NOTE FROM ALICE
NFCA Executive Director

Summer sunshine brings some of the tastiest gluten-free snacks on the planet: fresh fruit! Now is the perfect time to pick those tart raspberries, sweet strawberries and juicy blueberries and savor their naturally celiac-friendly deliciousness.

If you're headed to the beach, stock your trusty cooler with grapes, watermelon, cheese and some gluten-free crackers. Fruit is a refreshing way to reenergize after spending hours in the intense summer sun, while cheese and crackers will tide you over for a long afternoon of sand and surf.

Planning to go hiking? No adventure is complete without the right snacks! Don't leave home without chocolate, trail mix, gluten-free granola, almonds, peanut butter and plenty of water.

Of course, no matter where you go don't forget to bring a few Do I Have Celiac? brochures along for the trip.

You never know who you might bump into! Raising awareness can be as simple as stopping to speak to a stranger and telling them your story. From all of us at NFCA, make sure you get out there, lend a helping hand and have a wonderful time this summer!

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BEYOND RICE CAKES
Sizzling Summer Food: Gluten-Free and Delicious

By Vanessa Maltin
NFCA Director of Outreach & Programming

Fresh fruits and vegetables, hamburgers, watermelon margaritas and ice cream are the first foods that come to mind when I think about summer. I love being outside at the pool, having picnics and preparing the freshest and most delicious food.

Typically I stick to traditional summer foods. I don't like most gluten-free hamburger or hotdog buns, so I've always resorted to eating mine bun-less or wrapped in lettuce. But this year, I decided to start thinking outside of the box and look for foods that are high quality, gluten-free and...exquisite.

My favorite summer cooking adventure so far is Chili Pecan Crusted Goat Cheese with Peach Salsa and Spinach Salad. I came up with this recipe for one reason only. I had too much stuff in my refrigerator and needed to use it up! And, the combination sounded delicious to me!

At first glance, it sounds somewhat difficult to make, but if you break it down into three parts plus assembly, it is actually a fairly simple recipe to make.

Step 1: Peach Salsa

• 2 Semi-Ripe Yellow Peaches
• 1 Red Onion, diced
• 2 Tomatoes, diced
• 1 bunch Cilantro, finely chopped
• 1 Serrano Chili, finely diced and seeds removed
• 2 tablespoons Lime Juice
• 1 teaspoon Kosher Salt
• 1 tablespoon Garlic Powder

In a mixing bowl, gently stir all ingredients together. Chill while you prepare the rest of the food items.

Step 2: Spinach Salad

• 1 tablespoon Garlic, minced
• 1 tablespoon Olive Oil
• 2 tablespoons Lime Juice
• 2 tablespoons Orange Juice
• 2 tablespoons Lemon Juice
• 2 teaspoons Sugar
• Pinch Salt
• Pinch Pepper
• 1 package fresh Spinach

In a mixing bowl, whisk together all ingredients except for spinach to make dressing. Pour dressing over spinach and toss. Set aside.

Step 3: Goat Cheese

• 1/2 cup Oil for frying
• 1 cup Pecans, crushed into a powder
• 1 tablespoon Chili Powder
• 1 Egg
• 1 package Goat Cheese

Heat oil in a large frying pan.

Pour pecans into a ziplock bag and using a mallet, crush pecans into a chunky powder. Add chili powder to ziplock and toss until completely mixed in. In a small bowl beat egg.

Slice goat cheese into 3-inch diameter circles or squares. Dip goat cheese into egg and then coat it with pecan and chili mixture.

Place coated goat cheese into heated oil and fry for no more than 1 minute on each side, just long enough to brown pecans.

Plating & Serving:
On a plate, put a heaping pile of spinach. Top the spinach with a 1-cup portion of peach salsa. Lay slices of chili pecan crusted goat cheese on top of salsa. Enjoy!

To learn how to make this recipe on a budget, visit the new Gluten-Free on a Budget blog.

Of course, there are always the traditional stand by summer foods, but I hope over the next three months to give you some great ideas for making delicious gluten-free food!

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Clinical Update
Digestive Disease Week Roundup

By Vanessa Maltin
NFCA Director of Outreach & Programming

Have you ever been in a place where there are 16,000 people talking about diarrhea, constipation, bloating, gas and intestinal swelling? I'm guessing the answer is no!! But don't worry, I was there and am going to give you a comprehensive round-up of what happened at the San Diego Convention Center during Digestive Disease Week 2008.

For those of you who don't know, Digestive Disease Week (DDW) is the largest and most prestigious meeting in the world for gastrointestinal professionals. The meeting brings together approximately 16,000 physicians and researchers from around the world to learn the most advanced techniques for diagnosing and treating digestive diseases, such as celiac disease!

The National Foundation for Celiac Awareness exhibited at the conference. Our purpose for attending the conference was to educate the attendees about the resources we provide both for medical professionals and for patients. We spotlighted programs including the Gluten-Free Cooking Spree, celiac disease continuing education opportunities, patient resources, opportunities to work with the NFCA, and of course, gluten-free food! And, I got to attend all of the incredible educational sessions.

The theme of the conference seemed to be: changing the gold standard of celiac disease diagnosis.

There were several oral and poster presentations that evaluated the specificity of various celiac blood panels and looked at new options for improving accuracy rates in hopes that patients will less often have to undergo an invasive biopsy in order to make a definitive celiac diagnosis.

One study found evidence to suggest that patients can have positive celiac blood antibodies without having a positive endoscopy. Their research showed that symptomatic patients can produce positive blood antibodies that signify early celiac disease long before intestinal damage occurs. They evaluated 70 patients and found that regardless of villous atrophy (flattened villi in the small intestines) that antibody positive patients may respond to a gluten-free diet years before they present with damaged villi in their intestines.

What does this mean for you? That a positive celiac blood test and a negative endoscopy means you may have early-stage celiac disease and a gluten-free diet could cure your ailments. The research is still developing, so keep looking for updated data.

Another session I attended was about a celiac pill that Alba Therapeutics is developing. Daniel Leffler presented preliminary results of their research, which found that patients experienced significantly fewer symptoms when ingesting gluten while taking their enzyme than patients taking a placebo and undergoing the same gluten challenge. Approximately 70% of patients in the placebo group experienced symptoms, compared with only 20% in the group taking the drug (Larazotide). Now...the research here sounds good, but you have to understand the whole picture. The goal is for patients to be able to prevent against symptoms during accidental gluten ingestion, such as cross-contamination. The pill would NOT allow a person to eat pizza, pasta, or any other glutinous ingredients!

One of the most eye opening sessions was one of early bird sessions! Celiac experts filled room 32 of the San Diego Convention Center at 7am to talk about the latest advances in celiac disease. Dr. Bob Anderson from Australia explored basic scientific advances and had some very interesting things to point out.

• Researchers estimate that 5% of celiac patients in the United States are now correctly diagnosed. That doesn't sound like a lot, but considering that last year there was only 1%, this is a huge improvement! Only 95% more to go! Thank goodness for awesome awareness campaigns.
• 20% of celiac patients are correctly diagnosed in Australia, UK, and Sweden.
• 50% of celiac patients are diagnosed in Finland...they must be doing something right!
• The most common path to diagnosis is through a gastroenterologist.
• Diagnosis is confirmed through an invasive intestinal biopsy.
• Today, the only treatment is a gluten-free diet.

After presenting the State of Celiac Disease Today, Dr. Anderson hypothesized about where celiac disease will be in 10 years. Here's what he predicts:

• More than 50% of celiac patients in the United States will be correctly diagnosed.
• Primary care physicians will lead the charts in number of diagnoses.
• There will be non-invasive methods to accurately diagnose celiac disease. This means a change in the gold standard.
• Treatment will include both drugs and/or a gluten-free diet.
• The gluten-free diet will be considered normal.
• Physicians will be able to predict responses in patients.

Dr. Anderson also listed priorities for celiac researchers including preventing the disease, improving treatment methods and promoting collaboration amongst researchers, industry and advocacy groups. He also suggested that better diagnostic tools would be developed including rapid tests and more specific blood tests.

All of this information is tremendously exciting and gives hope to all of us with celiac disease. New research is emerging everyday and someday, maybe...there will be a cure.

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Burger Basics
Tips for Making the Best Summer Burgers

By Chef Edgar Steele
NFCA Chef Spokesman

It's a burger contest! What are we going to prepare? What on earth are we going to do that will make our burger stand out amongst any other?

These were questions on everyone's mind back in January 2008 when ThinkFoodGroup, the restaurant group which includes the Jaleos, Zaytinya, Oyamel, Café Atlantico and minibar, announced that a burger contest has been arranged, and each restaurant would participate. The challenge was on, and the research began. It is amazing to eat something as popular as a hamburger, which is basically an American staple food, and one day realize... bam!

A burger can be as simple as a backyard grill-out with ketchup, mustard and some Redbridge, or a detailed balance of the crust in the bread, the ratio of fat in the meat, and which cuts of meat we are using to grind and which to blend together. After tasting nine burgers that day, I can now say in confidence that the small details make an incredible difference in the burger you eat.

I decided that the easiest way to approach research for the worlds best burger would be to work on each component separately, and once each component is satisfying for me, put them all together and give it a try.

The burger categories are the bun, the meat, the fat, the toppings, and the cooking method. The bun itself is an often-underestimated key to the quality of a burger. It should act as the shell which holds the fillings together, yet not be too firm. It should act as a sponge to soak up and not lose any of the delicious juices that will flush from the meat and toppings, yet not fall apart and leave juices running down your arm while eating. The bun that achieves a firm yet creamy texture lies within the balance of the egg and fat content of the dough, the type of grains and flours used, and a proper egg wash to result in a flaky crumb.

Brioche bread, rich in eggs and butter and finished with an egg wash prior to baking resulting in a lustrous golden brown bun, is a great starting point for a burger bun. Toasting the bun whole, prior to using it will give it a slightly crunchy crust on the outer shell, leaving the inside of the bun soft and creamy. Once toasted and cut in half, the cut side of the bun can be toasted in a skillet with a little butter or oil, and this will work as a barrier between the juiciness of the meat and toppings and the inner soft bread of the bun, thus preserving the dry crumb.

Texture is key with a burger, or anything else in the universe. Through planning, we have established and set texture boundaries, which we will strive to preserve in the rest of the planning. The juiciness and meatiness of the patty, the dry crumb of the inner bread, and the crisp shell of the outer bun. Many people may not notice these detailed intricacies as they eat, but they will identify it as an incredible burger as they eat it.

Typically, it is good to choose meat that is well marbled with fat, and has some collagen. Fat in a burger is important to preserve the juiciness, because as the ground meat cooks, it loses a greater amount of fat than meat that is not ground. Top round, sirloin, shoulder, and brisket are some good examples of cuts to use if you wish to prepare a beef burger. Other meats such as turkey and chicken are now very popular for burger making, and can be prepared with the same techniques described in this article. Try each one, and decide which is best for you.

After tasting each one of these I decided I liked the top round and shoulder the most. The top round had a wonderful crumbly and firm texture, yet lacked flavor for my liking. The shoulder had a great flavor, yet was lacking in texture, as it was a little pasty. My solution is to equally mix the two, and the result is exactly what I was looking for. If you have aver tasted a burger that is more like a dense slice of meatloaf than a crumbly patty of meat, it was probably ground warm.

When the meat is ground while warm, the fat melts, and the resulting grind is nothing more than a meat paste which when cooked is dense and usually dry because of lost fat. When grinding the meat, it is good form to work with extremely cold parts. When choosing a grinder, choose a larger die. The die of the grinder controls the size that the meat is ground into. Place the entire grinding device in the freezer a half hour before using it. Cut your meat of choice into cubes, and place them in the freezer as well, allowing them to become very cold and slightly frozen on the outside, but not completely frozen. When meat is ground under these conditions, it will remain crumbly and retain its natural fat.

The method used in cooking the meat demands attention. Grilling a burger may impart some desired smoky and "charred" flavor, but will lose large amounts of fat. My favorite method of burger cooking is on a flat surface, such as a flat top or a skillet, with no additional fat since the burger will contain some already. The advantage of cooking the burger meat on a flat surface is that it will lose far less juices, and any that leak out will be the ones that cook it, imparting more flavor.

When choosing toppings, think back to the importance of small details. A tomato that is not ripe will not add any value to the burger. Carefully sautéed onions with extra virgin olive oil and a golden color will make the burger as good as they are. For an outstanding burger, use outstanding ingredients, and they will add up to smiling faces.

Steamed Brioche Buns

• 2 1/2 - Cups Gluten Free All Purpose Flour
• Extra Flour For Dusting And Kneading
• 1 1/2 - Teaspoons Active Dry Yeast
• 1 1/2 - Tablespoons Granulated Sugar
• 1 - Teaspoon Salt
• 1/4 - Cup Cool Water
• 2 - Teaspoons Xantham Gum
• 4 - Large Eggs
• 1 - Egg Yolk
• 1 - Cup Cold Unsalted Butter, Cut Into Small Cubes, About 1/2 Inch

Put the water and xantham gum in a blender, and blend on high speed until completely smooth. Place 1 1/2 cups of the G.F.A.P. flour, yeast, sugar, salt, water with xantham gum and eggs into a bowl and mix them until they come together. Knead these ingredients in the bowl just until smooth until smooth (a bit of oil may be used on your hands to prevent sticking). Cover the mixture with plastic film, and let it sit for 45 minutes.

Add the remaining cup of flour, transfer the dough to a flat surface, and knead it until it is shiny and elastic and doesn't stick to the surface, about 10 minutes.

Sprinkle the flat surface with some flour. Put the dough ball on the floured surface and flatten it a bit, then spread the butter cubes over it. Knead the dough with the butter until the butter is completely mixed in.

Cover the dough again with plastic film and allow it to rise for 1 hour. It will be very soft at this point, and should have risen by about one-third.

Place the dough again onto a lightly floured surface and fold it over several times. Place the dough into an oiled bowl, cover the bowl tight with plastic film, and refrigerate it for at least six hours, and up to about twelve hours.

Remove the dough from the refrigerator and cut it into 2 oz. Pieces, then form them into balls. The dough will become very sticky as it warms, so work quickly. Place the portioned brioche balls onto the racks of a bamboo steamer, and cover the dough with a light cloth towel. Allow it to rise for 2 1/2 to 3 hours, or until it has doubled in size.

Whisk the egg yolk with a pinch of salt, and brush all exposed surfaces of the brioche balls with it.

Choose a saucepot whose diameter is slightly smaller than the diameter of the bamboo steamer trays. Fill the pot half full with water, and bring the water to a boil. Place the bamboo trays on top of the pot, and allow the brioche buns to steam cook for about 30 minutes.

Remove the bamboo trays from the pot, and allow them to cool at room temperature for 5 minutes. After five minutes, place the buns onto a cooling rack to cool completely.

* If an electric mixer is available and you wish to save some elbow grease, the kneading of the bread may be done with a dough hook with the machine set on medium speed.

Balsamic Caramelized Onions

• 3-Cups Onions, Sliced
• 1-Tablespoon Butter
• 1-Bay Leaf
• 2-Tablespoons Balsamic Vinegar
• 1-Teaspoon Worcestershire Sauce
• Salt To Taste

Melt the butter in a small sauté pan over very low heat. Add the onions and bay leaf and allow them to cook, stirring occasionally, until the onions are slightly golden in color, about 30 minutes. If browning occurs at the bottom of the pan before the onions are finished cooking, try adjusting the heat to a lower flame or you may add a few drops of water to the pan and scrape the bottom of the pan to lift the browning areas.

Stir in the balsamic vinegar and Worcestershire sauce, and adjust the heat to medium. Allow the onions to simmer until the liquid is almost completely reduced. Season to taste with salt and reserve hot.

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Kids in the Kitchen
Teaching Your Child to Cook Gluten-Free Food

By Abby Schwartz, NFCA Volunteer

Kids love helping out in the kitchen. And while there are nights when it seems simpler to knock out the meal by myself, allowing my 11-year-old celiac daughter to help is a better option for her development. Cooking is an essential skill for celiacs. We simply don't have the same variety of prepared food choices at our fingertips, so learning to create a healthy, delicious gluten-free meal is both important and empowering.

One of the meals my daughter loves to help with is spicy fried chicken. The recipe is surprisingly low in calories because the chicken "fries" in the oven, not in oil. Preheat your oven to 400º F. Set out a shallow bowl of buttermilk and a bowl of your favorite gluten-free bread crumbs (see the January newsletter for my recipe for the best GF breadcrumbs) seasoned with your favorite spices, plus paprika and cayenne pepper for an added kick. I first dip pieces of boneless, skinless chicken breast (we prefer thin sliced) into the buttermilk, coating it liberally. Before arranging the chicken in a shallow baking pan coated with butter-flavored Pam or Crisco cooking spray (both are GF) I hand off each piece to my daughter who is in charge of coating both sides of each piece with the breadcrumbs. After the chicken is arranged in the pan, spray the chicken with your cooking spray until it is lightly coated. This is what allows the chicken to fry up crispy in the oven.

We usually prepare a pan of seasoned sweet potatoes to roast along with the chicken. Scrub 2-3 sweet potatoes or yams and chop them into medium-sized chunks. Let your child toss the chunks in a bowl with extra virgin olive oil before spreading them in a single layer in their own baking pan. Your child can then season the potatoes with salt and freshly ground pepper. Cook both the chicken and the potatoes for 40-45 minutes until the chicken is crispy and golden and the potatoes are caramelized.

Another great way to get your child involved in cooking is to invite him or her to help with dishes that involve a lot of assembly. Tacos are a good example. Once you cook up some ground meat (beef, turkey or chicken are all good) with seasonings have your child arrange bowls of toppings like sour cream, shredded cheese, diced avocado, shredded lettuce, diced tomatoes and more. Ask your child for suggestions. Almost anything goes with tacos: beans, corn, onions, olives, salsa, and diced fruit. Warm up some corn taco shells and let your child create his own masterpiece.

Pizza is another fun and creative meal to make together. We use Brazilian cheese bread pizza crust. One packet of mix is enough for two medium sized pizzas in our house, so we usually make one traditional and one white gourmet pizza. My daughter loves mixing together the ingredients and kneading the dough. With older children it is great practice for them to read the instructions out loud and follow the recipe step by step under your supervision. While the crust is pre-baking I let my daughter gather ingredients for toppings.

My daughter spreads jarred pizza sauce on the crust and sprinkles handfuls of shredded Italian cheese on top. For the white pizza, she brushes a light coating of olive oil on the crust and sprinkles shredded Italian cheese on top. Next, we put handfuls of peppery arugula leaves and a layer of thinly sliced proscuitto. Finally, a few dollops of ricotta cheese to decorate the top, and into the oven it goes.

Do you get The Food Network on TV? We love to watch cooking shows together. There is something distinctly pleasurable about watching a beautifully filmed meal prepared in front of your eyes. When we see a meal that looks easily translatable to a gluten-free version my daughter jumps on the computer and looks it up on the Food Network web site and prints it out (a bonus to teaching my daughter to cook is watching her develop great Internet research skills). After she prints out a recipe we review it together to determine if any substitutions are necessary. From there we put together a shopping list and get to work.

Here are some general suggestions to introducing your child to cooking:

• Involve him or her in the planning. Watch cooking shows together and discuss how you would approach each step as a gluten-free chef. Look through magazines together for recipes with enticing photos. Check out the recipe books that were written specifically with children in mind. Rachael Ray and Emeril Lagasse have each authored several.
• Make tasks age-appropriate. Young children should not handle knives, but they can break eggs, whisk ingredients, knead dough, coat food in crumbs, and more.
• Ask your child's opinion. Should we add anything to this cake mix? How about chopped nuts or chocolate chips?
• Don't stop with the prep work. Have your child set the table and ask for his or her help with arranging the food on plates.
• Make it fun. Don't cook together on a night when dinner is running late, homework needs to be done or the pressure is on. Plan ahead, play music, get out the aprons and dig in.

A funny thing happens when your child helps prepare a meal. They actually eat it. Equally important: they take pride in creating something themselves, and they start to develop an expanded food vocabulary. It is so important to give your celiac child the gift of variety with food. So many delicious, fresh, versatile foods are available; gluten-free cooking should not be limited or boring. Start teaching your child that lesson early and they will grow up knowing a world of culinary pleasure awaits. And the best part? Before you know it you can sit back and let your child cook the entire meal for your family. Bon appétit!

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Summer Fun
Theme Parks Offer Allergen-Free Food

By Christina Gentile,
NFCA Volunteer

Summer is finally here, bringing us the opportunity to relax and enjoy ourselves with family and friends. Different activities and adventures with loved ones will ultimately form memories that will last a long time. There are many things people like to do to enjoy their summer, but being gluten-free means having to be extra prepared to make sure there are food choices available.

Do you enjoy the thrill of theme parks and roller coasters on a hot summer day? But, does being on a gluten-free diet impact how you spend your time at a theme park?

Well, if you answered yes and are thinking about a summer vacation with family and friends and want to enjoy being able to eat gluten-free, plan a trip to Santa Claus, Indiana! Holiday World and Splashin' Safari is a theme park in Indiana that offers an allergen-free menu for eight of the most common food allergies: wheat, fish, shellfish, tree nuts, peanuts, milk, soy, and eggs. These foods come prepackaged and there is also designated equipment that handles gluten-free and dairy-free food items. The eateries within the theme park that offer the allergen-free food menus can be found at Kringle's Kafé, Safari Pizza and Jungle Jake's, Mrs. Klaus' Kitchen, and Plymouth Rock Café. Items on the menu include wheat-free chicken nuggets and pizza, brownies, gluten-free snicker doodle cookies, chocolate chip cookies, dessert bars, gluten-free sandwich bread and buns, and prepackaged carrots, applesauce, and corn chips.

The menus are located on the theme park's website, www.holidayworld.com, food containers, and at the actual restaurants. The complete menu can be found at: www.holidayworld.com/allergen-freemenu.pdf.

However, cross-contamination is a major concern for everyone with celiac disease. Patrons should still question the safety of the food as well as how aware and well trained the foodservice staff is regarding proper handling of gluten-free food. In addition, the menus at the park claim that some products are wheat-free and others are wheat-free and gluten-free.

Before planning a trip I recommend contacting the foodservice director to make sure the wheat-free items, such as the chicken nuggets and pizza, are free of gluten or if they are just wheat-free. Ask the foodservice director if he or she could e-mail the ingredient list for these items. Before making final vacation plans double check these items so that you know in advance that these items are completely gluten-free. This will help you know if you need to go prepared to the theme park with nonperishable gluten-free items like pretzels, bread, chips, cut up vegetables, cereals, or snack bars. Also, find out how much the cost is for the allergen-free alternatives.

Do these foods cost more than the original or is the price the same because it is a substitution? The website does give an overview of what is gluten-free