Archive for ‘Dietary Compliance’

October 20, 2019

A Perfect Pair

If you don’t have a recipe, how do find a perfect pair of flavors? My oldest son once called me during a layover in Vegas on his way home asking me to make Mexican lasagne for dinner. I had no idea what that was. He described it as a layered dish with lasagne noodles, meat, red sauce seasoned with a ton of spices like you’d use in tacos plus those in traditional lasagne, and cheese. I told him I’d give it a shot.

In that instance, I imagined the flavors in tacos. For that flavor profile, I chose salt, pepper, garlic, chili powder, and cumin. For the lasagne flavors, I added oregano, basil, thyme, and rosemary. I combined both of these profiles using sight, smell, and taste to judge the amount of each to add. The result turned out better than I would have guessed when he suggested it.

This request didn’t throw me because I rarely use recipes when I’m cooking for my family. So how do I know what to put in the pot? I’ve probably mentioned before that I imagine flavor combinations in my head. I do. But there are several things in play when I’m cooking.
perfect pair
For one, I use my sense of smell. If you hold your head over a pan and smell for a moment, you’ll realize you can smell salt as well as garlic, and curry powder, and basil. When the balance of the aroma is off, the taste will be as well.

I also use my eyes. If I’m adding beans to chili or cranberries to a salad, I use proportions that look pleasing. This results in a full combination of flavors in each bite.

Throwing something together often begins with inspiration or imagination. Sometimes I take a bite of something and have a sudden thought that it would pair well with X. Other times, I take the ingredients in my refrigerator and imagine different combinations of the flavors there. Sometimes I do this when I’m choosing my groceries for pickup or purchasing items at the farmers market.

Beyond my senses and imagination, I use memory. I both watched and helped my grandmother cook. I think about how she seasoned things. I also pay attention to the flavors and ingredients I can identify in restaurant dishes. And I envision combinations I’ve seen in recipes before.

Even if I can remember the general ingredients, once I get started I have to determine proportions. Knowing how something should look is helpful. If I’ve seen the consistency of pancake batter, then I can tell if there’s too much liquid or not enough.

Cooking experience is valuable as well. If you’ve baked a lot of cakes, you’ll have an idea what the ratio of flour to sugar, oil, and eggs should be. It’s probably worth noting that when you make gluten or dairy-free versions, traditional rules may not apply.

The best gluten-free sandwich bread I make has a dough that’s more like batter than dough. But once you’re practiced in these adaptations, you’ll still be able to rely on experience to help you.

If you have never cooked, or watched anyone cook, from scratch and cannot imagine flavor pairings, there’s a handy tool called The Flavor Bible that tells you what to mix and match. This comprehensive reference book of compatible flavors was named by Forbes as one of the 10 best cookbooks in the world of the past century. It also won a James Beard Book Award.

Following a specific recipe to the letter will yield a more consistent result, but using a flavor guide can introduce playfulness into your cooking. Life is made of so many repetitious chores, I like to add a sense of fun and play whenever I can. Sometimes the best way to do that is to try to find yet another perfect pair.

https://www.karenandandrew.com/books/the-flavor-bible/

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”

September 9, 2019

Please Don’t Kiss the Chickens!

Please don’t kiss the chickens! Not only do we have a new rooster in the neighborhood, the CDC has warned me not to kiss it. As if I would. I know better. I grew up on a farm. I do not kiss chickens or play with piglets when the mother is around. An angry sow targeted me for death when I was three. I barely escaped and I still remember it. That was enough piglet playing for me.

Most of us are aware we should be careful when cooking eggs or chicken, but we may not think twice before taking a cute photo of the kids kissing a baby chick. It is time to think twice.
chicken
On August 30th, the CDC issued an investigation notice regarding several multi-state outbreaks of salmonella infections linked to backyard poultry. At the time there were 1003 infections across 49 states resulting in 175 hospitalizations and 2 deaths. By now, there may be more.

Salmonella can cause mild, severe, or life threatening diarrhea depending on the person infected. Chickens, ducks, geese, and turkeys can contaminate their feathers, feet, beaks, and environment with salmonella even when they appear healthy and clean. People can get sick from touching coops, cages, hay, soil, feed, water dishes, and anything else in the bird’s environment even if they don’t touch the birds.

What I learned on the farm is that animals are carriers of disease so certain rules must be followed. The boots we wore in the barn came off in the utility room so we didn’t track contaminated soil into the house. Even if we had worn gloves, hands were washed thoroughly when we came in and always before cooking or eating. We wore shoes in the yard if we had dogs.

We washed our vegetables and fruits as a matter of routine. I never saw my grandmother sample a tomato or a piece of lettuce without washing it first. When we picked apples, we weren’t allowed to eat them until we got home. Huckleberries, blackberries, and strawberries had the same rule. We never placed raw meat on the same surface as the vegetables we were prepping.

As a child, I did not pick up wild animals that were sick even if they were teeny tiny and cute. If I saw a bat or possum during the day, I stayed away out of caution. That doesn’t mean I was taught to be fearful. I walked through a line of honeybees every time I went down the driveway. I didn’t run if I saw a spider or a snake as long as I determined it wasn’t poisonous.

Today, there seems to be a disconnect from these common sense rules. I now live in the city where if it’s cute most folks I know will let their kids pick it up and kiss it with no thought whatsoever. They’ll eat berries out of the farmer’s market crate without cleaning hands or fruit. But if they see a snake, bee, spider, or wasp of any kind, they run without ever looking to see whether it’s dangerous.

And there are other disconnects. Some friends who will only buy organic vegetables are quick to use wasp spray on their houses, insect spray on their skin, and Roundup® on their yards.
chickens
Perhaps a few common sense rules for disease prevention bear repeating:

Always wash your hands thoroughly using soap and water:
(Adults should supervise the hand washing of young children.)
Before eating and after using the bathroom.
After changing diapers or cleaning your toddler’s bottom.
Before preparing food, during food preparation after handling meat, eggs, poultry, fish, and seafood and again when food prep is done.
Before and after caring for someone who is sick.
Before and after visiting a hospital room.
After blowing your nose, coughing or sneezing or cleaning a child’s nose.
After touching animals, animal food, animal waste, animal blankets, saddles, leashes, bedding, or hay.
After handling pet food or pet treats.
After touching trash.

To prevent spread of colds, flu, stomach viruses, hand foot & mouth disease and other illness spread through close contact:
Do not share cups and eating utensils.
Clean and disinfect frequently touched surfaces in your home (including toys), at work, and at school.
Follow hand washing recommendations and/or use hand sanitizer after contact with public handrails, door knobs, touchscreens, pens, shopping carts, elevators, remotes, vending machines, and shared keyboards and phones.
Stay home when you are sick.
Keep your child home when he is sick.
As often as possible, avoid close contact with people who are sick.
Cover your nose and mouth with a tissue when coughing or sneezing.
Avoid touching your eyes, nose, and mouth especially when you are around someone who has a cold or flu.

To lessen the risk of giardia, cryptosporidium, campylobacter jejuni, E. coli, legionella pneumophila, hepatitis A, and salmonella:
Do not drink water from standing bodies of water or any water that may be contaminated with feces.
Try not to swallow water when swimming even in chlorinated pools.
Wash all fruits and vegetables thoroughly.
Follow hand washing recommendations.
Follow USDA recommendations for safe food handling.
Cook meat to the recommended temperature.
Pay attention to food recalls.
Keep farm animals out of the house.
Set aside a pair of shoes to wear while taking care of poultry and keep those shoes outside of the house.
Don’t eat or drink where poultry live or roam.
Stay outdoors when cleaning any equipment or materials used to raise or care for animals such as cages and feed or water containers.
Don’t eat after your pets.

Avoid hookworms by:
Wearing shoes when walking outdoors, especially in places that may have feces in the soil.

To avoid hepatitis B, rotavirus, diphtheria, whooping cough, pneumococcal infections, measles, mumps, rubella, tetanus, polio, chickenpox, meningitis, and HPV:
Stay up-to-date on long-lasting vaccinations and consider seasonal flu shots.

To lessen the risk of rabies:
Vaccinate your pets.
Leave stray cats and dogs alone.
Leave wild animals alone. Don’t keep them as pets.
Wash animal bites and scratches immediately with soap and water.
Consult a healthcare professional if you are bitten or scratched by an unvaccinated animal.

To lessen the risk of any illness:
Keep your body healthy, robust, and ready to fight disease by getting plenty of sleep, drinking plenty of fluids, eating nutritious food, being physically active, and managing stress levels.

And finally, it’s worth taking a moment to learn about the organisms with whom we share the planet. All spiders and bees are not to be feared and all furry creatures are not safe to embrace. If you’re determined to kill all insects anyway, please remember that poison is poison whether it goes on your skin, your yard, or your food.

If you want to choose a single piece of advice to help prevent disease, take it from the CDC and please don’t kiss the chickens!

https://www.cdc.gov/salmonella/backyardpoultry-05-19/index.html

https://www.cdc.gov/media/dpk/food-safety/live-poultry-salmonella/live-poultry-salmonella.html

https://www.cdc.gov/features/handwashing/index.html

https://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/safe-food-handling/basics-for-handling-food-safely/ct_index

http://www.cooking2thrive.com/blog/?s=safety/

Holiday Baking – Keep it Safe!

June 11, 2019

Where Do You Draw the Line?

A recent restaurant meal leaves me wondering, where do you draw the line? A hectic day last week left me without time for lunch until mid-afternoon. Low blood sugar demanded I choose something nearby so I stopped into an Outback Steakhouse® because I know they have a gluten-free menu.
line
I enjoy the bite of horseradish in Outback’s Caesar dressing. I settled on a gluten-free Caesar salad with grilled chicken. The food arrived quickly. I stared at it for a couple of seconds questioning whether I should eat the Parmesan, but hunger won out and I dug in. The first bite of salad tasted good. I was ready for another. On the second plunge, my fork pierced a hard crouton. CROUTON!?…in a gluten-free salad?

A crouton raises all sorts of questions. How did it get there? Was it dropped in the bowl when they prepared another salad nearby? Do they use the same bowl to toss regular and gluten-free salads? Did they make a regular Caesar and then pull off the croutons when my waiter noticed? Is this kitchen trained to avoid cross contact?

These questions hold the possibility that there could have been a significant amount of crouton residue throughout the salad. I ate the chicken that was arranged on top and left the salad uneaten. About the time I finished the chicken, a manager arrived with an apology and offer of a new salad or dessert.
CaesarSalad
I considered both, but I couldn’t accept. I was done. I had no trust left in that kitchen. After one more apology, they comped my meal. In this case, a free meal in exchange for a single crouton seems like a fair resolution, but there are larger questions that loom in the background.

A study published in 2018 in the American Journal of Clinical Nutrition concluded:
These surrogate biomarkers of gluten ingestion indicate that many individuals following a GFD regularly consume sufficient gluten (>200 mg/d of gluten) to trigger symptoms and perpetuate intestinal histologic damage.

It is possible that the patients studied were not strict in their adherence to a gluten-free diet, but it’s also possible that they ingested a damaging amount of gluten in spite of their best efforts to avoid it. My recent restaurant experience is a perfect example of how that can happen. My recent experience with Cheerios is another example.

The fact that studies seem to indicate accidental exposure is frequent begs the question whether a comped meal is a sufficient penalty to get the attention of a commercial kitchen regarding the serious health damage that can result to those with celiac disease from incidents of gluten exposure. I can’t think that it is but too much squawking about a specific incident could mean retaliation from an angry wait staff or chef.

Again, I’m left asking, where do you draw the line? It is important to my health to avoid gluten. It is important to my social life to occasionally eat in restaurants or attend events. It is important for me to feel like I can trust food labeled gluten-free.

It is important for all of us to be able to trust that we are getting accurate information. It is important for all of us to have food prepared in a safe manner. The more I think about this, the more I feel myself wanting to scream, “I want to be able to trust that you understand the importance to my health of providing me with carefully prepared and accurately labeled food without me having to emphasize my request in any way!”

Some are taking it a step further than screaming in their heads. One father sued Colonial Williamsburg over an incident in which its restaurant, Shields Tavern, did not allow his 11-year-old son with celiac disease to eat the homemade meal he brought with him on a 2017 school field trip because they do not allow outside food in the restaurant. Instead they offered to prepare him a gluten-free meal. The basis for the lawsuit was that the restaurant violated the ADA (Americans with Disabilities Act), the Rehabilitation Act and the Virginians with Disabilities Act.

The case was dismissed by a district court judge, but in a 2-1 ruling May 31st, 2019 the 4th District Court of Appeals reinstated the case. Writing for the majority, Judge Albert Diaz noted that Shields Tavern has rigorous protocols for preparing gluten-free meals that may suffice for most people with gluten intolerance, and a jury might decide those protocols sufficiently addressed J.D.’s disability.

But, he added, “The district court incorrectly overlooked the testimony that J.D. repeatedly became sick after eating purportedly gluten-free meals prepared by commercial kitchens. Until a jury resolves the disputes surrounding the nature and extent of J.D.’s disability, we cannot determine if the accommodation Shields Tavern offered, as good as it may be, fully accounted for his disability.”

We’ll have to wait to see how a jury views this case, but the publicity it is receiving just by being filed could be helpful to put commercial kitchens on notice that they can be held responsible if they do not accommodate dietary requests in a manner conducive to eliminating limits to the disabled of major physical activities or major bodily functions (see ADA definition of disability below).

On the other hand, I don’t know that a bevy of lawsuits over perceived insults that could result from a favorable jury decision is good. Protesting too much can yield the same result as saying nothing. But I think making an 11-year-old struggle to take care of himself because of a policy sounds like bad policy.

I applaud the boy for being willing to put his health above the stigma of being different from his classmates. If more of us showed such strong resolve, we’d all be healthier.

Perhaps reframing exposure to gluten for those with celiac disease and the gluten intolerant as a food safety issue would give it more credence amongst kitchen workers and waitstaff. The question then would be how to identify patrons for whom this is a safety issue as opposed to those who choose to eat gluten-free as a fad.

But should that really matter? As a matter of food safety, protocol should be followed for all patrons all of the time. If a customer requests gluten-free, then that’s exactly what they should receive–not maybe GF, almost GF, or what someone who doesn’t really know THINKS is GF. If gluten-free is not available, the customer should be informed upon ordering and outside food should be allowed. That would be the easiest way to avoid discrimination based on disability.

It would also be the easiest way for me to be able to relax through a meal instead of feeling braced for tomorrow’s tummy ache and next week’s rash. And while that would be welcome, it’s not reality right now. So, I choose to continue the traditions of pre-eating before events, carrying emergency food, and smilingly showing my waiter an errant crouton rather than delivering loud reprimands, throwing fits, or filing lawsuits. All of my screaming remains in my head.

Not everyone draws the line where I do, nor should they. Navigating the social intricacies of living gluten-free has many nuances. I don’t view celiac disease as a disability, but maybe it’s good to have a path of recourse when dealing with entities that choose to restrict requests rather than accommodate. I can see both sides. And my approach may change.

One more round of severe itching from dermatitis herpetiformis and my screaming may be out loud. If that happens, it will be because the itching has worn me down and gotten the best of me. And that may be where some people already find themselves. Celiac is a disease that comes with inherent frustrations and physical misery and it’s disheartening when you do everything right and still end up with damaging levels of gluten in your system.

The best way I know to minimize inadvertent gluten ingestion is to cook from scratch using fresh ingredients. When that’s not possible, patronize brands and places with which you feel comfortable. When you experience the occasional problem, draw the line where it feels right for you.

https://academic.oup.com/ajcn/article/107/2/201/4911450

https://www.richmond.com/news/virginia/court-reinstates-suit-about-boy-bringing-gluten-free-meal-into/article_aa022bd8-33f2-5db8-8e32-80f1e32f1926.html

https://www.ada.gov/q&a_lesley_university.htm

https://www.ada.gov/pubs/adastatute08.htm#12102

http://www.cooking2thrive.com/blog/im-saying-cheerio-to-cheerios/

http://www.cooking2thrive.com/blog/gluten-free-living-gotten-easier/


The Americans with Disabilities Act (ADA) defines disabilities as follows:

Sec. 12102. Definition of disability

As used in this chapter:

(1) Disability
The term “disability” means, with respect to an individual
(A) a physical or mental impairment that substantially limits one or more major life activities of such individual;
(B) a record of such an impairment; or
(C) being regarded as having such an impairment (as described in paragraph (3)).

(2) Major Life Activities

(A) In general
For purposes of paragraph (1), major life activities include, but are not limited to, caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.
(B) Major bodily functions
For purposes of paragraph (1), a major life activity also includes the operation of a major bodily function, including but not limited to, functions of the immune system, normal cell growth, digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine, and reproductive functions.
(3) Regarded as having such an impairment
For purposes of paragraph (1)(C):
(A) An individual meets the requirement of “being regarded as having such an impairment” if the individual establishes that he or she has been subjected to an action prohibited under this chapter because of an actual or perceived physical or mental impairment whether or not the impairment limits or is perceived to limit a major life activity.
(B) Paragraph (1)(C) shall not apply to impairments that are transitory and minor. A transitory impairment is an impairment with an actual or expected duration of 6 months or less.
(4) Rules of construction regarding the definition of disability
The definition of “disability” in paragraph (1) shall be construed in accordance with the following:
(A) The definition of disability in this chapter shall be construed in favor of broad coverage of individuals under this chapter, to the maximum extent permitted by the terms of this chapter.
(B) The term “substantially limits” shall be interpreted consistently with the findings and purposes of the ADA Amendments Act of 2008.
(C) An impairment that substantially limits one major life activity need not limit other major life activities in order to be considered a disability.
(D) An impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active.
(E)
(i) The determination of whether an impairment substantially limits a major life activity shall be made without regard to the ameliorative effects of mitigating measures such as
(I) medication, medical supplies, equipment, or appliances, low-vision devices (which do not include ordinary eyeglasses or contact lenses), prosthetics including limbs and devices, hearing aids and cochlear implants or other implantable hearing devices, mobility devices, or oxygen therapy equipment and supplies;
(II) use of assistive technology;
(III) reasonable accommodations or auxiliary aids or services; or
(IV) learned behavioral or adaptive neurological modifications.
(ii) The ameliorative effects of the mitigating measures of ordinary eyeglasses or contact lenses shall be considered in determining whether an impairment substantially limits a major life activity.
(iii) As used in this subparagraph
(I) the term “ordinary eyeglasses or contact lenses” means lenses that are intended to fully correct visual acuity or eliminate refractive error; and
(II) the term “low-vision devices” means devices that magnify, enhance, or otherwise augment a visual image….

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”

March 11, 2019

I’m Saying Cheerio to Cheerios®!

I’m saying cheerio to Cheerios! In fact, I already have. I don’t plan to ever eat them again. Why? Let me show you…
dh
I’ve been struggling with one of my worst breakouts of dermatitis herpetiformis (DH) in years. By struggling, I mean it’s all I can do not to claw myself until I bleed. I can’t sleep because I itch. I can’t concentrate because I itch. I’m irritable, you guessed it, because I ITCH!

If you have this skin version of celiac disease you know what I mean. There is nothing that itches like this. Sixteen years ago, it was the itchy rash that drove me to the doctor with celiac disease. That wasn’t my only symptom, but it was the one that was hardest to ignore.

Now I am aware I just need to find whatever it is that’s triggering my immune system and stop consuming it. By process of elimination, I finally landed on oats. Since Christmas, I have eaten Glutenfreeda instant oatmeal, Nature’s Path Organic instant oatmeal, and Cheerios. All are labeled gluten-free.

According to glutenfreewatchdog.org, both General Mills and Nature’s Path begin with oats that have been contaminated with wheat, barley, and/or rye. They then mechanically and optically sort the oats to remove the contaminants. General Mills tests and validates the resulting flour, then at the end of the process again tests gluten levels.

In order to label a product as gluten-free, it must contain less than 20 parts per million gluten. In 2015, General Mills recalled 1.8 million boxes of Cheerios and Honey Nut Cheerios due to wheat contamination. One sample in that lot tested at 43 parts per million gluten.

I don’t necessarily believe that another accidental contamination has occurred. It’s much more likely that I encountered a hot spot of contamination in the cereal. This could be true and the tests could still be compliant.

In other words, General Mills is not misrepresenting test results. The question mark comes from the way the contaminants are removed and the tests are conducted.

After contaminants are removed from the oats, Cheerios begin with validated gluten-free flour. This validation is based on the mean test results from a 24-hour production cycle of flour. Once the Cheerios are cereal, the product test is also based on the mean results of a 24-hour production cycle.

Gluten Free Watch Dog describes the protocol for determining a lot mean as:
(As reported to Gluten Free Watchdog and confirmed October 12, 2018)

To arrive at a lot mean for gluten-free Cheerios, the following protocol is followed:
Twelve to eighteen boxes of cereal are pulled during a production cycle or “lot”.
The contents of each individual box are ground.
A sub-sample of ground product is taken from each box.
The sub-samples are composited—meaning they are combined.
The combined sub-samples are subject to additional grinding.
A minimum of six, 1-gram sample extractions are taken from this combined, ground sample (Note, formerly this was a minimum of twelve, 0.25-gram sample extractions).
Extractions are tested using the Ridascreen Fast Gliadin (R7002) and cocktail extraction solution.

Once the product is ground and mixed, the test is no longer necessarily giving an accurate representation of what may be in your spoon or bowl. It is also worth noting that the number of samples taken decreased from 2015 to 2018.

Testing protocols like this could help explain why a study published in The American Journal of Clinical Nutrition in 2018 found that celiac patients adhering to a gluten-free diet typically consume up to 244mg of gluten per day. The study estimated the average inadvertent exposure to be 150–400mg using a stool test and 300–400mg using a urine test.

This inadvertent exposure is significant. A mere 15mg can cause symptoms in some of us. The damage underlying the symptoms undermines our attempts to be healthy. We certainly don’t spend our time reading labels, asking uncomfortable questions, missing out on our favorites, and enduring eye rolls just to end up ingesting gluten anyway. It is disheartening to know that labels may not present an accurate representation of the amount of gluten contained in food.

Of course, packaged foods are not the only source of gluten contamination. Restaurant food is a gamble as well. Some kitchens are better than others at avoiding cross-contact.

No matter how much awareness of gluten sensitivity increases, there is an ever-evolving question regarding the best way to navigate everyday life and avoid gluten. It isn’t realistic to think I can grow my own gluten-free grains, nuts, and seeds and grind my own flour. It is too isolating to never consume restaurant food.

I can cook the majority of my food at home. I can observe adverse reactions to specific foods. I can research sources of oats and testing protocols. I can eliminate Cheerios.

Due to my recent experience, I will no longer purchase “gluten-free” oat products that come from known contaminated sources. That means the remaining Nature’s Path oatmeal in my pantry is being donated. Once this round of DH heals, I will try Glutenfreeda oatmeal again…maybe. The memory of this itching will have to fade first.

The good news is, my rash is diminishing and I learned something about gluten-free oats. I cannot go backward. I must trust that my body will heal as miserable as I may be while it does.

I could have chosen to visit a dermatologist who may have prescribed Dapsone. That approach might have given me temporary relief, but once I quit eating Cheerios, I was better as quickly as the rash would have responded to the prescription. For me, a long-term solution is worth the time it takes to find it. You may not feel the same.

Each of us has unique tolerance levels, priorities, and health goals. We have to find the balance that works for us. Information is critical to finding that balance.

Now that I know more, I’m saying cheerio to Cheerios!

https://www.glutenfreewatchdog.org/news/updated-testing-protocol-from-general-mills-for-labeled-gluten-free-cheerios/

https://www.cheerios.com/our-gluten-free-process/

https://www.allergicliving.com/2015/10/06/gluten-free-labeled-cheerios-recalled-due-to-wheat-contamination/

https://www.glutenfreewatchdog.org/news/oats-produced-under-a-gluten-free-purity-protocol-listing-of-suppliers-and-manufacturers/

https://academic.oup.com/ajcn/article/107/2/201/4911450

https://consumer.healthday.com/diseases-and-conditions-information-37/celiac-disease-962/one-third-of-gluten-free-restaurant-foods-in-u-s-are-not-study-738383.html

http://www.cooking2thrive.com/blog/dermatitis-herpetiformis-leaves-little-rough-around-edges/

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”