The University Of Maryland Center for Celiac Research recently reported a study to me that I found interesting. The researchers found that the number of people with blood markers for celiac disease increased steadily from one in 501 in 1974, to one in 219 in 1989, to one in 133 in a 2003 study from the Center for Celiac Research. As the people in the study aged, the incidence of celiac disease rose, echoing a previous Finnish study that found the rate of celiac in the elderly to be nearly two and a half times higher than the general population. Here is what they sent me:

Working to solve the puzzle of when people develop celiac disease has led researchers from the University of Maryland School of Medicine Center for Celiac Research to some surprising findings. They have found that the autoimmune disorder is on the rise with evidence of increasing cases in the elderly. An epidemiological study published September 27 in the Annals of Medicine supports both trends—with interesting implications for possible treatment and prevention.

“You’re never too old to develop celiac disease,” says Alessio Fasano, M.D., director of the University of Maryland’s Mucosal Biology Research Center and the celiac research center, which led the study. The Universita Politecnica delle Marche in Ancona, Italy; the Johns Hopkins Bloomberg School of Public Health; the Women & Children’s Hospital of Buffalo; and Quest Diagnostics Inc. of San Juan Capistrano, Calif., also participated.

Celiac disease is triggered by consuming gluten, a protein found in wheat, barley and rye. Classic symptoms include diarrhea, intestinal bloating and stomach cramps. Left untreated, it can lead to the malabsorption of nutrients, damage to the small intestine and other medical complications.

Since 1974, in the U.S., the incidence of the disorder has doubled every 15 years. Using blood samples from more than 3,500 adults, the researchers found that the number of people with blood markers for celiac disease increased steadily from one in 501 in 1974 to one in 219 in 1989. In 2003, a widely cited study conducted by the celiac research center placed the number of people with celiac disease in the U.S. at one in 133.

As the people in the study aged, the incidence of celiac disease rose, echoing the findings of a 2008 Finnish study in Digestive and Liver Disease that found the prevalence of celiac disease in the elderly to be nearly two and a half times higher than the general population. The recent findings challenge the common speculation that the loss of gluten tolerance resulting in the disease usually develops in childhood.

“You’re not necessarily born with celiac disease,” says Carlo Catassi, M.D., of the Universita Politecnica delle Marche in Italy. Dr. Catassi is the lead author of the paper and co-director of the Center for Celiac Research. “Our findings show that some people develop celiac disease quite late in life.” The trend is supported by clinical data from the center, notes Dr. Catassi, who urges physicians to consider screening their elderly patients.

Although researchers have identified specific genetic markers for the development of celiac disease, exactly how and why an individual loses tolerance to gluten remains a mystery. “Even if you have these genetic markers, it’s not your destiny to develop an autoimmune disease,” adds Dr. Fasano. “Our study shows that environmental factors cause an individual’s immune system to lose tolerance to gluten, given the fact that genetics was not a factor in our study since we followed the same individuals over time.”

The finding contradicts the common wisdom that nothing can be done to prevent autoimmune disease unless the triggers that cause autoimmunity are identified and removed. Gluten is one of the triggers for celiac disease. But if individuals can tolerate gluten for many decades before developing celiac disease, some environmental factor or factors other than gluten must be in play, notes Dr. Fasano.

Identifying and manipulating those factors could lead to novel treatment and possible prevention of celiac disease and other autoimmune disorders including type 1 diabetes, rheumatoid arthritis and multiple sclerosis. Researchers at the University of Maryland Center for Celiac Research are working toward that goal, says Dr. Fasano. As the third most common disease category after cancer and heart disease, autoimmune disorders affect approximately five to eight percent of the U.S. population, according to the National Institutes of Health.

“The groundbreaking research of Dr. Fasano and his team sheds new light on the development of celiac disease, a complex disorder that continues to present challenges to physicians and their patients,” says E. Albert Reece, M.D., Ph.D., M.B.A, vice president for medical affairs, University of Maryland, and John Z. and Akiko K. Bowers Distinguished Professor and dean, University of Maryland School of Medicine.

Diagnosis of celiac disease can be a challenge as patients who test positive for the disease may not display the classic symptoms of gastrointestinal distress linked to the disease. Atypical symptoms include joint pain, chronic fatigue and depression. In the study, only 11 percent of people identified as positive for celiac disease autoimmunity through blood samples had actually been diagnosed with the disease.

The University of Maryland Center for Celiac Research engages in clinical care, diagnostic support, education, and clinical and basic science research in celiac disease. Founded in 1995, the center is an international leader in promoting the awareness of celiac disease to provide better care, better quality of life, and more adequate support for the celiac disease community worldwide.

View “Natural History of Celiac Disease Autoimmunity in a USA Cohort Followed Since 1974 here. The article will be featured in the December 2010 issue.

Enjoying pizza out on the town has been a no-no for my picky eater for some time. There are many reasons for this, and I find we're not alone.

It seems the main concern for many celiacs is cross-contamination. It's mine, too. After all, I spent years in high school kneading dough in a back room of a little shop. We would fill up buckets of water at the end of the night and wash off the counters only to see the clear fluid quickly turn a starchy white. My clothes would erupt in flour dust clouds when I sat down in my car seat to drive home and I would wash itchy specks of flour out of my hair at night. Flour was everywhere. How can any restaurant pizza be safe from contamination?

On top of that concern is the no-casein constriction my little one has. Even dairy-free/lactose-free cheese often has the milk protein in it. And I'm not willing to dose my picky eater with it, as he reacts strongly when digesting it. So, we've been making our own pizzas at home. Our favorite is Kinnikinnick frozen crusts (found at Hiller's) with Vegan Gourmet cheese (found at Whole Foods). Made in our gluten-free kitchen, we typically have some on hand to take with us to Chuck E Cheese birthday parties or weekend trips to see friends.

So, is the idea of eating a hot pizza fresh out of the oven just a pie in the sky? Not necessarily.

Here is what I uncovered recently on a personal quest to bring a good, fresh slice of the American standard to my son's plate:

1. Buddy's is the real deal
Established in 1936 on the corner of Conant and Six Mile Roads as a Blind Pig, it was not until 1946 that Buddy's first introduced its famous square pizza — the first of its kind — to Detroit. It soon gained a reputation for it pies as it's Sicilian owner drew nationwide praise. Today, it's a community standard and is voted again and again the best pizza in Metro Detroit.

Add to these accomplishments its efforts to produce a safe and delicious gluten-free pies at its many restaurants. Here is what the local chain does to assure you won't be dosed with gluten:

1. The restaurant cooks the pizza on a foil-lined platter
2. The crust is made off-premises at a gluten-free location
3. The pie is served uncut with its own, clean utensil (photo at right)
4. Buddy's will serve it without cheese and I added my own (the kitchen won't do it because of food regulations). Other cheese options are available, as well (low fat and veggie)
5. Everyone was very cooperative and willing to answer all of my questions
6. The gluten-free pizza is endorsed by the TCCSG

We did it. We ordered pizza, my son gobbled it up and didn't get glutened. A coup for celiacs who love pizza. Buddy's has locations in Auburn Hills, Dearborn, Royal Oak, Bloomfield Hills and Farmington. We visited the Dearborn location. Check out more on the chain here.


2. There's always GF Cucina's
The entire restaurant is gluten-free, so no worries about cross contamination here. The pizza is thin and crispy and there are other options, as well, such as a meatball sub, french fries and desserts. Located in Sterling Heights, it's a little out of the way for us. But it's worth a trip when we're in the area. Again, there are few casein-free options, but the staff is always informative and willing to accommodate our needs.

3. Word on the street
I also have heard of a few other celiac-friendly pizza shops although I have not experienced them personally. Word is Pizzaria Uno cooks its gluten-free pies on a fresh, disposable pan. Not sure if the dough is made on the premises, though, and there is a disclaimer on the bottom of its gluten-free menu that makes me skeptical. Check out the menu here. Another note I got from Gluten-Free Diva Penny Ray indicated that Picasso of Pizza makes a superb gluten-free pizza, but you have to call a day ahead. They will make the gluten-free crust in the morning before any other dough is made and are careful to protect it from being cross-contaminated. Penny says she has had a good experience at the Commerce Township shop. Check out a menu here.

So there it is, a slice of information on the most forbidden of gluten-free foods. The smile on my little one's face was priceless, even if the pizza had to be delivered without the cheese. I recommend doing your homework, calling ahead to ask questions and giving this often mysterious practice of ordering gluten-free pizza out a shot.

So, the school bells are ringing, cool breezes are wafting through the windows and orchards are beginning to beckon fall-lovers such as myself. And with the opening of the autumn season, my favorite food in the world begins to pile into markets: Squash.

In season from September to November in Michigan, this is the time to pick up some winter squash at the farmers market or anywhere that sells it. Acorn, butternut, Hubbard and spaghetti are the most common varieties. Easily baked in the oven (poke them with a fork and microwave for five minutes for easy cutting/de-seeding), it is a versatile veggie that packs more calories than the summer variety, but also a lot more vitamins. They contain 170 percent of the daily allowance of vitamin A, 40 percent of vitamin C. For more on squash, see this link.

Here is a quick recipe that warms my soul:

Butternut Squash Soup
2 butternut squash, cut from shell and cubed
1 box chicken or vegetable stock (Kitchen Basics is gluten-free)
2 bunches fresh sage
Salt, pepper to taste

Put squash pieces into soup pot. As mentioned above, a quick 5-10 minutes in the microwave makes for easy cutting. Simply slice lengh-wise, spoon out seeds and slice into strips. Cut off outer shell and chop into cubes. Cover with broth and add spices and sage leaves. Bring to boil and simmer about 20 minutes or until squash is soft and mushy. Add one ladle at time into food processor or blender and puree in batches, transferring to another pot or large glass bowl. Serve with sour cream if desired.

Another sign of the times? Birthday invitations. It seems when school begins, so do the parties. And I want to be ready. So I baked up some festive cupcakes and frosting. I added sprinkles and colorful touches. Here is a fun site with lots of choices.

My son's teacher asked if I wanted to freeze some cupcakes for the year and I was more than happy to comply. I picked up some cupcake holders at a cake supply store (but I have also seen them at JoAnne's and Target) and filled them with my creations. I made sure there was one for Halloween and a variety of colors. I used King Arthur brand cake mix this time and was very happy with the result. The cake was moist and delicious and the box made 24 cupcakes (two layers of cake). Warning, though: The mix calls for four eggs.

I made my grandmother's famous 20 Minute Frosting with some dairy free milk and buttery spread and omitted the egg white. I'm being safe on behalf of my son, and it worked well without it, but my grandmother has been making this frosting with the egg white for years. Eating raw eggs increases the risk for food-born illness. For more on egg safety, click here.

Anyway, the cupcakes are made, the soup is on the stove and the football game is on. Before we know it, the leaves will burst into the masterpiece that is autumn. Then I will have to start thinking about other holidays...

20 Minute Frosting Redux
1 egg white (optional)
1/2 cup buttery spread (such as Earth Balance)
1/2 cup shortening (Crisco is gluten-free)
1 cup sugar
1/2 cup Vanilla Rice Dream (or milk)
1 1/2 teaspoon vanilla

If using egg white, beat until foamy. Add remaining ingredients into standup mixer and mix on medium speed for 20 minutes, scraping down sides a few times. Frosting will be creamy white. Add coloring if desired.

I got a little too excited when I learned that there was a gluten-free Bisquick available. Here's the deal: It's mighty pricey and probably easily reconstructed with some baking powder, gluten-free flour mix, xanthan gum and sugar. But what the heck? One less thing to think about. And I got to take my Bisquick Cookbook off the shelf!

I cooked up these on a busy night. It is derived from the recipe in "Betty Crocker's Bisquick Cookbook." They went well dipped in some Dijon mustard.

Apricot Glazed Coconut Chicken Bites
1 cup coconut milk
2 tablespoons Dijon mustard (such as Heinz)
1 1/2 cup Bisquick
2/3 cup coconut flakes
salt, paprika to taste
2-3 pounds boneless chicken breasts, cut into 1-inch pieces
1/4 cup butter or buttery spread, melted
Apricot glaze (recipe below)

Line two jelly roll pans with aluminum foil. Preheat oven to 425 F.

Mix coconut milk with Dijon mustard in shallow bowl. In another bowl, blend Bisquick, coconut and spices. Dip chicken into milk mixture, then coat with dry mixture. Place onto baking sheets and drizzle with butter.

Bake 20 minutes. Make apricot glaze while it is cooking. Take pans out of oven and turn over. Brush with glaze and bake another 10-15 minutes or until chicken is no longer pink and glaze is bubbly.

Glaze
1 jar apricot spreadable fruit
2 tablespoons honey
2 tablespoons Dijon mustard
1 tablespoon distilled white vinegar

It's been a long, exhausting summer. But an exhilarating one, as well.

I realize that a mere 9 hours from now, my soon-to-be first-grader will be boarding a bus and summer will be over. I also realize it's been quite a while since I have posted any recipes or daily goings-on when it comes to planning meals for those with special diets.

Here's the deal: I could not tear myself away, not for one moment, from my son's amazing summer. That's the truth. I'm hoping most of the readers who frequent this blog have had the same experience. Time spent outdoors with their families, laughing and losing the stress of everyday life, if only for a moment...

As we all begin to hunker down for fall and head back into our kitchens, I am noticing the things I have neglected. Numero Uno is this blog. Why? Because I had another priority.

I'll talk about something I rarely discus in this forum: My son has autism. Years after his heartbreaking diagnosis (and soon after, a celiac diagnosis) and years after spending countless hours cooking special meals, I can look back and smile proudly at all my little picky eater has overcome. Not least of which is being able to recognize that certain foods make him feel sick.

When he sees other kids eating bagels, pizza or cupcakes he says without hesitation "no thanks, that will make me sick." Not too shabby for a kid that just over three years ago had trouble answering any form of question and mostly spoke in repeated phrases from others or television.

A million, tiny miracles happen every day in our house. And we are thankful for them all. The teachers who spend countless hours with my son, the parapros who help calm him when he loses control and the children who stick around long enough teach him subtle social cues are all part of our team of miracle workers. And sometimes we get stuck on the bad stuff: Outbursts, defiance, what he CAN'T eat.

As our family has been busy planning our lives trying to avoid these things, sometimes all these miracles can escape us. And the more recent things, little strides my son was taking between the meltdowns and defiance, seemed to be lost on us through the year. But they crossed the finish line in full force this summer.

As the days heated up, his smile grew bigger. He jumped into lakes and onto bicycles. He spoke unprompted to other children and waved to passers-by. All big feats for someone with an impairment in social interaction and a general uncomfortableness with the world around him. But in the lake, in motion and running through sprinklers, he was just a kid. A smiling, calm and comfortable kid.

And during the summer, I scheduled my life around his happiness. At the end of the day, instead of plugging in the laptop and logging on, I got some rest for the busy chain of events sure to face me the next day. Play dates ensued, impromptu trips to beaches, bike rides down the street and calls to friends and family were made. We didn't sit still. We couldn't.

And as I tucked him into bed tonight I kissed him on the cheek and said "that was one fantastic summer, kid."

"Yeah," he replied. "It was fun."




A morning pick-me-up for busy days:

Easy Egg Sandwich
2 eggs, beaten
salt, pepper to taste
1 slice Vegan Gourmet or Kraft cheese
1/2 Kinnickinnick English muffin, toasted
Pam cooking spray (Pam for Baking is NOT gluten-free)

Spray pan with cooking spray and add egg mixture. Season. Cook on medium heat until ready to flip. Flip eggs, add cheese and fold. Top muffin with egg mixture.