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    USDA Researches Use of Sorghum as a Gluten-Free Alternative Grain


    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.


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    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. 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.
    2. 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.
    3. 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:

    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!

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    Great article. Does anyone have a sorghum based (or gluten free) bread recipe that contains no corn and no tapioca? I am sensitive to both materials as well!

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    Guest Hallie Davis

    Posted

    I suggested to Dr. Schober that the above recipe was not 'kitchen friendly' since few persons have a kitchen scale that measures in grams. He was kind enough to make the conversions to volume, revising the recipe as follows:

     

    ******************************

     

    Dept. of Agriculture Sorghum Bread: (multiplied by 10)

     

    1050 g (4+3/4 cup) water,

    700 g (6+1/2 cup) sorghum flour,

    300 g (2 cup) potato starch,

    17.5 g (2+1/2 to 3 teaspoon) salt,

    10 g (2 teaspoon) sugar,

    20 g (5 teaspoon) dry yeast, and

    20 g (4 Tablespoons) HPMC.

     

    (We use Methocel K4M, food grade, from Dow)

     

    Mix all dry ingredients first in a large bowl (make sure that the HPMC is well mixed with the rest, it tends to form lumps with water) to make your bread mix.

     

    I would recommend using very small bread pans. I bought mine in the local grocery shop, dimensions should be around 6 x 3 x 2 inches (2 inches is the height). Thus, the above quantity should yield more than 2 loaves. (Could you maybe tell the people to simply make several small loaves at once, or upscale/downscale the recipe? It is required to fill the pans only 2/3 of their height.

     

     

    Mix (electric mixer) until a smooth batter results, and pour (or spoon) the batter in the greased bread pans (use small pans, otherwise the bread will collapse; e.g. 6 x 3 x 2 inches (2 inches is the height). Let the dough rise for about 30-45 min (depends on temperature, observe how it increases in volume) and bake at 355 degrees F. for about 30 min (depends on pan size, you will need to find out for your pan size and oven type).

     

    I have optimized the water content in several studies. Less water makes the bread dry and low in volume (the dough is so firm that it cannot rise – the situation is completely different from normal wheat bread, in which less water is required). HPMC contributes to water binding. The actual amount of water may vary depending on the flour properties, but should always be around 1:1 (by weight, not by volume).

     

    ******************

     

    I have tried this recipe exactly as written above. I did find that the Methocel, instead of gums and egg whites, allowed it to have an improved crumb. However, I think that more potato starch, and slightly increased water might allow it to rise more, and might improve the taste and make the crust less cement-like. Using the Methocel has, I believe, opened a new door for experimentation, and I welcome all of you to start experimenting with sorghum flour-potato starch recipes, substituting Methocel for eggs and gums. I know we are all looking for a recipe that will rise well enough to give a loaf large enough to be sliced for sandwich bread. Happy experimenting!

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    I can't find Methocel on the EnerG Foods website. Hallie, did you purchase from them or elsewhere?

     

    Look forward to your reply.

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    I purchased it direct from Dow, but generally they only sell to companies. I had to buy 10 pounds, which is much more than I need. I'm tempted to package it into smaller portions for sale to people who are having trouble getting it.

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    Guest Celeste

    Posted

    Great info, but not sure where the sourdough comes into the recipe? (seems a straight recipe with no fermentation)

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    Phyllis Morrow
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    Gluten-Free Recipe Sources:

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    Destiny Stone
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    Pre-Made Gluten-Free Condiments, BBQ sauce and Marinades *Tip: Not all spices are created equal. While most spices are naturally gluten-free,  many spices have gluten added as a filler ingredient. Make sure your spices are gluten-free and check with the manufacturer if you have any doubts.

    Gluten Free Finger Foods:
    No BBQ is satisfying without finger foods. Make sure to bring your own finger foods to a BBQ & it's  always good to bring extra to share. Whenever I have taken gluten-free snacks to a party, my gluten-free snacks get eaten up before any of the other snacks. Whether it is the novelty of the gluten-free  snacks, I don't know. So if you want to enjoy the  snacks you bring-bring extra because everyone seems to love gluten-free snacks. There are many salty snacking options, but don't forget that healthy choices like celery and carrot sticks are naturally gluten-free, and they make a wonderful finger food.
    Gluten Free Chips & Snacks Vegan Gluten-Free Garlic Hummus DipIngredients:
    1 can (16 ounces) gluten free chick peas or garbanzo beans¼ liquid from the can
    3 tablespoons fresh squeezed lemon juice
    1 ½ tablespoons tahini
    5cloves garlic, crushed
    ½ teaspoon Himalayan salt
    2 tablespoons extra virgin olive oil
    SERVES 5 -10
    Preparation:
    Drain chickpeas and reserve 1/4 of a cup of the liquid. Place all ingredients in a blender and blend on low until smooth. This is a  basic recipe, but you can add your favorite  spices to  make whatever variation strikes your fancy.

    Gluten-Free Alcohol:
    What BBQ is complete without a cold beer or blended margarita to wash down all the yummy grub? While beer is typically made with wheat or barley and is therefore not gluten-free, in these modern times, we have more options than our celiac/gluten intolerant relatives ever drempt of. Today, we can find beer brewed with rice, sorghum, millet and other gluten-free grains. Sampling gluten-free beers before a BBQ or event will allow you to decide which beers you like so you know what to bring to the BBQ. I have included links below  to gluten-free beers world-wide, though many of the following beers can be found at your local grocery store. (Please note, not all beers on the following list are certified gluten-free. Some are from a dedicated facility, but all are gluten-free).
    Gluten-Free Beers

    New Grist Redbridge Green's Hambleton Ales O'Brien
    Certified Gluten-Free Beers
    Billabong Brewing St. Peter's Gluten-Free Dedicated Breweries
    Schnitzer Bräu Bard's
    Distilled Alcohol:
    It is a bit easier to accommodate gluten sensitivities with mixed drinks, as all distilled alcohol is naturally gluten-free. However, most drink mixers contain gluten. For a list of gluten-free alcohol and gluten-free mixers go here:
    Distilled Alcohol and Spirits And for those of us looking for non-alcoholic gluten-free beverages, there are many wonderful gluten-free, non-alcoholic drinks on the market. Although, I always feel more confident making my own gluten-free beverages whenever possible. The following is a recipe for agave sweetened lemonade-perfect for a hot day!
    Gluten-Free Lemonade With Agave
    Ingredients:

    1/2 cup agave nectar syrup 1 cup water 10 leaves lemon verbena, slightly crushed in a mortar pestle 8 large lemons (organic if possible) enough water to suit your taste buds
    *Tip: If you are looking for a kick, you can also use this as a mixer for alcoholic beverages.Preparation:

    To create the simple syrup, combine the agave and water to boil in a small saucepan When the mixture has come to a boil, add the lemon verbena leaves Turn off the heat and let the syrup sit on the stove top for half an hour Refrigerate until cool Making the lemonade: Juice the lemons as much as possible Add the lemon verbena syrup to the lemon juice Add water, in small batches, until the lemonade tastes the way you like to drink it Serve over ice and garnish with a leaf of lemon verbena
    Serves 4
    Gluten-Free Quick Check:
    Use a gluten-free dedicated BBQ whenever possible Keep all gluten-free food separate from gluten containing food Make sure your spices, dips and drinks are all gluten-free Check all labels Contact manufacturers whenever necessary Keep your hands clean Enjoy!

    Gini Warner
    Celiac.com 11/20/2012 - Gluten-free diets are making headlines and trimming waistlines. For those with celiac disease, gluten–free living is prescribed to ensure proper nutrient absorption, but just about everyone can benefit from eliminating gluten from their diet. While going gluten free may sound difficult, the benefits such as increased energy and a smaller belt size are well worth the effort.
    Cutting gluten from your diet is not synonymous with cutting taste. There are so many delicious gluten-free substitutes, one of which is garbanzo bean flour. Garbanzo bean flour, also know as chickpea flour, gram flour and besan is made from grinding dried chickpeas to a fine flour that can be used by itself or blended with other flours. Garbanzo bean flour is an excellent substitute for the gluten-containing flours that are used for baking, such as wheat flour. It can also be used to thicken soups, sauces or gravies.
    Garbanzo bean flour is high in protein and low in fat. It is a good source of dietary fiber and iron and is completely grain-free. Garbanzo bean flour contains no cholesterol, sodium or saturated fat. Wheat flour, in contrast, contains 190 mg of sodium, less fiber, no vitamin C and less iron. Garbanzo bean flour is inexpensive, under $3.00 for 22 ounces and recipes required less garbanzo bean flour, 7/8 cup replace one cup of wheat flour. Garbanzo bean flour is easily found in most markets, but you can make your own at home by grinding dried chickpeas in a food processor and coffee/spice blender.
    As an experienced clinical nutritionist, I work with people who have a wide variety of health issues. My specialties include the gluten-free diet and weight loss. Over the past 20 years, I have seen significant health improvement in my clients after only one week on the gluten-free diet and continued changes for the better as they embrace a gluten-free lifestyle.
    Gluten-free living has changed my life and it can improve yours. The gluten-free diet can help with weight management; it can elevate your energy levels, improve your attention and speed up your digestion. Whatever your motivation is for going gluten free - whether you have celiac disease, gluten intolerance or a desire to live a healthier, stronger life, my book, The Gluten-Free Edge, will help you to achieve your goal. It’s an easy-to-read guide to living without gluten that includes 200 delicious gluten-free recipes. This book will also help you with social situations and teach you the key to reading food labels. You will learn how to look for gluten-free products both at restaurants and in your supermarket. The Gluten-Free Edge is equipped with all of the information you need to get through the world without gluten.

    Connie Sarros
    This article originally appeared in the Winter 2004 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 09/25/2014 - Every year, life seems to get more hectic.  There is never enough time to get the things done on the ever-growing “to-do” list, let alone find time to relax.  Then you are diagnosed with celiac disease and suddenly realize you can no longer stop at Subway for a hoagie sandwich on your way home.  You get a sinking feeling in the pit of your stomach as you acknowledge that you will have to actually cook most of your own meals at home!  
    There is no need to panic.  There are many shortcuts that can help you get in and out of the kitchen faster.  Here are just a few:
    Make a list of all the items you buy at the grocery store.  Make your list very specific, organized by aisles at the store.  Print off multiple copies.  As you run out of things during the week, put a check mark next to the item on your list.  When it is time to go shopping, most of your list will already be done. Keep a “basic pantry.”  These are items you should always have on hand.  Not only does this include spices, household cleaners, paper products, and canned goods, but a back-up pantry meal is always good to stock as well.  This can be anything from cans of beans for a bean salad, gluten-free pork and beans or a can of tuna fish, to gluten-free spaghetti and gluten-free spaghetti sauce. Make extras.  If you are making soup, chili, spaghetti sauce, marinated chicken breasts, cookie dough, etc., make two or three times the quantity you need; freeze the extra portions so you have meals that just need to be popped into the microwave on the days you don’t have time to cook. Use disposable foil cookware for those really messy recipes.  Also, dish out dinners in the kitchen, from pot to plate; that way, you won’t have serving dishes to wash. Soak whole potatoes in hot water before baking them—they will cook much faster.  When potatoes need peeling, peel them after they are cooked when they are cool enough to handle and the skins will slip right off. Use leftovers to make a different meal.  Open a bag of ready-to-use lettuce and top it with last night’s leftover corn, taco filling, diced tomatoes, and sprinkle with gluten-free cheddar cheese.  Or top the salad with thin slices of the leftover roast beef, diced leftover asparagus spears…you get the idea.  You can also chop leftovers into bite-sized pieces and place them in a resealable freezer bag, and the next time you have leftovers toss them in.  When the bag is full, open a large can of gluten-free chicken or beef broth, add the contents of the bag, and voila—you have Recycled Soup! Save the crusts.  If you can’t get the kids to eat their crusts, trim them from their bread and store them in a resealable freezer bag (gluten-free bread is too expensive to buy and too time-consuming to make to throw out the crusts!).  When the bag is full, let the crusts dry out for 24 hours, then run them through a food processor or blender, adding spices like dried parsley, garlic powder, paprika, and/or Italian seasoning, and make breadcrumbs. Use a crock pot.  There are many meals that can be made in crock-pots, such as the recipe that follows.  Cut up your leftover veggies and meat from the night before.  You can also cut up potatoes ahead of time and soak them in cold water in the refrigerator.  In the morning, layer everything in the crock pot, add some liquid (gluten-free barbecue sauce, gluten-free spaghetti sauce, tomato sauce, gluten-free broth, or salsa), turn the temperature to low or slow cook, and eight hours later your meal is ready. With a little practice and planning, you can enjoy healthy, quick, gluten-free meals.  Planning ahead is the key to saving time.  Plan your meals for the week, including how you are going to use up the leftovers.  There definitely is time for “life after cooking” on a gluten-free diet.  You can find more quick meal ideas in my book, Wheat-free Gluten-free Cookbook for Kids and Busy Adults.
     

  • Recent Articles

    Jefferson Adams
    Celiac.com 06/19/2018 - Could baking soda help reduce the inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease? Scientists at the Medical College of Georgia at Augusta University say that a daily dose of baking soda may in fact help reduce inflammation and damage caused by autoimmune diseases like rheumatoid arthritis, and celiac disease.
    Those scientists recently gathered some of the first evidence to show that cheap, over-the-counter antacids can prompt the spleen to promote an anti-inflammatory environment that could be helpful in combating inflammatory disease.
    A type of cell called mesothelial cells line our body cavities, like the digestive tract. They have little fingers, called microvilli, that sense the environment, and warn the organs they cover that there is an invader and an immune response is needed.
    The team’s data shows that when rats or healthy people drink a solution of baking soda, the stomach makes more acid, which causes mesothelial cells on the outside of the spleen to tell the spleen to go easy on the immune response.  "It's most likely a hamburger not a bacterial infection," is basically the message, says Dr. Paul O'Connor, renal physiologist in the MCG Department of Physiology at Augusta University and the study's corresponding author.
    That message, which is transmitted with help from a chemical messenger called acetylcholine, seems to encourage the gut to shift against inflammation, say the scientists.
    In patients who drank water with baking soda for two weeks, immune cells called macrophages, shifted from primarily those that promote inflammation, called M1, to those that reduce it, called M2. "The shift from inflammatory to an anti-inflammatory profile is happening everywhere," O'Connor says. "We saw it in the kidneys, we saw it in the spleen, now we see it in the peripheral blood."
    O'Connor hopes drinking baking soda can one day produce similar results for people with autoimmune disease. "You are not really turning anything off or on, you are just pushing it toward one side by giving an anti-inflammatory stimulus," he says, in this case, away from harmful inflammation. "It's potentially a really safe way to treat inflammatory disease."
    The research was funded by the National Institutes of Health.
    Read more at: Sciencedaily.com

    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. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    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