yourlife XVI Year - 11/2009 - Schär No. 38
25 years Mas
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On a visit
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The Schär Magazine for a higher quality of life
en s of glut
to the master bakers ...
ART OF COOKING: Baking bread in an automatic baking machine Research & development: Baking without gluten Interview: The importance of the right diagnosis
Editorial
Dear reader, Bread is one of the most important global food products. In many cultures, bread is even regarded as a religious symbol or a symbol of life. This issue is all about bread. We make ten varieties of naturally gluten-free bread for you gradually brought to the highest quality standard. We have developed a new recipe for Pane Casereccio and Panini. Both now taste fresh and soft even without toasting. This time for our news report we rose bright and early at 5:45 to meet in Burgstall. Let's sneak a peek over the shoulders of our team of bakers!
gluten intolerance. It is not only the quality of our products that is important to us, it is also the well-being of our customers - be it in regard to the development or improvement of our product range, to services such as recipes, information on living gluten-free and travel tips, or to the new sales outlet locator. We are there for you - we care! And finally an idea for a snack: Succumb to the new, sweet products in our range. Try Pausa Ciok and Petit and let us know what you think! Sincerely, Ulrich Ladurner
"We care" is the slogan we have been using recently as an expression of our tradition and attitude. What do we want our slogan to communicate to you? The answer is quite simple. "We look after you because you are important to us!" To us, "We care" means that we are not just continually striving to improve and enhance our products, we also have you in mind when we are working. We have been active in the field of coeliac condition for more than 25 years. Our research centre is also addressing every aspect of
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In the prime of life: When bread bites back
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Research & development: A constant challenge: Baking without gluten ...
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Interview: The importance of the right diagnosis
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Legal notice: Schär Communication & PR | Winkelau 9, I-39014 Burgstall, Italy | www.schaer.com | yourlife@schaer.com
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Contents News report: On a visit to the master bakers
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@Schär: New delicacies from Schär
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Art of cooking: Baking bread in an automatic baking machine
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Recipes: Homemade bread
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News report
Early in the morning at six o'clock … . . . On a visit to the master bakers at Schär - baking tradition paired with expertise
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Monday morning at 5:45. The meeting point is Schär in Burgstall. The smell hits you even before the bakery door opens. It is one of yeast, of fresh, warm bread, of flour. The only real difference to a traditional bakery is the scale of the establishment. The pastry bowls are on the floor and have rollers. A grown man would easily have enough room in them. The dough is mixed by a powerful machine and the oven is several metres in length. This is where gluten-free bread for the whole of Europe is baked. . .
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News report
Despite the larger scale of the bakery, has responsibility for the entire production the spirit with which bakers go about their cycle, from making the dough to the finwork is the same as that which drove traished baked bread. Today Pane Caserecditional baking from the very beginning. cio and Ciabattine will be made. It is the passion and enjoyment in proOnly natural products are used ducing a natural, living product, a prodfor making bread uct which is almost as old as the history of mankind: bread. But also in making a product which is also something very Bread from Schär is naturally gluten-free, special: naturally gluten-free bread. This meaning only selected raw ingredients is because baking such as maize and 5.45: bread without glurice from monithe wonderful smell of freshly tored contract ten is certainly not baked, oven-warm bread farming are used easy and has very special require(see the news rements. This fine art is only mastered by port in the last issue) - and of course no very few, whose decades of experience preservatives are used. State-of-the-art and tradition in the art of gluten-free bakpiping systems feed the flour and speing can literally be felt in the bakery atcial baking mix for the different varieties mosphere . of bread to the scales, which accurately measure the ingredients. The recipes for The master bakers make it the individual bread varieties - a strictly personal guarded secret, of course - are entered into the computer. This guarantees that The night shift is preparing to hand over. every item of bread tastes the same. We The early shift starts in 15 minutes at 6:00. can only reveal this much: these are exGünther, the team leader, is one of the clusively natural ingredients that must first to arrive and does his rounds. Before undergo not just one, but multiple qualhe starts, he walks alongside the long ity checks before being converted into oven, checks production and enquires bread. how the night shift was. He will do this again at the end of the working day. After delivery, individual raw ingredients are held in quarantine until tests show A total of six master bakers are responsithat they do not contain any gluten. Only then are these raw ingredients approved ble for production. They are assisted by for use. other employees. The master baker A living product As soon as the required amount of flour and baking mix for the recipe (Pane Casereccio and Ciabattine in our case) is in the bowl, Günther adds water and checks the dough method. Another portion of yeast is swiftly added. "The mix must harmonise. This is the only way we can attain our customary flavour." Even when adding the ingredients, which make each variety of bread from sourdough or yeast
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dough, waiting for the correct time so the dough does not sag is crucial. All of the skills and experience of the master baker are called for here. The dough is then kneaded, rolled, shaped according to recipe, placed on the metal tray and then again left to stand for fermenting. From here the bread then moves on to the heat of the oven. It rises briefly one last time in the hot air. The skill of the baker is again called for here because only the correct temperature provides the right colour and desired crust. "And that temperature is what we give it - after mixing the starter culture, glutenfree flour and water, 16 whole hours for the sourdough! For the bread to arrive freshly baked and flavour some at your table, and to also be easily digestible, we have taken advantage of an old tradition and use natural sourdough in addition to yeast for many recipes." Sourdough makes the dough airy and fluffy and lends the bread a delicate, aromatic, typically acidic flavour. Bread baked with sourdough also stays fresh longer and is less susceptible to mould. A taste of oven-fresh bread every hour At the end of the oven, where the wonderfully smelling, fresh, warm bread comes out, a display board with multiple areas (divided into 24 hours) documents the baking process. This where the bakers regularly check the colour and shape of their ready-baked bread and also sample it. A piece is also put aside to test the appearance, flavour, core temperature, etc. of the bread. By doing so, the quality check can retrace the baking process hour by hour: Are the rolls or is the bread too dark or too light in colour? Do they have a shape they are not supposed to have? Is the temperature not right? Each individual step can be clarified and traced back to the raw ingredients if need be. Only masterpieces are allowed to leave the premises.
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The bakers at Schär previously worked in "normal" bakeries. They agree that the difference between now and then is the special relationship to their gluten-free product and the associated responsibility. Georg, the head of production, hits the
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With heart and soul . .
Baking the traditional way
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Good things need time and Schär takes its time in guaranteeing the quality of our bread. In everything: preparation, fermentation, baking and afterwards. When the freshly baked bread leaves the oven, it is a long way from being ready and needs to stand and cool for almost two hours again before moving on to final inspection and packaging. Only then are the master bakers at Schär certain that everything is in order and the fresh bread can take its place on shop shelves.
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ak n Georg, a master baker from the very beginning of Schär, recte ers of glu ollects, "Back then, 25 years ago, a lot was different. We had one small oven which four bakers used to bake the bread. But that wasn't all. We were also encouraged to introduce new ideas and refine recipes. We only made a few types of bread, and the taste and texture were nothing like they are today. Many things were more difficult, even the sourcing of raw ingredients. Everything was still in its infancy back then. Now we are 'all grown up', with wisdom, experience and brilliant ideas for the future," he says smiling. Today, the production of ten different bread varieties (small bread, loaves, Pane Casereccio, white bread and grain bread) and various pastries is split between six master bakers and other assistants. Our own research department is working continually on new ideas and recipe improvements. This is also the reason why Schär is the market leader in Europe and now has a market presence in the USA. But traditional skills have been used for baking for more than 25 years now. For bread, this is most noticeable in the dough method, which allows for the natural rhythm of yeast and milk bacteria cultures.
nail on the head: "All our employees put responsibility in making gluten-free bread their heart into their work and can identify than with the production of conventional with Schär. That is my bread, my product." bread. It is precisely this that makes our A baker starting work at Schär must learn work so interesting," explains Günther. "Also," add bakers a great deal in Markus and Chrisaddition to the Good things need time: Kneadbaking skills he tine, "the relationship ing, fermentation, baking . . or she already to the product is a possesses, such as becoming familiar with completely different one because this is the new raw ingredients and the peculiarinot just any old bread. We are producing ties of baking with gluten-free flour. "The a very special bread for very special connew employee has considerably greater sumers and we are proud of that!"
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@Schär
Petit: Delicious aroma in a convenient size A perfect flavour, a crunchy bite and a convenient size: the new Petit has everything that goes into making a classic. These biscuits with an extra fine buttery aroma are already packed in conveniently sized portions, which make them an ideal sweet snack to pack for sport, play and when out and about.
Pane Casereccio: The original is only available from the gluten-free master baker The new, improved recipe means that our Pane Casereccio, made from natural sourdough and with a hearty strong taste, is even fresher and more luscious. Not only does it taste like real Pane Casereccio, it can also be enjoyed straight from the pack without toasting and stays fresh for a long time. Ideal for enjoying at home, on holiday and for snacks between meals.
Saltí: The gluten-free party king Lightly salted and irresistibly delicious thanks to a new recipe: This light cracker is the star of any party, adds fun to evenings in front of the television and makes car journeys seem shorter. Just pop them in your mouth and savour the taste! Lactose and wheat-free!
Pausa Ciok: The new, small chocolate tartlet Not only a wonderful treat for the kids: Delicate sponge cake filled with a delicious milky cream filling and covered in cocoa icing – it’s hard to imagine a more tempting snack. Not only gluten and wheat-free, but also without colouring and with oodles of milk in the cream filling! Best enjoyed fresh from the fridge!
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@Schär
Mini-Baguette: The little baguette in a convenient pack The little baguette in a convenient packReady, steady, bake! Become a master baker at home. Bake the new mini baguette in just 5 minutes and eat it with something sweet or savoury. Now you can enjoy it even more, thanks to a new recipe and convenient individual packaging!
Ciabattine rustiche: New multi-grain bread rolls for oven baking In the mood for fresh, crispy Ciabattine? No problem. Simply place the bread in the oven and enjoy a deliciously smelling Ciabattine in just 5 minutes. Discover the new multi-grain Ciabattine oven-fresh!
Panini: A practical companion when you’re out and about These classics amongst Schär bread rolls are great at any time of day, no matter where you are. Simply remove them from the convenient keepfresh pack and enjoy them straight away - in the office, at school, on an outing or on the road. Thanks to our new recipe, they are now even softer and tastier and stay fresher for longer.
Twinny: Chocolate snack with a bite First the delicate, creamy milk chocolate quite literally melts away on the tongue, then the crunchy, crispy waffle layer follows: Opposites really do attract and they combine perfectly into one in the new Twinny. The sweet crunch delight for two almost a shame to share.
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Art of cooking
Baking bread is child's play The machine does it all itself when using the Bread-Mix baking mixture.
6:30 a.m. The alarm clock goes off. And even before you open your eyes, you can smell the seductive, irresistible scent of freshly baked bread. A dream? No! I will show you how this is done very easily... Fresh bread stirs emotions and memories. Of home, of Mum's homemade bread. Hardly anyone can resist this smell and the desire to take a bite of crispy bread still oven-warm. There's no need to, either. Baking is child's play with our Bread-Mix ready bake mixture, even for non-experts
and set bread type, baking mode, degree of browning and time, and that's it. The machine does everything else by itself. I tested the Kenwood BM350 automatic bread baking machine for you, made of
Important basic rules: 1. Always put liquid ingredients into the container first. 2. Measure ingredients accurately (electronic kitchen scales) 3. Always add yeast (or sourdough) last. 4. Do not add yeast (or sourdough) together with salt. 5. Add bread seasoning depending on required flavour: it makes the bread flavoursome and rich in variety. 6. Addition of fruit, nuts or seeds: always when the acoustic signal sounds. The dough hook will grind up the ingredients if they are added too early. 7. Immediately remove the bread from the tin after baking and allow to cool on a cooling rack. 8. The end product depends on local conditions (soft water, high humidity, elevation, properties of the ingredients etc.) So keep your spirits up if it doesn't work first time! 9. Changing ingredient quantities: note that proportions must match the original recipe. 10. Use lukewarm ingredients when baking immediately. If you bake using a preset time, i.e. overnight, ingredients should be cold so the yeast does not ferment too early.
who do not yet have the confidence for yeast dough. For use in a baking machine or in a normal baking oven. Wake up to the smell of fresh bread Even you can become a master baker with a baking machine. And with no effort at all! With a baking machine, the bread mixes and bakes itself and the machine can be pre-programmed such that the white loaf really is ready for breakfast at 6:30 on the dot when the alarm goes off. All you need do is add the ingredients
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premium quality stainless steel with a separate gluten-free programme, and am thrilled by it. Fourteen different (kneading and baking) programmes for different bread and dough varieties. A 58-minute quick bake programme. Three levels of browning: light, medium and dark, preprogrammable up to 12 hours. Capacity: 500 g, 750 g and 1000 g. Operation is
"For anyone baking bread in the oven: preheat and do not forget to place a small bowl of water at the bottom of the oven."
child's play and the end product a delight! Sweet, savoury, substantial, light . . There are no limits to your sweet and savoury fantasy with the automatic baking machine: pumpkin seeds, nuts, olives, tomatoes, dried fruit, fresh fruit, cinnamon. You can augment the base dough as your heart desires. Read the operating instructions to find out whether the ingredients should be added immediately or after a specific pre-baking time. Individual bread creations are particularly suited to summer picnics and garden parties.
"Keeping bread in a terracotta mould keeps it fresh for longer." Anyone baking bread in a normal baking oven should mix the dough in a food processor. This is quicker than using a handmixer (use a dough hook!) and the dough is guaranteed to be smooth. Preparation is also simple in this case, if a little more time-consuming. To ferment, I shape the dough on the baking tray and then place it in the oven, preheated to 40 degrees, for 30 minutes. It is important that the oven is preheated after fermenting and before the bread goes in for baking. This makes the bread crispier. I have compiled a recipe selection on the left which is bound to appeal to all lovers of freshly baked white bread. Good luck and enjoy your bread! Oscar
French bread
Linseed bread
Almond bread
Tuscan white bread
French bread for Kenwood baking machine Ingredients 350 ml water 5 g salt 20 g butter 350 g Schär Bread-Mix/Mix-Pane 20 g honey 7 g dry yeast (12 g fresh yeast)
Programme: Gluten-free; Fill quantity: 750 g 3h
The butter can be replaced by the same amount of olive oil if you do not want to use any animal fats. This also gives the bread a more distinctive flavour.
1 h 30 min.
Linseeds can be swapped for the same quantity of any other suitable seeds, such as sunflower seeds, pumpkin seeds and even nuts.
Programme: Gluten-free; Fill quantity: 750 g
Method Place all of the ingredients into the baking machine in the order given above, select programme and start.
Linseed bread for Kenwood baking machine Ingredients 350 ml water 150 ml milk 10 g sugar 5 g salt 30 g butter 500 g Schär Bread-Mix/Mix-Pane 10 g dry yeast (15 g fresh yeast) 3 g bread clover 50 g linseeds Method Place all of the ingredients (except the linseeds) into the baking machine in the order given above and start the programme. Add the linseeds to the baking mix after the acoustic signal sounds (after the rising phase).
Almond bread
for Kenwood baking machine
Ingredients 250 ml water 100 ml milk 5 g salt 20 g butter 250 g Schär Bread-Mix/Mix-Pane 100 g coarsely ground buckwheat flour 30 g honey 100 g finely ground almonds 7 g dry yeast (12 g fresh yeast)
Programme: Gluten-free; Fill quantity: 750 g
3h
Without almonds, this bread can also be used for toasting.
3h
This bread goes well with Italian meats and cheeses such as Parmesan, Gorgonzola, Sorpressa and cured meat.
Programme: Gluten-free; Fill quantity: 750 g
Method Place all of the ingredients into the baking machine in the order given above, select programme and start.
Tuscan white bread
for Kenwood baking machine
Ingredients 350 ml water 10 g sugar 350 g Schär Bread-Mix/Mix-Pane 20 g olive oil 7 g dry yeast (12 g fresh yeast) 50 g dried tomatoes, cut into small cubes 50 g (black) olives, pitted and chopped
Method Place all of the ingredients (except the tomatoes and olives) into the baking machine in the order given above and start the programme. Add tomatoes and olives to the baking mix when the acoustic signal sounds.
In the prime of life
When bread bites back
True stories about the road to happiness - three generations, three views and one common goal for quality of life.
Although small, Istria has a large association of wonderful people, united by their coeliac condition. Over the years, we have been linked with festivals, tours and projects.
The Istrian Coeliac Association made the largest gluten-free cake in the world
A father’s story I always thought that the mothers in our association were the only ones who bear the burden of gluten-free diets in the family. Until I heard the story of one dad: “When I heard our baby’s diagnosis, I was shaken. I was thinking: what will she be able to eat? Will we ever understand her condition? Is it just a phase? And what will happen if she ever eats the ‘wrong’ type of food? I soon discovered that all of these questions do have answers. And if I want my child to have the correct attitude towards the restrictions, then I’ll have to be the first to obey the rules.” He knew that he was doing the right thing when he read a school story written by his brave girl: “I suffer from coeliac condition. I am small and quite thin for my age. I can’t eat breaded meat, milk, bread, pasta, cakes, cookies and biscuits. I don’t eat food from the school canteen, so in the morning before school, my mum makes a sandwich for me. The condition doesn’t really bother me. I’m happy!” And when he managed to make the first gluten-free cake for his daughter, he felt something really special inside. “Coeliac condition has become just a way of life for us. We simply care for our darling daughter and keep an eye on what she eats.”
of health. Her problems began in 1973 when she was just one year old, having been diagnosed with coeliac condition. She was on a gluten-free diet for 8 years and then began to eat normally again. There were no changes and she had no major difficulties for a while, so everyone said she was cured. But she was still thin, sickly and sensitive. When she was 19, the intestinal problems re-appeared. Specialists diagnosed chronic intestinal inflammation, followed by Crohn’s disease. A number of years of acute inflammation, remission, anti-inflammatory drugs and corticosteroids followed. When she asked the doctors whether it could be coeliac condition again, she was told “No, but everyone would do better to stick to a gluten-free diet.” Iva became pregnant at 28, and her life moved in a new direction. She even began to enjoy her health and it seemed that the Crohn’s disease was in remission. However, her health declined after the birth. She suffered from leg oedema, terrible joint pain and a recurrence of her intestinal problems – which meant that she had to start taking corticosteroids again. “Shortly after that,” she explains, “my mother found an article in the Glas Istre newspaper which stated that coeliac condition was not a children’s disease. That made me realise what my problem really was, and I began a new healing process. I found the Istrian Coeliac Association, and they gave me the phone number of Dr. Peršić, a gastroenterologist at a children’s hospital in Rijeka, from whom I received exact instructions on what to do in order to obtain the correct diagnosis. I’ve now done all the tests and confirmed the diagnosis. I’ve followed a strict gluten-free diet for seven years now and I have never felt better. I am finally healthy and life is beautiful. I am infinitely grateful to the Istrian Coeliac Association and Dr. Peršić for their help.”
Grandfathers get it, too Coeliac condition is definitely not just a children’s disease, as Granddad Rudolf can testify. We usually hear the phrase “my child has got coeliac condition” but I’d never before heard about grandfathers getting it! But this is exactly what is happening more and more often. Adults or even senior citizens can also discover a gluten intolerance. Here is Rudolf’s story: “I am 74 years old, and my stomach has always hurt, ever since I can remember. All my life I was dogged by pain and horrendous attacks that would last for hours, and at night I was woken up by acid reflux. Nobody knew what was wrong with me, I just had countless gastroscopies. Drugs helped for a short while, and then it’d be back to square one again. Four years ago I became seriously ill - I couldn’t eat anything, my health was deteriorating and I only weighed 40 kg. However, one doctor suspected the possible answer to all of this: coeliac condition. It turns out I have had it all my life and I just didn’t know. At the age of 70 I found myself faced with a big change in life. Fortunately, the Coeliac Association helped me, gave me a baking machine, special flour and most importantly, armed me with knowledge. Today I am generally in good health; but I can’t ignore the fact that I am an old man, and cannot recover as quickly as someone younger. I sometimes reflect on how much less pain I would have had in my life if I had learned about my condition sooner.” Rudolf is satisfied because at least his pain was reduced, but he still emphasises that the only way around the issue is to have the answer to everything. These are three stories from Istria, three generations, three people, who along with many others, bring their joy of living to the Coeliac Association. Even though we don’t meet up in person that often, we can still be found on our internet forum: www.celijakija-istra.hr/forum.
“Cured childhood disease” Iva is a young woman who has had a rocky road to get to where she is today, a picture
This is Istria, our Croatian beauty.
Do come and join us - exchange ideas and chat. Iva can now live a healthy and happy life
Marina JADREJČIĆ
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Research & development
A constant challenge: Baki Tradition & innovation in two steps Just why is it so difficult to make good bread without gluten? Bread rolls rising nicely and loaves not collapsing are attributable first and foremost to gluten. Baking without gluten requires considerable experience and a complex fallback system. Flavoursome products can be made without gluten nevertheless. This fine art requires the perfect combination of experience and continual innovation. The meaning of binding proteins The two gluten components "glutenin" and "gliadin" can bond a huge amount of water and hence provide the dough structure for bread and pastries. Gluten, a protein, is therefore also called "glue". The dough can be formed elastically and forms fine pores during the baking process. Even though Schär has been making gluten-free bread for over 25 years, developing a new variety is a big challenge every time. No replacement has yet been found for gluten, the protein in wheat grain which gives normal bread not only its texture but also its familiar taste. The challenge therefore is to develop a recipe which combines the perfect quantities of different natural gluten-free raw ingredients to produce a dough which satisfies all requirements: one which is not too
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sticky, is light, rises easily and has a taste in line with current trends.
Identifying and implementing sensory preferences
It is for this reason that Schär has been running its own R&D laboratory in the internationally recognised Area Science Park in Trieste since 2003. Ten research and development experts, together with laboratory technicians (most with a degree in food technology), are engaged in various research projects in all aspects of naturally gluten-free foodstuffs and in research into new raw ingredients. Our latest product, Pane Casereccio with natural sourdough, was also developed in Trieste and is the result of meticulous research lasting many months.
The expectations of bread depend on the consumer's preference: by and large that the product is soft, light, crispy and seeded with essentially its own inherent taste. The goal posts were set high for the latest creation, Pane Casereccio: a bread that tastes homemade, baked according to ancient master baker traditions with the typical consistency and the powerful, slightly acidic taste of farmhouse bread. Even breads go in and out of fashion. Today's consumers make different demands to those 20 years ago. The chal-
Ten varieties of naturally gluten-free bread “De gustibus non disputandum est.” There's no accounting for taste. This applies
especially to bread. White or wholemeal, soft or crispy — everybody has personal preferences when it comes down to daily bread. For you to be able to acquire the taste of your very own gluten-free bread, we offer a selection of ten naturally gluten-free varieties: Baguette, Duo, Panini, Pan carré, Ciabattine and the sweet version Bon Matin for lovers of white bread, or for those who prefer something more substantial, Rustico, Sunna, Ertha and the new Pane Casereccio.
Research & development
ng without gluten ... lenge is therefore to seek out trends whilst developing new varieties. They differ in taste, ingredients, nutritional value and shape, but they all have one thing in common: they are the result of intensive research, continually oriented towards current trends and the particular requirements of the consumer.
Test after test until all requirements are satisfied
latest product samples before they are available to buy. This completes the constantly changing cycle at Schär.
In the laboratory trials, different parameters of the trial dough must be analysed: viscoelasticity of the dough, fermenting characteristics, consistency and airiness of the baked bread, etc. The texture and taste of the end product undergoes a Innovation and criteria for sensory examination by tasting specialskilled workmanship ists in accordance with DIN (Deutsches Institut für Normung), the German InstiThe main goal in the development of the tute for Standardisation. Some of the new Pane Casereccio was the applicaobjective criteria are softness, nutritional tion of skilled content, consistworkmanship ency (grainy by The Pane Casereccio should taste and large), the criteria. The new like bread with dough that was taste of milk, of bread was to rolled with a rolling pin, sprinkled yeast, of buckexhibit all of the with flour by hand and rolled into characteristics wheat/rice, acidshape. and the typical ity and any poflavour of a traditential aftertaste tional Pane Casereccio worked by hand. which has an overbearing effect on other It was to be tasteful and substantial, the tastes. Test after test is conducted, first in the laboratory and then in production perfect accompaniment to hearty dishes or part of a wholesome meal. It was first until all requirements are satisfied. Paa question of selecting raw materials and tience is often stretched to the limit until finding a suitable combination of these the product is finally developed. ingredients to attain properties similar to wheat flour. For Pane Casereccio, the Then there is only one more hurdle to overcome before the new product is research team chose a combination of launched on the market: the consumbuckwheat and rice flour following sever. Our bread is even "coeliac tested", eral trial runs and agreement from the bakers in production (see also news remeaning that a group of people affected port, p. 4 onwards). by coeliac condition continually test the
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Interview
The importance of the right diagnosis An interview with Jernej Dolinsek, MD PHD
coeliac condition research will certainly have a major impact on this. Sometimes I got the impression that a lack of solid medical facts presented in the native language was a major obstacle for changes in perception of the disease. Once this is overcome, there is a rapid improvement in diagnostic approach,” Jernej Dolinsek explains in describing his experience of diagnosing coeliac condition in t c e the corr t n Eastern Europe. a rt impo
.“ ws how dition is ek kno ac con li j Dolins e e o rn c e f J Changing perceptions Dr sis o diagno
Coeliac condition is one of the main topics covered by the work of Jernej Dolinsek, paediatrician/gastroenterologist from the Paediatric Department of the Maribor University Medical Centre. Besides regular diagnostic work and research in the hospital, in the past few years he has also given lectures about coeliac condition in many Eastern European countries and is currently involved in a project called CD Medics, which has the important role of raising awareness among medical professionals in the region. Different approaches “The diagnostic approach in Eastern Europe varies dramatically between different regions. There are some countries which have access to the latest diagnostic tools, but there are also regions and whole countries where only few centres are in a position to make use of these tests. There is also a large gap between these regions as regards the number of diagnosed patients, or rather as regards the perception by medical professionals about the prevalence of coeliac condition. It is still very common to hear it being said that coeliac condition is extremely rare and that it is a “Western” disease. However, I have the feeling that this attitude is about to change. Quick dissemination of the latest information in the field of 14 yourlife
In this region coeliac condition is still treated as a childhood disease. “Adults are still overlooked in almost every case,” Dolinsek explains. “This can also be seen in all European countries, but the gap in adults between the onset of symptoms and final diagnosis has been much improved in many regions. It is also common to see a patient who does not appear with typical symptoms to pass several diagnostic procedures before someone thinks of coeliac disease as the underlying cause of all the problems. It is therefore extremely important to stress that the disease is not merely a children’s disease causing chronic diarrhoea, but a systemic disease which can affect many organs and can become apparent at any age.” However, alongside these common factors, there are also differences between countries. What are these differences and which countries demonstrate a higher awareness about coeliac condition? Recognising coeliac condition “Countries which have a long tradition in coeliac condition diagnosis and are able to use all the available diagnostic tests, are also those where medical professionals are very much aware of the fact that the disease has many faces and can affect people at any age,” says Dolinsek. “Sadly, however, there are many countries that
still have a long way to go. There are still regions which claim that there are only a few children per 100,000 typically affected by the disease, and no other coeliac patients exist. Knowing what is really the case, this must mean that all the others who suffer from the condition are overlooked,” explains Dolinsek. This could be because of a lack of testing and also because of the simple fact that experts do not even consider coeliac condition when confronted with certain symptoms. “Once you think of a disease as being a common one, you will find the right tools to deal with it - for instance you will look up which tests are available. So maybe testing does not happen only because of economic deprivation, but also because no one considers them to be particularly beneficial.” Raising awareness In Jernej Dolinsek’s opinion, there is one thing which will improve the current situation and that is increased awareness. “Awareness of the true burden of coeliac condition worldwide, of the availability of very reliable tests on the market, of the many faces of coeliac condition and finally of the fact that by a strict gluten-free diet, which is nowadays much more accessible for every patient, a person with coeliac condition can live a very productive life. The number of those diagnosed is increasing. That is the fact,” says Jernej Dolinsek. “Many would agree that 1% is a very reasonable figure, and one which is backed by many studies. But I have the feeling that this is not only because we have better diagnostic tools - it is more complex than that. Certainly better testing does play an important role, but a major role is also played by the many experts and patient societies which have brought about a greatly increased awareness about the disease. We must not forget that the most effective treatment of the disease, namely with a strict gluten-free diet, has improved the quality of life of so many young coeliac sufferers in the past. For example, coeliac patients no longer fear having their own families any more, and can bear the increased risk of passing the disease onto their children,” concludes Dr. Dolinsek.
Milly’s kitchen tip
Simple
yoghurt cake
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30 min.
easy
...and this is how you do it
01 02 You need: 250 g “Mix Pâtisserie” (Schär Mix C) 125 g sugar 125 g yoghurt (1 pot) 2 eggs 1 pack of baking powder
03 04
Beat egg white until peaks are formed. In another bowl, stir the egg yolk and sugar into a creamy mixture, then add a pot of yoghurt, the sieved flour and the baking powder. Slowly stir with a wooden cooking spoon (no mixer) into a dough with uniform consistency. Then fold the egg white (already beaten) slowly into the dough just formed. Grease the baking tin and dust with flour. Bake in the oven at 180°C for the first 10 minutes, then at 150°C for the rest of the time.
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