghum-Bean Flour Blend. Furtherreferences for the mixes and also a brownie recipe is given as:
    Fenster, C. 2004. Wheat-Free Recipes & Menus: Delicious, Healthful Eating for People with Food Sensitivities. New York: Avery (Penguin Group).
    Arecipe for Sorghum Waffles was also given with a citation, "Recipe byAmy Perry and Meredith Wiking, used with permission fromwww.twinvalleymills.com." So, the ARS, like me, is using recipesby popular authors and Twin Valley Mills as a starting point, and areexperimenting from there.I don't know about you, but I, forone, intend to get the Methocel K4M, food grade, and try using itinstead of guar gum or xanthan gum! I also plan to try the 70-30sorghum mix described today by Dr. Schober. I am TIRED of gummy bread,and collapses!


    Jefferson Adams
    Celiac.com 03/14/2014 - The time is here again to celebrate all things green, all things Irish, and all things gluten-free!
    For a truly glorious gluten-free St. Patty's Day, be sure to see some of our classic recipes from previous years, such as our recipes for corned beef and cabbage, gluten-free Irish soda bread.
    Also, be sure to check out our recipe for delicious gluten-free lamb stew.
    For those serving corned beef, you should know that most commercial corned beef is gluten-free. Here, once again is our annual list of gluten-free.
    Remember, there are many other brands not listed here that are also gluten free. As always, be sure to check the ingredients on the package, including those for any extra seasonings.
    Some brand labels list natural flavorings, which usually do not contain gluten. Still, if you're not sure, ask your butcher, check the manufacturer's website, or look for a brand that is reliably gluten-free.
    The labels or websites for the following brands state that their products as 'gluten-free':
    Brookfield Farms Colorado Premium - all corned beef products Cook's Freirich - all corned beef Giant Eagle Grobbel's Gourmet corned beef briskets Hormel Libby's Canned Meats (Corned Beef and Corned Beef Hash) Market Day: Corned Beef Brisket Mosey's corned beef Nathan's corned beef Safeway, Butchers Cut bulk-wrapped corned beef brisket, corn beef brisket, vac-packed cooked corn beef Thuman’s cooked corn beef brisket, first cut corned beef (cooked and raw), top round corned beef (cooked), cap and capless corned beef Wegmans corned beef brisket

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    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center