THE CENTRAL IOWA CELIAC CONNECTION Education and Support for Those with Celiac Disease And Other Gluten Intolerance Issues June 2019 Newsletter and Recipes

Thank you all who came to our summer potluck! We had a great crowd for our Summer Picnic theme, even though it was the July 4th weekend. I was a little concerned if we would have a good turnout, but we always have our great group of members who want to share our wonderful gluten free potlucks. The steering committee provided Ball Park Franks and gluten free sausages, as well as hash brown potatoes and tater tots. The sausages from Costco were Gilbert’s Chicken Sausage (cheddar), Amylu Chicken Sausage (apple and Gouda) and Sabatino’s Chicken Sausage (Mozzarella and roasted garlic). The sides and desserts were fabulous!!! I just know there are no better gluten free cooks and bakers anywhere than we have in our Central Iowa Celiac Connection!!! We had a fun bread challenge that was organized by Ashley Danielson from the West Des Moines Hy-Vee Health Market. Ashley set out several different types of bread for you to vote on - Rotella's, Udi's white bread loaf, Glutino, Canyon Bakehouse, and Schar. This was a great chance to taste 4 or 5 different breads! We wanted everyone's input! Udi's new white bread loaf won first place! Second place was the Canyon Bakehouse Heritage Bread. Thanks to all who emailed your recipes to me for the newsletter before and after this pot luck! I really appreciate that since it takes much time for me to retype all those that were not sent, along with all the ones that don’t have email! There are lots of information (and pictures!) on the Central Iowa Celiac Connection website! Go to www.celiacsconnect.com. Don't forget to check out the Gluten Free Library organized by Amber Huber. It is available for you to use any of the books, magazines and CDs at no charge. However, these items are not to be taken permanently, but rather should be returned at the next potluck. If you won't be able to come to the next meeting just let Barb know and we can make arrangements to get the item you checked out. Thank you so much for your cooperation! Thanks always to the steering committee for making the great entrees. We have such a great committee that makes these potlucks so fabulous! That includes the following: Kathy Titus for making copies of the newsletters that need to be mailed to those without email; Kathy also coordinates the Children’s Program! Angie and Jeff Wagner for organizing the room and sample tables, and Jeff for his expertise with the production equipment; Jan Morgan for all she does with the room set up and assisting with samples; Lucy Newcomb for being our "professional chef in residence"; Christie Engelbert for registration and coordinating the Newbies Group; Diana Heard for coordinating the Celiac Walk and the new kids/teens group; Lisa Huyette Smith and Micca Guyler for help with everything needed. Also, thanks to some of our other dedicated volunteers; Adam Gudenkauf as our webmaster; Steve Huyette for help with set up, clean up, making all the drinks and all other odd jobs needed; Amber Huber for organizing the gluten free library; Barbara Moore for her help with registration and providing the cups and plastic ware. Oh, and I (Barb Huyette) am usually running around trying to get something (or maybe anything!) done! We appreciate the samples and donations from the following companies and individuals:

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Gift basket made and donated by Angie and Jeff Wagner. Rebecca VanDorpe ([email protected]) brought cinnamon rolls, pumpkin bread, white and chocolate cakes. Becca’s Gluten Free Bakery, check out her Facebook page; she delivers to the Des Moines area a couple times a month; $5 extra travel free; can ship things also; she will be at the Celiac Walk on Sept 28! Some of the breads were donated for the bread challenge. Sue Horning donated a giveaway (bag with maple syrup, gf oats and blueberries). Thank you, Sue! Lisanatti Foods provided some soy based cheese samples. It is cholesterol and lactose free while having less than half the fat of conventional cheese. Colleen Meyer from Friedrich's Coffee donated the coffee and a $10 gift card for the door prize. Smart Baking Company is giving a 10% online discount on their products (see information below).

FUTURE MEETINGS AND EVENTS

Our next pot luck will be the Holiday potluck in November. I am waiting for a date from Lutheran Church of Hope for that event. I will let you all know as soon as I get it. The Central Iowa Celiac Connection offers a “Newbie’s Group” for individuals during the first 6 months after being diagnosed with celiac disease. This group is held at Lutheran Church of Hope the second Monday of each month, 7:00 pm. This allows for a small group atmosphere to encourage questions and discussion. Christie Engelbert is the facilitator for this group and provides lots of valuable information. Gluten-Free Newbies for Kids and Teens: Second Monday of the month (April 8 – Aug. 12), 7:00-8:00 pm. This new small group is designed for any child or teenager (age 5 and up) in their first year of being gluten-free (although all are welcome!). We will focus on safe foods, eating out, and being gluten-free at school and in social situations. There will be plenty of time to share, ask questions and get ideas from each other. Diana Heard let people know kids and teens can meet at the same time the adult Newbies meet, and she and her daughter organize that group. You can contact Diana at [email protected], or call 515-259-9157. From Diana Heard: Mark your calendars! Please join us on September 28th, 2019 for the 7th Annual Celiac Disease Awareness Walk in central Iowa! Iowans from around the state will gather to raise funds for researching this disease. The walk will take place at Jordan Creek Town Center amphitheater outside the mall (on the lake) from 9-11am. Should there be inclement weather, we will move inside the mall, between the movie theater and the food court. Registration is $25 (tax deductible) for ages 14 and up. We will have some fabulous prizes for the raffle, which will take place before the walk! Registration begins at 9am. More details will follow. We would love to see you there! Contact the chair of the walk, Diana, at 831-332-3306, or email [email protected] if you would like to volunteer your time or have ideas for raffle prizes. Any connections to local businesses that may want to donate would be very welcome!

PRODUCT INFORMATION

From Angie, the following products were from Costco: Gilbert’s Chicken Sausage (2 flavors – cheddar, caprese) – 16 links for $12.99; Amylu Chicken Sausage (1 flavor – apple and Gouda) – 18 links for $13.99; Sabatino’s Chicken Sausage (1 flavor – basil and black pepper) – 12 links for $13.89; Kirkland Original Brats (1/4 lb. links) – 14 links for $8.99.

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From Jan: I sent an inquiry to the company that makes SmartCakes asking if they could send me brochures for the new member packets along with samples for our next meeting. Their response is below: We cannot offer free samples, but will be able to offer a coupon code as a take home flyer for the event. The coupon discount will be valid towards 10% off anything in our shop on smartbakingco.com. The coupon code is smart10. They told me most people they work with just create a simple Word document with their logo (which they emailed to me) to let people know how to get the 10% discount. I will go ahead and do that for the new member packets and can also copy a large number of those for the sample table if that’s okay with you. I have found the SmartCakes at the Waukee Hy-Vee along with their SmartBUN hamburger buns. I have only tried the SmartCakes. I have not found them at the West Lakes Hy-Vee on University. Peanut Butter Chex is a new item. Canyon Bakehouse's English Muffins are soft on the inside and crunchy on the outside, available in Original and Honey Whole Grain. Whole Grain muffins are sold in stay fresh packaging to stay fresh longer, certified gluten free, soy free, nut and dairy free, non-GMO, $5.49 per package. Kris Morine talked about the restaurant she found while a family member was at Mayo Clinic at Rochester. The restaurant name is Twigs Tavern and Grille. It was located about 5 blocks from Mayo. It has a 4 page GF menu. Aldi has been adding more gluten-free products starting May 8, 2019. In addition to the many products they already carry, Aldi will have gluten-free donuts, ravioli, skillet meals, snacks, linguini and fettucine, a new seed and grain bread, cinnamon raisin bread, hamburger and hot dog buns, cheesecake sampler, croutons and empanadas. Jolovelies is no longer doing business in Indianola. Haylee has moved to Idaho! GIG (Gluten Intolerance Group) recently announced that their Gluten-Free Food Service Certification no longer certifies the gluten-free pizzas at Pizza Hut. Pizza Hut does not recommend their pizzas on GF crusts for customers with celiac disease. Barilla has two new pastas that are made of beans: Red Lentil Rotini or Penne and Chickpea Casarece or Rotini. In addition to being gluten free, these pastas have anywhere from 11 – 13 grams of protein and 6 – 8 grams of fiber! Franz Gluten Free 7 Grain Bread is available at Costco, two 20-ounce loaves for $8.99. This is a really, really good bread that is shelf-stable and doesn’t need to be toasted. How Does Quaker Make Gluten Free Oats? Oats are inherently gluten free, but may come in contact with gluten containing grains in the field, during storage or during transportation. As the world's leading experts in oat milling, Quaker employs a breakthrough process to sort and clean the oats. This process uses both mechanical and optical sorters to specifically remove these stray grains based on density, color and length, applying a sorting protocol that we believe to be unique to the industry. We confirm our capability to remove these grains with multiple quality checks throughout the milling process, up through finished product testing so that our millers can confidently produce a gluten free oat product that meets FDA standards. This includes testing individual samples from each production lot of our finished product. Only if each of those samples in the product lot passes analytical testing can the lot be released from the mill. Our milling expertise is unparalleled and is how we've been able to turn oats into Quaker oats. As is always the case, the quality of our products and safety of our consumers is our number one priority. We take this seriously. It's that care and attention to detail that we believe has helped earn us the trust of consumers for all these years. (Note: When purchasing Quaker Oats products, be sure that you pick up products which are labeled "gluten free". Other products listed on their website which are gluten free include Original Instant Oatmeal and Maple &Brown Sugar Instant Oatmeal, along with their Quick 1 Minute Gluten Free Oats.)

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McDonald's Fries Not Safe For Celiacs: E-Mail from NCA (National Celiac Association) There has been some debate about McDonald's French Fries and whether or into they are safe to eat. For as long as this has been an issue, McDonald's has stated that the natural beef flavor in the French fries contains (hydrolyzed) wheat, which some people do not have a problem with. Now, however, McDonald's is serving donut sticks which absolutely do contain wheat, and they are fried in the same fryers as their French fries. https://www.mcdonalds.com/us/en-us/about-oour-food/nutrition-calculator.html. (McDonald's website) The Club Car has been sold. I asked Dave (previous owner) if there are going to be any changes to the menu or the types of foods but he did not think so at this point. I asked at Fareway if their brats were gluten free, but the meat manager told me he did not think that their brats would be safe for people needing gluten free.

ADDITIONAL INFORMATION I called the Food Bank of Iowa to see if they have many requests for GF foods because I wondered if we might want to have a gluten free food drive. The person with whom I spoke did not seem to think so. I spoke with the manager and she said that they have regular donations from Barilla, General Mills and others that distribute gluten free items to the food pantries. This person felt that their gluten free needs were being met. ImmusanT Discontinues Phase 2 Clinical Trial for Nexvax2® in Patients with Celiac Disease - CAMBRIDGE, Mass. – June 25, 2019 ImmusanT, Inc., a clinical stage company leveraging its Epitope-Specific Immuno-Therapy™ (ESIT™) platform to deliver first-in-class peptide-based immunomodulatory vaccine therapies to patients with autoimmune diseases, has discontinued the Phase 2 global study for its lead candidate, Nexvax2®, intended as a treatment for celiac disease. The results from an interim analysis revealed Nexvax2 did not provide statistically meaningful protection from gluten exposure for celiac disease patients when compared with placebo. Similar to earlier Phase 1 results, Nexvax2 was found to be safe and generally well tolerated. There were no concerning safety issues identified during the study. ImmusanT will be actively investigating data gathered from the trial to further understand this outcome. The company will provide further information once available. Media Contact: Andrew Mielach Account Supervisor LifeSci Public Relations (646) 876-5868 [email protected] What is the link between gluten and rheumatoid arthritis? Last reviewed Thur 20 June 2019 - By Jon Johnson Rheumatoid arthritis is an inflammatory condition. Some people with gluten intolerance may feel that eating gluten causes their symptoms to flare up. Some people find that removing certain foods, such as those that cause inflammation, from their diet can help people control their rheumatoid arthritis (RA) symptoms. The foods that cause RA flares can differ from person to person. In people with celiac disease, which is a severe form of gluten intolerance, eating gluten can lead to inflammation in the body. Therefore, avoiding gluten could help people with gluten intolerance improve their RA symptoms. In this article, we look at the link between gluten and RA. We also discuss whether gluten can make the symptoms worse, as well as which foods to eat and avoid.

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Can gluten make RA symptoms worse? There may be a link between diet and RA, but it is not entirely clear. RA is a chronic condition in which the immune system wrongly attacks tissues and synovial fluid in the joints. This causes pain and inflammation in the joints, which can lead to damage and deformity over time. The link between diet and RA is not completely clear. Removing certain foods from the diet can help some people manage their RA symptoms. However, scientists need to conduct more formal, high-quality research before healthcare professionals can definitively link any specific foods with RA symptoms. Also, different foods affect people in different ways. Some people find that eating gluten makes their RA symptoms flare up, and that eliminating gluten from the diet helps relieve their symptoms. These people may have an intolerance to gluten. Celiac disease refers to a severe intolerance to gluten. It is an autoimmune condition that affects around 1 in 100 people around the world, according to the Celiac Disease Foundation. Celiac disease and RA are both autoimmune conditions that can cause inflammation in the body. In people with celiac disease, eating foods that contain gluten can cause sluggishness, bloating, and digestive problems. It can also cause pain, swelling, and inflammation in many areas of the body, including the joints. This occurs because the immune system treats gluten as a foreign invader, so it mistakenly attacks the tissue in the intestine. Some of the inflammatory proteins related to this process can enter the bloodstream and cause joint changes that may feel similar to the symptoms of arthritis. In general, diet tips for people with RA include eating a wide variety of healthful whole foods and cutting out those that could cause inflammation, such as processed and sugary foods. How common is celiac disease in RA? People with RA may be more likely to have celiac disease or gluten sensitivity than people without the condition. One study notes that antibodies associated with celiac disease and gluten intolerance appear more frequently in people with RA and Sjogren's syndrome than people without these conditions. Another study explains that there seems to be overlap between RA and celiac disease. The researchers revealed that people with celiac disease frequently have markers for RA (rheumatoid factors), and that people with RA frequently have signs of celiac disease. This does not, however, mean that everyone who has RA will have a gluten sensitivity. Seeking testing for both RA and celiac disease as soon as the symptoms appear can help doctors correctly identify the underlying issue and work toward finding the best treatment.

Celiac and Gluten Free Family and Friends Cruise! Families and individuals who are Gluten Free due to Celiac disease or Gluten sensitivity know that travel can be a burden and at times, scary—if you choose to travel at all. You leave your kitchen and home grocery stores behind and enter a world that is often unknown. What if there’s nothing safe to eat? What will my options be? They say it’s “gluten free” but how do I know? These are the reasons Celiac Cruise and Total Travel and Events have partnered with Royal Caribbean for the first ever Celiac and Gluten Free Cruise, sailing January 17-20 in 2020. https://www.celiaccruise.com/

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On this Gluten Free Cruise aboard Royal Caribbean you will find:  Nationally recognized speakers and experts who will share their learnings on Celiac Disease, talk about best practices and provide insights on where the medical community is headed with regard to research.  Gluten Free menus, with the ability to order meals & dessert ahead of time in an organized, safe and efficient manner.  An orientation to eating “Gluten Free” once you board the ship with the executive chef explaining the ins and outs of Gluten Free dining for your cruise.  The chance for your family members to meet other Gluten Free friends and socialize during receptions both on and off the ship.  Informative presentations by a noteworthy Gastroenterologist on the “Past, Present & Future” of Celiac Disease and Gluten sensitivity.  GLUTEN FREE excursions to a resort in Nassau.  A stress free, relaxing vacation in the Bahamas!

NEW INFANT? NEW GUIDELINES: FEEDING INFANTS AT RISK FOR CELIAC DISEASE - By Stefano Guandalini, MD IMPACT (The University of Chicago Celiac Disease Newsletter) talking about the latest infant feeding guidelines. It discussed timing (the optimal time to introduce gluten to your baby) as well as the protective effect of breast feeding. That information was backed up by studies and was widely accepted. As sometimes happens in science, new studies disprove the old and our knowledge changes and evolves. In this case, through a number of large prospective studies, we discovered that our old assumptions about infant feeding were largely inaccurate and that new feeding recommendations are needed. The new recommendations, based on data that has emerged over the past 4 years, are NEW INFANT? NEW GUIDELINES: FEEDING INFANTS AT RISK FOR CELIAC DISEASE by Stefano Guandalini, MD. They pertain strictly to families who are at risk for celiac disease, where one of the following two conditions exists: • One first degree family member (a parent or a sibling) has celiac disease • The newborn baby has been tested for genetic predisposition to celiac and is positive for DQ2.5 or DQ8 WHAT WE KNOW FROM THE RECENT STUDIES IS THE FOLLOWING: • Gluten in large amounts in the first two years favors the onset of celiac disease (again, only in the patient population described above). Thus, gluten-containing foods should be given, beginning at the usual age of 4-6 months, but during the first 2 years should be less than 5 grams per day on the average, (i.e. less than one thing that has not changed since 2010 is that the overall risk of your child developing celiac disease is still small. about 1 ounce of pasta or 1 slice of bread); • The best preventative strategy to reduce incidence of celiac disease in this vulnerable population is healthy eating in accordance with the Mediterranean Diet, again during the crucial first 2 years of life. Such a diet in particular should be based on high consumption of vegetables and grains and low consumption of refined cereals and sweet beverages. Although breast feeding does not provide protective benefit to those at risk of celiac disease as we previously thought, we hope people do not conclude that breast feeding is not beneficial to newborns! It is, for many other reasons, and we do not want to discourage new mothers from breast feeding. However, it just does not appear to have a benefit in reducing incidence of celiac disease. One thing that has not changed since 2010 is that the overall risk of your child developing celiac disease is still small: 1/8

6 of daughters and 1/13 of sons of celiac parents will develop celiac disease in the course of their lives. However, the steps outlined here can make it smaller still. BODY MASS INDEX AND THE GLUTENFREE DIET By Hilary Jericho, MD and Stefano Guandalini, MD* This study reviewed charts of children seen at the University of Chicago Celiac Center from January 2002 to May 2016. Patients included in the study were confirmed to have a diagnosis of celiac disease based on the current guidelines (1). Our goal was to assess body mass index (BMI) changes occurring on the gluten-free diet in celiac children pre- and post- 2011, as this represents a potential cause of morbidity that may at least in part counteract the benefits of diagnosis. The children’s BMI was noted when they started the gluten-free diet and at least one other time over the next four-plus years. We compared the rate of BMI increase in children who were diagnosed before 2011 versus after 2011. The study included 147 children (66% female) with biopsy-confirmed celiac disease. The mean BMI at diagnosis was 17.8 for those diagnosed before 2011 and 17.1 for those diagnosed after 2011, when processed gluten-free foods became readily available on the market. Serologies were monitored after patients started the gluten free diet and approached normal values, indicating that the patients were following the gluten-free diet. We saw BMI values overall increase after starting the gluten-free diet, even at the first post-diagnosis appointment. We observed a trend toward higher BMIs in adolescent celiac patients post-2011 as compared to pre-2011, when there was a surge in the production of processed gluten-free foods on the market. We determined that younger celiac patients consume less processed gluten- free foods, most likely due to the influence of their health-conscious parents over their food choices; and that special attention must be paid to the adolescent celiac population to insure ongoing healthy food choices even after many years on the gluten-free diet. OUR FINDINGS - The BMIs for both pediatric celiac disease groups on the gluten free diet rose with time, even at the first follow up appointment, as soon as six months after diagnosis. BMIs continued to rise at increasingly larger intervals at 1, 2, and 3 years after baseline. The greatest percent change in BMI from baseline was at 4+ years after starting the gluten-free diet (14.9% in children diagnosed pre- 2011 and 11.5% in children diagnosed post- 2011). We also analyzed BMI trends by age group. Overall, as children aged, their BMIs increased with time on the gluten-free diet. While children aged 0-6 demonstrated little change in BMI over time at 0.5, 1, 2, 3, and 4+ years after starting the gluten-free diet, the 7-12-year old age group showed an increasing trend in BMI change over time, with further increases in the 13-18 group. FOLLOW UP - We sent a follow up survey to further assess consumption of processed gluten-free food options pre-2011 as compared to post-2011. Thirty-one patients within the 13-18-yearold age group (now all 18 years of age or older) were contacted to complete a short survey on their consumption of processed gluten-free foods. We received 10 responses, four from patients diagnosed before January 1, 2011 and six who were diagnosed after 2011. The most common reasons they gave for consuming processed gluten free food versus natural gluten free food were convenience, ease, faster time of preparation, more availability of processed gluten-free foods on the market after 2011, as well as a desire to fit in with their peers. All the post-2011 patients reported consuming processed gluten-free foods “sometimes to most of the time.” In contrast, there was a greater variation in responses in the pre-2011 patients, ranging from “never” (one patient) to “always” (one patient). This last patient specifically reported never consuming processed gluten free food prior to 2011 but always consuming processed gluten free food after 2011, given the ease of purchasing them in grocery stores now. The BMI of this patient increased from 22 at diagnosis to 25.8 eight years after diagnosis. On the other hand, the BMI of the patient who reported “never” eating processed gluten-free foods decreased from 26.9 at diagnosis to 22.8 seven years after diagnosis. The surge in processed gluten-free foods occurred around 2011, and we suspect this has contributed significantly to the ongoing rise in obesity rates in celiac patients. Processed gluten-free foods are often denser, and in an effort to compensate for this denseness, manufacturers may increase the fat and sugar content. It is not unusual for these processed gluten-free foods to contain more saturated fat and sodium and less fiber and protein than gluten-containing counterparts (2).

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With appropriate instruction from a trained dietitian, the gluten-free diet can be balanced and healthy. However, many patients initiate the diet without guidance and lean toward the convenience of processed gluten-free options. CONCLUSIONS - While overall we observed no significant changes in BMI before and after 2011, we did notice that in adolescent celiac patients there was a trend toward a higher post-diagnosis BMI in the years after 2011. We speculate that teenagers may be especially vulnerable to choosing quick and easy processed gluten free options over healthier, natural alternatives leading to a rise in their body mass indexes after the 2011 surge in production of processed gluten-free foods on the market. Therefore, this population needs special attention to ensure ongoing healthy food choices even after many years on the gluten-free diet. These findings indicate important clinical implications regarding processed gluten-free foods that are becoming more readily available and affordable on the market. The rising obesity epidemic in the United States underscores the importance of nutritional support at diagnosis and afterward, especially in the adolescent years. In this particular population, reasonable and convenient, but healthy, gluten free food options should be emphasized. [* This article is adapted from a recent study undertaken at The University of Chicago Celiac Disease Center. The authors are pleased to acknowledge Kristen Wroblewski, Biostatistician at the University of Chicago who provided assistance with statistical analysis. 1. Valletta E, Fornaro M, Cipolli M, Conte S, Bissolo F, Danchielli C. Celiac Disease And Obesity: need for nutritional follow-up after diagnosis. European Journal Of Clinical Nutrition. 2010;64(11):1371-2. 2. Miranda J, Lasa A, Bustamante MA, Churruca I, Simon E. Nutritional differences between a gluten-free diet and a diet containing equivalent products with gluten. Plant foods for human nutrition. 2014;69(2):182-7. ] This population needs special attention to ensure ongoing healthy food choices even after many years on the gluten-free diet. WHAT IS BMI? According to the National Institutes of Health, Body Mass Index, or BMI, is a measure of body fat based on one’s height and weight. “BMI is an estimate of body fat and a good gauge of your risk for diseases that can occur with more body fat. The higher your BMI, the higher your risk for certain diseases such as heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers.”(1) A healthy BMI is a range between 18.5 and 25. However, this range does not account for special situations such as increased muscle mass in highly athletic people, or decreased muscle mass in older adults. You can figure out your own BMI on the National Institutes of Health website. The measures for BMI for children and teens are somewhat different and require a different calculator. There is one available on the website of the Centers for Disease Control and Prevention. [BMI Underweight Below 18.5, Normal 18.5–24.9, Overweight 25.0–29.9, Obesity 30.0 and Above]

SURPRISING FOODS THAT MAY CAUSE GLUTEN CROSS-CONTAMINATION According to Jane Anderson from verywellfit.com, there are some foods to watch out for if you are still having symptoms after going gluten free. Mushrooms are frequently cultivated on straw from rye and/or wheat, which could leave a tiny amount on the mushrooms. Your best bet is to buy wild mushrooms from a local farmers’ market or online. Strawberries are often bedded on straw to keep the berries off the ground and protect them from frost. Again, the amounts of gluten are small, but could be enough to cause symptoms. Soy is one of the top eight allergens, but is also cross-contaminated with wheat during its growing phase. Most farmers who grow soy also grow wheat, so soy is another product to watch out for. In her article, Ms. Anderson specifically mentions that her reaction to soy is the same as her reaction to gluten – dermatitis herpetiformis. Beans are another product that is rotated with wheat or barley in the fields. Farmers also use the same harvest and storage equipment so some cross-contamination is inevitable. Sorting through dry beans and rinsing helps, but it can often be hard to distinguish between small kernels. 8

How big of a deal are these cross-contamination possibilities and what does it mean for you? That depends on how sensitive you are. If you’re still having symptoms and are sure you’re consuming only gluten-free foods, these are items you should consider eliminating, at least for a few weeks to see if that helps. Experts Weigh In on Celiac Disease Research and Treatment in 2019 By Quinn Phillips - Published March 20, 2019 Living with celiac disease, and managing a gluten-free lifestyle, involves navigating a bounty of information and making numerous decisions every day. With all the breathless media coverage of research updates and lifestyle advice, it can be easy to lose track of the big picture when it comes to celiac disease treatment and research. So we asked three celiac disease experts — two top doctors and the director of the leading advocacy group in the United States — to answer a few questions about where celiac disease management is right now, and where it might be headed. Their responses (condensed and edited for clarity) appear below. Gluten-Free Living (GFL): What have we learned about the causes and biology of celiac disease in recent years? How might these discoveries lead to advances in treatment or prevention? Alessio Fasano, MD, Gastroenterologist and Director of the Center for Celiac Research and Treatment, Massachusetts General Hospital: For many years, we’ve known a great deal about how people develop celiac disease. We were convinced we really had a grasp of the entire story. The two ingredients that were considered necessary and sufficient were a genetic predisposition, and an environmental trigger that’s mismanaged by the immune system, which is gluten. What we’ve learned in the last few years is that genetics and environment are absolutely necessary, but not sufficient, to explain who gets celiac disease. We saw things that were at odds with that premise. In identical twins, with identical genes, who ate the same stuff, one twin would develop celiac disease and the other would not in 25 percent of cases. How do you explain that? In the last 10 to 15 years, we learned that there are three other elements: a gut that leaks, allowing gluten to interact with the immune system; an immune system that’s hyperbelligerent, continuing to fight when it’s not necessary; and a very different microbiome, the ecosystem of the gut, between people with and without celiac disease. These five elements offer treatment and prevention opportunities that we didn’t have before. Except for genetics, they’re all fair targets to change the destiny of people with celiac disease. Prevention would be the Holy Grail, and that’s what we’re looking at in this megastudy called CDGEMM (Celiac Disease, Genomic, Environmental, Microbiome and Metabolomic Study), where we’re following infants since birth when someone in their family has celiac disease. We follow everything about these kids. We’re asking why some take a wrong turn and develop celiac disease, while others do not. What kind of changes happen before the storm is on their doorstep? Daniel A. Leffler, MD, Gastroenterologist and Associate Professor of Medicine, Harvard Medical School: I think our better understanding of celiac disease has allowed us to see that there’s a need for therapies. It’s really more about the clinical picture of the disease, rather than the scientific background. That being said, I think there are areas where science has helped us attempt to make really safe, targeted therapeutics for celiac disease, even though they’re not really hitting any part of the disease we didn’t know about before. I think you can group celiac disease therapies into three main groups. One is things that try to detoxify or protect you from gluten. These would be largely glutenase enzymes, but other things have been tried, including gluten binders. Second, there are drugs that prevent gluten from interacting with the immune

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system in the intestinal wall. And the third category is drugs that try to turn off the abnormal immune response to gluten. Our improved scientific understanding has suggested ways to target those three parts of the pathogenesis of celiac disease to create an effective therapy, even though we’ve known that those three things are important for a long time. Marilyn Grunzweig Geller, chief executive officer, Celiac Disease Foundation: As research continues to prove that a gluten-free diet is not a “cure” for celiac disease as was once thought, the case for investing in celiac disease research — both to create new treatments, and to find ways to prevent it — becomes more compelling. As more physicians learn and accept that patients with celiac disease cannot be written off with “just go on a gluten-free diet”, there should be a corresponding increase in diagnosis with a potential patient base attractive to biopharmaceutical investment to bring therapeutics to market. GFL: What have we learned about the causes and biology of non-celiac gluten sensitivity in recent years? Fasano: Not much. We know that besides celiac disease, there are other forms of gluten reactions, which we thought was not the case until the recent past. This includes non-celiac gluten sensitivity. Some of the steps in the disease process seem to be the same as in celiac disease. You have to be exposed to gluten, it’s only partially digested, there’s gut permeability, and the immune system reacts to it. What comes next is very nebulous for non-celiac gluten sensitivity. There’s a 30-year difference in science between the two conditions, and that gap can be closed once we have a better understanding of how to define non-celiac gluten sensitivity and what kind of diagnostic tests we can use. Leffler: Unlike celiac disease, non-celiac gluten sensitivity is just not a well-defined condition. There are no clear biomarkers; there’s no clear genetic marker — yet it’s real. I see it in my patients. I think the likelihood is that it’s not one disorder. It’s likely a combination of different disorders in different people that lead to significant symptoms when people get exposed to gluten. From a therapeutic perspective, it may be significantly more challenging than celiac disease because we don’t have the same scientific understanding yet. I think a lot more foundational work has to be done before we get to medications for non-celiac gluten sensitivity. GFL: What, in your view, are the most promising recent developments in treatments to reduce the effects of gluten exposure in celiac patients? Fasano: Unfortunately, we have very little for exposure after the fact. If you’re exposed and have symptoms, the only thing you can do is go through the storm and wait for the inflammation to go away. There are much more promising developments in terms of protection if you find yourself in a situation where the risk of cross-contamination is higher. There are three or four possible pathways that have been explored in clinical trials: drugs for gut permeability, using enzymes to completely digest gluten, blocking the enzyme that activates gluten to be seen by the immune system, and immunosuppressants. These could all help prevent a reaction in cases of cross-contamination, a safety net if you wish. Leffler: Drug development is such a tricky process that it’s always hard to predict what’s further along. There’s larazotide, which appears to work on some level by preventing gluten entry into the intestine. That should enter a phase 3 trial in the near future, which would clearly make it the front-runner. But it’s the lone drug in its class.

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On the other hand, you have things like glutenase enzymes, where there’s a couple of drugs in different phases of development. There’s a lot of experience with those, and a lot of belief that they should be safe and effective, yet none of them is actually in phase 3. And then there are some of the potentially more transformative types of therapies, ones that try to reset the immune system, that are in phase 2 somewhere. I think you can make an argument for any one of those classes being a front-runner in some regard. Geller: There are a number of potential celiac disease treatments in the pipeline. While most are in preclinical development or phase 1, ImmusanT is currently in phase 2, Provention Bio and ImmunogenX are heading in to phase 2, and Innovate Biopharmaceuticals [larazotide] is heading into phase 3. GFL: Gluten-free food options have grown enormously in recent years, supported by many people without celiac disease adopting gluten-free and reduced-gluten diets. Do you think this development has led to improved quality of life for people with celiac disease? Fasano: I can tell you that there have been a lot of positive outcomes from this gluten-free frenzy, but of course they come at a price. Twenty years ago, if you were a celiac, you had to go to the special health-food store. Your options were limited to three or four items whose palatability was questionable, with the prices astronomically high. Now you have a wealth of products everywhere, very palatable, much more affordable. That was simply unimaginable before. But people who are very careful, and people who are reckless, have jumped on this business opportunity. Imagine if you go to a restaurant as a celiac and say you have to go gluten-free because you have a condition, and a half hour before, they’ve served someone who said, “I want a gluten-free menu, and bring me a beer.” This fuels the sense of a fad diet, and people may take this very lightly and not use the proper stringency in serving you. Leffler: I think it’s been a net positive for sure. Having celiac disease today is much more manageable on some level than it was 10 or 20 years ago. The costs of gluten-free foods haven’t really dropped much, but certainly the variety and availability have increased, and the quality has probably increased. At the same time, we know that it has also led to sort of an erosion of a feeling of the seriousness of the condition. You go to restaurants and see people order gluten-free, but then still have bites of their roll. It leads to a lot of confusion. And it hasn’t addressed what’s in many ways the biggest issue for people with celiac disease, which are these small cross-contamination gluten exposures in restaurants. Yes, it’s easier to go the supermarket and go shopping for tasty foods. But I’m not sure that’s made the celiac community healthier. We still see a lot of people for whom these small, unavoidable contaminations are leading to ongoing symptoms and an inability to control their celiac disease well. Geller: Mostly yes. Certainly the availability of gluten-free foods in the market, and the FDA labeling rule for these products, have been life-changing for people with celiac disease. In 2009, I was ordering gluten-free bread from Colorado and paying exorbitant shipping fees just so my son could have sandwiches that looked similar to his classmates’. Dining out was more difficult then too, as no restaurant offered gluten-free options on their menu. However, because of the gluten-free fad, we have seen a backlash in the public’s and restaurant servers’ acceptance of the seriousness of celiac disease — what can be so hard about eating gluten-free if everyone is? And when you dig deeper and ask questions about those gluten-free options, it turns out that while the meal may have been prepared without gluten-containing ingredients, that meal has been contaminated through cross-contact in many ways.

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So while quality of life has improved due to greater choice of foods and better opportunities to dine out, most people with celiac disease still face daily the stress of accidentally ingesting gluten and all of the horrible symptoms that follow. GFL: How do you guide celiac patients to adopt the proper precautions to avoid gluten exposure, without those precautions going too far? Fasano: There are two breeds of patient that come to our clinic. One is those who don’t really appreciate the importance of a gluten-free diet, who think that once in a while, you can make an exception. Much more common is the attitude of putting yourself in a bubble, being so paranoid that you don’t live a life anymore. They don’t travel anymore, they don’t go out, they don’t let their kids go to camp or sleepovers. Both attitudes are inappropriate. Ultimately, we’re trying to implement a treatment that preserves the patient’s quality of life. Once you have learned the do’s and don’ts, and you know how to navigate a gluten- free diet, the intent is that you lead a normal life. That’s what we communicate to patients. Ultimately, if everything works well, you won’t be distinguishable from anyone else. Your symptoms are gone, your autoantibodies are gone, your intestinal biopsy shows that it’s healed. And if you don’t tell me that you’re a celiac, I can’t tell. Leffler: I have that conversation quite frequently with all my patients. We want to strike that balance between being adequately vigilant, but not neurotic. In the end, we want people to have a good quality of life. It’s not a net gain to be miserable but have great control of your celiac disease. Unfortunately, one of the issues is that because we don’t have great tools for assessment and monitoring, we treat a gluten-free diet as a one-size-fits-all therapy, where we tell everyone to be as strict as possible — even though we know that some people can probably do fine with small amounts of gluten exposure. We just don’t know who they are. And some people, no matter how strict they are, will probably never be able to get full disease control. This is one reason why I think there’s a real need for celiac disease monitoring and follow-up. For example, we tell people to try eating oats and see how they do. I worry about people who over-restrict, in some ways, just as much as I worry about people who aren’t careful enough. Geller: Label reading and asking questions are your two best tools in avoiding gluten exposure. If you’re sharing a kitchen with others who do not eat gluten-free, use your own toaster, cutting board, colander, and cleaning sponges, and do not share condiments that have been exposed to gluten. For social events, offer to bring a gluten-free dish if you’re not sure the host understands how to avoid cross-contact with gluten. And my personal advice is what I call the pre-eat and post-eat. If you don’t think you’ll be able to eat safely at an event, and cannot bring your own food or snacks, make sure to eat a substantial gluten-free meal before and then again after the event if you’re still hungry. While it may feel unfair that you cannot enjoy the food at an event, there’s no need to punish yourself by going without food altogether. In fact, one of my son’s favorite memories is our In-N-Out Burger post-party runs — protein-style, of course. 

My friends, I really never complain about anything, but I have to make a comment right now. I had a lot of difficulty typing the recipes from the February potluck for the newsletter, because there were so many recipes without names! PLEASE, my friends, put your names on your recipes so if I have a problem typing them from the sheet of paper you wrote it on I can contact you. There were so many recipes without any instructions! I don't understand why this is not included on the recipe! I already spend time typing the recipes that are not emailed (even though many of you have email!), but then I have to try and decipher what is written. Please have a little consideration and help me out. Now forgive me while I jump down off my soap box!

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I want to thank Jan Morgan for typing the recipes from the summer pot luck for me. I was a bit under the weather and she was so kind to do that. If any of you have ideas for the pot lucks, newsletters, feedback or questions please email or call Barb at 515- 224-4145 or email [email protected]. We would love to hear from you! We hope to see you all at our next gluten free Holiday potluck! Remember, watch for an email to give you the date! If you have any questions or concerns please feel free to call me at the number below. Glutenfreely Yours, Barb Huyette, 515-224-4145

The Central Iowa Celiac Connection Steering Committee Members: Barb Huyette, Angela Wagner, Lucy Newcomb, Kathy Titus, Christie Engelbert, Lisa Huyette Smith, Micca Guyler and Jan Morgan, and Diana Heard. The Central Iowa Celiac Connection provides information and education for its members. We have attempted to compile accurate information in this newsletter for the benefit of the members of this group. However, food manufacturers may change the ingredients in their products or their manufacturing process at any time, so always check the ingredient labels. Call the manufacturer if you have questions about their product. Consult your physician if you have any medical concerns.

______RECIPES

SNICKERS TARA SMITH 1 (3.4 oz.) package instant vanilla pudding (I used Hy- Combine the pudding mix and milk in a large Vee brand) bowl. Fold in the whipped topping. 1 cup milk Add the apples, Snickers (save some to sprinkle over 1 (8 oz.) container Cool Whip (I used Aldi's brand) the top), grapes and strawberries to the bowl and stir 3 apples, chopped to combine. Refrigerate until ready to serve. 5 full size Snickers bars, chopped 1/2 cup grapes, cut in half 1/2 cup sliced strawberries

CUCUMBER SALAD MICHAEL AVERWEG 4 cucumbers peeled and thinly sliced Mix together and let flavor develop for several hours 1 sweet medium onion thinly sliced in the refrigerator. ½ cup chopped green pepper (optional) Serve chilled. ½ cup cider vinegar Optional: may add halved cherry or grape tomatoes. ¾ cup sugar ½ teaspoon celery seed ½ teaspoon salt 1/8 teaspoon pepper

LOADED BROCCOLI CAULIFLOWER SALAD JAN MORGAN Ingredients Directions Dressing: Whisk all dressing ingredients together in a medium 3/4 cup plain Greek yogurt sized mixing bowl. Cover and chill. In a large salad 13

1/2 cup mayonnaise bowl, toss all salad ingredients. Pour dressing over 1/4 cup clover honey salad and toss to evenly coat. Top with additional 2 Tablespoons red wine vinegar bacon if desired. Cover and refrigerate until served. 1 Tablespoon granulated sugar

1/4 teaspoon salt 1/2 teaspoon black pepper Salad: 4 cups small broccoli florets, diced 4 cups small cauliflower florets, diced 12 slices thick cut bacon, cooked and diced 8 ounces Colby Jack cheese, small cubed 1/2 medium red onion, chopped and rinsed

BAKED BEANS JAN MORGAN BUSH’S ORIGINAL BAKED BEANS (GLUTEN FREE)

SNACK PRETZELS ERIN HANNAH 1 – 16oz bottle Orville Redenbacher popcorn oil Mix the above and pour over 2 – 16oz pkgs. of small 1 – pkg. dry Ranch dressing mix (Hidden Valley) pretzels (Glutino) 2 – tsp. dill weed (Tones) Mix well, turn over often the first day. Ready to serve!

EASIEST SARA LUPKES [dairy free, gluten free, vegetarian 15 minute meal] Combine strawberries, mandarin oranges, mini 1lb strawberries, sliced marshmallows, and bananas in a large bowl then chill 15oz can mandarin oranges, drained and serve. Can make several hours ahead of time, but 1 cup mini marshmallows add sliced bananas just before serving. SERVES 5-6. 2 large bananas (or 3 small bananas,) sliced Brands of ingredients used: Mandarin Oranges: Market Pantry (Target brand): Mini Marshmallows: Hy-Vee brand labeled “Gluten Free” on the bag. Recipe from: Iowa Girl Eats

TACO ANGIE MCCORMICK PREP TIME; 10 MINUTES. COOK TIME; 10 MINUTES. Cook the pasta according to the package directions. CHILL TIME; 2 HOURS. TOTAL TIME; 2 HOURS 20 Drain and rinse with cold water then set aside. Add MINUTES. mayo, sour cream, taco seasoning and ranch mix to a 12 ounces Rotini (I used Barilla GF) very large bowl. Using a rubber spatula mix until well 1 cup mayonnaise combined. Add pasta and toss until well coated. Add 1/2 cup sour cream remaining ingredients and stir to combine. Taste to 1 tablespoon taco seasoning (I used McCormick GF) check for seasoning balance. Add more salt, pepper, 1 tablespoon ranch seasoning mix. (I used Hidden lime juice, cilantro, etc. if desired. Cover and place in Valley) refrigerator for at least 2 hours before serving. 1 cup green bell peppers, diced Pasta salad will keep airtight in the fridge for up to 4 1 1/2 cups shredded cheddar cheese days. 1/4 cup chopped cilantro

1/4 cup green onion, diced 1-2 tablespoons lime juice 1 teaspoon kosher salt, or to taste 1 teaspoon ground black pepper, or to taste 14

COCONUT CREAM CAKE BARBARA BRANDT 1 box of white or yellow gluten free cake mix Prepare the cake according to the directions on the 1 7.4 oz. can of Sweetened Condensed Coconut Milk cake mix box and bake in a 9 X 13 inch pan until done. (I found mine at Hy-Vee in the health food section) Remove the cake from the oven and while still hot, 1 8 oz. container of Cool Whip poke holes all over the top of the cake using a large 8 oz. of coconut fork. Open the can of Sweetened Condensed Coconut Milk and pour over the top of the cake while it is still

warm. Make sure to spread it evenly over the top of the cake. Allow it to cool. Once the cake is cooled frost with the Cool Whip and sprinkle coconut over the top of the cake. Refrigerate until ready to serve.

HEALTHY SUGAR FREE BAKED BEANS JUDY HAMMEL 1 lb. uncooked beans (used pinto and great northern) Place all ingredients in crockpot, stir, and cook on high 1 (28 oz.) can crushed tomato sauce (used Aldi’s) for 7 hours (or until beans are soft and sauce has 5 T Worcestershire sauce (used Lea and Perrin) thickened). Let sit for one more hour with heat 3 T. apple cider vinegar (used Bragg’s) turned off and lid on. Makes about 8 cups. 4 garlic cloves, minced

1 1/4 tsp chili powder (used Tones) 1 1/2 T onion powder (used Nutmeg Spice) 25 drops Sweet Leaf Liquid Stevia (Stevia Clear Sweet Drops) 2 T hickory smoked paprika (used Nutmeg Spice) 2 T kicken maple honey rub (used Nutmeg Spice) 1/2 C maple walnut syrup (used Walden Farms) 2 T liquid hickory smoke (used Tones) 1 C brown sugar (used Swerve) Salt and pepper to taste (used Nutmeg Spice)

HEALTHY NO-BAKE CHOCOLATE PEANUT BUTTER JUDY HAMMEL COOKIES WITH COCONUT 1/2 cup creamy peanut butter (used Skippy reduced Melt peanut butter, honey and coconut oil; then add fat) the rest of the ingredients and form into balls; 1/4 cup honey refrigerate or freeze. Serve cold or dip in chocolate 1/4 cup coconut oil measured in solid state (used (optional). Nutiva Organic Butter flavored)

1 1/2 scoops chocolate protein powder (used Primal Kitchen Collagen Fuel) 1/4 tsp sea salt (used Nutmeg Spice) 1 tsp vanilla (used Tones) 1 C quick cooking oats (used Trader Joe’s gluten free) 1/4 cup shredded unsweetened coconut (used Hy- Vee) 1/2 C chocolate hazelnut peanut powder 93% less fat (used Full Circle Market) GF chocolate chips (Lily’s for GF and Sugar Free or Enjoy Life optional)

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GOOEY S’MORES BARS (BY THE DIY FOODIE) ANGELA WAGNER 2 cups Kinnikinnik graham crackers crumbs Preheat oven to 350 degrees. In a medium mixing ½ cup Hy-Vee unsalted butter, melted bowl, combine graham cracker crumbs and melted 1 can Eagle Brand sweetened condensed milk butter. Press into a greased 9x13 pan. Pour and 1 cup Nestle Toll-House semi-sweet chocolate chips spread the sweetened condensed milk over the 1 cup Nestle Toll-House milk chocolate chips graham cracker crust. Sprinkle on both kinds of 2 cups Hy-Vee miniature marshmallows chocolate chips. Bake for 25 minutes. Place marshmallows on top in an even layer. Broil for 1-2 minutes until marshmallows turn a light golden brown. Watch carefully!! Refrigerate at least 30-60 minutes prior to serving. NOTE: Do not brown them to a campfire roasted color; it will make them slightly chewy.

CLASSIC SALAD ANGELA WAGNER (WWW.KRAFTRECIPES.COM) 1 tub (8 oz.) Light Cool Whip In a large mixing bowl, mix all ingredients together. 2 – 11 oz. cans Hy-Vee mandarin oranges, drained Refrigerate 1 hour before serving. Note: recipe called 20 oz. can Hy-Vee pineapple tidbits, drained for crushed pineapple, I substituted pineapple tidbits. 3 cups Hy-Vee miniature marshmallows 2 cups Baker’s Angel Flake sweetened coconut

GLUTEN-FREE FRENCH BUTTER CAKE HEIDI WUBBEN Bottom Layer: 1. Preheat oven to 350 degrees 1 Pillsbury Gluten-Free yellow Cake Mix 2. Lightly grease a 9 x 13 baking dish and set aside. ½ cup butter, melted 3. In a large bowl, mix together first three 2 eggs ingredients (Cake mix, butter, and 2 eggs) until Top Layer: completely incorporated. 1, 8oz. block of cream cheese, softened 4. In a second large bowl, combine remaining 2 eggs ingredients and beat until smooth 4 cups powdered sugar 5. Press cake mix mixture into prepared baking dish 1 teaspoon vanilla 6. Pour cream cheese mixture on top and spread evenly. 7. Bake in center of oven for 35- 40 minutes, until cake no longer jiggles when moved (The toothpick test won’t work on this cake!) 8. Remove from oven and allow to cool. 9. Once cake is cool, cut into squares and serve. 10. Store any leftovers in the refrigerator for up to a week. 11. Enjoy!

BETTY CROCKER CHOCOLATE CHIP GLUTEN FREE COOKIES TRICIA LLOYD 1 Stick of Butter (Softened-not melted) Heat Oven to 350 Stir in Cookie mix softened Butter, 1 Tablespoon Water Water, Vanilla and Egg in medium bowl until Well 1 teaspoon Gluten Free Vanilla Blended. Drop dough by tablespoonsful 2 inches 1 Egg apart onto ungreased cookie sheet Bake 13 minutes

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POTATO SALAD WITH PASTA DAVID JOHANSON Using Corn Fusilli and Organic Brown Rice & Quinoa Penne 4 Med Potatoes Peel and dice into ½ inch cubes - Place in a pot with 4 quarts of salted water. 8 oz. each of the above Pasta varieties (Aldi’s) - Chop celery, red onion, green and red pepper (about 1.5 cup volume) Spice with mixture of equal parts salt, pepper and garlic powder as desired, (I used about 1.5 teaspoons) 2 hard-boiled eggs chopped. Mayonnaise (about 2 cups add what you want to make it taste the way you like it. Paprika to garnish Boil pasta per package instruction. Boil potato’s 10 minutes. Drain both and mix. If pasta is sticky after draining, put 3 tablespoons of olive oil in the empty pot and swish the pasta in it to moisten. Add chopped spices (Mix when you add mayo). Refrigerate to chill. 1 hour should do it. Mix everything while adding mayonnaise until smooth in texture.

PARTY POTATOES MARY (STAN) GUTHRIE 1 bag (32 oz. Ore-Ida diced potatoes Add potatoes to crock pot. 1 cup Daisy sour cream In a bowl mix soup, salt, sour cream. Stir to combine. 1 can Great Value GF Cream of Chicken soup Pour over potatoes. I Teaspoon salt Add cheese to top, cook for 4 hours on high. 2 Cups Hy-Vee shredded Colby Jack shredded cheese

STRAWBERRY PRETZEL SALAD EMILY CROW Crust: Topping: 2 C GF pretzels, crushed 1 box (3 oz.) strawberry Jell-O 3/4 C butter, melted 2 C boiling water 3 T sugar 10 oz. sliced sweet strawberries Mix & press in bottom of 9x13 inch pan. Cool to room Dissolve Jell-O in water; add berries. Cool to room temp. temp; pour over cheese layer. First layer: 1 8 oz. cream cheese, softened 1 C sugar 8 oz. Cool Whip Cream the cream cheese & sugar. Fold in Cool Whip. Chill until served

STRAWBERRY PRETZEL SALAD MARY HARPER 1st: 1 ½ c. GF pretzels (Snyder) crushed ½ c. Sugar ½ c. Margarine melted Combine ingredients pat into 9 x 13 pan. Bake at 350 degrees for 10 minutes. Cool

2nd: 8oz cream cheese 1 c. Sugar 9oz Cool Whip Combine ingredients. Spread over cooled pretzel crust.

3rd: 6oz strawberry Jell-O 2 c. boiling water 20oz frozen sliced strawberries 17

Dissolve Jell-O in boiling water. Add strawberries. Let mixture set partially in freezer. Spread over cream cheese mixture. Chill for at least 2 hours. Make day before and keep refrigerated until serving. Gluten Free but not dairy free

CHEESY HASHBROWN CASSEROLE DIANA HEARD 1 pkg. frozen shredded hash browns Mix all together and put in greased 9x13. Bake 1 can cream of chicken soup, GF uncovered at 350 degrees for about an hour. 1 cup sour cream Salt and pepper to taste Optional- as a main dish, mix in 2 cups pre-chopped ¼ cup melted butter ham. 1 cup milk ¼ cup diced onions (optional) 2 cups shredded cheddar cheese

EASY BREEZY HAWAIIAN SHIRLEY KEKSTADT 5 cups shredded cabbage (about one small head) Combine mayonnaise, vinegar, sugar, mustard and salt 2 medium carrots, shredded and pepper in the bottom of a large bowl and mix 1 8-oz can Dole crushed pineapple, drained and juice well. Add cabbage, carrots and drained pineapple and reserved (see note) toss well. Taste and adjust flavors, adding some of the 1/4 cup Burman's mayonnaise (Aldi”s) reserved pineapple juice, more vinegar or sugar as 3 tablespoon Great Value white vinegar desired. Cover and chill for at least 1 hour before 1 tablespoon sugar serving to allow flavors to meld. NOTES: The vinegar 1/2 teaspoon McCormick's ground mustard plus the sugar in the dressing give it a delicious 1/4 teaspoon salt sweet–and-sour flavor but if you wish, you can simply 1/8 teaspoon fresh ground pepper use 3 tablespoons of the juice from the drained can. Serves 6.

SUMMER PASTA SALAD (GLUTEN & DAIRY FREE) SUSAN HORNING 2 C POW Pasta Green Lentil Penne (gluten free) Cook pasta according to package instructions. Add 1/2 C Tru Roots Just Green Pea Pasta (gluten free) tomatoes and olive oil. Stir. 1/2 pkg. Sunset Wild Wonders Medley tomatoes (washed & sliced) 2 T. olive oil

3 BARBARA MOORE 1 can drained green beans Pour over beans. Add onion rings and green pepper. 1 can drained yellow wax beans Let set for a day or two or at least overnight. 1 can drained kidney beans Mix: 1/2 C vinegar 2/3 C sugar 1/3 C salad oil Salt to taste

APPLE SALAD WITH WALNUTS SUE RAWSON 6 red delicious apples - peeled and chopped 1 C chopped walnuts (Grower Direct California shelled) 1 C chopped celery 2 C red seedless grapes-halved 18

1 C miniature marshmallows (Fireside) 1 C Earth Balance Mindful mayo (no soy; no eggs)

VEGGIE DIP NO NAME 3 tsp Fox Point seasoning (Penzey's) 1 C yogurt (Greek non-fat) 1/4 C spinach dip (organic)

TACO PASTA SALAD ANGIE MCCORMICK 12 oz. Rotini (used Barilla GF) Cook pasta according to the package directions. Drain 1 C mayonnaise and rinse with cold water then set aside. Add mayo, 1/2 C sour cream sour cream, taco seasoning and ranch mix to a very 1 T taco seasoning (used McCormick GF) large bowl. Using a rubber spatula, mix until well 1 T ranch seasoning mix (used Hidden Valley) combined. Add pasta and toss until well coated. Add 1 C green bell peppers, diced remaining ingredients and stir to combine. Taste to 1 1/2 C shredded cheddar cheese check for seasoning balance. Add more salt, pepper, 1/4 C chopped cilantro lime juice, cilantro, etc. if desired. Cover and place in 1/4 C green onion, diced refrigerator for at least 2 hours before serving. Pasta 1-2 T lime juice salad will keep airtight in the fridge for up to 4 days. 1 tsp kosher salt, or to taste 1 tsp ground black pepper, or to taste

TACO SALAD PAT OLESON 1 head of lettuce Brown meat; drain beans and add to meat; simmer 10 2 tomatoes minutes. 1/2 onion Break up lettuce; add cut-up tomatoes, onion, and Cheese cheese. 1 pkg. Doritos Crunch up 1/2 bag Doritos. 1 lb. hamburger (used ground turkey) Add dressing and serve. 1 can kidney beans Western or French dressing (used Wishbone original Western)

EASIEST FRUIT SALAD SARA LUPKES 1 lb. strawberries, sliced Combine strawberries, mandarin oranges, mini 15 oz. can mandarin oranges, drained (used Market marshmallows, and bananas in a large bowl then chill Pantry-Target brand) and serve. Can make several hours ahead of time but 1 C mini marshmallows (used Hy-Vee brand labeled add sliced bananas just before serving. “Gluten Free” on bag) 2 large bananas, sliced

PASTA SALAD TRENT ANDREWS Cook Butter and Herb Rice Pasta and Sauce Mix according to directions (found at Walmart) Add 1/2 C celery Add 1/2 C cucumbers Add 1/2 C shredded carrots Add 1/4 C mozzarella cheese

CARROTS AND DIP AMBER HUBER 19

32 oz. bag of carrots Rinse carrots. Mix sour cream and seasoning. 8 oz. Daisy sour cream 2 T Hidden Valley Ranch seasoning

MARINATED TOMATOES DAWN KEKSTADT 6 large tomatoes cut into wedges (or equal amount of Wisk everything but the tomato wedges together in a halved cherry or grape tomatoes) bowl. Add tomatoes and stir to coat. Marinate at 3 T fresh parsley-chopped room temperature for at least 2 hours – stirring every 2 T fresh basil-chopped now and then. 1 T sugar 1 1/2 tsp garlic salt 1 tsp paprika 1 tsp onion salt 1/2 tsp pepper 3/4 C olive oil 1/2 C red wine vinegar 3 green onions

DEVILED EGGS TARA AMUNDSON Organic eggs (18) Cook eggs 8 minutes, high pressure, sealed valve with Sir Kensington’s mayo (1/2 cup-ish) 1 C water in instant pot. Then peel eggs, cut in half, Organic coconut aminos (few drops) remove yolk and mix ingredients into yokes and Redmond real salt (pinch) return yolk mixture to egg white halves. Tones Spanish paprika (sprinkle on top at end)

MUSTARD DEAN MINAR 4 lbs. red potatoes – peeled Boil potatoes until just done, drain and refrigerate 1 medium yellow onion – chopped fine until cold. Cut cold potatoes into 1/2 inch cubes. 1 doz. Eggs – hard boiled Chop up eggs. In medium bowl, combine dressing Dressing: ingredients, mix well. In large bowl, fold dressing into 2 T. white vinegar potatoes, onions and egg. 1/4 C yellow mustard 2 1/4 C Miracle Whip 1 1/2 tsp salt 1/2 tsp pepper 1 T sugar

CREAMY POTATO SALAD JOSEPH LAMB 6 medium potatoes (2 pounds) In a large saucepan, boil potatoes with skin on for 25 1 C thinly sliced celery to 30 minutes or until tender; drain well. Cool 1/2 C finely chopped onion potatoes. Peel and cube potatoes. Transfer to a large 1/3 C Vlasic dill relish bowl. Add celery, onion, dill relish. Combine 1 1/4 C Hellmann’s real mayonnaise mayonnaise, celery salt, Spanish paprika, vinegar and 2 tsp Baker’s Corner Premium granulated sugar mustard. Add mayonnaise mixture to potatoes. Toss 2 tsp Tones celery salt lightly to coat mixture. Cover and chill thoroughly. 2 tsp Tones Spanish paprika 2 tsp Great Value distilled white vinegar 2 tsp Burman’s yellow mustard

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SPICY CORN RELISH/SALAD/SALSA TERESA KOCH Corn 1 bell pepper 1/3 C avocado dressing (dairy, no eggs) 2 jalapeno peppers

AVOCADO SLAW TERESA KOCH Cabbage Carrot Avocado dressing (dairy, no eggs)

CRANBERRY WALNUT COLESLAW SUE AND BECKY BRINKER 14 oz. bag of Dole Classic Coleslaw Mix all ingredients and refrigerate a few hours before 3/4 C Hy-Vee dried cranberries serving. 3/4 C chopped walnuts Penzey's Mural of Flavor, to taste Seasoned salt, to taste 3/4 C Jimmy’s Fat Free Coleslaw Dressing (contains egg)

CHOCOLATE ZUCCHINI CAKE BARBARA MOORE 1/2 C butter Mix butter, oil and sugar. Add eggs, vanilla and milk. 1/2 C vegetable oil Beat well. Stir in dry ingredients and beat well. 1 3/4 C sugar Stir in zucchini. Pour into greased and floured 9x13” 2 eggs pan. Sprinkle on topping. Bake at 350 for 40-45 min. 1 tsp vanilla No need for frosting. Also freezes well. 1/2 C sour milk or buttermilk 2 1/2 C. gluten free flour 1 tsp cinnamon 4 T cocoa 1/2 tsp baking powder 1/2 tsp salt 1 tsp baking soda 1/2 tsp. Xanthan Gum 2 C shredded zucchini Topping: 1/2 C chocolate chips 1/2 C chopped walnuts 2 T sugar

COCONUT CREAM POKE CAKE BARBARA BRANDT 1 box of white or yellow gluten free cake mix Prepare cake according to the directions on the cake 1 7.4 oz. can of Sweetened Condensed Coconut Milk mix box and bake in 9x13 inch pan until done. (found at Hy-Vee Health Market food section) Remove the cake from oven and while still hot, poke 1 8 oz. container of Cool Whip holes all over the top of the cake using a large fork. 8 oz. of coconut Open the can of Sweetened Condensed Coconut Milk and pour over the top of the cake while it is still warm. Make sure to spread it evenly over the top of the cake. Allow it to cool. Once the cake is cool, frost with the Cool Whip and sprinkle coconut over the top 21

of the cake. Refrigerate until ready to serve.

FUNFETTI COOKIES MICCA GUYLER Gluten free Funfetti cake mix Mix, drop on cookie sheet. Bake 8 minutes. 3 eggs 1/3 C oil

DEBBIE KAY’S CELEBRATION YELLOW CAKE SALLY PASSMORE 1 cup Premium Gold Gluten Free Flour Preheat oven to 350 degrees F and place rack in 1 1/2 tsp baking powder center of oven. Grease and flour two 9 inch round 1/2 tsp salt pans. In a medium bowl, combine the flour, baking 1/2 stick butter, softened powder and salt. Set aside. Cream together the 1/2 cup + 2 T sugar butter and sugar. Add egg and beat until combined. 1 large egg Add vanilla and beat again. Add the dry ingredients 2 tsp vanilla alternately with the milk to the butter/sugar mixture 2/3 cup milk and mix until smooth. Evenly pour the batter into 1/4 C gluten free sprinkles cake pans and bake for 25-35 minutes (or 20 minutes Frosting: for cupcakes), until a toothpick inserted in the center Unsalted butter comes out clean. When cool, frost. Powdered sugar Milk Vanilla extract

CHOCOLATE CHIP COOKIES JOSEPH LAMB 1 C. Blue Bonnet vegetable oil spread (sticks) Preheat oven to 375 degrees. In large mixing bowl, 3/4 C. Baker’s Corner Premium granulated sugar beat butter, sugars, vanilla and eggs until creamy. 3/4 C. Ginger Evans brown sugar In another bowl, combine flour, baking soda. 2 Great Value large white eggs Gradually add flour mixture to creamed mixture. Stir 2 1/4 C. Bob’s Red Mill gluten free all-purpose baking in chocolate chips. Drop rounded tablespoons of flour dough onto ungreased cookie sheet. Bake 8 to 10 1 tsp Arm & Hammer pure baking soda minutes or until lightly browned. Allow cookies to 1 bag Hy-Vee semi-sweet chocolate chips cook on cookie sheet for about 2 minutes. Remove 1 tsp That’s Smart imitation vanilla flavoring cookies and cool on wire racks completely.

TRADITIONAL SCOTCHAROOS TERESA KOCH 1 C. light corn syrup Generously butter a 9x13 inch baking pan. Set aside. 1 C. white sugar In a large pot, mix together corn syrup, sugar, and 1 1/2 C. peanut butter peanut butter. Cook over medium heat, stirring until 6 C. crisp rice cereal peanut butter melts. Bring mixture to a boil. Remove 1/2 C. each butterscotch and semisweet chocolate from heat and stir in crisp rice cereal. Transfer chips mixture into a well buttered 9x13 inch pan. With your hands well buttered, pat it down into pan. In a medium saucepan, over medium low heat, melt chocolate chips and butterscotch chips until smooth. Spread over top of bars and let bars cool. Cut into squares.

BLACK BEAN BROWNIES VELMA ROBERTS 1 1/2 C black beans (15 oz. can) Bake at 350 for 30 min in 8x8 greased pan. Combine 22

2 T cocoa powder all ingredients except chips in food processor until 1/2 C. quick oats very well blended. Stir in chips, then pour into pan 1/4 tsp. salt and sprinkle extra chips on top. Refrigerate a couple 3/4 C honey hours before cutting. 2 T. vanilla 1/2 tsp. baking powder 2/3 C. chocolate chips (All ingredients gluten and soy free)

HASH BROWN CASSEROLE CHRISTIE ENGELBERT 1 can condensed cream of potato soup, undiluted In a large bowl, combine the soup, sour cream and (GF) garlic salt. Add potatoes and cheddar cheese; mix 1 C (8 oz.) sour cream well. Pour into a greased 9x13x2 inch baking dish. 1 T garlic salt Top with parmesan cheese. Bake, uncovered at 350 1 (2 lb.) pkg. frozen hash brown potatoes for 55 to 60 minutes, or until potatoes are tender. 2 C (8 oz.) shredded cheddar cheese Yield: 12 to 16 servings. 1/2 C grated parmesan cheese

ORE-IDA TATER TOTS BARB HUYETTE Baked according to package directions

BERRY SUMMER JELLO POKE CAKE ANGIE MCCORMICK 1 box white cake mix (I used Bobs Red Mill Yellow Preheat oven to 325 degrees F. Lightly grease 13 x 9 Cake Mix) inch baking pan. Set aside. In large bowl, combine Water, melted butter, eggs as called for on cake mix dry cake mix along with water, melted butter, and 1 box (3 oz.) Strawberry Gelatin (I used Hy-Vee) eggs as called for on cake mix box. Blend with 1 box (3 oz.) Berry Blue Gelatin (I used Hy-Vee) electric mixer on medium speed for 2 minutes. Pour 2 cups boiling water batter into prepared pan. Bake at 325 degrees until Cool Whip Topping cake is light golden brown and toothpick inserted into center of cake comes out mostly clean. Remove pan to wire rack to cool. Using two small saucepans, place one cup of water into each saucepan and bring to a boil. Add packet of strawberry gelatin to one saucepan and berry blue gelatin to other saucepan. Stir for 2 minutes. Poke holes into cake using end of wooden spoon or a straw. Use long-handled teaspoon to pour strawberry gelatin into alternating rows followed by berry blue gelatin in remaining rows. Cover and refrigerate for at least 3 - 4 hours to chill. 10. Use spatula to spread whipped cream topping evenly on top of cake. Keep dessert refrigerated.

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