Celiac Digest

A publication of the Southern Arizona Celiac Support Group (SACS)
online at WWW.SouthernArizonaCeliacSupport.org
vol 5, issue 3
January 2007

DISCLAIMER: This publication is intended as a general information resource for gluten-intolerant individuals. It is NOT intended for use in diagnosis, treatment, or any other medical application. Please consult your physician for professional medical advice and treatment.

In this Issue

SACS Medical Advisory Board gives credibility

The new Southern Arizona Celiac Support Medical Advisory Board (MAB) will hold their first official meeting on January 19, 2007 to meet each other and discuss any goals that their collaboration might be able to Wataru Tamura, MD achieve in the future. A much-desired objective of SACS presidents for the last decade, the MAB has been “in-the making” for several years. Past-President Georgina Rubal took up the cause as a personal project and really pushed it to the forefront, and the current SACS executive board has now been able to help this dream become a reality.

A Medical Advisory Board increases the credibility of any local support group, both in the eyes of national organizations and in those looking for a support group. Naturally, MABs also provide “in-house” experts, or resources, for our membership. We have been so fortunate in SACS to have found some of our own support group members, who are also celiacs/gluten intolerant, to serve on our new MAB.

SACS members Geri Bazzell (RN) Nancy Schuller (Registered Dietician), Geri Bazzell (RN), Karen Luce (D.D.S./ periodontist ) and Diane Sheehey (Pharmacist) have agreed to serve us in this capacity. Also joining the MAB will be Erin Overgard (Registered Dietician), Joseph “Roccie” Zappia (Pharmacist), and Nancy Schuller
(Registered Dietician) Wataru Tamura, MD (Gastroenterologist).

This impressive list of professionals will make SACS one of the few CSA Chapters that have a Medical Advisory Board. We believe this will not only help draw more people to our chapter, but will help us increase awareness of celiac disease throughout southern Arizona, or perhaps even beyond that.

We plan to introduce our Medical Advisory Board at the January 27th , 2006 general meeting and hope that all of you will warmly welcome them. Then, after the meeting, please make a point of personally thanking them for taking the time out of their busy schedules to serve our support group.

Be watching our web site, as well as future newsletters, for profiles and more photos of our MAB members.

Jan. meeting to feature PillCam presentation by Dr. Tamura

Wataru Tamura, MD, a gastroenterologist and member of the SACS Medical Advisory Board, will project PillCam views of his patients’ damaged intestinal villi at 9 a.m. Saturday, Jan. 27, at our general meeting in the Marshall Auditorium, Tucson Medical Center. (Please see map Page 3.) His presentation will introduce SACS members to the value of the capsule endoscopy versus the standard endoscopic view and biopsy.

The PillCam procedure requires the patient to swallow an encapsulated camera that sends images that are recorded outside the body as the capsule travels through the entire small intestine.

Dr. Tamura, in a meeting with the SACS Board in December, said the PillCam image resolution is superior to those seen through the traditional endoscope. He also claims the Pill- Cam is an improvement over biopsies, which often miss the atrophied spots, which are flattened villi in the small intestine.

Dr. Tamura also told the board that he found in his practice that negative biopsies frequently will show up as positives in the PillCam images. Dr. Tamura says he has done more capsule endoscopies than any other Tucson area physician, and he maintained that he is astounded by his findings.

Dr. Tamura told the board that he finds himself surprised over and over again when patients with GERD (reflux) come to him after years of suffering, and then find out they have CD. “Ninety percent of my recently diagnosed Celiacs were GERD + NCCP (chest pain). You know, all the the real truth that hurts...there is a portion (who are Celiacs) that is being masked. If I were an academic, that would be the study I would do right now.”

Dr Tamura reported that doctors are taught to follow a protocol. “If a patient comes in with certain symptoms… you do certain tests, and prescribe certain medications. If that medicine doesn’t work, we up the dose…if that doesn’t work, then we change medications.”

This should be an especially informative meeting that you will not want to miss. Please bring a dish (if you can) to the meeting to share with others. Include the wrapper if you purchased the completed dish, or make a complete list of ingredients if the dish is home made. Set the ingredients list next to the dish. If feasible, bring copies of the recipes to share.

We need to display ingredients because many SACS members come with a variety of food sensitivities. You do not have to be a member to attend, and you certainly do not have to bring a GF dish to share. Everyone is welcome. (Directions to Marshall Auditorium: East bound on Grant, turn north on Craycroft and access the east side of the campus. Or, see map in this issue. )

Oscar update

I was very surprised and excited to receive a cash donation a couple of weeks ago for Oscar from SACS. I just wanted to thank everyone who made a donation; it went to good use for Oscar.

My mom and I went to Nogales on New Years Eve. I parked my car and Evangelina (Oscar’s mom) picked us up and took us to visit her mom and then she took us to her home, which is about 40 minutes from the border. She has done an amazing job with cooking gluten free. For breakfast she made us tamales and eggs, and for lunch she served us two different kinds of a Mexican soup, with fresh homemade corn tortillas. It was delicious.

Evangelina showed me all the ingredients she used and how she has learned to separate all of Oscar’s cooking supplies. Oscar stores his GF food in a small cabinet in his room. We also made a chocolate cake with frosting topped with bananas and peaches. We had a very nice visit. I also collected money from work, and we bought Oscar a Game Boy with games and bought his sister clothes. They enjoyed the gifts and, as always, Oscar was very thrilled with his GF cookies. I just wanted to give you an update on Oscar as his health has improved tremendously and he has not been sick to his stomach in a long time. Thanks for all your help.

Nov. Potluck small but tasty

Only 38 members turned out for the November 18th Potluck and general meeting at St. Mark’s, which was still an impressive number when we considered how close it was to the Thanksgiving Break and also took into account the traffic problems caused by the El Tour de Tucson. President Cheryl Wilson vowed that the 2007 Potluck would be timed to avoid the El Tour.

We still raised (from the raffle) over $150 to donate for Oscar’s Christmas gifts of GF food. Plus, the food was plentiful and really good. Jeanne Faidley brought a turkey and a new member made some delicious orange/cranberry sauce to go with it. There were lots of casseroles, meat loaf, quiche, lasagna, sweet potatoes, and fruit salad as well as a good variety of breads and cookies.

Member Laura D. reported on raising CD awareness among District 16 and Amphi School nurses and also gave a report on camping options for children with CD. President Cheryl Wilson and Past-President Georgina Rubal reported on the CSA conference in Green Bay Wisconsin. Georgina gave a special report on drug ingredient labeling and the special problems associated with generic medications. Member Nancy Schuller, R.D. reported on the International Celiac Symposium in NYC and has complete notes she will be happy to share upon request.

? Chipolte ?

Member Laura D. received this note from Chipotle Grill manager David Chrisman regarding whether it’s safe to eat at his restaurant.

“As far as gluten, your family can eat everything we serve except our large burrito tortillas, our small soft taco tortillas, and our hot red tomatillo salsa (there is some distilled vinegar in it which some celiac web sites say is bad and others say is okay).

As for our crispy corn tortillas and corn chips, although there is no wheat in them, our corn tortillas are made at a facility that also makes wheat tortillas, albeit in a completely separated area. We have followed every possible precaution to ensure that there is no transfer of wheat into the corn. But you may wish to be cautious of this if any of you are highly sensitive.”

Chapter 15 Notes

Boars Head Meats, according to the manufacturer: “All Boar's Head Brand® Meats, Cheeses and Condiments, as well as Hans Jurgen® Pickles are Gluten Free. But, always check the labels on store prepared entrees and sandwiches as they may contain gravies and sauces that contain gluten. For specific questions: contact us at our Nutritional Information Line by calling 800-352-6277.”

Benefiber has replaced guar gum in its formulation with wheat dextrin. Benefiber® (N) Powder which contains less than 10 ppm of gluten, is considered 'gluten-free', based on the Codex Alimentarius Commission's proposed definition of less than 20 ppm. They recommend not consuming their product unless you have a doctor’s OK.

Sun-Maid Vanilla Yogurt Covered Raisins and Chocolate Yogurt Covered Raisins are gluten-free. They are handy for lunch boxes. Call (559) 896-8000 if you need more info.

Warning: Paul Newman now has chocolate chip cookies and Oreo-type cookies in a package that reads in large letters: WHEAT FREE LACTOSE FREE and then in smaller letters ‘not gluten free’. Read all the labels, all the time. Sigh.

Warning: Progresso soups are not all GF. Progresso's Split Pea Soup with Bacon has barley flour in the ingredient list. Since it's not one of the eight major allergens, they don't declare it in the "contains" statement and it's not in the name of the soup. Don’t rely totally on the major allergen summary at the end of the ingredient list.

Dining in a Japanese restaurant and ordering ‘mugicha tea’? Well, don’t as the mugicha tea is made from mildly toasted barley. Stick with green or black tea.

CSA/USA: 877-272-4272, 8 a.m. to 3 p.m. Central Time. Their URL is: www.csaCeliacs.org.

Change of address/phone number or email: Notify us via the web site or call 742-4813.

Roundtable Resumes Jan. 24th

Health news to use

Overweight in Celiac Disease

According to a study posted in the November 2006 American Journal of Gastroenterology, “Few celiac patients are underweight at diagnosis and a large minority is overweight; these are less likely to present with classical features of diarrhea and reduced hemoglobin.” In fact, a large minority of patients are overweight at diagnosis and failure to acknowledge this leads to delayed or no diagnosis for this group. After diagnosis and implementation of a GF diet, 81% of patients gain weight, including 82% of the initially overweight patients. The authors of the study conclude, “The increase in weight of already overweight patients after dietary gluten exclusion is a potential cause of morbidity, and the gluten-free diet as conventionally prescribed needs to be modified accordingly.”

Celiac and its ‘Sister Diseases’

We all know that celiacs are especially prone to a host of other ‘sister diseases’, all autoimmune diseases, some of which can be life threatening. Dr. Alessio Fasano investigated the two main theories regarding this phenomenon - linked genes or untreated celiac leading to onset of other auto-immune diseases.

He concludes: “The current literature did not clearly establish which of the two theories explain the comorbidity between celiac disease and other autoimmune disorders. There is, however, growing evidence that the loss of the intestinal barrier function typical of celiac disease could be responsible of the onset of other autoimmune disease. This concept implies that the autoimmune response can be theoretically stopped and perhaps reversed if the interplay between autoimmune predisposing genes and trigger(s) is prevented or eliminated by a prompt diagnosis and treatment.”

He goes on to stress that even if celiac disease is ‘silent’ in an individual, it is very important to follow the diet so that the ‘sister’ diseases will not occur. Yes, it’s time to start nagging your relatives to get tested.

Map of TMC- Marshall Aud

Lemon Chicken is tangy and easy

Buy enough boneless/skinless chicken breast for two servings.

Meat: Beat one tablespoon corn starch into one egg white. Cut chicken into thin slices and put in bowl with the cornstarch mixture to coat.

Veggies: The recipe called for seeded cucumber, green onions and red bell pepper, all cut into slices. I prefer onions sliced into wedges and red bell pepper sliced into ½ “ strips. Thinner for softer and thicker for crisper.

Sauce: ¼ cup fresh lemon juice, three tablespoons honey (make sure to use a spatula to scrape correct amount out or your sauce will be too sour) and 1/8 cup GF soy sauce. Use about 1 to 2 teaspoons cornstarch stirred in to thicken.

Heat non-stick skillet over medium-high heat. Coat bottom with oil (I use olive) and quickly sauté chicken, breaking apart the strips. Don’t overcook as they will cook some more with the rest of the dish. Remove chicken from skillet and reserve.

Add more oil and stir fry the veggies for about three minutes, more if you like softer veggies.

Add the Sauce, stirring until mixture thickens. Add the chicken and heat for one minute through , covering the skillet. Serve over rice if you wish. This is easy to ruin if you cook it too much. Or, not— if you like well cooked vegetables.

Mark your calendar

2007

Jan. 24 - Roundtable, 1 p.m. Ward Six City Hall at 3202 E. 1st St.
Jan. 26 — 9:30 a.m.: Gluten-Free Cooking Class. See the article in this newsletter for details.
Jan. 27 — 9:00 a.m. - noon: General meeting, M.A.B and Dr. Tamura. Marshall Auditorium, TMC
Feb. 9 - noon: Lunch Bunch – Location TBA
Feb. 10 - 9:30 a.m.: Gluten-Free Cooking Class. See the article in this newsletter for details.
Feb. 16 - 9:30 a.m.: Gluten-Free Cooking Class. See the article in this newsletter for details.
Feb. 24 - 9:30 a.m.: Gluten-Free Cooking Class. See the article in this newsletter for details.
Feb. 28 - Roundtable, 1 p.m. Ward Six City Hall at 3202 E. 1st St.
March 9 — noon: Lunch Bunch - Location TBA
March 10 - 9:30 a.m.: Gluten-Free Cooking Class. See the article in this newsletter for details.
March 17 - 9:30 a.m.: Gluten-Free Cooking Class. See the article in this newsletter for details.
March 23 - 9:30 a.m.: Gluten-Free Cooking Class..See the article in this newsletter for details.
March 28 - Roundtable, 1 p.m. Ward Six City Hall at 3202 E. 1st St.
April 13 - noon: Lunch Bunch – Location TBA
April 25 - Roundtable, 1 p.m. Ward Six City Hall at 3202 E. 1st St.
May 23 - Roundtable, 1 p.m. Ward Six City Hall at 3202 E. 1st St.

PAGE FIVE

Open letter from Dr. Tamura

Thank you so much for letting me attend your board meeting, and I was very impressed at how much support you give celiac patients. I do agree there is a complete lack of cooperation with gastroenterologists who ought to be diagnosing and aiding dietary management, and the support groups who are making up for all of the aftercare, usually after much delay in diagnosis/neglect.

Too many gastroenterologists have become endoscopists (scope jockeys), who don't delve deeply into GI disorders. I believe now I have found MY support group - especially for the dietary management part. That’s another reason that GIs have given up on celiacs – noncompliance with the diet.

So now you all know that there is a doc out there who does not take IBS, GERD, or NUD (nonulcer dyspepsia) as a final diagnosis easily. But I must say, I am one of the few - even considering the academic circle- who utilizes capsule endoscopy to the fullest. If you would like the brochure for this procedure for your organization, I would be happy to supply copies of this.

Please tell every one who contacts you regarding their symptoms to consider the capsule endoscopy. It is NOT an expensive test, since it is definitive and means other tests do not have to be performed.

In order to see me, you must specifically request a consultation, because my office has another doctor (Dr. McCallum) whose wife is the office manager. We have a phone answering system with extensions that may occasionally be confusing.

The following information may be helpful:
Office number: (520) 818-3680 Extension: 23(or 5) appointment (usually voice mail) line, leave a message and the receptionist will contact the patient
Extension: 15(or 7) my nurse's line (as a back up)

Wataru Tamura, M.D.
Foothills Gastroenterology
1521 West Tangerine Road, Ste 361
Oro Valley, AZ 85755
Affiliated with Northwest Medical Center Oro Valley
Shop at Amazon.com through our web site at www.SouthernArizonaCeliacSupport.org. Go to our web site and follow the links so SACS can get a percentage of whatever purchases you make from whatever you buy at Amazon. com.

Gourmet gluten-free cooking classes

Gourmet gluten-free cooking classes are being offered at the Blue Sky Ranch, located in the Historic town of Tubac, Arizona. These classes will be taught by Dr. Nancy Aton, NMD (Naturopathic physician), preceptor in Dr. Andrew Weil's Program in Integrated Medicine at the University of Arizona Medical College, and by Tori Christie, Executive Chef, former NBC affiliate cook show host and Assistant director of food services for the University of Arizona. Classes are limited to 12 people, are $45.00 each and will begin at 9:30 a.m. For more information contact Sande Smith, at 520-400-0412 or email Sandara_S@hotmail.com. Below is a list of classes and dates:

Webmasters note: For the most up-to-date information on the Gourmet Gluten Free Cooking Classes, please see our web page about them..
Saturday, January 20th, taught by Tori Christie
Comfort Foods:
Penne Quarto Formaggio
Organic Ham Steaks
Sautéed Veggies
Caramelized Golden Pineapple with walnut Florentine cookies
Friday, January 26th taught by Dr. Nancy Aton
Sumptuous Salmon Dinner:
Wild grilled Salmon with pesto
Veggies with roasted pepper dip
Yukon gold smashed potatoes
Mesclun salad with honey mustard vinaigrette
Poached pears
Saturday, February 10th, taught by Tori Christie
Romance on the Orient Express:
Abundant Spring Rolls with ginger mint dressing sauce
Szechuan Garlic Sauce
Sesame Broccoli
Decadent Chocolate Truffles
Friday, February 16th, taught by Dr. Nancy Aton
Moroccan Feast:
Black Bean Hummus with Veggies
Moroccan Chicken with Basmati rice
Tzatziki (cucumber, yogurt and garlic sauce)
Stuffed Dates
Saturday, February 24th, taught by Tori Christie
Week-End Supper for Friends:
Southwestern Caesar Salad with Corn Tortilla “Croutons”
Baja Grilled Fish Taco Buffet
Corn and Black Beans with roasted peppers and tequila butter
Grilled Sweet Potatoes Salad with cilantro vinaigrette
Mocha Crème Brûlée
Saturday, March 10th, taught by Tori Christie
All American Spring Fling:
Cold Crab and Cucumber Bisque
Bacon wrapped Organic Chicken with fresh basil
Yellow corn and zucchini with pepper confetti
Grilled Asparagus with Grand Marnier dressing
Lemon Mousse
Saturday, March 17th, taught by Tori Christie
Saint Patrick’s Day Brunch:
Grilled Baby Lamb Chop with mint Smoked Salmon Benedict/Corn Beef
Potato Benedict
Hollandaise Sauce/Horseradish Mustard Sauce
Sautéed Spinach with Caramelized shallots
Roasted Root Vegetables with Gluten Free Guinness Ale
Baked Apples with Irish Whiskey
Friday, March 23rd, taught by Dr. Nancy Aton
Salads, Salads, Salads:
Celery Stuffed with Goat Cheese, Herbs and Bacon
Lentil Salad
White Bean Salad
Wild Rice Salad
Extraordinary Tofu Cheese Cake
Saturday, March 31st, taught by Tori Christie
Alfresco Spring Dinner:
Marinated Olives and Feta Cheese
Spiced Almonds
Baby Greens Salad with crisp proscuitto and fresh pears and lemon basil dressing
Chicken and Wild Mushroom Lasagna with potato “noodles”
Fresh Berries in Port
Friday, April 27th, taught by Dr. Nancy Aton
Travel to India:
Ginger Snap Peas
Quinoa Timbales
Lamb stuff with Chard, Garlic and Feta
Roasted Red Potatoes
Berry Parfait
Friday, May 25th, taught by Dr. Nancy Aton
Oaxacan Style Cooking:
Guacamole with a twist and Corn Tortillas
Oaxacan Style Roast Chicken
Cuban style Black Beans with Basmati Rice
Jicama Salad
Fresh Fruit Platter with Mango Sorbet

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