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            American Celiac Society--Panel Discussion
            -----------------------------------------
                    summarized by Jim Lyles

The American Celiac Society held a conference on June 10-11, 1994,
during which a panel discussion was held.  The panelists were:
     Ms. Nancy Anderson, MS, Ed
        Ms. Annette Bentley
        Dr. Alessio Fasano
        Laurie Schussel, RD
        Nancy Winouski, CPNP

This panel fielded questions from the audience.  This article
summarizes some of the questions raised and the answers given by the
panel.

  Q:  I heard wheat starch is sometimes used as a binder in charcoal
briquettes.  Will gluten from the charcoal transfer onto the food
that is cooked over it?

  A:  None of the panelists had heard of this, and none could offer
an opinion as to whether the food would be safe to eat.  (Author's
note: As of April 1994, Chef's Wood 100% Natural Mesquite Charcoal
was listed as being gluten-free.)


  Q:  With all the limitations in what I can eat, how can I be sure
to get a balanced diet?

  A:  Look for products that are a good source of fiber.  For
example, brown rice flour, popcorn, and beans all contain a lot more
fiber than white rice flour.  Also fresh fruits and vegetables all
have a lot of fiber, as well as many other important nutrients.  Rice
bran is a good source of supplemental fiber and is available from
some of the mail order companies.

      Be careful when taking fiber supplements; some of them are not
gluten-free.  For example, only the plain unflavored variety of
Metamucil is gluten-free; avoid the other varieties.  The panelists
that Fibercon was okay.

      Warning: If you've only recently been diagnosed and still
suffer from bloating, beans will probably make you uncomfortable.
You may want to avoid beans until the bloating symptom has
disappeared.


  Q:  Concerning fat content: Many recipes for bread, etc., contain a
lot of butter, oil, eggs, mayonnaise, and other high fat foods.
Since I have fewer choices on this diet, how can I reduce the amount
of fat called for in recipes?

  A:  First, look at your overall diet.  Are there things that are
easy to change?  For example, switch from whole or 2% milk to 1/2% or
skim milk.  Do you buy leaner cuts of meat?  Eat turkey and chicken
more often.  When you buy ground turkey or chicken, be sure to get
the kind that does not include the skin.

      Next, look at the fats you pour or spread onto prepared foods:
butter, salad dressings, etc.  Are you using the lower-fat varieties
of these products?  Use them less frequently, and in smaller amounts.
If you are having a weight problem, limit the fats you pour or spread
onto foods.

      Most bakers have found you can use two egg whites instead of
one egg in most recipes.  You'll get better results if you beat the
egg whites.  (Author's note: You can also use Egg Beaters or a
similar product, so long as the product is gluten-free.)  However, it
was pointed out that one to three eggs spread throughout an entire
loaf of bread is not really a big source of fat or cholesterol.
You'll get better results from reducing the fats you pour or spread
onto foods.

      Fats are very calorie-dense.  A teaspoon of fat is about 45
calories, whereas a teaspoon of sugar is only 15 calories.  For
example, a baked potato has about 80 calories, which isn't too bad.
But if you add a tablespoon of butter, you've just added an
additional 135 calories.  Cutting back to a teaspoon of butter
eliminates 90 calories, which is more than the potato itself has.


  Q:  What about natural flavorings?

  A:  This is a catch-all term: If it is animal, vegetable, or even
petroleum based, it can be considered "natural".  (Author's note:
There is no legal definition of the term "natural" with regard to
food products.)  Artificial flavorings tend to be chemical in nature,
which means they are concocted in a lab instead of being extracted
from plant, animal, or petroleum products.  Natural flavorings could
be extracted from sludge or by-products derived from grains,
including wheat and barley.  There is no way of knowing from the
product label; you would have to write to the manufacturer to know
for sure.


  Q:  What can you tell me about the new home gluten test kits?

  A:  In reality, these kits test for the presence of wheat, barley,
and rye.  It does not test for the presence of oats.  Annette Bentley
believes the test is fairly accurate.  She tried it on a number of
products.  Gluten-free products tested negative, regular bread and
other gluten-containing products tested positive.  She believes you
can rely on the test as long as you know the product does not contain
oats.  (Author's note: I would question the validity of the test.
Does it pick up minute amounts of gluten, such as might be found in
vinegar distilled from wheat?  Since oats contain gluten, the test
must not be detecting gluten itself, but some other agent found in
wheat, rye, and barley, but not in oats.  What if that other agent is
removed during processing?  Our group does not recommend using these
tests.)


  Q:  What about medications?

  A:  There is an important difference between over-the-counter and
prescription drugs.  For prescription drugs, ALL ingredients must be
listed.  However, for over-the- counter drugs, only the active
ingredients need to be listed.  The inert ingredients might contain
gluten, so if they are not listed you should avoid using the product.
(Author's note: For medications, do not assume that "starch" means
"corn starch", as it does with foods.  The labeling laws regarding
medications and foods are different in this respect.)

      With prescription drugs, often the generic equivalents have
different inert ingredients.  Therefore, when a doctor knows of your
gluten-free diet and prescribes a drug, make sure the drug store does
not substitute a generic equivalent.  Have your doctor write
"Dispense as Written" on the subscription form to avoid an unintended
substitution.