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Dermatitis Herpetiformis
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Discussions concerning the skin condition associated with celiac disease.

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    Jefferson Adams
    What’s the Deal with Gluten Sniffing Dogs?
    Celiac.com 09/20/2018 - Some people with celiac disease experience extreme symptoms when they eat gluten. These folks adopt various strategies for navigating the world. One of those strategies involves getting a gluten-sniffing service dog.
    We’ve done a few stories on gluten-sniffing dogs over the years. Dogs like Zeus and Hawkeye are famous for helping their owners sniff out gluten before they can eat it.
    Can Gluten-Sniffing Dogs Help People with Celiac Disease?  The stories are always popular. People love the stories, and people love the dogs. After all, pretty much anyone with celiac disease who has ever read about gluten-sniffing dogs would love to have one. Who could say no to a warm, fuzzy dog that can take a sniff of your food and signal you when it contains gluten?
    The stories almost always generate plenty of feedback and more than a few questions. To answer some of those questions, we’ve decided to do an article that provides some facts about gluten-sniffing dogs.
    Here are a few factors to keep in mind about gluten-sniffing service dogs:
    Gluten-free Dog Status:
    One thing to remember is that proper gluten-sniffing dogs are professionally trained service animals, much like seeing-eye dogs or hearing-ear dogs. 
    As professional service animals, the dogs must be trained and certified as service animals. The dogs may then accompany their master pretty much anywhere they go, and are available to assess all food and snacks.
    Gluten-free Dog Training:
    Proper training takes time, which equals money. Professional trainers might only train one or two dogs, and the training can take about a year. There are very few trainers for gluten-sniffing dogs, and there are also currently no official guidelines or certification.
    Gluten-free Dog Cost:
    In our recent story on the gluten-sniffing black Lab, Hawkeye, we noted that the dog cost $16,000, not including food, and vet bills. 
    Gluten-free Dog Reliability:
    Nimasensor.com notes that “[g]luten-sniffing dogs may detect gluten in amounts as small as .0025 parts per million with 95 percent to 98 percent accuracy.”
    The Mercola.com website says that Willow, a gluten-sniffing German shorthaired pointer in Michigan, can detect gluten with 95 percent to 98 percent accuracy. 
    Read more on gluten-sniffing dogs:
    Gluten-Sniffing Dogs Are Game Changers for People With Celiac Disease Gluten-sniffing dogs help people with celiac disease What to Know About Gluten-Sniffing Dogs Gluten-Sniffing Assistance Dog Helps Celiac Sufferer Lead Normal Life

    Jefferson Adams
    The Girl Scouts Adds New Gluten-Free Cookie to Popular Lineup
    Celiac.com 09/19/2018 - Great news for gluten-free cookies lovers!  Girl Scouts has announced the debut of a new gluten-free cookie to its enormously popular cookie brand. 
    The new Caramel Chocolate Chip is a chewy cookie that contains caramel, semi-sweet chocolate chips, and a hint of sea salt. also happens to be gluten-free. The new gluten-free treat will be available in select areas during the 2019 cookie-selling season; which typically runs from February to April each year.
    The gluten-free Caramel Chocolate Chip joins the Girl Scouts’ two other gluten-free offerings: Toffee-tastic, a buttery cookie with sweet and crunchy golden toffee bits, and Trios, a peanut butter oatmeal cookie with chocolate chips. 
    The Girl Scouts of America has been around for over 100 years and now hosts more than 1.8 million girl members. Every year, about 100 million scouts between the ages of five and 18 sell approximately 200 million boxes of cookies nationwide. According to the Girl Scouts website, that money stays local to develop local leadership training activities, summer camps, and more activities.
    According to a 2016 study conducted by the Girl Scout Research Institute, approximately 85% of Girl Scouts surveyed said that Girl Scout Cookie Program helped them learn how to set goals and meet deadlines, while 88% said it helped them become effective decision-makers. Another 88% said they learned how to manage money, while 94% said the program helped them to learn business ethics.
    The Girl Scouts have also added online sales and iOS and Android apps that allow people to find cookies or order from their phones.

    Jefferson Adams
    No Gluten-Free Diet for Tennis Champion Roger Federer
    Celiac.com 09/18/2018 - With a number of major tennis stars singing the praises of a gluten-free diet, including top players like Novak Djokovic, Swiss great Roger Federer weighed in on the topic.
    The 20-time Grand Slam winner says that he’s never tried the gluten-free diet, and that he doesn’t not “even know what that all means…I eat healthy, and I think that's what people should do, too, if they have the options. It's sure important the right diet for an athlete.”
    Djokovic, the 2018 US Open winner has been gluten-free since 2011, and calls the diet his biggest key to his success.
    For Federer, diet is helpful, but not the whole story. “[Diet] can help you, you know. I mean, I think every athlete should be in good shape. I don't think we should have any fat athletes, to be honest. We do too much sports and we should be too professional to let that happen to ourselves.
    If it happens, well, we should wake up. You don't have the right entourage. They're not telling you that you're a bit fat. Players try different things, and whatever works for them. I do my thing. It's been very easy and natural and healthy, and it's worked.”
    So, while Novak Djokovic, and a number of other athletes, have gone gluten-free and continue to tout the benefits, look for Federer to remain faithful to his generally nutritious non-gluten-free diet.
    Read more at: TennisWorldUSA.org

    Connie Sarros
    All About Eggplant
    Celiac.com 09/15/2018 - People have a love/hate relationship with the purple fruit called ‘eggplant’. Eggplants, first cultivated in southern India and Sri Lanka, are also known as aubergine, Guinea squash, melazana, and ‘poor-man’s caviar’. Like potatoes they are members of the nightshade family, and despite the fact that we all consider eggplant to be a vegetable, biologically it is defined as a berry, and therefore it is a fruit.
    When selecting the fruit, select ones that are firm to the touch, have a smooth and shiny skin and are heavy. Avoid those with brown or soft spots and have a dull color. Gently push with your thumb or forefinger. If the flesh gives slightly but then bounces back, it is ripe. If the indentation remains, it is overripe and the insides will be mushy. If there is no give at all, the eggplant was picked too early. Once you bring it home, avoid placing it near tomatoes and apples, as they give off a gas that quickens the ripening process. Try to use the eggplant within two days of purchase.
    There are several cooking hints that will make your ‘eggplant experience’ more tasteful. Do not cook this fruit in an aluminum pan as it may cause discoloration (both of the pan and the fruit!). The skin is edible on small, younger plants, but should be removed on coarser, older ones. Once you cut the eggplant and cook it right away because the flesh will brown (similar to cut bananas). This fruit absorbs oil very easily, so it is recommended that you coat the slices with cornmeal before frying or baking. To help reduce the bitter flavor in older plants, ‘de-gorge’ the eggplant—Slice the eggplant into ½-inch pieces, salt well, then weigh down each slice in a colander to allow the liquid to drain out of the eggplant for 30 minutes—then rinse with cold water and pat dry.
    Equivalents and Nutritional Value—one pound of eggplant equals 3½ cups of diced eggplant and 1¾ cups cooked eggplant. One medium eggplant weights about 1 pound. It contains vitamin C and potassium, has anti-bacterial and diuretic effects, as well as flavanoids (cancer fighting antioxidants). One cup cooked eggplant contains 25 calories.
    The different ways to prepare eggplant are limited only by your imagination. Cut it into matchsticks to add to a stir-fry. Cube it for vegetable stews (Ratatouille). Shred it to make fritters, or puree it for a hummus-style dip. You can also slice it lengthwise and grill it.
    This fruit is probably most famous for the Italian rendition of Eggplant Parmigiana. But the Greeks have taken this dish one step further, ‘Moussaka’. If you have never eaten this, it is a delight to savor. Lean ground beef may be substituted for the ground lamb. Three zucchini may be used in place of the eggplant (if you prefer). Even if you hate eggplant, you will love Moussaka.
    The beauty of Moussaka is that this casserole may be made in advance, then covered and refrigerated overnight, or covered with foil and frozen—before you bake it (thaw in the refrigerator completely before baking). Time is precious for us all, and this concoction does take some time to assemble, but every moment is worth it. This makes an impressive side dish for company, it is perfect for a buffet table, or it can be used as a main dish for a family dinner.
    The following recipe is from my “Wheat-free Gluten-free Reduced Calorie Cookbook”. Traditional Moussaka is ‘loaded’ with calories and fat and cholesterol. This version is lower in calories and fat without sacrificing any of the delicious taste.
    Moussaka (Greek Casserole Dinner)
    Ingredients:
    1 large eggplant, peeled 2 teaspoons olive oil 1 large onion, chopped ½ pound lean ground lamb 5 teaspoons tomato paste ¼ cup white wine ¼ cup chopped fresh parsley 1/8 teaspoon cinnamon 18 teaspoon salt 1/8 teaspoon pepper 1 tablespoon margarine 1 ½ tablespoon cornstarch 1 cup scalded 1% milk 1 egg beaten until frothy 1/8 teaspoon nutmeg ½ cup gluten-free lowfat cottage cheese 1/3 cup gluten-free corn muffin crumbs, dried 1/3 cup Parmesan cheese, shredded Directions:
    Preheat broiler. Cut the peeled eggplant lengthwise into ½-inch thick slices. Spray both sides of the slices with gluten-free nonstick spray; set on a broiler pan and broil until browned, turning once. Preheat oven to 350F. Heat olive oil in a skillet; add onion and sauté until lightly browned. Add the lamb and cook, breaking meat up with a fork, for 10 minutes or until the meat is browned. In a small bowl, stir together the tomato paste, wine, parsley, cinnamon, salt and pepper; add to the meat and simmer, stirring frequently, until all liquid has been absorbed. Remove from heat. Melt the margarine in a medium-size saucepan; blend in the cornstarch with a whisk. Slowly stir the hot milk into the cornstarch; cook over medium heat, stirring constantly, until thickened. Cool slightly, and then stir in the beaten egg, nutmeg, and cottage cheese. Spray a 9-inch square pan with gluten-free nonstick spray. Sprinkle the bottom lightly with 2 tablespoons of the corn muffin crumbs. Arrange alternate layers of eggplant slices and meat mixture in the pan. Sprinkle each meat layer with the Parmesan cheese and remaining corn muffin crumbs. Pour the cottage cheese mixture over the top. Bake 45 minutes or until the top is golden. Cool slightly before cutting. Makes 6 (4 ½ X3-inch) serving.

    Jefferson Adams
    Nima Labs Claps Back at Gluten Free Watchdog Over Gluten Sensor Data
    Celiac.com 09/14/2018 - Celiac.com was all set to do a story on the latest peer-reviewed data on the Nima gluten testing device, when along comes Gluten-Free Watchdog with another of their famous non-recommendations. Gluten-Free Watchdog says they cannot recommend the Nima gluten test kit because of alleged flaws.
    But what does the science say? The latest Nima article and Gluten-Free Watchdog’s complaint both focus on the science, so let’s start there.
    Nima makes two different food sensors: one detects gluten, the other detects peanuts. Each sensor comprises a small, handheld electronic device and a cartridge. To test food, consumers place a pea sized amount into the cartridge, place the cartridge inside the sensor, and run the device.  They then receive a smiley face or wheat symbol with "gluten found," depending on whether or not the Nima device detected the allergen.
    Nima reported their original data in a peer-reviewed scientific journal. Among the conclusions: “Compared with reference R5, Nima antibodies (13F6 and 14G11) had 35- and 6.6-fold higher gliadin affinities, respectively. Nima demonstrated device performance using a comprehensive list of foods, assessing detection sensitivity, reproducibility, and cross-reactivity. Nima presented a 99.0% true positive rate, with a 95% confidence interval of 97.8%–100%.”
    Gluten Free Watchdog says that:
    “Based on third party testing data, the Nima Sensor fails to detect gluten at the 20 ppm level over 20 percent of the time. It isn’t until a sample contains a level of gluten at the 40 ppm level, that a gluten found result is received close to 100% of the time.” Gluten Free Watchdog suggests that this is a problem, because:
    “At a level of gluten in a sample from less than 2 ppm up to a level of gluten between 30 ppm and 40 ppm, the result displayed on the Nima Sensor may be either smiley face or gluten found. If a sample is tested with a Nima Sensor and the result is a smiley face, there is no practical way for a consumer to know if the level of gluten in the sample is less than or more than 20 ppm. If a sample is tested with a Nima Sensor and the result is gluten found, there is no practical way for a consumer to know if the level of gluten in the sample is less than or more than 20 ppm. As a result, the data point received from the Nima Sensor for gluten presents major interpretation problems.” Gluten Free Watchdog charges that Nima uses “NOT the scientifically validated Ridascreen Gliadin R5 ELISA Mendez Method from R-Biopharm used by Gluten Free Watchdog.” The fact is that R5 Elisa remains the industry standard for most testing applications. 
    Gluten Free Watchdog closes its warning with a word from their independent expert: According to Adrian Rogers, Senior Research Scientist at Romer Labs, “It could be argued that the device is not fit for purpose as the company states that there is a clear differentiation between safe and unsafe products based on a 20 ppm level which the validation data does not corroborate.”
    It’s worth noting that for all his accomplishments, Rogers is neither a doctor, nor a PhD. Rogers' LinkdIn page lists his education as: Bsc (Hons), Microbiology, University of Wales, Aberystwyth. A Bachelor of Science degree may not necessarily make an expert in this subject, yet he is presented as one.
    Rogers also seems to have a potential conflict of interest that was omitted in Thompson’s press release. Directly from Rogers’ LinkdIn site:
    “Romer Labs®, Inc. developed an immunochromatographic lateral flow assay for the qualitative detection of gluten in raw ingredients, processed foods, finished food products, and environmental surfaces, using the G12 antibody developed by Belén Morón. The G12 antibody targets a 33-mer peptide which is resistant to enzymatic digestion and heat denaturation, as well as being the fragment of the gliadin protein to which celiac disease sufferers react, making it a reliable analytical marker.” The company Rogers works for, Romer Labs, makes its own gluten testing kits. It seems a bit disingenuous for Gluten Free Watchdog to use a spokesperson from a potentially competing company to try to counteract a peer-reviewed scientific publication for a device which is made by a potential competitor.
    Nima’s Scientific Advisory Board includes some of the most highly respected celiac disease researchers and scientists in the world. They include: Peter HR Green, MD Phyllis and Ivan Seidenberg Professor of Medicine. Director, Celiac Disease Center at Columbia University; Jody Puglisi, PhD Stanford University Professor of Structural Biology; Lucille Beseler, MS, RDN, LDN, CDE, FAND Family Nutrition Center of South Florida; Benjamin Lebwohl, MD, MS Director of Clinical Research Celiac Disease Center at Columbia University; John Garber, MD Gastroenterology, Mass General; and Thanai Pongdee, MD Consultant, Division of Allergic Diseases, Mayo Clinic.
    Nima says that Gluten Free Watchdog’s view of their recently published validation is incomplete and misleading. Nima wrote:
    “All the studies show Nima is highly sensitive across a range of both low and high levels of gluten." "The Nima third party data accurately reported gluten found at 20 ppm and above between 93.3% for food as prepared (a food item that is spiked with an intended quantity of gluten) and 97.2% for food as quantified by an ELISA lab kit (used to determine the exact ppm of gluten in the food)." "The Nima peer reviewed study published in the Food Chemistry Journal reported gluten found at 20 ppm and above at 96.9% accuracy." The statement that:
    “'Nima will fail to detect gluten at 20 ppm 20% of the time' is almost entirely driven by 1 specific food out of 13 tested. That sample, when quantified, was actually below 20 ppm." "In real life, people get glutened at many different ppm levels, not just 20 ppm. Nima has been shown to detect gluten at levels below, at and above 20 ppm across a variety of foods in a number of studies.” Reading the peer reviewed data provided by Nima, and reading Gluten Free Watchdog’s complaints, it becomes clear that Gluten Free Watchdog’s complaints sound serious and authoritative, but ring a bit hollow. 
    Consider the Following Analogy
    Imagine a gluten-sniffing dog that performed as well as Nima in scientific trials; same performance, same exact data. 
    You can give this dog a sniff, or a small bite of food, and he can signal you if the food’s got gluten in it with 97% accuracy at 20ppm or below. Nearly 100% accuracy at 40ppm or above (as stated by Gluten Free Watchdog).
    People would think that the dog was not only cute and fluffy, but wonderfully helpful and everyone would love it, and everyone with celiac disease would want one. And it would be a great big gushing warm and fuzzy feel-good story. Pretty much no one would be arguing that the dog was potentially dangerous, or somehow unfit for people with celiac disease. Such dogs would also be far more expensive to own and maintain than the Nima device. Apparently such dogs can cost upwards of $16,000, not including the cost of food, vet bills, etc.
    So, what’s the accuracy rate of a gluten-sniffing dog, anyway? From Mercola.com: Willow, a German shorthaired pointer, is another gluten-sniffing dog, in this case living in Michigan. Her owner, Dawn Scheu, says she can detect gluten with 95 percent to 98 percent accuracy. She worked with a trainer (the same one who trained Zeus) to teach her own dog to detect gluten, with excellent results.
    Gluten-sniffing dogs may detect gluten in amounts as small as .0025 parts per million with 95 percent to 98 percent accuracy. So, will Gluten Free Watchdog be warning against gluten-sniffing dogs anytime soon?
    Somehow, because Nima is a mechanical device made by a company, it's not so warm and fuzzy, not so feel-good. Maybe Nima needs to shape their device like a cute little doggy, or a Pez candy dispenser?
    But the data remains, as does the fact, whatever its drawbacks, anything that detects gluten like Nima does, as well as it does, is potentially very helpful for celiac disease in numerous situations. And it is extremely unlikely to do them any harm.
    Nima seems very much committed to transparency, scientific excellence, and continual product improvement. These are noble goals and generally a win for people with celiac disease. Think of it, just ten years ago, a portable gluten-sensor with the kind of accuracy Nima is reliably achieving would have been the stuff of fantasy. Yet here it is. More accurate than any gluten-sniffing dog, and for a couple hundred bucks. People with celiac disease are living in a very different world than just a few years ago.
    Nima did not have to publish its data, but it chose to do so, and in a reputable, peer-reviewed scientific journal. Nima conducted its research using solid scientific standards, and reported those results publicly. They explained their methodology and results, they acknowledged product limitations and expressed a commitment to improvement. How is this remotely controversial?
    The celiac disease community is fortunate to have companies committed to investing time and money into products and devices that help to improve the lives of people with celiac disease. We feel strongly that the perfect should not be the enemy of the good. Devices like the Nima gluten sensor can be helpful for numerous people with celiac disease.  
    Disclosure: Nima is a paid advertiser on Celiac.com. Celiac.com's advertisers do not influence our editorial content. 
    Read Nima’s full report on test data at: Food Chemistry.com Read Gluten Free Watchdog’s Statement on the Nima device at: Glutenfreewatchdog.org Read Nima’s Reply to Gluten Free Watchdog at: Nimasensor.com

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