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Celiac.com 11/19/2008 - Day Four: After a ride on a local public bus, which hugged the narrow road's teetering edge and rounded hairpin curves with an alarming sense of speed, we felt grateful for the solid earth beneath our feet in Positano. Our first order of business was to check into the Hotel Villa Rosa and find a nearby trattoria to fill our grumbling stomachs! One of the staff, Stefania, recommended Caffè Positano on the Fornillo side of the town and arranged for a courtesy taxi to deposit us at its doorstep. Without a doubt, its chief allure was the alfresco terrace facing the sea. Situated across the road from the main restaurant and kitchen, the terrace held a dozen or so umbrella-topped tables and beckoned foreigners with unforgettable views. Jill: We decided to share an enormous plate of salty prosciutto and cold sweet melon as an appetizer. Jeff ordered pesce spada griglia (grilled swordfish) and I chose petto di pollo aceto (grilled chicken with a balsamic vinaigrette, parmesan and arugula). We nibbled at each other's dishes and savored every bite of that culinary welcoming, so much so that we'd find ourselves back for more during our stay. Days later, upon seeing zuppa di verdura (minestrone soup) on the menu, Jeff asked how it was prepared. Our server confirmed it did not contain any noodles/macaroni or gluten, and Jeff was pleased to have his fill of the strictly vegetable-based soup, which we learned is how minestrone is typically prepared in the region. Experimental cook that he is, Jeff was eager already to replicate the recipe when we returned home to San Francisco. Jeff: The Villa Rosa provided an ample gluten-free breakfast. Each morning my tray included a gluten-free chocolate croissant and gluten-free toast with butter and jam, along with our usual assortment of coffee, tea and yogurt. After we finished a late breakfast, lounging at the beach was one of our favorite things to do. Like many beach areas, lunch fare leaned toward sandwiches, pizzas and the like. The few restaurants tended to be overpriced, but we found a reliable alternative in the salumeria, the Italian version of the delicatessen which means "cured meat shop." It had a variety of cheeses, meats and salads priced by the kilo. In addition to fresh pasta and pasta salads, the place usually had salads that were pasta-free and gluten-free. Also, once I discovered that French fries were readily accessible (yes, in Italy) and the minestrone was, in my experience, always gluten-free, I knew I had a reliable fallback. This reinforced my confidence and led us to make an exception of avoiding sit-down lunches near the beach. We tried La Cambusa, where the waiter called us by our city of origin: Mr. and Mrs. San Francisco. I had my staple fallback meal, and Jill snacked on a tasty ham and cheese omelet that she washed down with a glass of prosecco. Jill: While most of our experiences were positive, we had a few missteps along the way. During our first evening at a beach snack shop, Jeff ordered saltimbocca, a dish generally prepared with rolled veal, prosciutto or ham and cooked in a wine and butter sauce. However, what he ended up with was a sandwich version, pressed between thick slabs of bread, that I stuck in our fridge for my lunch the following day. Another time for dinner, we visited Donna Rosa, a family-run trattoria perched high in the hills of nearby Montepertuso, where the locals know to go to eat well and on the cheap. For an appetizer we chose scallops which, to our consternation, were lightly dusted with a bread-crumb gratin that wasn't described on the menu. These surprises could have been averted, though, if we hadn't let down our guard and relied too heavily on the menu. Ultimately, these experiences nudged us to remember to ask questions upfront and not get too comfortable. Day Nine: When we arrived in the more isolated fishing village of Praiano, a veritable country cousin to cosmopolite Positano, Jeff plopped down in the pastel-hued restaurant of the Hotel Margherita mere minutes after dropping his bags. He was famished and awaited a sumptuous plate of spaghetti posillipo, made with the hotel's gluten-free spaghetti and mushrooms. In fact, Jeff was so enamored with the heaping dish of gluten-free goodness that he borrowed my digital camera to snap a photo and in a flurry of excitement accidentally erased all of our other pictures! Well, at least we've got the memories... The Hotel Margherita proprietor Suela and her husband Andrea were also attentive to Jeff's breakfast needs. In addition to the standard buffet that had a generous gluten-free assortment of eggs, deli meat, cheeses, yogurt, coffee and tea, they purchased extras for Jeff, including a sweet, gluten-free lemon muffin and gluten-free toast. Jeff: On the Vettica side of Praiano, the Trattoria San Gennaro was a brisk fifteen-minute walk from the hotel and sat above the main piazza and church. The view from the terrace was both panoramic and quaint, with the Mediterranean offsetting glittering Positano at night and the piazza coming alive with families sitting about while their children played soccer. The place had been recommended by a kind gentleman named Nicola who works at the Villa Rosa in Positano and lives in Praiano. The restaurant served the best bowl of gluten-free minestrone yet! It was so big I have described it as a “tankard” of soup, loaded with fresh vegetables. Though, you do need to ask the kitchen to hold off on the freshly toasted bread garnish. I’ve rarely been so completely well- fed as when I ordered the fries, minestrone and local fish specialty for dinner on our first night. We lingered well into the night, sipping the local wine and taking in the smell of the sea. Day Twelve: Perched on the cliffs, Ravello is often heralded for its gardens, Villa Rufulo and Villa Cimbrone, and has played host to departing Crusaders, famous authors and numerous other visitors throughout history. The town's stone walls, quaint walkways and tight, cobblestone streets exude the charm of antiquity. Gluten-free dining proved to be equally simple here. We arrived at the Hotel Graal early afternoon and were starving after two long cramped bus rides from Praiano. We headed to the restaurant, where the maître d' guided us to a shaded table on the terrace. Soon we lunched on gluten-free mushroom penne pasta and salad and took in stunning views of the ocean and the nearby seaside village of Minori. Jill: Perusing our guidebook, we found a trattoria tucked away beyond the main piazza called Cumpa' Cosimo and decided to give it a try for dinner. Thankfully we'd made a reservation, as the medieval-inspired place that was dotted with pictures of celebrities and run by Italian nonna (grandmother) Netta Bottone filled up fast. Everything on the menu looked enticing. The roasted rabbit caught Jeff's eye, along with more minestrone soup. He couldn't seem to get enough of the stuff! Craving comfort food, I bypassed the local specialties for a four-cheese pizza and glass of beer. After trying a bit of Jeff's entrée, though, I had a serious case of rabbit envy! We were pushing our last-bite limits when Netta paraded over to our table with a complimentary dessert, something like a cross between cheesecake and tiramisù, which Jeff picked at in order to avoid the crust (Celiac.com does not recommend doing this), and I couldn't resist polishing off. When Jeff mentioned that he was a writer as we paid our tab, Netta darted back to the kitchen and returned with a plate of figs and grapes. From her garden, she said, and insisted we put them in our pockets for later. Day Fourteen: Rome may be the Eternal City, but we had all of a day and a half there to explore, with the half starting after our nine-hour transit by private car, Amtrak train and then a female Formula One taxi driver at Termini Station. Since the next day was Sunday and we had no desire to fight the faithful who would attend mass, we opted for a quick visit to St. Peter's and from there trotted over to the Trastevere district for dinner. The Trastevere, a bohemian counterpart to New York's East Village, is one of my favorite places and it won over Jill, who hadn't quite been captured by the Roman magic. Even in August when the area was thick with tourists, street vendors and buskers, it seemed like a breath of fresh air in a city that can be every bit as overbearing as New York or London. We eyeballed a few menus and sniffed out a crowded place that seemed to move food at a good clip. It was elbow-to-elbow seating at our cramped alleyway table, with throngs of tourists shuffling past, but soon we dined under a blue Roman sky at dusk. We enjoyed a flavorful gluten-free meal of fresh salads, veal marsala, mushroom risotto and handmade local sausages. Despite being stuffed already, we couldn't resist some stracciatella (chocolate chip) and nocciola (hazelnut) gelato near the Piazza Santa Maria, where a polished quartet of young classical musicians serenaded the crowd. In general, we noticed an abundance of gluten-free salads, soups, roasted meats and risottos in Rome and in all four towns we passed through along the Amalfi Coast. We found reliable delis and easy access to fresh fruit. When we asked, places that did not have gluten-free pasta showed a willingness to prepare any that you provided. So, with a quick trip to the local pharmacy for some gluten-free pasta, you could dine with confidence! Contrary to our fears before the trip, eating gluten-free while traveling in Italy proved easy to do. With a bit of planning, a call to the airline to line up a gluten-free meal, an Italian/English explanation of your dietary needs and the standard caution nearly all people with gluten intolerance bring to eating out, anyone can look forward to an enjoyable, gluten-free holiday in Italy. Co-written by Jefferson Adams

Celiac.com 08/02/2002 - The Bishops National Liturgy Office in Italy recently approved a low-gluten Eucharistic host made by a specific German firm for use by worshippers who have celiac disease. The hosts have been approved by the scientific committee of the Italian Celiac Association and are made using Codex Alimentarius quality wheat starch that contains 0.0374 milligrams of gluten. Additionally, the Vaticans Congregation for the Doctrine of the Faith has also approved the hosts for use in the Eucharist. According to the Catholic Church the bread used in the Eucharist must be made exclusively from wheat, and the German-made hosts are currently the only ones produced that meet all of the Catholic Churchs requirements. This decision creates controversy, however, between worshippers with celiac disease in Europe and the United States, mainly due to the differing opinion with regard to whether those with celiac disease need to be on a 100% gluten-free diet. Since support groups and some segments of the American scientific community advocate a 100% gluten-free diet, the Catholic Church recommends that worshippers with celiac disease in the United States only receive communion if the form of consecrated wine.

Celiac.com 08/07/2008 - We'd begun practicing basic Italian⎯buon giorno! We'd practically memorized the Frommer's travel guide. We'd scoured multitudes of online travel sites and finally made all the arrangements for our once-in-a-lifetime romantic getaway to the sun-kissed shores of the Amalfi Coast. As the date of our departure approached, we grew more excited to spend our first major vacation together, tucked away in cliffside hotels, taking in sweeping views of the Mediterranean from our seaside balconies. We had some lingering doubts, though. Jeff follows a gluten-free diet, and I was concerned about how well he'd be able to eat in Italy, the land of pizza, pasta and bread. I know how difficult it can be to dine out, even in our neighborhood in San Francisco. What could he possibly find that would be gluten-free in Italy? And, with the language barrier, how would we be able to easily communicate his needs? Jeff: I know a little Italian, but solo un po’ (only a little), as the Italians say. So I, too, was a bit worried. At home, I keep tight control over what I buy, prepare most of my own meals and eat out only at select places that I know are safe. I was worried that consuming every meal at a hotel or restaurant for two weeks straight would present challenges. Like so many people with celiac disease, I've lost more than a few days to gluten contamination. That's the last thing I wanted to happen on such a special trip. One of the first things we did was to e-mail the hotels several weeks in advance to see what gluten-free options they might offer. We crafted a short inquiry in English, and just in case the staff only spoke Italian, put it through a free online translation service called Babel Fish. We included both versions in our messages. All four hotels responded within a day or two, most in English. Three confirmed gluten-free options in the hotel and/or its restaurant. One pledged a solution upon arrival, suggesting that Jeff could communicate a preference for breakfast, and the hotel would meet his needs. Jill: I was especially impressed with Casa Astarita, a bed and breakfast along the first leg of our trip in Sorrento. The staff at Casa Astarita noted that we could request food without wheat or barley, recommended a restaurant in the square and pledged to help us during our stay in Sorrento. In addition, the Hotel Margherita in Praiano, a charming seaside town off the beaten path, assured us of gluten-free pasta and biscuits (probably what we would call crackers) in the hotel. Another step we took about two weeks before our flight was to contact the airline about gluten-free meal options. We wondered if Jeff would be able to eat gluten-free on both legs of the trip⎯from San Francisco to Chicago, and more importantly, the nine-hour haul from Chicago to Rome. Either way, we planned to pack plenty of gluten-free snacks to have on hand as a precautionary measure. Jill: The American Airlines customer service representative told me the airline did not offer gluten-free meals on the short flight from Chicago to San Francisco, and we'd need to bring our own food. However, on the longer flight from Chicago to Rome, they could accommodate gluten-free needs. The representative confirmed a special meals code for the gluten-free food request (GFML is the code) that was entered into the reservation. American Airlines also pointed us to its Web site, which lists sample menu options that may vary month to month: Brunch/hot breakfast - Mushroom cheddar omelet with sweet potato hash, yogurt, seasonal fruit Cold breakfast - Yogurt, seasonal fruit, breakfast cookie Lunch/dinner - Sweet chili salmon, green beans, white rice, salad, fresh fruit Snack - Penne pasta with artichokes, fresh fruit The quick and positive responses from the hotels and airline immediately put us at ease. A little online research into gluten-free travel in Italy promised a smooth experience.Jeff: It turns out that the Italians are actually at the forefront of celiac disease awareness and treatment. In fact, all Italians are screened for celiac disease before they are six years old. [1,2] Those with celiac disease receive excellent support, including monthly payments from the government for gluten-free food, as well as more vacation to offset extra time used to shop for and prepare gluten-free food. Italians are also on the vanguard of the gluten-free food movement. The country's robust celiac association, called the Associazione Italiana Celiachia (AIC), the Italian government and several large Italian companies that make and distribute gluten-free foods have joined together to promote awareness and understanding of celiac disease. This makes for knowledgeable restaurant owners, managers, chefs and waiters. [3] Italians are among the most expert crafters of gluten-free pastas and baked goods. Italian companies like Beretta and BioLand make delicious gluten-free rice pasta and a variety of other gluten-free food products, while others produce numerous gluten-free specialty items for import, such as chestnut flour. AIC has a helpful Web site and convenient 24/7 telephone hotline. Both offer celiac information and support in English and Italian, along with tips on gluten-free food and dining in every region of Italy. [4] So, all of the useful information we turned up in our search made us hopeful that our first vacation together just might be a gluten-free gastronomic delight. Tune in next month to find out how things turned out on the ground. Until then, happy gluten-free travels and, as the Italians say, Mangia bene! Eat well! http://healthlink.mcw.edu/article/1009402816.html http://celiac-disease.emedtv.com/celiac-disease/ celiac-disease-screening.html http://www.prlog.org/10063446-at-last-the-gluten-free-guide-to-italy-guide-to-the-gluten-free-land-of-pasta.html http://www.celiachia.it/default.asp Co-written by Jefferson Adams

Celiac.com 09/11/2008 - After a two-leg flight and multiple trains, Jeff and I finally stepped off the local Circumvesuviana train in sunny Sorrento, our first destination on the fabled Amalfi Coast. It was hot, or as the Italians say, molto caldo. We’d been traveling for nearly 24 hours straight, and as we lugged our bags along the final stretch of cobbled sidewalks toward Casa Astarita, we both felt exhausted, ravenous and more than a bit disoriented. Jill: Any nourishment from our 10-hour flight from Chicago to Rome had long since faded. However, American Airlines had made good on its promise to provide Jeff with decent gluten-free meals. The attendant had confirmed his special meal selection at the beginning of the flight, and at both dinner and breakfast he was among the first to be served (much to the envy of the other hungry passengers!). Jeff: For dinner American served me a gluten-free meal of blackened chicken on a bed of quinoa, with green beans, melon and a gluten-free German chocolate cookie. Now, airline food is never going to win any Michelin stars, but I was grateful that my meal was gluten-free, hot and reasonably palatable. As we checked into Casa Astarita, the helpful receptionist Marella suggested that we try Bar Syrenuse, a nearby ristorante with gluten-free menu options. Marella even gave us a referral card good for a 10 percent discount. After freshening up, we sauntered a couple blocks to the Piazza Tasso, the main square, where we easily found the cheerful and airy establishment. Jill: Bar Syrenuse offered a separate gluten-free menu selection. Many of the items, such as the meats and salads, were regular staples on the menu. Jeff had many options to choose from – including gluten-free pasta. I opted for a club sandwich, stuffed with local ham and cheese, and a caffe alla nocciola (hazelnut coffee). Jeff: The intense heat of the day was just beginning to break, and I wasn’t in a pasta mood at that moment, so I ordered pollo al forno (grilled chicken with balsamic vinegar, parsley and chili flakes) and an insalata verde (green salad). The food was delicious, and sitting on the terrace made for a lovely introduction to Italy. All this for two for under 25 euros. Perfecto! Day Two: Our stay at Casa Astarita included breakfast, and we’d been assured via email of gluten-free options. The staff did not disappoint and even offered to prepare an omelet if Jeff wished. He ultimately chose from the standard offerings of orange/pineapple yogurt, fresh juices, individually brewed coffee, cheese and corn flakes (which for some might best be avoided) before we began our morning walk. Jill: During our meanderings through the town and along the cliffs overlooking the spectacular Bay of Naples, we checked out a few potential lunch spots and perused their menus. We decided on a simple outdoor restaurant, Angelina Lauro, near that train station that offered shaded tables and faced a grassy piazza bearing the same name. Jeff had a vegetable and cheese omelet along with fries, which would frequently become his reliable substitute for bread. I had a scrumptious margherita pizza. It was so big that I was able to save half for lunch the next day. Jeff: After a short nap followed by another evening walk along the Marina Grande, we again headed for Bar Syrenuse – this time, with gluten-free pasta in mind! We decided to share a few dishes and ordered gluten-free penne pasta with tiny tomatoes, grilled seasonal vegetables and an insalata caprese. The pasta was nicely cooked, with a flavorful sauce. Jill commented it tasted so good she’d have never known it was gluten-free. It was then I realized just how good it felt to be in Italy, sitting outside and eating pasta, an almost forgotten favorite, as the sun went down. The manager of Bar Syrenuse is a personable gentleman named Toni. We were able to pull him aside during a pause in his busy dinner rush and ask a few questions about how the restaurant came to offer gluten-free options. Toni explained that there are so many special diets that it is important to offer many choices to attract the fullest clientele, and noted that a wide range of food options is a reflection of good service, which is good for business. Consequently, Bar Syrenuse offers numerous items that cater to a number of specialty diets. Day Three: After a torrid afternoon spent traipsing through the ruins at Pompeii, where we’d consumed just a few snacks – gelato, granita and coconut snack bars – we were ready for a proper meal. The day before, we’d spotted several quaint restaurants tucked away in the alleys near our hotel, and so we headed in that direction. We nestled in at Ristorante Sorrento, a charming establishment with a large awning and phalanx of outdoor tables adorned in crisp white tablecloths. Jeff started with minestrone soup, followed by a main course of fresh local white fish with tomatoes in a white wine sauce and a green salad. I choose lemon risotto with shrimp and an order of pane (bread). Jeff got a little extra protein that night as I quickly passed over the jumbo shrimp to his plate. Their heads, with those little black eyes staring back at me, were more than I could take! During our stroll back to the hotel, we stopped to purchase a few postcards and sip some cappuccino before settling in for a good night’s rest, before moving on to what would be the absolute gem of our trip, picture-perfect Positano. Check back for our next article featuring our gluten-free gastronomical adventures in this serene oasis by the sea!

Associazione Famiglie Bambini Celiachi Contact: Emilia Romague Via Masia 21 I-40138 Bologna, Italy Tel: 39/51/391980 A.I.C. Associazione Italiana Celiachia Home page: http://www.celiachia.it/ Contact: Anna Maria Vallesi Via Picotti 22 56124 Pisa, Italy Tel/Fax: +39 (50) 580939 E-Mail: aic@cibernet.it Ancona Group: Marche Contact: Ratini Paolo Via A.Rocca, 20 60011 Arcevia (Ancona) Tel. +39-731-9047 Bologna Group: Assoc Famigilie Bambini Celiaci Contact: Silvio Costantini Via Masia 21 I-40138 Bolgna Tel. +39-51-391980 Bolzano Group: Alto Adige Contact: Sinn Franz Via Am Eichamt, 29 39050 Cornaiano (Bolzano) Tel. +39-471-662424 Cagliari Group: Sardegna Contact: Maria Teresa Russo Via Sassari, 69 09121 Cagliari Tel. +39-70-652912 Capoterra Resource of Italy Contact: Luigi Delussu Strada 47, Poggio dei Pini 09012 Capoterra CA Tel: 39 70 725483 E-mail: luigi.delussu@galactica.it, or gioppo@freenet.hut.fi Catanzaro Contact: Quattromani Antonio Via Brigata, 7 88100 Catanzaro Tel. +39-961-782310 Foggia Group: Puglia - Basilicata Contact: Gasperi Anna Maria Pia Via Padre Ardelio della Bella, 13 71100 Foggia Tel. +39-881-686930 Genova Group: Liguria Contact: Spanio Barbara Via Telesio, 4/3 16145 Genova Tel. +39-10-319232 Italian Coeliac Association Piazza Costituzione Italiana, 2 50023 Figline Valdarno Firenze Milano Group: Lombardia Piazza Erculea, 11 20122 Milano Tel./Fax: +39-2-86.78.20 Napoli Group: Campania Via Fiorentine a Chiaia, 9 80122 Napoli Tel. +39-81-7612112 Palermo Group: Sicilia Donizetti, 12 90134 Palermo Tel./Fax. +39-91-320702 Perugia Group: Umbria Contact: Pellicori Spinelli Elsa Via Cortonese, 74/A 06127 Perugia Tel. +39-75-5007369 Pescara Group: Abruzzo Contact: Innamorati Paolo Via Botticelli, 53 65100 Pescara Tel. +39-85-4210355 Prato Group: Toscanav Contact: Ricci Viviana Viale Montegrappa, 314 50047 Prato Tel. +39-574-583169 Reggio Emilia Group: Emilia Romagna Contact: Gualtieri Mauro Via Bonazza, 22 42016 S.Giorgio Di Guastalla (Reggio Emilia) Tel. +39-522-830328 Roma Group: Lazio Contact: Sgroi Maria Rosa Via dei Giovi, 45 00141 Roma Tel. +39-6-87181786 Torino Group: Piemonte - Valle dAosta Contact: Lucia Bramante Via Palestro, 11bis 10036 Settimo Torinese (Torino) Tel. +39-11-8950476 Trento Contact: Vettori Elsa Loc.Man S.Antonio, 25 38050 Villazzano (Trento) Tel. +39-461-922117 Treviso Group: Veneto Contact: Finardi Umberto Via Fabia, 17/9 31010 One Di Fonte (Treviso) Tel. +39-423-948166 Trieste Group: Friuli Venezia Giulia Contact: Spinelli Caterina Via Tolmezzo, 8 34100 Trieste Tel. +39-40-422472

Author: Auricchio S; De Ritis G; De Vincenzi M; Silano V. Source: J Pediatr Gastroenterol Nutr, 1985 Dec, 4:6, 923-30. This paper is a critical appraisal of current theories on the mechanisms of toxicity of wheat and other cereals in celiac disease and some related enteropathies. The peptidase deficiency, primary immune defect, and gluten-lectin theories on celiac disease are examined and critically discussed on the basis of the relevant data available in 88 references. Special attention has been paid in this review to the nature of the cereal components triggering the appearance of toxic symptoms and signs in celiac disease as well as to underlying action mechanisms. The gluten-lectin theory is the one best able to explain celiac disease. It also explains some secondary intolerance that may occur in temporarily predisposed individuals as a consequence to viral hepatitis and intestinal infections, as well as the occurrence of intestinal lesions in healthy subjects that are administered very high amounts of gluten.