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Sample records for disease gluten-free diet

  1. Celiac disease: understanding the gluten-free diet.

    Bascuñán, Karla A; Vespa, María Catalina; Araya, Magdalena

    2017-03-01

    The only effective and safe treatment of celiac disease (CD) continues being strict exclusion of gluten for life, the so-called gluten-free diet (GFD). Although this treatment is highly successful, following strict GFD poses difficulties to patients in family, social and working contexts, deteriorating his/her quality of life. We aimed to review main characteristics of GFD with special emphasis on factors that may interfere with adherence to it. We conducted a search of various databases, such as PubMed, Google Scholar, Embase, and Scielo, with focus on key words such as "gluten-free diet", "celiac disease", "gluten" and "gluten-free diet adherence". Available literature has not reached definitive conclusions on the exact amount of gluten that is harmless to celiac patients, although international agreements establish cutoff points for gluten-free products and advise the use of clinical assessment to tailor the diet according to individual needs. Following GFD must include eliminating gluten as ingredient as well as hidden component and potential cross contamination in foods. There are numerous grains to substitute wheat but composition of most gluten-free products tends to include only a small number of them, especially rice. The diet must be not only free of gluten but also healthy to avoid nutrient, vitamins and minerals deficiencies or excess. Overweight/obesity frequency has increased among celiac patients so weight gain deserves attention during follow up. Nutritional education by a trained nutritionist is of great relevance to achieve long-term satisfactory health status and good compliance. A balanced GFD should be based on a combination of naturally gluten-free foods and certified processed gluten-free products. How to measure and improve adherence to GFD is still controversial and deserves further study.

  2. Celiac disease treatment: gluten-free diet and beyond.

    Mäki, Markku

    2014-07-01

    The basis for celiac disease (CD) treatment is a strict lifelong gluten-free diet. On the diet, the small intestinal mucosal injury heals and gluten-induced symptoms and signs disappear. The mucosal healing is a prerequisite for sustaining health and is also obtained with a diet containing oats and trace amounts of gluten, industrially purified wheat starch-based gluten-free products. The small intestinal mucosa does not heal in noncompliant people, nor when a patient is inadvertently ingesting gluten. Development of adjunctive or alternative therapies is on its way. There are several novel treatment pipelines within academy and industry. Examples are the ideas of using glutenases as a drug to degrade the ingested gluten, polymers to bind and sequester the gluten to the feces, and also vaccine development for an immunotherapy to induce tolerance towards gluten. Clinical drug trials are to be foreseen in CD, soon also in children.

  3. Gluten-free diet - facts and myths.

    Hejduk Bobková, Barbora

    2017-01-01

    The aim of this bachelor thesis was to gain a comprehensive view of the gluten-free diet and to confirm or refute the claim that the gluten-free diet became a fashion trend in nutrition. The theoretical part explains the relationship between gluten-free diet and diseases caused by intolerance of gluten. Greater attention is paid to the most serious of these, celiac disease, whose only treatment is gluten-free diet Research of commonly available sources for the general public has produced a li...

  4. Living with coeliac disease and a gluten-free diet: a Canadian perspective.

    Zarkadas, M; Dubois, S; MacIsaac, K; Cantin, I; Rashid, M; Roberts, K C; La Vieille, S; Godefroy, S; Pulido, O M

    2013-02-01

    Strict adherence to a gluten-free diet is the only treatment for coeliac disease. The gluten-free diet is complex, costly and impacts on all activities involving food, making it difficult to maintain for a lifetime. The purpose of this cross-sectional study was to evaluate the difficulties experienced, the strategies used and the emotional impact of following a gluten-free diet among Canadians with coeliac disease. A questionnaire was mailed to all members (n = 10 693) of both the Canadian Celiac Association and the Fondation québécoise de la maladie cœliaque in 2008. The overall response rate was 72%. Results are presented for the 5912 respondents (≥18 years) reporting biopsy-confirmed coeliac disease and/or dermatitis herpetiformis. Two-thirds never intentionally consumed gluten. Women reported significantly greater emotional responses to a gluten-free diet but, with time, were more accepting of it than men. Difficulties and negative emotions were experienced less frequently by those on the diet for >5 years, although food labelling and eating away from home remained very problematic. Frustration and isolation because of the diet were the most common negative emotions experienced. The present study quantifies the difficulties experienced, the strategies used and the emotional impact of following a gluten-free diet. It highlights the need to improve the training and education of dietitians, other health providers and the food service industry workers about coeliac disease and a gluten-free diet, with the aim of better helping individuals improve their adherence to a gluten-free diet and their quality of life. © 2012 Canadian Celiac Association and Food Directorate Health Canada Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

  5. The immunopathogenesis of celiac disease reveals possible therapies beyond the gluten-free diet.

    McAllister, Christopher S; Kagnoff, Martin F

    2012-07-01

    Celiac disease is a T cell-mediated autoimmune inflammatory disease of the small intestine that is activated by gluten. The diagnosis of celiac disease is challenging as patients display a wide range of symptoms and some are asymptomatic. A lifelong gluten-free diet is the only currently approved treatment of celiac disease. Although the diet is safe and effective, the compliance rates and patient acceptance vary. Furthermore, many patients treated with a gluten-free diet continue to be mildly to severely symptomatic with persistent histological abnormalities, and a small number of patients develop refractory celiac disease. New therapeutic adjuncts and potential alternatives to the gluten-free diet could improve the treatment options for these patients. Advances in understanding the immunopathogenesis of celiac disease have suggested several types of therapeutic strategies that may augment or supplant the gluten-free diet. Some of these strategies attempt to decrease the immunogenicity of gluten-containing grains by manipulating the grain itself or by using oral enzymes to break down immunogenic peptides that normally remain intact during digestion. Other strategies focus on preventing the absorption of these peptides, preventing tissue transglutaminase from rendering gluten peptides more immunogenic, or inhibiting their binding to celiac disease-specific antigen-presenting molecules. Strategies that limit T cell migration to the small intestine or that reestablish mucosal homeostasis and tolerance to gluten antigens are also being explored. Additionally, it is vital to develop new therapeutic options for refractory celiac disease patients. This review highlights therapeutic strategies that may ultimately improve the health and well-being of individuals with celiac disease.

  6. Clinical Features and Symptom Recovery on a Gluten-Free Diet in Canadian Adults with Celiac Disease

    Olga Pulido

    2013-01-01

    Full Text Available BACKGROUND: Celiac disease can present with mild or nongastrointestinal symptoms, and may escape timely recognition. The treatment of celiac disease involves a gluten-free diet, which is complex and challenging.

  7. Clinical benefit of gluten-free diet in screen-detected older celiac disease patients

    Vilppula Anitta

    2011-12-01

    Full Text Available Abstract Background The utility of serologic screening for celiac disease is still debatable. Evidence suggests that the disorder remains undetected even in the older population. It remains obscure whether screening makes good or harm in subjects with long-standing gluten ingestion. We evaluated whether older subjects benefit from active detection and subsequent gluten free dietary treatment of celiac disease. Methods Thirty-five biopsy-proven patients aged over 50 years had been detected by serologic mass screening. We examined the disease history, dietary compliance, symptoms, quality of life and bone mineral density at baseline and 1-2 years after the commencement of a gluten-free diet. Symptoms were evaluated by gastrointestinal symptom rating scale and quality of life by psychological general well-being questionnaires. Small bowel biopsy, serology, laboratory parameters assessing malabsorption, and bone mineral density were investigated. Results Dietary compliance was good. The patients had initially low mean serum ferritin values indicating subclinical iron deficiency, which was restored by a gluten-free diet. Vitamin B12, vitamin D and erythrocyte folic acid levels increased significantly on diet. Celiac patients had a history of low-energy fractures more often than the background population, and the diet had a beneficial effect on bone mineral density. Alleviation in gastrointestinal symptoms was observed, even though the patients reported no or only subtle symptoms at diagnosis. Quality of life remained unchanged. Of all the cases, two thirds would have been diagnosed even without screening if the family history, fractures or concomitant autoimmune diseases had been taken carefully into account. Conclusions Screen-detected patients benefited from a gluten-free diet. We encourage a high index of suspicion and active case-finding in celiac disease as an alternative to mass screening in older patients.

  8. Symptomatic suspected gluten exposure is common among patients with coeliac disease on a gluten-free diet.

    Silvester, J A; Graff, L A; Rigaux, L; Walker, J R; Duerksen, D R

    2016-09-01

    A gluten-free diet is the only recommended treatment for coeliac disease. To determine the prevalence and characteristics of reactions to gluten among persons with coeliac disease on a gluten-free diet. Adults with biopsy proven, newly diagnosed coeliac disease were prospectively enrolled. A survey related to diet adherence and reactions to gluten was completed at study entry and 6 months. The Coeliac Symptom Index, Coeliac Diet Assessment Tool (CDAT) and Gluten-Free Eating Assessment Tool (GF-EAT) were used to measure coeliac disease symptoms and gluten-free diet adherence. Of the 105 participants, 91% reported gluten exposure gluten was reported by 66%. Gluten consumption was unsuspected until a reaction occurred (63%) or resulted from problems ordering in a restaurant (29%). The amount of gluten consumed ranged from cross-contact (30%) to a major ingredient (10%). Median time to symptom onset was 1 h (range 10 min to 48 h), and median symptom duration was 24 h (range 1 h to 8 days). Common symptoms included abdominal pain (80%), diarrhoea (52%), fatigue (33%), headache (30%) and irritability (29%). Reactions to suspected gluten exposure are common among patients with coeliac disease on a gluten-free diet. Eating at restaurants and other peoples' homes remain a risk for unintentional gluten exposure. When following individuals with coeliac disease, clinicians should include questions regarding reactions to gluten as part of their assessment of gluten-free diet adherence. © 2016 John Wiley & Sons Ltd.

  9. Symptoms of Functional Intestinal Disorders Are Common in Patients with Celiac Disease Following Transition to a Gluten-Free Diet.

    Silvester, Jocelyn A; Graff, Lesley A; Rigaux, Lisa; Bernstein, Charles N; Leffler, Daniel A; Kelly, Ciarán P; Walker, John R; Duerksen, Donald R

    2017-09-01

    Celiac disease and functional intestinal disorders may overlap, yet the natural history of functional symptoms in patients with celiac disease is unknown. To investigate the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), and functional bloating (FB) symptoms among patients with celiac disease at diagnosis and during the first year of a gluten-free diet. Adults with a new diagnosis of celiac disease were surveyed at baseline, 6 months and 1 year using standardized measures for intestinal symptoms [Rome III diagnostic questionnaire and celiac symptom index (CSI)] and gluten-free diet adherence [gluten-free eating assessment tool (GF-EAT) and celiac diet adherence test]. At diagnosis, two-thirds fulfilled Rome III diagnostic questionnaire symptom criteria for IBS (52%), functional dyspepsia (27%), and/or functional bloating (9%). One year post-diagnosis, there was high adherence to a gluten-free diet as 93% reported gluten exposure less than once per month on the GF-EAT and only 8% had ongoing celiac disease symptoms (CSI score >45). The rates of those meeting IBS (22%) and functional dyspepsia (8%) symptom criteria both decreased significantly on a gluten-free diet. The prevalence of functional symptoms (any of IBS, FD or FB) at 1 year was 47%. Long-term follow-up of patients with celiac disease is necessary because many patients with celiac disease who are adherent to a gluten-free diet have persistent gastrointestinal symptoms.

  10. Factors governing long-term adherence to a gluten-free diet in adult patients with coeliac disease.

    Villafuerte-Galvez, J; Vanga, R R; Dennis, M; Hansen, J; Leffler, D A; Kelly, C P; Mukherjee, R

    2015-09-01

    A strict gluten-free diet is the cornerstone of treatment for coeliac disease. Studies of gluten-free diet adherence have rarely used validated instruments. There is a paucity of data on long-term adherence to the gluten-free diet in the adult population. To determine the long-term adherence to the gluten-free diet and potential associated factors in a large coeliac disease referral centre population. We performed a mailed survey of adults with clinically, serologically and histologically confirmed coeliac disease diagnosed ≥5 years prior to survey. The previously validated Celiac Disease Adherence Test was used to determine adherence. Demographic, socio-economic and potentially associated factors were analysed with adherence as the outcome. The response rate was 50.1% of 709 surveyed, the mean time on a gluten-free diet 9.9 ± 6.4 years. Adequate adherence (celiac disease adherence test score 75% of respondents. Perceived cost remains a barrier to adherence. Perceptions of effectiveness of gluten-free diet as well as its knowledge, are potential areas for intervention. © 2015 John Wiley & Sons Ltd.

  11. Motives for adherence to a gluten-free diet: a qualitative investigation involving adults with coeliac disease.

    Dowd, A J; Tamminen, K A; Jung, M E; Case, S; McEwan, D; Beauchamp, M R

    2014-12-01

    Currently , the only treatment for coeliac disease is life long adherence to a strict gluten-free diet. Strict adherence to a gluten-free diet is challenging, with recent reports suggesting that adherence rates range from 42% to 91%. The present study aimed to: (i) identify motives for adhering to a gluten-free diet and (ii) explore factors implicated in adherence and non-adherence behaviour in terms of accidental and purposeful gluten consumption among adults with coeliac disease. Two hundred and three adults with coeliac disease completed an online questionnaire. Using a qualitative design, relationships were examined between reported adherence and motivation to follow a gluten-free diet, as well as the onset, duration and severity of symptoms. Feelings of desperation (‘hitting rock bottom’) and needing to gain or lose weight were associated with the strictest adherence to a gluten-free diet. Participants who accidentally consumed gluten over the past week developed symptoms the most quickly and reported the most pain over the past 6 months. Participants who consumed gluten on purpose over the past week reported a shorter duration of symptoms and less pain over the past 6 months. Hitting rock bottom and needing to gain or lose weight were factors associated with the strictest adherence, when considered in the context of both accidental and purposeful gluten consumption. Future research is warranted to develop resources to help people with coeliac disease follow a strict gluten-free diet.

  12. A gluten-free diet effectively reduces symptoms and health care consumption in a Swedish celiac disease population.

    Norström, Fredrik; Sandström, Olof; Lindholm, Lars; Ivarsson, Anneli

    2012-09-17

    A gluten-free diet is the only available treatment for celiac disease. Our aim was to investigate the effect of a gluten-free diet on celiac disease related symptoms, health care consumption, and the risk of developing associated immune-mediated diseases. A questionnaire was sent to 1,560 randomly selected members of the Swedish Society for Coeliacs, divided into equal-sized age- and sex strata; 1,031 (66%) responded. Self-reported symptoms, health care consumption (measured by health care visits and hospitalization days), and missed working days were reported both for the year prior to diagnosis (normal diet) and the year prior to receiving the questionnaire while undergoing treatment with a gluten-free diet. Associated immune-mediated diseases (diabetes mellitus type 1, rheumatic disease, thyroid disease, vitiligo, alopecia areata and inflammatory bowel disease) were self-reported including the year of diagnosis. All investigated symptoms except joint pain improved after diagnosis and initiated gluten-free diet. Both health care consumption and missed working days decreased. Associated immune-mediated diseases were diagnosed equally often before and after celiac disease diagnosis. Initiated treatment with a gluten-free diet improves the situation for celiac disease patients in terms of reduced symptoms and health care consumption. An earlier celiac disease diagnosis is therefore of great importance.

  13. Anxiety and depression in adult patients with celiac disease on a gluten-free diet

    Winfried; Huser; Karl-Heinz; Janke; Bodo; Klump; Michael; Gregor; Andreas; Hinz

    2010-01-01

    AIM: To compare anxiety and depression levels in adult patients with celiac disease (CD) on a gluten-free diet (GFD) with controls.METHODS: The levels of anxiety, depression and of a probable anxiety or depressive disorder were assessed by the Hospital Anxiety and Depression Scale in 441 adult patients with CD recruited by the German Celiac Society, in 235 age-and sex-matched patients with inflammatory bowel disease (IBD) in remission or with slight disease activity, and in 441 adult persons of a representa...

  14. Treatment of celiac disease: from gluten-free diet to novel therapies.

    Francavilla, R; Cristofori, F; Stella, M; Borrelli, G; Naspi, G; Castellaneta, S

    2014-10-01

    Gluten-free diet (GFD) is the cornerstone treatment for celiac disease (CD). This diet excludes the protein gluten a protein forum in in grains such as wheat, barley, rye and triticale. Gluten causes small intestines inflammation in patients with CD and eating a GFD helps these patients in controlling signs and symptoms and prevent complications. Following a GFD may be frustrating, however, it is important to know that plenty of foods are naturally gluten-free and nowadays is relatively easy to find substitutes for gluten-containing foods. Certain grains, such as oats, are generally safe but can be contaminated with wheat during growing and processing stages of production. For this reason, it is generally recommended avoiding oats unless they are specifically labelled gluten-free. Other products that may contain gluten include food additives, such as malt flavouring, modified food starch and some supplement and/or vitamins that use gluten as a binding agent. Cross-contamination occurs when gluten-free foods come into contact with foods that contain gluten. It can happen during the manufacturing process or if the same equipment is used to make a variety of products. Cross-contamination can also occur at home if foods are prepared on common surfaces or with utensils that have not been cleaned after being used to prepare gluten-containing foods (using a toaster for gluten-free and regular bread). Although safe and effective, the GFD is not ideal: it is expensive, of limited nutritional value, and not readily available in many countries. Consequently, a need exists for novel, non-dietary therapies for celiac disease. Advances in understanding the immunopathogenesis of CD have suggested several types of therapeutic strategies alternative to the GFD. Some of these strategies attempt to decrease the immunogenicity of gluten-containing grains by manipulating the grain itself or by using oral enzymes to break down immunogenic peptides that normally remain intact during

  15. Paediatric Patients with Coeliac Disease on a Gluten-Free Diet: Nutritional Adequacy and Macro- and Micronutrient Imbalances.

    Sue, Alison; Dehlsen, Kate; Ooi, Chee Y

    2018-01-22

    A strict, lifelong gluten-free diet is the cornerstone for management of coeliac disease. Elimination of gluten from the diet may be associated with nutritional imbalance; however, the completeness of this diet in energy and macro- and micronutrients in children is not well described. Understanding the nutritional adequacy of the gluten-free diet in children during this critical period of growth and development when dietary intake is strongly influential is important. Children, regardless of whether they have eliminated gluten from their diet, have a tendency to consume excess fat and insufficient fibre, iron, vitamin D and calcium, compared to recommendations. In the context of a gluten-free diet, these imbalances may be worsened or have more significant consequences. Paediatric studies have demonstrated that intakes of folate, magnesium, zinc and selenium may decrease on a gluten-free diet. Nutritional inadequacies may be risks of a gluten-free diet in a paediatric population. The potential implications of these inadequacies, both short and long term, remain unclear and warrant further investigation and clarification.

  16. Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges

    Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W.

    2017-01-01

    A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products? quality, availability, saf...

  17. Dermatomyositis Associated with Celiac Disease: Response to a Gluten-Free Diet

    Min Soo Song

    2006-01-01

    Full Text Available The association between dermatomyositis and celiac disease in children has been well documented. In the adult population, however, the association has not been clearly established. A rare case of concomitant dermatomyositis and celiac disease in a 40-year-old woman is presented. After having been diagnosed with dermatomyositis and iron deficiency anemia, this patient was referred to the gastroenterology clinic to exclude a gastrointestinal malignancy. Blood tests revealed various vitamin deficiencies consistent with malabsorption. The results of gastroscopy with duodenal biopsy were consistent with celiac disease. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient’s human leukocyte antigen haplotype study was positive for DR3 and DQ2, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms.

  18. Gluten-Free Diet Does Not Appear to Induce Endoscopic Remission of Eosinophilic Esophagitis in Children with Coexistent Celiac Disease

    Joseph R Abraham

    2012-01-01

    Full Text Available BACKGROUND: Celiac disease and eosinophilic esophagitis are usually considered to be separate gastrointestinal diseases; however, it appears that they may coexist more often than would be expected. It is unknown whether eosinophilic esophagitis in patients with celiac disease responds to a gluten-free diet.

  19. Prediction of adherence to a gluten-free diet using protection motivation theory among adults with coeliac disease.

    Dowd, A J; Jung, M E; Chen, M Y; Beauchamp, M R

    2016-06-01

    Coeliac disease is a chronic autoimmune disease that requires strict adherence to a gluten-free diet. However, strict adherence to a gluten-free diet is difficult, with findings from a recent review suggesting that up to 42% of individuals with coeliac disease do not eat a strict gluten-free diet. The present study aimed to examine psychosocial predictors of adherence (purposeful and accidental) to a gluten-free diet among adults with coeliac disease over a 1-month period. In this longitudinal study, 212 North American adults with coeliac disease completed online questionnaires at two time points, baseline and 1 month later. The results revealed that intentions partially mediated the effects of symptom severity, self-regulatory efficacy, planning and knowledge on purposeful gluten consumption. Intentions did not mediate the effects of severity, response cost, self-regulatory efficacy, planning and knowledge for accidental gluten consumption but, interestingly, self-regulatory efficacy directly predicted fewer accidental incidents of gluten-consumption. These findings delineate the differential psychological processes in understanding accidental and purposeful gluten consumption among adults with coeliac disease and emphasise the importance of bolstering self-regulatory efficacy beliefs to prevent accidental and purposeful consumption of gluten. © 2015 The British Dietetic Association Ltd.

  20. LOWER BIFIDOBACTERIA COUNTS IN ADULT PATIENTS WITH CELIAC DISEASE ON A GLUTEN-FREE DIET

    Lisléia GOLFETTO

    2014-04-01

    Full Text Available Context The ingestion of gluten is responsible for the symptoms of Celiac disease, but other environmental factors can also influence. Strains of the Bifidobacterium genus have been shown to afford protection against the inflammatory response and mucosal damage caused by gliadin peptides in vitro. Objectives This study was designed to compare the concentration of fecal bifidobacteria and pH of patients with celiac disease on gluten-free diet and control subjects in order to identify if the imbalance on fecal microbiota still remain during the treatment of celiac disease and identify the necessity of dietary supplementation with pre- or probiotics. Methods It was analyzed the feces of 42 healthy subjects and 14 celiac patients. The bifidobacteria count in feces was done in selective medium BIM-25. Microscopic analysis of the colonies was performed by Gram stain. The identification of the genus Bifidobacterium was performed by determination of fructose-6-phosphate phosphoketolase. Fecal pH was measured using a pH meter. Results The concentration of bifidobacteria per gram of feces was significantly higher in healthy subjects (controls (1.5 ± 0.63 x108 CFU/g when compared to celiac patients (2.5 ± 1.5 x107 CFU/g. The fecal pH was not different between celiac patients (7.19 ± 0.521 and controls (7.18 ± 0.522. Conclusions These results suggest that with lower levels of bifidobacteria, celiac patients have an imbalance in the intestinal microbiota, regardless of pH, even while on a gluten-free diet. This fact could favor the pathological process of the disorder.

  1. Challenges in gluten-free diet in coeliac disease: Prague consensus

    Samasca, G.; Lerner, U.; Girbovan, A.; Sur, G.; Lupan, I.; Makovický, Peter; Matthias, T.; Freeman, H.J.

    2017-01-01

    Roč. 47, č. 5 (2017), s. 394-397 ISSN 0014-2972 Institutional support: RVO:68378050 Keywords : Adult * biomarkers * childhood * dietary adherence * gluten-free diet * transition Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Nutrition, Dietetics Impact factor: 2.714, year: 2016

  2. Essential amino acids in the gluten-free diet and serum in relation to depression in patients with celiac disease

    Hees, Van Nathalie J.M.; Giltay, E.J.; Tielemans, Susanne M.A.J.; Geleijnse, J.M.; Puvill, Thomas; Janssen, Nadine; Does, Van Der Willem

    2015-01-01

    Introduction: Celiac disease (CD) is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other

  3. Difficulties related to compliance with gluten-free diet by patients with coeliac disease living in Upper Silesia

    Magdalena Ferster

    2015-12-01

    Full Text Available Compliance with gluten-free diet is the basic method for controlling coeliac disease in patients regardless of their age. It may be, however, challenging to follow in daily life. The prevalence of the disease (approx. 1% of European population is affected makes it an important public health problem. Aim of the study: Investigating the difficulties and obstacles related to compliance with gluten-free diet by children and adult patients living in Upper Silesia region. Material and method: The study included 30 mothers of children with coeliac disease (Group I and 30 adult coeliac disease patients (Group II. The patients kept a gluten-free diet. Data were obtained in an anonymous survey drawn up for the purpose of this study, conducted in 2010. Results: The respondents reported a very limited access to gluten-free meals in mass-catering establishments (76.7% of the participants in Group II, and 70% children at nurseries, kindergartens and schools, lack of adequate food product labelling (93% in both groups, difficulties experienced in social life (60% in Group II, difficulties experienced when travelling within Poland (76.7% in Group II and abroad (83.3% in Group II, and no existing reimbursement plan for the high diet costs (16.7% in Group I vs. 26.7% in Group II. Conclusions: 1 The necessity of compliance with gluten-free diet causes a lot of difficulties in everyday life to patients with coeliac disease and parents of children suffering from coeliac disease. Proper treatment requires their identification by the attending physician. 2 Improved food labelling as regards gluten content as well as inclusion of gluten-free meals in the menu of food-serving establishments will contribute to improved quality of life of children and adults suffering from coeliac disease. 3 Associations of patients on a gluten-free diet should continue their efforts to have high costs of this diet refunded.

  4. Clinical features and symptom recovery on a gluten-free diet in Canadian adults with celiac disease.

    Pulido, Olga; Zarkadas, Marion; Dubois, Sheila; Macisaac, Krista; Cantin, Isabelle; La Vieille, Sebastien; Godefroy, Samuel; Rashid, Mohsin

    2013-08-01

    Celiac disease can present with mild or nongastrointestinal symptoms, and may escape timely recognition. The treatment of celiac disease involves a gluten-free diet, which is complex and challenging. To evaluate clinical features and symptom recovery on a gluten-free diet in a Canadian adult celiac population. All adult members (n=10,693) of the two national celiac support organizations, the Canadian Celiac Association and Fondation québécoise de la maladie coeliaque, were surveyed using a questionnaire. A total of 5912 individuals (≥18 years of age) with biopsy-confirmed celiac disease and⁄or dermatitis herpetiformis completed the survey. The female to male ratio was 3:1, and mean (± SD) age at diagnosis was 45.2 ± 16.4 years. Mean time to diagnosis after onset of symptoms was 12.0 ± 14.4 years. Abdominal pain and bloating (84.9%), extreme weakness⁄tiredness (74.2%), diarrhea (71.7%) and anemia (67.8%) were the most commonly reported symptoms at the time of diagnosis. Many respondents continued to experience symptoms after being on a gluten-free diet for >5 years. Sex differences were reported in clinical features before diagnosis, recovery after being on gluten-free diet and perceived quality of life, with women experiencing more difficulties than men. Delays in diagnosis of celiac disease in Canada remain unacceptably long despite wider availability of serological screening tests. Many patients report continuing symptoms despite adhering to a gluten-free diet for >5 years, with women experiencing more symptoms and a lower recovery rate than men. Awareness of celiac disease needs improvement, and follow-up with a physician and a dietitian is essential for all patients with celiac disease.

  5. Hypervigilance to a Gluten-Free Diet and Decreased Quality of Life in Teenagers and Adults with Celiac Disease.

    Wolf, Randi L; Lebwohl, Benjamin; Lee, Anne R; Zybert, Patricia; Reilly, Norelle R; Cadenhead, Jennifer; Amengual, Chelsea; Green, Peter H R

    2018-06-01

    Avoidance of gluten is critical for individuals with celiac disease (CD), but there is also concern that "extreme vigilance" to a strict gluten-free diet may increase symptoms such as anxiety and fatigue, and therefore, lower quality of life (QOL). We examined the associations of QOL with energy levels and adherence to, and knowledge about, a gluten-free diet. This is a cross-sectional prospective study of 80 teenagers and adults, all with biopsy-confirmed CD, living in a major metropolitan area. QOL was assessed with CD-specific measures. Dietary vigilance was based on 24-h recalls and an interview. Knowledge was based on a food label quiz. Open-ended questions described facilitators and barriers to maintaining a gluten-free diet. The extremely vigilant adults in our sample had significantly lower QOL scores than their less vigilant counterparts [(mean (SD): 64.2 (16.0) vs 77.2 (12.2), p = 0.004]. Extreme vigilance was also associated with greater knowledge [5.7 (0.7) vs 5.1 (0.8), p = 0.035]. Adults with lower energy levels had significantly lower overall QOL scores than adults with higher energy levels [68.0 (13.6) vs 78.9 (13.0), p = 0.006]. Patterns were similar for teenagers. Cooking at home and using internet sites and apps were prevalent strategies used by the hypervigilant to maintain a strict gluten-free diet. Eating out was particularly problematic. There are potential negative consequences of hypervigilance to a strict gluten-free diet. Clinicians must consider the importance of concurrently promoting both dietary adherence and social and emotional well-being for individuals with CD.

  6. [Nutritional assessment of gluten-free diet. Is gluten-free diet deficient in some nutrient?].

    Salazar Quero, J C; Espín Jaime, B; Rodríguez Martínez, A; Argüelles Martín, F; García Jiménez, R; Rubio Murillo, M; Pizarro Martín, A

    2015-07-01

    The gluten-free diet has traditionally been accepted as a healthy diet, but there are articles advocating that it may have some nutritional deficiencies. The current study assesses whether there was any change in the contributions of calories, essential elements, proportion of fatty acids, vitamins, minerals and fiber in children who were diagnosed with celiac diseases, comparing the diet with gluten prior one year after diagnosis with the diet without gluten to the year of diagnosis. The level of clinical or analytical impact that nutritional deficits could have was also assessed. A prospective,descriptive, observational study in which information was collected from a dietary survey, anthropometric and analytical data at pre-diagnosis of celiac disease and following a gluten diet and one year after celiac disease diagnosis, under gluten-free diet. A total of 37 patients meet the study criteria. A decrease in the intake of saturated fatty acids was found, with an increase of monounsaturated fatty acids and an increase in the intake of phosphorus in the diet without gluten. A deficient intake of vitamin D was found in both diets. Clinically, at year of gluten-free diet there was an improvement in weight and size. Analytically, there was an improvement in hemoglobin, ferritin, vitamin D, and parathyroid hormone in plasma. The gluten-free diet has minimal deficiencies, similar to those present in the diet with gluten, with an improvement in the lipid profile by increasing the proportion of monounsaturated fatty acids to the detriment of saturated fatty acids. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  7. Gluten-Free Diet Indications, Safety, Quality, Labels, and Challenges.

    Rostami, Kamran; Bold, Justine; Parr, Alison; Johnson, Matt W

    2017-08-08

    A gluten-free diet (GFD) is the safest treatment modality in patient with coeliac disease (CD) and other gluten-related disorders. Contamination and diet compliance are important factors behind persistent symptoms in patients with gluten related-disorders, in particular CD. How much gluten can be tolerated, how safe are the current gluten-free (GF) products, what are the benefits and side effects of GFD? Recent studies published in Nutrients on gluten-free products' quality, availability, safety, as well as challenges related to a GFD are discussed.

  8. Compliance with the gluten-free diet: the role of locus of control in celiac disease.

    Bellini, Anna; Zanchi, Chiara; Martelossi, Stefano; Di Leo, Grazia; Not, Tarcisio; Ventura, Alessandro

    2011-03-01

    To verify whether subjects with celiac disease (CD) have a different locus of control (LoC) compared with healthy subjects, and to evaluate the relationship between LoC and compliance with a prescribed gluten-free diet (GFD) and quality of life (QoL). We studied 156 subjects on a GFD (mean age, 10 years) and 353 healthy controls (mean age, 12 years). All subjects completed tests on the Nowicki-Strickland Locus of Control Scale; the subjects with CD also completed a questionnaire to measure compliance with dietary treatment and the disease's impact on QoL. There was no difference in LoC values between patients with CD and controls. Subjects with CD with good dietary compliance had a more internal LoC compared with those who were not compliant (P = .01). Patients who reported a satisfactory QoL had a more internal LoC compared with those who reported negative affects on QoL due to CD (P = .01). Our study confirms the usefulness of the LoC concept for identifying those patients who might be at risk for dietary transgression. Given the enhanced, psychological, and social well being that can result from adherence to a GFD, educational and psychological support can help internalize the LoC in those patients at risk for dietary transgression. Copyright © 2011 Mosby, Inc. All rights reserved.

  9. Celiac Disease Associated with a Benign Granulomatous Mass Demonstrating Self-Regression after Initiation of a Gluten-Free Diet.

    Tiwari, Abhinav; Sharma, Himani; Qamar, Khola; Khan, Zubair; Darr, Umar; Renno, Anas; Nawras, Ali

    2017-01-01

    Celiac disease is a chronic immune-mediated enteropathy in which dietary gluten induces an inflammatory reaction predominantly in the duodenum. Celiac disease is known to be associated with benign small bowel thickening and reactive lymphadenopathy that often regresses after the institution of a gluten-free diet. A 66-year-old male patient with celiac disease presented with abdominal pain and diarrheal illness. Computerized tomography of the abdomen revealed a duodenal mass. Endoscopic ultrasound-guided fine needle aspiration of the mass revealed bizarre stromal cells which represent a nonspecific tissue reaction to inflammation. This inflammatory mass regressed after the institution of a gluten-free diet. This case report describes a unique presentation of celiac disease in the form of a granulomatous self-regressing mass. Also, this is the first reported case of bizarre stromal cells found in association with celiac disease. In addition to lymphoma and small bowel adenocarcinoma, celiac disease can present with a benign inflammatory mass, which should be serially monitored for resolution with a gluten-free diet.

  10. Celiac Disease Associated with a Benign Granulomatous Mass Demonstrating Self-Regression after Initiation of a Gluten-Free Diet

    Abhinav Tiwari

    2017-08-01

    Full Text Available Celiac disease is a chronic immune-mediated enteropathy in which dietary gluten induces an inflammatory reaction predominantly in the duodenum. Celiac disease is known to be associated with benign small bowel thickening and reactive lymphadenopathy that often regresses after the institution of a gluten-free diet. A 66-year-old male patient with celiac disease presented with abdominal pain and diarrheal illness. Computerized tomography of the abdomen revealed a duodenal mass. Endoscopic ultrasound-guided fine needle aspiration of the mass revealed bizarre stromal cells which represent a nonspecific tissue reaction to inflammation. This inflammatory mass regressed after the institution of a gluten-free diet. This case report describes a unique presentation of celiac disease in the form of a granulomatous self-regressing mass. Also, this is the first reported case of bizarre stromal cells found in association with celiac disease. In addition to lymphoma and small bowel adenocarcinoma, celiac disease can present with a benign inflammatory mass, which should be serially monitored for resolution with a gluten-free diet.

  11. Gluten-free diet may improve obstructive sleep apnea-related symptoms in children with celiac disease.

    Yerushalmy-Feler, Anat; Tauman, Riva; Derowe, Ari; Averbuch, Eran; Ben-Tov, Amir; Weintraub, Yael; Weiner, Dror; Amir, Achiya; Moran-Lev, Hadar; Cohen, Shlomi

    2018-02-07

    Enlarged tonsils and adenoids are the major etiology of obstructive sleep apnea (OSA) in children. Lymphatic hyperplasia is common to both OSA and celiac disease. We aimed to investigate the effect of a gluten-free diet on OSA symptoms in children with celiac disease. Children with celiac disease aged 2-18 years were prospectively recruited before the initiation of a gluten-free diet. Children with negative celiac serology who underwent gastrointestinal endoscopies for other indications served as controls. All participants completed a validated OSA-related symptoms questionnaire and the pediatric sleep questionnaire (PSQ) at baseline and 6 months later. Thirty-four children with celiac disease (mean age 6.6 ± 3.5 years) and 24 controls (mean age 7.3 ± 4.6 years, P = 0.5) were recruited. There were no significant differences in gender, body mass index or season at recruitment between the two groups. The rate of positive PSQ scores was higher (more OSA-related symptoms) in the control group compared to the celiac group, both at recruitment and at the 6-month follow-up (33.3% vs. 11.8%, P = 0.046, and 16.7% vs. 0, P = 0.014, respectively). PSQ scores improved significantly in both groups at the 6-month follow-up (P celiac group compared to controls (0.1 ± 0.09 vs.0.06 ± 0.06, respectively, P = 0.04). Children with celiac disease had fewer OSA-related symptoms than controls, but the degree of improvement following the initiation of a gluten-free diet was significantly higher. These findings suggest that a gluten-free diet may improve OSA-related symptoms in children with celiac disease.

  12. Are patients with coeliac disease seeking alternative therapies to a gluten-free diet?

    Aziz, Imran; Evans, Kate E; Papageorgiou, Vasiliki; Sanders, David S

    2011-03-01

    The cornerstone of treatment for coeliac disease is a gluten-free diet (GFD). However, adherence to a GFD is variable. Recently investigators have been reporting their preliminary findings using novel therapies. In addition, there is a growing interest in the use of complementary or alternative medicine (CAM) in gastrointestinal illnesses. These observations suggest that patients with coeliac disease may be dissatisfied with a GFD and possibly are seeking/using alternative therapies for their disease. Our aim was to assess the satisfaction levels of adults with coeliac disease towards a GFD, their use of oral CAM and views regarding novel therapies. 310 patients with coeliac disease completed a questionnaire survey while attending their out-patient appointment. The control group comprised 477 individuals. Over 40% of patients with coeliac disease were dissatisfied with a GFD. The frequency of CAM use in patients with coeliac disease was 21.6% (67/310) vs 27% in the control group (129/477), p=0.09. All patients expressed an interest in novel therapies, with a vaccine being the first choice in 42% of patients, 35% and 23% for anti- zonulin and peptidases, respectively. Universally, patients placed genetically modified wheat as the lowest preference. A large proportion of patients with coeliac disease are dissatisfied with a GFD. Coeliac patients are not taking CAM any more than controls, suggesting they do not view CAM as an alternative to a GFD. However, all the patients in this survey were keen to consider novel therapies, with a vaccine being the most preferred option.

  13. Pure Oats as Part of the Canadian Gluten-Free Diet in Celiac Disease: The Need to Revisit the Issue.

    de Souza, M Cristina P; Deschênes, Marie-Eve; Laurencelle, Suzanne; Godet, Patrick; Roy, Claude C; Djilali-Saiah, Idriss

    2016-01-01

    The question about recommending pure, noncontaminated oats as part of the gluten-free diet of patients with celiac disease remains controversial. This might be due to gluten cross contamination and to the possible immunogenicity of some oat cultivars. In view of this controversy, a review of the scientific literature was conducted to highlight the latest findings published between 2008 and 2014 to examine the current knowledge on oats safety and celiac disease in Europe and North America. Results showed that regular oats consumed in Canada are largely contaminated. Overall, the consumption of pure oats has been generally considered to be safe for adults and children. However, it appears that some oat cultivars may trigger an immune response in sensitive individuals. Therefore, further long-term studies on the impact of consumption of oats identifying the cultivar(s) constitute an important step forward for drawing final recommendations. Furthermore, a closer and more accurate monitoring of the dietary intake of noncontaminated oats would be paramount to better determine what its actual contribution in the gluten-free diet of adults and children with celiac disease are in order to draw sound recommendations on the safety of pure oats as part of the gluten-free diet.

  14. Celiac disease: management of persistent symptoms in patients on a gluten-free diet.

    Dewar, David H; Donnelly, Suzanne C; McLaughlin, Simon D; Johnson, Matthew W; Ellis, H Julia; Ciclitira, Paul J

    2012-03-28

    To investigate all patients referred to our center with non-responsive celiac disease (NRCD), to establish a cause for their continued symptoms. We assessed all patients referred to our center with non-responsive celiac disease over an 18-mo period. These individuals were investigated to establish the eitiology of their continued symptoms. The patients were first seen in clinic where a thorough history and examination were performed with routine blood work including tissue transglutaminase antibody measurement. They were also referred to a specialist gastroenterology dietician to try to identift any lapses in the diet and sources of hidden gluten ingestion. A repeat small intestinal biopsy was also performed and compared to biopsies from the referring hospital where possible. Colonoscopy, lactulose hydrogen breath testing, pancreolauryl testing and computed tomography scan of the abdomen were undertaken if the symptoms persisted. Their clinical progress was followed over a minimum of 2 years. One hundred and twelve consecutive patients were referred with NRCD. Twelve were found not to have celiac disease (CD). Of the remaining 100 patients, 45% were not adequately adhering to a strict gluten-free diet, with 24 (53%) found to be inadvertently ingesting gluten, and 21 (47%) admitting non-compliance. Microscopic colitis was diagnosed in 12% and small bowel bacterial overgrowth in 9%. Refractory CD was diagnosed in 9%. Three of these were diagnosed with intestinal lymphoma. After 2 years, 78 patients remained well, eight had continuing symptoms, and four had died. In individuals with NRCD, a remediable cause can be found in 90%: with continued gluten ingestion as the leading cause. We propose an algorithm for investigation.

  15. Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients.

    Niland, Benjamin; Cash, Brooks D

    2018-02-01

    Gluten-related diseases such as celiac disease and gluten ataxia are rare conditions, affecting less than 1% of the population in the United States. Despite the rarity of these diseases, there have been significant increases in the adoption of a gluten-free lifestyle and the consumption of gluten-free foods in the United States over the last 3 decades. More than $15.5 billion were spent on retail sales of gluten-free foods in 2016. The gluten-free diet is driven by multiple factors, including social and traditional media coverage, aggressive consumer-directed marketing by manufacturers and retail outlets, and reports in the medical literature and mainstream press of the clinical benefits of gluten avoidance. Individuals may restrict gluten from their diets for a variety of reasons, such as improvement of gastrointestinal and nongastrointestinal symptoms, as well as a perception that gluten is potentially harmful and, thus, restriction represents a healthy lifestyle. Emerging evidence shows that gluten avoidance may be beneficial for some patients with gastrointestinal symptoms, such as those commonly encountered with irritable bowel syndrome. However, high-quality evidence supporting gluten avoidance for physical symptoms or diseases other than those specifically known to be caused by immune-mediated responses to gluten is neither robust nor convincing. In fact, gluten avoidance may be associated with adverse effects in patients without proven gluten-related diseases. This article provides insight regarding gluten avoidance patterns and effects on patients without gluten-related diseases, and highlights concerns surrounding gluten avoidance in the absence of a gluten-mediated immunologic disease.

  16. Beneficial effects of gluten free diet in potential coeliac disease in adult population.

    Imperatore, Nicola; Tortora, Raffaella; De Palma, Giovanni Domenico; Capone, Pietro; Gerbino, Nicolò; Donetto, Sara; Testa, Anna; Caporaso, Nicola; Rispo, Antonio

    2017-08-01

    To date, potential coeliac disease (PCD) occurring in adults remains an almost unexplored condition. To explore the prognostic role of Marsh grade in adult PCD patients, and to evaluate the effects of gluten-containing diet (GCD) in asymptomatic PCD patients. We retrospectively evaluated all consecutive adult PCD patients followed-up for at least 6 years. Patients were divided into: Group A (patients with Marsh 0 histology) and Group B (Marsh 1 patients). Symptomatic patients were started gluten-free diet (GFD), while asymptomatic subjects were kept on GCD and were followed-up. 56 PCD patients were enrolled (21 in Group A and 35 in Group B). Forty-three patients were symptomatic and started GFD. Of these, none of 15 patients in Group A and 8 of 28 patients in Group B developed immune-mediated disorders (IMD) during follow-up (P=0.03; OR=4.2). The 13 asymptomatic PCD patients were kept on GCD. During the follow-up, 9 patients developed CD-related symptoms, 6 villous atrophy and 8 IMD. At the end, patients kept on GCD were at higher risk of developing IMD than those following a GFD (61% vs 18%, P=0.03, OR=3.3). Although PCD with normal mucosa seems to be a milder disease, the continuation of GCD places patients at a high risk of developing villous atrophy and IMD compared to commencement of GFD. Adult PCD patients should start GFD even if not symptomatic. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Gastrointestinal Symptoms in Celiac Disease Patients on a Long-Term Gluten-Free Diet.

    Laurikka, Pilvi; Salmi, Teea; Collin, Pekka; Huhtala, Heini; Mäki, Markku; Kaukinen, Katri; Kurppa, Kalle

    2016-07-14

    Experience suggests that many celiac patients suffer from persistent symptoms despite a long-term gluten-free diet (GFD). We investigated the prevalence and severity of these symptoms in patients with variable duration of GFD. Altogether, 856 patients were classified into untreated (n = 128), short-term GFD (1-2 years, n = 93) and long-term GFD (≥3 years, n = 635) groups. Analyses were made of clinical and histological data and dietary adherence. Symptoms were evaluated by the validated GSRS questionnaire. One-hundred-sixty healthy subjects comprised the control group. Further, the severity of symptoms was compared with that in peptic ulcer, reflux disease, inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Altogether, 93% of the short-term and 94% of the long-term treated patients had a strict GFD and recovered mucosa. Untreated patients had more diarrhea, indigestion and abdominal pain than those on GFD and controls. There were no differences in symptoms between the short- and long-term GFD groups, but both yielded poorer GSRS total score than controls (p = 0.03 and p = 0.05, respectively). Furthermore, patients treated 1-2 years had more diarrhea (p = 0.03) and those treated >10 years more reflux (p = 0.04) than controls. Long-term treated celiac patients showed relatively mild symptoms compared with other gastrointestinal diseases. Based on our results, good response to GFD sustained in long-term follow-up, but not all patients reach the level of healthy individuals.

  18. The Role of Celiac Disease in Severity of Liver Disorders and Effect of a Gluten Free Diet on Diseases Improvement

    Rostami-Nejad, Mohammad; Haldane, Thea; AlDulaimi, David; Alavian, Seyed Moayed; Zali, Mohammad Reza; Rostami, Kamran

    2013-01-01

    Context Celiac disease (CD) is defined as a permanent intolerance to ingested gluten. The intolerance to gluten results in immune-mediated damage of small intestine mucosa manifested by villous atrophy and crypt hyperplasia. These abnormalities resolve with initiationa gluten-free diet. Evidence Acquisition PubMed, Ovid, and Google were searched for full text articles published between 1963 and 2012. The associated keywords were used, and papers described particularly the impact of celiac disease on severity of liver disorder were identified. Results Recently evidence has emerged revealingthat celiac disease not only is associated with small intestine abnormalities and malabsorption, but is also a multisystem disorder affecting other systems outside gastrointestinal tract, including musculo-skeletal, cardiovascular and nervous systems. Some correlations have been assumed between celiac and liver diseases. In particular, celiac disease is associated with changes in liver biochemistry and linked to alter the prognosis of other disorders. This review will concentrate on the effect of celiac disease and gluten-free diets on the severity of liver disorders. Conclusions Although GFD effect on the progression of CD associated liver diseases is not well defined, it seems that GFD improves liver function tests in patients with a hypertransaminasemia. PMID:24348636

  19. Extraintestinal Manifestations of Celiac Disease: Effectiveness of the Gluten-Free Diet.

    Jericho, Hilary; Sansotta, Naire; Guandalini, Stefano

    2017-07-01

    The aim of the study was to evaluate the effectiveness of the gluten-free diet (GFD) on extraintestinal symptoms in pediatric and adult celiac populations at the University of Chicago. We conducted a retrospective chart review of the University of Chicago Celiac Center clinic charts from January 2002 to October 2014. Demographics, serologic testing, intestinal biopsies, and extraintestinal symptoms at presentation, 12, 24, and >24 months were recorded. Extraintestinal symptoms included abnormal liver enzymes, arthralgia/arthritis, dermatitis herpetiformis, alopecia, fatigue, headache, anemia, stomatitis, myalgias, psychiatric disorders, rashes, seizures, neuropathy, short stature, delayed puberty, osteoporosis, and infertility. A total of 737 patients with biopsy-confirmed celiac disease or skin biopsy-confirmed dermatitis herpetiformis were included. Patients lost to follow-up, or with insufficient data were excluded leaving 328 patients (157 pediatrics younger than 18 years). For pediatrics, the female to male ratio was 2:1 and the mean age at diagnosis was 8.9 years. For adults, 4:1 and 40.6 years old. Extraintestinal symptom rates were similar in children (60%) and adults (62%). Short stature (33%), fatigue (28%), and headache (20%) were most common in children. Iron deficiency anemia (48%), fatigue (37%), and headache/psychiatric disorders (24%) were common in adults. Children had faster/higher rates of symptom resolution compared with adults. Twenty-eight percent of children with unresolved short stature on a GFD were found to have other comorbidities. Children and adults with celiac disease have similar rates of extraintestinal manifestations. In children short stature, fatigue, and headache were most common, whereas anemia, fatigue, and headache/psychiatric disorders were most common in adults. Children on a strict GFD showed faster and higher rates of symptom resolution as compared to adults. Unresponsive children with short stature must be assessed for

  20. Coeliac disease in adolescence: Coping strategies and personality factors affecting compliance with gluten-free diet.

    Wagner, Gudrun; Zeiler, Michael; Grylli, Vasileia; Berger, Gabriele; Huber, Wolf-Dietrich; Woeber, Christian; Rhind, Charlotte; Karwautz, Andreas

    2016-06-01

    Patients suffering from a chronic condition such as coeliac disease (CD) need to develop coping strategies in order to preserve emotional balance and psychosocial functioning while adhering to their obligatory life-long gluten free diet (GFD). However, this can be particularly challenging for adolescents and may lead to dietary transgressions. Little is currently known about the influence of coping strategies and personality factors on dietary compliance. This study aims to explore these factors for the first time in adolescents with biopsy-proven CD. We included 281 adolescents with CD and 95 healthy controls. We classified patients according to their GFD adherence status (adherent vs. non-adherent) and assessed coping strategies using the KIDCOPE and personality traits using the Junior-Temperament and Character Inventory (J-TCI). Adolescents with CD adherent to GFD used less emotional regulation and distraction as coping strategies than non-adherent patients. In terms of personality traits, adherent patients differed from non-adherent patients with respect to temperament, but not with respect to character, showing lower scores in novelty seeking, impulsivity and rule transgressions and higher scores in eagerness with work and perfectionism compared to non-adherent patients. No differences were found between healthy controls and adherent CD patients across these personality traits. Coping strategies and personality traits differ in adolescent patients with CD adherent to GFD from those not adherent, and may therefore relate to risk or protective factors in adherence. Targeting coping and temperament using psychological interventions may therefore be beneficial to support adolescents with CD and optimise their adherence to GFD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Latiglutenase Improves Symptoms in Seropositive Celiac Disease Patients While on a Gluten-Free Diet.

    Syage, Jack A; Murray, Joseph A; Green, Peter H R; Khosla, Chaitan

    2017-09-01

    Celiac disease (CD) is a widespread condition triggered by dietary gluten and treated with a lifelong gluten-free diet (GFD); however, inadvertent exposure to gluten can result in episodic symptoms. A previous trial of latiglutenase (clinicaltrials.gov; NCT01917630), an orally administered mixture of two recombinant gluten-specific proteases, was undertaken in symptomatic subjects with persistent injury. The primary endpoint for histologic improvement was not met, presumably due to a trial effect. In this post hoc analysis, we investigated the efficacy of latiglutenase for reducing symptoms in subgroups of the study participants based on their seropositivity. The study involved symptomatic CD patients following a GFD for at least one year prior to randomization. Patients were treated for 12 weeks with latiglutenase or placebo. Of 398 completed patients, 173 (43%) were seropositive at baseline. Symptoms were recorded daily, and weekly symptom scores were compiled. p values were calculated by analysis of covariance. A statistically significant, dose-dependent reduction was detected in the severity and frequency of symptoms in seropositive but not seronegative patients. The severity of abdominal pain and bloating was reduced by 58 and 44%, respectively, in the cohort receiving the highest latiglutenase dose (900 mg, n = 14) relative to placebo (n = 54). Symptom improvement increased from week 6 to week 12. There was also a trend toward greater symptom improvement with greater baseline symptom severity. Seropositive CD patients show symptomatic improvement from latiglutenase taken with meals and would benefit from the availability of this treatment.

  2. [Treating coeliac disease. How do we measure adherence to the gluten-free diet?

    Aranda, Elisa A; Araya, Magdalena

    Coeliac disease (CD) is a systemic autoimmune disorder triggered by gluten consumption in genetically susceptible individuals. It exhibits several clinical features, such as blood auto-antibodies (anti-endomysial antibodies EMA, anti-transglutaminase antibodies tTG, anti-deamidated gliadin peptides PGD), plus variable degrees of damage in the small intestinal mucosa. In Chile, tTG is positive in 0.76% in individuals >15 years, with the prevalence of CD being estimated at 0.6%. Approximately17% of first-degree relatives of coeliac patients have been reported tTG positive. To date, the gluten free diet (GFD) is the only known treatment for CD. To be effective, this must be lifelong, permanent, and strict. Gluten content in the GFD is not zero, but is limited to a cut-off of 3ppm (ormg/kg of product) in Chile. Mortality higher than that of the general population has been reported among coeliac patients, and poor adherence to GFD is associated with complications (mainly autoimmune processes and cancer). GFD is difficult to maintain strictly and poor adherence is by far the main cause of lack of response to treatment. Follow-up of adherence is also difficult because there are no objective measurements to assess it. In clinical practice determination of serum EMA, tTG and PGD is routinely used for these purposes, although more recently, the interview by an expert dietitian, validated questionnaires and measurement of faecal 33-mer peptide are being assessed as alternatives or complements to measure adherence to GFD. A review is presented with the current concepts on the available tools to follow up patients on GFD, emphasising those available in Chilel. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Essential amino acids in the gluten-free diet and serum in relation to depression in patients with celiac disease.

    Nathalie J M van Hees

    Full Text Available Celiac disease (CD is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other neurotransmitters are depleted in the diet and serum of CD patients with major depressive disorder.In a cross-sectional study we assessed dietary intake of amino acids and serum levels of amino acids, in 77 CD patients on a gluten-free diet and in 33 healthy controls. Major depressive disorder was assessed with structured interviews (using the Mini International Neuropsychiatric Interview Plus. Dietary intake was assessed using a 203-item food frequency questionnaire.Participants had a mean age of 55 years and 74% were women. The intake of vegetable protein was significantly lower in CD patients than in healthy controls (mean difference of 7.8 g/d; 95% CI: 4.7-10.8, as were serum concentrations of tyrosine, phenylalanine and tryptophan (all p < 0.005. However, within the CD patient group, the presence of major depressive disorder (n = 42 was not associated with intake or serum levels of essential amino acids.Patients with CD on a long-term gluten-free diet, with good adherence, consume significantly less vegetable protein than controls, and their serum levels of several essential amino acids were also lower. Despite its potential adverse effect, intake and serum levels of essential amino acids were not related to major depression.

  4. [Benefits of gluten-free diet: myth or reality?].

    Coattrenec, Yann; Harr, Thomas; Pichard, Claude; Nendaz, Mathieu

    2015-10-14

    Non celiac gluten sensitivity may explain digestive and general symptoms in patients without celiac disease but this recently described entity is controversial. The role of gluten in comparison to other nutriments such as saccharides and polyols (FODMAPs) remains debated. If a gluten-free diet is clearly indicated in celiac disease and wheat allergy, it remains debatable in non-celiac gluten sensitivity given weak and contradictory evidence. There is no strong evidence for a strict indication to a gluten-free diet in endocrinological, psychiatric, and rheumatologic diseases, or to improve performance in elite sports.

  5. Prevalence of gluten-free diet adherence among individuals without celiac disease in the USA: results from the Continuous National Health and Nutrition Examination Survey 2009-2010.

    DiGiacomo, Daniel V; Tennyson, Christina A; Green, Peter H; Demmer, Ryan T

    2013-08-01

    Clinical inference suggests the prevalence of non-celiac gluten sensitivity is substantially higher than that of celiac disease in the USA. Unfortunately, there are currently no data supporting these claims. The authors analyzed nationally representative data to estimate the prevalence of adherence to a gluten-free diet among participants without celiac disease and also to characterize the demographics and general health status of these participants. The Continuous National Health and Nutrition Examination Survey (NHANES) 2009-2010 enrolled 7762 individuals representing the civilian, non-institutionalized, US population free of celiac disease. Participants responded to interviewer administered questionnaires regarding current adherence to a gluten-free diet. Prevalence estimates were computed using SAS survey procedures. There were 49 individuals who reported current adherence to a gluten-free diet reflecting a weighted prevalence of 0.548% (95% CI 0.206-0.889). The prevalence of a gluten-free diet was higher in females (0.58%) than males (0.37%), although this was not statistically significant (p = 0.34). Participants reporting a gluten-free diet were older (46.6 vs. 40.5 years, p = 0.005), had higher high-density lipoprotein, lower iron and lower body mass index. The estimated national prevalence of non-celiac gluten sensitivity is 0.548%, approximately half that of celiac disease. Future studies are merited in order to better understand the population burden of non-celiac gluten sensitivity.

  6. The association between semaphorin 3A levels and gluten-free diet in patients with celiac disease.

    Kessel, Aharon; Lin, Chen; Vadasz, Zahava; Peri, Regina; Eiza, Nasren; Berkowitz, Drora

    2017-11-01

    Celiac disease (CD) is an inflammatory disease affecting the small intestine. We aim to assess serum level and expression of semaphorin 3A (Sema3A) on T regulatory (Treg) cells in CD patients. Twenty-six newly diagnosed celiac patients, 13 celiac patients on a gluten-free diet and 16 healthy controls included in the study. Sema3A protein level in the serum of celiac patients was significantly higher compared to healthy group (7.17±1.8ng/ml vs. 5.67±1.5ng/ml, p=0.012). Sema3A expression on Treg cells was statistically lower in celiac patients compared to healthy subjects (p=0.009) and significantly lower in celiac patients compared to celiac patients on gluten free diet (p=0.04). Negative correlation was found between Sema3A on Teg cells and the level of IgA anti-tTG antibodies (r=-0.346, p<0.01) and anti-DGP (r=-0.448, p<0.01). This study suggests involvement of the Sema3A in the pathogenesis of CD. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Effect of an oats-containing gluten-free diet on symptoms and quality of life in coeliac disease. A randomized study.

    Peräaho, M; Kaukinen, K; Mustalahti, K; Vuolteenaho, N; Mäki, M; Laippala, P; Collin, P

    2004-01-01

    Evidence suggests the acceptability of oats in a gluten-free diet in coeliac disease. We investigated the impact of an oats-containing diet on quality of life and gastrointestinal symptoms. Thirty-nine coeliac disease patients on a gluten-free diet were randomized to take either 50 g of oats-containing gluten-free products daily or to continue without oats for 1 year. Quality of life was assessed using the Psychological General Well-Being questionnaire and gastrointestinal symptoms using the Gastrointestinal Symptom Rating Scale. Small-bowel mucosal villous architecture, CD3+, alphabeta+, gammadelta+ intraepithelial lymphocytes, serum endomysial and tissue transglutaminase antibodies were investigated. Twenty-three subjects were randomized to the oats-containing diet and 16 to the traditional gluten-free diet. All adhered strictly to their respective diet. Quality of life did not differ between the groups. In general, there were more gastrointestinal symptoms in the oats-consuming group. Patients taking oats suffered significantly more often from diarrhoea, but there was a simultaneous trend towards a more severe average constipation symptom score. The villous structure did not differ between the groups, but the density of intraepithelial lymphocytes was slightly but significantly higher in the oats group. The severity of symptoms was not dependent on the degree of inflammation. Antibody levels did not increase during the study period. The oats-containing gluten-free diet caused more intestinal symptoms than the traditional diet. Mucosal integrity was not disturbed, but more inflammation was evident in the oats group. Oats provide an alternative in the gluten-free diet, but coeliac patients should be aware of the possible increase in intestinal symptoms.

  8. Gluten-free diet may alleviate depressive and behavioural symptoms in adolescents with coeliac disease: a prospective follow-up case-series study

    Sipilä Ilkka

    2005-03-01

    Full Text Available Abstract Background Coeliac disease in adolescents has been associated with an increased prevalence of depressive and disruptive behavioural disorders, particularly in the phase before diet treatment. We studied the possible effects of a gluten-free diet on psychiatric symptoms, on hormonal status (prolactin, thyroidal function and on large neutral amino acid serum concentrations in adolescents with coeliac disease commencing a gluten-free diet. Methods Nine adolescents with celiac disease, aged 12 to 16 years, were assessed using the semi-structured K-SADS-Present and Lifetime Diagnostic interview and several symptom scales. Seven of them were followed at 1 to 2, 3, and 6 months on a gluten-free diet. Results Adolescent coeliac disease patients with depression had significantly lower pre-diet tryptophan/ competing amino-acid (CAA ratios and free tryptophan concentrations, and significantly higher biopsy morning prolactin levels compared to those without depression. A significant decrease in psychiatric symptoms was found at 3 months on a gluten-free diet compared to patients' baseline condition, coinciding with significantly decreased coeliac disease activity and prolactin levels and with a significant increase in serum concentrations of CAAs. Conclusion Although our results of the amino acid analysis and prolactin levels in adolescents are only preliminary, they give support to previous findings on patients with coeliac disease, suggesting that serotonergic dysfunction due to impaired availability of tryptophan may play a role in vulnerability to depressive and behavioural disorders also among adolescents with untreated coeliac disease.

  9. Gluten intake and gluten-free diet in the Netherlands

    Hopman, Geertruida Dorothea

    2008-01-01

    Celiac disease is an intolerance to dietary gluten in genetically predisposed individuals, leading to alterations of the small bowel mucosa. The treatment consists of a life-long, gluten-free diet. The aims of this thesis were to measure some of the environmental factors considered to play a role

  10. Clinical benefit of a gluten-free diet in type 1 diabetic children with screening-detected celiac disease

    Hansen, Dorte; Brock-Jacobsen, Bendt; Lund, Elisabeth

    2006-01-01

    OBJECTIVE: This study was performed to 1) determine the prevalence of celiac disease in Danish children with type 1 diabetes and 2) estimate the clinical effects of a gluten-free diet (GFD) in patients with diabetes and celiac disease. RESEARCH DESIGN AND METHODS: In a region comprising 24......% of the Danish population, all patients diabetes were identified and 269 (89%) were included in the study. The diagnosis of celiac disease was suspected in patients with endomysium and tissue transglutaminase antibodies in serum and confirmed by intestinal biopsy. Patients with celiac...... a lower SD score (SDS) for height (P diabetes onset (P = 0.041). A GFD was obtained in 31 of 33 patients. After 2 years of follow-up, there was an increase in weight SDS (P = 0.006) and in children

  11. Value of IgA tTG in Predicting Mucosal Recovery in Children with Celiac Disease on a Gluten Free Diet

    Leonard, Maureen M.; Weir, Dascha C.; DeGroote, Maya; Mitchell, Paul D.; Singh, Prashant; Silvester, Jocelyn A.; Leichtner, Alan M.; Fasano, Alessio

    2017-01-01

    Objective Our objective was to determine the rate of mucosal recovery in pediatric patients with celiac disease on a gluten free diet. We also sought to determine whether IgA tissue transglutaminase (tTG) correlates with mucosal damage at the time of a repeat endoscopy with duodenal biopsy in these patients. Methods We performed a retrospective chart review of one-hundred and three pediatric patients, under 21 years of age, with a diagnosis of celiac disease defined as Marsh 3 histology, and who underwent a repeat endoscopy with duodenal biopsy at least twelve months after initiating a gluten free diet. Results We found that 19% of pediatric patients treated with a gluten free diet had persistent enteropathy. At the time of the repeat biopsy, tTG was elevated in 43% of cases with persistent enteropathy and 32% of cases in which there was mucosal recovery. Overall the positive predictive value of the autoantibody tissue transglutaminase was 25% and the negative predictive value was 83% in patients on a gluten free diet for a median of 2.4 years. Conclusions Nearly one in five children with celiac disease in our population had persistent enteropathy despite maintaining a gluten free diet and IgA tTG was not an accurate marker of mucosal recovery. Neither the presence of symptoms nor positive serology were predictive of a patient’s histology at the time of repeat biopsy. These findings suggest a revisitation of monitoring and management criteria of celiac disease in childhood. PMID:28112686

  12. Regional enteritis and gluten-free diet. A clinical study

    Merwe, Christiaan Frederik van der

    1974-01-01

    The purpose of this clinical study was to determine whether the use of a gluten-free diet influenced the course and prognosis of regional enteritis. Following a few clinical communications in the Dutch medical literature reporting favourable results obtained with the gluten-free diet in the

  13. Frequency and Cause of Persistent Symptoms in Celiac Disease Patients on a Long-term Gluten-free Diet.

    Stasi, Elisa; Marafini, Irene; Caruso, Roberta; Soderino, Federica; Angelucci, Erika; Del Vecchio Blanco, Giovanna; Paoluzi, Omero A; Calabrese, Emma; Sedda, Silvia; Zorzi, Francesca; Pallone, Francesco; Monteleone, Giovanni

    2016-03-01

    To estimate the frequency and cause of nonresponsive celiac disease (CD). Treatment of CD is based on life-long adherence to a gluten-free diet (GFD). Some celiac patients experience persistence of symptoms despite a GFD. This condition is defined as nonresponsive CD. Celiac patients on a GFD for at least 12 months underwent diet compliance assessment, laboratory tests, breath tests, endoscopic, and histologic evaluations according to the symptoms/signs reported. Seventy of 321 (21.8%) patients had persistent or recurrent symptoms/signs. The cause of symptom persistence was evaluated in 56 of 70 patients. Thirteen of 56 (23%) patients were antiendomysial antibody positive. Among the patients with negative serology, 1 had fibromyalgia, and 3 had evidence that disproved the diagnosis of CD. The remaining 39 patients with negative serology underwent duodenal biopsy sampling, which evidenced histologic alterations in 24 patients. Among the 15 patients with normal histology 3 were lactose intolerant, 9 had irritable bowel syndrome, 2 had gastroesophageal reflux disease, and in 1 patient a cause for the persistent symptom was not identified. In patients with confirmed diagnosis of CD, exposure to dietary gluten was the main cause of persistence of symptoms/signs, and consistently after dietary modification, symptoms resolved in 63% of the patients at later time points during follow-up. Nonresponsive CD occurs in nearly one fifth of celiac patients on GFD and its occurrence suggests further investigations to optimize the management of celiac patients.

  14. Serum zinc, copper and iron status of children with coeliac disease on three months of gluten-free diet with or without four weeks of zinc supplements: a randomised controlled trial.

    Negi, K; Kumar, R; Sharma, L; Datta, S P; Choudhury, M; Kumar, P

    2018-04-01

    Data about the effect of zinc supplementation with gluten-free diet on normalisation of plasma zinc, copper and iron in patients with coeliac disease are scanty. We evaluated the effect of zinc supplementation on serum zinc, copper and iron levels in patients with coeliac disease, by randomising 71 children newly diagnosed with coeliac disease into two groups: Group A = gluten-free diet (GFD); and Group B = gluten-free diet with zinc supplements (GFD +Zn). The rise in iron and zinc was significantly higher in the latter, but the mean rise of copper levels was slightly higher in the former, but the difference was not significant.

  15. Osteogenesis Imperfecta with Celiac Disease and Type II Diabetes Mellitus Associated: Improvement with a Gluten-Free Diet

    Luis Rodrigo

    2012-01-01

    Full Text Available Osteogenesis imperfecta (OI is a genetic disease, with a connective tissue alteration, consisting in the presence of multiple spontaneous fractures or after minimal traumatism. Its association with other metabolic processes is rarely described. We present the clinical case of a female adult patient of 43 years. From her infancy, she has had multiple fractures, needing several surgical interventions, and she was diagnosed of OI type 2 at adolescence age. Due mainly to difficulties in walking remaining in wheel-chair in the last three years, she was overweight with morbid obesity (BMI=45.4 and had a type-II DM associated. She suffered from recurrent abdominal pain and chronic diarrhea and was diagnosed of celiac disease (CD with increased intraepithelial duodenal infiltration, being classified as lymphocytic enteritis, Marsh I type. She was put on a gluten-free diet (GFD, having lost 6 kg of weight after 6 months, with a good control of DM-II and presenting a significant clinical improvement. It is rewarding to search the presence of two coincidental metabolic diseases associated to OI, specially CD, because of the dramatic clinical benefit in the general found after putting on a GFD.

  16. Osteogenesis Imperfecta with Celiac Disease and Type II Diabetes Mellitus Associated: Improvement with a Gluten-Free Diet

    Rodrigo, Luis; Pérez-Martinez, Isabel

    2012-01-01

    Osteogenesis imperfecta (OI) is a genetic disease, with a connective tissue alteration, consisting in the presence of multiple spontaneous fractures or after minimal traumatism. Its association with other metabolic processes is rarely described. We present the clinical case of a female adult patient of 43 years. From her infancy, she has had multiple fractures, needing several surgical interventions, and she was diagnosed of OI type 2 at adolescence age. Due mainly to difficulties in walking remaining in wheel-chair in the last three years, she was overweight with morbid obesity (BMI = 45.4) and had a type-II DM associated. She suffered from recurrent abdominal pain and chronic diarrhea and was diagnosed of celiac disease (CD) with increased intraepithelial duodenal infiltration, being classified as lymphocytic enteritis, Marsh I type. She was put on a gluten-free diet (GFD), having lost 6 kg of weight after 6 months, with a good control of DM-II and presenting a significant clinical improvement. It is rewarding to search the presence of two coincidental metabolic diseases associated to OI, specially CD, because of the dramatic clinical benefit in the general found after putting on a GFD. PMID:22481956

  17. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.

    Nachman, Fabio; Vázquez, Horacio; González, Andrea; Andrenacci, Paola; Compagni, Liliana; Reyes, Hugo; Sugai, Emilia; Moreno, María Laura; Smecuol, Edgardo; Hwang, Hui Jer; Sánchez, Inés Pinto; Mauriño, Eduardo; Bai, Julio César

    2011-03-01

    Celiac disease (CD) patients often complain of symptoms consistent with gastroesophageal reflux disease (GERD). We aimed to assess the prevalence of GERD symptoms at diagnosis and to determine the impact of the gluten-free diet (GFD). We evaluated 133 adult CD patients at diagnosis and 70 healthy controls. Fifty-three patients completed questionnaires every 3 months during the first year and more than 4 years after diagnosis. GERD symptoms were evaluated using a subdimension of the Gastrointestinal Symptoms Rating Scale for heartburn and regurgitation domains. At diagnosis, celiac patients had a significantly higher reflux symptom mean score than healthy controls (P 3) compared with 5.7% of controls (P symptoms were significantly associated with the classical clinical presentation of CD (35.0%) compared with atypical/silent cases (15.2%; P symptoms are common in classically symptomatic untreated CD patients. The GFD is associated with a rapid and persistent improvement in reflux symptoms that resembles the healthy population. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. Green banana pasta: an alternative for gluten-free diets.

    Zandonadi, Renata Puppin; Botelho, Raquel Braz Assunção; Gandolfi, Lenora; Ginani, Janini Selva; Montenegro, Flávio Martins; Pratesi, Riccardo

    2012-07-01

    The objective of this study was to develop and analyze a gluten-free pasta made with green banana flour. The study was divided into five steps: preparation/selection, chemical, sensory, technological, and statistical analysis. The modified sample presented greater acceptance (84.5% for celiac individuals and 61.2% for nonceliac) than standard samples (53.6% for nonceliac individuals). There was no significant difference between the modified and the standard samples in terms of appearance, aroma, flavor, and overall quality. The modified pastas presented approximately 98% less lipids. Green bananas are considered a subproduct of low commercial value with little industrial use. The possibility of developing gluten-free products with green banana flour can expand the product supply for people with celiac disease and contribute to a more diverse diet. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  19. The Effect of Gluten-free Diet on Clinical Symptoms and the Intestinal Mucosa of Patients With Potential Celiac Disease.

    Mandile, Roberta; Discepolo, Valentina; Scapaticci, Serena; Del Vecchio, Maria Rosaria; Maglio, Maria Antonia; Greco, Luigi; Troncone, Riccardo; Auricchio, Renata

    2018-04-01

    In this prospective study, we evaluated the effect of gluten-free diet (GFD) in a cohort of 65 children with potential celiac disease. Patients received GFD for signs/symptoms (N = 47) or parents' choice (N = 18). Most frequent signs/symptoms were low body mass index (36%), recurrent abdominal pain (34%), and diarrhea (19%). Of the 35/47 patients followed-up on GFD, only 54% (19/35) showed a complete clinical response. In 9 of 65 patients an intestinal biopsy was also performed after at least 1 year of GFD. No significant differences were observed in terms of Marsh grade (P = 0.33), lamina propria CD25+ cells (P = 0.80), CD3+ (P = 0.9), and γδ+ (P = 0.59) intraepithelial lymphocytes density and intestinal anti-TG2 deposits (P = 0.60). In conclusion, caution is necessary before attributing all symptoms to gluten in this condition.

  20. Oral health status and salivary properties in relation to gluten-free diet in children with celiac disease.

    Shteyer, Eyal; Berson, Tamar; Lachmanovitz, Odelia; Hidas, Ariela; Wilschanski, Michael; Menachem, Moti; Shachar, Edna; Shapira, Joseph; Steinberg, Doron; Moskovitz, Moti

    2013-07-01

    Patients with celiac disease (CD) have a wide variety of symptoms, from being asymptomatic to having chronic diarrhea, abdominal pain, and extraintestinal symptoms. In the oral cavity, enamel defects and recurrent aphthous stomatitis are the most common symptoms. The aim of the study was to assess oral health, bacterial colonization and salivary buffering capacity of patients with CD at diagnosis were compared with patients with CD receiving a gluten-free diet (GFD) and healthy children. Three groups were prospectively investigated: newly diagnosed CD, CD treated with GFD, and a control group. All of the children were examined by pediatric dentists, and saliva samples were collected for bacterial and pH analysis. Ninety children were enrolled in the study, 30 in each group. A higher prevalence of enamel hypoplasia (66%) was found in children with CD. Plaque index was significantly lower in the celiac-treated group, which correlated with oral health behavior: teeth brushing and frequency of eating between meals. Children receiving GFD brushed their teeth and used fluoride significantly more often than other children in the study. No difference between groups was found in snack consumption, mutans streptococci and lactobacilli counts in saliva, as well as pH and buffer capacity. A lower degree of plaque was found in children with CD receiving GFD. This finding could not be explained by salivary properties or bacteria, but rather by better oral hygiene. The results should raise the awareness of pediatric gastroenterologists toward oral health-related issues in children with CD.

  1. Addition of a Short Course of Prednisolone to a Gluten-Free Diet vs. Gluten-Free Diet Alone in Recovery of Celiac Disease: A Pilot Randomized Controlled Trial.

    Abbas, Asad; Shahab, Tabassum; Sherwani, Rana K; Alam, Seema

    2018-01-28

    Background A gluten-free diet (GFD) is the standard of care in the management of patients with celiac disease, but clinical and histological recovery are often delayed. In newly diagnosed patients, strict compliance to GFD is difficult to achieve; this is especially true in developing countries where gluten-free food is often difficult to obtain. Steroids, when used alone, can be effective in inducing recovery in patients with celiac disease. We performed a randomized controlled trial to study the effect of a short course of prednisolone combined with a GFD on the recovery of celiac disease. Materials and methods This study was a single-center, randomised, open-label trial. This investigation was done in a pediatric gastroenterology unit of a tertiary teaching hospital in north India.Twenty-eight newly diagnosed celiac disease patients were enrolled in the study. Prednisolone was given at 1 mg/kg for four weeks; duodenal biopsies and IgA anti-tissue transglutaminase (tTg) levels were assessed at eight weeks, six months, and 12 months from the start of the study. Outcome measures The primary outcome measures used to indicate clinical, histological, and immunological recovery of celiac disease were clinical improvement at eight weeks and the proportion of patients with improved histology by at least one grade and who were tissue transglutaminase (tTg) seronegative at eight weeks. The secondary measures were the proportion of patients showing normalization of histological features and the proportions of patients becoming seronegative at six months and one year of GFD. Results Patients were randomized into the GFD only (n = 14) or GFD with prednisolone (GFD+P) (n = 14) groups. No significant differences were detected in clinical recovery at eight weeks; none of the patients became seronegative at eight weeks, six months, or 12 months. The proportion of patients with improvement in histology by at least one grade was higher in the GFD+P group at eight weeks, and there

  2. A comparison of antibody testing, permeability testing, and zonulin levels with small-bowel biopsy in celiac disease patients on a gluten-free diet.

    Duerksen, D R; Wilhelm-Boyles, C; Veitch, R; Kryszak, D; Parry, D M

    2010-04-01

    Active celiac disease is associated with positive endomysial (EMA) and tissue transglutaminase (TTG) antibodies, elevated zonulin levels, and increased intestinal permeability. There is little known about what happens to these immunologic and structural abnormalities in patients on a gluten-free diet and their correlation with small-bowel biopsy changes. Adult patients previously diagnosed with celiac disease and on a gluten-free diet for greater than 1 year were considered for the study. All patients underwent the following: measurement of EMA and TTG antibodies, serum zonulin levels, intestinal permeability (IP) testing with lactulose/mannitol ratios, food diary analysis for gluten ingestion and small- bowel biopsy. A total of 21 patients on a gluten-free diet for a mean of 9.7 years completed the study. There were ten patients who had normalization of intestinal biopsies, IP and TTG, and EM antibodies. Six patients had Marsh type 2 or 3 lesions and all had either abnormal IP (5/6) or TTG antibody (4/6). In patients with Marsh type 3 lesions, there was a correlation between IP and zonulin levels. A subgroup of patients with celiac disease on a gluten-free diet has complete normalization of intestinal biopsies, intestinal permeability defects, and antibody levels. Patients with Marsh type 3 lesions have abnormal TTG antibodies and intestinal permeability with zonulin levels that correlate with IP. These abnormalities may be due to continued gluten ingestion. Further study is needed to determine the clinical utility of TTG antibodies and IP testing in following patients with celiac disease.

  3. Impact of an active patient education program on gastrointestinal symptoms in women with celiac disease following a gluten-free diet: a randomized controlled trial.

    Jacobsson, Lisa Ring; Friedrichsen, Maria; Göransson, Anne; Hallert, Claes

    2012-01-01

    Despite living with a gluten-free diet, Swedish women with celiac disease report a higher rate of gastrointestinal symptoms than women without the disease. This study was designed to assess the impact of active patient education on gastrointestinal symptoms in women with a gluten-free diet. A total of 106 Swedish women, aged 20 years or older, with celiac disease on a gluten-free diet for a minimum of 5 years took part in a randomized controlled trial. The intervention group (n = 54) underwent a 10-session educational program, "Celiac School," based on problem-based learning. Controls (n = 52) were sent information regarding celiac disease at home. The outcome measure was gastrointestinal symptoms at 10 weeks and 6 months after intervention, assessed with the Gastrointestinal Symptom Rating Scale. After 10 weeks of "Celiac School," the participating women reported significant improvements that remained 6 months later (p = .029). The controls did not improve significantly. A comparison of the development of scores, from baseline to 10 weeks, could not demonstrate a significant difference in the overall index between the 2 groups but showed a significant improvement concerning 1 of its components, namely the index reflecting Abdominal Pain (p = .007). Intervention methods should be refined to reach an even more pronounced effect.

  4. Gluten-free diet and the possibility of enriching the diet coeliacs

    BLAŽKOVÁ, Klára

    2014-01-01

    This thesis deals with the gluten-free diet and its possible enrichment. It is divided into two parts. The first part includes chapters such as history of gluten-free diet, basics of a gluten free diet, the first step in the introduction of a gluten-free diet, gluten-free food labeling legislation and the use of alcohol on a gluten-free diet. The practical part is focused on enriching the diet celiac patients. I focused on the preparation of bakery products for celiac, I have designed and pra...

  5. Learn about gluten-free diets

    ... gluten-free, including: Fruits and vegetables Meat, fish, poultry, and eggs Beans Nuts and seeds Dairy products ... including frozen foods, soups, and rice mixes Salad dressings, sauces, marinades, and gravies Some candies, licorice Some ...

  6. Dietary Factors and Mucosal Immune Response in Celiac Disease Patients Having Persistent Symptoms Despite a Gluten-free Diet.

    Laurikka, Pilvi; Lindfors, Katri; Oittinen, Mikko; Huhtala, Heini; Salmi, Teea; Lähdeaho, Marja-Leena; Ilus, Tuire; Mäki, Markku; Kaukinen, Katri; Kurppa, Kalle

    2018-03-02

    The aim of this study was to investigate the role of dietary factors, distinct small-bowel mucosal immune cell types, and epithelial integrity in the perpetuation of gastrointestinal symptoms in treated celiac disease patients. For unexplained reasons, many celiac disease patients suffer from persistent symptoms, despite a strict gluten-free diet (GFD) and recovered intestinal mucosa. We compared clinical and serological data and mucosal recovery in 22 asymptomatic and 25 symptomatic celiac patients on a long-term GFD. The density of CD3 and γδ intraepithelial lymphocytes (IELs), CD25 and FOXP3 regulatory T cells, and CD117 mast cells, and the expression of tight junction proteins claudin-3 and occludin, heat shock protein 60, interleukin 15, and Toll-like receptor 2 and 4 were evaluated in duodenal biopsies. All subjects kept a strict GFD and had negative celiac autoantibodies and recovered mucosal morphology. The asymptomatic patients had higher mean fiber intake (20.2 vs. 15.2 g/d, P=0.028) and density of CD3 IELs (59.3 vs. 45.0 cell/mm, P=0.045) than those with persistent symptoms. There was a similar but nonsignificant trend in γδ IELs (17.9 vs. 13.5, P=0.149). There were no differences between the groups in other parameters measured. Low fiber intake may predispose patients to persistent symptoms in celiac disease. There were no differences between the groups in the markers of innate immunity, epithelial stress or epithelial integrity. A higher number of IELs in asymptomatic subjects may indicate that the association between symptoms and mucosal inflammation is more complicated than previously thought.

  7. The everyday life of adolescent coeliacs: issues of importance for compliance with the gluten-free diet.

    Olsson, C; Hörnell, A; Ivarsson, A; Sydner, Y M

    2008-08-01

    Noncompliance with the gluten-free diet is often reported among adolescents with coeliac disease. However, knowledge is limited regarding their own perspectives and experiences of managing the disease and the prescription of a gluten-free diet. The aim of this study was to explore how adolescents with coeliac disease perceive and manage their everyday lives in relation to a gluten-free diet. In total, 47 adolescents with coeliac disease, divided into 10 focus groups, were interviewed. In the qualitative analysis, themes emerged to illustrate and explain the adolescents' own perspectives on life with a gluten-free diet. The probability of compliance with the gluten-free diet was comprised by insufficient knowledge of significant others, problems with the availability and sensory acceptance of gluten-free food, insufficient social support and their perceived dietary deviance. Three different approaches to the gluten-free diet emerged: compliers, occasional noncompliers, and noncompliers. Each approach, as a coping strategy, was rational in the sense that it represented the adolescents' differing views of everyday life with coeliac disease and a prescription of a gluten-free diet. dolescents with coeliac disease experience various dilemmas related to the gluten-free diet. The study demonstrated unmet needs and implies empowerment strategies for optimum clinical outcomes.

  8. Gluten-free diet in gluten-related disorders.

    Mulder, Chris J J; van Wanrooij, R L J; Bakker, S F; Wierdsma, N; Bouma, G

    2013-01-01

    A gluten-free diet (GFD) is recommended for all patients with coeliac disease (CD). The spectrum of gluten-related disorders in the early 1980s was simple: CD and dermatitis herpetiformis. In the last few years, wheat allergy, gluten ataxia and noncoeliac gluten sensitivity have become new gluten-related topics. Adherence to GFDs in CD is limited and factors influencing adherence are poorly understood. Noncoeliac gluten sensitivity has stimulated the GFD food industry not only in Australia but all over the world. This article provides an overview of GFD in daily practice. Copyright © 2013 S. Karger AG, Basel.

  9. Anti-Saccharomyces cerevisiae and perinuclear anti-neutrophil cytoplasmic antibodies in coeliac disease before and after gluten-free diet.

    Granito, A; Zauli, D; Muratori, P; Muratori, L; Grassi, A; Bortolotti, R; Petrolini, N; Veronesi, L; Gionchetti, P; Bianchi, F B; Volta, U

    2005-04-01

    Anti-Saccharomyces cerevisiae and perinuclear anti-neutrophil cytoplasmic autoantibodies are markers of Crohn's disease and ulcerative colitis respectively. To determine the prevalence of anti-S. cerevisiae and perinuclear anti-neutrophil cytoplasmic autoantibodies in a large series of coeliac disease patients before and after gluten free diet, and to correlate anti-S. cerevisiae-positivity with intestinal mucosal damage. One hundred and five consecutive coeliac disease patients and 141 controls (22 ulcerative colitis, 24 Crohn's disease, 30 primary sclerosing cholangitis, 15 postenteritis syndrome, 50 blood donors) were tested for anti-S. cerevisiae by enzyme-linked immunosorbent assay and for perinuclear anti-neutrophil cytoplasmic autoantibodies by indirect immunofluorescence. In coeliac disease anti-S. cerevisiae (immunoglobulin G and/or immunoglobulin A) were slightly less frequent (59%) than in Crohn's disease (75%, P = 0.16) and significantly more frequent than in ulcerative colitis (27%), primary sclerosing cholangitis (30%), postenteritis syndrome (26%) and blood donors (4%) (P = 0.009, P = 0.0002, P = 0.025, P < 0.0001). No correlation was found between anti-S. cerevisiae and degree of mucosal damage. Perinuclear anti-neutrophil cytoplasmic autoantibodies were detected only in one coeliac. After gluten free diet the disappearance of anti-S. cerevisiae-immunoglobulin A (93%) was more frequent than that of immunoglobulin G (17%, P = 0.0001); perinuclear anti-neutrophil cytoplasmic autoantibodies disappeared in the only coeliac positive at diagnosis. More than half of untreated coeliacs are anti-S. cerevisiae-positive irrespective of the severity of mucosal damage. Differently from immunoglobulin A, anti-S. cerevisiae-immunoglobulin G persisted in more than 80% after gluten free diet. The high prevalence of anti-S. cerevisiae in coeliac disease suggests that they may be the effect of a non-specific immune response in course of chronic small bowel disease.

  10. Does a Coeliac School increase psychological well-being in women suffering from coeliac disease, living on a gluten-free diet?

    Ring Jacobsson, Lisa; Friedrichsen, Maria; Göransson, Anne; Hallert, Claes

    2012-03-01

    To assess the effects of an active method of patient education on the psychological well-being of women with coeliac disease in remission. Despite remission with a gluten-free diet, adults with coeliac disease and especially women experience a subjective poor health. Self-management education seems to be promising tool to help patients suffering from coeliac disease to cope with their disorder. A randomised controlled trial. A total of 106 women, ≥ 20 years, with confirmed coeliac disease, who had been on a gluten-free diet for a minimum of five years. The intervention group (n = 54) underwent a 10-session educational programme, 'Coeliac School', based on problem-based learning. The controls (n = 52) received information regarding coeliac disease sent home on a regular basis. The primary outcomes were psychological general well-being measured with a validated questionnaire. Participants in the Coeliac School reported a significant improvement in psychological well-being at 10 weeks, whereas the controls given usual care reported a worsening in psychological well-being. After six months, a significant improvement remained for the index of vitality. Patient education increased psychological well-being in women with coeliac disease. There is a need to refine the methods of patient education to make the effects of well-being more pronounced over time. Patient education using problem-based learning promotes self-management in coeliac disease by improving the well-being of patients who have been struggling with the gluten-free diet for years. © 2011 Blackwell Publishing Ltd.

  11. Larazotide acetate for persistent symptoms of celiac disease despite a gluten-free diet: a randomized controlled trial.

    Leffler, Daniel A; Kelly, Ciaran P; Green, Peter H R; Fedorak, Richard N; DiMarino, Anthony; Perrow, Wendy; Rasmussen, Henrik; Wang, Chao; Bercik, Premysl; Bachir, Natalie M; Murray, Joseph A

    2015-06-01

    Celiac disease (CeD) is a prevalent autoimmune condition. Recurrent signs and symptoms are common despite treatment with a gluten-free diet (GFD), yet no approved or proven nondietary treatment is available. In this multicenter, randomized, double-blind, placebo-controlled study, we assessed larazotide acetate 0.5, 1, or 2 mg 3 times daily to relieve ongoing symptoms in 342 adults with CeD who had been on a GFD for 12 months or longer and maintained their current GFD during the study. The study included a 4-week placebo run-in, 12 weeks of treatment, and a 4-week placebo run-out phase. The primary end point was the difference in average on-treatment Celiac Disease Gastrointestinal Symptom Rating Scale score. The primary end point was met with the 0.5-mg dose of larazotide acetate, with fewer symptoms compared with placebo by modified intention to treat (n = 340) (analysis of covariance, P = .022; mixed model for repeated measures, P = .005). The 0.5-mg dose showed an effect on exploratory end points including a 26% decrease in celiac disease patient-reported outcome symptomatic days (P = .017), a 31% increase in improved symptom days (P = .034), a 50% or more reduction from baseline of the weekly average abdominal pain score for 6 or more of 12 weeks of treatment (P = .022), and a decrease in the nongastrointestinal symptoms of headache and tiredness (P = .010). The 1- and 2-mg doses were no different than placebo for any end point. Safety was comparable with placebo. Larazotide acetate 0.5 mg reduced signs and symptoms in CeD patients on a GFD better than a GFD alone. Although results were mixed, this study was a successful trial of a novel therapeutic agent targeting tight junction regulation in patients with CeD who are symptomatic despite a GFD. Clinicaltrials.gov: NCT01396213. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  12. Living gluten-free: adherence, knowledge, lifestyle adaptations and feelings towards a gluten-free diet.

    Silvester, J A; Weiten, D; Graff, L A; Walker, J R; Duerksen, D R

    2016-06-01

    A gluten-free diet (GFD) requires tremendous dedication, involving substantive changes to diet and lifestyle that may have a significant impact upon quality of life. The present study aimed io assess dietary adherence, knowledge of a GFD, and the emotional and lifestyle impact of a GFD. Community dwelling adults following a GFD completed a questionnaire with items related to reasons for avoiding gluten, diagnostic testing, GFD adherence, knowledge and sources of information about a GFD, the Work and Social Adjustment Scale, and the effect of a GFD diet on lifestyle, feelings and behaviours. Strict GFD adherence among the 222 coeliac disease (CD) patients was 56%. Non-CD individuals (n = 38) were more likely to intentionally ingest gluten (odds ratio = 3.7; 95% confidence interval = 1.4-9.4). The adverse impact of a GFD was modest but most pronounced in the social domain. Eating shifted from the public to the domestic sphere and there were feelings of social isolation. Affective responses reflected resilience because acceptance and relief were experienced more commonly than anxiety or anger. Non-CD respondents were less knowledgeable and less likely to consult health professionals. They experienced less anger and depression and greater pleasure in eating than CD respondents. The findings obtained in the present suggest there is good potential for positive adaptation to the demands of a GFD; nevertheless, there is a measurable degree of social impairment that merits further study. The GFD may be a viable treatment option for conditions other than CD; however, education strategies regarding the need for diagnostic testing to exclude CD are required. © 2015 The British Dietetic Association Ltd.

  13. The Availability of Food for a Gluten-free Diet and Possibilities at Dining Establishments

    Olga Regnerová

    2016-01-01

    Full Text Available The aim of the paper is to evaluate options for customers-consumers with a gluten-free diet (coeliac disease patients at food establishments on the Czech market. A gluten-free diet is the only treatment for patients with coeliac disease and it significantly affects their health. The availability of food was investigated during February and March 2014 in three types of food operations. These establishments were visited in forty-three urban, rural and non-residential areas, and the availability of food for people with a gluten-free diet was investigated through interviews at 226 facilities. The preferences of the specific group of customers with a gluten-free diet were determined through comprehensive comparative research. The data was collected from February to June 2014, and 441 respondents were interviewed. The survey revealed that the majority of consumers who must follow this diet fall in the age group of up to 40 years old. This age group consists of preschool and school-age children, students and people of working age who frequently eat away from home. The paper deals with the evaluation of the level of public food services used by customers with gluten intolerance and gives some recommendations for improving the availability and offer of food for a gluten-free diet in selected types of hospitality establishments.

  14. The influence of a short-term gluten-free diet on the human gut microbiome

    Bonder, Marc Jan; Tigchelaar, Ettje F.; Cai, Xianghang; Trynka, Gosia; Cenit, Maria C; Hrdlickova, Barbara; Zhong, Huanzi; Vatanen, Tommi; Gevers, Dirk; Wijmenga, Cisca; Wang, Yang; Zhernakova, Alexandra

    2016-01-01

    Background: A gluten-free diet (GFD) is the most commonly adopted special diet worldwide. It is an effective treatment for coeliac disease and is also often followed by individuals to alleviate gastrointestinal complaints. It is known there is an important link between diet and the gut microbiome,

  15. Adherence to a Gluten Free Diet Is Associated with Receiving Gluten Free Foods on Prescription and Understanding Food Labelling.

    Muhammad, Humayun; Reeves, Sue; Ishaq, Sauid; Mayberry, John; Jeanes, Yvonne M

    2017-07-06

    Treatment of coeliac disease requires a strict gluten-free (GF) diet, however, a high proportion of patients do not adhere to a GF diet. The study explores the practical challenges of a GF diet and dietary adherence in Caucasian and South Asian adults with coeliac disease. Patients with biopsy- and serology-proven coeliac disease were recruited from a hospital database. Participants completed a postal survey ( n = 375), including a validated questionnaire designed to measure GF dietary adherence. Half of Caucasians (53%) and South Asians (53%) were adhering to a GF diet. The quarter of patients ( n = 97) not receiving GF foods on prescription had a lower GF dietary adherence score compared with those receiving GF foods on prescription (12.5 versus 16.0; p diet in all population groups.

  16. Gluten-Free Diet in Children: An Approach to a Nutritionally Adequate and Balanced Diet

    Penagini, Francesca; Dilillo, Dario; Meneghin, Fabio; Mameli, Chiara; Fabiano, Valentina; Zuccotti, Gian Vincenzo

    2013-01-01

    Gluten-free diet (GFD) is the cornerstone treatment for celiac disease (CD). GFD implies a strict and lifelong elimination from the diet of gluten, the storage protein found in wheat, barley, rye and hybrids of these grains, such as kamut and triticale. The absence of gluten in natural and processed foods, despite being the key aspect of GFD, may lead to nutritional consequences, such as deficits and imbalances. The nutritional adequacy of GFD is particularly important in children, this the a...

  17. The Effect of Depressive Symptoms on the Association between Gluten-Free Diet Adherence and Symptoms in Celiac Disease: Analysis of a Patient Powered Research Network.

    Joelson, Andrew M; Geller, Marilyn G; Zylberberg, Haley M; Green, Peter H R; Lebwohl, Benjamin

    2018-04-26

    The prevalence of depression in celiac disease (CD) is high, and patients are often burdened socially and financially by a gluten-free diet. However, the relationship between depression, somatic symptoms and dietary adherence in CD is complex and poorly understood. We used a patient powered research network (iCureCeliac ® ) to explore the effect that depression has on patients' symptomatic response to a gluten-free diet (GFD). We identified patients with biopsy-diagnosed celiac disease who answered questions pertaining to symptoms (Celiac Symptom Index (CSI)), GFD adherence (Celiac Dietary Adherence Test (CDAT)), and a 5-point, scaled question regarding depressive symptoms relating to patients' celiac disease. We then measured the correlation between symptoms and adherence (CSI vs. CDAT) in patients with depression versus those without depression. We also tested for interaction of depression with regard to the association with symptoms using a multiple linear regression model. Among 519 patients, 86% were female and the mean age was 40.9 years. 46% of patients indicated that they felt "somewhat," "quite a bit," or "very much" depressed because of their disorder. There was a moderate correlation between worsened celiac symptoms and poorer GFD adherence ( r = 0.6, p symptoms and worsening dietary adherence ( r = 0.5, p symptoms related to their disorder, correlation between adherence and symptoms was weaker than those without depressive symptoms. This finding was confirmed with a linear regression analysis, showing that depressive symptoms may modify the effect of a GFD on celiac symptoms. Depressive symptoms may therefore mask the relationship between inadvertent gluten exposure and symptoms. Additional longitudinal and prospective studies are needed to further explore this potentially important finding.

  18. Abdominal Pain-Associated Functional Gastrointestinal Disorder Prevalence in Children and Adolescents with Celiac Disease on Gluten-Free Diet: A Multinational Study.

    Saps, Miguel; Sansotta, Naire; Bingham, Sean; Magazzu, Giuseppe; Grosso, Caterina; Romano, Simone; Pusatcioglu, Cenk; Guandalini, Stefano

    2017-03-01

    To test the hypothesis that children with celiac disease (CD) on gluten-free diet are at increased risk of abdominal pain (AP) associated-functional gastrointestinal disorders (FGIDs). This was a multinational cross-sectional study performed from 2014 to 2015. Patients 4-18 years of age with CD on gluten-free diet for longer than 6 months were recruited from pediatric CD clinics in US and Italy. Control groups included siblings of children with CD (with normal tissue transglutaminase levels) and unrelated controls. Subjects or parents completed the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III. Children (n = 289) were recruited (55% US, 45% Italy): 96 children with CD, 96 sibling controls, and 97 unrelated controls. Chronic AP was present in 30 (30.9%) subjects with CD, 22 (22.7%) sibling controls, and 21 (21.6%) unrelated controls (P = .26 patients with CD vs siblings; P = .18 patients with CD vs unrelated; P = .96 siblings vs unrelated). AP-FGIDs were present in 8 (8.2%) subjects with CD, 8 (8.2%) sibling controls, and 2 (2.1%) unrelated controls (P = 1.00 subjects with CD vs sibling controls; P = .06 subjects with CD vs unrelated controls; P = .06 sibling controls vs unrelated controls). This multinational study evaluated the prevalence of chronic abdominal pain and AP-FGIDs in the pediatric population with CD. We found that subjects with CD and controls have a similar prevalence of chronic AP and AP-FGIDs. This suggests that not all types of gastrointestinal inflammation result in AP-FGIDs in children. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Gluten-free diet is for some a necessity, for others a lifestyle

    Jønsson, Iben Møller; Møller, Gitte Leth; Pærregaard, Anders

    2017-01-01

    This review provides a brief overview of the gluten-related conditions coeliac disease (CD), wheat allergy (WA), and non-coeliac gluten sensitivity (NCGS). NCGS is a new entity which includes individuals who report symptoms when exposed to gluten and benefit from gluten-free diet, but do not have...

  20. Food label usage and reported difficulty with following a gluten-free diet among individuals in the USA with coeliac disease and those with noncoeliac gluten sensitivity.

    Verrill, L; Zhang, Y; Kane, R

    2013-10-01

    Individuals with coeliac disease (CD) and those with noncoeliac gluten sensitivity (GS) have reported difficulty following a gluten-free diet (GFD); however, few studies have explored the link between the food label, gluten-free (GF) claims and the difficulty associated with following a GFD. The present study surveyed adults with CD (n = 1,583) and adults with GS (n = 797) about their reported difficulty following a GFD, including assessing the role of food labels and GF claims, as well as other factors known to contribute to this difficulty. A two-sample t-test and chi-squared tests for equality of means or proportions were used for the descriptive data and ordinal logistic regression (OLR) was used to model associations. On average, individuals with GS reported slightly more difficulty following the GFD than did participants with CD. According to the OLR results, reading the food label often was significantly associated with less reported difficulty following a GFD, whereas consuming packaged processed foods and looking for GF claims more often were significantly associated with more reported difficulty for both respondent groups. Individuals with GS may rely more heavily on the GF claim for information about a product's gluten content. Individuals with CD, on the other hand, may be more experienced food label readers and may rely more on the ingredient list for finding GF foods. More studies are needed aiming to understand the role of the food label in facilitating consumers' ability to follow a GFD. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  1. Estimated levels of gluten incidentally present in a Canadian gluten-free diet.

    La Vieille, Sébastien; Dubois, Sheila; Hayward, Stephen; Koerner, Terence B

    2014-02-21

    Avoiding exposure to gluten is currently the only effective treatment for celiac disease. However, the evidence suggests that for most affected individuals, exposure to less than 10 mg/day is unlikely to cause histological changes to the intestinal mucosa. The daily diet of people with celiac disease does not rely solely on gluten-free pre-packaged foods, but also on naturally gluten-free grains (e.g., rice, buckwheat, ...) and foods with grain-derived ingredients (i.e., flour and starches) used for cooking and baking at home. The objective of this study was to estimate the level of incidental gluten potentially present in gluten-free diets from a Canadian perspective. We have conducted gluten exposure estimations from grain-containing foods and foods with grain-derived ingredients, taking into consideration the various rates of food consumption by different sex and age groups. These estimates have concluded that if gluten was present at levels not exceeding 20 ppm, exposure to gluten would remain below 10 mg per day for all age groups studied. However, in reality the level of gluten found in naturally gluten-free ingredients is not static and there may be some concerns related to the flours made from naturally gluten-free cereal grains. It was found that those containing a higher level of fiber and that are frequently used to prepare daily foods by individuals with celiac disease could be a concern. For this category of products, only the flours and starches labelled "gluten-free" should be used for home-made preparations.

  2. Remission without insulin therapy on gluten-free diet in a 6-year old boy with type 1 diabetes mellitus

    Sildorf, Stine Møller; Fredheim, Siri; Svensson, Jannet

    2012-01-01

    A 5-year and 10-month old boy was diagnosed with classical type 1 diabetes mellitus (T1DM) without celiac disease. He started on a gluten-free diet after 2–3 week without need of insulin treatment. At the initiation of gluten-free diet, HbA1c was 7.8% and was stabilised at 5.8%–6.0% without insulin...... therapy. Fasting blood glucose was maintained at 4.0–5.0 mmol/l. At 16 months after diagnosis the fasting blood glucose was 4.1 mmol/l and after 20 months he is still without daily insulin therapy. There was no alteration in glutamic acid decarboxylase positivity. The gluten-free diet was safe and without...... side effects. The authors propose that the gluten-free diet has prolonged remission in this patient with T1DM and that further trials are indicated....

  3. The Effect of Depressive Symptoms on the Association between Gluten-Free Diet Adherence and Symptoms in Celiac Disease: Analysis of a Patient Powered Research Network

    Andrew M. Joelson

    2018-04-01

    Full Text Available Background: The prevalence of depression in celiac disease (CD is high, and patients are often burdened socially and financially by a gluten-free diet. However, the relationship between depression, somatic symptoms and dietary adherence in CD is complex and poorly understood. We used a patient powered research network (iCureCeliac® to explore the effect that depression has on patients’ symptomatic response to a gluten-free diet (GFD. Methods: We identified patients with biopsy-diagnosed celiac disease who answered questions pertaining to symptoms (Celiac Symptom Index (CSI, GFD adherence (Celiac Dietary Adherence Test (CDAT, and a 5-point, scaled question regarding depressive symptoms relating to patients’ celiac disease. We then measured the correlation between symptoms and adherence (CSI vs. CDAT in patients with depression versus those without depression. We also tested for interaction of depression with regard to the association with symptoms using a multiple linear regression model. Results: Among 519 patients, 86% were female and the mean age was 40.9 years. 46% of patients indicated that they felt “somewhat,” “quite a bit,” or “very much” depressed because of their disorder. There was a moderate correlation between worsened celiac symptoms and poorer GFD adherence (r = 0.6, p < 0.0001. In those with a positive depression screen, there was a moderate correlation between worsening symptoms and worsening dietary adherence (r = 0.5, p < 0.0001 whereas in those without depression, the correlation was stronger (r = 0.64, p < 0.0001. We performed a linear regression analysis, which suggests that the relationship between CSI and CDAT is modified by depression. Conclusions: In patients with depressive symptoms related to their disorder, correlation between adherence and symptoms was weaker than those without depressive symptoms. This finding was confirmed with a linear regression analysis, showing that depressive symptoms may

  4. Adherence to a Gluten Free Diet Is Associated with Receiving Gluten Free Foods on Prescription and Understanding Food Labelling

    Humayun Muhammad

    2017-07-01

    Full Text Available Treatment of coeliac disease requires a strict gluten-free (GF diet, however, a high proportion of patients do not adhere to a GF diet. The study explores the practical challenges of a GF diet and dietary adherence in Caucasian and South Asian adults with coeliac disease. Patients with biopsy- and serology-proven coeliac disease were recruited from a hospital database. Participants completed a postal survey (n = 375, including a validated questionnaire designed to measure GF dietary adherence. Half of Caucasians (53% and South Asians (53% were adhering to a GF diet. The quarter of patients (n = 97 not receiving GF foods on prescription had a lower GF dietary adherence score compared with those receiving GF foods on prescription (12.5 versus 16.0; p < 0.001. Not understanding food labelling and non-membership of Coeliac UK were also associated with lower GF dietary adherence scores. A higher proportion of South Asian patients, compared with Caucasians, reported difficulties understanding what they can eat (76% versus 5%; p < 0.001 and understanding of food labels (53% versus 4%; p < 0.001. We recommend retaining GF foods on prescription, membership of a coeliac society, and regular consultations with a dietitian to enable better understanding of food labels. Robust studies are urgently needed to evaluate the impact of reducing the amount of GF foods prescribed on adherence to a GF diet in all population groups.

  5. Gluten-free diet does not influence the occurrence and the Th1/Th17-Th2 nature of immune-mediated diseases in patients with coeliac disease.

    Imperatore, Nicola; Rispo, Antonio; Capone, Pietro; Donetto, Sara; De Palma, Giovanni Domenico; Gerbino, Nicolò; Rea, Matilde; Caporaso, Nicola; Tortora, Raffaella

    2016-07-01

    Coeliac disease (CD) is the most common Th1-mediated enteropathy, frequently associated with other immune-mediated disorders (IMD). To evaluate: (1) the prevalence of IMD at the time of and after CD diagnosis; (2) a possible change in immune response to gluten free diet (GFD); (3) the potential role of GFD in reducing and/or preventing IMD in CD. Prospective study including all consecutive adult CD patients who underwent investigations for Th1-Th17/Th2-IMD at the time of CD diagnosis and after a 5-year follow-up period. 1255 CD were enrolled. Of these, 257 patients (20.5%) showed IMD at the time of CD diagnosis, with 58.4% presenting a Th1/Th17-IMD. After a 5-year follow-up period, 682 patients (54.3%) showed new IMD despite GFD. Of these, 57.3% presented a Th1/Th17-IMD and 42.7% a Th2-IMD (p=0.8). When compared the prevalence of each type of IMD before and after CD diagnosis, we did not identify any significant "switch" from Th1/Th17- to Th2-IMD or vice versa. The number of patients with Th1/Th17- and/or Th2-IMD increased during the GFD period (20.5% vs 54.3%; p<0.01; OR 1.9). The prevalence of IMD at the time of CD diagnosis is high and it seems to increase in the follow-up period despite GFD. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. Normal Bone Mineral Density Associates with Duodenal Mucosa Healing in Adult Patients with Celiac Disease on a Gluten-Free Diet

    Tiziana Larussa

    2017-01-01

    Full Text Available Impairment of bone mineral density (BMD is frequent in celiac disease (CD patients on a gluten-free diet (GFD. The normalization of intestinal mucosa is still difficult to predict. We aim to investigate the relationship between BMD and duodenal mucosa healing (DMH in CD patients on a GFD. Sixty-four consecutive CD patients on a GFD were recruited. After a median period of a 6-year GFD (range 2–33 years, patients underwent repeat duodenal biopsy and dual-energy X-ray absorptiometry (DXA scan. Twenty-four patients (38% displayed normal and 40 (62% low BMD, 47 (73% DMH, and 17 (27% duodenal mucosa lesions. All patients but one with normal BMD (23 of 24, 96% showed DMH, while, among those with low BMD, 24 (60% did and 16 (40% did not. At multivariate analysis, being older (odds ratio (OR 1.1, 95% confidence interval (CI 1.03–1.18 and having diagnosis at an older age (OR 1.09, 95% CI 1.03–1.16 were associated with low BMD; in turn, having normal BMD was the only variable independently associated with DMH (OR 17.5, 95% CI 1.6–192. In older CD patients and with late onset disease, BMD recovery is not guaranteed, despite a GFD. A normal DXA scan identified CD patients with DMH; thus, it is a potential tool in planning endoscopic resampling.

  7. Normal Bone Mineral Density Associates with Duodenal Mucosa Healing in Adult Patients with Celiac Disease on a Gluten-Free Diet.

    Larussa, Tiziana; Suraci, Evelina; Imeneo, Maria; Marasco, Raffaella; Luzza, Francesco

    2017-01-31

    Impairment of bone mineral density (BMD) is frequent in celiac disease (CD) patients on a gluten-free diet (GFD). The normalization of intestinal mucosa is still difficult to predict. We aim to investigate the relationship between BMD and duodenal mucosa healing (DMH) in CD patients on a GFD. Sixty-four consecutive CD patients on a GFD were recruited. After a median period of a 6-year GFD (range 2-33 years), patients underwent repeat duodenal biopsy and dual-energy X-ray absorptiometry (DXA) scan. Twenty-four patients (38%) displayed normal and 40 (62%) low BMD, 47 (73%) DMH, and 17 (27%) duodenal mucosa lesions. All patients but one with normal BMD (23 of 24, 96%) showed DMH, while, among those with low BMD, 24 (60%) did and 16 (40%) did not. At multivariate analysis, being older (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.03-1.18) and having diagnosis at an older age (OR 1.09, 95% CI 1.03-1.16) were associated with low BMD; in turn, having normal BMD was the only variable independently associated with DMH (OR 17.5, 95% CI 1.6-192). In older CD patients and with late onset disease, BMD recovery is not guaranteed, despite a GFD. A normal DXA scan identified CD patients with DMH; thus, it is a potential tool in planning endoscopic resampling.

  8. Gastrointestinal symptoms and well-being of adults living on a gluten-free diet: a case for nursing in celiac disease.

    Roos, Susanne; Kärner, Anita; Hallert, Claes

    2009-01-01

    Women with celiac disease (CD) living on a gluten-free diet (GFD) show a lower health-related quality of life and report a higher rate of gastrointestinal (GI) symptoms than men with CD. Uncertainty exists as to whether GI symptoms may explain the poorer treatment outcome of women with CD. This study was designed to explore relationships of GI symptoms and psychological well-being in men and women with long-standing CD. Patients with CD (n = 108; 59% women), aged 45-64 years, treated with a GFD for at least 8 years were evaluated by the Gastrointestinal Symptom Rating Scale and the Psychological General Well-Being index. The results show that women with a high rate of GI symptoms have no lower level of psychological well-being than corresponding men with CD and that women with CD with reduced psychological well-being have no more GI symptoms than corresponding men. Our results fail to support the notion that the reduced subjective health in CD is explained by GI symptoms. They may be secondary to perceived difficulties in managing everyday life, suggesting that launching a nurse-led follow-up may be helpful, as has been proven to be useful in other lifelong disorders.

  9. Role of the gluten-free diet on neurological-EEG findings and sleep disordered breathing in children with celiac disease.

    Parisi, P; Pietropaoli, N; Ferretti, A; Nenna, R; Mastrogiorgio, G; Del Pozzo, M; Principessa, L; Bonamico, M; Villa, M P

    2015-02-01

    To determine whether celiac children are at risk for EEG-neurological features and sleep disordered breathing (SDB), and whether an appropriate gluten-free diet (GFD) influences these disorders. We consecutively enrolled 19 children with a new biopsy-proven celiac disease (CD) diagnosis. At CD diagnosis and after 6 months of GFD, each patient underwent a general and neurological examination, an electroencephalogram, a questionnaire about neurological features, and a validated questionnaire about SDB: OSA (obstructive sleep apnea) scores0 predict OSA. At CD diagnosis, 37% of patients complained headache that affected daily activities and 32% showed positive OSA score. The EEG examinations revealed abnormal finding in 48% of children. After 6 months of GFD headache disappeared in 72% of children and EEG abnormalities in 78%; all children showed negative OSA score. According to our preliminary data, in the presence of unexplained EEG abnormalities and/or other neurological disorders/SDB an atypical or silent CD should also be taken into account. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  10. Estimated Levels of Gluten Incidentally Present in a Canadian Gluten-Free Diet

    Sébastien La Vieille

    2014-02-01

    Full Text Available Avoiding exposure to gluten is currently the only effective treatment for celiac disease. However, the evidence suggests that for most affected individuals, exposure to less than 10 mg/day is unlikely to cause histological changes to the intestinal mucosa. The daily diet of people with celiac disease does not rely solely on gluten-free pre-packaged foods, but also on naturally gluten-free grains (e.g., rice, buckwheat, ... and foods with grain-derived ingredients (i.e., flour and starches used for cooking and baking at home. The objective of this study was to estimate the level of incidental gluten potentially present in gluten-free diets from a Canadian perspective. We have conducted gluten exposure estimations from grain-containing foods and foods with grain-derived ingredients, taking into consideration the various rates of food consumption by different sex and age groups. These estimates have concluded that if gluten was present at levels not exceeding 20 ppm, exposure to gluten would remain below 10 mg per day for all age groups studied. However, in reality the level of gluten found in naturally gluten-free ingredients is not static and there may be some concerns related to the flours made from naturally gluten-free cereal grains. It was found that those containing a higher level of fiber and that are frequently used to prepare daily foods by individuals with celiac disease could be a concern. For this category of products, only the flours and starches labelled “gluten-free” should be used for home-made preparations.

  11. Altered duodenal microbiota composition in celiac disease patients suffering from persistent symptoms on a long-term gluten-free diet.

    Wacklin, Pirjo; Laurikka, Pilvi; Lindfors, Katri; Collin, Pekka; Salmi, Teea; Lähdeaho, Marja-Leena; Saavalainen, Päivi; Mäki, Markku; Mättö, Jaana; Kurppa, Kalle; Kaukinen, Katri

    2014-12-01

    A significant fraction of celiac disease patients suffer from persistent symptoms despite a long-term gluten-free diet (GFD) and normalized small bowel mucosa. The commonly suggested reasons, such as inadvertent gluten-intake or presence of other gastrointestinal disease, do not explain the symptoms in all these patients. Recently, alterations in intestinal microbiota have been associated with autoimmune disorders, including celiac disease. This led us to test a hypothesis that abnormal intestinal microbiota may be associated with persisting gastrointestinal symptoms in treated celiac disease patients. Duodenal microbiota was analyzed in 18 GFD-treated patients suffering from persistent symptoms and 18 treated patients without symptoms by 16S rRNA gene pyrosequencing. The celiac disease patients had been following a strict GFD for several years and had restored small bowel mucosa and negative celiac autoantibodies. Their symptoms on GFD were assessed with Gastrointestinal Symptom Rating Scale. The results of several clustering methods showed that the treated celiac disease patients with persistent symptoms were colonized by different duodenal microbiota in comparison with patients without symptoms. The treated patients with persistent symptoms had a higher relative abundance of Proteobacteria (P=0.04) and a lower abundance of Bacteroidetes (P=0.01) and Firmicutes (P=0.05). Moreover, their microbial richness was reduced. The results indicated intestinal dysbiosis in patients with persistent symptoms even while adhering to a strict GFD. Our findings indicate that dysbiosis of microbiota is associated with persistent gastrointestinal symptoms in treated celiac disease patients and open new possibilities to treat this subgroup of patients.

  12. Gluten-free and casein-free diets in the therapy of autism.

    Lange, Klaus W; Hauser, Joachim; Reissmann, Andreas

    2015-11-01

    The purpose of this study is to discuss the role of gluten-free and casein-free diets in the treatment of autism. In a recent UK survey, more than 80% of parents of children with autism spectrum disorder reported some kind of dietary intervention for their child (gluten-free and casein-free diet in 29%). When asked about the effects of the gluten-free and casein-free diet, 20-29% of the parents reported significant improvements on the autism spectrum disorder core dimensions. The findings of this study suggest additional effects of a gluten-free and casein-free diet on comorbid problems of autism such as gastrointestinal symptoms, concentration, and attention. The findings of another recent investigation suggested that age and certain urine compounds may predict the response of autism symptoms to a gluten-free and casein-free diet. Although these results need to be replicated, they highlight the importance of patient subgroup analysis. Intervention trials evaluating the effects of a gluten-free and casein-free diet on autistic symptoms have so far been contradictory and inconclusive. Most investigations assessing the efficacy of a gluten-free and casein-free diet in the treatment of autism are seriously flawed. The evidence to support the therapeutic value of this diet is limited and weak. A gluten-free and casein-free diet should only be administered if an allergy or intolerance to nutritional gluten or casein is diagnosed.

  13. Adherence to the gluten-free diet can achieve the therapeutic goals in almost all patients with coeliac disease: A 5-year longitudinal study from diagnosis.

    Newnham, Evan D; Shepherd, Susan J; Strauss, Boyd J; Hosking, Patrick; Gibson, Peter R

    2016-02-01

    Key aims of treatment of coeliac disease are to heal the intestinal mucosa and correct nutritional abnormalities. We aim to determine prospectively the degree of success and time course of achieving those goals with a gluten-free diet. Ninety-nine patients were enrolled at diagnosis and taught the diet. The first 52 were reassessed at 1 year and 46 at 5 years, 25 being assessed at the three time points regarding dietary compliance (dietitian-assessed), coeliac serology, bone mineral density and body composition analysis by dual energy X-ray absorptiometry, and intestinal histology. Mean age (range) was 40 (18-71) years and 48 (76%) were female. Dietary compliance was very good to excellent in all but one. Tissue transglutaminase IgA was persistently elevated in 44% at 1 year and 30% at 5 years and were poorly predictive of mucosal disease. Rates of mucosal remission (Marsh 0) and response (Marsh 0/1) were 37% and 54%, and 50% and 85% at 1 and 5 years, respectively. Fat mass increased significantly over the first year in those with normal/reduced body mass index. Lean body mass indices more slowly improved irrespective of status at diagnosis with significant improvement at 5 years. Bone mass increased only in those with osteopenia or osteoporosis, mostly in year 1. Dietary compliance is associated with a high chance of healing the intestinal lesion and correction of specific body compositional abnormalities. The time course differed with body fat improving within 1 year, and correction of the mucosal lesion and improvement in lean mass and bone mass taking longer. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  14. Adherence to the Gluten-free Diet and Health-related Quality of Life in an Ethnically Diverse Pediatric Population With Celiac Disease.

    Mager, Diana R; Marcon, Margaret; Brill, Herbert; Liu, Amanda; Radmanovich, Kristin; Mileski, Heather; Nasser, Roseann; Alzaben, Abeer; Carroll, Matthew W; Yap, Jason; Persad, Rabin; Turner, Justine M

    2018-06-01

    Celiac disease (CD) is an autoimmune disease that requires lifelong adherence to a gluten-free diet (GFD). Adherence to the GFD in childhood may be poor and adversely influence health-related quality of life (HRQOL). The study purpose was to determine sociodemographic and socioeconomic factors influencing adherence to the GFD and HRQOL in a multiethnic cohort of youth with CD. A multisite (Edmonton, Hamilton, Toronto) study examining child-parent HRQOL in youth with CD (n = 243) and/or mild gastrointestinal complaints (GI-CON; n = 148) was conducted. Sociodemographic (age, child-parental age/education/ethnicity/place of birth), anthropometric (weight, height, body mass index), disease (diagnosis, age at diagnosis, duration, Marsh score, serology), household characteristics (income, family size, region, number of children/total household size), HRQOL (Peds TM/KINDL and Celiac Disease DUX), GI Complaints (PedsQL: Gastrointestinal Symptom Scale) and gluten intake were measured. Younger age (children (P children (parent/child) had higher HRQOL (average, composite domains) than GI-CON (P children were comparable to healthy children. Lack of GI symptoms, non-Caucasian ethnicity and age (<10 years) were associated with increased HRQOL in composite/average domains for CD (P < 0.05). Child-parent perceptions of HRQOL in a multiethnic population with CD are comparable to healthy reference populations, but significantly higher than in parent/child GI-CON. Adherence to the GFD in ethnically diverse youth with CD was related to GI symptoms, age of the child, and ethnicity of the parent-child.

  15. Fecal Gluten Peptides Reveal Limitations of Serological Tests and Food Questionnaires for Monitoring Gluten-Free Diet in Celiac Disease Patients

    Comino, Isabel; Fernández-Bañares, Fernando; Esteve, María; Ortigosa, Luís; Castillejo, Gemma; Fambuena, Blanca; Ribes-Koninckx, Carmen; Sierra, Carlos; Rodríguez-Herrera, Alfonso; Salazar, José Carlos; Caunedo, Ángel; Marugán-Miguelsanz, J M; Garrote, José Antonio; Vivas, Santiago; lo Iacono, Oreste; Nuñez, Alejandro; Vaquero, Luis; Vegas, Ana María; Crespo, Laura; Fernández-Salazar, Luis; Arranz, Eduardo; Jiménez-García, Victoria Alejandra; Antonio Montes-Cano, Marco; Espín, Beatriz; Galera, Ana; Valverde, Justo; Girón, Francisco José; Bolonio, Miguel; Millán, Antonio; Cerezo, Francesc Martínez; Guajardo, César; Alberto, José Ramón; Rosinach, Mercé; Segura, Verónica; León, Francisco; Marinich, Jorge; Muñoz-Suano, Alba; Romero-Gómez, Manuel; Cebolla, Ángel; Sousa, Carolina

    2016-01-01

    Objectives: Treatment for celiac disease (CD) is a lifelong strict gluten-free diet (GFD). Patients should be followed-up with dietary interviews and serology as CD markers to ensure adherence to the diet. However, none of these methods offer an accurate measure of dietary compliance. Our aim was to evaluate the measurement of gluten immunogenic peptides (GIP) in stools as a marker of GFD adherence in CD patients and compare it with traditional methods of GFD monitoring. Methods: We performed a prospective, nonrandomized, multicenter study including 188 CD patients on GFD and 84 healthy controls. Subjects were given a dietary questionnaire and fecal GIP quantified by enzyme-linked immunosorbent assay (ELISA). Serological anti-tissue transglutaminase (anti-tTG) IgA and anti-deamidated gliadin peptide (anti-DGP) IgA antibodies were measured simultaneously. Results: Of the 188 celiac patients, 56 (29.8%) had detectable GIP levels in stools. There was significant association between age and GIP in stools that revealed increasing dietary transgressions with advancing age (39.2% in subjects ≥13 years old) and with gender in certain age groups (60% in men ≥13 years old). No association was found between fecal GIP and dietary questionnaire or anti-tTG antibodies. However, association was detected between GIP and anti-DGP antibodies, although 46 of the 53 GIP stool-positive patients were negative for anti-DGP. Conclusions: Detection of gluten peptides in stools reveals limitations of traditional methods for monitoring GFD in celiac patients. The GIP ELISA enables direct and quantitative assessment of gluten exposure early after ingestion and could aid in the diagnosis and clinical management of nonresponsive CD and refractory CD. Trial registration number NCT02711397. PMID:27644734

  16. Gluten-free diet in children: an approach to a nutritionally adequate and balanced diet.

    Penagini, Francesca; Dilillo, Dario; Meneghin, Fabio; Mameli, Chiara; Fabiano, Valentina; Zuccotti, Gian Vincenzo

    2013-11-18

    Gluten-free diet (GFD) is the cornerstone treatment for celiac disease (CD). GFD implies a strict and lifelong elimination from the diet of gluten, the storage protein found in wheat, barley, rye and hybrids of these grains, such as kamut and triticale. The absence of gluten in natural and processed foods, despite being the key aspect of GFD, may lead to nutritional consequences, such as deficits and imbalances. The nutritional adequacy of GFD is particularly important in children, this the age being of maximal energy and nutrient requirements for growth, development and activity. In recent years, attention has focused on the nutritional quality of gluten-free products (GFPs) available in the market. It is well recognized that GFPs are considered of lower quality and poorer nutritional value compared to the gluten-containing counterparts. The present review focuses on the nutritional adequacy of GFD at the pediatric age, with the aim being to increase awareness of the potential complications associated with this diet, to identify strategies in order to avoid them and to promote a healthier diet and lifestyle in children with CD.

  17. Maintenance of a gluten free diet in coeliac disease: The roles of self-regulation, habit, psychological resources, motivation, support, and goal priority.

    Sainsbury, Kirby; Halmos, Emma P; Knowles, Simon; Mullan, Barbara; Tye-Din, Jason A

    2018-06-01

    A strict lifelong gluten free diet (GFD) is the only treatment for coeliac disease (CD). Theory-based research has focused predominantly on initiation, rational, and motivational processes in predicting adherence. The aim of this study was to evaluate an expanded collection of theoretical constructs specifically relevant to the maintenance of behaviour change, in the understanding and prediction of GFD adherence. Respondents with CD (N = 5573) completed measures of GFD adherence, psychological distress, intentions, self-efficacy, and the maintenance-relevant constructs of self-regulation, habit, temptation and intentional and unintentional lapses (cognitive and behavioural consequences of lowered or fluctuating psychological resources and self-control), motivation, social and environmental support, and goal priority, conflict, and facilitation. Correlations and multiple regression were used to determine their influence on adherence, over and above intention and self-efficacy, and how relationships changed in the presence of distress. Better adherence was associated with greater self-regulation, habit, self-efficacy, priority, facilitation, and support; and lower psychological distress, conflict, and fewer self-control lapses (e.g., when busy/stressed). Autonomous and wellbeing-based, but not controlled motivations, were related to adherence. In the presence of distress, the influence of self-regulation and intentional lapses on adherence were increased, while temptation and unintentional lapses were decreased. The findings point to the importance of considering intentional, volitional, automatic, and emotional processes in the understanding and prediction of GFD adherence. Behaviour change interventions and psychological support are now needed so that theoretical knowledge can be translated into evidence-based care, including a role for psychologists within the multi-disciplinary treatment team. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Clinical impact of a gluten-free diet on health-related quality of life in seven fibromyalgia syndrome patients with associated celiac disease.

    Rodrigo, Luis; Blanco, Ignacio; Bobes, Julio; de Serres, Frederick J

    2013-11-09

    Celiac disease (CD) is an autoimmune disorder, characterized by the presence of gastrointestinal and multisystem symptoms, which occasionally mimic those of Irritable Bowel Syndrome (IBS) and Fibromyalgia Syndrome (FMS). To assess the effectiveness of a Gluten-Free Diet (GFD) in seven adult female screening-detected CD subjects, categorized as severe IBS and FMS patients. All subjects showed villous atrophy in duodenal biopsies, were HLA-DQ2/DQ8-positive, and fulfilled the Rome III and ACR 1990 criteria respectively for IBS and FMS classification. GFD effectiveness was assessed at baseline and after 1 year, examining the score changes in the Tender Points (TPs) test, Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-36), Visual Analogue Scales (VAS) for gastrointestinal complaints, pain and tiredness, drug prescriptions and tissue-Trans-Glutaminase (tTG) serum levels. At baseline, all patients had poor Quality of Life and VAS scores, a high number of TPs and drug prescriptions, and increased tTG levels. After 1 year of GFD, all outcome measures significantly improved, with a decrease of 51-60% in TPs, FIQ, HAQ, and VAS scales, and in the number of prescribed drugs, accompanied by an increase of 48-60% in SF-36 Physical and Mental Component Summary scores, and a decrease of tTG to normal values. Results of this pilot study show that the adherence to a GFD by CD-related IBS/FMS patients can simultaneously improve CD and IBS/FMS symptoms, and indicate the merit of further research on a larger cohort.

  19. Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing.

    Moreno, María de Lourdes; Cebolla, Ángel; Muñoz-Suano, Alba; Carrillo-Carrion, Carolina; Comino, Isabel; Pizarro, Ángeles; León, Francisco; Rodríguez-Herrera, Alfonso; Sousa, Carolina

    2017-02-01

    Gluten-free diet (GFD) is the only management for coeliac disease (CD). Available methods to assess GFD compliance are insufficiently sensitive to detect occasional dietary transgressions that may cause gut mucosal damage. We aimed to develop a method to determine gluten intake and monitor GFD compliance in patients with CD and to evaluate its correlation with mucosal damage. Urine samples of 76 healthy subjects and 58 patients with CD subjected to different gluten dietary conditions were collected. A lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant gluten immunogenic peptides (GIP) and a LFT reader were used to quantify GIP in solid-phase extracted urines. GIP were detectable in concentrated urines from healthy individuals previously subjected to GFD as early as 4-6 h after single gluten intake, and remained detectable for 1-2 days. The urine assay revealed infringement of the GFD in about 50% of the patients. Analysis of duodenal biopsies revealed that most of patients with CD (89%) with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed incomplete intestinal mucosa recovery. GIP are detected in urine after gluten consumption, enabling a new and non-invasive method to monitor GFD compliance and transgressions. The method was sensitive, specific and simple enough to be convenient for clinical monitoring of patients with CD as well as for basic and clinical research applications including drug development. NCT02344758. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Potential beneficial effects of a gluten-free diet in newly diagnosed children with type 1 diabetes

    Svensson, Jannet; Sildorf, Stine Møller; Pipper, Christian B.

    2016-01-01

    Aim: Gluten-free diet has shown promising effects in preventing type 1 diabetes (T1D) in animals as well as beneficial effects on the immune system. Gluten-free diet at diabetes onset may alter the natural course and outcome of autoimmune diseases such as T1D. Methods: In a 12-month study, 15...... children newly diagnosed with T1D were instructed to follow a gluten-free diet. Questionnaires were used to evaluate adherence to the gluten-free diet. Partial remission (PR) was defined by insulin dose-adjusted A1c (IDAA1c) ≤9 or stimulated C-peptide (SCP) >300 pmol/L measured 90 min after a liquid mixed...... meal at the inclusion, six and 12 months after onset. The intervention group was compared with two previous cohorts. Linear mixed models were used to estimate differences between cohorts. Results: After 6 months, more children on a gluten-free diet tended to have SCP values above 300 pmol/L compared...

  1. Safety of Adding Oats to a Gluten-Free Diet for Patients With Celiac Disease: Systematic Review and Meta-analysis of Clinical and Observational Studies.

    Pinto-Sánchez, María Inés; Causada-Calo, Natalia; Bercik, Premysl; Ford, Alexander C; Murray, Joseph A; Armstrong, David; Semrad, Carol; Kupfer, Sonia S; Alaedini, Armin; Moayyedi, Paul; Leffler, Daniel A; Verdú, Elena F; Green, Peter

    2017-08-01

    Patients with celiac disease should maintain a gluten-free diet (GFD), excluding wheat, rye, and barley. Oats might increase the nutritional value of a GFD, but their inclusion is controversial. We performed a systematic review and meta-analysis to evaluate the safety of oats as part of a GFD in patients with celiac disease. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE databases for clinical trials and observational studies of the effects of including oats in GFD of patients with celiac disease. The studies reported patients' symptoms, results from serology tests, and findings from histologic analyses. We used the GRADE approach to assess the quality of evidence. We identified 433 studies; 28 were eligible for analysis. Of these, 6 were randomized and 2 were not randomized controlled trials comprising a total of 661 patients-the remaining studies were observational. All randomized controlled trials used pure/uncontaminated oats. Oat consumption for 12 months did not affect symptoms (standardized mean difference: reduction in symptom scores in patients who did and did not consume oats, -0.22; 95% CI, -0.56 to 0.13; P = .22), histologic scores (relative risk for histologic findings in patients who consumed oats, 0.24; 95% CI, 0.01-4.8; P = .35), intraepithelial lymphocyte counts (standardized mean difference, 0.21; 95% CI, reduction of 1.44 to increase in 1.86), or results from serologic tests. Subgroup analyses of adults vs children did not reveal differences. The overall quality of evidence was low. In a systematic review and meta-analysis, we found no evidence that addition of oats to a GFD affects symptoms, histology, immunity, or serologic features of patients with celiac disease. However, there were few studies for many endpoints, as well as limited geographic distribution and low quality of evidence. Rigorous double-blind, placebo-controlled, randomized controlled trials, using commonly available oats sourced from

  2. Tests for Serum Transglutaminase and Endomysial Antibodies Do Not Detect Most Patients With Celiac Disease and Persistent Villous Atrophy on Gluten-free Diets: a Meta-analysis.

    Silvester, Jocelyn A; Kurada, Satya; Szwajcer, Andrea; Kelly, Ciarán P; Leffler, Daniel A; Duerksen, Donald R

    2017-09-01

    Tests to measure serum endomysial antibodies (EMA) and antibodies to tissue transglutaminase (tTG) were developed to screen for celiac disease in patients consuming gluten. However, they are commonly used to monitor patients on a gluten-free diet (GFD). We conducted a meta-analysis to assess the sensitivity and specificity of tTG IgA and EMA IgA assays in identifying patients with celiac disease who have persistent villous atrophy despite a GFD. We searched PUBMED, EMBASE, BIOSIS, SCOPUS, clinicaltrials.gov, Science Citation Index, and Cochrane Library databases through November 2016. Inclusion criteria were studies of subjects with biopsy-confirmed celiac disease, follow-up biopsies, and measurement of serum antibodies on a GFD, biopsy performed on subjects regardless of symptoms, or antibody test results. Our analysis excluded subjects with refractory celiac disease, undergoing gluten challenge, or consuming a prescribed oats-containing GFD. Tests were considered to have positive or negative findings based on manufacturer cut-off values. Villous atrophy was defined as a Marsh 3 lesion or villous height:crypt depth ratio below 3.0. We constructed forest plots to determine the sensitivity and specificity of detection for individual studies. For the meta-analysis, a bivariate random effects model was used to jointly model sensitivity and specificity. Our search identified 5408 unique citations. Following review of abstracts, 442 articles were reviewed in detail. Only 26 studies (6 of tTG assays, 15 of EMA assays, and 5 of tTG and EMA assays) met our inclusion criteria. The most common reason studies were excluded from our analysis was inability to cross-tabulate histologic and serologic findings. The serum assays identified patients with persistent villous atrophy with high levels of specificity: 0.83 for the tTG IgA assay (95% CI, 0.79-0.87) and 0.91 for the EMA IgA assay (95% CI, 0.87-0.94). However, they detected villous atrophy with low levels of sensitivity: 0

  3. The Gluten-Free Diet: Can Oats and Wheat Starch Be Part of It?

    Poley, J Rainer

    2017-01-01

    Objective and Conclusion: Uncertainty still exists about the use of oats and wheat starch as part of a gluten-free diet in patients with celiac disease (CD). This review should help to clarify the issues at hand. Whereas uncontaminated (from gluten/gliadin) oats and oats from cultivars not containing celiac-activating sequences of proline and glutamine can be used without risk of intestinal damage, wheat starch should not be used, unless it is free of gluten-that is, deglutinized-because even small amounts of gluten over time are able to induce small intestinal mucosal damage.

  4. Navigating the gluten-free boom.

    Gaesser, Glenn A; Angadi, Siddhartha S

    2015-08-01

    Gluten-free diets have gained popularity with the public at a rate greater than would be expected based on the prevalence of gluten-related disorders such celiac disease, nonceliac gluten sensitivity, and wheat allergy. This article reviews gluten-related disorders, indications for gluten-free diets, and the possible health benefits of gluten. Despite the health claims for gluten-free eating, no published experimental evidence supports weight-loss with a gluten-free diet or suggests that the general population would benefit from avoiding gluten.

  5. Cereal-Based Gluten-Free Food: How to Reconcile Nutritional and Technological Properties of Wheat Proteins with Safety for Celiac Disease Patients

    Carmela Lamacchia

    2014-01-01

    Full Text Available The gluten-free diet is, to date, the only efficacious treatment for patients with Celiac Disease. In recent years, the impressive rise of Celiac Disease incidence, dramatically prompted changes in the dietary habit of an increasingly large population, with a rise in demand of gluten-free products. The formulation of gluten-free bakery products presents a formidable challenge to cereal technologists. As wheat gluten contributes to the formation of a strong protein network, that confers visco-elasticity to the dough and allows the wheat flour to be processed into a wide range of products, the preparation of cereal-based gluten-free products is a process somehow difficult process. This review focuses on nutritional and technological quality of products made with gluten-free cereals available on the market. The possibility of using flour from naturally low toxic ancient wheat species or detoxified wheat for the diet of celiacs is also discussed.

  6. Tax-deductible provisions for gluten-free diet in Canada compared with systems for gluten-free diet coverage available in various countries

    Pinto-Sanchez, Maria Ines; Verdu, Elena F; Gordillo, Maria C; Bai, Julio C; Birch, Stephen; Moayyedi, Paul; Bercik, Premysl

    2015-01-01

    Celiac disease affects 1% of the North American population, with an estimated 350,000 Canadians diagnosed with this condition. The disease is triggered by the ingestion of gluten, and a lifelong, strict gluten-free diet (GFD) is the only currently available treatment. Compliance with a strict GFD is essential not only for intestinal mucosal recovery and alleviation of symptoms, but also for the prevention of complications such as anemia, osteoporotic fractures and small bowel lymphoma. However, a GFD is difficult to follow, socially inconvenient and expensive. Different approaches, such as tax reduction, cash transfer, food provision, prescription and subsidy, have been used to reduce the additional costs of the GFD to patients with celiac disease. The current review showed that the systems in place exhibit particular advantages and disadvantages in relation to promoting uptake and compliance with GFD. The tax offset system used in Canada for GFD coverage takes the form of a reimbursement of a cost previously incurred. Hence, the program does not help celiac patients meet the incremental cost of the GFD – it simply provides some future refund of that cost. An ideal balanced approach would involve subsidizing gluten-free products through controlled vouchers or direct food provision to those who most need it, independently of ‘ability or willingness to pay’. Moreover, if the cost of such a program is inhibitive, the value of the benefits could be made taxable to ensure that any patient contribution, in terms of additional taxation, is directly related to ability to pay. The limited coverage of GFD in Canada is concerning. There is an unmet need for GFD among celiac patients in Canada. More efforts are required by the Canadian medical community and the Canadian Celiac Association to act as agents in identifying ways of improving resource allocation in celiac disease. PMID:25803021

  7. Tax-Deductible Provisions for Gluten-Free Diet in Canada Compared with Systems for Gluten-Free Diet Coverage Available in Various Countries

    Maria Ines Pinto-Sanchez

    2015-01-01

    Full Text Available Celiac disease affects 1% of the North American population, with an estimated 350,000 Canadians diagnosed with this condition. The disease is triggered by the ingestion of gluten, and a lifelong, strict gluten-free diet (GFD is the only currently available treatment. Compliance with a strict GFD is essential not only for intestinal mucosal recovery and alleviation of symptoms, but also for the prevention of complications such as anemia, osteoporotic fractures and small bowel lymphoma. However, a GFD is difficult to follow, socially inconvenient and expensive. Different approaches, such as tax reduction, cash transfer, food provision, prescription and subsidy, have been used to reduce the additional costs of the GFD to patients with celiac disease. The current review showed that the systems in place exhibit particular advantages and disadvantages in relation to promoting uptake and compliance with GFD. The tax offset system used in Canada for GFD coverage takes the form of a reimbursement of a cost previously incurred. Hence, the program does not help celiac patients meet the incremental cost of the GFD – it simply provides some future refund of that cost. An ideal balanced approach would involve subsidizing gluten-free products through controlled vouchers or direct food provision to those who most need it, independently of ‘ability or willingness to pay’. Moreover, if the cost of such a program is inhibitive, the value of the benefits could be made taxable to ensure that any patient contribution, in terms of additional taxation, is directly related to ability to pay. The limited coverage of GFD in Canada is concerning. There is an unmet need for GFD among celiac patients in Canada. More efforts are required by the Canadian medical community and the Canadian Celiac Association to act as agents in identifying ways of improving resource allocation in celiac disease.

  8. Tax-deductible provisions for gluten-free diet in Canada compared with systems for gluten-free diet coverage available in various countries.

    Pinto-Sanchez, Maria Ines; Verdu, Elena F; Gordillo, Maria C; Bai, Julio C; Birch, Stephen; Moayyedi, Paul; Bercik, Premysl

    2015-03-01

    Celiac disease affects 1% of the North American population, with an estimated 350,000 Canadians diagnosed with this condition. The disease is triggered by the ingestion of gluten, and a lifelong, strict gluten-free diet (GFD) is the only currently available treatment. Compliance with a strict GFD is essential not only for intestinal mucosal recovery and alleviation of symptoms, but also for the prevention of complications such as anemia, osteoporotic fractures and small bowel lymphoma. However, a GFD is difficult to follow, socially inconvenient and expensive. Different approaches, such as tax reduction, cash transfer, food provision, prescription and subsidy, have been used to reduce the additional costs of the GFD to patients with celiac disease. The current review showed that the systems in place exhibit particular advantages and disadvantages in relation to promoting uptake and compliance with GFD. The tax offset system used in Canada for GFD coverage takes the form of a reimbursement of a cost previously incurred. Hence, the program does not help celiac patients meet the incremental cost of the GFD - it simply provides some future refund of that cost. An ideal balanced approach would involve subsidizing gluten-free products through controlled vouchers or direct food provision to those who most need it, independently of 'ability or willingness to pay'. Moreover, if the cost of such a program is inhibitive, the value of the benefits could be made taxable to ensure that any patient contribution, in terms of additional taxation, is directly related to ability to pay. The limited coverage of GFD in Canada is concerning. There is an unmet need for GFD among celiac patients in Canada. More efforts are required by the Canadian medical community and the Canadian Celiac Association to act as agents in identifying ways of improving resource allocation in celiac disease.

  9. Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity.

    Caio, Giacomo; Volta, Umberto; Tovoli, Francesco; De Giorgio, Roberto

    2014-02-13

    Non-celiac gluten sensitivity is a syndrome characterized by gastrointestinal and extra-intestinal symptoms occurring in a few hours/days after gluten and/or other wheat protein ingestion and rapidly improving after exclusion of potential dietary triggers. There are no established laboratory markers for non-celiac gluten sensitivity, although a high prevalence of first generation anti-gliadin antibodies of IgG class has been reported in this condition. This study was designed to characterize the effect of the gluten-free diet on anti-gliadin antibodies of IgG class in patients with non-celiac gluten sensitivity. Anti-gliadin antibodies of both IgG and IgA classes were assayed by ELISA in 44 non-celiac gluten sensitivity and 40 celiac disease patients after 6 months of gluten-free diet. The majority of non-celiac gluten sensitivity patients (93.2%) showed the disappearance of anti-gliadin antibodies of IgG class after 6 months of gluten-free diet; in contrast, 16/40 (40%) of celiac patients displayed the persistence of these antibodies after gluten withdrawal. In non-celiac gluten sensitivity patients anti-gliadin antibodies IgG persistence after gluten withdrawal was significantly correlated with the low compliance to gluten-free diet and a mild clinical response. Anti-gliadin antibodies of the IgG class disappear in patients with non-celiac gluten sensitivity reflecting a strict compliance to the gluten-free diet and a good clinical response to gluten withdrawal.

  10. The Gluten-Free, Casein-Free Diet and Autism: Limited Return on Family Investment

    Hurwitz, Sarah

    2013-01-01

    The gluten-free, casein-free (GFCF) diet is widely used by families of children with autism spectrum disorders (ASD). Despite its popularity, there is limited evidence in support of the diet. The purpose of this article was to identify and evaluate well-controlled studies of the GFCF diet that have been implemented with children with ASD. A review…

  11. Prevalence of Self-Reported Gluten-Related Disorders and Adherence to a Gluten-Free Diet in Salvadoran Adult Population

    Noé Ontiveros

    2018-04-01

    Full Text Available Gluten-related disorders are not considered of relevance at public health level in Central America. The prevalence of gluten-related disorders, and adherence to a gluten-free diet, remain unknown in the Central American region. We conducted a cross-sectional survey of the Central American population from San Salvador, El Salvador, to estimate the prevalence rates of self-reported gluten-related disorders and adherence to a gluten-free diet. 1326 individuals were surveyed. Self-reported prevalence rates were (95% Confidence Interval: gluten sensitivity 3.1% (2.3–4.2; physician-diagnosed celiac disease 0.15% (0.04–0.5; wheat allergy 0.75% (0.4–1.3; non-celiac gluten sensitivity 0.98% (0.5–1.6. The prevalence rate of adherence to a gluten-free diet was 7.0% (5.7–8.5. Seven self-reported physician diagnosed gluten-sensitive cases informed the co-existence of non-celiac gluten sensitivity with celiac disease and/or wheat allergy. Among the non-self-reported gluten sensitivity individuals following a gluten-free diet, 50% reported that they were seeing a health professional for gluten-free dietary advice. Gluten sensitivity is commonly reported in Salvadoran population, but some health professionals acknowledge the coexistence of wheat allergy, celiac disease, and non-celiac gluten sensitivity. Among studies at population level, the prevalence of adherence to a gluten-free diet in Salvadoran population is the highest reported until now. However, just a few of the gluten-free diet followers were doing it for health-related benefits; the others reported weight control and the perception that the diet is healthier as the main motivation for adopting such a diet.

  12. Prevalence of Self-Reported Gluten-Related Disorders and Adherence to a Gluten-Free Diet in Salvadoran Adult Population.

    Ontiveros, Noé; Rodríguez-Bellegarrigue, Cecilia Ivonne; Galicia-Rodríguez, Gerardo; Vergara-Jiménez, Marcela de Jesús; Zepeda-Gómez, Elia María; Arámburo-Galvez, Jesús Gilberto; Gracia-Valenzuela, Martina Hilda; Cabrera-Chávez, Francisco

    2018-04-18

    Gluten-related disorders are not considered of relevance at public health level in Central America. The prevalence of gluten-related disorders, and adherence to a gluten-free diet, remain unknown in the Central American region. We conducted a cross-sectional survey of the Central American population from San Salvador, El Salvador, to estimate the prevalence rates of self-reported gluten-related disorders and adherence to a gluten-free diet. 1326 individuals were surveyed. Self-reported prevalence rates were (95% Confidence Interval): gluten sensitivity 3.1% (2.3–4.2); physician-diagnosed celiac disease 0.15% (0.04–0.5); wheat allergy 0.75% (0.4–1.3); non-celiac gluten sensitivity 0.98% (0.5–1.6). The prevalence rate of adherence to a gluten-free diet was 7.0% (5.7–8.5). Seven self-reported physician diagnosed gluten-sensitive cases informed the co-existence of non-celiac gluten sensitivity with celiac disease and/or wheat allergy. Among the non-self-reported gluten sensitivity individuals following a gluten-free diet, 50% reported that they were seeing a health professional for gluten-free dietary advice. Gluten sensitivity is commonly reported in Salvadoran population, but some health professionals acknowledge the coexistence of wheat allergy, celiac disease, and non-celiac gluten sensitivity. Among studies at population level, the prevalence of adherence to a gluten-free diet in Salvadoran population is the highest reported until now. However, just a few of the gluten-free diet followers were doing it for health-related benefits; the others reported weight control and the perception that the diet is healthier as the main motivation for adopting such a diet.

  13. Health-related quality of life in adolescents with screening-detected celiac disease, before and one year after diagnosis and initiation of gluten-free diet, a prospective nested case-referent study

    Nordyke Katrina

    2013-02-01

    Full Text Available Abstract Background Celiac disease (CD is a chronic disorder in genetically predisposed individuals in which a small intestinal immune-mediated enteropathy is precipitated by dietary gluten. It can be difficult to diagnose because signs and symptoms may be absent, subtle, or not recognized as CD related and therefore not prompt testing within routine clinical practice. Thus, most people with CD are undiagnosed and a public health intervention, which involves screening the general population, is an option to find those with unrecognized CD. However, how these screening-detected individuals experience the diagnosis and treatment (gluten-free diet is not fully understood. The aim of this study is to investigate the health-related quality of life (HRQoL of adolescents with screening-detected CD before and one year after diagnosis and treatment. Methods A prospective nested case-referent study was done involving Swedish adolescents who had participated in a CD screening study when they were in the sixth grade and about 12 years old. Screening-detected adolescents (n = 103 and referents without CD who participated in the same screening (n = 483 answered questionnaires at the time of the screening and approximately one year after the screening-detected adolescents had received their diagnosis that included the EQ-5D instrument used to measure health status and report HRQoL. Results The HRQoL for the adolescents with screening-detected CD is similar to the referents, both before and one year after diagnosis and initiation of the gluten-free diet, except in the dimension of pain at follow-up. In the pain dimension at follow-up, fewer cases reported problems than referents (12.6% and 21.9% respectively, Adjusted OR 0.50, 95% CI 0.27-0.94. However, a sex stratified analysis revealed that the significant difference was for boys at follow-up, where fewer screening-detected boys reported problems (4.3% compared to referent boys (18.8% (Adjusted OR 0

  14. Obesogenic habits among children and their families in response to initiation of gluten-free diet.

    Levran, Neriya; Wilschanski, Michael; Livovsky, Jessica; Shachar, Edna; Moskovitz, Moti; Assaf-Jabrin, Lama; Shteyer, Eyal

    2018-06-01

    Initiation of a lifelong, gluten-free diet (GFD) in children with celiac disease (CD) influences the child's life in many ways. The aim of this study was to assess the influence of GFD on the child and his/her family's eating habits and lifestyle behaviors. To study this, we asked children and their parents completed the Family Eating and Activity Habits Questionnaire (FEAHQ) at the time of diagnosis of CD and at least 6 months after initiation of GFD and a questionnaires assessing symptoms related to CD and adherence to the GFD diet. We analyzed questionnaires from 40 children with CD and their families. There were 21 females, ranging in age from 4 to 15.7 years (median age 7.4 years±2.8 years). The control group comprised 15 healthy children. After initiation of GFD the family ate more junk food including snacks and candies (p = 0.05), with the significant change reported by children and fathers (p = 0.001 and 0.03 respectively). All family members in the control group had significantly less snacks. Parents and children reported a significant increase in obesogenic eating styles, such as eating from the cooking pot and eating while doing other activities (mothers, p = 0.001; fathers, 0.02; and children, 0.02 respectively). Our study shows that initiation of GFD in children with CD leads to changes in eating habits and staple food eating that may lead to a more obesogenic environment. Care givers, pediatricians, gastroenterologists, and dieticians alike should be aware of these implications and educate families towards a healthier lifestyle and diet beyond the GFD itself. What's Known: • Gluten-free diet has been shown to affect various psychosocial aspects of children with celiac disease. • Obesity and celiac are associated. What is New: • Initiation of gluten-free diet led to increased eating of junk food both in the patient and his/her family. • After initiation of GFD pro-obesogenic eating habits is increased.

  15. New Treatments for Autism: Effects of a Gluten-Free Diet on Rate of Learning.

    Grace, Jennifer B.; Velez, Denise M.; Chambliss, Catherine

    This study assessed the effects of a gluten-free diet over one year on learning patterns in three autistic children (ages 5 to 8) participating in an applied behavioral analysis program. Rates of learning for five behavioral targets 3 months, 6 months, 9 months, and 12 months after the start of the diet were compared using a within-subjects…

  16. The Effect of Oligofructose-Enriched Inulin on Faecal Bacterial Counts and Microbiota-Associated Characteristics in Celiac Disease Children Following a Gluten-Free Diet: Results of a Randomized, Placebo-Controlled Trial

    Jarocka-Cyrta, Elżbieta; Markiewicz, Lidia Hanna

    2018-01-01

    Celiac disease (CD) is associated with intestinal microbiota alterations. The administration of prebiotics could be a promising method of restoring gut homeostasis in CD. The aim of this study was to evaluate the effect of prolonged oligofructose-enriched inulin (Synergy 1) administration on the characteristics and metabolism of intestinal microbiota in CD children following a gluten-free diet (GFD). Thirty-four paediatric CD patients (mean age 10 years; 62% females) on a GFD were randomized into two experimental groups receiving Synergy 1 (10 g/day) or placebo (maltodextrin; 7 g/day) for 3 months. The quantitative gut microbiota characteristics and short-chain fatty acids (SCFAs) concentration were analysed. In addition, side effects were monitored. Generally, the administration of Synergy 1 in a GFD did not cause any side effects. After the intervention period, Bifidobacterium count increased significantly (p bacterial metabolite production in CD children. PMID:29439526

  17. Effects of a Gluten-Free Diet on Rate of Achievement in Autistic Children in an Applied Behavioral Analysis Program.

    Gemmell, Melissa; Chambliss, Catherine

    This study used both between-subjects and within-subjects analyses to examine the effects of a gluten-free diet on the academic achievement of autistic children. The between-subjects analysis included data from eight autistic children (ages 5 to 7) with four on a gluten-free diet and four serving as controls. The number of attempts needed before…

  18. Is it gluten-free? Relationship between self-reported gluten-free diet adherence and knowledge of gluten content of foods.

    Silvester, Jocelyn A; Weiten, Dayna; Graff, Lesley A; Walker, John R; Duerksen, Donald R

    2016-01-01

    To assess the relationship between self-reported adherence to a gluten-free diet (GFD) and the ability to determine correctly the appropriateness of particular foods in a GFD. Persons with celiac disease were recruited through clinics and support groups. Participants completed a questionnaire with items related to GFD information sources, gluten content of 17 common foods (food to avoid, food allowed, and food to question), GFD adherence, and demographic characteristics. Diagnosis was self-reported. The 82 respondents (88% female) had a median of 6 y GFD experience. Most (55%) reported strict adherence, 18% reported intentional gluten consumption and 21% acknowledged rare unintentional gluten consumption. Cookbooks, advocacy groups, and print media were the most commonly used GFD information sources (85-92%). No participant identified correctly the gluten content of all 17 foods; only 30% identified at least 14 foods correctly. The median score on the Gluten-Free Diet Knowledge Scale (GFD-KS) was 11.5 (interquartile ratio, 10-13). One in five incorrect responses put the respondent at risk of consuming gluten. GFD-KS scores did not correlate with self-reported adherence or GFD duration. Patient advocacy group members scored significantly higher on the GFD-KS than non-members (12.3 versus 10.6; P gluten ingestion overestimate GFD adherence. Individuals who believe they are following a GFD are not readily able to correctly identify foods that are GF, which suggests ongoing gluten consumption may be occurring, even among patients who believe they are "strictly" adherent. The role of patient advocacy groups and education to improve outcomes through improved adherence to a GFD requires further research. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Disappearance of mesenteric lymphadenopathy with gluten-free diet in celiac sprue

    de Boer, W. A.; Maas, M.; Tytgat, G. N.

    1993-01-01

    In an adult patient with untreated celiac sprue, mesenteric lymphadenopathy was detected by computerized tomography (CT). Although malignant lymphoma was suspected, the nodes disappeared after treatment with a gluten-free diet, as was documented by CT follow-up. This report demonstrates that

  20. Diabetes preventive gluten-free diet decreases the number of caecal bacteria in non-obese diabetic mice

    Hansen, Axel Kornerup; Ling, Fenjung; Anne, Kaas

    2006-01-01

    disease prevention. Methods Two groups of NOD mice from the age of 3 weeks were fed either a gluten-free diet or a standard diet. Each diabetic mouse, when diagnosed, along with a non-diabetic mouse from the same diet group and two nondiabetic mice from the alternate diet group were euthanized and sampled...... qualitatively and quantitatively substantially altered the composition of the caecal bacterial flora in NOD mice. Although Gram-positive bacteria might influence the beta cells through certain digestive products, it is more likely to assume that any effect on diabetes incidence is immunological. Copyright (c...

  1. Swedish children with celiac disease comply well with a gluten-free diet, and most include oats without reporting any adverse effects: a long-term follow-up study.

    Tapsas, Dimitrios; Fälth-Magnusson, Karin; Högberg, Lotta; Hammersjö, Jan-Åke; Hollén, Elisabet

    2014-05-01

    The only known treatment for celiac disease is a gluten-free diet (GFD), which initially meant abstention from wheat, rye, barley, and oats. Recently, oats free from contamination with wheat have been accepted in the GFD. Yet, reports indicate that all celiac disease patients may not tolerate oats. We hypothesized that celiac children comply well with a GFD and that most have included oats in their diet. A food questionnaire was used to check our patients; 316 questionnaires were returned. Mean time on the GFD was 6.9 years, and 96.8% of the children reported that they were trying to keep a strict GFD. However, accidental transgressions occurred in 263 children (83.2%). In 2 of 3 cases, mistakes took place when the patients were not at home. Symptoms after incidental gluten intake were experienced by 162 (61.6%) patients, mostly (87.5%) from the gastrointestinal tract. Small amounts of gluten (gluten consumption. Oats were included in the diet of 89.4% of the children for a mean of 3.4 years. Most (81.9%) ate purified oats, and 45.3% consumed oats less than once a week. Among those who did not consume oats, only 5.9% refrained because of symptoms. General compliance with the GFD was good. Only the duration of the GFD appeared to influence adherence to the diet. Most patients did not report adverse effects after long-term consumption of oats. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Increased Mercury Levels in Patients with Celiac Disease following a Gluten-Free Regimen

    Luca Elli

    2015-01-01

    Full Text Available Background and Aim. Although mercury is involved in several immunological diseases, nothing is known about its implication in celiac disease. Our aim was to evaluate blood and urinary levels of mercury in celiac patients. Methods. We prospectively enrolled 30 celiac patients (20 treated with normal duodenal mucosa and 10 untreated with duodenal atrophy and 20 healthy controls from the same geographic area. Blood and urinary mercury concentrations were measured by means of flow injection inductively coupled plasma mass spectrometry. Enrolled patients underwent dental chart for amalgam fillings and completed a food-frequency questionnaire to evaluate diet and fish intake. Results. Mercury blood/urinary levels were 2.4±2.3/1.0±1.4, 10.2±6.7/2.2±3.0 and 3.7±2.7/1.3±1.2 in untreated CD, treated CD, and healthy controls, respectively. Resulting mercury levels were significantly higher in celiac patients following a gluten-free diet. No differences were found regarding fish intake and number of amalgam fillings. No demographic or clinical data were significantly associated with mercury levels in biologic samples. Conclusion. Data demonstrate a fourfold increase of mercury blood levels in celiac patients following a gluten-free diet. Further studies are needed to clarify its role in celiac mechanism.

  3. What happens to food choices when a gluten-free diet is required? A prospective longitudinal population-based study among Swedish adolescent with coeliac disease and their peers.

    Kautto, E; Rydén, P J; Ivarsson, A; Olsson, C; Norström, F; Högberg, L; Carlsson, A; Hagfors, L; Hörnell, A

    2014-01-01

    A dietary survey was performed during a large screening study in Sweden among 13-year-old adolescents. The aim was to study how the intake of food groups was affected by a screening-detected diagnosis of coeliac disease (CD) and its gluten-free (GF) treatment. Food intake was reported using a FFQ, and intake reported by the adolescents who were diagnosed with CD was compared with the intake of two same-aged referent groups: (i) adolescents diagnosed with CD prior to screening; and (ii) adolescents without CD. The food intake groups were measured at baseline before the screening-detected cases were aware of their CD, and 12-18 months later. The results showed that food intakes were affected by screen-detected CD and its dietary treatment. Many flour-based foods were reduced such as pizza, fish fingers and pastries. The results also indicated that bread intake was lower before the screened diagnosis compared with the other studied groups, but increased afterwards. Specially manufactured GF products (for example, pasta and bread) were frequently used in the screened CD group after changing to a GF diet. The present results suggest that changing to a GF diet reduces the intake of some popular foods, and the ingredients on the plate are altered, but this do not necessarily include a change of food groups. The availability of manufactured GF replacement products makes it possible for adolescents to keep many of their old food habits when diagnosed with CD in Sweden.

  4. Evaluation of gastric and small bowel transit times in coeliac disease with the small bowel PillCam®: a single centre study in a non gluten-free diet adult Italian population with coeliac disease.

    Urgesi, R; Cianci, R; Bizzotto, A; Costamagna, G; Riccioni, M E

    2013-05-01

    The mechanisms underlying bowel disturbances in coeliac disease are still relatively unclear. Past reports suggested that small bowel motor abnormalities may be involved in this pathological condition; there are no studies addressing small bowel transit in coeliac disease before and after a gluten-free diet. The objective of this study was to determine whether capsule endoscopy (CE) could serve as a test for measurement of gastric and small bowel transit times in a group of symptomatic or asymptomatic coeliac patients at the time of diagnosis with respect to a control group. Thirty coeliac untreated patients and 30 age-, sex- and BMI-matched healthy controls underwent CE assessment of whole gut transit times. All subjects completed the study per protocol and experienced natural passage of the pill. No statistical significant differences between gastric emptying and small bowel transit times both in coeliac and control group were found (p = 0.1842 and p = 0.7134; C.I. 95%, respectively). No correlation was found in coeliac patients and control group between transit times and age, sex and BMI. By using the Pearson's correlation test, significant correlation emerged between gastric emptying time and small bowel transit times in coeliac disease (r = 0.1706). CE reveals unrecognized gender differences and may be a novel outpatient technique for gut transit times' assessment without exposure to radiation and for the evaluation of upper gut dysfunction in healthy patients suffering from constipation without evidence of intestinal malabsorption. Nevertheless, CE does not seem to be the most suitable method for studying gut transit times in untreated coeliac patients; this might be ascribed to the fact that CE consists of inert (non-digestible, non-absorbable) substances.

  5. Monitoring of daily gliadin intake in patients on gluten-free diets

    Gabrovská, D.; Kocna, P.; Rysová, J.; Borovská, Dana; Tlaskalová-Hogenová, Helena

    2011-01-01

    Roč. 112, č. 1 (2011), s. 5-17 ISSN 1214-6994 R&D Projects: GA MZe 1B53002; GA AV ČR 1QS500200572; GA ČR GA310/07/0414; GA MŠk 2B06155 Institutional research plan: CEZ:AV0Z50200510 Keywords : Gliadin * Gluten -free diet Subject RIV: EC - Immunology

  6. The effect of gluten-free diet on microbes in the colon

    Kopečný, Jan; Mrázek, Jakub; Fliegerová, Kateřina; Kott, T.

    2006-01-01

    Roč. 51, č. 4 (2006), s. 287-290 ISSN 0015-5632 R&D Projects: GA AV ČR 1QS500200572 Grant - others:6th Framework Program EU COOP CT 2004 508421 Institutional research plan: CEZ:AV0Z50450515 Keywords : gluten -free diet Subject RIV: FB - Endocrinology, Diabetology, Metabolism, Nutrition Impact factor: 0.963, year: 2006

  7. Adherence to a Gluten-Free Diet in Mexican Subjects with Gluten-Related Disorders: A High Prevalence of Inadvertent Gluten Intake.

    Ramírez-Cervantes, Karen Lizzette; Romero-López, Angélica Viridiana; Núñez-Álvarez, Carlos Alberto; Uscanga-Domínguez, Luis F

    2016-01-01

    The rate of compliance with a gluten-free diet in patients with gluten-related disorders is unknown in most Latin American countries. To study the adherence to a gluten-free diet of Mexican individuals with celiac disease and nonceliac gluten sensitivity at the time of their first medical and nutritional consultation at a tertiary referral center. A cross-sectional study was performed. A specific questionnaire was used to gather information on demographics, clinical condition, and self-reported adherence to a gluten-free diet, and to determine strict compliance and intentional or inadvertent gluten consumption. All questionnaires were applied by a nutritionist with expertise in gluten-related disorders. Fifty-six patients with celiac disease and 24 with non-celiac gluten sensitivity were included. Overall, 46 (57.5%) subjects perceived themselves as strictly adherent; however, inadvertent gluten intake was frequent in both celiac disease and non-celiac gluten sensitivity patients (39.2 vs. 33.3%; p = 0.2). Intentional consumption was more prevalent in subjects with celiac disease (48.8 vs. 29.1%; p = 0.048) and individuals with non-celiac gluten sensitivity showed better adherence (37.5 vs. 12.5%; p = 0.035). The importance of a gluten-free diet is underestimated by Mexican patients with celiac disease. The role of a team with expertise in gluten-related disorders is essential to identify inadvertent gluten intake.

  8. The Gluten-Free Diet: Testing Alternative Cereals Tolerated by Celiac Patients

    Carolina Sousa

    2013-10-01

    Full Text Available A strict gluten-free diet (GFD is the only currently available therapeutic treatment for patients with celiac disease, an autoimmune disorder of the small intestine associated with a permanent intolerance to gluten proteins. The complete elimination of gluten proteins contained in cereals from the diet is the key to celiac disease management. However, this generates numerous social and economic repercussions due to the ubiquity of gluten in foods. The research presented in this review focuses on the current status of alternative cereals and pseudocereals and their derivatives obtained by natural selection, breeding programs and transgenic or enzymatic technology, potential tolerated by celiac people. Finally, we describe several strategies for detoxification of dietary gluten. These included enzymatic cleavage of gliadin fragment by Prolyl endopeptidases (PEPs from different organisms, degradation of toxic peptides by germinating cereal enzymes and transamidation of cereal flours. This information can be used to search for and develop cereals with the baking and nutritional qualities of toxic cereals, but which do not exacerbate this condition.

  9. Changes in Rate of Learning in Autistic Children Following 9 Months on a Gluten-Free Diet.

    Pontino, Jamie Lyn; Schaal, Kelly; Chambliss, Catherine

    This report discusses the outcomes of a study that investigated the effects of a gluten-free diet on three males with autism between the ages of 5 to 8 years old. All subjects were also participants in prior studies on the effects of the gluten-free diet on the learning processes of children with autism in an applied behavioral analysis program.…

  10. Decrease by 50% of plasma IgA tissue transglutaminase antibody concentrations within 2 months after start of gluten-free diet in children with celiac disease used as a confirming diagnostic test

    Lund, Flemming; Hermansen, Mette N; Pedersen, Merete F

    2016-01-01

    BACKGROUND: Histological examination of small bowel biopsies is normally the gold standard for the diagnosis of celiac disease (CD). The objective of this study was to investigate whether the rate of decreases in elevated plasma IgA tissue transglutaminase antibody (IgA-tTG) and/or IgG deamidated...... gliadin peptides antibody (IgG - DGP) concentrations could be used as a confirming test for CD in children on a gluten-free diet (GFD) when biopsy was omitted in the diagnostic process. METHODS: In this retrospective study we compared children (≤18 years old) with a CD-confirming biopsy (n = 16......) to children without a biopsy (n = 18). After initiation of GFD the antibody half-life (the time (T½) when the antibody concentration is 50% decreased) was determined in all children. RESULTS: Children with a biopsy (IgA-tTG, T½ = 1.9 months; IgG - DGP, T½ = 2.2 months) and children without a biopsy (Ig...

  11. The Effect of Oligofructose-Enriched Inulin on Faecal Bacterial Counts and Microbiota-Associated Characteristics in Celiac Disease Children Following a Gluten-Free Diet: Results of a Randomized, Placebo-Controlled Trial.

    Drabińska, Natalia; Jarocka-Cyrta, Elżbieta; Markiewicz, Lidia Hanna; Krupa-Kozak, Urszula

    2018-02-12

    Celiac disease (CD) is associated with intestinal microbiota alterations. The administration of prebiotics could be a promising method of restoring gut homeostasis in CD. The aim of this study was to evaluate the effect of prolonged oligofructose-enriched inulin (Synergy 1) administration on the characteristics and metabolism of intestinal microbiota in CD children following a gluten-free diet (GFD). Thirty-four paediatric CD patients (mean age 10 years; 62% females) on a GFD were randomized into two experimental groups receiving Synergy 1 (10 g/day) or placebo (maltodextrin; 7 g/day) for 3 months. The quantitative gut microbiota characteristics and short-chain fatty acids (SCFAs) concentration were analysed. In addition, side effects were monitored. Generally, the administration of Synergy 1 in a GFD did not cause any side effects. After the intervention period, Bifidobacterium count increased significantly ( p < 0.05) in the Synergy 1 group. Moreover, an increase in faecal acetate and butyrate levels was observed in the prebiotic group. Consequently, total SCFA levels were 31% higher than at the baseline. The presented trial shows that Synergy 1 applied as a supplement of a GFD had a moderate effect on the qualitative characteristics of faecal microbiota, whereas it stimulated the bacterial metabolite production in CD children.

  12. The Effect of Oligofructose-Enriched Inulin on Faecal Bacterial Counts and Microbiota-Associated Characteristics in Celiac Disease Children Following a Gluten-Free Diet: Results of a Randomized, Placebo-Controlled Trial

    Natalia Drabińska

    2018-02-01

    Full Text Available Celiac disease (CD is associated with intestinal microbiota alterations. The administration of prebiotics could be a promising method of restoring gut homeostasis in CD. The aim of this study was to evaluate the effect of prolonged oligofructose-enriched inulin (Synergy 1 administration on the characteristics and metabolism of intestinal microbiota in CD children following a gluten-free diet (GFD. Thirty-four paediatric CD patients (mean age 10 years; 62% females on a GFD were randomized into two experimental groups receiving Synergy 1 (10 g/day or placebo (maltodextrin; 7 g/day for 3 months. The quantitative gut microbiota characteristics and short-chain fatty acids (SCFAs concentration were analysed. In addition, side effects were monitored. Generally, the administration of Synergy 1 in a GFD did not cause any side effects. After the intervention period, Bifidobacterium count increased significantly (p < 0.05 in the Synergy 1 group. Moreover, an increase in faecal acetate and butyrate levels was observed in the prebiotic group. Consequently, total SCFA levels were 31% higher than at the baseline. The presented trial shows that Synergy 1 applied as a supplement of a GFD had a moderate effect on the qualitative characteristics of faecal microbiota, whereas it stimulated the bacterial metabolite production in CD children.

  13. The influence of a short-term gluten-free diet on the human gut microbiome.

    Bonder, Marc Jan; Tigchelaar, Ettje F; Cai, Xianghang; Trynka, Gosia; Cenit, Maria C; Hrdlickova, Barbara; Zhong, Huanzi; Vatanen, Tommi; Gevers, Dirk; Wijmenga, Cisca; Wang, Yang; Zhernakova, Alexandra

    2016-04-21

    A gluten-free diet (GFD) is the most commonly adopted special diet worldwide. It is an effective treatment for coeliac disease and is also often followed by individuals to alleviate gastrointestinal complaints. It is known there is an important link between diet and the gut microbiome, but it is largely unknown how a switch to a GFD affects the human gut microbiome. We studied changes in the gut microbiomes of 21 healthy volunteers who followed a GFD for four weeks. We collected nine stool samples from each participant: one at baseline, four during the GFD period, and four when they returned to their habitual diet (HD), making a total of 189 samples. We determined microbiome profiles using 16S rRNA sequencing and then processed the samples for taxonomic and imputed functional composition. Additionally, in all 189 samples, six gut health-related biomarkers were measured. Inter-individual variation in the gut microbiota remained stable during this short-term GFD intervention. A number of taxon-specific differences were seen during the GFD: the most striking shift was seen for the family Veillonellaceae (class Clostridia), which was significantly reduced during the intervention (p = 2.81 × 10(-05)). Seven other taxa also showed significant changes; the majority of them are known to play a role in starch metabolism. We saw stronger differences in pathway activities: 21 predicted pathway activity scores showed significant association to the change in diet. We observed strong relations between the predicted activity of pathways and biomarker measurements. A GFD changes the gut microbiome composition and alters the activity of microbial pathways.

  14. Biomarkers to Monitor Gluten-Free Diet Compliance in Celiac Patients

    María de Lourdes Moreno

    2017-01-01

    Full Text Available Gluten-free diet (GFD is the only treatment for celiac disease (CD. There is a general consensus that strict GFD adherence in CD patients leads to full clinical and histological remission accompanied by improvement in quality of life and reduced long-term complications. Despite the importance of monitoring the GFD, there are no clear guidelines for assessing the outcome or for exploring its adherence. Available methods are insufficiently accurate to identify occasional gluten exposure that may cause intestinal mucosal damage. Serological tests are highly sensitive and specific for diagnosis, but do not predict recovery and are not useful for follow-up. The use of serial endoscopies, it is invasive and impractical for frequent monitoring, and dietary interview can be subjective. Therefore, the detection of gluten immunogenic peptides (GIP in feces and urine have been proposed as new non-invasive biomarkers to detect gluten intake and verify GFD compliance in CD patients. These simple immunoassays in human samples could overcome some key unresolved scientific and clinical problems in CD management. It is a significant advance that opens up new possibilities for the clinicians to evaluate the CD treatment, GFD compliance, and improvement in the quality of life of CD patients.

  15. Salivary and fecal microbiota and metabolome of celiac children under gluten-free diet.

    De Angelis, Maria; Vannini, Lucia; Di Cagno, Raffaella; Cavallo, Noemi; Minervini, Fabio; Francavilla, Ruggiero; Ercolini, Danilo; Gobbetti, Marco

    2016-12-19

    Celiac disease (CD) is an inflammatory autoimmune disorder resulting from the combination of genetic predisposition and gluten ingestion. A life-long gluten free diet (GFD) is the only therapeutic approach. Dysbiosis, which can precede the CD pathogenesis and/or persist when subjects are on GFD, is reviewed and discussed. Salivary microbiota and metabolome differed between healthy and celiac children treated under GFD (T-CD) for at least two years. The type of GFD (African- vs Italian-style) modified the microbiota and metabolome of Saharawi T-CD children. Different studies showed bacterial dysbiosis at duodenal and/or fecal level of patients with active untreated CD (U-CD) and T-CD compared to healthy subjects. The ratio of protective anti-inflammatory bacteria such as Lactobacillus-Bifidobacterium to potentially harmful Bacteroides-Enterobacteriaceae was the lowest in U-CD and T-CD children. In agreement with dysbiosis, serum, fecal and urinary metabolome from U-CD and T-CD patients showed altered levels of free amino acids and volatile organic compounds. However, consensus across studies defining specific bacteria and metabolites in U-CD or T-CD patients is still lacking. Future research efforts are required to determine the relationships between CD and oral and intestinal microbiotas to improve the composition of GFD for restoring the gut dysbiosis as a preventative or therapeutic approach for CD. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Assessing the proposed association between DED and gluten-free diet introduction in celiac children.

    de Queiroz, Alexandra Mussolino; Arid, Juliana; de Carvalho, Fabrício Kitazono; da Silva, Raquel Assed Bezerra; Küchler, Erika Calvano; Sawamura, Regina; da Silva, Lea Assed Bezerra; Nelson-Filho, Paulo

    2017-07-01

    A strong association between celiac disease (CD) and dental enamel defects (DEDs) have been extensively reported, however, the nature of this relationship is still unclear. The aim of this study was to evaluate DEDs phenotype in CD individuals according to the time they were introduced to a gluten-free diet (GFD). Forty-five CD individuals were examined by a pediatric dentist. DEDs were classified according to the type of affected teeth. CD individuals were classified into two groups (with or without DEDs) and the differences between these groups were tested using chi-square or Fisher´s exact tests and t-test to compare differences between means. The Pearson coefficient test was used to evaluate the degree of the correlation between the age of GFD introduction and number of affected teeth. Individuals with MIH were introduced earlier to the GFD (p = 0.038). An association was also observed for molar DED (p = 0.013). In conclusion, our study suggested an association between a specific type of DED and the time that CD individuals were introduced to a GFD. © 2017 Special Care Dentistry Association and Wiley Periodicals, Inc.

  17. The effect of oligofructose-enriched inulin supplementation on gut microbiota, nutritional status and gastrointestinal symptoms in paediatric coeliac disease patients on a gluten-free diet: study protocol for a pilot randomized controlled trial.

    Krupa-Kozak, Urszula; Drabińska, Natalia; Jarocka-Cyrta, Elżbieta

    2017-08-22

    A lifelong gluten-free diet (GFD) is regarded as the only proven and accepted therapy for coeliac disease (CD). However, even patients who strictly follow a GFD often suffer from intestinal symptoms and malabsorption. Selective modulation of intestinal microbiota with prebiotics could remedy various symptoms associated with CD. The use of prebiotics in the treatment of intestinal diseases remains insufficiently investigated. To our knowledge, this study makes the first attempt to evaluate the effect of prebiotic supplementation on gastrointestinal symptoms and nutritional status of children with CD. We hypothesized that adherence to a GFD supplemented with oligofructose-enriched inulin (Synergy 1) would deliver health benefits to children suffering from CD without any side effects, and that it would alleviate intestinal inflammation, restore and stabilize gut microbial balance and reverse nutritional deficiencies through enhanced absorption of vitamins and minerals. A randomized, placebo-controlled clinical trial was designed to assess the impact of the Synergy 1 on paediatric CD patients following a GFD. We randomized 34 children diagnosed with CD into an intervention group receiving 10 g of the Synergy 1 supplement daily and a placebo group (receiving maltodextrin) during a 12-week nutritional intervention. Selected biochemical parameters, nutritional status and the characteristics of faecal bacteria will be determined in samples collected before and after the intervention. Analysis of vitamins and amino acids concentration in biological fluids will allow to assess the dietary intake of crucial nutrients. The compliance to a GFD will be confirmed by a Food Frequency Questionnaire (FFQ-6) and the analysis of serum anti-tissue transglutaminase and faecal gluten immunogenic peptides (GIP). The identification of the beneficial effects of the Synergy 1 supplement on children with CD could have important implications for nutritional recommendations for CD patients and

  18. Living Gluten Free

    ... Disease" Articles Celiac Disease Changes Everything / What is Celiac Disease? / Symptoms, Diagnosis & Treatment / Four Inches and Seven Pounds… / Learning to Live Well with Celiac Disease / Living Gluten-Free Spring 2015 Issue: Volume 10 ...

  19. Self-Reported Prevalence of Symptomatic Adverse Reactions to Gluten and Adherence to Gluten-Free Diet in an Adult Mexican Population.

    Ontiveros, Noe; López-Gallardo, Jesús A; Vergara-Jiménez, Marcela J; Cabrera-Chávez, Francisco

    2015-07-21

    The prevalence of symptomatic adverse reactions to gluten and adherence to gluten-free diet in Latin American countries is unknown. These measurements are strongly linked to gluten-related disorders. This work aimed to estimate the prevalence of adverse reactions to oral gluten and the adherence to gluten-free diet in the adult Mexican population. To reach this aim, a self-administered questionnaire was designed and tested for clarity/comprehension and reproducibility. Then, a self-administered questionnaire-based cross-sectional study was conducted in the Mexican population. The estimated prevalence rates were (95% CI): 11.9% (9.9-13.5) and 7.8 (6.4-9.4) for adverse and recurrent adverse reactions to gluten respectively; adherence to gluten-free diet 3.7% (2.7-4.8), wheat allergy 0.72% (0.38-1.37); celiac disease 0.08% (0.01-0.45), and NCGS 0.97% (0.55-1.68). Estimated pooled prevalence of self-reported physician-diagnosis of gluten-related disorders was 0.88% (0.49-1.5), and 93.3% respondents reported adherence to gluten-free diet without a physician-diagnosis of gluten-related disorders. Symptom comparisons between those who reported recurrent adverse reactions to gluten and other foods showed statistically significant differences for bloating, constipation, and tiredness (p Gluten-related disorders may be underdiagnosed in the Mexican population and most people adhering to a gluten-free diet are doing it without proper diagnostic work-up of these disorders, and probably without medical/dietician advice.

  20. Self-Reported Prevalence of Symptomatic Adverse Reactions to Gluten and Adherence to Gluten-Free Diet in an Adult Mexican Population

    Noe Ontiveros

    2015-07-01

    Full Text Available The prevalence of symptomatic adverse reactions to gluten and adherence to gluten-free diet in Latin American countries is unknown. These measurements are strongly linked to gluten-related disorders. This work aimed to estimate the prevalence of adverse reactions to oral gluten and the adherence to gluten-free diet in the adult Mexican population. To reach this aim, a self-administered questionnaire was designed and tested for clarity/comprehension and reproducibility. Then, a self-administered questionnaire-based cross-sectional study was conducted in the Mexican population. The estimated prevalence rates were (95% CI: 11.9% (9.9–13.5 and 7.8 (6.4–9.4 for adverse and recurrent adverse reactions to gluten respectively; adherence to gluten-free diet 3.7% (2.7–4.8, wheat allergy 0.72% (0.38–1.37; celiac disease 0.08% (0.01–0.45, and NCGS 0.97% (0.55–1.68. Estimated pooled prevalence of self-reported physician-diagnosis of gluten-related disorders was 0.88% (0.49–1.5, and 93.3% respondents reported adherence to gluten-free diet without a physician-diagnosis of gluten-related disorders. Symptom comparisons between those who reported recurrent adverse reactions to gluten and other foods showed statistically significant differences for bloating, constipation, and tiredness (p < 0.05. Gluten-related disorders may be underdiagnosed in the Mexican population and most people adhering to a gluten-free diet are doing it without proper diagnostic work-up of these disorders, and probably without medical/dietician advice.

  1. A possible role for ghrelin, leptin, brain-derived neurotrophic factor and docosahexaenoic acid in reducing the quality of life of coeliac disease patients following a gluten-free diet.

    Russo, Francesco; Chimienti, Guglielmina; Clemente, Caterina; Ferreri, Carla; Orlando, Antonella; Riezzo, Giuseppe

    2017-03-01

    A gluten-free diet (GFD) has been reported to negatively impact the quality of life (QoL) of coeliac disease (CD) patients. The gut-brain axis hormones ghrelin and leptin, with the brain-derived neurotrophic factor (BDNF), may affect QoL of CD patients undergoing GFD. Our aims were to evaluate whether: (a) the circulating concentrations of leptin, ghrelin and BDNF in CD patients were different from those in healthy subjects; (b) GFD might induce changes in their levels; (c) BDNF Val66Met polymorphism variability might affect BDNF levels; and (d) serum BDNF levels were related to dietary docosahexaenoic acid (DHA) as a neurotrophin modulator. Nineteen adult coeliac patients and 21 healthy controls were included. A QoL questionnaire was administered, and serum concentrations of ghrelin, leptin, BDNF and red blood cell membrane DHA levels were determined at the enrolment and after 1 year of GFD. BDNF Val66Met polymorphism was analysed. Results from the questionnaire indicated a decline in QoL after GFD. Ghrelin and leptin levels were not significantly different between groups. BDNF levels were significantly (p = 0.0213) lower in patients after GFD (22.0 ± 2.4 ng/ml) compared to controls (31.2 ± 2.2 ng/ml) and patients at diagnosis (25.0 ± 2.5 ng/ml). BDNF levels correlated with DHA levels (p = 0.008, r = 0.341) and the questionnaire total score (p = 0.041, r = 0.334). Ghrelin and leptin seem to not be associated with changes in QoL of patients undergoing dietetic treatment. In contrast, a link between BDNF reduction and the vulnerability of CD patients to psychological distress could be proposed, with DHA representing a possible intermediate.

  2. Bio-physical characteristics of gastrointestinal mucosa of celiac patients: comparison with control subjects and effect of gluten free diet-

    Villanacci Vincenzo

    2011-11-01

    Full Text Available Abstract Background Intestinal mucosa is leaky in celiac disease (CD, and this alteration may involve changes in hydrophobicity of the mucus surface barrier in addition to alteration of the epithelial barrier. The aims of our study were i to compare duodenal hydrophobicity as an index of mucus barrier integrity in CD patients studied before (n = 38 and during gluten- free diet (GFD, n = 68, and in control subjects (n = 90, and ii to check for regional differences of hydrophobicity in the gastro-intestinal tract. Methods Hydrophobicity was assessed by measurement of contact angle (CA (Rame Hart 100/10 goniometer generated by a drop of water placed on intestinal mucosal biopsies. Results CA (mean ± SD of distal duodenum was significantly lower in CD patients (56° ± 10° than in control subjects (69° ± 9°, p corpus > rectum > duodenum > oesophagus > ileum. Conclusions We conclude that the hydrophobicity of duodenal mucous layer is reduced in CD patients, and that the resulting decreased capacity to repel luminal contents may contribute to the increased intestinal permeability of CD. This alteration mirrors the severity of the mucosal lesions and is not completely reverted by gluten-free diet. Intestinal hydrophobicity exhibits regional differences in the human intestinal tract.

  3. Nutritional Impact of a Gluten-Free Casein-Free Diet in Children with Autism Spectrum Disorder

    Marí-Bauset, Salvador; Llopis-González, Agustín; Zazpe, Itziar; Marí-Sanchis, Amelia; Suárez-Varela, María Morales

    2016-01-01

    We compared anthropometric values, nutrient intake, the Healthy Eating Index and food variety in children with autism spectrum disorder (ASD), 20 on a gluten-free casein-free (GFCF) diet and 85 on a regular diet in Valencia (Spain) using 3-days food diaries. Those on the GFCF diet had a lower weight, body mass index, and total energy, pantothenic…

  4. Celiac disease and school food service in Piedmont Region: Evaluation of gluten-free meal.

    Bioletti, L; Capuano, M T; Vietti, F; Cesari, L; Emma, L; Leggio, K; Fransos, L; Marzullo, A; Ropolo, S; Strumia, C

    2016-01-01

    The Law 123/2005 recognizes celiac disease as a social disease and so Ministry of Public Health annually allocates specific resources to Regions for managing gluten-free meals in school canteens. Therefore in 2009 Piedmont Region approved a specific project, in collaboration with Food Hygiene and Nutrition Department (SIAN) of several ASL (Local Health Authority), including ASL TO3 as regional leader, and the "Italian Celiac Association - Piedmont and Valle d'Aosta". This project was intended to facilitate the natural integration of celiac people in social life. A retrospective analysis of data has been carried out to assess the management of gluten- free meal of school food services in Piedmont Region in 2010. Furthermore the intervention efficacy has been evaluated comparing the critical points observed in 2010 and 2012. The object of the study includes primary and secondary schools that have provided gluten-free food service in Piedmont Region. These school were examined by SIAN staff. (the examination included the check of hygienic aspects and qualitative assessment of the meal). The data were collected using the same checklist throughout the region. All data were included in the unified regional system ("Reteunitaria"). The results show that 29% of the sampled schools (277) are acceptable in all eight sections (supply, storage, process analysis, equipment check, packaging and transport, distribution of meals, self-control plan and qualitative assessment), whereas 71% are inadequate for at least one of the profiles (60% does not perform the qualitative valuation of service) and in 18% of schools three to seven insufficiencies are observed. Correlations between the number of total insufficiencies and the most critical sections of the check list were performed (with lower scores in "good") such as process analysis, distribution of meals, self-control plan and qualitative assessment. The analysis process has achieved a high score in the field of deficiency for at

  5. Addendum to "Gluten-Free and Casein-Free Diets in Treatment of Autism Spectrum Disorders: A Systematic Review"

    Mulloy, Austin; Lang, Russell; O'Reilly, Mark; Sigafoos, Jeff; Lancioni, Giulio; Rispoli, Mandy

    2011-01-01

    Shortly after the publication of our literature review on gluten-free and casein-free (GFCF) diets in the treatment of autism spectrum disorders (ASD; Mulloy et al., 2010), Whiteley et al. (2010) published the results of experimental evaluation of a GFCF diet. To update our previous literature review, we herein provide an analysis of the Whiteley…

  6. Profile of volatile organic compounds in exhaled breath changes as a result of gluten-free diet

    Baranska, Agnieszka; Tigchelaar, Ettje; Smolinska, Agnieszka; Dallinga, Jan W.; Moonen, Edwin J. C.; Dekens, Jackie A. M.; Wijmenga, Cisca; Zhernakova, Alexandra; van Schooten, Frederik J.

    In the present longitudinal study, we followed volatile organic compounds (VOCs) excreted in exhaled breath of 20 healthy individuals over time, while adhering to a gluten-free diet for 4 weeks prior to adherence to a normal diet. We used gas chromatography coupled with mass spectrometry

  7. Decrease in lactobacilli in the intestinal microbiota of celiac children with a gluten-free diet, and selection of potentially probiotic strains.

    Lorenzo Pisarello, María J; Vintiñi, Elisa O; González, Silvia N; Pagani, Florencia; Medina, Marcela S

    2015-01-01

    The intestinal microbiota would be implicated in pathology associated with celiac disease caused by an abnormal immune system reaction against gluten present in cereal grains. The objectives of this work were to detect through basic methods the changes in the composition of the most common genera of bacteria from the intestinal microbiota of symptom-free celiac disease children with a gluten-free diet compared with healthy children from Tucumán and to select lactobacilli (Lb) strains with probiotic potential from the feces of healthy children. Results demonstrated that the feces of celiac children with a gluten-free diet showed significantly lower counts of Lb (P LC4) showed the highest percentage of autoaggregation while Lactobacillus paracasei (LC9) showed high hydrophobicity. Based on these results, LC4 and LC9 were selected, and their use as potential probiotic strains to improve signs and symptoms associated with celiac disease is discussed. This is the first study performed in Argentina concerning the relationship between intestinal microbiota and celiac disease in celiac children with a gluten-free diet. In addition, the development of a probiotic food addressed towards celiac patients and designed with Lb isolated from the feces of healthy children from our province represents a promising alternative to improve the quality of life of celiac patients.

  8. "But we're not hypochondriacs": the changing shape of gluten-free dieting and the contested illness experience.

    Moore, Lauren Renée

    2014-03-01

    "Gluten free" exploded onto the American foodscape in recent years: as of January 2013, 30 percent of U.S. adults reported reducing or eliminating gluten in their diets. How do individuals participate in the expansion of gluten-free dieting, and what are the implications of that expansion? This article is based on 31 in-depth, semi-structured interviews conducted between May and October 2012 with gluten-free and -restricted persons. I identify three interrelated factors contributing to the expansion of gluten-free dieting among non-celiacs. Participants broaden the lay understanding of gluten-related disorders, undermine biomedical authority, and diagnose others. Such participant-driven change, termed self-ascriptive looping, is one factor in the diet's rapid popularization. I show how participants question the doctor-patient relationship and increase social contestability for other dieters. My findings challenge previous work on contested illness and suggest food intolerances may require a reconceptualization of contested illness experience. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. The Gluten-Free, Casein-Free Diet in Autism: Results of a Preliminary Double Blind Clinical Trial

    Elder, Jennifer Harrison; Shankar, Meena; Shuster, Jonathan; Theriaque, Douglas; Burns, Sylvia; Sherrill, Lindsay

    2006-01-01

    This study tested the efficacy of a gluten-free and casein-free (GFCF) diet in treating autism using a randomized, double blind repeated measures crossover design. The sample included 15 children aged 2-16 years with autism spectrum disorder. Data on autistic symptoms and urinary peptide levels were collected in the subjects' homes over the 12…

  10. Gluten-Free and Casein-Free Diets in the Treatment of Autism Spectrum Disorders: A Systematic Review

    Mulloy, Austin; Lang, Russell; O'Reilly, Mark; Sigafoos, Jeff; Lancioni, Giulio; Rispoli, Mandy

    2010-01-01

    This paper systematically reviews research on the effects of gluten-free and/or casein-free (GFCF) diets in the treatment of ASD. Database, hand, and ancestry searches identified 15 articles for review. Each study was analyzed and summarized in terms of (a) participants, (b) specifics of the intervention, (c) dependent variables, (d) results, and…

  11. Human leukocyte antigen genetics and clinical features of self-treated patients on a gluten-free diet.

    Coburn, John A; Vande Voort, Jennifer L; Lahr, Brian D; Van Dyke, Carol T; Kroning, Cynthia M; Wu, Tsung-Teh; Gandhi, Manish J; Murray, Joseph A

    2013-01-01

    Increasingly, people start a gluten-free diet (GFD) without a clear celiac disease (CD) diagnosis. Human leukocyte antigen (HLA) genotyping is useful in ruling out CD in patients with equivocal results of serologic testing or small-bowel biopsy (SBB), but its utility and the clinical features of patients on self-treated GFD (ST-GFD) are largely unknown. Retrospective study of single tertiary care center cohort compared 137 patients on ST-GFD and 443 patients with well-defined CD. We compared HLA genotype, symptoms, serologic and SBB results, and response to GFD between the 2 groups. Analysis used univariate logistic regression modeling, adjusted for age and sex. Patients with ST-GFD presented more often with diarrhea (Pgluten sensitivity may play a role.

  12. Long term effects of gluten-free diet in non-celiac wheat sensitivity.

    Tovoli, Francesco; Granito, Alessandro; Negrini, Giulia; Guidetti, Elena; Faggiano, Chiara; Bolondi, Luigi

    2017-12-26

    Information about the clinical outcome of patients with non-celiac wheat sensitivity (NCWS) treated with gluten-free diet (GFD) derive from studies assessing the symptom response in the first few weeks of treatment. We aimed to evaluate the clinical response to the GFD and the quality of life (QoL) of NCWS patients in the long term. Forty-four NCWS (diagnosed according to the Salerno criteria) participated in the study. Participants rated their symptoms according to a 0-10 scale patients and filled in a QoL questionnaire (CDQ) before the beginning of the GFD and during a follow-up evaluation performed after at least one year. To assess the reliability of the questionnaire we also included a control group of 43 matched patients with celiac disease (CD). Upon diagnosis, NCWS patients had a high prevalence of intestinal and extraintestinal symptoms. Also, most symptoms were described as severe and the QoL questionnaire showed high scores. On follow-up, both prevalence and severity of the most common symptoms were significantly reduced. However, persistent intestinal and extraintestinal symptoms of mild severity were found in 65.9 and 72.7% of NCWS patients. In comparison, in the CD group, the prevalence was lower (32.6 and 23.2% respectively) and consistent with previous studies. The analyses of the determinant of QoL showed that, upon diagnosis, NCWS patients had higher scores in the CDQ "gastrointestinal symptoms" (p < 0.001), "emotional aspects" (p < 0.001) and "social problems" (p < 0.001) subclasses compared to CD patients. After the GFD, NCWS and CD patients shared similar scores in all of the subclasses. A significant proportion of NCWS patients still complains of intestinal and extraintestinal symptoms, even if significantly attenuated by the GFD, even years after the diagnosis. A comprehensive nutritional evaluation of these patients is required to further improve their symptoms and their QoL. Copyright © 2017 Elsevier Ltd and European Society for

  13. The Gluten-Free/Casein-Free Diet: A Double-Blind Challenge Trial in Children with Autism

    Hyman, Susan L.; Stewart, Patricia A.; Foley, Jennifer; Cain, Usa; Peck, Robin; Morris, Danielle D.; Wang, Hongyue; Smith, Tristram

    2016-01-01

    To obtain information on the safety and efficacy of the gluten-free/casein-free (GFCF) diet, we placed 14 children with autism, age 3-5 years, on the diet for 4-6 weeks and then conducted a double-blind, placebo-controlled challenge study for 12 weeks while continuing the diet, with a 12-week follow-up. Dietary challenges were delivered via weekly…

  14. Gambaran Pola Perilaku Anak Penyandang Autisme dengan Penerapan Diet Gluten Free-casein Free (Gfcf) di Sekolah Inklusi Cahaya Bangsa Khatulistiwa Pontianak

    Yesi Putri Ari Hartiningrum

    2013-01-01

    Diet Gluten-Free Casein-Free (GFCF) merupakan salahsatu terapi yang kontroversial pada gangguan autistik. Tujuan: Penelitianini bertujuan mengetahui gambaran pola perilaku pada anak penyandangautisme dengan penerapan diet GFCF.

  15. Accumulation of Heavy Metals in People on a Gluten-Free Diet.

    Raehsler, Stephanie L; Choung, Rok Seon; Marietta, Eric V; Murray, Joseph A

    2018-02-01

    Specific foods such as fish and rice have high concentrations of metals such as arsenic, mercury, lead, cadmium, and cobalt. Many gluten-free diets (GFDs) include these foods, so we evaluated whether a GFD was associated with increased metal bioaccumulation. We performed a population-based, cross-sectional study using data collected from the National Health and Nutrition Examination Survey (NHANES), from 2009 through 2012, collecting information on the diagnosis of celiac disease and adherence to a GFD. We tested NHANES blood samples to identify individuals with undiagnosed celiac disease, using assays for immunoglobulin A tissue transglutaminase followed by a confirmatory test for endomysial antibody. Among a total of 11,354 NHANES participants, celiac disease was diagnosed in 55 participants, based on test results or a reported clinical diagnosis. We collected NHANES survey data on blood levels of lead, mercury, and cadmium from subjects who were on a GFD (n = 115) and participants who were not on a GFD (n = 11,239). Levels of total arsenic in urine samples were available from 3901 subjects not following a GFD and 32 individuals following a GFD. NHANES participants were asked questions about fish and shellfish consumption. We performed multivariate logistic regression analyses to associate gluten-related conditions with blood concentrations of mercury, cadmium, and lead and urine concentration of total arsenic, adjusting for demographic characteristics, as well as for rice consumption or seafood intake. Geometric means were reported for urinary concentrations of total arsenic and blood concentrations of mercury, cadmium, and lead for demographic groups and subjects with gluten-related conditions (subjects without celiac disease who avoid gluten). Persons following a GFD had significantly increased total blood mercury levels (1.37 mcg/L) compared with persons not on a GFD (0.93 mcg/L) (P = .008), as well as increased blood levels of lead (1.42 vs 1.13 mcg/L; P

  16. Going Gluten-Free: Life with Celiac Disease

    ... diagnose it. Diagnosis can often be difficult, as celiac disease symptoms are often similar to those of other conditions. ... of Diabetes and Digestive and Kidney Diseases (NIDDK) Celiac Disease or Gluten Sensitivity? Some of the symptoms of gluten sensitivity (also known as gluten intolerance) ...

  17. Gluten-free but also gluten-enriched (gluten+) diet prevent diabetes in NOD mice; the gluten enigma in type 1 diabetes.

    Funda, David P; Kaas, Anne; Tlaskalová-Hogenová, Helena; Buschard, Karsten

    2008-01-01

    Environmental factors such as nutrition or exposure to infections play a substantial role in the pathogenesis of type 1 diabetes (T1D). We have previously shown that gluten-free, non-purified diet largely prevented diabetes in non-obese diabetic (NOD) mice. In this study we tested hypothesis that early introduction of gluten-enriched (gluten+) diet may increase diabetes incidence in NOD mice. Standard, gluten-free, gluten+ modified Altromin diets and hydrolysed-casein-based Pregestimil diet were fed to NOD females and diabetes incidence was followed for 310 days. Insulitis score and numbers of gut mucosal lymphocytes were determined in non-diabetic animals. A significantly lower diabetes incidence (p gluten-free diet (5.9%, n = 34) and Pregestimil diet (10%, n = 30) compared to mice on the standard Altromin diet (60.6%, n = 33). Surprisingly, gluten+ diet also prevented diabetes incidence, even at the level found with the gluten-free diet (p gluten+, gluten-free, Pregestimil) diets, did that slightly later compared to those on the standard diet. Lower insulitis score compared to control mice was found in non-diabetic NOD mice on the gluten-free, and to a lesser extent also gluten+ and Pregestimil diets. No substantial differences in the number of CD3(+), TCR-gammadelta(+), and IgA(+) cells in the small intestine were documented. Gluten+ diet prevents diabetes in NOD mice at the level found with the non-purified gluten-free diet. Possible mechanisms of the enigmatic, dual effect of dietary gluten on the development of T1D are discussed. 2007 John Wiley & Sons, Ltd

  18. Gluten-free and casein-free diets in the treatment of autism

    Andreas Reissmann

    2014-08-01

    Full Text Available Background: Autism is a complex psychiatric disorder characterized by three core symptoms, i.e. impairments in social interaction, restricted patterns of behavior and impairments in communication. In the framework of the “opioid excess theory”, the disorder symptoms are compared to the behavioral effects of opiates. Based on this, a possible nutritional basis of autism has been proposed, hypothesizing that certain food proteins such as gluten and casein can be transformed to opioid peptides during digestion. These peptides might eventually be able to enter the blood stream and act upon the central nervous system. As a consequence, a diet low in such proteins has been hypothesized to ameliorate the behavioral symptoms of autistic children. Objective: The scope of this review was to analyze the effects of gluten-free and casein-free (GFCF diets on children with autism, as well as to provide information concerning additional aspects related to the GFCF diet in autism. Methods: A literature search was conducted including scientific publications up until December 2013. Search results were screened for any kind of GFCF dietary intervention as well as surveys dealing with GFCF as a treatment for autism. Results: A review of survey data shows that up to 25 % of parents of affected children report on current use of a GFCF diet. The majority of identified studies evaluating GFCF diet outcomes failed to meet basic methodological standards of interventional science. Comparison of study results did not show any clear-cut results, with a substantial proportion of studies failing to show any positive dietary effect. The results of more sophisticated trials were far from equivocal and the studies differed by many methodological aspects. Some variables such as information source and trial duration seemed to affect outcome. Conclusions: Evidence for the effectiveness of the GFCF diet in the treatment of autism is sparse. Rigorous scientific evaluations partly

  19. Prevalence of antigliadin IgA antibodies in psoriasis vulgaris and response of seropositive patients to a gluten-free diet

    Kolchak NA

    2017-12-01

    Full Text Available Nikolai A Kolchak,1 Maria K Tetarnikova,2 Maria S Theodoropoulou,3 Alexandra P Michalopoulou,4 Demetrios S Theodoropoulos5 1Department of Hematology, Omsk State Medical Academy, Omsk, Russia; 2Dermatology Private Practice, Chelyabinsk, Russia; 3Department of Pharmacy, Trikala General Hospital, Trikala, Greece; 4Department of Philosophy and Social Studies, School of Philosophy, University of Crete, Rethymnon, Greece; 5Allergy Associates of La Crosse, Onalaska, WI, USA Introduction: The course of psoriasis relies on a variety of metabolic and immunological parameters. Identification of underlying pro-inflammatory conditions and their control is desired for optimal management. Background: Increased prevalence of serum markers for celiac disease has been reported among patients with psoriasis. The likelihood of occult celiac disease in a subpopulation of patients has been postulated and gluten-free diets have been reported to be effective. Patients and methods: The prevalence of gliadin IgA antibodies was assessed among patients with psoriasis in an urban population. The clinical effects of a strict gluten-free diet were followed. Results: Over a 2-year period, 97 patients with Psoriasis Area and Severity Index greater than 2.4 were recruited from a population followed in a dermatology clinic. Gliadin IgA antibodies were assessed in all participants and in 91 controls. Elevated gliadin IgA antibodies were found in 13 patients (14% and two controls (2%. Values in five patients were assessed as greater than 30.0 U/mL or “strong positive” according to the manufacturer of the assay. All 13 patients were placed on a strict gluten-free diet without any other modifications in their ongoing treatment of psoriasis. Improvement of psoriatic lesions was observed in all patients with positive gliadin IgA antibodies but the decline in the Psoriasis Area and Severity Index score and the scaling down of pharmaceutical treatment was more pronounced in the five

  20. Applying Simulation Method in Formulation of Gluten-Free Cookies

    Nikitina Marina

    2017-01-01

    Full Text Available At present time priority direction in the development of new food products its developing of technology products for special purposes. These types of products are gluten-free confectionery products, intended for people with celiac disease. Gluten-free products are in demand among consumers, it needs to expand assortment, and improvement of quality indicators. At this article results of studies on the development of pastry products based on amaranth flour does not contain gluten. Study based on method of simulation recipes gluten-free confectionery functional orientation to optimize their chemical composition. The resulting products will allow to diversify and supplement the necessary nutrients diet for people with gluten intolerance, as well as for those who follow a gluten-free diet.

  1. Exploring the popularity, experiences, and beliefs surrounding gluten-free diets in nonceliac athletes.

    Lis, Dana M; Stellingwerff, Trent; Shing, Cecilia M; Ahuja, Kiran D K; Fell, James W

    2015-02-01

    Adherence to a gluten-free diet (GFD) for nonceliac athletes (NCA) has become increasingly popular despite a paucity of supportive medical or ergogenic evidence. This study aimed to quantify the demographics of NCA and determine associated experiences, perceptions, and sources of information related to GFD. Athletes (n = 910, female = 528, no gender selected = 5) completed a 17-question online survey. Forty-one percent of NCA respondents, including 18-world and/or Olympic medalists, follow a GFD 50-100% of the time (GFD > 50): only 13% for treatment of reported medical conditions with 57% self-diagnosing their gluten sensitivity. The GFD > 50 group characteristics included predominantly endurance sport athletes (70.0%) at the recreationally competitive level (32.3%), between 31 and 40 years of age (29.1%). Those who follow a GFD > 50 reported experiencing, abdominal/gastrointestinal (GI) symptoms alone (16.7%) or in conjunction with two (30.7%) or three (35.7%) additional symptoms (e.g., fatigue) believed to be triggered by gluten. Eighty-four percent of GFD > 50 indicated symptom improvement with gluten-removal. Symptom-based and non-symptom-based self-diagnosed gluten-sensitivity (56.7%) was the primary reason for adopting a GFD. Leading sources of GFD information were online (28.7%), trainer/coach (26.2%) and other athletes (17.4%). Although 5-10% of the general population is estimated to benefit clinically from a GFD a higher prevalence of GFD adherence was found in NCA (41.2%). Prescription of a GFD among many athletes does not result from evidence-based practice suggesting that adoption of a GFD in the majority of cases was not based on medical rationale and may be driven by perception that gluten removal provides health benefits and an ergogenic edge in NCA.

  2. Effect of Bifidobacterium breve on the Intestinal Microbiota of Coeliac Children on a Gluten Free Diet: A Pilot Study

    Andrea Quagliariello

    2016-10-01

    Full Text Available Coeliac disease (CD is associated with alterations of the intestinal microbiota. Although several Bifidobacterium strains showed anti-inflammatory activity and prevention of toxic gliadin peptides generation in vitro, few data are available on their efficacy when administered to CD subjects. This study evaluated the effect of administration for three months of a food supplement based on two Bifidobacterium breve strains (B632 and BR03 to restore the gut microbial balance in coeliac children on a gluten free diet (GFD. Microbial DNA was extracted from faeces of 40 coeliac children before and after probiotic or placebo administration and 16 healthy children (Control group. Sequencing of the amplified V3-V4 hypervariable region of 16S rRNA gene as well as qPCR of Bidobacterium spp., Lactobacillus spp., Bacteroides fragilis group Clostridium sensu stricto and enterobacteria were performed. The comparison between CD subjects and Control group revealed an alteration in the intestinal microbial composition of coeliacs mainly characterized by a reduction of the Firmicutes/Bacteroidetes ratio, of Actinobacteria and Euryarchaeota. Regarding the effects of the probiotic, an increase of Actinobacteria was found as well as a re-establishment of the physiological Firmicutes/Bacteroidetes ratio. Therefore, a three-month administration of B. breve strains helps in restoring the healthy percentage of main microbial components.

  3. Reduced-Gliadin Wheat Bread: An Alternative to the Gluten-Free Diet for Consumers Suffering Gluten-Related Pathologies

    Gil-Humanes, Javier; Pistón, Fernando; Altamirano-Fortoul, Rossana; Real, Ana; Comino, Isabel; Sousa, Carolina; Rosell, Cristina M.; Barro, Francisco

    2014-01-01

    Wheat flour cannot be tolerated by those who suffer allergies to gluten. Human pathologies associated with grain proteins have increased worldwide in recent years, and the only effective treatment available is a lifelong gluten-free diet, which is complicated to follow and detrimental to gut health. This manuscript describes the development of wheat bread potentially suitable for celiac patients and other gluten-intolerant individuals. We have made bread using wheat flour with very low content of the specific gluten proteins (near gliadin-free) that are the causal agents for pathologies such as celiac disease. Loaves were compared with normal wheat breads and rice bread. Organoleptic, nutritional, and immunotoxic properties were studied. The reduced-gliadin breads showed baking and sensory properties, and overall acceptance, similar to those of normal flour, but with up to 97% lower gliadin content. Moreover, the low-gliadin flour has improved nutritional properties since its lysine content is significantly higher than that of normal flour. Conservative estimates indicate that celiac patients could safely consume 67 grams of bread per day that is made with low-gliadin flour. However, additional studies, such as feeding trials with gluten-intolerant patients, are still needed in order to determine whether or not the product can be consumed by the general celiac population, as well as the actual tolerated amount that can be safely ingested. The results presented here offer a major opportunity to improve the quality of life for millions of sufferers of gluten intolerance throughout the world. PMID:24621595

  4. Effect of Bifidobacterium breve on the Intestinal Microbiota of Coeliac Children on a Gluten Free Diet: A Pilot Study.

    Quagliariello, Andrea; Aloisio, Irene; Bozzi Cionci, Nicole; Luiselli, Donata; D'Auria, Giuseppe; Martinez-Priego, Llúcia; Pérez-Villarroya, David; Langerholc, Tomaž; Primec, Maša; Mičetić-Turk, Dušanka; Di Gioia, Diana

    2016-10-22

    Coeliac disease (CD) is associated with alterations of the intestinal microbiota. Although several Bifidobacterium strains showed anti-inflammatory activity and prevention of toxic gliadin peptides generation in vitro, few data are available on their efficacy when administered to CD subjects. This study evaluated the effect of administration for three months of a food supplement based on two Bifidobacterium breve strains (B632 and BR03) to restore the gut microbial balance in coeliac children on a gluten free diet (GFD). Microbial DNA was extracted from faeces of 40 coeliac children before and after probiotic or placebo administration and 16 healthy children (Control group). Sequencing of the amplified V3-V4 hypervariable region of 16S rRNA gene as well as qPCR of Bidobacterium spp., Lactobacillus spp., Bacteroides fragilis group Clostridium sensu stricto and enterobacteria were performed. The comparison between CD subjects and Control group revealed an alteration in the intestinal microbial composition of coeliacs mainly characterized by a reduction of the Firmicutes/Bacteroidetes ratio, of Actinobacteria and Euryarchaeota . Regarding the effects of the probiotic, an increase of Actinobacteria was found as well as a re-establishment of the physiological Firmicutes/Bacteroidetes ratio. Therefore, a three-month administration of B. breve strains helps in restoring the healthy percentage of main microbial components.

  5. Transcultural adaptation and validation of the Celiac Dietary Adherence Test: a simple questionnaire to measure adherence to a gluten-free diet

    Ricardo Fueyo-Díaz

    Full Text Available Background and aims: A gluten-free diet is to date the only treatment available to celiac disease sufferers. However, systematic reviews indicate that, depending on the method of evaluation used, only 42% to 91% of patients adhere to the diet strictly. Transculturally adapted tools that evaluate adherence beyond simple self-informed questions or invasive analyses are, therefore, of importance. The aim is to obtain a Spanish transcultural adaption and validation of Leffler's Celiac Dietary Adherence Test. Methods: A two-stage observational transversal study: translation and back translation by four qualified translators followed by a validation stage in which the questionnaire was administered to 306 celiac disease patients aged between 12 and 72 years and resident in Aragon. Factorial structure, criteria validity and internal consistency were evaluated. Results: The Spanish version maintained the 7 items in a 3-factor structure. Feasibility was very high in all the questions answered and the floor and ceiling effects were very low (4.3% and 1%, respectively. The Spearman correlation with the self-efficacy and life quality scales and the self-informed question were statistically significant (p < 0.01. According to the questionnaire criteria, adherence was 72.3%. Conclusion: The Spanish version of the Celiac Dietary Adherence Test shows appropriate psychometric properties and is, therefore, suitable for studying adherence to a gluten-free diet in clinical and research environments.

  6. Gluten-free diet increases beta-cell volume and improves glucose tolerance in an animal model of type 2 diabetes

    Haupt-Jørgensen, Martin; Buschard, Karsten; Hansen, Axel Kornerup

    2016-01-01

    Background Gluten-free (GF) diet alleviates type 1 diabetes in animal models and possibly in humans. We recently showed that fatty acid-induced insulin secretion is enhanced by enzymatically digested gluten (gliadin) stimulation in INS-1E insulinoma cells. We therefore hypothesized that GF diet...... would induce beta-cell rest and ameliorate type 2 diabetes. Methods C57BL/6JBomTac (B6) mice were fed a high-fat (HF), gluten-free high-fat (GF–HF), standard (STD) or gluten-free (GF) diet for 42 weeks. Results Short-term (6–24 weeks) GF–HF versus HF feeding impaired glucose tolerance and increased...... capacity controls pancreas volume. Thus, long-term GF diets may be beneficial for obese type 2 diabetes patients and trials should be performed....

  7. Prevalence of Self-Reported Gluten Sensitivity and Adherence to a Gluten-Free Diet in Argentinian Adult Population

    Cabrera-Chávez, Francisco; Dezar, Gimena V. A.; Islas-Zamorano, Anna P.; Espinoza-Alderete, Jesús G.; Vergara-Jiménez, Marcela J.; Magaña-Ordorica, Dalia; Ontiveros, Noé

    2017-01-01

    Background: Previous studies suggest that the prevalence of wheat/gluten sensitivity and adherence to a gluten-free diet (GFD) are high in Latin population despite a poor diagnosis of celiac disease. However, these prevalence rates still remain unknown in most Latin American countries. Methods: A cross-sectional survey study was conducted in Santa Fe, Argentina. Results: The estimated self-reported prevalence rates were (95% Confidence Interval [CI]): self-reported gluten sensitivity (SR-GS) 7.61% (6.2–9.2), SR-GS currently following a GFD 1.82% (1.2–2.7), celiac disease 0.58% (0.3–1.2), wheat allergy 0.33% (0.12–0.84), self-reported non-celiac gluten sensitivity (SR-NCGS) 6.28% (5.1–7.8), SR-NCGS currently following a GFD 0.91% (0.5–1.6), and adherence to a GFD 6.37% (5.1–7.9). SR-GS was more common in women (6.0%; p < 0.001) and associated with irritable bowel syndrome (p < 0.001). Among the GFD followers, 71.4% were doing it for reasons other than health-related benefits and 50.6% without medical/dietitian advice. In the non-SR-GS group, the main motivations for following a GFD were weight control and the perception that a GFD is healthier. Conclusion: In Argentina, gluten sensitivity is commonly reported and it seems that physicians/gastroenterologists are aware of celiac disease diagnosis. Trustable information about the benefits and potential consequences of following a GFD should be given to the general population. PMID:28117706

  8. Prevalence of Self-Reported Gluten Sensitivity and Adherence to a Gluten-Free Diet in Argentinian Adult Population

    Francisco Cabrera-Chávez

    2017-01-01

    Full Text Available Background: Previous studies suggest that the prevalence of wheat/gluten sensitivity and adherence to a gluten-free diet (GFD are high in Latin population despite a poor diagnosis of celiac disease. However, these prevalence rates still remain unknown in most Latin American countries. Methods: A cross-sectional survey study was conducted in Santa Fe, Argentina. Results: The estimated self-reported prevalence rates were (95% Confidence Interval [CI]: self-reported gluten sensitivity (SR-GS 7.61% (6.2–9.2, SR-GS currently following a GFD 1.82% (1.2–2.7, celiac disease 0.58% (0.3–1.2, wheat allergy 0.33% (0.12–0.84, self-reported non-celiac gluten sensitivity (SR-NCGS 6.28% (5.1–7.8, SR-NCGS currently following a GFD 0.91% (0.5–1.6, and adherence to a GFD 6.37% (5.1–7.9. SR-GS was more common in women (6.0%; p < 0.001 and associated with irritable bowel syndrome (p < 0.001. Among the GFD followers, 71.4% were doing it for reasons other than health-related benefits and 50.6% without medical/dietitian advice. In the non-SR-GS group, the main motivations for following a GFD were weight control and the perception that a GFD is healthier. Conclusion: In Argentina, gluten sensitivity is commonly reported and it seems that physicians/gastroenterologists are aware of celiac disease diagnosis. Trustable information about the benefits and potential consequences of following a GFD should be given to the general population.

  9. Self-Reported Prevalence of Gluten-Related Disorders and Adherence to Gluten-Free Diet in Colombian Adult Population

    Francisco Cabrera-Chávez

    2016-01-01

    Full Text Available Background. Celiac disease seems to be rare in Colombians, but there are currently no data about the prevalence rates of symptomatic adverse reactions to gluten or adherence to gluten-free diet (GFD in this population. Aim. to evaluate the self-reported prevalence rates of adverse reactions to gluten, adherence to GFD, and gluten-related disorders at population level in Colombia. Methods. A self-administered questionnaire-based cross-sectional study was conducted in a population from Northwest Colombia. Results. The estimated prevalence rates were (95% CI 7.9% (6.5–9.6 and 5.3% (4.1–6.7 for adverse and recurrent adverse reactions to wheat/gluten, respectively, adherence to GFD 5.9% (4.7–7.4, wheat allergy 0.74% (0.3–1.4, and nonceliac gluten sensitivity 4.5% (3.5–5.8. There were no self-reported cases of celiac disease. Prevalence of self-reported physician-diagnosis of gluten-related disorders was 0.41% (0.17–0.96. Most respondents reported adherence to GFD without a physician-diagnosis of gluten-related disorders (97.2%. The proportion of gluten avoiders was 17.2% (15.2–19.5. Most of them did not report recurrent adverse reactions to wheat/gluten (87.0%. Conclusions. Nonceliac gluten sensitivity is rarely formally diagnosed in Colombia, but this population has the highest prevalence rate of adherence to GFD reported to date. Consequently, most respondents were avoiding wheat- and/or gluten-based products for reasons other than health-related symptoms.

  10. Skepticism Regarding Vaccine and Gluten-Free Food Safety Among Patients with Celiac Disease and Non-celiac Gluten Sensitivity.

    Rabinowitz, Loren G; Zylberberg, Haley M; Levinovitz, Alan; Stockwell, Melissa S; Green, Peter H R; Lebwohl, Benjamin

    2018-05-01

    There has been a marked increase in the adoption of the gluten-free (GF) diet. To query individuals with celiac disease (CD) and non-celiac gluten sensitivity (NCGS) on their beliefs toward the health effects of gluten, and safety of vaccines and GF food products. We distributed a Web-based survey to individuals with CD and NCGS on a CD center e-mail list. We used univariate and multivariate analysis to compare responses of respondents with CD and NCGS. The overall response rate was 27% (NCGS n = 217, CD n = 1291). Subjects with NCGS were more likely than those with CD to disagree with the statement that "vaccines are safe for people with celiac disease" (NCGS 41.3% vs. CD 26.4% (p diet improves energy and concentration (aOR 2.52; 95% CI 1.86-3.43). Subjects with NCGS were more likely than those with CD to have doubts about vaccine safety and believe in the value of non-GMO and organic foods. Our findings suggest that the lack of reliable information on gluten and its content in food and medications may reinforce beliefs that result in a detriment to public health.

  11. A 70-year-old male with peripheral neuropathy, ataxia and antigliadin antibodies shows improvement in neuropathy, but not ataxia, after intravenous immunoglobulin and gluten-free diet

    Dharshan Anandacoomaraswamy

    2008-10-01

    Full Text Available Dharshan Anandacoomaraswamy1, Jagdeesh Ullal2, Aaron I Vinik21Department of Internal Medicine, Coney Island Hospital, Brooklyn, NY, USA; 2Strelitz Diabetes Center, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA, USAAbstract: This is a case of a 70-year-old man with severe peripheral neuropathy, type 2 diabetes and progressively worsening cerebellar ataxia. He was found to have circulating antigliadin and antireticulin antibodies compatible with celiac disease in the absence of intestinal pathology. The peripheral neuropathy improved with a gluten-free diet, antioxidants and intravenous immunoglobulin, whereas the ataxia did not. This case illustrates the need to test for celiac disease in patients with idiopathic ataxia and peripheral neuropathy and the need for alternative therapies for ataxia. Keywords: celiac disease, peripheral neuropathy, autoimmune disease, cerebellar ataxia, type 2 diabetes

  12. Persistent Intraepithelial Lymphocytosis in Celiac Patients Adhering to Gluten-Free Diet Is Not Abolished Despite a Gluten Contamination Elimination Diet

    Barbara Zanini

    2016-08-01

    Full Text Available The gluten-free diet (GFD is the only validated treatment for celiac disease (CD, but despite strict adherence, complete mucosal recovery is rarely obtained. The aim of our study was to assess whether complete restitutio ad integrum could be achieved by adopting a restrictive diet (Gluten Contamination Elimination Diet, GCED or may depend on time of exposure to GFD. Two cohorts of CD patients, with persisting Marsh II/Grade A lesion at duodenal biopsy after 12–18 months of GFD (early control were identified. Patients in Cohort A were re-biopsied after a three-month GCED (GCED control and patients in Cohort B were re-biopsied after a minimum of two years on a standard GFD subsequent to early control (late control. Ten patients in Cohort A and 19 in Cohort B completed the study protocol. There was no change in the classification of duodenal biopsies in both cohorts. The number of intraepithelial lymphocytes, TCRγδ+ (T-Cell Receptor gamma delta T cell and eosinophils significantly decreased at GCED control (Cohort A and at late control (Cohort B, compared to early control. Duodenal intraepithelial lymphocytosis persisting in CD patients during GFD is not eliminated by a GCED and is independent of the length of GFD. [NCT 02711696

  13. Overview on the General Approaches to Improve Gluten-Free Pasta and Bread

    Padalino, Lucia; Conte, Amalia; Del Nobile, Matteo Alessandro

    2016-01-01

    The use of gluten-free products is increasing since a growing number of people are suffering from celiac disease and thereby need gluten-free diet. Gluten is responsible for the visco-elastic characteristics of wheat-based products; therefore, its lack makes the gluten-free products not similar to wheat-based product, with scarce textural properties. This reason constitutes the major industrial limitation. Thus, obtaining good-quality gluten-free products represents a technological challenge. This review reports the main strategies adopted to produce high quality gluten-free pasta and bread. They are mainly obtained by the utilization of specific ingredients (hydrocolloids, proteins or enzymes) to be incorporated into the standard formulation or the adoption of proper technological variables that can enhance above all the functional properties, the texture and the taste. PMID:28231182

  14. A radioimmunoassay for wheat gliadin to assess the suitability of gluten free foods for patients with coeliac disease

    Ciclitira, P.J.; Ellis, H.J.; Evans, D.J.; Lennox, E.S.

    1985-01-01

    Coeliac disease is a clinical condition characterised by malabsorption secondary to abnormalities of the small intestine. The condition is known to be exacerbated by wheat gliadin, rye, barley and possibly oats. The only assays that are available for testing for the presence of wheat gluten in foods are double diffusion against rabbit anti-gliadin antiserum and measurement of Kjeldahl nitrogen in products derived from wheat flour. We have developed a radioimmunoassay for wheat gliadin with a detection limit of 1 ng. Nominally gluten free foods based on wheat starch have been shown to contain up to 1.9x10 -2 % wheat gliadin. Bread made from Nutregen wheat starch which has now been withdrawn contains 6.4 mg gliadin per standard 30 g slice. A radioimmunoassay for wheat gliadin could be used to define standards for the suitability of gluten free products based on wheat starch for patients with coeliac disease. (author)

  15. A radioimmunoassay for wheat gliadin to assess the suitability of gluten free foods for patients with coeliac disease.

    Ciclitira, P J; Ellis, H J; Evans, D J; Lennox, E S

    1985-03-01

    Coeliac disease is a clinical condition characterised by malabsorption secondary to abnormalities of the small intestine. The condition is known to be exacerbated by wheat gliadin, rye, barley and possibly oats. The only assays that are available for testing for the presence of wheat gluten in foods are double diffusion against rabbit anti-gliadin antiserum and measurement of Kjeldahl nitrogen in products derived from wheat flour. We have developed a radioimmunoassay for wheat gliadin with a detection limit of 1 ng. Nominally gluten free foods based on wheat starch have been shown to contain up to 1.9 X 10(-2)% wheat gliadin. Bread made from Nutregen wheat starch which has now been withdrawn contains 6.4 mg gliadin per standard 30 g slice. A radioimmunoassay for wheat gliadin could be used to define standards for the suitability of gluten free products based on wheat starch for patients with coeliac disease.

  16. Effects of a Gluten-Free Diet on Rate of Learning in Autistic Children in an Applied Behavioral Analysis Program: Summary Analysis.

    Pontino, Jamie Lyn; Schaal, Kelly; Chambliss, Catherine

    This summary analysis discusses a series of studies that used both between-subjects and within-subjects analyses to examine the effects of a gluten-free diet on the academic achievement of children with autism. In the first study, the between-subjects analysis included data from eight children with autism (ages 5-7), with four on a gluten-free…

  17. Gluten-free but also gluten-enriched (gluten+) diet prevent diabetes in NOD mice; the gluten enigma in type 1 diabetes

    Funda, D.P.; Kaas, A.; Tlaskalova-Hogenova, H.

    2008-01-01

    BACKGROUND: Environmental factors such as nutrition or exposure to infections play a substantial role in the pathogenesis of type 1 diabetes (T1D). We have previously shown that gluten-free, non-purified diet largely prevented diabetes in non-obese diabetic (NOD) mice. In this study we tested...... hypothesis that early introduction of gluten-enriched (gluten+) diet may increase diabetes incidence in NOD mice. METHODS: Standard, gluten-free, gluten+ modified Altromin diets and hydrolysed-casein-based Pregestimil diet were fed to NOD females and diabetes incidence was followed for 310 days. Insulitis...... score and numbers of gut mucosal lymphocytes were determined in non-diabetic animals. RESULTS: A significantly lower diabetes incidence (p diet (5.9%, n = 34) and Pregestimil diet (10%, n = 30) compared to mice on the standard Altromin diet (60.6%, n...

  18. Gluten contamination in gluten-free bakery products: a risk for coeliac disease patients.

    Farage, Priscila; de Medeiros Nóbrega, Yanna Karla; Pratesi, Riccardo; Gandolfi, Lenora; Assunção, Pedro; Zandonadi, Renata Puppin

    2017-02-01

    The present study aimed to assess the safety of gluten-free bakery products for consumption by coeliac patients. Design/setting In the current exploratory cross-sectional quantitative study, a total of 130 samples were collected from twenty-five bakeries in Brasilia (Brazil). For the quantification of gluten, an ELISA was used. The threshold of 20 ppm gluten was considered as the safe upper limit for gluten-free food, as proposed in the Codex Alimentarius. The results revealed a total of 21·5 % of contamination among the bakery products sampled. Sixty-four per cent of the bakeries sold at least one contaminated product in our sample. These findings represent a risk for coeliac patients since the ingestion of gluten traces may be sufficient to adversely impact on their health.

  19. Rapid Partial Repigmentation of Vitiligo in a Young Female Adult with a Gluten-Free Diet

    Birgit N. Khandalavala

    2014-12-01

    Full Text Available Vitiligo is a common pigmentary skin condition with a profound impact. Despite a number of therapeutic modalities, few have been demonstrated to result in significant repigmentation within a brief period of time. Reported dietary interventions are sparse. Following exclusion of gluten in the diet, early and extensive repigmentation of facial lesions were noted in a young female adult of Asian ethnicity with acrofacial vitiligo. The majority of the benefits occurred within the first month and stabilized at 4 months. Previous topical and phototherapy had not been found to be effective. The patient was maintained on the previously prescribed dapsone therapy. Dietary elimination can potentially be a disease-modifying intervention for vitiligo and should be considered even in patients without concomitant celiac disease.

  20. The effects of gluten-free diet versus hypocaloric diet among patients with fibromyalgia experiencing gluten sensitivity symptoms: protocol for a pilot, open-label, randomized clinical trial.

    Slim, Mahmoud; Molina-Barea, Rocio; Garcia-Leiva, Juan Miguel; Rodríguez-Lopez, Carmen Maria; Morillas-Arques, Piedad; Rico-Villademoros, Fernando; Calandre, Elena P

    2015-01-01

    Fibromyalgia is a chronic musculoskeletal pain syndrome characterized by a broad spectrum of manifestations. Patients with fibromyalgia frequently suffer from manifestations similar to those experienced by patients with gluten-related disorders raising the possibility that some patients with fibromyalgia could suffer from underlying gluten sensitivity. This study aims to assess whether avoiding gluten among patients with fibromyalgia and gluten sensitivity is beneficial. Adult patients with fibromyalgia presenting gluten sensitivity symptoms are randomly allocated to receive gluten-free diet or hypocaloric diet for 24 weeks. The primary outcome measure is the mean change in the number of experienced gluten sensitivity symptoms. Secondary outcome measures include the mean changes in the body mass index, Revised Fibromyalgia Impact Questionnaire, Pittsburgh Sleep Quality Index, Brief Pain Inventory, Beck Depression Inventory-II, State-Trait Anxiety Inventory, Short-Form Health Survey and Patient Global Impression Scale of Severity. Other secondary outcome measures include the frequency of potential adverse events and the proportion of responders according to the Patient Global Impression Scale of Improvement. Previous studies assessing dietary interventions in fibromyalgia primarily evaluated their effects on the severity and impact of fibromyalgia symptoms and pain. The current study is the first to evaluate the effects of gluten-free diet on the gluten sensitivity symptoms experienced by patients with fibromyalgia. The results of this study will contribute to a better understanding of the potential role of gluten sensitivity in fibromyalgia. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Functionality of alternative protein in gluten-free product development.

    Deora, Navneet Singh; Deswal, Aastha; Mishra, Hari Niwas

    2015-07-01

    Celiac disease is an immune-mediated disease triggered in genetically susceptible individuals by ingested gluten from wheat, rye, barley, and other closely related cereal grains. The current treatment for celiac disease is life-long adherence to a strict gluten-exclusion diet. The replacement of gluten presents a significant technological challenge, as it is an essential structure-building protein, which is necessary for formulating high-quality baked goods. A major limitation in the production of gluten-free products is the lack of protein functionality in non-wheat cereals. Additionally, commercial gluten-free mixes usually contain only carbohydrates, which may significantly limit the amount of protein in the diet. In the recent past, various approaches are attempted to incorporate protein-based ingredients and to modify the functional properties for gluten-free product development. This review aims to the highlight functionality of the alternative protein-based ingredients, which can be utilized for gluten-free product development both functionally as well as nutritionally. © The Author(s) 2014.

  2. Administration of Inulin-Supplemented Gluten-Free Diet Modified Calcium Absorption and Caecal Microbiota in Rats in a Calcium-Dependent Manner

    Urszula Krupa-Kozak

    2017-07-01

    Full Text Available In coeliac disease (CD, the risk of adverse calcium balance and reduced bone density is induced mainly by the disease, but also by a gluten-free diet (GFD, the only accepted CD therapy. Prebiotics through the beneficial impact on intestinal microbiota may stimulate calcium (Ca absorption. In the present study, we hypothesised that the dietary inulin in GFD would influence positively the intestinal microbiota, and by that will stimulate the absorption of calcium (Ca, especially in the conditions of Ca malnutrition. In a six-weeks nutritional experiment on growing a significant (p < 0.05 luminal acidification, decrease in ammonia concentration and stimulation of short chain fatty acids formation indicated inulin-mediated beneficial effects on the caecal microbiota. However, the effect of inulin on characteristics of intestinal microbiota and mineral utilization depended on the dietary Ca intake from GFDs. Inulin stimulated bifidobacteria, in particular B. animalis species, only if a recommended amount of Ca was provided. Most benefits to mineral utilization from inulin consumption were seen in rats fed Ca-restricted GFD where it increased the relative Ca absorption. Administration of inulin to a GFDs could be a promising dietary strategy for beneficial modulation of intestinal ecosystem and by that for the improvement the Ca absorption.

  3. Administration of Inulin-Supplemented Gluten-Free Diet Modified Calcium Absorption and Caecal Microbiota in Rats in a Calcium-Dependent Manner.

    Krupa-Kozak, Urszula; Markiewicz, Lidia H; Lamparski, Grzegorz; Juśkiewicz, Jerzy

    2017-07-06

    In coeliac disease (CD), the risk of adverse calcium balance and reduced bone density is induced mainly by the disease, but also by a gluten-free diet (GFD), the only accepted CD therapy. Prebiotics through the beneficial impact on intestinal microbiota may stimulate calcium (Ca) absorption. In the present study, we hypothesised that the dietary inulin in GFD would influence positively the intestinal microbiota, and by that will stimulate the absorption of calcium (Ca), especially in the conditions of Ca malnutrition. In a six-weeks nutritional experiment on growing a significant ( p < 0.05) luminal acidification, decrease in ammonia concentration and stimulation of short chain fatty acids formation indicated inulin-mediated beneficial effects on the caecal microbiota. However, the effect of inulin on characteristics of intestinal microbiota and mineral utilization depended on the dietary Ca intake from GFDs. Inulin stimulated bifidobacteria, in particular B. animalis species, only if a recommended amount of Ca was provided. Most benefits to mineral utilization from inulin consumption were seen in rats fed Ca-restricted GFD where it increased the relative Ca absorption. Administration of inulin to a GFDs could be a promising dietary strategy for beneficial modulation of intestinal ecosystem and by that for the improvement the Ca absorption.

  4. Celiac disease - sprue

    Sprue; Nontropical sprue; Gluten intolerance; Gluten-sensitive enteropathy; Gluten-free diet celiac disease ... intestines will heal if you follow a lifelong gluten-free diet . Do not eat foods, drink beverages, or take ...

  5. Low incidence of spontaneous type 1 diabetes in non-obese diabetic mice raised on gluten-free diets is associated with changes in the intestinal microbiome.

    Marietta, Eric V; Gomez, Andres M; Yeoman, Carl; Tilahun, Ashenafi Y; Clark, Chad R; Luckey, David H; Murray, Joseph A; White, Bryan A; Kudva, Yogish C; Rajagopalan, Govindarajan

    2013-01-01

    Human and animal studies strongly suggest that dietary gluten could play a causal role in the etiopathogenesis of type 1 diabetes (T1D). However, the mechanisms have not been elucidated. Recent reports indicate that the intestinal microbiome has a major influence on the incidence of T1D. Since diet is known to shape the composition of the intestinal microbiome, we investigated using non-obese diabetic (NOD) mice whether changes in the intestinal microbiome could be attributed to the pro- and anti-diabetogenic effects of gluten-containing and gluten-free diets, respectively. NOD mice were raised on gluten-containing chows (GCC) or gluten-free chows (GFC). The incidence of diabetes was determined by monitoring blood glucose levels biweekly using a glucometer. Intestinal microbiome composition was analyzed by sequencing 16S rRNA amplicons derived from fecal samples. First of all, GCC-fed NOD mice had the expected high incidence of hyperglycemia whereas NOD mice fed with a GFC had significantly reduced incidence of hyperglycemia. Secondly, when the fecal microbiomes were compared, Bifidobacterium, Tannerella, and Barnesiella species were increased (p = 0.03, 0.02, and 0.02, respectively) in the microbiome of GCC mice, where as Akkermansia species was increased (p = 0.02) in the intestinal microbiomes of NOD mice fed GFC. Thirdly, both of the gluten-free chows that were evaluated, either egg white based (EW-GFC) or casein based (C-GFC), significantly reduced the incidence of hyperglycemia. Interestingly, the gut microbiome from EW-GFC mice was similar to C-GFC mice. Finally, adding back gluten to the gluten-free diet reversed its anti-diabetogenic effect, reduced Akkermansia species and increased Bifidobacterium, Tannerella, and Barnesiella suggesting that the presence of gluten is directly responsible for the pro-diabetogenic effects of diets and it determines the gut microflora. Our novel study thus suggests that dietary gluten could modulate the incidence of

  6. Doença celíaca: avaliação da obediência à dieta isenta de glúten e do conhecimento da doença pelos pacientes cadastrados na Associação dos Celíacos do Brasil (ACELBRA Celiac disease: evaluation of compliance to a gluten-free diet and knowledge of the disease in celiac patients registered at the Brazilian Celiac Association (BCA

    Vera Lucia SDEPANIAN

    2001-10-01

    . Conclusões - Quanto maior o grau de conhecimento da doença e seu tratamento, maior a obediência à dieta isenta de glúten.Background — The compliance to a gluten-free diet may prevent the development of both non-malignant and malignant complications. Aim - To evaluate compliance to a gluten-free diet and knowledge of the disease in celiac patients registered at the Brazilian Celiac Association (BCA. Methods - A structured questionnaire was designed to assess compliance to a gluten-free diet as well as knowledge of the celiac disease. It was mailed to 584 members of BCA. Results - Five hundred and twenty nine (90.6% of a total of 534 (91.4% answered questionnaires were analyzed; 69.4% were classified as compliant patients whereas 29.5% were classified as noncompliant. The proportion of patients age 21 or older who consume gluten frequently or without any restriction is larger (17.7% than those who were younger than 21 years (9.9%. Frequency of dietary compliance was higher when the diagnosis had taken less than 5 years to be established; 82% of the patients replied that the small intestine was the part of the body affected by the disease. The most common symptoms of the disease according to the answers were diarrhea (96.6%, weight loss (93.4%, protuberant abdomen (90.4%, anemia (68.1% and vomiting (59.6%. Only 59.0% agreed with the existence of genetic predisposition; 90.4% answered that the disease is permanent and 96.2% stated that the diet should exclude gluten absolutely; 67.1% answered that the gluten is a protein and according to 92.1% questionnaires this protein is present in wheat, rye, barley and oat. Greater compliance was observed when there was an understanding of the disease and diet. The small intestine biopsy was considered necessary for just 67.5% of the patients, and greater compliance was observed in patients who had undergone at least one small intestine biopsy. Conclusion - Our findings indicate that the more the patients know and understand about

  7. The obestatin/ghrelin ratio and ghrelin genetics in adult celiac patients before and after a gluten-free diet, in irritable bowel syndrome patients and healthy individuals.

    Russo, Francesco; Chimienti, Guglielmina; Linsalata, Michele; Clemente, Caterina; Orlando, Antonella; Riezzo, Giuseppe

    2017-02-01

    Ghrelin levels and obestatin/ghrelin ratio have been proposed as activity markers in ulcerative colitis, but no data are available in celiac disease (CD) and irritable bowel syndrome (IBS). Our aims were as follows: (a) to assess obestatin and ghrelin concentrations in adult active CD patients, diarrhea-predominant IBS (IBS-d), and healthy controls (HC) in relation to intestinal permeability; (b) to evaluate the ghrelin-obestatin profile in CD patients after a 1-year gluten-free diet (GFD); and (c) to establish the impact of ghrelin genetics. The study included 31 CD patients, 28 IBS-d patients, and 19 HC. Intestinal permeability, assayed by high-performance liquid chromatography determination of urinary lactulose (La)/mannitol (Ma), and circulating concentrations of obestatin, ghrelin, and their ratio were evaluated at enrollment and after GFD. The ghrelin single nucleotide polymorphisms Arg51Gln (rs34911341), Leu72Met (rs696217), and Gln90Leu (rs4684677) were analyzed. Intestinal permeability was impaired in CD patients and ameliorated after GFD. Ghrelin was significantly (P=0.048) higher and the obestatin/ghrelin ratio was significantly (P=0.034) lower in CD patients compared with both IBS-d and HC, and GFD reduced the peptide levels, but without reaching the concentrations in HC. Significant differences (Ppolymorphism among groups, with the reduction of the GT genotype and the T allele in both CD and IBS-d patients compared with HC. Intestinal permeability is altered in CD, but not in IBS-d patients, and ghrelin levels increase in CD patients as observed in other inflammatory conditions. Moreover, a role for ghrelin genetics is hypothesized in sustaining the many pathogenetic components of these different pathologies, but with a similar symptom profile.

  8. Exposure assessment to fumonisins B1, B2 and B3 through consumption of gluten-free foodstuffs intended for people affected by celiac disease.

    Esposito, Francesco; Fasano, Evelina; Scognamiglio, Gelsomina; Nardone, Antonio; Triassi, Maria; Cirillo, Teresa

    2016-11-01

    Fumonisins are mycotoxins produced by Fusarium species and affecting maize crops. Some analogues of fumonisins are known for their toxic and possible carcinogenic effects on humans and animals. Because of their occurrence in corn-based food, diet is the main source of exposure to these mycotoxins, especially among people affected by celiac disease. Hence, the purpose of this paper was to evaluate the amount of fumonisins B1, B2 and B3 in maize-based products and to assess the exposure of people affected by celiac disease to fumonisins. The sample consisted of 154 gluten-free products analyzed according to method UNI EN 14352:2005. Results showed a heterogeneous contamination by fumoninisin B1, B2 and B3, although below limits of Commission Regulation No 1126/2007 and consistent with other European literature data. Exposure to fumonisins was evaluated for different age groups. In some cases exposure to fumonisins could not be ignored since the total intake could exceed EFSA Provisional Maximum Tolerable Intake up to 150%. Therefore, in the light of an overall contamination by fumonisins the total dietary exposure could be underrated not only in people affected by celiac disease, but also in non-celiac population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: based on parental report.

    Pennesi, Christine M; Klein, Laura Cousino

    2012-03-01

    Studies on the gluten-free and/or casein-free (GFCF) dietary intervention for children with autism spectrum disorders (ASDs) suggest that some children may positively respond to implementation of the dietary intervention. Other research suggests that children diagnosed with ASD can be classified into subpopulations based on various factors, including gastrointestinal (GI) abnormalities and immune function. This study analyzes parental report data collected using a 90-item online questionnaire from 387 parents or primary caregivers of children diagnosed with ASD on the efficacy of the GFCF diet. Parents reported on their child's GI symptoms, food allergy diagnoses, and suspected food sensitivities, as well as the degree and length of their diet implementation. Overall, diet efficacy among children whose parents reported the presence of GI symptoms, food allergy diagnoses, and suspected food sensitivities included greater improvement in ASD behaviors, physiological symptoms, and social behaviors compared with children whose parents reported none of these symptoms, diagnoses, or sensitivities (P diet implementation, indicated by complete gluten/casein elimination and infrequent diet errors during and outside of parental care, also corresponded to improvement in ASD behaviors, physiological symptoms, and social behaviors (P diet implementation and GI and immune factors may play a role in differentiating diet responders from diet non-responders and substantiate the importance of further investigations into the various, nuanced factors that influence efficacy of the intervention among children with ASDs.

  10. Evaluation of commercial gluten-free foods from the Brazilian market

    In addition to Celiac Disease, there are other gluten related disorders classified according to immunological response, e.g. autoimmune, allergic and sensitivity (non-autoimmune and non-allergic). In all cases, the only effective therapy is strict adherence to a gluten free diet, which consists of a...

  11. Enzyme-linked immunosorbent assay gliadin assessment in processed food products available for persons with celiac disease: a feasibility study for developing a gluten-free food database.

    Agakidis, Charalampos; Karagiozoglou-Lampoudi, Thomais; Kalaitsidou, Marina; Papadopoulos, Theodoros; Savvidou, Afroditi; Daskalou, Efstratia; Dimitrios, Triantafyllou

    2011-12-01

    Inappropriate food labeling and unwillingness of food companies to officially register their own gluten-free products in the Greek National Food Intolerance Database (NFID) result in a limited range of processed food products available for persons with celiac disease (CDP). The objective of the study was to evaluate the feasibility of developing a gluten-free food product database based on the assessment of the gluten content in processed foods available for CDP. Gluten was assessed in 41 processed food products available for CDP. Group A consisted of 26 products for CDP included in the NFID, and group B contained 15 food products for CDP not registered in the NFID but listed in the safe lists of the local Celiac Association (CA). High-sensitivity ω-gliadin enzyme-linked immunosorbent assay (ELISA) was used for analysis. Gluten was lower than 20 ppm in 37 of 41 analyzed products (90.2%): in 24 of 26 (92.3%) products in group A and in 13 of 15 (86.7%) products in group B (P = .61). No significant difference was found between the 2 groups regarding gluten content. No product in either group contained gluten in excess of 100 ppm. Most of the analyzed products included in the Greek NFID or listed in the lists of the local CA, even those not officially labeled "gluten free," can be safely consumed by CDP. The use of commercially available ω-gliadin ELISA is able to identify those products that contain inappropriate levels of gluten, making feasible it to develop an integrated gluten-free processed food database.

  12. Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study.

    Elkan, Ann-Charlotte; Sjöberg, Beatrice; Kolsrud, Björn; Ringertz, Bo; Hafström, Ingiäld; Frostegård, Johan

    2008-01-01

    The purpose of this study was to investigate the effects of vegan diet in patients with rheumatoid arthritis (RA) on blood lipids oxidized low-density lipoprotein (oxLDL) and natural atheroprotective antibodies against phosphorylcholine (anti-PCs). Sixty-six patients with active RA were randomly assigned to either a vegan diet free of gluten (38 patients) or a well-balanced non-vegan diet (28 patients) for 1 year. Thirty patients in the vegan group completed more than 3 months on the diet regimen. Blood lipids were analyzed by routine methods, and oxLDL and anti-PCs were analyzed by enzyme-linked immunosorbent assay. Data and serum samples were obtained at baseline and after 3 and 12 months. Mean ages were 50.0 years for the vegan group and 50.8 years for controls. Gluten-free vegan diet induced lower body mass index (BMI) and low-density lipoprotein (LDL) and higher anti-PC IgM than control diet (p vegan group, BMI, LDL, and cholesterol decreased after both 3 and 12 months (p vegan patients into clinical responders and non-responders at 12 months, the effects on oxLDL and anti-PC IgA were seen only in responders (p vegan diet in RA induces changes that are potentially atheroprotective and anti-inflammatory, including decreased LDL and oxLDL levels and raised anti-PC IgM and IgA levels.

  13. Perspective: Gluten-Free Products for Patients with Celiac Disease Should Not Contain Trace Levels

    Makovický, Peter; Makovický, P.; Lupan, L.; Samasca, G.; Sur, G.; Freeman, H.J.

    2017-01-01

    Roč. 8, č. 3 (2017), s. 409-411 ISSN 2161-8313 Institutional support: RVO:68378050 Keywords : united-states * double-blind * oats * diet * complications * prevalence * children Subject RIV: EB - Genetics ; Molecular Biology OBOR OECD: Nutrition, Dietetics Impact factor: 5.233, year: 2016

  14. Enrichment of dry mixes for gluten-free muffins

    Y. P. Dombrovskaya

    2017-01-01

    Full Text Available Now we are focusing on the production of food products that meet the modern requirements of quality and safety, the development of domestic production of food ingredients and production technologies, and specialized functional purpose. The interest for the modern confectionery manufacture are ready to dry semi-finished products - multi-component mixture, designed to produce a wide range of confectionery products like functional purpose and specialized. These mixtures are possible for use not only at home but also in production (capacity of small enterprises and public catering. Semi-finished bakery products are food concentrates and dry mixes are pre-preliminarily prepared foods: flour, sugar, milk, egg powder and other components for the preparation of various types of flour confectionery products – cakes, pies, cookies and others. One way to improve the quality and range of bakery is the use in the production of dry mixes that have a number of advantages compared with other types of materials. They contain minimal amounts of moisture, have a small volume and weight, and no active enzyme systems they contribute to a longer storage. This article discusses the development of a vital topic of gluten-free mix and improved assortment of gluten-free flour confectionery products for people with celiac disease and aspiring to a healthy diet. On getting products out experiments: determination of acidity and moisture performance of products, the study of organoleptic indicators of quality of the product. Received innovative gluten-free mixture of nutritional therapy.

  15. PENGEMBANGAN TORTILA BERKALSIUM SEBAGAI ALTERNATIF PANGAN DIET CASEIN FREE-GLUTEN FREE PADA INDUSTRI KECIL DENGAN METODE VALUE ENGINEERING (Development of Fortified Calcium Tortilla Snack as an Alternative Food for Casein-Free Gluten-Free Diet with Value Engineering Method for Small Scale Industry

    Jeremy Yonathan Sadikin

    2015-09-01

    Full Text Available The number of people with autism increased 56% in 1998 – 2013, and it was a global problem. People with autism need special treatments and CFGF diet (casein free, gluten free was one of those treatments. That’s why, the development The calcium content was expected to substitute the calcium from dairy consumption, which shouldn’t be consumed by people with autism. The method used in this product development was value engineering which separated in three steps: information, creativity, and analysis steps. Respectively, this research was also further completed with chemical The goal of this research was to design some product implemented in small scale industry. Respondends and panelist in this research were consisted of students and teachers. They acted as the market of the product, especially as a  part of general society. This product were designed to provide CFGF snack for people with autism, and those who need CFGF diet. But this product was not limited to that market, it can be consumed by general society not only for people with autism, hence the students and teachers were used. The research showed that the best concept was a product produced with to get 200 grams of dough. This product concept was also designed to be packed in big size gusset packaging materials and the chips was triangle-shaped with size of feasible to be produced in small scale industry. Keywords: value engineering, casein-free gluten-free diet,autism   ABSTRAK Dengan jumlah penyandang autis yang terus meningkat, misalnya peningkatan sebesar 56% pada 1998 – 2013, maka produk tortila berkalsium potensial dikembangkan sebagai alternatif pangan untuk diet CFGF (, dan kandungan kalsiumnya bisa membantu menggantikan kalsium dari susu sapi yang mengandung kasein. Tujuan penelitian adalah merancang sejumlah konsep produk tortila berkalsium dan memilih satu konsep yang paling disukai Metode penelitian adalah yang terdiri dari tiga tahap: informasi, kreativitas dan

  16. Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study

    Elkan, Ann-Charlotte; Sjöberg, Beatrice; Kolsrud, Björn; Ringertz, Bo; Hafström, Ingiäld; Frostegård, Johan

    2008-01-01

    Introduction The purpose of this study was to investigate the effects of vegan diet in patients with rheumatoid arthritis (RA) on blood lipids oxidized low-density lipoprotein (oxLDL) and natural atheroprotective antibodies against phosphorylcholine (anti-PCs). Methods Sixty-six patients with active RA were randomly assigned to either a vegan diet free of gluten (38 patients) or a well-balanced non-vegan diet (28 patients) for 1 year. Thirty patients in the vegan group completed more than 3 months on the diet regimen. Blood lipids were analyzed by routine methods, and oxLDL and anti-PCs were analyzed by enzyme-linked immunosorbent assay. Data and serum samples were obtained at baseline and after 3 and 12 months. Results Mean ages were 50.0 years for the vegan group and 50.8 years for controls. Gluten-free vegan diet induced lower body mass index (BMI) and low-density lipoprotein (LDL) and higher anti-PC IgM than control diet (p vegan group, BMI, LDL, and cholesterol decreased after both 3 and 12 months (p vegan patients into clinical responders and non-responders at 12 months, the effects on oxLDL and anti-PC IgA were seen only in responders (p vegan diet in RA induces changes that are potentially atheroprotective and anti-inflammatory, including decreased LDL and oxLDL levels and raised anti-PC IgM and IgA levels. PMID:18348715

  17. Impact of Tragacanth and Xanthan Gums on the Physical and Textural Characteristics of Gluten-free Cake

    Mahsa Hojjatoleslami; Mohammad Hossain Azizi

    2015-01-01

    Background and Objectives: The quality of cakes made of wheat flour depends on the quantity and quality of its gluten proteins; however, these proteins may have side effects for some people, including the patients with celiac, and the only way to cure this disease is to take a lifelong gluten-free diet. Materials and Methods: This research aims to produce gluten- free cake by using rice flour and xanthan and tragacanth gums, including two treatments of xanthan gum (0.5 &1 %), two treatment...

  18. Effect of Lupine Flour on Baking Characteristics of Gluten Free Cookies

    Sofyan Maghaydah; Selma Abdul-hussain; Radwan Ajo; Yousef Tawalbeh; Noor Elsahoryi

    2013-01-01

    Celiac Disease (CD) is an immune-mediated disease in genetically susceptible individuals caused by intolerance to gluten protein in some cereals, resulting in mucosal inflammation, which causes malabsorption. An effective treatment for CD is a gluten-free diet that excludes cereals containing gluten. One of the most desirable wheat products is the cookie, which is considered suitable for all ages due to its low manufacturing cost, convenience, long shelf life and good eating quality. Therefor...

  19. Rheological Properties of Gluten Free Dough Systems

    Tandazo, Stephany Aurea

    2013-01-01

    Bread is the one of the oldest processed foods and a major wheat based product. The basic process involves mixing of ingredients until the flour is converted into dough, followed by baking the dough into a loaf. A very important step in breadmaking is to know how to make good quality dough. However, the increasing knowledge of people being diagnosed with celiac disease (gluten intolerance) has encouraged scientists to develop healthier and better quality gluten-free products that would greatl...

  20. A Maternal Gluten-Free Diet Reduces Inflammation and Diabetes Incidence in the Offspring of NOD Mice

    Hansen, Camilla Hartmann Friis; Krych, Lukasz; Buschard, Karsten

    2014-01-01

    a pronounced difference between both mothers and their offspring on different diets, characterized by increased numbers of Akkermansia, Proteobacteria, and TM7 in the GF diet group. In addition, pancreatic forkhead box P3 regulatory T cells were increased in GF-fed offspring, as were M2 macrophage gene markers...... and tight junction-related genes in the gut, while intestinal gene expression of proinflammatory cytokines was reduced. An increased proportion of T cells in the pancreas expressing the mucosal integrin alpha 4 beta 7 suggests that the mechanism involves increased trafficking of gut-primed immune cells...

  1. Improved xenobiotic metabolism and reduced susceptibility to cancer in gluten-sensitive macaques upon introduction of a gluten-free diet.

    Karol Sestak

    2011-04-01

    Full Text Available A non-human primate (NHP model of gluten sensitivity was employed to study the gene perturbations associated with dietary gluten changes in small intestinal tissues from gluten-sensitive rhesus macaques (Macaca mulatta.Stages of remission and relapse were accomplished in gluten-sensitive animals by administration of gluten-free (GFD and gluten-containing (GD diets, as described previously. Pin-head-sized biopsies, obtained non-invasively by pediatric endoscope from duodenum while on GFD or GD, were used for preparation of total RNA and gene profiling, using the commercial Rhesus Macaque Microarray (Agilent Technologies,targeting expression of over 20,000 genes.When compared with normal healthy control, gluten-sensitive macaques showed differential gene expressions induced by GD. While observed gene perturbations were classified into one of 12 overlapping categories--cancer, metabolism, digestive tract function, immune response, cell growth, signal transduction, autoimmunity, detoxification of xenobiotics, apoptosis, actin-collagen deposition, neuronal and unknown function--this study focused on cancer-related gene networks such as cytochrome P450 family (detoxification function and actin-collagen-matrix metalloproteinases (MMP genes.A loss of detoxification function paralleled with necessity to metabolize carcinogens was revealed in gluten-sensitive animals while on GD. An increase in cancer-promoting factors and a simultaneous decrease in cancer-preventing factors associated with altered expression of actin-collagen-MMP gene network were noted. In addition, gluten-sensitive macaques showed reduced number of differentially expressed genes including the cancer-associated ones upon withdrawal of dietary gluten. Taken together, these findings indicate potentially expanded utility of gluten-sensitive rhesus macaques in cancer research.

  2. Improved Xenobiotic Metabolism and Reduced Susceptibility to Cancer in Gluten-Sensitive Macaques upon Introduction of a Gluten-Free Diet

    Sestak, Karol; Conroy, Lauren; Aye, Pyone P.; Mehra, Smriti; Doxiadis, Gaby G.; Kaushal, Deepak

    2011-01-01

    Background A non-human primate (NHP) model of gluten sensitivity was employed to study the gene perturbations associated with dietary gluten changes in small intestinal tissues from gluten-sensitive rhesus macaques (Macaca mulatta). Methodology Stages of remission and relapse were accomplished in gluten-sensitive animals by administration of gluten-free (GFD) and gluten-containing (GD) diets, as described previously. Pin-head-sized biopsies, obtained non-invasively by pediatric endoscope from duodenum while on GFD or GD, were used for preparation of total RNA and gene profiling, using the commercial Rhesus Macaque Microarray (Agilent Technologies),targeting expression of over 20,000 genes. Principal Findings When compared with normal healthy control, gluten-sensitive macaques showed differential gene expressions induced by GD. While observed gene perturbations were classified into one of 12 overlapping categories - cancer, metabolism, digestive tract function, immune response, cell growth, signal transduction, autoimmunity, detoxification of xenobiotics, apoptosis, actin-collagen deposition, neuronal and unknown function - this study focused on cancer-related gene networks such as cytochrome P450 family (detoxification function) and actin-collagen-matrix metalloproteinases (MMP) genes. Conclusions/Significance A loss of detoxification function paralleled with necessity to metabolize carcinogens was revealed in gluten-sensitive animals while on GD. An increase in cancer-promoting factors and a simultaneous decrease in cancer-preventing factors associated with altered expression of actin-collagen-MMP gene network were noted. In addition, gluten-sensitive macaques showed reduced number of differentially expressed genes including the cancer-associated ones upon withdrawal of dietary gluten. Taken together, these findings indicate potentially expanded utility of gluten-sensitive rhesus macaques in cancer research. PMID:21533263

  3. Gluten-free but also gluten-enriched (gluten+) diet prevent diabetes in NOD mice; the gluten enigma in type 1 diabetes

    Funda, David P.; Kaas, A.; Tlaskalová, Helena; Buschard, K.

    2007-01-01

    Roč. 24, - (2007), s. 59-63 ISSN 1520-7552 R&D Projects: GA AV ČR IAA5020405; GA ČR GA303/06/1329 Institutional research plan: CEZ:AV0Z50200510 Keywords : gluten * gluten -free * type 1 diabetes Subject RIV: EE - Microbiology, Virology Impact factor: 3.087, year: 2007

  4. Recent developments in gluten-free bread baking approaches: a review

    Kun WANG

    Full Text Available Abstract Celiac disease (CD is one of the most common human intestinal malabsorption diseases. The only effective treatment for patients with CD is to follow a gluten-free (GF diet strictly. Nowadays, the increasing incidence of CD promotes worldwide interests for various desirable GF products. However, baking without gluten, the key ingredient for bread structure and quality, is a big challenge for all bakers and cereal researchers. Several approaches have been applied to understand and improve gluten-free bread (GFB elaboration and further studies are still required. The main focus of this review is to discuss the approaches for GFB improvements in recent 5 years, including the use of novel alternative flours, functional ingredients, processing aids, additives, innovative techniques, and their combinations.

  5. BUCKWHEAT AS A GLUTEN-FREE CEREAL IN COMBINATION WITH MAIZE FLOUR

    Stanislav Kráčmar

    2012-02-01

    Full Text Available Celiac disease is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages. Symptoms include chronic diarrhoea, and fatigue. The only treatment is long life diet with absence of gluten. Many researches concerning gluten-free nutrition have been done but it is still a big challenge. The main aim of this work was to observe changes in gluten-free breads quality made from maize-buckwheat mixtures depending on ratio of maize and buckwheat flour. To obtain samples, bread baking test was applied and these were provided to analyses (dough and pastry yield, baking loss, specific volume and texture analysis. The results showed that rising amount of maize flour in mixtures improved texture characteristics such as chewiness and gumminess, concerning specific volume of breads no significant differences were found and it was proved, that all texture parameters deteriorate with staling time.

  6. Starch Characteristics Linked to Gluten-Free Products

    Stefan W. Horstmann

    2017-04-01

    Full Text Available The increasing prevalence of coeliac disease (CD and gluten-related disorders has led to increasing consumer demand for gluten-free products with quality characteristics similar to wheat bread. The replacement of gluten in cereal-based products remains a challenge for scientists, due to its unique role in network formation, which entraps air bubbles. When gluten is removed from a flour, starch is the main component left. Starch is used as gelling, thickening, adhesion, moisture-retention, stabilizing, film forming, texturizing and anti-staling ingredient. The extent of these properties varies depending on the starch source. The starches can additionally be modified increasing or decreasing certain properties of the starch, depending on the application. Starch plays an important role in the formulation of bakery products and has an even more important role in gluten-free products. In gluten-free products, starch is incorporated into the food formulation to improve baking characteristics such as the specific volume, colour and crumb structure and texture. This review covers a number of topics relating to starch; including; an overview of common and lesser researched starches; chemical composition; morphology; digestibility; functionality and methods of modification. The emphasis of this review is on starch and its properties with respect to the quality of gluten-free products.

  7. Starch Characteristics Linked to Gluten-Free Products.

    Horstmann, Stefan W; Lynch, Kieran M; Arendt, Elke K

    2017-04-06

    The increasing prevalence of coeliac disease (CD) and gluten-related disorders has led to increasing consumer demand for gluten-free products with quality characteristics similar to wheat bread. The replacement of gluten in cereal-based products remains a challenge for scientists, due to its unique role in network formation, which entraps air bubbles. When gluten is removed from a flour, starch is the main component left. Starch is used as gelling, thickening, adhesion, moisture-retention, stabilizing, film forming, texturizing and anti-staling ingredient. The extent of these properties varies depending on the starch source. The starches can additionally be modified increasing or decreasing certain properties of the starch, depending on the application. Starch plays an important role in the formulation of bakery products and has an even more important role in gluten-free products. In gluten-free products, starch is incorporated into the food formulation to improve baking characteristics such as the specific volume, colour and crumb structure and texture. This review covers a number of topics relating to starch; including; an overview of common and lesser researched starches; chemical composition; morphology; digestibility; functionality and methods of modification. The emphasis of this review is on starch and its properties with respect to the quality of gluten-free products.

  8. Refractory iron-deficiency anemia and gluten intolerance: Response to gluten-free diet Anemia ferropénica refractaria e intolerancia al gluten: respuesta a la dieta sin gluten

    Luis Rodrigo-Sáez

    2011-07-01

    Full Text Available Introduction: refractory iron-deficiency anemia has a multifactorial origin related to various gastrointestinal conditions, with celiac disease plus malabsorption and IBD together with isolated gluten intolerance being most common. Objectives: to determine the prevalence of serum, genetic, and histological markers for gluten intolerance, and to analyze the response to gluten withdrawal from the diet in these patients. Methods: a number of patients with refractory anemia were prospectively and consecutively enrolled. A protocol to measure serum (TGt-2, genetic (HLA-DQ2/DQ8, and histological markers for celiac disease was applied. All followed a gluten-free diet for a median 3.6 years. Sustained remission of anemia during follow-up was interpreted as positive response. Results: ninety-eight patients (84% females with a mean age of 54 years were studied. Anti-TGt2 antibodies were positive in 5% of cases. A total of 67 cases (68% were haplotype HLA-DQ2 or -DQ8 (+. We found villous atrophy (Marsh III in 13% of patients, and an inflammatory pattern (Marsh I or II in 13%. All remaining 72 patients (74% had no histological duodenal changes. Age, anemia duration, number of transfusions, number of parenteral iron doses, and time on a gluten-free diet were all compared according to the presence or absence of villous atrophy and HLA-DQ2/8 positivity, and no significant differences were found for any of the analyzed variables. Response was positive in 92% of subjects. Conclusions: celiac disease with villous atrophy is rarely a cause of refractory anemia. Gluten intolerance with no histological lesions is seen in almost 75% of patients, and therefore plays a relevant role in its development.Introducción: la anemia ferropénica refractaria presenta un origen multifactorial, relacionado con diversas enfermedades digestivas, siendo las más frecuentes la enfermedad celiaca con malabsorción y la EII junto con la intolerancia al gluten aislada. Objetivos

  9. Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease.

    Leonard, Maureen M; Cureton, Pamela; Fasano, Alessio

    2017-10-18

    For the majority of patients diagnosed with celiac disease, once a gluten-free diet is initiated, symptoms improve within weeks and may completely resolve in months. However, up to 30% of patients may show signs, symptoms or persistent small intestinal damage after one year on a gluten-free diet. These patients require evaluation for other common GI etiologies and assessment of their celiac disease status in order to make a diagnosis and suggest treatment. Here, we propose an approach to evaluating patients with celiac disease with persistent symptoms, persistently elevated serology, and or persistent villous atrophy despite a gluten-free diet. We detail how to diagnose and distinguish between non-responsive and refractory celiac disease. Finally, we introduce the indications for use of the gluten contamination elimination diet and provide information for practitioners to implement the diet when necessary in their practice.

  10. Treating autism spectrum disorder with gluten-free and casein-free diet: the underlying microbiota-gut-brain axis mechanisms

    Ciéslińska, Anna; Kostyra, Elzbieta; Savelkoul, H.F.J.

    2017-01-01

    There is a rising interest in the use of dietary interventions to
    ameliorate prevalent brain diseases, including Autism Spectrum
    Disorder (ASD). Nowadays, the existence of communication between
    gut and brain is well accepted and thus diet can influence
    brain functioning. A well-known

  11. Safety evaluation of transgenic low-gliadin wheat in Sprague Dawley rats: An alternative to the gluten free diet with no subchronic adverse effects.

    Ozuna, Carmen Victoria; Barro, Francisco

    2017-09-01

    Gluten-associated pathologies have increased in recent years and there is a greater demand for low or gluten-free products. Transgenic low-gliadin wheat lines showed low T-cell response, good bread-making properties, and excellent sensory assets. The aim of this study was to evaluate the safety of the whole-wheat flour from one transgenic low-gliadin line (named E82) in a 90-day feeding study. In this study males (n = 50) and females (n = 50) SD rats were used. They were fed with doses of 1.42, 2.83 and 5.67 g/kg/day of the transgenic E82 line, 5.67 g/kg/day of the WT and a blank group. We found that there were no significant differences in the development of animals. Biochemistry for liver and kidney function were similar for males and females of all groups. Other haematological and metabolic blood parameters, as well as organ weight did not show significant differences in the five groups of animals. In the histopathological study performed for the higher dose of transgenic E82 line, WT and blank group no abnormalities were observed. The whole-wheat flour of E82 line administered to rats at tested doses for 90 days did not have any adverse effects and there was no difference with the rats which ate WT wheat. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. The Effects of a Gluten-free Diet Versus a Hypocaloric Diet Among Patients With Fibromyalgia Experiencing Gluten Sensitivity-like Symptoms: A Pilot, Open-Label Randomized Clinical Trial.

    Slim, Mahmoud; Calandre, Elena P; Garcia-Leiva, Juan M; Rico-Villademoros, Fernando; Molina-Barea, Rocio; Rodriguez-Lopez, Carmen M; Morillas-Arques, Piedad

    2017-07-01

    Patients with fibromyalgia frequently present with symptoms similar to those experienced by patients with gluten-related disorders, raising the possibility that a subgroup of these patients could be experiencing underlying gluten sensitivity. This study aimed to evaluate the effects of a gluten-free diet (GFD) compared with a hypocaloric diet (HCD) among patients with fibromyalgia. Adult patients diagnosed with fibromyalgia were randomly allocated to receive a GFD or a HCD over a 24-week period. The primary outcome measure was the change in the number of gluten sensitivity symptoms. The following secondary outcomes were evaluated: body mass index, Revised Fibromyalgia Impact Questionnaire, Pittsburgh Sleep Quality Index, Brief Pain Inventory, Beck Depression Inventory-II, State-Trait Anxiety Inventory, Short-Form Health Survey, Patient Global Impression Scale of Severity, Patient Global Impression Scale of Improvement, and adverse events. Seventy-five subjects were randomly allocated to receive either a GFD (n=35) or an HCD (n=40). The least squares mean change in the total number of gluten sensitivity symptoms from baseline did not differ significantly between the GFD and HCD groups (-2.44±0.40 for the GFD; -2.10±0.37 for the HCD; P=0.343). Similarly, the 2 dietary interventions did not differ in any of the remaining measured secondary outcomes. Both dietary interventions were well tolerated. Both dietary interventions were associated with similar beneficial outcomes in reducing gluten sensitivity symptoms and other secondary outcomes. However, despite its specificity, GFD was not superior to HCD in reducing the number of gluten sensitivity symptoms or secondary outcomes.

  13. Quick Start Gluten Free Diet Guide for Celiac Disease and Non Celiac Sensitivity

    ... bread for lunch; and rice, corn or quinoa pasta for dinner. Include lean meats and proteins, fresh ... Cakes and other Baked Goods • Crackers • Croutons • Flour • Pastas • Stuffings and Dressings Foods that may contain gluten ...

  14. RHEOLOGICAL CHARACTERISTICS OF GLUTEN-FREE DOUGH

    Iva Burešová

    2014-02-01

    Full Text Available Dynamic oscillation rheometry was used to determine the viscoelastic properties of gluten-free dough prepared from amaranth, chickpea, millet, corn, quinoa, buckwheat and rice flours. The viscoelastic properties was described by storage modulus G´, loss modulus G´´ and phase angle tg(δ. The relationship between viscoelastic properties of gluten-free dough and bread-making quality was evaluated. The results of this study indicated that dynamic oscillation rheometry may be used to differentiate the bread-making quality of gluten-free flour. Bread-making quality of gluten-free flour is the best characterised by curve slope of storage modulus G´and phase angle tg(δ while bread made from the flour with storage modulus and phase angle with non-linear slope in low deformation frequencies 0.01–0.10 Hz achieved the largest volume.

  15. Quinoa Well Tolerated in Patients with Celiac Disease

    ... Maryland (January 21, 2014) – Adding quinoa to the gluten-free diet of patients with celiac disease is well-tolerated, ... grain, is traditionally recommended as part of a gluten-free diet. However, in-vitro data suggests that quinoa storage ...

  16. QUALITY OF GLUTEN-FREE BUCKWHEAT-RICE BREAD

    Petra Dvořáková

    2013-02-01

    Full Text Available In case of celiac disease the products containing gluten must be excluded from the nutrition. The offer of gluten-free products (especially pastry is low and in addition the gluten-free breads are typical of dry crust and crumb and higher firmness in comparison with wheat bread. This work deals with gluten-free mixtures prepared from buckwheat and rice flour and the effect of rising amount of these flours on bread quality, crumb hardness, elasticity, chewiness and gumminess. With rising portion of buckwheat flour in the mixture the bread volume, dough and bread yield increased. The biggest improvement was found for mean bread volume (30% between the samples FO 1090 (166.7 cm3 and FO 9010 (216.7 cm3. The texture analysis showed positive effect of rice flour on hardness, chewiness and gumminess. Hardness decreased from 114.5 N (F 100 to 91.3 N (FO 1090. Very similar results showed chewiness and gumminess. Chewiness of F 100 (314.0 was reduced by 32.5% to 212.2 at the sample FO 1090. Gumminess was improved almost linearly through the samples, the biggest difference (44.3% was found between the check sample F 100 (88.3 and FO 1090 (49.7.

  17. Sweet potato in gluten-free pancakes.

    Gluten-free pancakes were prepared using rice flour, and rice flour replaced with various amounts, at 10, 20, and 40% of sweet potato flour. At 40% sweet potato, the apparent viscosity became comparable to that of the traditional wheat pancake batter. Texture properties of the cooked pancakes, such...

  18. Label free targeted detection and quantification of celiac disease immunogenic epitopes by mass spectrometry

    Broeck, van den H.C.; Cordewener, J.H.G.; Nessen, M.A.; America, A.H.P.; Meer, van der I.M.

    2015-01-01

    Celiac disease (CD) is a food-related disease caused by certain gluten peptides containing T-cell stimulating epitopes from wheat, rye, and barley. CD-patients have to maintain a gluten-free diet and are therefore dependent on reliable testing and labeling of gluten-free products. So far, the

  19. Optimization of corn, rice and buckwheat formulations for gluten-free wafer production.

    Dogan, Ismail Sait; Yildiz, Onder; Meral, Raciye

    2016-07-01

    Gluten-free baked products for celiac sufferers are essential for healthy living. Cereals having gluten such as wheat and rye must be removed from the diet for the clinical and histological improvement. The variety of gluten-free foods should be offered for the sufferers. In the study, gluten-free wafer formulas were optimized using corn, rice and buckwheat flours, xanthan and guar gum blend as an alternative product for celiac sufferers. Wafer sheet attributes and textural properties were investigated. Considering all wafer sheet properties in gluten-free formulas, better results were obtained by using 163.5% water, 0.5% guar and 0.1% xanthan in corn formula; 173.3% water, 0.45% guar and 0.15% xanthan gum in rice formula; 176% water, 0.1% guar and 0.5% xanthan gum in buckwheat formula. Average desirability values in gluten-free formulas were between 0.86 and 0.91 indicating they had similar visual and textural profiles to control sheet made with wheat flour. © The Author(s) 2015.

  20. Specificity analysis of anti-gliadin mouse monoclonal antibodies used for detection of gliadin in food for gluten-free diet

    Sánchez, Daniel; Tučková, Ludmila; Burkhard, M.; Plicka, J.; Mothes, T.; Hoffmanová, I.; Tlaskalová, Helena

    2007-01-01

    Roč. 55, - (2007), s. 2627-2632 ISSN 0021-8561 R&D Projects: GA AV ČR 1QS500200572; GA AV ČR IAA500200709; GA ČR GP310/04/P242; GA ČR GA310/05/2245; GA ČR GA310/07/0414; GA MZe 1B53002; GA MŠk 2B06155 Institutional research plan: CEZ:AV0Z50200510 Keywords : antibody specificity * gliadin * celiac disease Subject RIV: EE - Microbiology, Virology Impact factor: 2.532, year: 2007

  1. Gluten-Free Diet Guide for Families

    ... sumer Act. This new law requires companies to identify in “plain English” the eight most prevalent food allergens in- cluding eggs, fish, milk, peanuts, shellfish, soybeans, tree nuts and wheat. If wheat protein or a ...

  2. Nutritional evaluation of the gluten free diet

    Mazzeo, Teresa

    2014-01-01

    Attualmente l’unico trattamento previsto per la malattia celiaca è una rigorosa e permanente eliminazione del glutine dalla dieta. Nella comunità scientifica esiste ancora incertezza riguardo l’adeguatezza e la qualità nutrizionale di tale regime alimentare, poiché gli studi presenti al riguardo sono abbastanza contrastanti rendendo pertanto complicato trarre delle conclusioni definitive. I limitati dati esistenti sulla composizione nutrizionale dei prodotti senza glutine potrebbero in parte ...

  3. La salute del christifidelis celiaco tra dieta gluten free e invalidità delle ostie quibus glutinum ablatum est

    Tiziana Di Iorio

    2015-04-01

    SOMMARIO: 1. L’Eucarestia: “augusto” strumento per la salute deichristifideles nell’economia della salvezza - 2. La transustanziazione - 3. La malattia celiaca e l’unico rimedio terapeutico: la dieta gluten free - 4. Ilchristifidelis affetto dalla sprue celiaca tra dieta gluten free e pane mere triticeus - 5. Prime disposizioni sul divieto dell’uso di ostie quibus glutinum ablatum est - 6. La particola con “una minima quantità di glutine” - 7. Le vigenti prescrizioni sulla validità della materia eucaristica e l’uso di ostie a basso contenuto di glutine - 8. La normativa sulla comunione dei celiaci tra sospetti e apprezzamenti - 9. Ultime precisazioni sull’uso del pane con poca quantità di glutine - 10. Conclusioni. The health of the christifidelis celiac between diet gluten free and invalidity of the hosts quibus glutinum ablatum est.  ABSTRACT: The communion of celiac has aroused the attention of the Congregation for the Doctrine of the Faith for the direct connection between gluten, cause of the disease, and bread mere triticeus, precious element of the Eucharist. The complex matter concerns the impelling urgency to allow the christifidelis celiac to follow a super stricte gluten free diet, necessary way to the protection of his mental and physical health, without expelling him from the eucharistic banquet, indispensable instrument of salvation of his own soul. Therefore, in the saving mission of the Church called to the salus animarum of every man, without discriminating exclusions, direct specific norms are emanated to harmonize the dogmatic demands, connected to the Eucharestic, and the therapeutic needs related to mental and physical health of the faithful with the disease. Such norms have faced the validity of the eucharistic matter sealing the invalidity of the hosts quibus glutinum ablatum est, with a meaningful evolution, during the time. It stays, nevertheless, the suspect of an exhaustive solution of the question

  4. Preparation and Quality Evaluation of Gluten-Free Biscuits

    Simona Maria Man

    2014-05-01

    Full Text Available The aglutenics biscuits are intended to those persons who are suffering due to gluten intolerance, also named celiac disease. The fabrication technologies of the aglutenics products can be developed in on two ways: by separating the gluten from the grain or by replacing the grain flour with other types of gluten less flour, in case of bakery and pastry products. In this experiment, the gluten-free biscuits were obtained from the following flours mixture: maize flour (MF, rice flour (RF and soybeans flour (SF. Other raw materials were used, such as: palmtree oil, honey, maize starch, eggs, sugar powdered, vanilla essence and sodium bicarbonate. Four experimental variants (gluten-free biscuits were obtained by varying the proportion of flours ; these variants were coded as follows T1, T2 T3 and T4. The optimization of the aglutenics biscuits manufacture recipe was realized through sensory analyze, using the hedonic test (9 point scale. Samples of biscuits was subjected to the following physico-chemical analysis: moisture content, alkalinity, total carbohydrate content, total fat and protein content. Also the physical properties (length, width, thickness, weight and spread ratio were determined in order to asses the blending influence on the biscuits quality. The blend with flour levels 30:30:40 (MF:RF:SF led to the highest acceptability.

  5. Whole grain gluten-free pastas and flatbreads

    Whole grain gluten-free products were formulated and evaluated for acceptance by volunteer tasters. The tastes judged acceptance of whole grain, gluten-free, egg-free pastas for corn 83%, sorghum 79%, brown rice 77% and millet 50%. The acceptance for similar high protein pasta was corn-garbanzo 70...

  6. Whole grain gluten-free vegetable spicy snacks

    Four kinds of spicy snacks (gluten-free, whole grains with fresh vegetables, low in fat, sugar and salt) were evaluated. Acceptance of spicy snacks tested were Carrot-Garlic 77%, Broccoli-Garlic 68%, Spinach-Garlic 61% and Red Onion 53%. This is the first report of spicy gluten-free, 50% vegetable...

  7. The Role of Oxidative Stress in the Etiopathogenesis of Gluten-Sensitive Enteropathy Disease

    Kaplan Mustafa

    2017-09-01

    Full Text Available Background: The objective here is to examine the role of overall oxidative stress in the etiopathogenesis of gluten-sensitive enteropathy disease and its relationship with gluten free diet and autoantibodies.

  8. Serum lysozyme activity in coeliac disease: a possible aid to athe diagnosis of malignant change.

    Cooper, B T; Ukabam, S O; Barry, R E; Read, A E

    1981-01-01

    Serum lysozyme activities were measured in 34 control subjects, 13 untreated adult coeliac patients, 21 adult coeliac patients on gluten-free diet, and eight coeliac patients with a histiocytic lymphoma. Serum lysozyme activities were raised in three untreated patients, three patients treated with a gluten-free diet, and in only two patients with coeliac disease and lymphoma. Serum lysozyme estimations cannot be recommended as an aid to the diagnosis of lymphoma in patients with coeliac disease.

  9. Going Gluten Free? Necessary for Some, Optional for Others

    ... Special Issues Subscribe May 2016 Print this issue Going Gluten Free? Necessary for Some, Optional for Others ... may confirm the diagnosis by removing a small piece of your intestine to inspect it for damage. ...

  10. Chemometric analysis of minerals in gluten-free products.

    Gliszczyńska-Świgło, Anna; Klimczak, Inga; Rybicka, Iga

    2018-06-01

    Numerous studies indicate mineral deficiencies in people on a gluten-free (GF) diet. These deficiencies may indicate that GF products are a less valuable source of minerals than gluten-containing products. In the study, the nutritional quality of 50 GF products is discussed taking into account the nutritional requirements for minerals expressed as percentage of recommended daily allowance (%RDA) or percentage of adequate intake (%AI) for a model celiac patient. Elements analyzed were calcium, potassium, magnesium, sodium, copper, iron, manganese, and zinc. Analysis of %RDA or %AI was performed using principal component analysis (PCA) and hierarchical cluster analysis (HCA). Using PCA, the differentiation between products based on rice, corn, potato, GF wheat starch and based on buckwheat, chickpea, millet, oats, amaranth, teff, quinoa, chestnut, and acorn was possible. In the HCA, four clusters were created. The main criterion determining the adherence of the sample to the cluster was the content of all minerals included to HCA (K, Mg, Cu, Fe, Mn); however, only the Mn content differentiated four formed groups. GF products made of buckwheat, chickpea, millet, oats, amaranth, teff, quinoa, chestnut, and acorn are better source of minerals than based on other GF raw materials, what was confirmed by PCA and HCA. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  11. Gluten-free is not enough--perception and suggestions of celiac consumers.

    do Nascimento, Amanda Bagolin; Fiates, Giovanna Medeiros Rataichesck; dos Anjos, Adilson; Teixeira, Evanilda

    2014-06-01

    The present study investigated the perceptions of individuals with celiac disease about gluten-free (GF) products, their consumer behavior and which product is the most desired. A survey was used to collect information. Descriptive analysis, χ² tests and Multiple Logistic Regressions were conducted. Ninety-one questionnaires were analyzed. Limited variety and availability, the high price of products and the social restrictions imposed by the diet were the factors that caused the most dissatisfaction and difficulty. A total of 71% of the participants confirmed having moderate to high difficulty finding GF products. The logistic regression identified a significant relationship between dissatisfaction, texture and variety (p < 0.05) and between variety and difficulty of finding GF products (p < 0.05). The sensory characteristics were the most important variables considered for actual purchases. Bread was the most desired product. The participants were dissatisfaction with GF products. The desire for bread with better sensory characteristics reinforces the challenge to develop higher quality baking products.

  12. Formulation of gluten-free flour culinary products of high nutritional value

    Y. P. Dombrovskaya

    2016-01-01

    Full Text Available The article is devoted to the production of gluten-free foods that are necessary for people suffering from this disease as celiac disease. The article reveals the relevance of developing recipes for gluten-free foods, which are not inferior to traditional in many respects. Classic recipes gluten-free bakery products, mainly based on rice, buckwheat, corn flour, which have little nutritional value. In this regard, the current development of technologies and formulations pastry dishes with use of nonconventional vegetable raw materials rich in dietary fibers, proteins and other beneficial substances that improve the biological and nutritional value of these products. The paper describes the formulation of gluten-free muffins, was based on the recipe of the cake "Capital". The main raw material for the new compositions of selected rice flour, and as enriching additives – flax flour and flour from the eggshell. Was conducted baking tests on the basis of which was chosen percentage of the input substances and the assessment of quality of semifinished and finished products. The quality of semi-finished products was evaluated by such indicators as humidity and the microstructure of the test. The quality of finished products was assessed using organoleptic and physical-chemical parameters, the results presented in the tables. Investigated the antioxidant activity of products. Produced sensometrical evaluation of aroma of control and experimental samples. Calculated chemical composition. The content of protein, vitamins, mineral substances in the experimental sample is significantly increased compared to control. Making flour egg shell has achieved the ratio of Ca-Mg-P as close to a perfect 1:0,39:1,53 Replacement of wheat flour with flaxseed and rice flour and the introduction of egg shell improve the amino acid composition of the product. The biological value increased by 2.3%.

  13. Smoking and Diet: Impact on Disease Course?

    Cosnes, Jacques

    2016-01-01

    The impact of current smoking on inflammatory bowel disease (IBD) course has been studied extensively; smoking is deleterious in Crohn's disease (CD), and beneficial in ulcerative colitis (UC). Except for enteral nutrition, there are only limited data regarding the impact of diet on disease course. Current smoking worsens the course of CD, increasing the incidence of flares, the need for steroids, immunosuppressants and re-operations. Conversely, smoking cessation has a rapid beneficial effect on disease course, decreasing the risk of flares and of post-operative recurrences. From 3 months after the quit date, quitters have a disease course similar to that of never smokers. Achieving smoking cessation in CD is thus an important goal of therapy. On the contrary, smoking improves the course of UC and in particular, is associated with a decreased need for colectomy. Smoking cessation increases the risk of flare and the need for steroids or immunosuppressants. However, patients with UC should not be discouraged to quit, because the beneficial effect of smoking for their disease is counterbalanced by the deleterious systemic effects of tobacco. Among dietary interventions, only exclusive enteral nutrition was shown to induce remission and achieve mucosal healing in some patients with CD. The beneficial effect of liquid-defined diet is observed whatever be the type of administration (orally or by tube), the type of diet regarding protein and fat content and resulting alterations in the gut microbiota. In UC, enteral nutrition has no effect. Finally, popularized restrictive diets in IBD as the specific-carbohydrate diet and the gluten-free diet have not been rigorously tested. In a small trial, a semi-vegetarian diet was shown to be effective in maintaining remission over 2 years in CD. Patients with IBD should not smoke and avoid passive smoking. Aside from the defined liquid diets, there is no rationale for advising particular diets. © 2016 S. Karger AG, Basel.

  14. Heart disease and diet

    Diet - heart disease; CAD - diet; Coronary artery disease - diet; Coronary heart disease - diet ... diet and lifestyle can reduce your risk of: Heart disease, heart attacks, and stroke Conditions that lead ...

  15. Macrocospic and physiochemical characterization of a sugarless and gluten-free cake enriched with fibers made from pumpkin seed (Cucurbita maxima, L. flour and cornstarch

    Cristiane Mesquita da Silva Gorgônio

    2011-03-01

    Full Text Available The Consumers' interest for products with caloric reduction has increased, and their development is a technological challenge. The consumption of cakes has grown in importance and the demand for dietary products has stimulated the use of sweeteners and the optimization of bakery products. The consumption of fibers is related to chronic diseases prevention. Pumpkin seeds (maximum Cucurbita, L., rich in fibers, can be used as a source of fiber in food products. A gluten-free diet is not easy to follow since gluten free products are not always available. The objective of this work was to perform a physicochemical characterization of cakes prepared with flours blends (FB based on Pumpkin Seed Flour (PSF. The cakes were elaborated with FB in the ratios of 30:70 (C30 and 40:60 (C40 of PSF and cornstarch (CS, respectively. The results showed gluten absence and near-neutral pH. The chemical analysis of C30 and B40 showed increase of ashes, lipids, proteins, and insoluble dietary fiber and a decrease in the content of carbohydrates and calories. The chemical composition of C40 presented the greatest content of lipids, proteins, and dietary fibers, the lowest content of calories, and the best physical parameters. Therefore, both products proved suitable for human consumption.

  16. Restaurant Dining: Seven Tips for Staying Gluten Free

    GiG Education Bulletin Restaurant Dining: Seven Tips for Staying Gluten-Free Updated May 2014 Tips for Dining Away from Home 1. Selection of ... a number of factors, including the type of restaurant you choose. • Be careful in restaurants where language ...

  17. Ancient whole grain gluten-free egg-free Pasta

    The USDA food guide recommends that at least ½ of all the grains eaten should be whole grains. The FDA allows food Health Claim labels for food containing 51% whole gains and 11 g of dietary fiber per serving. This is the only report demonstrating innovative ancient whole grain, gluten-free, egg-fre...

  18. Whole grain gluten-free egg-free pasta

    The USDA food guide recommends that at least ½ of all the grains eaten should be whole grains. The FDA allows food Health Claim labels for food containing 51% whole grains and 11 g of dietary fiber. This is the only report demonstrating innovative whole grain gluten free, egg free (no chemicals adde...

  19. Ancient whole grain gluten-free buckwheat snacks

    Four kinds of whole grain Buckwheat snacks (gluten-free, low in fat and salt) were evaluated. The snacks were Buckwheat, Buckwheat-Turmeric, Buckwheat-Pepper and Buckwheat-Ginger. Turmeric and Ginger are very common ingredients of Asian cuisines. Turmeric and ginger have been reported to have heal...

  20. Whole grain gluten-free vegetable savory snacks

    Four kinds of savory snacks (gluten-free, whole grains with fresh vegetables, low in fat and salt) were evaluated. Composition of the base formulation (BF) as is basis was brown rice flour (45%), sorghum flour (20%), tapioca flour (7%), mashed potato (8%), canola oil (6%), guar gum (2%), baking pow...

  1. Quinoa ancient whole grain gluten-free snacks

    Four kinds of whole grain gluten-free low fat and salt quinoa snacks were evaluated. The snacks were Quinoa, Quinoa-Pepper, Quinoa-Ginger and Quinoa-Turmeric. In the Asian cuisines ginger and turmeric are very common. Ginger has been reported to improve blood flow and prevent joint pains. Turmer...

  2. Sensory evaluation of gluten-free quinoa whole grain snacks

    Quinoa gluten-free whole grain low fat and salt snacks were evaluated. The snacks were Quinoa, Quinoa-Cayenne Pepper, Quinoa-Ginger and Quinoa-Turmeric. Cayenne pepper, ginger and turmeric are common spices that contain health promoting nutrients. Cayenne pepper has been associated with enhancing ...

  3. Whole grain Gluten-free vegetable spicy snacks (abstract)

    Four kinds of spicy snacks (gluten-free, whole grains with fresh vegetables, low in fat and salt) were evaluated. Composition of the base mix was brown rice flour 45%, sorghum flour 20%, tapioca flour 17%, mashed potato 8%, canola oil 6%, guar gum 2%, baking powder 1.5%, salt 0.5% and cayenne peppe...

  4. Fundamental Study on the Impact of Gluten-Free Starches on the Quality of Gluten-Free Model Breads

    Stefan W. Horstmann

    2016-04-01

    Full Text Available Starch is widely used as an ingredient and significantly contributes to texture, appearance, and overall acceptability of cereal based foods, playing an important role due to its ability to form a matrix, entrapping air bubbles. A detailed characterisation of five gluten-free starches (corn, wheat, rice, tapioca, potato was performed in this study. In addition, the influence of these starches, with different compositional and morphological properties, was evaluated on a simple gluten-free model bread system. The morphological characterisation, evaluated using scanning electron microscopy, revealed some similarities among the starches, which could be linked to the baking performance of the breads. Moreover, the lipid content, though representing one of the minor components in starch, was found to have an influence on pasting, bread making, and staling. Quality differences in cereal root and tuber starch based breads were observed. However, under the baking conditions used, gluten-free rendered wheat starch performed best, followed by potato starch, in terms of loaf volume and cell structure. Tapioca starch and rice starch based breads were not further analysed, due to an inferior baking performance. This is the first study to evaluate gluten-free starch on a simple model bread system.

  5. A randomised, double-blind, cross-over trial to evaluate bread, in which gluten has been pre-digested by prolyl endoprotease treatment, in subjects self-reporting benefits of adopting a gluten-free or low-gluten diet.

    Rees, Dinka; Holtrop, Grietje; Chope, Gemma; Moar, Kim M; Cruickshank, Morven; Hoggard, Nigel

    2018-03-01

    The aim of the present study was to determine if the enzyme Aspergillus niger prolyl endoprotease (ANPEP), which degrades the immunogenic proline-rich residues in gluten peptides, can be used in the development of new wheat products, suitable for gluten-sensitive (GS) individuals. We have carried out a double-blind, randomised, cross-over trial with two groups of adults; subjects, self-reporting benefits of adopting a gluten-free or low-gluten diet (GS, n 16) and a control non-GS group (n 12). For the trial, volunteers consumed four wheat breads: normal bread, bread treated with 0·8 or 1 % ANPEP and low-protein bread made from biscuit flour. Compared with controls, GS subjects had a favourable cardiovascular lipid profile - lower LDL (4·0 (sem 0·3) v. 2·8 (sem 0·2) mmol/l; P=0·008) and LDL:HDL ratio (3·2 (sem 0·4) v. 1·8 (sem 0·2); P=0·005) and modified haematological profile. The majority of the GS subjects followed a low-gluten lifestyle, which helps to reduce the gastrointestinal (GI) symptoms severity. The low-gluten lifestyle does not have any effect on the quality of life, fatigue or mental state of this population. Consumption of normal wheat bread increased GI symptoms in GS subjects compared with their habitual diet. ANPEP lowered the immunogenic gluten in the treated bread by approximately 40 %. However, when compared with the control bread for inducing GI symptoms, no treatment effects were apparent. ANPEP can be applied in the production of bread with taste, texture and appearance comparable with standard bread.

  6. Impact of Quince Flour on Gluten-free Muffins Production

    Adriana PAUCEAN

    2017-05-01

    Full Text Available This study aimed to obtain gluten free muffins, with increased nutritional and sensorial value by adding quince flour into a composite flour. To optimize the recipe, four experimental variants using rice, soy, quince flours and starch in different proportions have been proposed. Quince is a rich source of vitamins, minerals, polyphenolic compounds and fibres. The quince flour addition led to muffins with increased content in minerals and very good sensorial properties in terms of taste, flavour, texture and general acceptance. It could be concluded that quince flour is a suitable source for obtaining gluten free muffins. Quince flour addition in aglutenic muffin composite flour up to 10% did not affect negatively their phisico-chemical and sensorial  properties.

  7. Biochemical and immunochemical evidences supporting the inclusion of quinoa (Chenopodium quinoa Willd.) as a gluten-free ingredient.

    Peñas, Elena; Uberti, Francesca; di Lorenzo, Chiara; Ballabio, Cinzia; Brandolini, Andrea; Restani, Patrizia

    2014-12-01

    To date, the only acceptable therapeutic approach for celiac disease (CD) is a strict elimination from the diet of gluten-containing foods, but this diet does not always guarantee an adequate nutritional intake. Pseudocereals are receiving considerable attention as interesting alternatives for the formulation of gluten-free products, and quinoa grains arise as nutritive substitutes of conventional cereals. The aim of this study was the characterization of different quinoa samples corresponding to 11 quinoa varieties, using polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate (SDS-PAGE) and immunoblotting techniques to assess their suitability for celiac subjects. Some of these varieties were grown in Italy to assess if the reproduction in a new habitat can guarantee the retention of the "safe" protein pattern. None of the quinoa varieties studied presented protein bands with electrophoretic mobility comparable with those of wheat gliadins, the toxic protein for celiac subjects. All the quinoa samples showed a low binding affinity for both specific anti-gliadin antibodies and IgAs from celiac subjects, confirming that quinoa can be considered as a safe ingredient for celiac patients. However, reliable varieties should be previously selected since the immuno cross-reactivity with anti-gliadin antibodies can vary significantly.

  8. Sensory evaluation of gluten-free quinoa whole grain snacks

    Kahlon, Talwinder S.; Avena-Bustillos, Roberto J.; Chiu, Mei-Chen M.

    2016-01-01

    Sensory evaluation of quinoa gluten-free whole grain low fat and salt snacks was conducted. The snacks were Quinoa, Quinoa-Cayenne Pepper, Quinoa-Ginger and Quinoa-Turmeric. Cayenne pepper, ginger and turmeric are common spices that contain health promoting nutrients. Cayenne pepper has been associated with enhancing heat production. Ginger has been reported to improve blood flow and prevent joint pains. Turmeric has been observed to have wound healing potential. All the snacks contained 6% c...

  9. Commercially available gluten-free pastas elevate postprandial glycemia in comparison to conventional wheat pasta in healthy adults: a double-blind randomized crossover trial.

    Johnston, C S; Snyder, D; Smith, C

    2017-09-20

    Given the popularity of gluten-free diets, research regarding the health implications of gluten-free (GF) products is necessary. This study compared the postprandial glycemic responses to three GF pastas commonly available in the U.S. market to that of wheat pasta in healthy adults. Thirteen healthy non-smoking men and women from a university campus population were enrolled in this randomized 4 × 4 block crossover study and completed all four treatments. Participants followed a standardized diet and activity protocol the day prior to testing, and one week separated testing periods. The test meal (a macaroni and cheese dish prepared with conventional wheat pasta or with GF pasta composed of either brown rice, rice and corn, or corn and quinoa flours) was consumed under observation, and blood was sampled in the fasted state and at one-half hour intervals for the first 2 hours following meal ingestion. A significant pasta × time interaction was observed for the incremental postprandial glycemia curves (p = 0.036, repeated measures ANOVA; effect size [partial eta squared], 0.943). Post-hoc analysis revealed a significant difference for the 30-minute postprandial blood glucose concentrations: the plasma glucose concentration was 57% higher for the GF rice and corn pasta compared to traditional wheat pasta (p = 0.011). Since postprandial glycemia was higher for GF pasta composed of rice and corn flours compared to wheat pasta, more research is needed to understand how the substitute ingredients for GF pastas impact health parameters and disease risk.

  10. Evolution of Gluten Content in Cereal-Based Gluten-Free Products: An Overview from 1998 to 2016

    María Ángeles Bustamante

    2017-01-01

    Full Text Available The treatment of Celiac disease consists in a strict lifelong gluten-free (GF diet. As the ingestion of small amounts can have damaging complications, there has been an ongoing discussion regarding the safe threshold for dietary residual gluten. The aim was to analyze the evolution of gluten content in cereal-based GF foodstuffs (n = 3141 from 1998 to 2016 measured by the enzyme-linked immunosorbent assay (ELISA technique. Eight categories were defined: flours, breakfast cereals/bars, bakery, pasta, breads, dough, snacks, and yeasts, and these were divided into GF labeled-foods (GF-L or reportedly GF foodstuffs, but not certified (GF-NC. Gluten-detection was decreased over time in line with the evolving European regulations about food information and gluten content claims. This decline started sooner in GF-L products than in GF-NC. As a whole, gluten was detected in 371 samples, with breakfast cereals/bars being the most contaminated group. Snacks and yeasts changed from being high gluten-detected samples to being totally GF over the years. The downside is that, of contaminated samples, those in the low levels of gluten detection range have decreased while flour samples containing over 100 mg/kg gluten have risen in the 2013–2016 period. Obtained data confirm that GF cereal-based foods are becoming safer but gluten control must be maintained.

  11. Plasma alkylresorcinols reflect gluten intake and distinguish between gluten-rich and gluten-poor diets in a population at risk of metabolic syndrome

    Lind, Mads Vendelbo; Madsen, Mia Linda; Rumessen, Jüri J

    2016-01-01

    BACKGROUND: Many patients with celiac disease experience difficulties in adherence to a gluten-free diet. Methods for testing compliance to a gluten-free diet are costly and cumbersome. Thus, a simple biomarker of gluten intake is needed in a clinical setting and will be useful for epidemiologic...... in plasma total alkylresorcinols per 1-g increase in reported gluten intake (P gluten-free diet as well as to help investigations into the possible effects of gluten in the wider population. This trial...... 8 wk of a gluten-rich and gluten-poor diet separated by a washout period of ≥6 wk. We measured fasting plasma concentrations of alkylresorcinols to determine if they reflected differences in gluten intake as a secondary outcome of the original study. In addition, we investigated in 118 Danish adults...

  12. In Vitro Bioavailability of Calcium, Magnesium, Iron, Zinc, and Copper from Gluten-Free Breads Supplemented with Natural Additives.

    Regula, J; Cerba, A; Suliburska, J; Tinkov, A A

    2018-03-01

    The aim of this study was to measure the content of calcium, magnesium, iron, zinc, and copper and determine the bioavailability of these ingredients in gluten-free breads fortified with milk and selected seeds. Due to the increasing prevalence of celiac disease and mineral deficiencies, it has become necessary to produce food with higher nutritional values which maintains the appropriate product characteristics. This study was designed for gluten-free breads fortified with milk and seeds such as flax, poppy, sunflower seeds, pumpkin seeds or nuts, and flour with amaranth. Subsequently, digestion was performed in vitro and the potential bioavailability of the minerals was measured. In the case of calcium, magnesium, iron, and copper, higher bioavailability was observed in rice bread, and, in the case of copper and zinc, in buckwheat bread. This demonstrated a clear increase in bioavailability of all the minerals when the bread were enriched. However, satisfactory results are obtained only for the individual micronutrients.

  13. Utilization of sorghum, rice, corn flours with potato starch for the preparation of gluten-free pasta.

    Ferreira, Sila Mary Rodrigues; de Mello, Ana Paula; de Caldas Rosa dos Anjos, Mônica; Krüger, Cláudia Carneiro Hecke; Azoubel, Patrícia Moreira; de Oliveira Alves, Márcia Aurelina

    2016-01-15

    The aim of this study was to evaluate the use of mixture of sorghum-rice-corn flour and potato starch in the development of gluten-free pasta for celiac disease patients. The experiment was designed according to simplex-lattice method and different types of gluten-free flours were used, such as sorghum, rice, corn, and potato starch. The fifteen formulations were subjected to sensory analysis (Mixed Structured Scale - MSS) and seven formulations were selected in respect to taste and grittiness. These formulations were subjected to Quantitative Descriptive Analysis (QDA), which evaluated the attributes: appearance, color, odor, hardness, elasticity, stickiness, grittiness, taste, residual bitterness and overall quality. Results showed significant difference in appearance, color and hardness. The formulations that showed the best sensory results were submitted to chemical analysis and cooking quality of pasta. It was observed that the best results for mixing is sorghum flour, rice flour and potato starch. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Development of gluten-free fish (Pseudoplatystoma corruscans) patties by response surface methodology.

    Romero, Mara C; Fogar, Ricardo A; Rolhaiser, Fabiana; Clavero, Verónica V; Romero, Ana M; Judis, María A

    2018-05-01

    The goal of this study was to develop a fish-based product suitable for people with celiac disease. Water and gluten-free flours (rice, corn, amaranth or quinoa) were added to improve cooking yield, texture parameters and as an aid in improving quality attributes such as taste and juiciness. Cooking yields of patties containing gluten-free flours were higher than control and maximum values ranged between 91 and 93%. Hardness was higher in patties made with amaranth or quinoa flour, whereas cohesiveness and springiness were higher in patties made with corn and rice flour, respectively. Response surface methodology was used to optimize patties formulations. Optimized formulations were prepared and evaluated showing a good agreement between predicted and experimental responses. Also, nutritional value and consumer acceptance of optimized formulations were analysed. Flours addition affected proximate composition increasing carbohydrates, total fat and mineral content compared to control. Sensory evaluation showed that no differences were found in the aroma of products. Addition of rice flour increased juiciness and tenderness whereas taste, overall acceptance and buying intention were higher in control patty, followed by patties made with corn flour. The present investigation shows good possibilities for further product development, including the scale up at an industrial level.

  15. Role of Diet in Influencing Rheumatoid Arthritis Disease Activity

    Badsha, Humeira

    2018-01-01

    Background: Patients with Rheumatoid Arthritis (RA) frequently ask their doctors about which diets to follow, and even in the absence of advice from their physicians, many patients are undertaking various dietary interventions. Discussion: However, the role of dietary modifications in RA is not well understood. Several studies have tried to address these gaps in our understanding. Intestinal microbial modifications are being studied for the prevention and management of RA. Some benefits of vegan diet may be explained by antioxidant constituents, lactobacilli and fibre, and by potential changes in intestinal flora. Similarly, Mediterranean diet shows anti-inflammatory effects due to protective properties of omega-3 polyunsaturated fatty acids and vitamins, but also by influencing the gut microbiome. Gluten-free and elemental diets have been associated with some benefits in RA though the existing evidence is limited. Long-term intake of fish and other sources of long-chain polyunsaturated fatty acids are protective for development of RA. The benefits of fasting, anti-oxidant supplementation, flavanoids, and probiotics in RA are not clear. Vitamin D has been shown to influence autoimmunity and specifically decrease RA disease activity. The role of supplements such as fish oils and vitamin D should be explored in future trials to gain new insights in disease pathogenesis and develop RA-specific dietary recommendations. Conclusion: Specifically more research is needed to explore the association of diet and the gut microbiome and how this can influence RA disease activity. PMID:29515679

  16. quality of corn-field bean gluten-free pasta

    Dib Ahlem

    2018-01-01

    Full Text Available Corn semolina supplemented by field bean semolina in ratio of 2/1 (w/w were used for obtaining protein and fiber enriched gluten-free pasta. The effect of hydrothermal treatment of corn flour on its applicability as gluten-free pasta improver was tested. A central composite design involving water hydration level and the amount of hydrothermal treated corn flour were used. Instrumental analyses of pasta (cooking loss, water absorption capacity, hydration and pasting properties, textural parameters and microstructure were carried out to assess the impact of experimental factors. Results showed that hydrothermal treatment of corn flour affected in different extent on pasta properties, improving cooking and textural characteristics of pasta. The optimum formulation of corn-field bean contained 7.41 g of treated corn flour and 77.26 mL of water was selected on the base of desirability function approach with value of 0.825 which showed the best pasta properties. Obtained results showed also that addition of treated flour induced significant differences (p < 0.05 in all parameters in comparison with control pasta.

  17. Designing a Score-Based Method for the Evaluation of the Nutritional Quality of the Gluten-Free Bakery Products and their Gluten-Containing Counterparts

    Morreale, Federico; Angelino, Donato; Pellegrini, Nicoletta

    2018-01-01

    Gluten-free (GF) products are consumed both by individuals with celiac disease and by an increasing number of people with no specific medical needs. Although the technological quality of GF products has been recently improved, their nutritional quality is still scarcely addressed. Moreover, the few

  18. Gluten-Free Diet: Nutrition and Healthy Eating

    ... Pastas Hot dogs and processed luncheon meats Salad dressings Sauces, including soy sauce Seasoned rice mixes Seasoned snack foods, such as potato and tortilla chips Self-basting poultry Soups, bouillon or soup mixes Vegetables in sauce ...

  19. Gluten-free diet prevents diabetes in NOD mice

    Funda, David P.; Kaas, A.; Bock, T.; Tlaskalová, Helena; Buschard, K.

    1999-01-01

    Roč. 15, - (1999), s. 323-327 ISSN 1520-7552 R&D Projects: GA ČR GA306/98/0433; GA ČR GA311/97/0784; GA MZd NI5051; GA AV ČR IAA7020716; GA AV ČR IAA7020808 Institutional research plan: CEZ:A53/98:Z5-020-9ii Subject RIV: EC - Immunology Impact factor: 2.417, year: 1999

  20. Structural analysis of gluten-free doughs by fractional rheological model

    Orczykowska, Magdalena; Dziubiński, Marek; Owczarz, Piotr

    2015-02-01

    This study examines the effects of various components of tested gluten-free doughs, such as corn starch, amaranth flour, pea protein isolate, and cellulose in the form of plantain fibers on rheological properties of such doughs. The rheological properties of gluten-free doughs were assessed by using the rheological fractional standard linear solid model (FSLSM). Parameter analysis of the Maxwell-Wiechert fractional derivative rheological model allows to state that gluten-free doughs present a typical behavior of viscoelastic quasi-solid bodies. We obtained the contribution dependence of each component used in preparations of gluten-free doughs (either hard-gel or soft-gel structure). The complicate analysis of the mechanical structure of gluten-free dough was done by applying the FSLSM to explain quite precisely the effects of individual ingredients of the dough on its rheological properties.

  1. Legumes as Functional Ingredients in Gluten-Free Bakery and Pasta Products.

    Foschia, Martina; Horstmann, Stefan W; Arendt, Elke K; Zannini, Emanuele

    2017-02-28

    The increasing demand for gluten-free food products from consumers has triggered food technologists to investigate a wide range of gluten-free ingredients from different sources to reproduce the unique network structure developed by gluten in a wheat-dough system. In recent times, the attention has been focused on novel application of legume flour or ingredients. The interest in this crop category is mainly attributed to their functional properties, such as solubility and water-binding capacity, which play an important role in gluten-free food formulation and processing. Their nutritional profile may also counteract the lack of nutrients commonly highlighted in commercial gluten-free bakery and pasta products, providing valuable sources of protein, dietary fiber, vitamins, minerals, and complex carbohydrates, which in turn have a positive impact on human health. This review reports the main chemical and functional characteristics of legumes and their functional application in gluten-free products.

  2. CELIAC DISEASE IN CHILDREN. A HISTORY CASE WITH ONSET AT THE AGE OF 17 YEARS

    M. O. Revnova

    2013-01-01

    Full Text Available Being one of the most common representatives of malabsorbtion syndrome celiac disease has been diagnosed more and more often in Russia. Celiac disease is a hereditary condition with high prevalence and different symptoms called «Great Mimic». The article deals with diagnostics based on testing the antibodies to tTG, DPG, biopsies of the duodenum and gluten free diet. There is given an example of severe case of celiac disease in a 17-years-old boy with weight loss, delayed sexual development and severe gastrointestinal symptoms. Gluten free diet and proper treatment led to permanent remission.

  3. Sensory evaluation of gluten-free quinoa whole grain snacks

    Talwinder S. Kahlon

    2016-12-01

    Full Text Available Sensory evaluation of quinoa gluten-free whole grain low fat and salt snacks was conducted. The snacks were Quinoa, Quinoa-Cayenne Pepper, Quinoa-Ginger and Quinoa-Turmeric. Cayenne pepper, ginger and turmeric are common spices that contain health promoting nutrients. Cayenne pepper has been associated with enhancing heat production. Ginger has been reported to improve blood flow and prevent joint pains. Turmeric has been observed to have wound healing potential. All the snacks contained 6% corn oil and 2% salt. Snack dough was prepared using 120 mL water for 100 g dry ingredients. About 20 g of snack dough was placed on center of preheated KrumKake Express Baker and cooked for 2 min. Seventy in-house volunteers judged Color/Appearance of Quinoa, Quinoa-Cayenne Pepper and Quinoa-Ginger snacks significantly (p ≤ 0.05 higher than Quinoa-Turmeric snacks. Odor/Aroma of Quinoa-Ginger snacks was significantly higher than other snacks tested. Texture/Mouth-feel of Quinoa-Cayenne Pepper, Quinoa-Ginger and Quinoa-Turmeric snacks was similar and significantly higher than Quinoa snacks. Taste/Flavor and Acceptance was similar in four kinds of snacks tested. Water activity of all the snacks tested ranged from 0.41–0.55 suggesting that these snacks were crispy with good antimicrobial stability. These snacks would be quite filling due to their expansion of 2.6–3.1 times due to high porosity. Acceptance of snacks tested was Quinoa 79%, Quinoa-Cayenne Pepper 77%, Quinoa-Ginger 73% and Quinoa-Turmeric 70%. These snacks contained only 3–4 ingredients and could be made in any house kitchen or commercial production. Acceptance of 70–79% is very desirable. These healthy nutritious gluten-free quinoa snacks offer choice for all including vegetarians and individuals hypersensitive to gluten.

  4. Sensory evaluation of gluten-free quinoa whole grain snacks.

    Kahlon, Talwinder S; Avena-Bustillos, Roberto J; Chiu, Mei-Chen M

    2016-12-01

    Sensory evaluation of quinoa gluten-free whole grain low fat and salt snacks was conducted. The snacks were Quinoa, Quinoa-Cayenne Pepper, Quinoa-Ginger and Quinoa-Turmeric. Cayenne pepper, ginger and turmeric are common spices that contain health promoting nutrients. Cayenne pepper has been associated with enhancing heat production. Ginger has been reported to improve blood flow and prevent joint pains. Turmeric has been observed to have wound healing potential. All the snacks contained 6% corn oil and 2% salt. Snack dough was prepared using 120 mL water for 100 g dry ingredients. About 20 g of snack dough was placed on center of preheated KrumKake Express Baker and cooked for 2 min. Seventy in-house volunteers judged Color/Appearance of Quinoa, Quinoa-Cayenne Pepper and Quinoa-Ginger snacks significantly ( p ≤ 0.05) higher than Quinoa-Turmeric snacks. Odor/Aroma of Quinoa-Ginger snacks was significantly higher than other snacks tested. Texture/Mouth-feel of Quinoa-Cayenne Pepper, Quinoa-Ginger and Quinoa-Turmeric snacks was similar and significantly higher than Quinoa snacks. Taste/Flavor and Acceptance was similar in four kinds of snacks tested. Water activity of all the snacks tested ranged from 0.41-0.55 suggesting that these snacks were crispy with good antimicrobial stability. These snacks would be quite filling due to their expansion of 2.6-3.1 times due to high porosity. Acceptance of snacks tested was Quinoa 79%, Quinoa-Cayenne Pepper 77%, Quinoa-Ginger 73% and Quinoa-Turmeric 70%. These snacks contained only 3-4 ingredients and could be made in any house kitchen or commercial production. Acceptance of 70-79% is very desirable. These healthy nutritious gluten-free quinoa snacks offer choice for all including vegetarians and individuals hypersensitive to gluten.

  5. Intraepithelial lymphocytes in refractory celiac disease : lost in transition

    Schmitz, Frederike

    2014-01-01

    Refractory coeliac disease type II (RCDII) is a severe complication of coeliac disease. Whereas celiac disease can successfully be treated by the strict avoidance of gluten, refractory celiac patients show no remission despite a gluten-free diet. The pathology of RCDII is only partially understood,

  6. Novel Therapeutic/Integrative Approaches for Celiac Disease and Dermatitis Herpetiformis

    Alessio Fasano

    2012-01-01

    Full Text Available Celiac disease (CD is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Gluten is a protein component in wheat and other cereals like rye and barley. At present, the only available treatment is a strict gluten-free diet. Recent advances have increased our understanding of the molecular basis for this disorder. Last decade has seen new scientific developments in this disease and led to the formulation of new concepts of pathophysiology that offer possible targets for new treatments or interventions integrative to the gluten-free diet.

  7. Celiac disease and pulmonary hemosiderosis in a patient with chronic granulomatous disease

    Hartl, Dominik; Belohradsky, Bernd H.; Griese, Matthias; Nicolai, Thomas; Krauss-Etschmann, Susanne; Roos, Dirk; Wintergerst, Uwe

    2004-01-01

    We report on a patient with the hitherto undescribed combination of chronic granulomatous disease, pulmonary hemosiderosis, and celiac disease. The hemosiderosis resolved with a gluten-free diet and glucocorticosteroid pulse therapy, but the restrictive lung function pattern remained unchanged. Lung

  8. Balancing consumer protection and scientific integrity in the face of uncertainty: the example of gluten-free foods.

    McCabe, Margaret Sova

    2010-01-01

    In 2009, gluten-free foods were not only "hot" in the marketplace, several countries, including the United States, continued efforts to define gluten-free and appropriate labeling parameters. The regulatory process illuminates how difficult regulations based on safe scientific thresholds can be for regulators, manufacturers and consumers. This article analyzes the gluten-free regulatory landscape, challenges to defining a safe gluten threshold, and how consumers might need more label information beyond the term "gluten-free." The article includes an overview of international gluten-free regulations, the Food and Drug Administration (FDA) rulemaking process, and issues for consumers.

  9. Prevalence of low bone mineral density in children and adolescents with celiac disease under treatment

    Maria Eugênia Farias Almeida Motta

    Full Text Available CONTEXT AND OBJECTIVE: Low bone mineral density may be a finding among children and adolescents with celiac disease, including those undergoing treatment with a gluten-free diet, but the data are contradictory. The aim of this study was to determine the frequency of bone mineral density abnormalities in patients on a gluten-free diet, considering age at diagnosis and duration of dietary treatment. DESIGN AND SETTING: Cross-sectional prevalence study at the Pediatric Gastroenterology Outpatient Clinic of Instituto Materno Infantil Professor Fernando Figueira. METHODS: Thirty-one patients over five years of age with celiac disease and on a gluten-free diet were enrolled. Bone mineral density (in g/cm² was measured in the lumbar spine and whole body using bone densitometry and categorized using the criteria of the International Society for Clinical Densitometry, i.e. low bone mineral density for chronological age < -2.0 Z-scores. Age at diagnosis and duration of dietary treatment were confirmed according to the date of starting the gluten-free diet. RESULTS: Low bone density for chronological age was present in 3/31 patients in the lumbar spine and 1/31 in the whole body (also with lumbar spine abnormality. At diagnosis, three patients with low bone mineral density for the chronological age were more than 7.6 years old. These patients had been on a gluten-free diet for six and seven months and 3.4 years. CONCLUSION: Pediatric patients with celiac disease on long-term treatment are at risk of low bone mineral density. Early diagnosis and long periods of gluten-free diet are directly implicated in bone density normalization.

  10. Coexistence of coeliac disease and type 1 diabetes

    Szaflarska-Popławska, Anna

    2014-01-01

    There is a selective review of the literature concerning the coexistence of coeliac disease and type 1 diabetes mellitus. This review focuses on the principles of serological tests towards coeliac disease in patients with type 1 diabetes mellitus and metabolic control measures as a result of a gluten-free diet.

  11. Nutritional and sensory challenges of gluten-free bakery products: a review.

    Stantiall, Sophie E; Serventi, Luca

    2018-06-01

    There is a growing need for gluten-free bakery products. Currently, gluten-free bakery products deliver lower protein, fibre and mineral content and elevated glycaemic index (GI) than gluten-containing foods. Only a mixture of rice and buckwheat flour or a low addition of either egg white or whey protein, has shown potential for the improvement of both nutrition and sensory qualities. To increase the fibre content, isolated cereal fibre and soluble fibre isolates have been incorporated into gluten-free formulations with some sensory success. Studies have shown that the GI of modern gluten-free products is no longer a major concern with the improvement of ingredient formulations and processing methods. The currently low mineral content can be increased with the use of mineral-rich ingredients such as amaranth, buckwheat or flaxseed flour. Nonetheless, consumers still show a preference to refined, low fibre breads over wholegrain fibre-rich bread.

  12. Gluten-Free Strategies in the Aisle and on the Menu

    ... favorite steamed vegetables. Be sure to tell the server you need a gluten-free meal and stress ... making a plan? The nutrition experts in our professional membership are ready to help you create the ...

  13. Diagnostic testing for celiac disease among patients with abdominal symptoms a systematic review

    van der Windt, D.A.W.M.; Jellema, A.P.; Mulder, C.J.J.; Kneepkens, C.M.F.; van der Horst, H.E.

    2010-01-01

    Context: The symptoms and consequences of celiac disease usually resolve with a lifelong gluten-free diet. However, clinical presentation is variable and most patients presenting with abdominal symptoms in primary care will not have celiac disease and unnecessary diagnostic testing should be

  14. Diagnostic testing for celiac disease among patients with abdominal symptoms: a systematic review

    van der Windt, Daniëlle A. W. M.; Jellema, Petra; Mulder, Chris J.; Kneepkens, C. M. Frank; van der Horst, Henriëtte E.

    2010-01-01

    The symptoms and consequences of celiac disease usually resolve with a lifelong gluten-free diet. However, clinical presentation is variable and most patients presenting with abdominal symptoms in primary care will not have celiac disease and unnecessary diagnostic testing should be avoided. To

  15. Health-related quality of life in children and adolescents with celiac disease

    Skjerning, Halfdan; Mahony, Ruth O; Husby, Steffen

    2014-01-01

    Celiac disease (CD) is a chronic inflammatory disease requiring constant management with a gluten-free diet (GFD). Little is known about how CD impacts on health-related quality of life (HRQOL) in children and adolescents, and how they feel about and cope with CD and GFD. This qualitative study...

  16. Oats in the Diet of Children with Celiac Disease: Preliminary Results of a Double-Blind, Randomized, Placebo-Controlled Multicenter Italian Study

    Simona Gatti

    2013-11-01

    Full Text Available A gluten-free diet (GFD is currently the only available treatment for patients with celiac disease (CD. Several clinical trials have demonstrated that most celiac patients can tolerate a medium-high quantity of oats without any negative clinical effects; however, the inclusion of oats in GFD is still a matter of debate. In this study, Italian children with CD were enrolled in a 15-month, randomized, double-blind, placebo-controlled multicenter trial. Participants were randomized in two groups following either A-B treatment (6 months of diet “A”, 3 months of standard GFD, 6 months of diet “B”, or B-A treatment (6 months of diet “B”, 3 months of standard GFD, 6 months of diet “A”. A and B diets included gluten-free (GF products (flour, pasta, biscuits, cakes and crisp toasts with either purified oats or placebo. Clinical data (Gastrointestinal Symptoms Rate Scale [GSRS] score and intestinal permeability tests (IPT, were measured through the study period. Although the study is still blinded, no significant differences were found in GSRS score or the urinary lactulose/mannitol (L/M ratio between the two groups after 6 months of treatment. These preliminary results suggest that the addition of non-contaminated oats from selected varieties in the treatment of children with CD does not determine changes in intestinal permeability and gastrointestinal symptoms.

  17. A curated gluten protein sequence database to support development of proteomics methods for determination of gluten in gluten-free foods.

    Bromilow, Sophie; Gethings, Lee A; Buckley, Mike; Bromley, Mike; Shewry, Peter R; Langridge, James I; Clare Mills, E N

    2017-06-23

    The unique physiochemical properties of wheat gluten enable a diverse range of food products to be manufactured. However, gluten triggers coeliac disease, a condition which is treated using a gluten-free diet. Analytical methods are required to confirm if foods are gluten-free, but current immunoassay-based methods can unreliable and proteomic methods offer an alternative but require comprehensive and well annotated sequence databases which are lacking for gluten. A manually a curated database (GluPro V1.0) of gluten proteins, comprising 630 discrete unique full length protein sequences has been compiled. It is representative of the different types of gliadin and glutenin components found in gluten. An in silico comparison of their coeliac toxicity was undertaken by analysing the distribution of coeliac toxic motifs. This demonstrated that whilst the α-gliadin proteins contained more toxic motifs, these were distributed across all gluten protein sub-types. Comparison of annotations observed using a discovery proteomics dataset acquired using ion mobility MS/MS showed that more reliable identifications were obtained using the GluPro V1.0 database compared to the complete reviewed Viridiplantae database. This highlights the value of a curated sequence database specifically designed to support the proteomic workflows and the development of methods to detect and quantify gluten. We have constructed the first manually curated open-source wheat gluten protein sequence database (GluPro V1.0) in a FASTA format to support the application of proteomic methods for gluten protein detection and quantification. We have also analysed the manually verified sequences to give the first comprehensive overview of the distribution of sequences able to elicit a reaction in coeliac disease, the prevalent form of gluten intolerance. Provision of this database will improve the reliability of gluten protein identification by proteomic analysis, and aid the development of targeted mass

  18. The postprandial glucose response to some varieties of commercially available gluten-free pasta: a comparison between healthy and celiac subjects.

    Bacchetti, T; Saturni, L; Turco, I; Ferretti, G

    2014-11-01

    The objective of the present paper is to evaluate the post-prandial response to some varieties of gluten free (GF) pasta that are commonly consumed in Italy. The glycaemic responses were compared with a glucose standard in healthy subjects and gluten-free diet celiac subjects. Subjects were served portions of the test foods and a standard food (glucose), on separate occasions, each containing 50 g available carbohydrates. Capillary blood glucose was measured from finger-prick samples in fasted subjects and at 15, 30, 45, 60, 90 and 120 minutes after the consumption of each test food. For each type of pasta, the glycaemic index (GI) was calculated by expressing the incremental area under the blood glucose curve as a percentage of each subject's average incremental area under the blood glucose curve (AUC) for the standard food. Gluten free pasta exhibited a range of GI values from 46 to 66. The glycaemic load (GL) and glycaemic profile (GP) were also calculated. A higher GI value was observed in pasta containing rice flour as the main ingredient. Lower values were observed in pasta obtained using corn or a mixture of corn and rice flour as the main ingredients. The results were confirmed in celiac subjects. The information presented in this paper may be useful in helping celiac people to select low-GI pasta.

  19. Structural, Culinary, Nutritional and Anti-Nutritional Properties of High Protein, Gluten Free, 100% Legume Pasta.

    Laleg, Karima; Cassan, Denis; Barron, Cécile; Prabhasankar, Pichan; Micard, Valérie

    2016-01-01

    Wheat pasta has a compact structure built by a gluten network entrapping starch granules resulting in a low glycemic index, but is nevertheless unsuitable for gluten-intolerant people. High protein gluten-free legume flours, rich in fibers, resistant starch and minerals are thus a good alternative for gluten-free pasta production. In this study, gluten-free pasta was produced exclusively from faba, lentil or black-gram flours. The relationship between their structure, their cooking and Rheological properties and their in-vitro starch digestion was analyzed and compared to cereal gluten-free commercial pasta. Trypsin inhibitory activity, phytic acid and α-galactosides were determined in flours and in cooked pasta. All legume pasta were rich in protein, resistant starch and fibers. They had a thick but weak protein network, which is built during the pasta cooking step. This particular structure altered pasta springiness and increased cooking losses. Black-gram pasta, which is especially rich in soluble fibers, differed from faba and lentil pasta, with high springiness (0.85 vs. 0.75) and less loss during cooking. In comparison to a commercial cereal gluten-free pasta, all the legume pasta lost less material during cooking but was less cohesive and springy. Interestingly, due to their particular composition and structure, lentil and faba pasta released their starch more slowly than the commercial gluten-free pasta during the in-vitro digestion process. Anti-nutritional factors in legumes, such as trypsin inhibitory activity and α-galactosides were reduced by up to 82% and 73%, respectively, by pasta processing and cooking. However, these processing steps had a minor effect on phytic acid. This study demonstrates the advantages of using legumes for the production of gluten-free pasta with a low glycemic index and high nutritional quality.

  20. Adverse effects of gluten ingestion and advantages of gluten withdrawal in nonceliac autoimmune disease.

    Lerner, Aaron; Shoenfeld, Yehuda; Matthias, Torsten

    2017-12-01

    In light of the coincident surge in overall gluten intake and the incidence of autoimmune diseases, the possible biological adverse effects of gluten were explored. PubMed, MEDLINE, and the Cochrane Library databases were screened for reports published between 1964 and 2016 regarding the adverse effects of gluten as well as the effects of a gluten-free diet on autoimmune diseases. In vitro and in vivo studies describing gluten intake in animal models or cell lines and gluten-free diets in human autoimmune diseases were reviewed. Multiple detrimental aspects of gluten affect human health, including gluten-dependent digestive and extradigestive manifestations mediated by potentially immunological or toxic reactions that induce gastrointestinal inadequacy. Gluten affects the microbiome and increases intestinal permeability. It boosts oxidative stress and affects epigenetic behavior. It is also immunogenic, cytotoxic, and proinflammatory. Gluten intake increases apoptosis and decreases cell viability and differentiation. In certain nonceliac autoimmune diseases, gluten-free diets may help curtail the adverse effects of gluten. Additional in vivo studies are needed to unravel the puzzle of gluten effects in humans and to explore the potential beneficial effects of gluten-free diets in autoimmune diseases. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  1. Medical nutrition therapy: use of sourdough lactic acid bacteria as a cell factory for delivering functional biomolecules and food ingredients in gluten free bread

    2011-08-30

    Abstract Celiac disease (CD) is an immune-mediated disease, triggered in genetically susceptible individuals by ingesting gluten from wheat, rye, barley, and other closely related cereal grains. Currently, the estimated prevalence of CD is around 1 % of the population in the western world and medical nutritional therapy (MNT) is the only accepted treatment for celiac disease. To date, the replacement of gluten in bread presents a significant technological challenge for the cereal scientist due to the low baking performance of gluten free products (GF). The increasing demand by the consumer for high quality gluten-free (GF) bread, clean labels and natural products is rising. Sourdough has been used since ancient times for the production of rye and wheat bread, its universal usage can be attributed to the improved quality, nutritional properties and shelf life of sourdough based breads. Consequently, the exploitation of sourdough for the production of GF breads appears tempting. This review will highlight how sourdough LAB can be an efficient cell factory for delivering functional biomolecules and food ingredients to enhance the quality of gluten free bread.

  2. Multivariable Analysis of Gluten-Free Pasta Elaborated with Non-Conventional Flours Based on the Phenolic Profile, Antioxidant Capacity and Color.

    Camelo-Méndez, Gustavo A; Flores-Silva, Pamela C; Agama-Acevedo, Edith; Bello-Pérez, Luis A

    2017-12-01

    The phenolic compounds, color and antioxidant capacity of gluten-free pasta prepared with non-conventional flours such as chickpea (CHF), unripe plantain (UPF), white maize (WMF) and blue maize (BMF) were analyzed. Fifteen phenolic compounds (five anthocyanins, five hydroxybenzoic acids, three hydroxycinnamic acids, one hydroxyphenylacetic acid and one flavonol) were identified in pasta prepared with blue maize, and 10 compounds were identified for samples prepared with white maize. The principal component analysis (PCA) led to results describing 98% of the total variance establishing a clear separation for each pasta. Both the proportion (25, 50 and 75%) and type of maize flour (white and blue) affected the color parameters (L*, C ab *, h ab and ΔE* ab ) and antioxidant properties (DPPH, ABTS and FRAP methods) of samples, thus producing gluten-free products with potential health benefits intended for general consumers (including the population with celiac disease).

  3. Catering Gluten-Free When Simultaneously Using Wheat Flour.

    Miller, Kathryn; McGough, Norma; Urwin, Heidi

    2016-02-01

    A European law on gluten-free (GF) labeling came into force in 2012, covering foods sold prepacked and in food service establishments, and a similar U.S. Food and Drug Administration (FDA) regulation covers GF labeling from August 2014. Gluten is found in the grains wheat, rye, and barley. A common source of gluten in the kitchen is wheat flour. This research aimed to determine variables that have a significant effect on gluten contamination in commercial kitchens when wheat flour is in use and to establish controls necessary to assure GF production. A pilot study was used to test the following hypotheses: (i) increasing duration of exposure to wheat flour would increase gluten contamination, (ii) increasing distance between the site of preparation and the site of wheat flour would reduce gluten contamination, (iii) the use of a ventilation hood would decrease gluten contamination, and (iv) the use of a barrier segregating the site of preparation of a GF meal and the use of wheat flour would decrease gluten contamination. Petri dishes containing GF rice pudding were placed in three directions at increasing distances (0.5 to 2 m) from a site of wheat flour use. A barrier was in place between a third of samples and the site of wheat flour. After wheat flour was handled for 0.5 and 4.0 h, petri dishes were sealed and the contents were analyzed for gluten. The experiment was duplicated with the ventilation hood on and off. The pilot study revealed that a distance of 2 m from the use of wheat flour was required to control gluten contamination at ≤20 ppm if wheat flour had been in use for 4.0 h. The identified control of distance was tested in five different study sites. In each of the study sites, a test meal was prepared a minimum of 2 m away from the site of wheat flour use. Although kitchens vary and must be considered individually, the established control of a minimum 2 m distance, along with good hygiene practices, was found to be effective in preparing GF meals

  4. Antioxidant Capacity, Mineral Content and Sensory Properties of Gluten-Free Rice and Buckwheat Cookies

    Mladenka Pestorić

    2015-01-01

    Full Text Available Light buckwheat flour was used to substitute rice fl our at the level of 10, 20 and 30 % to produce gluten-free cookies. The substitution of gluten-free cookie formulation with light buckwheat fl our contributed to the signifi cantly higher mineral content, especially magnesium, potassium, iron and copper, in comparison with the control rice cookies (p<0.05. Gluten-free cookies made with rice fl our and buckwheat fl our exhibited signifi cantly higher total phenolic and rutin content, scavenging activity against 1,1-diphenyl 2-picrylhydrazyl radicals (DPPH•, antioxidant activity and reducing power than the control cookies (p<0.05. Comparing all evaluated sensory properties, cookies containing 20 % of light buckwheat flour had the most acceptable sensory properties. The obtained results of principal component analysis showed that the cookies with 20 and 30 % buckwheat flour had better antioxidant and sensory properties in comparison with other two cookie samples.

  5. Optimization of gluten-free formulations for French-style breads.

    Mezaize, S; Chevallier, S; Le Bail, A; de Lamballerie, M

    2009-04-01

    The formulation of gluten-free bread, which will be suitable for patients with coeliac disease, was optimized to provide bread similar to French bread. The effects of the presence of hydrocolloids and the substitution of the flour basis by flour or proteins from different sources were studied. The added ingredients were (1) hydrocolloids (carboxymethylcellulose [CMC], guar gum, hydroxypropylmethylcellulose [HPMC], and xanthan gum), and (2) substitutes (buckwheat flour, whole egg powder, and whey proteins). The bread quality parameters measured were specific volume, dry matter of bread, crust color, crumb hardness, and gas cell size distribution. Specific volume was increased by guar gum and HPMC. Breads with guar gum had color characteristics similar to French bread. Hardness decreased with the addition of hydrocolloids, especially HPMC and guar. Breads with guar gum had the most heterogeneous cell size distribution, and guar gum was therefore selected for further formulations. Bread prepared with buckwheat flour had improved quality: an increased specific volume, a softer texture, color characteristics, and gas-cell size distribution similar to French bread. Bread with 1.9% guar gum (w/w, total flour basis) and 5% buckwheat flour (of all flours and substitutes) mimicked French bread quality attributes.

  6. Systematic review with meta-analysis: Dietary adherence influences normalization of health-related quality of life in coeliac disease

    Burger, J.P.; Brouwer, B. de; Hout, J. in't; Wahab, P.J.; Tummers, M.J.; Drenth, J.P.H.

    2017-01-01

    BACKGROUND & AIMS: Gluten-free diet is the keystone of coeliac disease treatment. Despite adherence, some patients continue to suffer from symptoms that negatively influence health-related quality of life (HRQoL). Therefore we performed a systematic review and meta-analysis to assess the effect of

  7. THE INFLUENCE OF GLUTEN - FREE FLOURS ON THE QUALITY INDICATORS OF BISCUIT SEMI - FINISHED PRODUCTS

    К. G. IORGACHOVA

    2016-12-01

    Full Text Available The article is devoted to the research of applicability of gluten-free flours from cereal crops and from by-products of cereal crop processing - ground crumbs sifted out in a process of flake production from rice, corn and millet during the production of biscuit semi-finished products. Taking into account that viscosity is an important technological characteristic of foam-like biscuit dough, as it determines foam strength and dispersed medium stability, the influence of gluten-free flours on the structural and rheological properties of biscuit dough was studied. It is determined that the substitution of wheat flour for cereal flours leads to viscosity reduction of the dough as a consequence of absence of gluten-forming proteins in them. A comparative analysis of changes in viscous properties of biscuit dough based on flour from flakes crumb while warming it up to 60°C with dough based on cereal flours and dough based on wheat flour was held. It is shown that the presence of partially gelatinized starch granules in flour from flake crumb, as a result of technological peculiarities of their extraction, promotes greater demonstration of thickening properties already at the initial stage of baking than in cereal flours. This leads to an increase of dough viscosity and formation of desired rheological characteristics, which provide the porous structure of finished products. To provide the high quality of gluten-free biscuit semi-finished products, the recipe composition of gluten-free biscuit semi-finished product, based on flour mixture from millet flakes crumb, corn and rice flour, was optimized by using the method of mathematical design of experiments.  The porosity indicator was chosen as the criteria for the evaluation of influence of proportion of gluten-free flours on the quality of biscuit semi-finished products. The response surfaces of dependency of biscuit porosity from mass ratio of recipe components in the composite mixture were

  8. If you can't eat what you like, like what you can: How coeliac disease patients and their families construct dietary restrictions as a matter of choice

    van der Veen, M.; te Molder, Hedwig Frederica Maria; Gremmen, B.; van Woerkum, C.

    2013-01-01

    Although it is recognised that a gluten-free diet has many social implications for coeliac disease patients, not much is known about how such patients actually manage these implications in their everyday interactions. This article examines how dietary restrictions are treated by patients and their

  9. Celiac disease: the situation on the Slovak market

    Ľudmila Nagyová

    2016-06-01

    Full Text Available Celiac disease, also known as celiac sprue, non‐tropical sprue, idiopathic sprue, idiopathic steatorrhoea and gluten‐sensitive enteropathy, is a serious genetic autoimmune disease, which damages the villi of the small intestine and interferes with absorption of nutrients from food. The latest researches show that while in the 1970s the prevalence of celiac disease in the world was 0.03%, in the present years the estimated prevalence is 1%. In average, the prevalence of celiac disease in the Western countries is close to 1:100. The celiac disease occurs more often in the case of women than of men, at a ratio of 2.8:1. The aim of the present paper was to bring few information about the celiac disease, highlight the increasing number of celiacs, as well as to determine the Slovak celiacs opinion about the situation on Slovak market and their consumer behaviour on the market of gluten free products. As research methods, there have been used the methods of survey and structured questionnaire consisting of 22 questions. The total number of respondents was 130 randomly selected celiacs from all over the Slovak republic. For a deeper analysis of the obtained results, there have been set out four assumptions and ten hypotheses, which have been tested with the use of Pearson´s chi-square test, Mann-Whitney U-Test and Cramer´s contingency coefficient. The results of the present paper show, that despite the fact that few of our findings are pleasing - almost 52% of our respondents stay that the labelling of gluten free products is sufficient, over 74% of respondents think that they have enough information about the availability of gluten free products and more than 89% of respondents think that the present scope of range of gluten free products is better as before; there are still some shortcomings, which has to be reduced or eliminated - only less than 7% of respondents think that the price of gluten free products is adequate, over 45% of respondents

  10. Imaging active lymphocytic infiltration in coeliac disease with iodine-123-interleukin-2 and the response to diet

    Signore, A.; Chianelli, M.; Annovazzi, A.; Rossi, M.; Greco, M.; Ronga, G.; Picarelli, A.; Maiuri, L.; Britton, K.E.

    2000-01-01

    Coeliac disease is diagnosed by the presence of specific antibodies and a jejunal biopsy showing mucosal atrophy and mononuclear cell infiltration. Mucosal cell-mediated immune response is considered the central event in the pathogenesis of coeliac disease, and untreated coeliac patients show specific features of T-cell activation in the small intestine. Here we describe the use of iodine-123-interleukin-2 scintigraphy in coeliac patients as a non-invasive tool for detection of lymphocytic infiltration in the small bowel and its use for therapy follow-up, and we demonstrate the specificity of binding of labelled-IL2 to activated lymphocytes by ex-vivo autoradiography of jejunal biopsies. 123 I-IL2 was administered i.v. [74 MBq (2 mCi)], and gamma camera images were acquired after 1 h. Ten patients were studied with 123 I-IL2 scintigraphy at diagnosis and seven were also investigated after 12-19 months of gluten-free diet. Results were expressed as target-to-background radioactivity ratios in six different bowel regions before and after the diet. At the time of diagnosis all patients showed a significantly higher bowel uptake of 123 I-IL2 than normal subjects (P 2 =0.66; P=0.008). Autoradiography of jejunal biopsies confirmed that labelled-IL2 only binds to activated T-lymphocytes infiltrating the gut mucosa. After 1 year of the diet, bowel uptake of 123 I-IL2 significantly decreased in five out of six regions (P 123 I-IL2 scintigraphy is a sensitive non-invasive technique for assessing in vivo the presence of activated mononuclear cells in the bowel of patients affected by coeliac disease. Unlike jejunal biopsy, this method provides information from the whole intestine and gives a non-invasive measure of the effectiveness of the gluten-free diet. (orig.)

  11. Gluten Sensitivity

    ... Getting Started Diet & Nutrition Adding Fiber to Your Gluten-Free Diet Celiac Disease in the Older Adult Flours, Grains, Thickening Agents, Starches GIG’s Gluten-Free Diet and Drug Instruction Gluten-Free Grains Heart Healthy ...

  12. Correlation analysis of protein quality characteristics with gluten-free bread properties.

    Horstmann, S W; Foschia, M; Arendt, E K

    2017-07-19

    The interest in gluten-free cereal products has increased significantly over the last number of years and there is still a high demand for high quality products. This study aims to establish possible connections between protein properties and dough and bread quality which could advance the knowledge for gluten-free product development. The objective of the present study was to correlate protein properties with bread characteristics. Therefore, a wide range of tests (solubility, emulsifying, foaming, water hydration properties) was performed to characterize a range of food proteins (potato, pea, carob, lupin and soy). Furthermore, the performance of these proteins in a dough matrix (pasting, rheology) and bread formulation (volume, structure, and texture) was analysed. Statistical analysis showed significant (p bread characteristics. The addition of the proteins to the gluten-free bread formulation affected pasting rheological and bread characteristics such as crumb density, crumb hardness and specific volume. The addition of potato and soy protein resulted in the lowest volume with a dense crumb structure and a low consumer acceptance score. However, lupin, pea and carob containing gluten-free breads had a higher specific volume and softer and less dense crumb structure. The protein solubility (r, 0.89; p bread quality.

  13. Teff, buckwheat, quinoa and amaranth: Ancient whole grain gluten-free egg-free pasta

    This report demonstrates innovative ancient whole grains, gluten-free, egg-free pasta (no chemicals added) made using a kitchen counter-top appliance. Whole grain, fusilli pasta was prepared with teff, buckwheat, quinoa and amaranth flours. These ancient grains are called “Super Foods” due to thei...

  14. Ancient whole grain Gluten-free egg-free Teff, Buckwheat, Quinoa and Amaranth pasta (abstract)

    This report demonstrates innovative ancient whole grain, gluten-free, egg-free pasta (no chemicals added) made using a kitchen counter-top appliance. Whole grain, fusilli pasta was prepared with teff, buckwheat, quinoa and amaranth flours. These ancient grains are called “Super Foods” due to thei...

  15. Whole grain gluten-free egg-free high protein pasta

    The USDA food guide recommends that at least ½ of all the grains eaten should be whole grains. The FDA allows food Health Claim labels for food containing 51% whole gains and 11 g of dietary fiber. This is the only report demonstrating innovative whole grain, high protein, gluten-free, egg-free past...

  16. 76 FR 46671 - Food Labeling; Gluten-Free Labeling of Foods; Reopening of the Comment Period

    2011-08-03

    ... were delineated and assessed in the following reaction timeframes: Acute (hours up to and including 14.... The Threshold Working Group, ``Approaches to Establish Thresholds for Major Food Allergens and for... Performance of the R5 Enzyme Linked Immunoassay to Determine Gliadin in Gluten-Free Food,'' European Journal...

  17. Preparation of gluten-free bread using a meso-structured whey protein particle system

    Riemsdijk, van L.E.; Goot, van der A.J.; Hamer, R.J.; Boom, R.M.

    2011-01-01

    This article presents a novel method for making gluten-free bread using mesoscopically structured whey protein. The use of the meso-structured protein is based on the hypothesis that the gluten structure present in a developed wheat dough features a particle structure on a mesoscopic length scale

  18. Application of extruded broken bean flour for formulation of gluten-free cake blends

    Luciana de Oliveira Froes Gomes

    2015-06-01

    Full Text Available The aim of this study was to determine the physical and microbiological characteristics of extruded broken beans flour, in addition to developing mixtures for gluten-free cake with these flours, evaluating their technological and sensory quality. Gluten-free formulations were prepared with 45%, 60% and 75% of extruded broken beans. All analyzes of the flours and mixtures for cakes were performed according to standard techniques found in the literature. Sensory analyzes of cakes applied the 9-point structured hedonic scale. Results were submitted to variance analysis and comparison of means test (Tukey, p<0.05. The use of extruded broken beans improved the water absorbed and water solubility index of the mixtures for gluten-free cake, and for the lower viscosity and retrogradation when compared to the standard formulation. All cakes were accepted (rate ≥ 7 for all the analyzed attributes. From the technological and sensory standpoints, the development of gluten-free cake mixtures is feasible with up to 75% of extruded broken beans.

  19. Physical and antioxidant properties of gluten-free bread enriched with carob fibre

    Różyło, Renata; Dziki, Dariusz; Gawlik-Dziki, Urszula; Biernacka, Beata; Wójcik, Monika; Ziemichód, Alicja

    2017-07-01

    There are no reports of addition of carob fibre to gluten-free bread, as only carob germ flour was used. The research task was to determine what level of carob fibre can be used and how it influences the physical and sensorial properties of gluten-free bread. Especially, the knowledge of the antioxidant properties of such bread is very valuable. The gluten-free bread from rice, corn, and buckwheat flour (35:35:30%) was prepared after mixing (5 min), proofing (40 min, 30°C), and baking (45-50 min, 230°C) of dough. Carob fibre was added in the amounts of 1, 2, 3, 4, and 5% of the total flour content. The results showed that increased content of carob fibre induced significant and favourable changes in the volume, colour, and texture (hardness and springiness) of the bread crumb. Carob fibre enriched the breads with lipophilic compounds able to chelate metal ions. The activity of hydrophilic compounds was significantly higher in the case of control bread and bread with the lowest percentage of the additive. In conclusion, the highest increase in antioxidant activity was found for breads with 1 and 2% of carob fibre. The most acceptable gluten-free bread can be obtained by adding up to 2% of carob.

  20. Dynamic viscoelasticity of protease-treated rice batters for gluten-free rice bread making.

    Honda, Yuji; Inoue, Nanami; Sugimoto, Reina; Matsumoto, Kenji; Koda, Tomonori; Nishioka, Akihiro

    2018-03-01

    Papain (cysteine protease), subtilisin (Protin SD-AY10, serine protease), and bacillolysin (Protin SD-NY10, metallo protease) increased the specific volume of gluten-free rice breads by 19-63% compared to untreated bread. In contrast, Newlase F (aspartyl protease) did not expand the volume of the rice bread. In a rheological analysis, the viscoelastic properties of the gluten-free rice batters also depended on the protease categories. Principal component analysis (PCA) analysis suggested that the storage and loss moduli (G' and G″, respectively) at 35 °C, and the maximum values of G' and G″, were important factors in the volume expansion. Judging from the PCA of the viscoelastic parameters of the rice batters, papain and Protin SD-AY10 improved the viscoelasticity for gluten-free rice bread making, and Protin SD-NY effectively expanded the gluten-free rice bread. The rheological properties differed between Protin SD-NY and the other protease treatments.

  1. Effect of tiger nut-derived products in gluten-free batter and bread.

    Aguilar, Núria; Albanell, Elena; Miñarro, Begoña; Guamis, Buenaventura; Capellas, Marta

    2015-07-01

    Tiger nut is a tuber used to produce tiger nut milk that yields a high quantity of solid waste, which can be dried and used as fiber source. The objective of this paper was to evaluate the quality of gluten-free bread formulated with different tiger nut-derived products in order to substitute soya flour (which is an allergen ingredient) and, at the same time, increase the use of tiger nut-derived products. Four gluten-free formulations based on corn starch and containing tiger nut milk, tiger nut milk by-product, tiger nut flour, or soya flour (as reference formulation) were studied. Tiger nut milk increased G' of gluten-free batter and rendered breads with the softest crumb (502.46 g ± 102.05), the highest loaf-specific volume (3.35 cm(3)/g ± 0.25), and it was mostly preferred by consumers (61.02%). Breads elaborated with tiger nut flour had similar characteristics than soya flour breads (except in color and crumb structure). The addition of tiger nut milk by-product resulted in a hard (1047.64 g ± 145.74) and dark (L(*)  = 70.02 ± 3.38) crumb bread, which was the least preferred by consumers. Results showed that tiger nut is a promising ingredient to formulate gluten-free baked products. © The Author(s) 2014.

  2. Physicochemical properties of gluten-free pancakes from rice and sweet potato flours

    Gluten-free pancakes were prepared using rice flour and rice flour replaced with various amounts, at 10, 20 and 40%, of sweet potato flour. Textural properties of the cooked pancakes, such as hardness and chewiness generally increased with time after cooking, whereas they decreased with increased sw...

  3. Physico-chemical properties of gluten-free pancakes from rice and sweet potato flours.

    Gluten-free pancakes were prepared using rice flour, and rice flour replaced with various amounts, at 10, 20 and 40%, of sweet potato flour. The apparent viscosity of the pancake batter increased with increased sweet potato flour replacement. Texture properties of the cooked pancakes, such as, har...

  4. Maize Prolamins Could Induce a Gluten-Like Cellular Immune Response in Some Celiac Disease Patients

    Ortiz-Sánchez, Juan P.; Cabrera-Chávez, Francisco; Calderón de la Barca, Ana M.

    2013-01-01

    Celiac disease (CD) is an autoimmune-mediated enteropathy triggered by dietary gluten in genetically prone individuals. The current treatment for CD is a strict lifelong gluten-free diet. However, in some CD patients following a strict gluten-free diet, the symptoms do not remit. These cases may be refractory CD or due to gluten contamination; however, the lack of response could be related to other dietary ingredients, such as maize, which is one of the most common alternatives to wheat used in the gluten-free diet. In some CD patients, as a rare event, peptides from maize prolamins could induce a celiac-like immune response by similar or alternative pathogenic mechanisms to those used by wheat gluten peptides. This is supported by several shared features between wheat and maize prolamins and by some experimental results. Given that gluten peptides induce an immune response of the intestinal mucosa both in vivo and in vitro, peptides from maize prolamins could also be tested to determine whether they also induce a cellular immune response. Hypothetically, maize prolamins could be harmful for a very limited subgroup of CD patients, especially those that are non-responsive, and if it is confirmed, they should follow, in addition to a gluten-free, a maize-free diet. PMID:24152750

  5. Celiac disease

    Radlović Nedeljko

    2013-01-01

    Full Text Available Celiac disease is a multysystemic autoimmune disease induced by gluten in wheat, barley and rye. It is characterized by polygenic predisposition, high prevalence (1%, widely heterogeneous expression and frequent association with other autoimmune diseases, selective deficit of IgA and Down, Turner and Williams syndrome. The basis of the disease and the key finding in its diagnostics is symptomatic or asymptomatic inflammation of the small intestinal mucosa which resolves by gluten-free diet. Therefore, the basis of the treatment involves elimination diet, so that the disorder, if timely recognized and adequately treated, also characterizes excellent prognosis.

  6. Long-term Follow-Up of Individuals with Celiac Disease: An Evaluation of Current Practice Guidelines

    Jocelyn A Silvester

    2007-01-01

    Full Text Available INTRODUCTION: Celiac disease can be treated by following a strict gluten-free diet for life. If properly followed, the diet resolves symptoms and nutritional deficiencies. It is generally recommended that individuals with celiac disease have careful long-term follow-up. However, it is not clear which elements of disease status evaluation, laboratory investigations and self-management support should be included in follow-up.

  7. Celiac disease and non-celiac gluten sensitivity

    Lebwohl, Benjamin; Ludvigsson, Jonas F

    2015-01-01

    Celiac disease is a multisystem immune based disorder that is triggered by the ingestion of gluten in genetically susceptible individuals. The prevalence of celiac disease has risen in recent decades and is currently about 1% in most Western populations. The reason for this rise is unknown, although environmental factors related to the hygiene hypothesis are suspected. The pathophysiology of celiac disease involves both the innate and adaptive immune response to dietary gluten. Clinical features are diverse and include gastrointestinal symptoms, metabolic bone disease, infertility, and many other manifestations. Although a gluten-free diet is effective in most patients, this diet can be burdensome and can limit quality of life; consequently, non-dietary therapies are at various stages of development. This review also covers non-celiac gluten sensitivity. The pathophysiology of this clinical phenotype is poorly understood, but it is a cause of increasing interest in gluten-free diets in the general population. PMID:26438584

  8. Application of Dairy Proteins as Technological and Nutritional Improvers of Calcium-Supplemented Gluten-Free Bread

    Krupa-Kozak, Urszula; Bączek, Natalia; Rosell, Cristina M.

    2013-01-01

    Effect of dairy proteins on gluten-free dough behavior, and nutritional and technological properties of gluten-free bread was evaluated. Experimental doughs, containing dairy powders, showed low consistency. Obtained gluten-free breads were rich in proteins, and, regarding the energy value delivered by proteins, they could be considered as a source of proteins or high in proteins. Applied dairy proteins affected the technological properties of experimental breads causing a significant (p bread with beneficial effects on technological and nutritional properties. PMID:24241213

  9. Clinical and Histologic Mimickers of Celiac Disease.

    Kamboj, Amrit K; Oxentenko, Amy S

    2017-08-17

    Celiac disease is an autoimmune disorder of the small bowel, classically associated with diarrhea, abdominal pain, and malabsorption. The diagnosis of celiac disease is made when there are compatible clinical features, supportive serologic markers, representative histology from the small bowel, and response to a gluten-free diet. Histologic findings associated with celiac disease include intraepithelial lymphocytosis, crypt hyperplasia, villous atrophy, and a chronic inflammatory cell infiltrate in the lamina propria. It is important to recognize and diagnose celiac disease, as strict adherence to a gluten-free diet can lead to resolution of clinical and histologic manifestations of the disease. However, many other entities can present with clinical and/or histologic features of celiac disease. In this review article, we highlight key clinical and histologic mimickers of celiac disease. The evaluation of a patient with serologically negative enteropathy necessitates a carefully elicited history and detailed review by a pathologist. Medications can mimic celiac disease and should be considered in all patients with a serologically negative enteropathy. Many mimickers of celiac disease have clues to the underlying diagnosis, and many have a targeted therapy. It is necessary to provide patients with a correct diagnosis rather than subject them to a lifetime of an unnecessary gluten-free diet.

  10. Celiac Disease Diagnosis: Endoscopic Biopsy

    ... the IgA antibody. DH is treated with a gluten-free diet and medication to control the rash, such as ... Drug treatment is short term, usually until the gluten-free diet starts to relieve symptoms. It is not necessary ...

  11. Diagnosis and management of refractory celiac disease: a systematic review.

    Labidi, Asma; Serghini, Meriem; Karoui, Sami; Boubaker, Jalel; Filali, Azza

    2013-01-01

    Refractory celiac disease is defined by persisting malabsorptive symptoms in spite of a strict gluten free diet for at least 6 to 12 months. Alternatives to gluten free diet seem to be still controversial. To describe the clinical and epidemiologic aspects of refractory celiac disease, and to identify therapeutic options in this condition. Systematic review and critical analysis of observational studies, clinical trials and case reports that focused on diagnosis and management of refractory celiac disease. Refractory celiac disease can be classified as type 1 or type 2 according to the phenotype of intraepithelial lymphocytes. Great complications such as enteropathy-associated T-cell lymphoma may occur in a subgroup of these patients mainly in refractory celiac disease type 2. Curative therapies are still lacking. Refractory celiac disease remains a diagnosis of exclusion. Its prognosis remains still dismal by the absence yet of curative therapies. However, some new treatments seem to hold promise during few cohort-studies.

  12. Optimization of Gluten-Free Tulumba Dessert Formulation Including Corn Flour: Response Surface Methodology Approach

    Yildiz Önder

    2017-03-01

    Full Text Available Tulumba dessert is widely preferred in Turkey; however, it cannot be consumed by celiac patients because it includes gluten. The diversity of gluten-free products should be expanded so that celiac patients may meet their daily needs regularly. In this study, corn flour (CF / potato starch (PS blend to be used in the gluten-free tulumba dessert formulation was optimized using the Response Surface Methodology (RSM. Increasing ratio of PS in the CF-PS led to a decrease in hardness of the dessert and to an increase in expansion, viscosity, adhesiveness, yield of dessert both with and without syrup (P0.05, additionally these desserts had a much higher sensory score compared to the control sample in terms of the overall quality and pore structure (P<0.05.

  13. Rheological, physical, and sensory attributes of gluten-free rice cakes containing resistant starch.

    Tsatsaragkou, Kleopatra; Papantoniou, Maria; Mandala, Ioanna

    2015-02-01

    In this study the effect of resistant starch (RS) addition on gluten-free cakes from rice flour and tapioca starch physical and sensorial properties was investigated. Increase in RS concentration made cake batters less elastic (drop of G'(ω), G''(ω) values) and thinner (viscosity decreased). Cakes specific volume increased with an increase in RS level and was maximized for 15 g/100 g RS, although porosity values were significantly unaffected by RS content. Crumb grain analysis exhibited a decrease in surface porosity, number of pores and an increase in average pore diameter as RS concentration increased. During storage, cake crumb remained softer in formulations with increasing amounts of RS. Sensory evaluation of cakes demonstrated the acceptance of all formulations, with cake containing 20 g/100 g RS mostly preferred. Gluten-free cakes with improved quality characteristics and high nutritional value can be manufactured by the incorporation of RS. © 2015 Institute of Food Technologists®

  14. Application of Dairy Proteins as Technological and Nutritional Improvers of Calcium-Supplemented Gluten-Free Bread

    Cristina M. Rosell

    2013-11-01

    Full Text Available Effect of dairy proteins on gluten-free dough behavior, and nutritional and technological properties of gluten-free bread was evaluated. Experimental doughs, containing dairy powders, showed low consistency. Obtained gluten-free breads were rich in proteins, and, regarding the energy value delivered by proteins, they could be considered as a source of proteins or high in proteins. Applied dairy proteins affected the technological properties of experimental breads causing a significant (p < 0.05 increase of the specific volume, crust darkening, and crumb lightness, depending on the dairy supplementation level, rather than the protein type. Dairy proteins incorporated at a 12% level, significantly (p < 0.05 decreased the hardness; nevertheless, the highest amount of proteins tested led to the opposite effect. These results indicate that milk proteins tested could be successfully added to gluten-free bread with beneficial effects on technological and nutritional properties.

  15. Laser-induced breakdown spectroscopy (LIBS) for rapid analysis of ash, potassium and magnesium in gluten free flours.

    Markiewicz-Keszycka, Maria; Casado-Gavalda, Maria P; Cama-Moncunill, Xavier; Cama-Moncunill, Raquel; Dixit, Yash; Cullen, Patrick J; Sullivan, Carl

    2018-04-01

    Gluten free (GF) diets are prone to mineral deficiency, thus effective monitoring of the elemental composition of GF products is important to ensure a balanced micronutrient diet. The objective of this study was to test the potential of laser-induced breakdown spectroscopy (LIBS) analysis combined with chemometrics for at-line monitoring of ash, potassium and magnesium content of GF flours: tapioca, potato, maize, buckwheat, brown rice and a GF flour mixture. Concentrations of ash, potassium and magnesium were determined with reference methods and LIBS. PCA analysis was performed and presented the potential for discrimination of the six GF flours. For the quantification analysis PLSR models were developed; R 2 cal were 0.99 for magnesium and potassium and 0.97 for ash. The study revealed that LIBS combined with chemometrics is a convenient method to quantify concentrations of ash, potassium and magnesium and present the potential to classify different types of flours. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Texture development in gluten-free breads: Effect of different enzymes and extruded flour

    Martínez, Mario M.; Marcos, Pablo; Gómez, Manuel

    2013-01-01

    Producción Científica One of the main problems with gluten-free breads is their texture and their rapid staling. In this work the influence of different enzymes (one protease, one lipase and two amylases) and of extruded rice flour on rice-bread texture and texture development was studied. For this purpose, the development of firmness, cohesiveness, resilience, springiness and chewiness was modelled and the parameters that define the initial values and the development of these characterist...

  17. Effect of hydrothermal treated corn flour addition on the quality of corn-field bean gluten-free pasta

    Dib Ahlem; Wójtowicz Agnieszka; Benatallah Leila; Bouasla Abdallah; Zidoune Mohammed Nasreddine

    2018-01-01

    Corn semolina supplemented by field bean semolina in ratio of 2/1 (w/w) were used for obtaining protein and fiber enriched gluten-free pasta. The effect of hydrothermal treatment of corn flour on its applicability as gluten-free pasta improver was tested. A central composite design involving water hydration level and the amount of hydrothermal treated corn flour were used. Instrumental analyses of pasta (cooking loss, water absorption capacity, hydration and pasting properties, textural param...

  18. Development of gluten-free cakes with the addition of methylcellulose and xanthan gum

    Viviane Borges Vallejos

    2015-06-01

    Full Text Available The removal of gluten results in many baking problems and many gluten-free products currently available in the market are of low quality. The addition of hydrocolloids, however, is an option to improve technological characteristics. The objective of this study was to evaluate the influence of the addition of methylcellulose and xanthan gum on the technological characteristics of gluten-free cakes made with 100% rice flour. Cakes using hydrocolloids at different concentrations were developed through an experimental design that evaluated technological features such as specific volume, crumb hardness and overall quality score. Mathematical models were obtained to describe the hardness and the score of cakes as a function of the addition of xanthan and methylcellulose. The smallest value of crumb hardness of the cakes was obtained when concentrations of 0.4% xanthan and 2% methylcellulose were added. With regards to the score, the highest value was obtained with the lowest levels of hydrocolloids, whose formulation contained 0.2% xanthan gum and 1% methylcellulose. It can be concluded that the addition of xanthan gum and methylcellulose enabled the development of a gluten-free cake with a softer crumb that presents technological quality attributes similar to that of a wheat cake.

  19. Modelling the effects of orange pomace using response surface design for gluten-free bread baking.

    O'Shea, N; Rößle, C; Arendt, E; Gallagher, E

    2015-01-01

    The development of gluten-free bread creates many challenges; producing bread that will match the properties of its wheat counterpart can be difficult. Fruit by-products are know from literature to contain a high level of dietary fibre which could improve the bread properties and fibre contents of gluten-free bread. Therefore, a mathematical design was created; three variables were identified from preliminary tests (water (85-100% flour weight, OP 0-8% flour weight and proofing time 35-100 min) as being crucial in the development of acceptable bread. Results illustrated longer proofing times (p<0.05) and lower orange pomace levels (OP) (p<0.001) produced a bread with a greater specific volume. OP had the most significant (p<0.0001) effect on hardness at 2h and 24h post-baking. The optimised formulation was calculated to contain 5.5% OP, 94.6% water and a proofing time of 49 min. Total fibre content of the control bread (2.1%) was successfully increased t o 3.9% in the OP containing bread. Substituting gluten-free flours with orange pomace flour can help improve the total dietary intake of a coeliac while not negating on the quality properties of the bread. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Effect of different iron compounds on wheat and gluten-free breads.

    Kiskini, Alexandra; Kapsokefalou, Maria; Yanniotis, Stavros; Mandala, Ioanna

    2010-05-01

    Iron fortification of bread often results in sub-optimal quality of the final product due to undesirable changes in the physical characteristics and sensory properties of the bread. In this study both the form of iron (soluble, insoluble or encapsulated) and the type of bread (wheat or gluten-free) were varied in order to investigate the effect of iron and gluten on the product characteristics. The effect of iron on the quality characteristics of the breads investigated depended on iron type, but not on iron solubility. Colour, crust firmness, specific volume, cell number and uniformity as well as aroma were the attributes that were mainly affected in iron-enriched wheat bread. In some cases, specific volume was 30% lower than that of the control sample, while cell uniformity was significantly lower, as low as 50% of the control sample in some fortified samples. In gluten-free breads, differences between unfortified and fortified samples included colour, crust firmness, cell number, 'moisture' odour, metallic taste and stickiness. In some cases, the sensory scores were better for fortified samples. Differences due to iron fortification were less pronounced in gluten-free compared to wheat breads. The choice of the appropriate iron compound which will not cause adverse quality changes is still a challenge.

  1. Influence of maize flour particle size on gluten-free breadmaking.

    de la Hera, Esther; Talegón, María; Caballero, Pedro; Gómez, Manuel

    2013-03-15

    Maize, one of the suitable grains for coeliac consumption, is, together with rice, the most cultivated cereal in the world. However, the inclusion of maize flour in gluten-free bread is a minority and studies are scarce. This paper analyses the influence of different maize flour types and their particle sizes on the quality of two types of bread without gluten (80% and 110% water in the formulation) obtained from them. We also analysed the microstructure of the dough and its behaviour during the fermentation. Finer flours had a lower dough development during fermentation in all cases. Among the different types of flour, those whose microstructure revealed compact particles were those which had higher specific bread volume, especially when the particle size was greater. Among the formulations, the dough with more water gave breads with higher specific volume, an effect that was more important in more compact flours. The higher volume breads had lower values of hardness and resilience. The type of corn flour and mainly its particle size influence significantly the dough development of gluten-free bread during fermentation and therefore the final volume and texture of the breads obtained. The flours having coarser particle size are the most suitable for making gluten-free maize bread. © 2012 Society of Chemical Industry.

  2. Fructan content of commonly consumed wheat, rye and gluten-free breads.

    Whelan, Kevin; Abrahmsohn, Olivia; David, Gondi J P; Staudacher, Heidi; Irving, Peter; Lomer, Miranda C E; Ellis, Peter R

    2011-08-01

    Fructans are non-digestible carbohydrates with various nutritional properties including effects on microbial metabolism, mineral absorption and satiety. They are present in a range of plant foods, with wheat being an important source. The aim of the present study was to measure the fructan content of a range of wheat, rye and gluten-free breads consumed in the United Kingdom. Fructans were measured in a range of breads using selective enzymic hydrolysis and spectrophotometry based on the AOAC 999.03 method. The breads generally contained low quantities of fructan (0.61-1.94 g/100 g), with rye bread being the richest source (1.94 g/100 g). Surprisingly, gluten-free bread contained similar quantities of fructan (1.00 g/100 g) as other breads. There was wide variation in fructan content between individual brands of granary (0.76-1.09 g/100 g) and gluten-free breads (0.36-1.79 g/100 g). Although they contain only low quantities of fructan, the widespread consumption of bread may make a significant contribution to fructan intakes.

  3. Tailoring rice flour structure by rubbery milling for improved gluten-free baked goods.

    Brütsch, Linda; Tribolet, Liliane; Isabettini, Stéphane; Soltermann, Patrick; Baumann, Andreas; Windhab, Erich J

    2018-05-10

    Ever-growing demand for gluten-free products calls for the development of novel food processing techniques to widen the range of existing baked goods. Extensive research has been targeted towards recipe optimization, widely neglecting the tailoring potential of process-induced structuring of gluten-free raw materials. Herein, we address this shortcoming by demonstrating the potential of rubbery milling for the generation of structure and techno-functionality in breads obtained from a variety of rice flour types. Moisture and temperature induced state transitions during milling were exploited to tailor the physicochemical properties of the flour. Moisture addition during conditioning of the different rice varieties and milling in the rubbery state considerably decreased starch damage due to more gentle disintegration. The degree of starch damage dictated the water absorption capacity of the rice flour types. Flour types with reduced starch damage upon milling offered lower dough densities, yielding bread loafs with a higher volume and better appearance. The choice of rice variety enables fine-tuning of the final product quality by influencing the dough viscoelasticity, which defines the final loaf volume. Whole grain rice flour dramatically increased the loaf volume, whilst simultaneously offering nutritional benefits. Combining the proposed functionalised flour types with current and future advances in product recipes paves the way towards optimised gluten-free goods.

  4. Novel Insights to Celiac Disease: A review article

    Alireza Pourtalebi-Firoozabadi

    2016-04-01

    Full Text Available Celiac disease is a chronic, systemic and autoimmune disorder of gastrointestinal track that involves approximately 1% of individuals of all ages throughout the world. The collaboration of environmental factor such as gluten proteins and genetic factors, notably HLA-DQ2 and/or HLA-DQ8 trigger the disease. Gluten-free diet is the simply and merely safe and proficient existing treatment. This article summarizes the latest trends in celiac disease.

  5. Gluten-free snacks using plantain-chickpea and maize blend: chemical composition, starch digestibility, and predicted glycemic index.

    Flores-Silva, Pamela C; Rodriguez-Ambriz, Sandra L; Bello-Pérez, Luis A

    2015-05-01

    An increase in celiac consumers has caused an increasing interest to develop good quality gluten-free food products with high nutritional value. Snack foods are consumed worldwide and have become a normal part of the eating habits of the celiac population making them a target to improve their nutritive value. Extrusion and deep-frying of unripe plantain, chickpea, and maize flours blends produced gluten-free snacks with high dietary fiber contents (13.7-18.2 g/100 g) and low predicted glycemic index (28 to 35). The gluten-free snacks presented lower fat content (12.7 to 13.6 g/100 g) than those reported in similar commercial snacks. The snack with the highest unripe plantain flour showed higher slowly digestible starch (11.6 and 13.4 g/100 g) than its counterpart with the highest chickpea flour level (6 g/100 g). The overall acceptability of the gluten-free snacks was similar to that chili-flavored commercial snack. It was possible to develop gluten-free snacks with high dietary fiber content and low predicted glycemic index with the blend of the 3 flours, and these gluten-free snacks may also be useful as an alternative to reduce excess weight and obesity problems in the general population and celiac community. © 2015 Institute of Food Technologists®

  6. Celiac Disease and Nonceliac Gluten Sensitivity: A Review.

    Leonard, Maureen M; Sapone, Anna; Catassi, Carlo; Fasano, Alessio

    2017-08-15

    The prevalence of gluten-related disorders is rising, and increasing numbers of individuals are empirically trying a gluten-free diet for a variety of signs and symptoms. This review aims to present current evidence regarding screening, diagnosis, and treatment for celiac disease and nonceliac gluten sensitivity. Celiac disease is a gluten-induced immune-mediated enteropathy characterized by a specific genetic genotype (HLA-DQ2 and HLA-DQ8 genes) and autoantibodies (antitissue transglutaminase and antiendomysial). Although the inflammatory process specifically targets the intestinal mucosa, patients may present with gastrointestinal signs or symptoms, extraintestinal signs or symptoms, or both, suggesting that celiac disease is a systemic disease. Nonceliac gluten sensitivity is diagnosed in individuals who do not have celiac disease or wheat allergy but who have intestinal symptoms, extraintestinal symptoms, or both, related to ingestion of gluten-containing grains, with symptomatic improvement on their withdrawal. The clinical variability and the lack of validated biomarkers for nonceliac gluten sensitivity make establishing the prevalence, reaching a diagnosis, and further study of this condition difficult. Nevertheless, it is possible to differentiate specific gluten-related disorders from other conditions, based on currently available investigations and algorithms. Clinicians cannot distinguish between celiac disease and nonceliac gluten sensitivity by symptoms, as they are similar in both. Therefore, screening for celiac disease must occur before a gluten-free diet is implemented, since once a patient initiates a gluten-free diet, testing for celiac disease is no longer accurate. Celiac disease and nonceliac gluten sensitivity are common. Although both conditions are treated with a gluten-free diet, distinguishing between celiac disease and nonceliac gluten sensitivity is important for long-term therapy. Patients with celiac disease should be followed up

  7. Celiac Family Health Education Video Series

    Full Text Available ... Group Patient Resources Gluten Free Cookbooks Gluten Free Recipes Videos Experiencing Celiac Disease What is Celiac Disease Diet Information At Home Shopping Cooking Gluten Free Baking School Eating Out Away From ...

  8. [Histological diagnosis and complications of celiac disease. Update according to the new S2k guidelines].

    Aust, D E; Bläker, H

    2015-03-01

    Celiac disease is a relatively common immunological systemic disease triggered by the protein gluten in genetically predisposed individuals. Classical symptoms like chronic diarrhea, steatorrhea, weight loss and growth retardation are nowadays relatively uncommon. Diagnostic workup includes serological tests for IgA antibodies against tissue transglutaminase 2 (anti-TG2-IgA) and total IgA and histology of duodenal biopsies. Histomorphological classification should be done according to the modified Marsh-Oberhuber classification. Diagnosis of celiac disease should be based on serological, clinical, and histological findings. The only treatment is a life-long gluten-free diet. Unchanged or recurrent symptoms under gluten-free diet may indicate refractory celiac disease. Enteropathy-associated T-cell lymphoma and adenocarcinomas of the small intestine are known complications of celiac disease.

  9. Psychosis and Silent Celiac Disease in a Down Syndrome Adolescent: A Case Report

    Amparo Morant

    2011-01-01

    Full Text Available Celiac disease is an autoimmune systemic disorder. It presents gastrointestinal and nongastrointestinal manifestations as well as associated conditions. We report a 16-year-old Down syndrome girl who presented psychosis symptomatology, and she was diagnosed as having silent celiac disease. Olanzapine treatment and gluten-free diet were satisfactory. It is necessary to consider celiac disease in Down syndrome patients with psychiatric symptoms, mainly psychotic symptomatology.

  10. Celiac Family Health Education Video Series

    Full Text Available ... is Celiac Disease Diet Information At Home Shopping Cooking Gluten Free Baking School Eating Out Away From ... How to shop for gluten-free food. VI. Cooking : How to cook and bake gluten-free foods. ...

  11. The influence of gluten-free bakery products consumption on selected anthropometric parameters

    Martina Gažarová

    2017-01-01

    Full Text Available The aim of the study was to evaluate the effect of a short-term consumption (six weeks of gluten-free bakery products on the anthropometric parameters. The study group was composed of volunteers from the general population and consisted of 30 healthy adults. The amount of bakery product was determined as follows: women consumed 150 - 200 grams per day; men 200 - 250 grams per day. Anthropometric measurements were made by using InBody 720, we received data such as body weight, Body Mass Index (BMI and Waist-to-Hip Ratio (WHR, which we evaluated the presence of overweight and obesity in the monitored groups. We also observed visceral fat area (VFA. We found out that the 6-week consumption of gluten-free bread and bakery products showed a significant reduction in body weight and BMI (p <0.01, but also to a significant increase in VFA (p <0.05. By the impact of consumption we recorded the increase of body weight and BMI in 70% of participants (in 30% there was slight increase, decrease of WHR in 33% (increase in 43% and decrease of VFA in 43% (increase in 57%. For other participants, the values remained unchanged. Two months after the termination of the consumption of gluten-free products we found out the increase of body weight and BMI, WHR remained unchanged, however in the case of VFA showed significant increase of values. We can summarize that dietary habits play a crucial role in the development of overweight and obesity and the consumption of bread and bakery products can also affect it. However, the overall effect of bread and bakery consumption on the development of overweight depends on many factors, such as the composition of the bread and bakery products and the presence of gluten.

  12. Effect of Ingredients on the Quality of Gluten-Free Sorghum Pasta.

    Palavecino, Pablo Martín; Bustos, Mariela Cecilia; Heinzmann Alabí, María Belén; Nicolazzi, Melani Solange; Penci, María Cecilia; Ribotta, Pablo Daniel

    2017-09-01

    Sorghum is an underutilized cereal in human food production, despite its flour being a potential gluten-free (GF) source in the development of several foods. Thus, the aim of the present investigation was to evaluate the effects and interactions of different ingredients on cooking quality and texture of GF pasta. Egg albumen (A), egg powder (E), xanthan gum (X), and pregelatinized corn starch (P) were used as ingredients, and Box-Behnken experimental design was applied to study the effects of these ingredients on pasta cooking behavior, color, and texture attributes. Responses were fitted to a second order polynomial equation, and multivariable optimization was performed using maximization of general desirability. Next, optimal formulations were validated, compared with two commercial gluten-free pastas by sensory evaluation, and finally, an industrial assay was carried out. Regression coefficients indicated that A and P improved cooking properties while A and E contributed the most to improving the pasta textural properties. As, X and P effects varied depending on the kind of sorghum flour used, the optimal formulations levels were different, but in both cases these models were satisfactory and capable of predicting responses. The industrial assay was carried out with white sorghum flour because it showed a higher acceptability in the sensory evaluation than brown sorghum flour pasta. This industrially made pasta resulted in slightly better cooking properties than the laboratory produced one, with the formulation adapting well to the conventional wheat pasta industrial process. Gluten-free sorghum pasta was produced, showing good cooking and textural properties and being a suitable option for gluten-sensitive individuals. © 2017 Institute of Food Technologists®.

  13. Composition of legume soaking water and emulsifying properties in gluten-free bread.

    Huang, San; Liu, Yuling; Zhang, Weihan; Dale, Kylie J; Liu, Silu; Zhu, Jingnan; Serventi, Luca

    2018-04-01

    Soaking of legumes results in the loss of macronutrients, micronutrients and phytochemicals. Fibre, protein and phytochemicals found in legumes exert emulsifying activity that may improve the structure and texture of gluten-free bread. The legume soaking water of haricot beans, garbanzo chickpeas, whole green lentils, split yellow peas and yellow soybeans were tested in this study for functional properties and use as food ingredients. Composition, physicochemical properties and effect on the quality of gluten-free bread were determined for each legume soaking water. Haricot beans and split yellow peas released the highest amount of solids in the legume soaking water: 1.89 and 2.38 g/100 g, respectively. Insoluble fibre was the main constituent of haricot beans legume soaking water, while water-soluble carbohydrates and protein were the major fraction of split yellow peas. High quantities of phenolics (∼400 µg/g) and saponins (∼3 mg/g) were found in the legume soaking water of haricot beans, whole green lentils and split yellow peas. High emulsifying activity (46 and 50%) was found for the legume soaking water of garbanzo chickpeas and split yellow peas, probably due to their protein content and high ratio of water-soluble carbohydrates to dry matter. Such activity resulted in softer texture of the gluten-free bread. A homogeneous structure of crumb pores was found for split yellow peas, opposing that of whole green lentils. A balance between the contents of yeast nutrients and antinutrients was the likely basis of the different appearances.

  14. Teff (Eragrostis tef) as a raw material for malting, brewing and manufacturing of gluten-free foods and beverages: a review.

    Gebremariam, Mekonnen Melaku; Zarnkow, Martin; Becker, Thomas

    2014-11-01

    The demand for gluten-free foods is certainly increasing. Interest in teff has increased noticeably due to its very attractive nutritional profile and gluten-free nature of the grain, making it a suitable substitute for wheat and other cereals in their food applications as well as foods for people with celiac disease. The main objective of this article is to review researches on teff, evaluate its suitability for different food applications, and give direction for further research on its applications for health food market. Teff is a tropical low risk cereal that grows in a wider ecology and can tolerate harsh environmental conditions where most other cereals are less viable. It has an excellent balance of amino acid composition (including all 8 essential amino acids for humans) making it an excellent material for malting and brewing. Because of its small size, teff is made into whole-grain flour (bran and germ included), resulting in a very high fiber content and high nutrient content in general. Teff is useful to improve the haemoglobin level in human body and helps to prevent malaria, incidence of anaemia and diabetes. The nutrient composition of teff grain indicates that it has a good potential to be used in foods and beverages worldwide. The high levels of simple sugars and α-amino acids as a result of breakdown of starch and protein, respectively, are essential for fermentation and beer making.

  15. Celiac Disease and Wheat Allergy: A Growing Association?

    Micozzi, Sarah; Infante, Sonsoles; Fuentes-Aparicio, Victoria; Álvarez-Perea, Alberto; Zapatero, Lydia

    2018-05-30

    Celiac disease and wheat allergy (WA) are infrequent diseases in the general population, and a combination of the 2 is particularly rare. Celiac disease occurs in around 1% of the general population and WA in around 1% of all children. We report 2 patients with celiac disease and a gluten-free diet who developed WA consistent in anaphylaxis and an eyelid angioedema, respectively, through accidental wheat exposure. A serum study and an intestinal biopsy confirmed celiac disease. Both patients were studied with a skin prick test and serum-specific IgE, with a diagnosis of WA. In patients with celiac disease, the trace amounts of cereals present in gluten-free food could act as a sensitization factor, and probably patients with persistent symptoms (despite a gluten-free diet) are experiencing WA symptoms rather than celiac disease symptoms. The number of patients diagnosed with celiac disease has increased in the recent decades: the association between celiac disease and WA, exceedingly rare to date, could increase as well, prompting special attention to the possibility of inadvertent intake of cereals. © 2018 S. Karger AG, Basel.

  16. Unusual Onset of Celiac Disease and Addison's Disease in a 12-Year-Old Boy.

    Miconi, Francesco; Savarese, Emanuela; Miconi, Giovanni; Cabiati, Gabriele; Rapaccini, Valentina; Principi, Nicola; Esposito, Susanna

    2017-07-29

    Celiac disease (CD) is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison's disease (AD) and CD may co-exist, although this association is relatively uncommon in children. In addition, it is not precisely defined whether a gluten-free diet influences the course of AD. A case of CD in a 12-year-old boy presenting as acute adrenal insufficiency is described here. A gluten-free diet had a significant therapeutic role in this case, wherein most of the clinical signs and symptoms of AD disappeared in a few days. In addition, the dosage of cortisol acetate, initially administered to treat the AD, was able to be rapidly reduced. This case highlights that CD can be associated with AD in children, and a gluten-free diet seems to positively influence the course of AD.

  17. Enrichment of gluten-free cakes with lupin (Lupinus albus L.) or buckwheat (Fagopyrum esculentum M.) flours.

    Levent, Hacer; Bilgiçli, Nermin

    2011-11-01

    In the present study, the effect of debittered lupin flour (LF) and whole buckwheat flour (BF) on the nutritional and sensory quality of gluten-free cake was studied. LF (10, 20, 30 and 40%) and BF (5, 10, 15 and 20%) were partially replaced with corn starch and rice flour mixture (1:1 w/w) in the gluten-free cake recipe. LF increased the protein, calcium, iron, manganese, phosphorus and zinc contents of the cakes, while BF caused a significant increase (P cakes. According to the overall acceptability rating, it was concluded that gluten-free cake could be produced with satisfactory results by the addition of LF and BF up to 30% and 10%, respectively.

  18. Effects of different hydrocolloids on properties of gluten-free bread based on small broken rice berry flour.

    Numfon, Rakkhumkaew

    2017-06-01

    Gluten-free bread formulations based on small broken rice berry using various types of hydrocolloids (xanthan gum, guar gum, and locust bean gum) at different concentrations (0, 1, 1.5, and 2 g/100 g) were tested in this study. The effects of hydrocolloid addition on the pasting properties of flour were also investigated, including the quality parameters of the breads. The pasting properties of small broken rice berry flour incorporated with guar gum were most affected. Gluten-free bread containing hydrocolloid showed improved qualities in terms of loaf specific volume, texture, sensory values, and microstructure. A 1 g/100 g of hydrocolloid addition was sufficient to improve the physical and chemical qualities of bread. The highest score of all attributes from the sensory evaluation was obtained by gluten-free bread containing 1 g/100 g guar gum.

  19. The present and the future in the diagnosis and management of celiac disease

    Castillo, Natalia E.; Theethira, Thimmaiah G.; Leffler, Daniel A.

    2015-01-01

    Celiac disease is an autoimmune enteropathy caused by gluten in genetically predisposed individuals. In celiac disease, adaptive and innate immune activation results in intestinal damage and a wide range of clinical manifestations. In the past, celiac disease was thought to result in signs and symptoms solely related to the gastrointestinal tract. Now, more than half of the adult population presents with extra-intestinal manifestations that can also be expected to improve on a gluten-free diet. For this reason, it is recommended that physicians have a low threshold of suspicion for celiac disease. Current knowledge of the immune pathogenesis of this autoimmune disease has served as a catalyst for the development of novel diagnostic tools and therapeutics. Over the years, highly sensitive and specific serological assays, in addition to genetic markers, have been found to target specific steps in the cascade pathway of celiac disease. Also the advent of the gluten challenge has enabled experts to design diagnostic algorithms and monitor clinical responses in clinical trials. The gluten challenge has provided substantial benefit in the advance of novel therapeutics as an adjuvant treatment to the gluten free diet. Generally, a strict gluten-free diet is highly burdensome to patients and can be limited in its efficacy. Alternative therapies—including gluten modification, modulation of intestinal permeability and immune response—could be central to the future treatment of celiac disease. PMID:25326000

  20. Using chemometric techniques to characterize gluten-free cookies containing the whole flour of a new quinoa cultivar

    Pagamunici, Lilian M.; Gohara, Aline K.; Souza, Aloisio H.P.; Batiston, Weliton P.; Gomes, Sandra T.M.; Visentainer, Jesui V.; Matsushita, Makoto

    2014-01-01

    Celiac disease is defined as intolerance to the gluten proteins present in certain cereals used to prepare foodstuffs. We developed and performed physico-chemical, sensory, and nutritional assessments of three formulations of gluten-free cookies containing Linum usitatissimum L. and different levels of whole Chenopodium quinoa BRS Piabiru flour. No gluten was detected in the prepared cookie formulations. The crude protein and total lipid contents ranged from 85.58 to 97.55 and 121.69 to 166.19 g per kg of sample, respectively. The polyunsaturated/saturated and n-6:n-3 fatty acid ratios ranged from 0.85:1 to 0.92:1 and 3.08:1 to 4.38:1, respectively. Formulation C had the best alpha-linolenic acid content, lipid fraction nutritional indices and mineral content per portion, with excellent sensory characteristics. Multivariate analysis highlighted the effect of the concentration of quinoa on the nutritional and sensory qualities of the product. (author)

  1. Using chemometric techniques to characterize gluten-free cookies containing the whole flour of a new quinoa cultivar

    Pagamunici, Lilian M.; Gohara, Aline K.; Souza, Aloisio H.P. [Universidade Estadual de Maringa (UEM), PR (Brazil). Centro de Ciencias Agrarias; Bittencourt, Paulo R.S.; Torquato, Alex S. [Universidade Tecnologica Federal do Parana (UTFPR), Medianeira, PR (Brazil); Batiston, Weliton P.; Gomes, Sandra T.M.; Visentainer, Jesui V.; Matsushita, Makoto, E-mail: mmakoto@uem.br [Universidade Estadual de Maringa (UEM), PR (Brazil). Dept. de Quimica; Souza, Nilson E. [Universidade Tecnologica Federal do Parana (UTFPR), Londrina, PR (Brazil)

    2014-02-15

    Celiac disease is defined as intolerance to the gluten proteins present in certain cereals used to prepare foodstuffs. We developed and performed physico-chemical, sensory, and nutritional assessments of three formulations of gluten-free cookies containing Linum usitatissimum L. and different levels of whole Chenopodium quinoa BRS Piabiru flour. No gluten was detected in the prepared cookie formulations. The crude protein and total lipid contents ranged from 85.58 to 97.55 and 121.69 to 166.19 g per kg of sample, respectively. The polyunsaturated/saturated and n-6:n-3 fatty acid ratios ranged from 0.85:1 to 0.92:1 and 3.08:1 to 4.38:1, respectively. Formulation C had the best alpha-linolenic acid content, lipid fraction nutritional indices and mineral content per portion, with excellent sensory characteristics. Multivariate analysis highlighted the effect of the concentration of quinoa on the nutritional and sensory qualities of the product. (author)

  2. Starch and antioxidant compound release during in vitro gastrointestinal digestion of gluten-free pasta.

    Camelo-Méndez, Gustavo A; Agama-Acevedo, Edith; Rosell, Cristina M; de J Perea-Flores, Maria; Bello-Pérez, Luis A

    2018-10-15

    The microstructure of cooked gluten-free pasta depends on the ingredients used, and this microstructure affects the starch hydrolysis (SH), the release of phenolic compounds (PC) and their antioxidant capacity (AC). The aim of this study was to evaluate the SD and bioaccessibility of PC during in vitro gastrointestinal digestion of gluten-free pasta and its relationship with the microstructure. The highest SH was during the intestinal phase (≈60%), but pasta with the highest content of unripe plantain and chickpea presented the lowest release of PC (≈60%). The insoluble dietary fibre could be responsible (≈12.5%) for these effects. The cooked pasta showed high AC in the intestinal phase. Regions with gelatinized starch granules in a less dense protein network and other regions with intact or swollen granules surrounded by a protein network were observed. The starch digestion and bioaccessibility of PC were related to the structure of the matrix. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Influence of final baking technologies in partially baked frozen gluten-free bread quality.

    Aguilar, Núria; Albanell, Elena; Miñarro, Begoña; Gallardo, Joan; Capellas, Marta

    2015-03-01

    The effect of final baking in convection oven (FBC), microwave oven (FBM), and microwave oven with susceptor packaging material (FBMS) on partially baked (PB) frozen gluten-free bread characteristics was investigated. Specific volume and crust color of loaves were measured at day 0. Bread moisture, water activity, and crumb and crust texture (at 15, 45, and 90 min after baking) were analyzed at day 0 and after 28 d of frozen storage (-18 °C). Volatile compounds from breads baked in convection oven or microwave oven with susceptor packaging material were also evaluated. Bread finally baked in convection oven or in microwave oven with susceptor packaging increased crust browning. Crumb and roll hardness increased with time after final baking (measured at 15, 45, 90 min) and after 28 d of frozen storage. Bread finally baked in microwave oven was the hardest, due to high water losses. At day 0, bread finally baked in convection oven had softer crumb than bread finally baked in microwave oven with susceptor packaging but, after 28 d of frozen storage, there were no differences between them. Moreover, FBC and FBMS rendered gluten-free breads that could not be distinguished in a triangular test and had the same volatile compounds profile. In conclusion, FBMS could be an alternative to FBC. © 2015 Institute of Food Technologists®

  4. Use of baru (Brazilian almond) waste from physical extraction of oil to produce gluten free cakes.

    Pineli, Lívia de Lacerda de Oliveira; de Aguiar, Lorena Andrade; de Oliveira, Guilherme Theodoro; Botelho, Raquel Braz Assunção; Ibiapina, Maria do Desterro Ferreira Pereira; de Lima, Herbert Cavalcanti; Costa, Ana Maria

    2015-03-01

    The extraction of oil from baru almonds produces a waste that carries part of their nutritional qualities and antioxidants. It can be used to produce partially deffated baru flour (PDBF). We aimed to evaluate the applicability of PDBF and the effect of the addition of xanthan gum (XG) to produce gluten free cakes. Cakes were prepared with 100% wheat flour (WF cake) and with 100% PDBF and four different levels of XG (0%-PDBF cake, 0.1%-X1, 0.2%-X2 and 0.3%-X3 cakes), and evaluated for composition, antioxidants, moisture, specific volume, texture and sensory acceptance. PDBF cakes showed lower carbohydrate values, but higher protein, lipids, calories and antioxidant contents. They were rich in fiber, as well as iron, zinc and copper. The replacement of WF by PDBF resulted in an increased hardness and adhesiveness and a decreased cohesiveness, elasticity and moisture. Chewiness of X2 cake was similar to that of WF cake. X2 and X3 cakes showed specific volume closer to that of WF cake. No difference was found among the treatments for texture and appearance acceptances. Flavor of X2 and X3 cakes were more accepted than WF cake. Acceptance of all cakes were in the liking region of hedonic scale. PBDF associated to XG is a feasible option to substitute WF in gluten free cake, improving its nutritional quality.

  5. Bones of contention: bone mineral density recovery in celiac disease--a systematic review.

    Grace-Farfaglia, Patricia

    2015-05-07

    Metabolic bone disease is a frequent co-morbidity in newly diagnosed adults with celiac disease (CD), an autoimmune disorder triggered by the ingestion of dietary gluten. This systematic review of studies looked at the efficacy of the gluten-free diet, physical activity, nutrient supplementation, and bisphosphonates for low bone density treatment. Case control and cohort designs were identified from PubMed and other academic databases (from 1996 to 2015) that observed newly diagnosed adults with CD for at least one year after diet treatment using the dual-energy x-ray absorptiometry (DXA) scan. Only 20 out of 207 studies met the inclusion criteria. Methodological quality was assessed using the Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE) statement checklist. Gluten-free diet adherence resulted in partial recovery of bone density by one year in all studies, and full recovery by the fifth year. No treatment differences were observed between the gluten-free diet alone and diet plus bisphosphonates in one study. For malnourished patients, supplementation with vitamin D and calcium resulted in significant improvement. Evidence for the impact of physical activity on bone density was limited. Therapeutic strategies aimed at modifying lifestyle factors throughout the lifespan should be studied.

  6. Beyond Irritable Bowel Syndrome: The Efficacy of the Low Fodmap Diet for Improving Symptoms in Inflammatory Bowel Diseases and Celiac Disease.

    Testa, Anna; Imperatore, Nicola; Rispo, Antonio; Rea, Matilde; Tortora, Raffaella; Nardone, Olga Maria; Lucci, Lucia; Accarino, Grazia; Caporaso, Nicola; Castiglione, Fabiana

    2018-05-15

    To evaluate the usefulness of a low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet on patients with irritable bowel syndrome (IBS), non-active inflammatory bowel diseases (IBD), and celiac disease (CD) on a gluten-free diet (GFD). Dietetic interventional prospective study. IBS, IBD, and CD subjects were evaluated to check if they fulfilled the Rome III criteria. Each subject was educated to follow a low FODMAP diet after being evaluated by filling out questionnaires that assessed the quality of life (QoL) and symptoms experienced (IBS-SSS and SF-36), and was reevaluated after 1 and 3 months. One hundred twenty-seven subjects were enrolled: 56 with IBS, 30 with IBD, and 41 with CD. IBS-SSS showed that abdominal symptoms improved after 1 and 3 months of diet in all subjects, with significant difference among the 3 groups at T0 (average scores IBS: 293 ± 137, IBD: 206 ± 86, CD: 222 ± 65, p symptoms in patients with IBS, non-active IBD, or CD on a GFD, and thus, improve their QoL and social -relations. © 2018 S. Karger AG, Basel.

  7. Characterization of Gluten-free Bread Prepared From Maize, Rice and Tapioca Flours using the Hydrocolloid Seaweed Agar-Agar

    Alvarenga, Nuno Bartolomeu; Cebola Lidon, Fernando; Belga, Elisa; Motrena, Patrícia; Guerreiro, Suse; Carvalho, Maria João; Canada, João

    2011-01-01

    Disponível em livre acesso no sítio do DOAJ em http://recent-science.com/index This work aims to check the rheological, physicochemical and sensory characteristics of gluten-free bread produced with corn, rice and tapioca flours, using the hydrocolloid seaweed agar-agar. Relatively to wheat bread, it was found that the pH was slightly lower in gluten-free bread. In the crust only the brightness remained significantly different between both bread types, but in the kernel, the parameters a*,...

  8. Coeliac disease in Asians in a single centre in southern Derbyshire

    Holmes, Geoffrey KT; Moor, Fiona

    2012-01-01

    Background Coeliac disease affects adult Asians from north India, Pakistan and Bangladesh in the UK but how commonly this occurs is unknown. An audit of coeliac disease was therefore conducted in a well-defined area in southern Derbyshire. Methods All white and Asian patients with biopsy-confirmed coeliac disease diagnosed between 1958 and 2008 were identified. Population data from the Office of National Statistics allowed the calculation of prevalence. Presenting symptoms, adherence to a gluten-free diet and follow-up record were determined for Asians and compared with matched white patients. Results Among 1305 coeliac patients diagnosed between 1958 and 2008, 82 were Asian. Coeliac disease occurred significantly more frequently in Asian than white individuals and this could be attributed to the significantly higher prevalence in women 16 years and older and under 60 years of age. No Asian man over the age of 65 years was diagnosed with coeliac disease. Asians are more likely to present with anaemia and less likely to present with diarrhoea than white individuals. Asians are less likely to adhere to a strict gluten-free diet than white patients. Conclusions This baseline audit indicates that increased efforts should be directed towards diagnosing coeliac disease in Asian men over the age of 65 years, in whom at present it is unrepresented. Strategies also need to be developed to help more Asian patients adhere strictly to the gluten-free diet. PMID:28839681

  9. Unusual Onset of Celiac Disease and Addison’s Disease in a 12-Year-Old Boy

    Francesco Miconi

    2017-07-01

    Full Text Available Background: Celiac disease (CD is an autoimmune disorder deriving from an aberrant adaptive immune response against gluten-containing grains in genetically predisposed subjects. In a number of patients, CD is associated with one or more other autoimmune diseases. Primary Addison’s disease (AD and CD may co-exist, although this association is relatively uncommon in children. In addition, it is not precisely defined whether a gluten-free diet influences the course of AD. Case presentation: A case of CD in a 12-year-old boy presenting as acute adrenal insufficiency is described here. A gluten-free diet had a significant therapeutic role in this case, wherein most of the clinical signs and symptoms of AD disappeared in a few days. In addition, the dosage of cortisol acetate, initially administered to treat the AD, was able to be rapidly reduced. Conclusion: This case highlights that CD can be associated with AD in children, and a gluten-free diet seems to positively influence the course of AD.

  10. Imaging active lymphocytic infiltration in coeliac disease with iodine-123-interleukin-2 and the response to diet

    Signore, A.; Chianelli, M.; Annovazzi, A.; Rossi, M.; Greco, M.; Ronga, G.; Picarelli, A. [Nuclear Medicine Unit (Nu.M.E.D. Group) and Gastroenterology Unit, Department of Clinical Sciences, University of Rome ' ' La Sapienza' ' (Italy); Maiuri, L. [Inst. of Paediatrics, Children' s Hospital Posilipon, University ' ' Federico II' ' , Naples (Italy); Britton, K.E. [Dept. of Nuclear Medicine, St. Bartholomew' s Hospital, London (United Kingdom)

    2000-01-01

    Coeliac disease is diagnosed by the presence of specific antibodies and a jejunal biopsy showing mucosal atrophy and mononuclear cell infiltration. Mucosal cell-mediated immune response is considered the central event in the pathogenesis of coeliac disease, and untreated coeliac patients show specific features of T-cell activation in the small intestine. Here we describe the use of iodine-123-interleukin-2 scintigraphy in coeliac patients as a non-invasive tool for detection of lymphocytic infiltration in the small bowel and its use for therapy follow-up, and we demonstrate the specificity of binding of labelled-IL2 to activated lymphocytes by ex-vivo autoradiography of jejunal biopsies. {sup 123}I-IL2 was administered i.v. [74 MBq (2 mCi)], and gamma camera images were acquired after 1 h. Ten patients were studied with {sup 123}I-IL2 scintigraphy at diagnosis and seven were also investigated after 12-19 months of gluten-free diet. Results were expressed as target-to-background radioactivity ratios in six different bowel regions before and after the diet. At the time of diagnosis all patients showed a significantly higher bowel uptake of {sup 123}I-IL2 than normal subjects (P<0.003 in all regions). A significant correlation was found between jejunal radioactivity and the number of IL2R+ve lymphocytes per millimetre of jejunal mucosa as detected by immunostaining of jejunal biopsy (r{sup 2}=0.66; P=0.008). Autoradiography of jejunal biopsies confirmed that labelled-IL2 only binds to activated T-lymphocytes infiltrating the gut mucosa. After 1 year of the diet, bowel uptake of {sup 123}I-IL2 significantly decreased in five out of six regions (P<0.03), although two patients still had a positive IL2 scintigraphy in one region. We conclude that {sup 123}I-IL2 scintigraphy is a sensitive non-invasive technique for assessing in vivo the presence of activated mononuclear cells in the bowel of patients affected by coeliac disease. Unlike jejunal biopsy, this method provides

  11. Diagnosis of Celiac Disease: Taking a Bite Out of the Controversy.

    Turner, Justine M

    2018-06-01

    Celiac disease is a common autoimmune disorder of the small intestine, triggered by an immunological response to the gluten present in wheat, barley, and rye in individuals who are genetically at risk. A key to reducing the complications of this disease is early diagnosis, preferably in childhood, and consuming a lifelong gluten-free diet once diagnosis is confirmed. Yet, the diagnosis of celiac disease is often considerably delayed, exposing patients to needless suffering and morbidity. It is also difficult to confirm histologically if dietary gluten has been restricted prior to obtaining a diagnostic biopsy, a significant problem given the current growing popularity of gluten-free diets. Furthermore, failure to understand or follow current guidelines means physicians may recommend patients commence the gluten-free diet before initiating referral to a gastroenterologist. Finally, adding further confusion, pediatric guidelines in Europe support a diagnosis based on serology rather than on histology, whereas those based in North America do not. The purpose of this review is to discuss these issues and other controversies in the diagnosis of celiac disease and to consider ways to optimize diagnosis across the lifespan.

  12. Prevalence of asymptomatic celiac disease in children with fibromyalgia: a pilot study

    Sherry David D

    2011-06-01

    Full Text Available Abstract Background The objective of this study was to prospectively determine the prevalence of asymptomatic celiac disease among children presenting with fibromyalgia. The secondary objective was to investigate if their symptoms resolved on a gluten free diet. Findings All children seen in the Amplified Musculoskeletal Pain clinic between the ages of 12 and 17 years of age who fulfilled the 1990 American College of Rheumatology diagnostic criteria for fibromyalgia were invited to participate. A total immunoglobulin A (IgA level, IgA antiendomysial (EMA and IgA anti-TTG antibodies was obtained on all study subjects. A visual analog scale for pain and a functional disability inventory were obtained on all patients. If a patient had elevated EMA or TTG a small bowel biopsy was done. Patients with celiac disease were placed on a gluten-free diet and observed to see if their symptoms resolved. 50 patients, 45 females, completed the study. Only one patient was found to have celiac disease. On a gluten-free diet her tissue transglutaminase antibody level returned to normal but her visual analog scale scores increased and her functional disability inventory was 40 initially and 21 at follow up. Conclusions In this pilot, single center study at a tertiary children's hospital patients with fibromyalgia do not seem to have occult celiac disease at an increased rate over the population as a whole.

  13. Quality characteristics of gluten-free cookies made of buckwheat, corn, and rice flour with/without transglutaminase.

    Altındağ, Gülçin; Certel, Muharrem; Erem, Fundagül; İlknur Konak, Ülgen

    2015-04-01

    Buckwheat is one of the most valuable pseudo-cereals in terms of its nutritional composition, and it is suitable for celiac patients because of its gluten-free characteristic. However, gluten is the main structure-forming protein responsible for the development of structure in baked products. Therefore, it is a challenge to produce high-quality gluten-free products. Transglutaminase addition is a relatively common application used in the production of gluten-free baked goods. The objective of this study was to investigate the combination of buckwheat flour with rice and corn flour at different levels in gluten-free cookie formulations and the impact of transglutaminase on the quality of cookies. Quality parameters evaluated were proximal chemical composition, spread ratio, color, and textural parameters (hardness and fracturability). Spread ratio, protein, crude fiber, ash content, and also b* and hardness values were significantly (p flour combinations. Further, addition of transglutaminase resulted in increased moisture content, spread ratio, and fracturability but decreased hardness values. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. Understanding the DASH diet

    ... has been widely studied and has many health benefits. Following this diet plan may help: Lower high blood pressure Reduce the ... more expensive than prepared foods. The diet is flexible enough to follow if you are vegetarian , vegan, or gluten-free .

  15. Sourdough fermentation and chestnut flour in gluten-free bread: A shelf-life evaluation.

    Rinaldi, Massimiliano; Paciulli, Maria; Caligiani, Augusta; Scazzina, Francesca; Chiavaro, Emma

    2017-06-01

    The effect of sourdough fermentation combined with chestnut flour was investigated for improving technological and nutritional quality of gluten-free bread during 5day shelf life by means of chemico-physical and nutritional properties. Sourdough fermentation by itself and with chestnut flour reduced volume of loaves and heterogeneity in crumb grain. Sourdough technology allowed increasing crumb moisture content with no significant variations during shelf-life. Chestnut flour darkened crumb and crust while no effects on colour were observed for sourdough. Sourdough and/or chestnut flour addition caused a significant increase in crumb hardness at time 0 while a significant reduction of staling was observed only at 5days, even if a decrease in amylopectin fusion enthalpy was observed. The percentage of hydrolysed starch during in vitro digestion was significantly reduced by sourdough fermentation with a presumable lower glycaemic index. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Effect of baking on reduction of free and hidden fumonisins in gluten-free bread.

    Bryła, Marcin; Roszko, Marek; Szymczyk, Krystyna; Jędrzejczak, Renata; Słowik, Elżbieta; Obiedziński, Mieczysław W

    2014-10-22

    The aim of the present work was to assess the influence of the baking process on the fumonisin content in gluten-free bread. The dough was made using two methods: without sourdough and with sourdough. Fumonisins were determined using high-performance liquid chromatography with ion-trap mass spectrometry. This study showed that the bread baking process caused a statistically significant drop in the mean concentration of free fumonisins: the reduction levels were 30 and 32% for the direct and sourdough-based methods, respectively. The lower reduction after baking was observed for hidden fumonisins: 19 and 10%, respectively. The presence of some compounds (such as proteins or starch) capable of stabilizing fumonisins during the baking process might be responsible for the observed increase in the hidden-to-free ratio from an initial 0.72 in flour to 0.83 in bread made from sourdough and to 0.95 in sourdough-free bread.

  17. Characterization of the Bread Made with Durum Wheat Semolina Rendered Gluten Free by Sourdough Biotechnology in Comparison with Commercial Gluten-Free Products.

    Rizzello, Carlo Giuseppe; Montemurro, Marco; Gobbetti, Marco

    2016-09-01

    Durum wheat semolina was fermented with sourdough lactic acid bacteria and fungal proteases aiming at a complete gluten hydrolysis. The gluten-free (GF) semolina, added with naturally GF ingredients and structuring agents, was used to produce bread (rendered GF bread; rGFB) at industrial level. An integrated approach including the characterization of the main chemical, nutritional, structural, and sensory features was used to compare rGFB to a gluten-containing bread and to 5 commercial naturally GF breads. High-performance liquid chromatography was used for free amino acids (FAAs), organic acids, and ethanol analysis. A methanolic extract was used for determining total phenols and antioxidant activity. The bread characterization also included the analysis of dietary fibers, mycotoxins, vitamins, and heavy metals. Beyond chemical analysis, nutritional profile was evaluated considering the in vitro protein digestibility and the predicted glycemic index, while the instrumental texture profile analysis was performed to investigate the structure and the physical/mechanical properties of the baked goods. Beyond the huge potential of market expansion, the main advantages of durum wheat semolina rendered GF can be resumed in the high availability of FAAs, the high protein digestibility, the low starch hydrolysis index, and the better technological properties of bread compared to the commercial GF products currently present on the market. Vitamins, minerals, and dietary fiber profiles are comparable to those of gluten-containing wheat bread. Also the sensory profile, determined by a panel test, can be considered the most similar to those of conventional baked goods, showing all the sourdough bread classic attributes. © 2016 Institute of Food Technologists®

  18. Diet - chronic kidney disease

    ... you will need to eat more protein. A high-protein diet with fish, poultry, pork, or eggs at every meal may be recommended. People on dialysis should eat 8 to 10 ounces (225 to 280 grams) of high-protein foods each day. Your provider or dietitian ...

  19. Hepatic manifestations of celiac disease

    Hugh James Freeman

    2010-05-01

    Full Text Available Hugh James FreemanDepartment of Medicine (Gastroenterology, University of British Columbia, Vancouver, British Columbia, CanadaAbstract: Different hepatic and biliary tract disorders may occur with celiac disease. Some have been hypothesized to share genetic or immunopathogenetic factors, such as primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis. Other hepatic changes in celiac disease may occur with malnutrition resulting from impaired nutrient absorption, including hepatic steatosis. In addition, celiac disease may be associated with rare hepatic complications, such as hepatic T-cell lymphoma.Keywords: celiac disease, autoimmune liver disease, primary biliary cirrhosis, fatty liver, gluten-free diet

  20. Treatment for Celiac Disease

    ... free diet. In recent years, grocery stores and restaurants have added many more gluten-free foods and ... Process Research Training & Career Development Funded Grants & Grant History Research Resources Research at NIDDK Technology Advancement & Transfer ...

  1. Current epidemiology and accessibility to diet compliance in adult celiac disease Epidemiología actual y accesibilidad al seguimiento de la dieta de la enfermedad celiaca del adulto

    F. Casellas

    2006-06-01

    Full Text Available Background: the widespread of serologic diagnosis for celiac disease has brought about an epidemiologic shift. Little up-to-date information is available on relevant epidemiologic issues regarding diagnosis, information, and therapy. Objective: to examine forms of presentation, diagnostic difficulties, follow-up, information sources, and treatment-related issues regarding celiac disease. Method: a cross-sectional observational study using a self-completed questionnaire. Results: seventy-three adult patients were included; 15.0% of cases were diagnosed over 60 years of age. Most were non-smokers (91.8%. The rate of first-degree relatives with celiac sprue was 10.9%. The disease had a classic presentation in only 54.7% of cases. A functional gastrointestinal disorder was initially suspected in 42.4% of patients. Diet adherence is adequate, with unintentional lack of compliance in 15.5% of patients. Diet results in absent or improved symptoms in virtually all patients, but most of them consider compliance a challenge. Forty percent had difficulty finding gluten-free food, and 50.8% had problems in labelling recognition. Conclusions: celiac disease presents at any age, has a great variety of manifestations, and responds very well to gluten-free diet. It is crucial that patients be highly motivated and informed, and that they know for certain which foods and manufactured products are to be to used. Therefore, adequate control will result from coordination and cooperation regarding all resources involved, including medical care, and information provided by associations and other sources such as the Web.

  2. Regression of conjunctival tumor during dietary treatment of celiac disease

    Tuncer Samuray

    2010-01-01

    Full Text Available A 3-year-old girl presented with a hemorrhagic conjunctival lesion in the right eye. The medical history revealed premature cessation of breast feeding, intolerance to the ingestion of baby foods, anorexia, and abdominal distention. Prior to her referral, endoscopic small intestinal biopsy had been carried out under general anesthesia with a possible diagnosis of Celiac Disease (CD. Her parents did not want their child to undergo general anesthesia for the second time for the excisional biopsy. We decided to follow the patient until all systemic investigations were concluded. In evaluation, the case was diagnosed with CD and the conjunctival tumor showed complete regression during gluten-free dietary treatment. The clinical fleshy appearance of the lesion with spider-like vascular extensions and subconjunctival hemorrhagic spots, possible association with an acquired immune system dysfunction due to CD, and spontaneous regression by a gluten-free diet led us to make a presumed diagnosis of conjunctival Kaposi sarcoma.

  3. Why Oats Are Safe and Healthy for Celiac Disease Patients

    Luud J. W. J. Gilissen

    2016-11-01

    Full Text Available The water-insoluble storage proteins of cereals (prolamins are called “gluten” in wheat, barley, and rye, and “avenins” in oat. Gluten can provoke celiac disease (CD in genetically susceptible individuals (those with human leukocyte antigen (HLA-DQ2 or HLA-DQ8 serotypes. Avenins are present at a lower concentration (10%–15% of total protein content in oat as compared to gluten in wheat (80%–85%. The avenins in the genus Avena (cultivated oat as well as various wild species of which gene bank accessions were analyzed are free of the known CD immunogenic epitopes from wheat, barley, and rye. T cells that recognize avenin-specific epitopes have been found very rarely in CD patients. CD patients that consume oats daily do not show significantly increased levels of intraepithelial lymphocyte (EIL cells. The safety and the positive health effects of the long-term inclusion of oats in the gluten-free diet have been confirmed in long-term studies. Since 2009 (EC 41/2009 and 2013 (FDA oat products may be sold as gluten-free in several countries provided a gluten contamination level below 20 ppm. Introduction of oats in the gluten-free diet of celiac patients is advised after the recovery of the intestine. Health effects of oat consumption are reflected in European Food Safety Authority (EFSA- and Food and Drug Administration (FDA-approved health claims. Oats can form a healthy, nutritious, fiber-rich, and safe complement to the gluten-free diet.

  4. What Is Celiac Disease?

    ... Disease" Articles Celiac Disease Changes Everything / What is Celiac Disease? / Symptoms, Diagnosis and Treatment / Four Inches and Seven Pounds… / Learning to Live Well with Celiac Disease / Living Gluten-Free Spring 2015 Issue: Volume 10 ...

  5. Celiac Disease Changes Everything

    ... Disease" Articles Celiac Disease Changes Everything / What is Celiac Disease? / Symptoms, Diagnosis and Treatment / Four Inches and Seven Pounds… / Learning to Live Well with Celiac Disease / Living Gluten-Free Spring 2015 Issue: Volume 10 ...

  6. Gluten-Free Diet Only during Pregnancy Efficiently Prevents Diabetes in NOD Mouse Offspring

    Antvorskov, J.C.; Josefsen, K.; Haupt-Jorgensen, M.; Fundová, Petra; Funda, David P.; Buschard, K.

    2016-01-01

    Roč. 2016, July (2016), s. 3047574 ISSN 2314-6745 R&D Projects: GA ČR GA15-24487S Institutional support: RVO:61388971 Keywords : ISLET AUTOIMMUNITY * RISK * MICE Subject RIV: FB - Endocrinology, Diabetology, Metabolism, Nutrition Impact factor: 2.717, year: 2016

  7. Gluten-Free Diet Only during Pregnancy Efficiently Prevents Diabetes in NOD Mouse Offspring

    Antvorskov, Julie C; Josefsen, Knud; Haupt-Jorgensen, Martin

    2016-01-01

    Studies have documented that the pathogenesis of autoimmune diabetes is influenced by the intake of gluten. Aims. To investigate the importance of gluten exposure during pregnancy and the subsequent development of autoimmune diabetes in offspring. Methods. Nonobese diabetic mice were divided into...

  8. Celiac Disease and Thyroid Conditions

    ... do not respond positively to any thyroid hormone treatment, discuss testing for CD with your doctor, as you may be malabsorbing the medication . Hypothyroidism and the Gluten-Free Diet (GF) •Some Patients ...

  9. The rheology, microstructure and sensory characteristics of a gluten-free bread formulation enhanced with orange pomace.

    O'Shea, Norah; Doran, Linda; Auty, Mark; Arendt, Elke; Gallagher, Eimear

    2013-12-01

    The present manuscript studied a previously optimised gluten-free bread formulation containing 5.5% orange pomace (OP) in relation to the batter characteristics (i.e. pre-baking), microstructure (of the flours, batter and bread) and sensory characteristics of the bread. Rheology, RVA and mixolab results illustrated that orange pomace improved the robustness of the gluten-free batter and decreased the occurrence of starch gelatinisation. This was confirmed from the confocal laser scanning microscopy (CLSM) images, which showed potato starch granules to be more expanded in the control batter when compared to the sample containing orange pomace. Starch granules were also observed to be more enlarged and swollen in the CLSM bread images, suggesting a higher level of gelatinisation occurred in the control sample. Sensory analysis was carried out on the optimised and control bread; panellists scored the flavour, crumb appearance and overall acceptability of the OP-containing breads comparable to the control.

  10. Effect of acorn meal-water combinations on technological properties and fine structure of gluten-free bread.

    Skendi, Adriana; Mouselemidou, Panagiota; Papageorgiou, Maria; Papastergiadis, Efthimios

    2018-07-01

    Gluten-free breads were developed from rice flour and corn starch at a constant ratio 1:1 with acorn meal addition (5, 15, 25%), at three levels of water (65, 70, 75%). Acorn supplemented gluten free breads better met sensory preference than rice breads in terms of colour (brown hue was enhanced) and were also nutritionally improved in terms of total phenolics. The specific volume of breads significantly decreased with increasing acorn addition while crumb hardness was also increased. SEM images confirmed that the decrease in the ΔH values at low water level (65%) was due to less swelling of starch as observed from large starch granule remnants present after baking. XRD measurements revealed coexistence of "B" and "V" type starch structures. Increasing of acorn concentration enhanced the intensity of FTIR bands at 994, 1016 and 1077 cm -1 . Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Effect of bioprocessing and fractionation on the structural, textural and sensory properties of gluten-free faba bean pasta

    Heiniö, Raija-Liisa; Cassan, Denis; Holopainen-Mantila, Ulla; Micard, Valerie; Lantto, Raija; Sozer, Nesli

    2016-01-01

    This work evaluated the effects of processing faba bean flour on textural, structural and sensory properties of gluten-free pasta. Pasta was prepared using faba bean flour, starch-rich fraction of faba bean flour or faba bean flour fermented with lactic acid bacteria. The impact of cross-linking enzyme transglutaminase (TG) on the quality of faba pasta was also studied. The structure, cooking quality, starch digestibility, textural and sensory characteristics of faba pasta samples were evalua...

  12. The influence of baking time and temperature on characteristics of gluten free cookies enriched with blueberry pomace

    Šarić Bojana M.; Nedeljković Nataša M.; Šimurina Olivera D.; Pestorić Mladenka V.; Kos Jovana J.; Mandić Anamarija I.; Sakač Marijana B.; Šarić Ljubiša Ć.; Psodorov Đorđe B.; Mišan Aleksandra Č.

    2014-01-01

    Blueberry pomace, by-product of juice production, was processed into a new food ingredient by drying and grinding and used for a new gluten-free cookies' formulation, with the aim of improving nutritional profile and antioxidant capacity. Since duration and temperature at which dough is thermally treated during baking highly influence the quality of a baked product, the objective of this work was to optimise the baking conditions in order to obtain the best technological quality of the cookie...

  13. Quality improvement of gluten-free bread based on soybean and enriched with sugar beet molasses

    Šimurina Olivera D.

    2017-01-01

    Full Text Available The aim of this work was to improve the quality of gluten-free bread made with high content of soy flour and enriched with sugar beet molasses by incorporating ingredients with a potential to simultaneously enhance the nutritional quality of the breads. The following ingredients were used: pea protein isolate, pea fibre and chia seeds. The chosen ingredients exerted positive effects on bread quality. They promoted volume increase and crumb softening. In this respect, the most effective ingredients were pea protein isolate (at 1% supplementation level, pea fibre (at up to 2% supplementation level and chia seeds (at 1% supplementation level. The sensory analysis revealed that pea fibre and chia addition at 1 and 2% supplementation level provided bread with higher scores regarding overall acceptance, crumb texture and taste. At 1% supplementation level, there was not found statistically significant difference in sensory attributes of bread supplemented with pea protein isolate in comparison to the control. However, pea protein isolate was found to strongly diminish bread taste at 4% supplementation level due to presence of beany taste.

  14. Gluten-Free Foods in Rural Maritime Provinces: Limited Availability, High Price, and Low Iron Content.

    Jamieson, Jennifer A; Gougeon, Laura

    2017-12-01

    We investigated the price difference between gluten-free (GF) and gluten-containing (GC) foods available in rural Maritime stores. GF foods and comparable GC items were sampled through random visits to 21 grocery stores in nonurban areas of Nova Scotia, New Brunswick, and Prince Edward Island, Canada. Wilcoxon rank tests were conducted on price per 100 g of product, and on the price relative to iron content; 2226 GF foods (27.2% staple items, defined as breads, cereals, flours, and pastas) and 1625 GC foods were sampled, with an average ± SD of 66 ± 2.7 GF items per store in rural areas and 331 ± 12 in towns. The median price of GF items ($1.76/100 g) was more expensive than GC counterparts ($1.05/100 g) and iron density was approximately 50% less. GF staple foods were priced 5% higher in rural stores than in town stores. Although the variety of GF products available to consumers has improved, higher cost and lower nutrient density remain issues in nonurban Maritime regions. Dietitians working in nonurban areas should consider the relative high price, difficult access, and low iron density of key GF items, and work together with clients to find alternatives and enhance their food literacy.

  15. Gluten-Free Bread: Influence of Sourdough and Compressed Yeast on Proofing and Baking Properties.

    Cappa, Carola; Lucisano, Mara; Raineri, Andrea; Fongaro, Lorenzo; Foschino, Roberto; Mariotti, Manuela

    2016-10-23

    The use of sourdough is the oldest biotechnological process to leaven baked goods, and it represents a suitable technology to improve traditional bread texture, aroma, and shelf life. A limited number of studies concerning the use of sourdough in gluten-free (GF) breadmaking have been published in comparison to those on traditional bread. The aim of this study was to compare the properties of GF breads obtained by using a previously in-lab developed GF-sourdough (SD), compressed yeast (CY; Saccharomyces cerevisiae ) or their mixture (SDCY) as leavening agents; more specifically, it aims to confirm the findings of a previous studies and to further improve (both in terms of recipe and process) the features of the resulting GF breads. Dough pH and rheological properties were measured. Fresh and stored breads were characterized for weight, height, specific volume, crust and crumb color, moisture, water activity, crumb hardness, and porosity. The combination SDCY was effective in improving bread volume and softness when compared to SD only. Furthermore, SD- and SDCY-crumbs exhibited a less crumbly behavior during storage (69 h, 25 °C, 60% of relative humidity) in comparison to CY-breads. This study confirms the positive effect of SD in GF breadmaking, in particular when used in combination with CY.

  16. Gluten-Free Bread: Influence of Sourdough and Compressed Yeast on Proofing and Baking Properties

    Carola Cappa

    2016-10-01

    Full Text Available The use of sourdough is the oldest biotechnological process to leaven baked goods, and it represents a suitable technology to improve traditional bread texture, aroma, and shelf life. A limited number of studies concerning the use of sourdough in gluten-free (GF breadmaking have been published in comparison to those on traditional bread. The aim of this study was to compare the properties of GF breads obtained by using a previously in-lab developed GF-sourdough (SD, compressed yeast (CY; Saccharomyces cerevisiae or their mixture (SDCY as leavening agents; more specifically, it aims to confirm the findings of a previous studies and to further improve (both in terms of recipe and process the features of the resulting GF breads. Dough pH and rheological properties were measured. Fresh and stored breads were characterized for weight, height, specific volume, crust and crumb color, moisture, water activity, crumb hardness, and porosity. The combination SDCY was effective in improving bread volume and softness when compared to SD only. Furthermore, SD- and SDCY-crumbs exhibited a less crumbly behavior during storage (69 h, 25 °C, 60% of relative humidity in comparison to CY-breads. This study confirms the positive effect of SD in GF breadmaking, in particular when used in combination with CY.

  17. Stability of gluten free sweet biscuit elaborated with rice bran, broken rice and okara

    Bruna Oliveira TAVARES

    2016-01-01

    Full Text Available Abstract A challenge to the food sector has been the development of new products incorporating co-products from the food processing industry with minimal impact on their pre-determined structures and adding nutritional quality. In order to add value and develop alternatives for the use of co-products generated during the agroindustrial processing, this work aimed to study the stability of gluten-free sweet biscuits developed with soybean okara, rice bran and broken rice. The formulations were elaborated with increasing percentages of these ingredients and compared with the standard (commercial sweet biscuit for ten months. The analyses were: weight, diameters (internal and external, thickness, specific volume, instrumental parameters of color, texture, scanning electron microscopy, water activity, proximal composition and isoflavones. The experimental sweet biscuits had characteristics of color, weight, volume and diameters (internal and external very similar to the commercial, whereas texture, lipids and energy value decreased, and aw, moisture and protein increased during storage. The sweet biscuits showed the same stability when compared to the standard, and the

  18. Degree of roasting of carob flour affecting the properties of gluten-free cakes and cookies.

    Román, Laura; González, Ana; Espina, Teresa; Gómez, Manuel

    2017-06-01

    Carob flour is a product rich in fibre obtained from by-products of the locust bean gum extraction processing. The flour is commercialised with different degrees of roasting in order to improve its organoleptic characteristics. In this study, carob flour with three different roasting degrees was used to replace rice flour (15%) in gluten-free cakes and cookies. The influence of this replacement was studied on the psychochemical characteristics and acceptability of the final products. The incorporation of carob flour increased the viscosity of cake batters and increased the solid elastic-like behaviour of the cookie doughs, indicating a stronger interaction among the formula ingredients. The inclusion of carob flour, with a low time of roasting, did not lead to any significant differences in the specific volume and hardness of the cakes, but reduced cake staling and the thickness and width of the cookies. Darker colours were obtained when carob flour was incorporated into the product. The acceptability of cakes was only reduced with the addition of highly roasted carob flour, while in the case of cookies there was a decline in the acceptability of all carob flour cookies, which was mostly perceived with the highest roasting degree, something mainly attributed to the bitter taste of the products.

  19. Sensory, digestion, and texture quality of commercial gluten-free bread: Impact of broken rice flour type.

    Feizollahi, Ehsan; Mirmoghtadaie, Leila; Mohammadifar, Mohammad Amin; Jazaeri, Sahar; Hadaegh, Haleh; Nazari, Bahman; Lalegani, Sajjad

    2018-02-08

    This research investigated the effects of two varieties of broken rice (Khouzestan and Lenjan) from warm and dry regions, and two (Hashemi and Tarom) from mild and humid regions on different parameters including dough rheology, digestibility, and quality (color, specific volume, textural properties, and sensorial properties) of a commercial gluten-free bread (GFB). Furthermore, the rice varieties' hydration properties, gelatinization temperatures, and starch-granule morphology were assessed. Significant differences were observed in the varieties' proximate composition and hydration properties from both climate zones. The granules' average size was 3.17-4.9 µm. The specific volume of the breads showed no correlation with either the damaged starch content or the amylose content, but had a significant negative correlation with hardness (r = -.923, p production. Moreover, it was determined that the rice varieties currently used in commercial manufacture of gluten-free bread do not necessarily yield the highest-quality bread. Gluten-free breads (GFBs) are generally used by Coeliac patients. In comparison to wheat bread, the quality of GFBs is lower. Rice is one of the main ingredients of GFBs' formulation, thence by determining the quality-related features of the rice, improvement in the final product could be achieved. In addition, by implementing the cheap and the broken rice variety, the price of the final product could be decreased and be more affordable for the patients. © 2018 Wiley Periodicals, Inc.

  20. Evaluation of sorghum flour functionality and quality characteristics of gluten-free bread and cake as influenced by ozone treatment.

    Marston, Kathryn; Khouryieh, Hanna; Aramouni, Fadi

    2015-12-01

    Commercially milled food-grade sorghum flour was subjected to ozone at the rate of 0.06 L/min for 15, 30, and 45 min. The pH of ozone-treated flour decreased as exposure time increased. The L* (lightness) values of sorghum flour significantly increased (p cake volume significantly increased as ozonation time increased. Additionally, longer ozonation exposure times increased cells per slice area, lightness, and slice brightness values in gluten-free cakes while reducing crumb firmness. Despite improving lightness and slice brightness values, ozonation did not significantly increase the specific volume of gluten-free batter-based bread. While ozonation improved the volume and texture in cakes, it did not have the same positive effects on gluten-free bread. Bread made from ozonated sorghum flour had an open ragged structure with equivalent volume to the control flour. In both applications, the increased brightness and lightness values due to ozone exposure is recommended to increase the acceptability of sorghum products. © The Author(s) 2014.

  1. Mixture design of rice flour, maize starch and wheat starch for optimization of gluten free bread quality.

    Mancebo, Camino M; Merino, Cristina; Martínez, Mario M; Gómez, Manuel

    2015-10-01

    Gluten-free bread production requires gluten-free flours or starches. Rice flour and maize starch are two of the most commonly used raw materials. Over recent years, gluten-free wheat starch is available on the market. The aim of this research was to optimize mixtures of rice flour, maize starch and wheat starch using an experimental mixture design. For this purpose, dough rheology and its fermentation behaviour were studied. Quality bread parameters such as specific volume, texture, cell structure, colour and acceptability were also analysed. Generally, starch incorporation reduced G* and increased the bread specific volume and cell density, but the breads obtained were paler than the rice flour breads. Comparing the starches, wheat starch breads had better overall acceptability and had a greater volume than maize-starch bread. The highest value for sensorial acceptability corresponded to the bread produced with a mixture of rice flour (59 g/100 g) and wheat starch (41 g/100 g).

  2. Rheological and secondary structural characterization of rice flour-zein composites for noodles slit from gluten-free sheeted dough.

    Jeong, Sungmin; Kim, Hee Won; Lee, Suyong

    2017-04-15

    Rice flour-zein composites in a hydrated viscoelastic state were utilized to compensate for the role of wheat gluten in gluten-free sheeted dough. The use of zein above its glass transition temperature was able to form a viscoelastic protein network of non-wheat dough with rice flour. The mixing stability and development time of the rice dough were positively increased with increasing levels of zein. The protein secondary structural analysis by FTIR spectroscopy demonstrated that the rice doughs with high levels of zein showed significant increases in β-sheet structures whose intensity was almost doubled by the use of 10% zein. The use of zein at more than 5% (w/w) successfully produced gluten-free dough sheets that could be slit into thin and long noodle strands. In addition, the composites were effective in improving the rheological characteristics of gluten-free noodle strands by increasing their maximum force to extension, compared to wheat-based noodles. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Eating, Diet, and Nutrition for Celiac Disease

    ... Section Navigation Celiac Disease Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Eating, Diet, & Nutrition for Celiac Disease What should I avoid eating if I have ...

  4. Effect of ingredients on the quality characteristics of gluten free snacks.

    Gupta, Monika; Bhattacharya, Sila

    2017-11-01

    Grain-based fabricated snacks from non-wheat grains (amaranth, finger millet, sorghum and black gram) were used to prepare puffed snacks employing the method of hot air toasting. The functional characteristics and sensory attributes of the snack were determined by varying the moisture content and time of toasting. The quality attributes of the snacks like the instrumental color parameters, peak force and puff thickness of the snack correlated well with the sensory attributes (appearance/color, texture and overall acceptability). A snack made from amaranth showed a bright reddish brown colour at a moisture content of 20-40%; the product had a good puffing and high overall acceptability. The moisture content of all the snacks was around 3% and had a fat content of 1-2%; protein and dietary fiber contents were in the ranges of 22-23 and 10-11%, respectively. The principal component analysis (PCA) accounted for a total of 89.6% variation. The PCA biplot showed that sensory appearance, sensory texture and sensory overall acceptability were closely related to the puff thickness. The microstructure of the snack indicated the presence of air cells to offer a porous structure. On toasting, the flakes increased their thickness creating a porous microstructure such that the toasted snacks were crispy having a brittle texture. Popped sorghum and gelatinized starch added doughs exhibited good puffing when toasted at 20-30% moisture content while popped amaranth samples required higher moisture content (30-40%). The grain based gluten-free snacks with improved sensory and nutritional characteristics can be prepared by using different ingredients.

  5. Celiac Disease: Four Inches and Seven Pounds...

    ... Disease" Articles Celiac Disease Changes Everything / What is Celiac Disease? / Symptoms, Diagnosis & Treatment / Four Inches and Seven Pounds… / Learning to Live Well with Celiac Disease / Living Gluten-Free Spring 2015 Issue: Volume 10 ...

  6. Coeliac disease - clinical presentation and diagnosis by anti tissue transglutaminase antibodies titre in children

    Hussain, S.; Sabir, M.U.D.; Afzal, M.; Asghar, I.

    2014-01-01

    Objective: To study the spectrum of clinical presentation of coeliac disease and the role of IgA anti-tissue transglutaminase antibodies titer in the diagnosis and effect of gluten-free diet on such titers in children. Methods: The prospective study was conducted in the paediatric department of Combined Military Hospital, Kharian from Sep 2011 to Sep 2012. Children of 1-12 years of age presenting with chronic diarrhoea, malnutrition and failure to thrive were included regardless of gender, socioeconomic status, ethnicity and geographical distribution. Anti-tissue transglutaminase antibodies titers were done on enrolment. Patients with levels more than 30u/ml were enrolled. They were advised strict gluten-free diet for six months. These titers were repeated after six months to document the effect of gluten-free diet on these titers. Paediatric endoscopy and duodenal biopsy facilities were not available at the study site, so the response was monitored through titers. Data was analysed using SPSS-20. Results: Out of 61 patients with IgA levels more than 10 u/ml, 52 (85.24%) were found to have a positive (>30u/ml) anti-tissue transglutaminase antibodies titers with a mean value of 42.67+-7.60 U/ml. These 52 patients were then put on a trial of gluten-free diet for six months after which significant reduction in titer was noticed, with a mean value of 13.25+-2.59 U/ml. This reduction in titer was associated with marked clinical improvement and regression of symptoms. Frequency of different clinical features in descending order revealed that chronic diarrhoea, abdominal distension, iron deficiency anaemia, failure to thrive, pallor and rickets were present in 38 (73.1%), 30 (57.7%), 29 (55.8%), 29 (53.8%), 28 (53.8%) patients respectively. Conclusion: Chronic diarrhoea, failure to thrive, pallor, abdominal distention and iron deficiency anaemia were common modes of presentation. The antibodies were strongly positive in most of the cases. All children showed significant

  7. Diet and Nutrition (Parkinson's Disease)

    ... Living With Parkinson's › Managing Parkinson's › Diet & Nutrition Diet & Nutrition 1. Maintain Health 2. Ease PD Symptoms 3. ... your team Seek reliable information about diet and nutrition from your medical team and local resources. Please ...

  8. Current and emerging therapy for celiac disease

    Govind K Makharia

    2014-03-01

    Full Text Available AbstractAt present, strict and lifelong gluten free diet is the only effective treatment for celiac disease. Even small amounts of gluten (50mg/day can be immunogenic; therefore all food and food items and drugs that contain gluten and its derivatives must be eliminated completely from the diet. While prescribing gluten free diet is easy; the key to the success is the dietary counseling by a nutrition specialist and maintenance of compliance by the patient. In recent times, a number of targets to halt the process of immunological injury have been explored to find out alternative treatment for celiac disease. These targets include exploration of ancient wheat if they are less immunogenic, intra-luminal digestion of gluten using prolylendopeptidases, pretreatment of whole gluten with bacterial-derived peptidase before ingestion; prevention of passage of immunogenic peptides through the tight junctions such as zonulin antagonists, Blocking of HLA-DQ2 to prevent binding of immunogenic peptides, inhibition of transglutaminase-2, immune-modulation and induction of tolerance to gluten using gluten tolerizing vaccines, use of gluten-sequestering polymers, use of anti-inflammatory drugs (glucocorticoides, budesonides and anti-cytokines such as anti TNF-α, and anti-interleukin-15. While many of these targets are still in the pre-clinical phase, some of them including zonulin antagonist and endopeptidases have already reached phase II and phase III clinical trials. Furthermore, while these targets appears very exciting; they at best are likely to be used as adjunctive therapy rather than a complete replacement for gluten free diet.

  9. Current and emerging therapy for celiac disease.

    Makharia, Govind K

    2014-01-01

    At present, strict and lifelong gluten-free diet is the only effective treatment for celiac disease. Even small amounts of gluten (50 mg/day) can be immunogenic; therefore all food and food items and drugs that contain gluten and its derivatives must be eliminated completely from the diet. While prescribing gluten-free diet is easy; the key to the success is the dietary counseling by a nutrition specialist and maintenance of adherence to GFD by the patient. In recent times, a number of targets to halt the process of immunological injury have been explored to find out alternative treatment for celiac disease. These targets include exploration of ancient wheat if they are less immunogenic, intra-luminal digestion of gluten using prolylendopeptidases, pretreatment of whole gluten with bacterial-derived peptidase before ingestion; prevention of passage of immunogenic peptides through the tight junctions such as zonulin antagonists, Blocking of HLA-DQ2 to prevent binding of immunogenic peptides, inhibition of transglutaminase 2, immune-modulation, and induction of tolerance to gluten using gluten tolerizing vaccines, use of gluten-sequestering polymers, use of anti-inflammatory drugs (glucocorticoids, budesonides) and anti-cytokines such as anti TNF-α, and anti-interleukin-15. While many of these targets are still in the pre-clinical phase, some of them including zonulin antagonist and endopeptidases have already reached phase II and phase III clinical trials. Furthermore, while these targets appear very exciting; they at best are likely to be used as adjunctive therapy rather than a complete replacement for gluten-free diet.

  10. Effect of germination temperatures on proteolysis of the gluten-free grains sorghum and millet during malting and mashing.

    Chiba, Y; Bryce, J H; Goodfellow, V; MacKinlay, J; Agu, R C; Brosnan, J M; Bringhurst, T A; Harrison, B

    2012-04-11

    Our study showed that sorghum and millet followed a similar pattern of changes when they were malted under similar conditions. When the malt from these cereals was mashed, both cereal types produced wide spectra of substrates (sugars and amino acids) that are required for yeast fermentation when malted at either lower or higher temperatures. At the germination temperatures of 20, 25, and 30 °C used in malting both cereal types, production of reducing sugars and that of free amino nitrogen (FAN) were similar. This is an important quality attribute for both cereals because it implies that variation in temperature during the malting of sorghum and millet, especially when malting temperature is difficult to control, and also reflecting temperature variations, experienced in different countries, will not have an adverse effect on the production and release of amino acids and sugars required by yeast during fermentation. Such consistency in the availability of yeast food (substrates) for metabolism during fermentation when sorghum and millet are malted at various temperatures is likely to reduce processing issues when their malts are used for brewing. Although sorghum has gained wide application in the brewing industry, and has been used extensively in brewing gluten-free beer on industrial scale, this is not the case with millet. The work described here provides novel information regarding the potential of millet for brewing. When both cereals were malted, the results obtained for millet in this study followed patterns similar to those of sorghum. This suggests that millet, in terms of sugars and amino acids, can play a role similar to that of sorghum in the brewing industry. This further suggests that millet, like sorghum, would be a good raw material for brewing gluten-free beer. Inclusion of millet as a brewing raw material will increase the availability of suitable materials (raw material sustainability) for use in the production of gluten-free beer, beverages, and

  11. Erythema Nodosum in a Child with Celiac Disease

    Andrew Fretzayas

    2011-01-01

    Full Text Available Erythema nodosum is an acute, nodular, erythematous eruption usually limited to the extensor aspects of the lower legs. It could be idiopathic or associated with other systemic diseases. We, herein, report a phenotypically healthy, ten-year-old boy who presented with erythema nodosum in whom serological tests of autoimmunity and intestinal histological examination were compatible with celiac disease. The eruption resolved within 2 months following a gluten-free diet. Therefore, the possibility that erythema nodosum represents an extraintestinal manifestation of celiac disease should be kept in mind accordingly in cases where other common causes of this rash are ruled out.

  12. Interest in medical therapy for celiac disease

    Tennyson, Christina A.; Simpson, Suzanne; Lebwohl, Benjamin; Lewis, Suzanne

    2013-01-01

    Objectives: A gluten-free diet is the treatment for celiac disease, but pharmaceutical agents are being developed. The level of interest amongst patients in using a medication to treat celiac disease is unknown. This study examined the level of interest amongst patients in medication to treat celiac disease. Methods: A questionnaire was distributed to celiac disease patients and data were collected on demographics, presentation, and interest in medication. Three validated celiac disease-specific instruments were incorporated: Celiac Disease Associated Quality of Life, the Celiac Symptom Index, and the Celiac Dietary Adherence Test. Results: Responses were received from 365 individuals with biopsy-proven celiac disease. Respondents were 78% (n = 276) female, 48% (n = 170) over 50 years of age, and experienced a classical (diarrhea predominant) presentation in 44% (n = 154). Of the 339 individuals answering the question regarding use of a medication to treat celiac disease, 66% were interested. Interest was greatest in older individuals (71% >50 years of age versus 60% symptoms with gluten exposure did not demonstrate any effect. Interest in medication was associated with a worse quality of life (CD-QOL 69.4 versus 80.1, p celiac disease are interested in using a medication. Interest was highest among men, older individuals, frequent restaurant customers, individuals dissatisfied with their weight or concerned with the cost of a gluten-free diet, and those with a worse quality of life. PMID:24003336

  13. Designing a Score-Based Method for the Evaluation of the Nutritional Quality of the Gluten-Free Bakery Products and their Gluten-Containing Counterparts.

    Morreale, Federico; Angelino, Donato; Pellegrini, Nicoletta

    2018-04-25

    Gluten-free (GF) products are consumed both by individuals with celiac disease and by an increasing number of people with no specific medical needs. Although the technological quality of GF products has been recently improved, their nutritional quality is still scarcely addressed. Moreover, the few published studies report conflicting results, mostly because the information from product nutrition facts is the only considered factor. The aim of the present study was to develop a score-based method for the nutritional evaluation of 134 packaged Italian GF bakery products and to compare it with that of 162 matched gluten-containing (GC) food items. The score included the information from the nutrition facts and the presence/absence of some nutritionally relevant components in the ingredients list. Results indicated an overall low nutritional quality of the considered GF bakery products. Additionally, with the sole exception of GF bread substitutes, there was no difference in nutritional quality between GF and equivalent GC bakery products. Future research and development of GF bakery products may take advantage of this scoring method, as it may represent an easy approach to evaluate their nutritional quality. The present findings do not justify the consumption of packaged GF bakery products by people without any specific medical needs.

  14. Improvement of gluten-free bread properties by the incorporation of bovine plasma proteins and different saccharides into the matrix.

    Rodriguez Furlán, Laura T; Pérez Padilla, Antonio; Campderrós, Mercedes E

    2015-03-01

    The aim of this work was to improve the quality of gluten-free bread, incorporating plasma bovine proteins concentrated by ultrafiltration and freeze-dried with saccharides (inulin and sucrose). The influence of these compounds on textural properties and final bread quality was assessed. The textural studies revealed that with the addition of proteins and inulin, homogeneous and smaller air cells were achieved improving the textural properties while the bread hardness was comparable with breads with gluten. The volume of gluten-free breads increased with increasing proteins and inulin concentrations, reaching a maximum at a protein concentration of 3.5% (w/w). The addition of the enhancers improved moisture retention of the loaves after cooking and an increase of lightness of crumb with respect to the control was observed. The sensory analysis found no statistically significant difference in sensory attributes evaluated with respect to the control, so these ingredients do not negatively affect the organoleptic properties of bread. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Incorporation of buriti endocarp flour in gluten-free whole cookies as potential source of dietary fiber.

    Becker, Fernanda Salamoni; Damiani, Clarissa; de Melo, Adriane Alexandre Machado; Borges, Paulo Rogério Siriano; Boas, Eduardo Valério de Barros Vilas

    2014-12-01

    Cookies were prepared by replacing a mixture of brown rice flour (70%) and corn starch (30%) (BRFCS) by buriti endocarp flour (BEF) (0, 5, 10, 15 or 20%). BEF figured as a potential source of dietary fiber (70.53 g 100 g(-1)), especially of insoluble fiber (67.50 g 100 g(-1)), and gluten-free whole cookies showed increased dietary fiber content by adding 5, 10, 15 and 20% BEF (8.58 to 20.02 g 100 g(-1)) when compared to control cookie (6.91 g 100 g(-1)). The addition of BEF affected diameter, spread ratio, color and texture of cookies. All cookies added with BEF were darker, harder and presented smaller diameter and smaller spread ratio than the control cookie. These difference increased proportionally to level of substitution of BRFSC by BEF. Gluten-free whole cookies with up to 15% BEF were well accepted by consumers. Therefore, the use of BEF in cookies may increase the availability of functional ingredients source of dietary fiber for celiac consumers, add economic value to buriti processing by-products and decrease environmental impacts due to the high amounts of waste generated by buriti processing industries.

  16. The influence of baking time and temperature on characteristics of gluten free cookies enriched with blueberry pomace

    Šarić Bojana M.

    2014-01-01

    Full Text Available Blueberry pomace, by-product of juice production, was processed into a new food ingredient by drying and grinding and used for a new gluten-free cookies' formulation, with the aim of improving nutritional profile and antioxidant capacity. Since duration and temperature at which dough is thermally treated during baking highly influence the quality of a baked product, the objective of this work was to optimise the baking conditions in order to obtain the best technological quality of the cookies. Referring to the results obtained at 160 and 170 °C and different baking times, the following was found: the difference in baking conditions caused variation between cookies' diameters of less than 1%, more regular shape of the cookies was obtained when baking time was shorter, hardness of cookies is highly correlated with moisture content, water activity, baking loss and short/long diameter ratio values. The colour characteristics (L*, a* and b* of cookies' top and bottom surfaces indicated that the cookies were not overbaked under the chosen baking conditions. Baking time of 14 min at 170°C was found to be the optimal baking conditions for the blueberry pomace enriched gluten-free cookies.

  17. Analysis of volatile compounds in gluten-free bread crusts with an optimised and validated SPME-GC/QTOF methodology.

    Pico, Joana; Antolín, Beatriz; Román, Laura; Gómez, Manuel; Bernal, José

    2018-04-01

    The aroma of bread crust, as one of the first characteristics perceived, is essential for bread acceptance. However, gluten-free bread crusts exhibit weak aroma. A SPME-GC/QTOF methodology was optimised with PCA and RSM and validated for the quantification of 44 volatile compounds in bread crust, extracting 0.75 g of crust at 60 °C for 51 min. LODs ranged between 3.60 and 1760 μg Kg -1 , all the R 2 were higher than 0.99 and %RSD for precision and %Er for accuracy were lower than 9% and 12%, respectively. A commercial wheat bread crust was quantified, and furfural was the most abundant compound. Bread crusts of wheat starch and of japonica rice, basmati rice and teff flours were also quantified. Teff flour and wheat starch crusts were very suitable for improving gluten-free bread crust aroma, due to their similar content in 2-acetyl-1-pyrroline and 4-hydroxy-2,5-dimethyl-3(2H)-furanone compared to wheat flour crust and also for their high content in pyrazines. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Trace gluten contamination may play a role in mucosal and clinical recovery in a subgroup of diet-adherent non-responsive celiac disease patients

    2013-01-01

    Background Patients with persistent symptoms and/or villous atrophy despite strict adherence to a gluten-free diet (GFD) have non-responsive celiac disease (NRCD). A subset of these patients has refractory celiac disease (RCD), yet some NRCD patients may simply be reacting to gluten cross-contamination. Here we describe the effects of a 3-6 month diet of whole, unprocessed foods, termed the Gluten Contamination Elimination Diet (GCED), on NRCD. We aim to demonstrate that this diet reclassifies the majority of patients thought to have RCD type 1 (RCD1). Methods We reviewed the records of all GFD-adherent NRCD patients cared for in our celiac center from 2005-2011 who were documented to have started the GCED. Response to the GCED was defined as being asymptomatic after the diet, with normal villous architecture on repeat biopsy, if performed. Results Prior to the GCED, all patients were interviewed by an experienced dietitian and no sources of hidden gluten ingestion were identified. 17 patients completed the GCED; 15 were female (88%). Median age at start of the GCED was 42 years (range 6-73). Fourteen patients (82%) responded to the GCED. Six patients met criteria for RCD prior to the GCED; 5 (83%) were asymptomatic after the GCED and no longer meet RCD criteria. Of the 14 patients who responded to the GCED, 11 (79%) successfully returned to a traditional GFD without resurgence of symptoms. Conclusions The GCED may be an effective therapeutic option for GFD-adherent NRCD patients. Response to this diet identifies a subgroup of patients, previously classified as RCD1, that is not truly refractory to dietary treatment. Preventing an inaccurate diagnosis of RCD1 avoids immunotherapy. Most patients are able to return to a traditional GFD without return of symptoms. PMID:23448408

  19. Obesity in adolescents with celiac disease: two adolescents and two different presentations.

    Balamtekin, Necati; Demir, Hülya; Baysoy, Gökhan; Uslu, Nuray; Yüce, Aysel

    2011-01-01

    Celiac disease (CD) usually presents with diarrhea and growth retardation in childhood. Obesity is one of the paradoxical conditions in children with CD. We present two adolescents with CD and obesity. One of these patients was diagnosed as CD with malnutrition. His body weight had returned to normal after a gluten-free diet, and after stopping the diet, he had become obese. The second patient was an obese adolescent presenting with dyspeptic symptoms who was diagnosed as CD. Although rare, pediatricians should remember that obesity might be seen in CD before or after the diagnosis.

  20. Diagnostic challenges in celiac disease.

    Kowalski, Karol; Mulak, Agata; Jasińska, Maria; Paradowski, Leszek

    2017-07-01

    Diagnosis of celiac disease in adults is currently based on serologic tests in combination with histopathological assessment of small intestinal biopsy specimens. High titers of celiac-specific antibodies in immunocompetent patients with villous atrophy in a good quality biopsy sample allow us to state a confident diagnosis. The relief of symptoms and histological improvement after embarking on a gluten free diet further support the initial diagnosis. However, in some cases, these conditions are not fulfilled, which requires a critical evaluation of laboratory and histopathology results and a consideration of other potential causes for the observed pathologies. To avoid diagnostic uncertainty, both biopsy and laboratory testing should be performed on a diet containing gluten. Immune deficiency, cross reaction of antibodies and possibilities of seronegative or latent celiac disease should be considered while evaluating serology results. Uneven distribution and variable intensity of histopathological changes in the small intestine along with multiple disorders presenting a similar specimen image may lead to invalid biopsy results. Additional laboratory testing and careful examination of a patient's history may deliver important data for a differential diagnosis and a more specific biopsy evaluation. Persistence or recurrence of symptoms, despite the ongoing treatment, requires a revision of the initial diagnosis, an evaluation of the gluten free diet and a search for concurrent disorders or complications.

  1. Thiol/disulphide homeostasis in celiac disease

    Kaplan, Mustafa; Ates, Ihsan; Yuksel, Mahmut; Ozderin Ozin, Yasemin; Alisik, Murat; Erel, Ozcan; Kayacetin, Ertugrul

    2017-01-01

    AIM To determine dynamic thiol/disulphide homeostasis in celiac disease and to examine the associate with celiac autoantibodies and gluten-free diet. METHODS Seventy three patients with celiac disease and 73 healthy volunteers were enrolled in the study. In both groups, thiol/disulphide homeostasis was examined with a new colorimetric method recently developed by Erel and Neselioglu. RESULTS In patients with celiac disease, native thiol (P = 0.027) and total thiol (P = 0.031) levels were lower, while disulphide (P < 0.001) level, disulphide/native thiol (P < 0.001) and disulphide/total thiol (P < 0.001) ratios were higher compared to the control group. In patients who do not comply with a gluten-free diet, disulphide/native thiol ratio was found higher compared to the patients who comply with the diet (P < 0.001). In patients with any autoantibody-positive, disulphide/native thiol ratio was observed higher compared to the patients with autoantibody-negative (P < 0.05). It is found that there is a negative correlation between celiac autoantibodies, and native thiol, total thiol levels and native thiol/total thiol ratio, while a positive correlation is observed between disulphide, disulphide/native thiol and disulphide/total thiol levels. CONCLUSION This study is first in the literature which found that the patients with celiac disease the dynamic thiol/disulphide balance shifts through disulphide form compared to the control group. PMID:28533921

  2. Celiac disease and new diseases related to gluten

    Jiménez Ortega, Ana Isabel; Martínez García, Rosa María; Quiles Blanco, María José; Majid Abu Naji, Jamil Abdel; González Iglesias, María José

    2016-07-12

    Celiac disease is the most common chronic intestinal disease. Nowadays it´s known that this is a multisistemic pathology of immune mechanism, triggered by gluten, which occurs in genetically susceptible individuals. It affects approximately 1% of the world population, which is a very high prevalence, affects all age groups and has symptoms both digestive and extra-digestive. Since it is a disease that requires maintaining a gluten-free diet and medical monitoring for life, it is important to know it and establish its diagnosis properly. Along with celiac disease a number of new diseases related to gluten are diagnosed increasingly, including the non celiac gluten sensitivity or wheat allergy. The suffering of celiac disease, or other related diseases, by conditioning diet changes of the affected individual, it may be associated with nutritional imbalances that need to monitor and try to solve. Therefore patients with this problem need special nutritional advice.

  3. Review Article: Celiac Disease, New Approaches to Therapy

    Rashtak, Shahrooz; Murray, Joseph A

    2014-01-01

    STRUCTURED SUMMARY Background Celiac disease is managed by life-long gluten withdrawal from the diet. However strict adherence to a gluten-free diet is difficult and is not always effective. Novel therapeutic approaches are needed to supplement or even replace the dietary treatment. Aims To review recent advances in new therapeutic options for celiac disease. Methods A literature search was performed on MEDLINE, EMBASE, Web of Science, Scopus, DDW.org and ClinicalTrial.gov for English articles and abstracts. The search terms used include but not limited to “Celiac disease”, “new”, “novel”, Advances”, “alternatives” and “Drug therapy”. The cited articles were selected based on the relevancy to the review objective. Results Several new therapeutic approaches for celiac disease are currently under development by targeting its underlying pathogenesis. Alternative therapies range from reproduction of harmless wheat strains to immunomodulatory approaches. Some of these therapies such as enzymatic cleavage of gluten and permeability inhibitors have shown promise in clinical studies. Conclusion Gluten-free diet is still the only practical treatment for patients with celiac disease. Novel strategies provide promise of alternative adjunctive approaches to diet restriction alone for patients with this disorder. PMID:22324389

  4. Soya protein antibodies in man: their occurrence and possible relevance in coeliac disease.

    Haeney, M R; Goodwin, B J; Barratt, M E; Mike, N; Asquith, P

    1982-01-01

    Circulating antibodies to soya-derived protein antigens have been measured in patients with duodenitis, Crohn's disease, ulcerative colitis and coeliac disease. Significantly raised antibody titres were found frequently in the coeliac group, particularly those patients showing a suboptimal response to a gluten-free diet, but rarely in subjects with other gastrointestinal diseases. Antisoya activity was not necessarily accompanied by antibodies to other common dietary antigens. We suggest that some coeliacs may have an associated dietary soya sensitivity which could adversely influence their response to gluten withdrawal. PMID:7040491

  5. [Celiac crisis with quadriplegia due to potassium depletion as presenting feature of celiac disease].

    Atikou, A; Rabhi, M; Hidani, H; El Alaoui Faris, M; Toloune, F

    2009-06-01

    Adult coeliac disease revealed by coeliac crisis and quadriplegia due to potassium depletion is an extremely rare situation. A 26-year-old woman presented with a suddenly developed weakness of all four limbs and a severe diarrhea. Authors emphasize coeliac crisis, which is a presenting feature of coeliac disease, characterized by acute diarrhea with life-threatening acid base and electrolyte abnormalities. The patient improved with correction of hypokalemia and gluten-free diet. A severe acute diarrhea with metabolic and systemic complications, the so-called coeliac crisis, is a possible presenting clinical feature of a previously undiagnosed adult celiac disease.

  6. The management of psoriasis through diet

    Duarte G

    2012-08-01

    Full Text Available Gleison Duarte,1 Luan Oliveira Barbosa,2 Maria Elisa A Rosa11Dermatology Division, Alergodermoclin, Salvador, Bahia, Brazil; 2Escola Bahiana de Medicina e Saúde Pública Salvador, Bahia, BrazilAbstract: Diet is an important factor in the management of several dermatological diseases, such as dermatitis herpetiformis, acne vulgaris, gout, phrynoderma, pellagra, psoriasis, and acrodermatitis enteropathica. New concepts have emerged concerning the influence of diet on psoriasis. For example, diet has an adjuvant role in the management of several cardiovascular comorbidities that exhibit a higher-than-expected prevalence in psoriatic patients. Functional foods, such as yellow saffron and fish oil, may exert favorable effects on immune and cardiovascular functions. A gluten-free diet may promote significant clinical and histologic improvement. Folate supplementation may induce clinical improvement of psoriasis, but side effects may also occur. Diets rich in fresh fruits and vegetables are associated with a lower prevalence of psoriasis, and vegetarian diets were associated with clinical improvement. Additionally, many drug-diet interactions (retinoids, methotrexate, cyclosporine must be considered in patients with psoriasis. Therefore, in addition to current nutritional advice given to psoriasis patients, further studies are necessary in the role of diet in psoriasis therapy.Keywords: diet, lifestyle, psoriasis, recommendations, supplementation

  7. Neurological Disorders in Adult Celiac Disease

    Hugh J Freeman

    2008-01-01

    Full Text Available Celiac disease may initially present as a neurological disorder. Alternatively, celiac disease may be complicated by neurological changes. With impaired nutrient absorption, different deficiency syndromes may occur and these may be manifested clinically with neurological changes. However, in patients with deficiency syndromes, extensive involvement of the small intestine with celiac disease is often evident. There are a number of reports of celiac disease associated with neuropathy, ataxia, dementia and seizure disorder. In these reports, there is no clear relationship with nutrient deficiency and a precise mechanism for the neurological changes has not been defined. A small number of patients have been reported to have responded to vitamin E administration, but most do not. In some, gluten antibodies have also been described, especially in those with ataxia, but a consistent response to a gluten-free diet has not been defined. Screening for celiac disease should be considered in patients with unexplained neurological disorders, including ataxia and dementia. Further studies are needed, however, to determine if a gluten-free diet will lead to improvement in the associated neurological disorder.

  8. Physical, chemical and sensory properties of gluten-free kibbeh formulated with millet flour (Pennisetum glaucum (L. R. Br.

    Tcherena Amorim Brasil

    2015-06-01

    Full Text Available Pearl millet flour was utilized in kibbeh formulations instead of whole-wheat flour. Physicochemical properties, oxidation stability and sensorial characteristics of control kibbeh made with whole-wheat flour (CT were compared with kibbehs prepared with millet flour (roasted or wet and stored for 90 days (–18 °C. Kibbeh prepared with millet flour presented good oxidation stability (TBARS concentration. Baked kibbehs (with roasted millet flour presented good acceptability and kibbeh samples did not differ significantly (p > 0.05 from the whole-wheat flour sample, when global appearance, texture and flavor were evaluated. Millet flour could be a suitable ingredient for kibbeh formulations, maintaining their nutritional value and sensorial quality in addition to being a gluten-free product.

  9. Mediterranean Diet in Prevention of Chronic Diseases

    Pelin Meryem

    2017-07-01

    Full Text Available Bad eating habits lead to the emergence of chronic health problems such as coronary artery diseases, hypertension, dyslipidaemia, cancer and obesity and the relationship between diet and diseases is emphasized and the relationship between them is clearly revealed in studies conducted over many years. The Mediterranean diet, which is first described by Angel Keys at the beginning of the 1960’s, is not a specific diet but a natural way of eating in olive-growing region. With the properties such as the use of vegetable oils such as olive oil in particular, and the consumption of fish instead of red meat, the diet constitutes a health-protective nutrition. So, this review conducted the relationship between Mediterranean diet and chronic diseases.

  10. Ketogenic Diet in Neuromuscular and Neurodegenerative Diseases

    Damiani, Ernesto; Bosco, Gerardo

    2014-01-01

    An increasing number of data demonstrate the utility of ketogenic diets in a variety of metabolic diseases as obesity, metabolic syndrome, and diabetes. In regard to neurological disorders, ketogenic diet is recognized as an effective treatment for pharmacoresistant epilepsy but emerging data suggests that ketogenic diet could be also useful in amyotrophic lateral sclerosis, Alzheimer, Parkinson's disease, and some mitochondriopathies. Although these diseases have different pathogenesis and features, there are some common mechanisms that could explain the effects of ketogenic diets. These mechanisms are to provide an efficient source of energy for the treatment of certain types of neurodegenerative diseases characterized by focal brain hypometabolism; to decrease the oxidative damage associated with various kinds of metabolic stress; to increase the mitochondrial biogenesis pathways; and to take advantage of the capacity of ketones to bypass the defect in complex I activity implicated in some neurological diseases. These mechanisms will be discussed in this review. PMID:25101284

  11. [Psychological alterations in patients with adult celiac disease].

    Martínez Cerezo, Francisco J; Castillejo, Gemma; Guillen, Núria; Morente, Vanessa; Simó, Josep M; Tena, Francisco J; Marsal, Joan; Pascual, Domingo

    2014-04-01

    Patients with recently-diagnosed adult celiac disease were evaluated with the Gastrointestinal Symptom rating Scale (GSRS) and Psychological General Well-Being Index (PGWBI) to evaluate their psychological alterations, the association between any alterations and gastrointestinal symptoms, and their outcome after starting a gluten-free diet. The patients underwent nutritional assessment and then started a gluten-free diet; they were reassessed 6 months later. Quantitative variables are expressed as the median and 25th-75th percentiles. We included 21 patients, 17 women and 4 mena, with a mean age of 43 years (31-47). The results of histological analysis were compatible with Marsh I lesions in 6 patients, Marsh IIIa in 6 and Marsh IIIb in 9. At baseline, 8 patients showed severe psychological distress, 4 showed moderate distress and 9 showed no distress. The GSRS score was 34 (17-43) and the PGWBI was 64 (48-87), with a significant correlation between the 2 indexes (rho=-.58, P=.006). At 6 months, 3 patients had severe psychological distress, 5 had moderate distress, 9 showed no distress and 4 showed psychological well-being. The GSRS score at 6 months was 13 (8-17) and the PGWBI was 83 (68-95) (P<.05 compared with baseline data for the 3 indicators). The 6 axes of the PGWBI showed significant improvement. At 6 months, no correlation was found between the GSRS and PGWBI. Patients with celiac disease have psychological alterations whose intensity is related to gastrointestinal symptoms. These symptoms improve after the start of a gluten-free diet. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  12. Tooth Wear Is Frequent in Adult Patients with Celiac Disease

    Massimo Amato

    2017-12-01

    Full Text Available (1 Background: Celiac disease (CD patients can be affected by mouth and tooth disorders, which are influenced by their gluten-free diet. The aim of our research was to evaluate the pathological conditions of the stomatognathic system observed in celiac patients on a gluten-free diet. (2 Methods: we consecutively recruited celiac patients on a gluten-free diet at our celiac center, as well as healthy volunteers. Two dentists examined all patients/controls and checked them for any mouth disorder. (3 Results: Forty-nine patients affected by celiac disease (age at test 31.8 ± 11.58, time on GFD 8.73 ± 7.7 and 51 healthy volunteers (age at test 30.5 ± 8.7 were included. Recurrent aphthous stomatitis was reported in 26 patients (53.0% and in 13 (25.5% controls (p = 0.005. Dental enamel disorders were reported in 7 patients (14.3% and in 0 controls (p = 0.002, with none having geographic tongue. We found non-specific tooth wear, characterized by loss of the mineralized tissue of the teeth, in 9 patients (18.3% and in 3 (5.9% controls (p = 0.05. (4 Conclusion: Recurrent aphthous stomatitis and enamel hypoplasia are “risk indicators” that may suggest that an individual has CD. We detected a high prevalence of non-specific tooth wear that can be caused by several factors such as malocclusion, sleep bruxism, parafunctional activity, and age.

  13. Breath Tests Application in Order to Improve the Outcomes of Treatment for Celiac Disease

    Ye.Yu. Gubskaya

    2014-02-01

    Full Text Available The article presents data from an own study on modern opportunities to improve the effectiveness of treatment of patients with celiac disease (n = 41. All patients were on a gluten-free diet, nonetheless effectiveness of treatment was regarded as unsatisfactory. Due to the use of modern carbon and hydrogen breath tests and diagnosis of bacterial overgrowth syndrome, lactase deficiency and exocrine pancreatic insufficiency, which were the causes for the persistence of clinical symptoms, we obtained reasons for their correction and achieved a complete remission of the underlying disease.

  14. Quadriplegia due to celiac crisis with hypokalemia as initial presentation of celiac disease: a case report.

    Bhattacharya, Malobika; Kapoor, Seema

    2012-02-01

    Celiac crisis is a rare, life-threatening complication of celiac disease characterized by worsening of clinical symptoms, multiple metabolic derangements and shock. We report an 8-year-old girl with previously undiagnosed celiac disease who presented with flaccid quadriparesis secondary to severe hypokalemia associated with celiac crisis. Diagnosis was expedited by an elevated anti-tissue transglutaminase antibody titer. The patient improved with correction of hypokalemia, corticosteroids and gluten-free diet. In tropical countries such as India, where both acute flaccid paresis and diarrhea are usually of infective etiologies, this rare clinical condition should also be considered in the differential diagnosis of both.

  15. Coeliac disease and gastrointestinal symptom screening in adult first-degree relatives.

    Vaquero, Luis; Rodríguez-Martín, Laura; Alvarez-Cuenllas, Begoña; Hernando, Mercedes; Iglesias-Blazquez, Cristina; Menéndez-Arias, Cristina; Vivas, Santiago

    2017-12-01

    The first-degree relatives (FDRs) of patients with coeliac disease are the main risk group for disease development. The study aims to evaluate the screening strategy in FDRs with negative coeliac serology based on human leukocyte antigen (HLA) genotyping, followed by duodenal biopsy, and to analyze the prevalence of gastrointestinal symptoms and the influence of gluten intake. Adult FDRs with negative coeliac serology were invited to participate (n = 205), and a total of 139 completed the study protocol. HLA genotyping, transglutaminase antibody assessment, and duodenal biopsy were performed. Symptomatology was assessed using questionnaires during the various phases of dietary modification (baseline diet, gluten-free diet, and gluten overload). The study included 139 participants (mean age, 42 years; 53.2% women). HLA-DQ2/8 was positive in 78.4% of the participants (homozygous, 15.1%; heterozygous, 63.3%). Histopathological alterations were noted in 37.1% of participants who underwent duodenal biopsy (Marsh I, 32.7%; Marsh IIIa, 4.4%). At baseline, symptoms were observed in 45.7% of the participants, and the proportion decreased to 24.5% after the gluten-free diet (P < 0.001). Symptoms were not associated with the presence of histological alterations or genetic risk. However, younger age (odds ratio [OR] = 0.91), female sex (OR = 2.9), and the presence of autoimmune disorders (OR = 2.8) were independently associated with a significant symptom response to the gluten-free diet. Duodenal lymphocytosis and atrophy are frequently noted in FDRs, despite negative serological markers. In addition, gastrointestinal symptoms are commonly present and associated with gluten intake regardless of the histological pathology. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  16. Celiac disease

    Hvas, Christian Lodberg; Jensen, Michael Dam; Reimer, Maria Christina

    2015-01-01

    This national clinical guideline approved by the Danish Society for Gastroenterology and Hepatology describes the diagnosis and treatment of celiac disease (CD) in adults. CD is a chronic immunemediated enteropathy of the small intestine triggered by the ingestion of gluten-containing proteins......, which are found in wheat, rye, and barley. The disease prevalence is 0.5-1.0%, but CD remains under-diagnosed. The diagnosis relies on the demonstration of lymphocyte infiltration, crypt hyperplasia, and villous atrophy in duodenal biopsies. Serology, malabsorption, biochemical markers......, and identification of specific HLA haplotypes may contribute to CD diagnosis. Classical CD presents with diarrhoea and weight loss, but non-classical CD with vague or extraintestinal symptoms is common. The treatment for CD is a lifelong gluten-free diet (GFD), which, in the majority of patients, normalises...

  17. Neuropsychiatric symptoms and celiac disease.

    Urban-Kowalczyk, Małgorzata; OEmigielski, Janusz; Gmitrowicz, Agnieszka

    2014-01-01

    Neuropsychiatric symptoms may represent an atypical manifestation of celiac disease that occur before a gastroenterological diagnosis is made. Some studies suggest that a gluten-free diet is effective in treating the depression, anxiety, and neurological complications associated with celiac disease. The article describes the case of a patient suffering from chronic, treatment-resistant symptoms of depression and anxiety. The diagnosis of celiac disease and introduction of an elimination diet caused a significant improvement in mental state and everyday functioning in the presenting patient. The presence of persistent anxiety and depressive symptoms, with a poor reaction to pharmacological treatment, indicates a need to identify somatic reasons for the underlying condition. It is important to remember that celiac disease can occur at any age, not only in childhood. The presence of this somatic cause of persistent depressive and anxiety symptoms should be considered in the diagnostic process in adults.

  18. Emerging drugs for coeliac disease.

    Mooney, Peter D; Hadjivassiliou, Marios; Sanders, David S

    2014-12-01

    Coeliac disease is an autoimmune gluten sensitive enteropathy and is now known to affect 1% of the adult population. A gluten-free diet (GFD) should be curative; however, up to 30% of patients have persistent symptoms and many patients find the diet difficult to fully adhere to. Currently, there are no licensed therapeutic options for patients with coeliac disease outside of a GFD. This review will outline the case for alternative treatments and discuss the potential therapeutic targets. The products in the most advanced stage of development will be discussed in detail. There is clearly an unmet need for alternatives to a GFD for the treatment of coeliac disease. Oral glutenase supplements to improve the degradation of gluten into non-toxic peptides appear to be the most likely to provide a breakthrough in the treatment of coeliac disease; however, other modalities such as a therapeutic vaccine or zonulin inhibitors to reduce intestinal permeability have shown promising results.

  19. Neurological symptoms in patients with biopsy proven celiac disease.

    Bürk, Katrin; Farecki, Marie-Louise; Lamprecht, Georg; Roth, Guenter; Decker, Patrice; Weller, Michael; Rammensee, Hans-Georg; Oertel, Wolfang

    2009-12-15

    In celiac disease (CD), the gut is the typical manifestation site but atypical neurological presentations are thought to occur in 6 to 10% with cerebellar ataxia being the most frequent symptom. Most studies in this field are focused on patients under primary neurological care. To exclude such an observation bias, patients with biopsy proven celiac disease were screened for neurological disease. A total of 72 patients with biopsy proven celiac disease (CD) (mean age 51 +/- 15 years, mean disease duration 8 +/- 11 years) were recruited through advertisements. All participants adhered to a gluten-free diet. Patients were interviewed following a standard questionnaire and examined clinically for neurological symptoms. Medical history revealed neurological disorders such as migraine (28%), carpal tunnel syndrome (20%), vestibular dysfunction (8%), seizures (6%), and myelitis (3%). Interestingly, 35% of patients with CD reported of a history of psychiatric disease including depression, personality changes, or even psychosis. Physical examination yielded stance and gait problems in about one third of patients that could be attributed to afferent ataxia in 26%, vestibular dysfunction in 6%, and cerebellar ataxia in 6%. Other motor features such as basal ganglia symptoms, pyramidal tract signs, tics, and myoclonus were infrequent. 35% of patients with CD showed deep sensory loss and reduced ankle reflexes in 14%. Gait disturbances in CD do not only result from cerebellar ataxia but also from proprioceptive or vestibular impairment. Neurological problems may even develop despite strict adherence to a gluten-free diet. (c) 2009 Movement Disorder Society.

  20. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial.

    Biesiekierski, Jessica R; Newnham, Evan D; Irving, Peter M; Barrett, Jacqueline S; Haines, Melissa; Doecke, James D; Shepherd, Susan J; Muir, Jane G; Gibson, Peter R

    2011-03-01

    Despite increased prescription of a gluten-free diet for gastrointestinal symptoms in individuals who do not have celiac disease, there is minimal evidence that suggests that gluten is a trigger. The aims of this study were to determine whether gluten ingestion can induce symptoms in non-celiac individuals and to examine the mechanism. A double-blind, randomized, placebo-controlled rechallenge trial was undertaken in patients with irritable bowel syndrome in whom celiac disease was excluded and who were symptomatically controlled on a gluten-free diet. Participants received either gluten or placebo in the form of two bread slices plus one muffin per day with a gluten-free diet for up to 6 weeks. Symptoms were evaluated using a visual analog scale and markers of intestinal inflammation, injury, and immune activation were monitored. A total of 34 patients (aged 29-59 years, 4 men) completed the study as per protocol. Overall, 56% had human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8. Adherence to diet and supplements was very high. Of 19 patients (68%) in the gluten group, 13 reported that symptoms were not adequately controlled compared with 6 of 15 (40%) on placebo (P=0.0001; generalized estimating equation). On a visual analog scale, patients were significantly worse with gluten within 1 week for overall symptoms (P=0.047), pain (P=0.016), bloating (P=0.031), satisfaction with stool consistency (P=0.024), and tiredness (P=0.001). Anti-gliadin antibodies were not induced. There were no significant changes in fecal lactoferrin, levels of celiac antibodies, highly sensitive C-reactive protein, or intestinal permeability. There were no differences in any end point in individuals with or without DQ2/DQ8. "Non-celiac gluten intolerance" may exist, but no clues to the mechanism were elucidated.

  1. Celiac disease: clinical observations

    Yu. A. Emel’yanova

    2016-01-01

    Full Text Available Presented clinical cases of patients with a diagnosis of gluten enteropathy in treatment in the department of gastroenterology Regional Clinical Hospital. The case is of interest to doctors of different specialties for the differential diagnosis of anemia and malabsorption syndrome, demonstrate both the classic version, and atypical forms of the disease course. Diagnosis of celiac disease is based on three key positions: clinical findings, histology and serological markers. The clinical picture of celiac disease is characterized by pronounced polymorphism, by going beyond the a gastroenterological pathology. For screening of gluten sensitive celiac typically used an antibody to tissue transglutaminase. Morphological research of the mucous membrane of the small intestine is the determining criterion in the diagnosis of celiac disease. The use of specific gluten-free diet leads to the positive dynamics of the disease and improve the quality of life of patients.

  2. Diet and risk of inflammatory bowel disease

    Andersen, Vibeke; Olsen, Anja; Carbonnel, Franck

    2012-01-01

    Background: A better understanding of the environmental factors leading to inflammatory bowel disease should help to prevent occurrence of the disease and its relapses. Aim: To review current knowledge on dietary risk factors for inflammatory bowel disease. Methods: The PubMed, Medline and Cochrane...... Library were searched for studies on diet and risk of inflammatory bowel disease. Results: Established non-diet risk factors include family predisposition, smoking, appendectomy, and antibiotics. Retrospective case–control studies are encumbered with methodological problems. Prospective studies...... on European cohorts, mainly including middle-aged adults, suggest that a diet high in protein from meat and fish is associated with a higher risk of inflammatory bowel disease. Intake of the n-6 polyunsaturated fatty acid linoleic acid may confer risk of ulcerative colitis, whereas n-3 polyunsaturated fatty...

  3. Celiac Family Health Education Video Series

    Full Text Available ... What is Celiac Disease Diet Information At Home Shopping Cooking Gluten Free Baking School Eating Out Away ... to keep your kitchen organized and safe. V. Shopping : How to shop for gluten-free food. VI. ...

  4. Co-morbidity of cystic fibrosis and celiac disease in Scandinavian cystic fibrosis patients

    Fluge, G; Olesen, H V; Gilljam, M

    2009-01-01

    BACKGROUND: The co-morbidity of cystic fibrosis (CF) and celiac disease (CD) has been reported sporadically since the 1960s. To our knowledge, this is the first time a systematic screening is performed in a large cohort of CF patients. METHODS: Transglutaminase-IgA (TGA), endomysium-IgA (EMA...... patients were detected in the Danish CF cohort. Patients diagnosed with untreated CD reported symptoms typical of both CF and CD (poor weight gain, loose and/or fatty stools, fatigue, irritability, abdominal pain). They improved after introduction of a gluten-free diet. CONCLUSIONS: Systematic screening...

  5. Celiac Disease Diagnosis and Management

    Leffler, Daniel

    2012-01-01

    Celiac disease is one of the most prevalent autoimmune gastrointestinal disorders but as the case of Ms. J illustrates, diagnosis is often delayed or missed. Based on serology studies, the prevalence of celiac disease in many populations is estimated to be approximately 1% and has been increasing steadily over the last 50 years. Evaluation for celiac disease is generally straightforward, and uses commonly available serologic tests, however the signs and symptoms of celiac disease are nonspecific and highly heterogeneous making diagnosis difficult. While celiac disease is often considered a mild disorder treatable with simple dietary changes, in reality celiac disease imparts considerable risks including reduced bone mineral density, impaired quality of life, and increased overall mortality. In addition, the gluten free diet is highly burdensome and can profoundly affect patients and their families. For these reasons, care of individuals with celiac disease requires prompt diagnosis and ongoing multidisciplinary management. PMID:21990301

  6. New coeliac disease treatments and their complications.

    Vaquero, Luis; Rodríguez-Martín, Laura; León, Francisco; Jorquera, Francisco; Vivas, Santiago

    2018-03-01

    The only accepted treatment for coeliac disease is strict adherence to a gluten-free diet. This type of diet may give rise to reduced patient quality of life with economic and social repercussions. For this reason, dietary transgressions are common and may elicit intestinal damage. Several treatments aimed at different pathogenic targets of coeliac disease have been developed in recent years: modification of gluten to produce non-immunogenic gluten, endoluminal therapies to degrade gluten in the intestinal lumen, increased gluten tolerance, modulation of intestinal permeability and regulation of the adaptive immune response. This review evaluates these coeliac disease treatment lines that are being researched and the treatments that aim to control disease complications like refractory coeliac disease. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

  7. Celiac disease

    Dina I Shehab

    2013-01-01

    Conclusion Mortality rates among patients with untreated CD increase two-fold every year as they age (gastrointestinal malignancies and most can be prevented/reversed with early diagnosis and initiation of a gluten-free diet. CD is a global health problem that requires a multidisciplinary and increasingly cooperative multinational research effort.

  8. Diet, Lifestyle and Chronic disease burden

    Struijk, E.A.

    2014-01-01

    Background Diet, Body Mass Index (BMI), physical activity and smoking are among the most important lifestyle factors that influence global disease burden. In this thesis we investigate the relations of these factors with total disease burden in a large Dutch population, the EPIC-NL cohort. In this

  9. Variable activation of immune response by quinoa (Chenopodium quinoa Willd.) prolamins in celiac disease.

    Zevallos, Victor F; Ellis, H Julia; Suligoj, Tanja; Herencia, L Irene; Ciclitira, Paul J

    2012-08-01

    Celiac disease is an enteropathy triggered by dietary gluten found in wheat, barley, and rye. The current treatment is a strict gluten-free diet. Quinoa is a highly nutritive plant from the Andes, with low concentrations of prolamins, that has been recommended as part of a gluten-free diet; however, few experimental data support this recommendation. We aimed to determine the amount of celiac-toxic prolamin epitopes in quinoa cultivars from different regions of the Andes and the ability of these epitopes to activate immune responses in patients with celiac disease. The concentration of celiac-toxic epitopes was measured by using murine monoclonal antibodies against gliadin and high-molecular-weight glutenin subunits. Immune response was assessed by proliferation assays of celiac small intestinal T cells/interferon-γ (IFN-γ) and production of IFN-γ/IL-15 after organ culture of celiac duodenal biopsy samples. Fifteen quinoa cultivars were tested: 4 cultivars had quantifiable concentrations of celiac-toxic epitopes, but they were below the maximum permitted for a gluten-free food. Cultivars Ayacuchana and Pasankalla stimulated T cell lines at levels similar to those for gliadin and caused secretion of cytokines from cultured biopsy samples at levels comparable with those for gliadin. Most quinoa cultivars do not possess quantifiable amounts of celiac-toxic epitopes. However, 2 cultivars had celiac-toxic epitopes that could activate the adaptive and innate immune responses in some patients with celiac disease. These findings require further investigation in the form of in vivo studies, because quinoa is an important source of nutrients for patients with celiac disease.

  10. Fundamental studies of sourdoughs fermented with Weissella cibaria and Lactobacillus plantarum: influence on baking characteristics, sensory profiles and in vitro starch digestibility of gluten-free breads

    Wolter, Anika

    2013-01-01

    The application of sourdough can improve texture, structure, nutritional value, staling rate and shelf life of wheat and gluten-free breads. These quality improvements are associated with the formation of organic acids, exopolysaccharides (EPS), aroma or antifungal compounds. Initially, the suitability of two lactic acid bacteria strains to serve as sourdough starters for buckwheat, oat, quinoa, sorghum and flours was investigated. Wheat flour was chosen as a reference. The obligate heterofer...

  11. Passage of dietary antigens into the blood of children with coeliac disease. Quantification and size distribution of absorbed antigens

    Husby, S; Foged, N; Høst, A

    1987-01-01

    The uptake of ovalbumin (OA) from egg and beta-lactoglobulin (BLG) from cow's milk into the blood was investigated for seven hours after a test meal in five children with coeliac disease on a gluten free diet and after gluten challenge, and in five children with normal jejunal mucosa. Ovalbumin...... fractionation in combination with ELISA, either in high MW fractions, or at the Mr of native OA and BLG, respectively. In one control degradation products (about 17 kD) of BLG were detectable in serum. The serum concentrations of OA and BLG were increased on gluten challenge in four or five coeliac children...

  12. WATER BOND FORMS IN THE DOUGH AND SORBTION PROPERTIES OF GLUTEN-FREE MACARONI PRODUCTS MADE FROM CORN FLOUR

    Olexandr ROZHNO

    2017-09-01

    Full Text Available Authors have developed macaroni products made from fine meal corn flour by structure forming additives of different nature and without them. The correlation between water of different bond forms in macaroni dough with different structural forming additives and without them has been investigated. Results show that water of macro and microcapillaries is prevalent in the corn dough – 39.40 - 54.69 % of overall amount of water. Osmotically bound water amounts 18.75 – 28.04 %, adsorbically bound water -18.49 – 23.13 % of overall amount of water. The absorbtion capability of the macaroni products and amount of adsorbed water has been determined. The micropore structure of these samples was characterized. The correlation between structures of macaroni products, both amount of adsorbed moisture and energy of sorption were proven. The amount of monomolecular layer’s moisture for gluten-free corn macaroni products is significantly higher – in 1.2 – 1.5 times – when compared to the wheat macaroni products. Due to this fact, corn samples obtained higher energy of moisture sorption. The correlation between structural characteristics of the macaroni samples and their quality was shown.

  13. Phenolic profile and fermentation patterns of different commercial gluten-free pasta during in vitro large intestine fermentation.

    Rocchetti, Gabriele; Lucini, Luigi; Chiodelli, Giulia; Giuberti, Gianluca; Gallo, Antonio; Masoero, Francesco; Trevisan, Marco

    2017-07-01

    The fate of phenolic compounds, along with short-chain fatty acids (SCFAs) production kinetics, was evaluated on six different commercial gluten-free (GF) pasta samples varying in ingredient compositions, focussing on the in vitro faecal fermentation after the gastrointestinal digestion. A general reduction of both total phenolics and reducing power was observed in all samples, together with a substantial change in phenolic profile over 24h of faecal fermentation, with differences among GF pasta samples. Flavonoids, hydroxycinnamics and lignans degraded over time, with a concurrent increase in low-molecular-weight phenolic acids (hydroxybenzoic acids), alkylphenols, hydroxybenzoketones and tyrosols. Interestingly, discriminant analysis also identified several alkyl derivatives of resorcinol as markers of the changes in phenolic profile during in vitro fermentation. Furthermore, degradation pathways of phenolics by intestinal microbiota have been proposed. Considering the total SCFAs and butyrate production during the in vitro fermentation, different fermentation kinetics were observed among GF pasta post-hydrolysis residues. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Impact of boiling on free and bound phenolic profile and antioxidant activity of commercial gluten-free pasta.

    Rocchetti, Gabriele; Lucini, Luigi; Chiodelli, Giulia; Giuberti, Gianluca; Montesano, Domenico; Masoero, Francesco; Trevisan, Marco

    2017-10-01

    Cooking by boiling dry pasta could have varying degrees of influence on nutritional and functional components. In the present study, its effect on total phenolic content and antioxidant capacity, as well as on the comprehensive profile of free and bound phenolics, was investigated in six commercial gluten-free (GF) pasta products. Overall, the heat treatment caused a significant reduction (Pphenolic content as well as FRAP reducing power and ORAC radical scavenging, with significant differences among the pasta samples considered. The highest values were recorded in free phenolic fraction remaining in black rice (41mggallic acid equivalents100g -1 and 25mmolTrolox Equivalents100g -1 ) and quinoa (24mggallic acid equivalents100g -1 and 14mmolTrolox Equivalents100g -1 ) cooked GF pasta. Significant correlations (Pphenolics and both the antioxidant capacity assays performed. UHPLC-ESI/QTOF-MS mass profiling allowed confirming the spectrophotometric results, while identifying the amount of free and bound fractions. Among phenolic classes, lignans exhibited the highest decrease during the cooking process, followed by stilbenes and flavonoids. However, phenolic acids and other phenolics showed the highest stability. Furthermore, cooking by boiling strongly lowered the bound-to-free ratio of phenolic compounds, by an averaged factor ranging from 14-folds for flavonoids to 5-folds for other classes of phenolics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. A study on fibre addition to gluten free bread: its effects on bread quality and in vitro digestibility.

    Sciarini, L S; Bustos, M C; Vignola, M B; Paesani, C; Salinas, C N; Pérez, G T

    2017-01-01

    The aim of this study was to assess the impact of fibre addition on gluten-free (GF) dough properties and bread technological quality, and on protein and starch in vitro digestibility. Soluble (Inulin, In) and insoluble fibres (oat fibre, OF, and type IV resistant starch, RSIV) were used at 5 and 10% substitution levels. Dough firmness increased when insoluble fibres were added, and decreased when In was used. Incorporation of insoluble fibres resulted into bread with a low specific volume (SBV) since firmer dough were more difficult to expand during proofing and baking. Staling rate was reduced after fibre addition, with the exception being OF 10%, as its lower SBV may have favoured molecule re-association. In general, protein and starch digestibility increased when fibres were added at 5%, and then decreased after further increasing the level. Fibres may have disrupted bread crumb structure, thus increasing digestibility, although the higher addition may have led to a physical and/or chemical impediment to digestion. Inulin has well-known physiological effects, while RS presented the most important effect on in vitro starch digestibility (GI). These results showed the possibility of adding different fibres to GF bread to decrease the GI and increase protein digestibility, while obtaining an overall high quality end-product.

  16. Exploitation of alfalfa seed (Medicago sativa L.) flour into gluten-free rice cookies: Nutritional, antioxidant and quality characteristics.

    Giuberti, Gianluca; Rocchetti, Gabriele; Sigolo, Samantha; Fortunati, Paola; Lucini, Luigi; Gallo, Antonio

    2018-01-15

    In an effort to increase the nutritional value of common gluten-free (GF) cereal-based foods, GF cookies using alfalfa seed flour (ASF), at different substitution levels to common rice flour (0% as control, 15%, 30% and 45% w/w), were produced. Crude protein, total dietary fibre, total polyunsaturated, total n-3 and n-6 fatty acid contents increased linearly (p<0.05) by raising the substitution levels of rice with ASF. The hardness, the total phenolic content, the in vitro antioxidant capacity and the resistant starch increased linearly (p<0.05), whereas the starch hydrolysis index decreased linearly (p<0.05) by raising the substitution levels of rice flour with ASF. Despite the fact that ASF-substituted GF cookies had inferior sensory attributes compared to the control, the score given by the panellists remained at fairly good levels for all tested parameters, showing acceptability of the substituted GF cookies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Improvement of physical properties of gluten-free steamed cake based on black waxy rice flour using different hydrocolloids.

    Itthivadhanapong, Pimchada; Jantathai, Srinual; Schleining, Gerhard

    2016-06-01

    This study aimed to compare the effects of 1 % addition of four selected hydrocolloids (xanthan, guar, hypdroxypropylmethylcellulose and carrageenan) on quality characteristics of batter and of black waxy rice steamed cake compared to a control without hydrocolloids. Dynamic frequency sweeps of the batters at 25 °C indicated that all formulations exhibited gel-like behaviour with storage moduli (G') higher than loss moduli (G″). Hydrocolloids increased the apparent viscosity and the thixotropic behaviour, depending on the type of hydrocolloids. Xanthan had the greatest effects on both moduli, whereas carrageenan had the smallest effects. During a storage period of 4 days the cakes with xanthan remained softer than control samples. The overall acceptability of cake with xanthan and guar were higher than control. This study is the first report on using black waxy rice flour as a main raw material in gluten free cake. The results of this study provided useful information for selection hydrocolloids as ingredients that can help to improve the physical properties of waxy rice steamed cake.

  18. Screening for celiac disease in average-risk and high-risk populations

    Aggarwal, Saurabh; Lebwohl, Benjamin

    2012-01-01

    The prevalence of celiac disease is rising. As a result there is increasing interest in the associated mortality and morbidity of the disease. Screening of asymptomatic individuals in the general population is not currently recommended; instead, a strategy of case finding is the preferred approach, taking into account the myriad modes of presentation of celiac disease. Although a gluten-free diet is the treatment of choice in symptomatic patients with celiac disease, there is no consensus on whether institution of a gluten-free diet will improve the quality of life in asymptomatic screen-detected celiac disease patients. A review of the studies that have been performed on this subject is presented. Certain patient groups such as those with autoimmune diseases may be offered screening in the context of an informed discussion regarding the potential benefits, with the caveat that the data on this issue are sparse. Active case finding seems to be the most prudent option in most clinical situations. PMID:22282707

  19. Differentiating coeliac disease from irritable bowel syndrome by urinary volatile organic compound analysis--a pilot study.

    Ramesh P Arasaradnam

    Full Text Available Coeliac disease (CD, a T-cell-mediated gluten sensitive enteropathy, affects ∼ 1% of the UK population and can present with wide ranging clinical features, often being mistaken for Irritable Bowel Syndrome (IBS. Heightened clinical awareness and serological screening identifies those with potential coeliac disease; the diagnosis is confirmed with duodenal biopsies, and symptom improvement with a gluten-free diet. Limitations to diagnosis are false negative serology and reluctance to undergo biopsy. The gut microbiome is altered in several gastrointestinal disorders, causing altered gut fermentation patterns recognisable by volatile organic compounds (VOC analysis in urine, breath and faeces. We aimed to determine if CD alters the urinary VOC pattern, distinguishing it from IBS. 47 patients were recruited, 27 with established CD, on gluten free diets, and 20 with diarrhoea-predominant IBS (D-IBS. Collected urine was stored frozen in 10 ml aliquots. For assay, the specimens were heated to 40 ± 0.1°C and the headspace analysed by Field Asymmetric Ion Mobility Spectrometry (FAIMS. Machine learning algorithms were used for statistical evaluation. Samples were also analysed using Gas chromatography and mass spectroscopy (GC-MS. Sparse logistic regression showed that FAIMS distinguishes VOCs in CD vs D-IBS with ROC curve AUC of 0.91 (0.83-0.99, sensitivity and specificity of 85% respectively. GCMS showed a unique peak at 4'67 found only in CD, not D-IBS, which correlated with the compound 1,3,5,7 cyclooctatetraene. This study suggests that FAIMS offers a novel, non-invasive approach to identify those with possible CD, and distinguishes from D-IBS. It offers the potential for monitoring compliance with a gluten-free diet at home. The presence of cyclooctatetraene in CD specimens will need further validation.

  20. Nutritional and sensory characteristics of gluten-free quinoa (Chenopodium quinoa Willd)-based cookies development using an experimental mixture design.

    Brito, Isabelle L; de Souza, Evandro Leite; Felex, Suênia Samara Santos; Madruga, Marta Suely; Yamashita, Fábio; Magnani, Marciane

    2015-09-01

    The aim of this study was to develop a gluten-free formulation of quinoa (Chenopodium quinoa Willd.)-based cookies using experimental design of mixture to optimize a ternary mixture of quinoa flour, quinoa flakes and corn starch for parameters of colour, specific volume and hardness. Nutritional and sensory aspects of the optimized formulation were also assessed. Corn starch had a positive effect on the lightness of the cookies, but increased amounts of quinoa flour and quinoa flakes in the mixture resulted in darker product. Quinoa flour showed a negative effect on the specific volume, producing less bulky cookies, and quinoa flour and quinoa flakes had a positive synergistic effect on the hardness of the cookies. According the results and considering the desirability profile for colour, hardness and specific volume in gluten-free cookies, the optimized formulation contains 30 % quinoa flour, 25 % quinoa flakes and 45 % corn starch. The quinoa-based cookie obtained was characterized as a product rich in dietary fibre, a good source of essential amino acids, linolenic acid and minerals, with good sensory acceptability. These findings reports for the first time the application of quinoa processed as flour and flakes in mixture with corn starch as an alternative ingredient for formulations of gluten-free cookies-type biscuits.

  1. Hepatobiliary Disorders in Celiac Disease: An Update

    Kaushal K. Prasad

    2011-01-01

    Full Text Available This communication reviews recent literature and summarizes hepatobiliary abnormalities that may complicate the clinical course of celiac disease. A wide spectrum of hepatobiliary diseases has been described, including asymptomatic elevations of liver enzyme levels, nonspecific hepatitis, nonalcoholic fatty liver disease, and autoimmune and cholestatic liver disease. Moreover, in the majority of patients, liver enzyme levels will normalize on a gluten-free diet. In addition, celiac disease may be associated with rare hepatic complications, such as hepatic T-cell lymphoma. Because many celiac patients do not have overt gastrointestinal symptoms, a high index of suspicion is required. Simple methods of detecting celiac disease such as serum antibody tests help in the early identification of the disease, thus preventing serious complications of the disorder. The IgG DGP antibody test and IgA tTG antibody test used in combination are an excellent screening test for suspected cases of celiac disease.

  2. [Irritable bowel syndrome, celiac disease and gluten].

    Mearin, Fermín; Montoro, Miguel

    2014-08-04

    For many years irritable bowel syndrome (IBS) and celiac disease (CD) have been considered 2 completely separate entities, with CD being clearly related to a permanent gluten intolerance and IBS having no relation with gluten ingestion. However IBS and CD symptoms may be indistinguishable, especially when diarrhea, bloating or abdominal pain predominate. In the last decade several studies have shown that the separation between CD and IBS is not so clear. Thus, some patients who have been diagnosed of IBS suffer in fact from CD. In addition, it seems that there is a group of patients who, without having CD, suffer gluten intolerance that cause them digestive symptoms similar to those of IBS. Gluten sensitivity is defined as the spectrum of morphological, immunological and functional abnormalities that respond to a gluten-free diet. This concept includes histological, immunological and clinical manifestations in the absence of evident morphological abnormalities. Therefore, it is mandatory to establish in a scientific way in which patients a gluten-free diet will be beneficial as well as when this is not justified. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  3. Gastrointestinal symptoms and quality of life in screen-detected celiac disease.

    Paavola, Aku; Kurppa, Kalle; Ukkola, Anniina; Collin, Pekka; Lähdeaho, Marja-Leena; Huhtala, Heini; Mäki, Markku; Kaukinen, Katri

    2012-10-01

    Active serological screening has proved an effective means of increasing the diagnostic rate in celiac disease. The effects of a long-term gluten-free diet on possible gastrointestinal symptoms and psychological well-being in screen-detected patients have nevertheless remained obscure. Abdominal symptoms and quality of life were measured in a large cohort of treated screen-detected celiac adults. Comparisons were made with corresponding symptom-detected patients and with non-celiac controls. Dietary adherence was assessed both by structured interview and by serological testing. In both screen- and symptom-detected celiac groups, 88% of the patients were adherent. On a diet, both screen- and symptom-detected patients reported significantly more gastrointestinal symptoms than non-celiac controls. Those screen-detected patients who reported having no symptoms at the time of diagnosis, also remained asymptomatic during the diet. Despite persistent symptoms, psychological well-being in screen-detected patients was comparable with that in non-celiac controls, whereas the symptom-detected patients showed lower quality of life. Long-term treated screen-detected celiac patients, especially women, suffer from gastrointestinal symptoms on a gluten free diet similarly to symptom-detected patients. However, despite a similar frequency of persistent symptoms, the quality of life was unimpaired in the screen found, but remained low in the symptom-detected group. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. Diabetes preventive gluten-free diet decreases the number of caecal bacteria in non-obese diabetic mice

    Hansen, A. K.; Ling, F.; Kaas, A.; Funda, David P.; Farlov, H.; Buschard, K.

    2006-01-01

    Roč. 22, - (2006), s. 220-225 ISSN 1520-7552 R&D Projects: GA AV ČR IAA5020405 Institutional research plan: CEZ:AV0Z50200510 Keywords : type 1 diabetes mellitus * non-obese diabetic mice * gluten Subject RIV: EE - Microbiology, Virology Impact factor: 2.551, year: 2006

  5. Celiac Disease Presenting as Profound Diarrhea and Weight Loss - A Celiac Crisis.

    Bul, Vadim; Sleesman, Brett; Boulay, Brian

    2016-08-05

    BACKGROUND Celiac disease is a hypersensitivity enteropathy that can have various presentations in adults. Rarely, patients can present with severe lab abnormalities, dehydration and weight loss caused by celiac disease - a celiac crisis. CASE REPORT A 46-year-old male with a past medical history significant for diabetes mellitus, type 2 (DM2) and recently treated Bell's Palsy presented to the emergency room complaining of weakness, diarrhea and lightheadedness. On presentation, the patient had a systolic blood pressure (SBP) of 60 mm Hg and a lactic acidosis with pH of 7.28. Infectious etiologies of diarrhea were ruled out. The patient had an EGD which showed erythema of the duodenal bulb. Serum anti-gliadin and anti-TTG IgA were both elevated suggesting Celiac disease. Biopsies showed histopathology consistent with celiac disease. The patient's diarrhea resolved after initiation of a gluten free diet. He gained 25 kilograms after discharge and did not require further hospitalizations for diarrhea. CONCLUSIONS Celiac crisis is a very rare presentation of celiac disease in adults but nonetheless should be considered in patients with marked metabolic derangements in the setting of osmotic diarrhea. Treatment consists of a gluten free diet and may require management with steroids and total parenteral nutrition (TPN).

  6. Refeeding syndrome in children in developing countries who have celiac disease.

    Agarwal, Jaya; Poddar, Ujjal; Yachha, Surender K; Srivastava, Anshu

    2012-04-01

    The clinical presentations of celiac crisis and refeeding syndrome in celiac disease are almost similar, but information about refeeding syndrome is scarce. We are reporting for the first time 5 cases of refeeding syndrome in children with celiac disease that could have otherwise been labeled as celiac crisis. From January to December 2010, a chart review of hospital records of all celiac disease cases was performed, and refeeding syndrome was ascribed in those celiac patients who deteriorated clinically after initiation of a gluten-free diet and had biochemical parameters suggestive of refeeding syndrome such as hypophosphatemia, hypokalemia, hypocalcemia, and hypoalbuminemia. Of the total 35 celiac disease patients, 5 (median age 6.5 [range 2.2-10] years, 3 boys) were identified as having refeeding syndrome. All 5 children were severely malnourished (body mass index refeeding syndrome. At the same time, their clinical features fulfilled the criteria for celiac crisis except that their symptoms have worsened after the introduction of a gluten-free diet. Nevertheless, instead of using steroids, they were managed as refeeding syndrome in terms of correction of electrolytes and gradual feeding, and that led to a successful outcome in all of them. Severely malnourished patients with celiac disease are at risk of developing potentially life-threatening refeeding syndrome, which may mimic celiac crisis, especially in developing countries. Early recognition and appropriate treatment are the keys to a successful outcome.

  7. Physical properties of gluten-free sugar cookies made from amaranth-oat composites

    Amaranth flour containing the essential amino acid, lysine, was blended with oat products that contain ß-glucan known for lowering blood cholesterol and preventing heart disease. These composites improved nutritional value, water holding capacity and the pasting properties along with their gluten fr...

  8. Functional properties of gluten-free sugar cookies made from amaranth-oat composites

    Amaranth flour containing the essential amino acid, lysine, was blended with oat products that contain ß-glucan known for lowering blood cholesterol and preventing heart disease. These composites improved nutritional value, water holding capacity and the pasting properties along with their gluten fr...

  9. Therapeutic approaches for celiac disease

    Plugis, Nicholas M.; Khosla, Chaitan

    2015-01-01

    Celiac disease is a common, lifelong autoimmune disorder for which dietary control is the only accepted form of therapy. A strict gluten-free diet is burdensome to patients and can be limited in efficacy, indicating there is an unmet need for novel therapeutic approaches to supplement or supplant dietary therapy. Many molecular events required for disease pathogenesis have been recently characterized and inspire most current and emerging drug-discovery efforts. Genome-wide association studies (GWAS) confirm the importance of human leukocyte antigen genes in our pathogenic model and identify a number of new risk loci in this complex disease. Here, we review the status of both emerging and potential therapeutic strategies in the context of disease pathophysiology. We conclude with a discussion of how genes identified during GWAS and follow-up studies that enhance susceptibility may offer insight into developing novel therapies. PMID:26060114

  10. Gluten-free dough-making of specialty breads: Significance of blended starches, flours and additives on dough behaviour.

    Collar, Concha; Conte, Paola; Fadda, Costantino; Piga, Antonio

    2015-10-01

    The capability of different gluten-free (GF) basic formulations made of flour (rice, amaranth and chickpea) and starch (corn and cassava) blends, to make machinable and viscoelastic GF-doughs in absence/presence of single hydrocolloids (guar gum, locust bean and psyllium fibre), proteins (milk and egg white) and surfactants (neutral, anionic and vegetable oil) have been investigated. Macroscopic (high deformation) and macromolecular (small deformation) mechanical, viscometric (gelatinization, pasting, gelling) and thermal (gelatinization, melting, retrogradation) approaches were performed on the different matrices in order to (a) identify similarities and differences in GF-doughs in terms of a small number of rheological and thermal analytical parameters according to the formulations and (b) to assess single and interactive effects of basic ingredients and additives on GF-dough performance to achieve GF-flat breads. Larger values for the static and dynamic mechanical characteristics and higher viscometric profiles during both cooking and cooling corresponded to doughs formulated with guar gum and Psyllium fibre added to rice flour/starch and rice flour/corn starch/chickpea flour, while surfactant- and protein-formulated GF-doughs added to rice flour/starch/amaranth flour based GF-doughs exhibited intermediate and lower values for the mechanical parameters and poorer viscometric profiles. In addition, additive-free formulations exhibited higher values for the temperature of both gelatinization and retrogradation and lower enthalpies for the thermal transitions. Single addition of 10% of either chickpea flour or amaranth flour to rice flour/starch blends provided a large GF-dough hardening effect in presence of corn starch and an intermediate effect in presence of cassava starch (chickpea), and an intermediate reinforcement of GF-dough regardless the source of starch (amaranth). At macromolecular level, both chickpea and amaranth flours, singly added, determined

  11. Health-Related Quality of Life in Children and Adolescents with Celiac Disease: From the Perspectives of Children and Parents

    Ing-Marie Byström

    2012-01-01

    Full Text Available Aim. To examine how celiac children and adolescents on gluten-free diet valued their health-related quality of life, and if age and severity of the disease at onset affected the children’s self-valuation later in life. We also assessed the parents’ valuation of their child’s quality of life. Methods. The DISABKIDS Chronic generic measure, short versions for both children and parents, was used on 160 families with celiac disease. A paediatric gastroenterologist classified manifestations of the disease at onset retrospectively. Results. Age or sex did not influence the outcome. Children diagnosed before the age of five scored higher than children diagnosed later. Children diagnosed more than eight years ago scored higher than more recently diagnosed children, and children who had the classical symptoms of the disease at onset scored higher than those who had atypical symptoms or were asymptomatic. The parents valuated their children’s quality of life as lower than the children did. Conclusion. Health-related quality of life in treated celiac children and adolescents was influenced by age at diagnosis, disease severity at onset, and years on gluten-free diet. The disagreement between child-parent valuations highlights the importance of letting the children themselves be heard about their perceived quality of life.

  12. Health-related quality of life in children and adolescents with celiac disease: from the perspectives of children and parents.

    Byström, Ing-Marie; Hollén, Elisabet; Fälth-Magnusson, Karin; Johansson, Annakarin

    2012-01-01

    Aim. To examine how celiac children and adolescents on gluten-free diet valued their health-related quality of life, and if age and severity of the disease at onset affected the children's self-valuation later in life. We also assessed the parents' valuation of their child's quality of life. Methods. The DISABKIDS Chronic generic measure, short versions for both children and parents, was used on 160 families with celiac disease. A paediatric gastroenterologist classified manifestations of the disease at onset retrospectively. Results. Age or sex did not influence the outcome. Children diagnosed before the age of five scored higher than children diagnosed later. Children diagnosed more than eight years ago scored higher than more recently diagnosed children, and children who had the classical symptoms of the disease at onset scored higher than those who had atypical symptoms or were asymptomatic. The parents valuated their children's quality of life as lower than the children did. Conclusion. Health-related quality of life in treated celiac children and adolescents was influenced by age at diagnosis, disease severity at onset, and years on gluten-free diet. The disagreement between child-parent valuations highlights the importance of letting the children themselves be heard about their perceived quality of life.

  13. Diagnosis and Updates in Celiac Disease.

    Shannahan, Sarah; Leffler, Daniel A

    2017-01-01

    Celiac disease is an autoimmune disorder induced by gluten in genetically susceptible individuals. It can result in intraintestinal and extraintestinal manifestations of disease including diarrhea, weight loss, anemia, osteoporosis, or lymphoma. Diagnosis of celiac disease is made through initial serologic testing and then confirmed by histopathologic examination of duodenal biopsies. Generally celiac disease is a benign disorder with a good prognosis in those who adhere to a gluten-free diet. However, in refractory disease, complications may develop that warrant additional testing with more advanced radiologic and endoscopic methods. This article reviews the current strategy to diagnose celiac disease and the newer modalities to assess for associated complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Celiac disease: implications for patient management.

    Ryan, Megan; Grossman, Sheila

    2011-01-01

    Celiac disease is an autoimmune disorder that is known specifically for causing inflammation of the mucosa in the small intestine. Through multiple diagnostic and screening tools such as small intestinal biopsy sample, serological testing, and human leukocyte antigen testing, healthcare providers can diagnose this disease that contains components related to genetic predisposition and intake of gluten proteins found in wheat, barley, and rye. There are some who believe that having an autoimmune disease may predispose one to acquiring another disease. With patients experiencing mostly diarrhea, abdominal pain, and weight loss, the implementation of a gluten-free diet is the treatment that healthcare providers recommend. Through monitoring gluten intake and providing nutritional supplementation, those diagnosed with celiac disease can lead a relatively normal life without complications. With celiac disease affecting all age ranges in the population, and with a documented higher frequency, there is a growing awareness in society that can be easily seen in grocery stores, restaurants, and food manufacturers.

  15. Celiac disease (CD), ulcerative colitis (UC), and primary sclerosing cholangitis (PSC) in one patient: a family study Enfermedad celiaca (EC), colitis ulcerosa (CU) y colangitis esclerosante primaria (CEP) asociadas en el mismo paciente: estudio familiar

    V. Cadahía; L. Rodrigo; D. Fuentes; S. Riestra; R. de Francisco; M. Fernández

    2005-01-01

    We discuss the case of a 17-year-old male who at the age of 7 was diagnosed with celiac disease (CD) together with ulcerative colitis (UC) and primary sclerosing cholangitis (PSC). The patient was treated with gluten-free diet and immunosuppressive drugs (azathioprine), and currently remains asymptomatic. The patient's younger, 12-year-old sister was diagnosed with CD when she was 1.5 years old, and at 7 years she developed type-I diabetes mellitus, which was difficult to control. A family st...

  16. Celiac disease in type 1 diabetes mellitus

    Camarca Maria

    2012-03-01

    Full Text Available Abstract Celiac Disease (CD occurs in patients with Type 1 Diabetes (T1D ranging the prevalence of 4.4-11.1% versus 0.5% of the general population. The mechanism of association of these two diseases involves a shared genetic background: HLA genotype DR3-DQ2 and DR4-DQ8 are strongly associated with T1D, DR3-DQ2 with CD. The classical severe presentation of CD rarely occurs in T1D patients, but more often patients have few/mild symptoms of CD or are completely asymptomatic (silent CD. In fact diagnosis of CD is regularly performed by means of the screening in T1D patients. The effects of gluten-free diet (GFD on the growth and T1D metabolic control in CD/T1D patient are controversial. Regarding of the GFD composition, there is a debate on the higher glycaemic index of gluten-free foods respect to gluten-containing foods; furthermore GFD could be poorer of fibers and richer of fat. The adherence to GFD by children with CD-T1D has been reported generally below 50%, lower respect to the 73% of CD patients, a lower compliance being more frequent among asymptomatic patients. The more severe problems of GFD adherence usually occur during adolescence when in GFD non compliant subjects the lowest quality of life is reported. A psychological and educational support should be provided for these patients.

  17. [Histological features of celiac disease in south Tunisia: a study of 114 pediatric cases].

    Kallel, Rim; Krichen-Makni, Saloua; Ellouze, Sameh; Châari, Chiraz; Charfi, Slim; Sellami, Ahmed; Tahri, Mohamed-Nabil; Hachicha, Mongia; Sellami-Boudawara, Tahya

    2009-04-01

    To report the histological features of celiac disease in a paediatric population originating from south Tunisia. A retrospective study of a series of duodenal biopsies from 114 children with celiac disease diagnosed over a period of 6 years (from January 1999 to December 2004). The diagnosis was confirmed by histological results, serological studies and clinical response to gluten free diet. The average age of patients was of 6.2 years (range 6 months-15 years). Sex ratio was 0.71. Symptoms were dominated by chronic diarrhea (48%), weight loss (50%) and anemia (20.1%). Histological findings showed an intraepithelial lymphocytosis (Marsh type 1) in 12.2% of cases, type 2 was present in 1.7% of cases and type 3 (villous atrophy) in 86% of cases. A treatment with a gluten-free diet was indicated for all patients, only the cases who haven't presented a clinical amelioration (11 cases) have beneficed a control biopsie; a villous atrophy was persistent in 80% of this patients. Histological features in duodenal biopsies for the diagnosis and the follow-up of patients with coeliac disease. This allows an appropriate treatment and prevents further complications.

  18. Autoimmune Hepatitis and Celiac Disease: Case Report Showing an Entero-Hepatic Link

    Francesco Tovoli

    2010-10-01

    Full Text Available Celiac disease is an autoimmune disorder primarily targeting the small bowel, although extraintestinal extensions have been reported. The autoimmune processes can affect the liver with manifestations such as primary biliary cirrhosis and autoimmune hepatitis. We describe a 61-year-old woman with celiac disease and an increased levels of aminotransferases. The persistence of increased levels of aminotransferases after 1 year of gluten-free diet and the positivity for an anti-nuclear and anti-double-strand DNA antibodies led to a misdiagnosis of systemic lupus erythematosus-related hepatitis. Based on these findings the patient was placed on steroids, which after a few months were stopped because of the onset of diabetes mellitus. Soon after steroid withdrawal, the patient had a marked increase in aminotransferases and γ-globulins, and a liver biopsy revealed chronic active hepatitis. A course of three months of steroids and azathioprine normalized both biochemical and clinical parameters. Currently the patient is symptom-free and doing well. In conclusion, a hypertransaminasemia persisting after a gluten-free diet should be interpreted as a sign of coexisting autoimmune liver disease. Any autoantibody positivity (in this case to ANA and anti-dsDNA should be carefully considered in order to avoid misdiagnosis delaying appropriate clinical management.

  19. The gut-kidney axis in IgA nephropathy: role of microbiota and diet on genetic predisposition.

    Coppo, Rosanna

    2018-01-01

    Recent data suggest that gut-associated lymphoid tissue (GALT) plays a major role in the development of immunoglobulin A (IgA) nephropathy (IgAN). A genome-wide association study showed that most loci associated with the risk of IgAN are also associated with immune-mediated inflammatory bowel diseases, maintenance of the intestinal barrier and regulation of response to gut pathogens. Studies involving experimental models have demonstrated a pivotal role of intestinal microbiota in the development of IgAN in mice producing high levels of IgA and in transgenic mice overexpressing BAFF, a B-cell factor crucial for IgA synthesis, indicating the role of genetic background, B-cell activity, GALT intestinal immunity and diet. The effect of diet was suggested by pilot studies carried out 30 years ago which showed that a gluten-rich diet induced IgAN in mice and that some patients benefited from a gluten-free diet. A recent experimental model in mice expressing human IgA1 and Fc alpha receptor CD89 reported clinical and histological improvement after a gluten-free diet. Clinical observations have elicited new interest in GALT hyper-reactivity in IgAN patients. In a pilot study, a reduction in proteinuria was attained using an enteric controlled-release formulation of the corticosteroid budesonide targeted to the Peyer's patches at the ileocecal junction. This formulation was tested in the placebo-controlled NEFIGAN phase 2b trial, with a reduction in proteinuria after 9 months of treatment together with stabilization of renal function in patients with persistent proteinuria. In conclusion, the gut-kidney axis modulated by microbiota and diet is a promising target for focused treatment of IgAN in genetically predisposed patients at risk of progression.

  20. Celiac Disease in Patients with Cystic Fibrosis-Related Bone Disease

    Melissa S. Putman

    2017-01-01

    Full Text Available Both cystic fibrosis (CF and celiac disease can cause low bone mineral density (BMD and fractures. Celiac disease may occur at a higher frequency in patients with CF than the general population, and symptoms of these conditions may overlap. We report on two patients presenting with CF-related bone disease in the past year who were subsequently found to have concurrent celiac disease. Because adherence to a gluten-free diet may improve BMD in patients with celiac disease, this could have important implications for treatment. Clinicians should consider screening for celiac disease in patients with CF who have low BMD, worsening BMD in the absence of other risk factors, and/or difficult to treat vitamin D deficiency.

  1. Celiac disease and endocrine autoimmunity.

    Kahaly, George J; Schuppan, Detlef

    2015-01-01

    Celiac disease (CD) is a small-intestinal inflammatory disease that is triggered by the ingestion of the storage proteins (gluten) of wheat, barley and rye. Endocrine autoimmunity is prevalent in patients with CD and their relatives. The genes that predispose to endocrine autoimmune diseases, e.g. type 1 diabetes, autoimmune thyroid diseases, and Addison's disease, i.e. DR3-DQ2 and DR4-DQ8, are also the major genetic determinants of CD, which is the best understood HLA-linked disease. Thus, up to 30% of first-degree relatives both of patients with CD and/or endocrine autoimmunity are affected by the other disease. In CD, certain gluten proteins bind with high affinity to HLA-DQ2 or -DQ8 in the small-intestinal mucosa, to activate gluten-specific T cells which are instrumental in the destruction of the resorptive villi. Here, the autoantigen tissue transglutaminase increases the T cell response by generating deamidated gluten peptides that bind more strongly to DQ2 or DQ8. Classical symptoms such as diarrhea and consequences of malabsorption like anemia and osteoporosis are often absent in patients with (screening-detected) CD, but this absence does not significantly affect these patients' incidence of endocrine autoimmunity. Moreover, once autoimmunity is established, a gluten-free diet is not able to induce remission. However, ongoing studies attempt to address how far a gluten-free diet may prevent or retard the development of CD and endocrine autoimmunity in children at risk. The close relationship between CD and endocrine autoimmunity warrants a broader immune genetic and endocrine screening of CD patients and their relatives. © 2015 S. Karger AG, Basel.

  2. Effects of carrot pomace powder and a mixture of pectin and xanthan on the quality of gluten-free batter and cakes.

    Majzoobi, Mahsa; Vosooghi Poor, Zahra; Mesbahi, Gholamreza; Jamalian, Jalal; Farahnaky, Asgar

    2017-12-01

    Carrot pomace powder (CPP) is a valuable by-product of carrot processing containing nutrients and fiber and can be utilized for enrichment of gluten-free products. The main purpose of this study was to determine the effects of various levels of CPP (0, 10, 20, and 30%) and a mixture of hydrocolloids (HC) including pectin and xanthan (1.5% of each) on the quality of batter and gluten-free cakes. With increasing the level of CPP and inclusion of HC the viscosity of the batter increased significantly from 87 mPa s for the control to >7000 mPa s for 30%CCP + HC sample. The density of the control batter was 1.2 g/cm 3 which reduced significantly to 0.899 g/cm 3 for HC sample. The pH of the cake reduced from 7.23 to 6.78 with addition of CPP but increased slightly with inclusion of HC. The density of the cake reduced from 0.510 g/cm 3 for the control to 0.395 g/cm 3 for 20%CCP + C sample. The texture of the cakes became softer, more springy and chewable with addition of CPP, CPP + HC, and HC. The control sample had the lowest uniformity index (0.178) which improved with addition of CPP and CPP + HC and a highly uniform cake with a uniformity index of 0.045 was obtained for the 30%CCP + HC cake. Addition of CPP increased the dark color of the cakes while inclusion of HC had no effect on the appearance of the cake and color. It was concluded that inclusion of maximum 30%CCP and 20%CPP + HC promoted the quality and sensory attributes of gluten-free cakes. Although different types of gluten-free products are available in the market, most of them contain insufficient amount of fiber and nutrients. Despite popularity, gluten-free cakes are poor in fiber and nutrient contents. Therefore, improving the nutritional value of these products has received an increasing attention by the food industry. Carrot pomace powder (CPP) is an available source of fiber and nutrients and hence can be utilized for enrichment of gluten-free products. This study showed that

  3. Supplementation of Reduced Gluten Barley Diet with Oral Prolyl Endopeptidase Effectively Abrogates Enteropathy-Associated Changes in Gluten-Sensitive Macaques

    Karol Sestak

    2016-06-01

    Full Text Available Celiac disease (CD is an autoimmune disorder that affects approximately three million people in the United States. Furthermore, non-celiac gluten sensitivity (NCGS affects an estimated additional 6% of the population, e.g., 20 million in the U.S. The only effective treatment of CD and NCGS requires complete removal of gluten sources from the diet. While required adherence to a gluten-free diet (GFD is extremely difficult to accomplish, efforts to develop additional supportive treatments are needed. To facilitate these efforts, we developed a gluten-sensitive (GS rhesus macaque model to study the effects of novel therapies. Recently reported results from phase one of this project suggest that partial improvement—but not remission—of gluten-induced disease can be accomplished by 100-fold reduction of dietary gluten, i.e., 200 ppm—by replacement of conventional dietary sources of gluten with a mutant, reduced gluten (RG barley (lys3a-derived source. The main focus of this (phase two study was to determine if the inflammatory effects of the residual gluten in lys3a mutant barley grain could be further reduced by oral supplementation with a prolylendopeptidase (PE. Results reveal that PE supplementation of RG barley diet induces more complete immunological, histopathological and clinical remission than RG barley diet alone. The combined effects of RG barley diet and PE supplementation resulted in a further decrease of inflammatory mediators IFN-γ and TNF secretion by peripheral lymphocytes, as well as decreased plasma anti-gliadin and anti-intestinal tissue transglutaminase (TG2 antibodies, diminished active caspase production in small intestinal mucosa, and eliminated clinical diarrhea—all comparable with a gluten-free diet induced remission. In summary, the beneficial results of a combined RG barley and PE administration in GS macaques may warrant the investigation of similar synergistic approaches.

  4. Screening and Monitoring Coeliac Disease: Multicentre Trial of a New Serum Antibody Test Kit

    Peter L. Devine

    1994-01-01

    average interassay CV was 6.4% for IgA and 4.3% for IgG (n=3. By defining a positive te st as both IgA and IgG elevated, a sensitivity of 93% in untreated coeliacs (n=75 was observed. The corresponding specificities in healthy adults (n=130 and healthy children (n=77 were >99% and 100% respectively, while in patients with other gastrointestinal disorders (disease controls the specificity was 94% (n=129. The test was also useful in monitoring patients, with anti-gliadin IgA and IgG falling for up to a year after commencing a gluten-free diet (GFD (12 adults. In some patients however, antibody levels did not reach the normal cutpoint after many months on a GFD, which may reflect the patients ' poor adherence to their gluten free diet. The test was superior to the Pharmacia anti-gliadin ELISA, and should be useful as an aid to the diagnosis of coeliac disease, as well as in the follow-up of treated patients.

  5. High Protein Diet and Huntington's Disease

    Wu, Yih-Ru; Chen, Pei; Tsai, Fuu-Jen; Yang, Chueh-Lien; Tsao, Ya-Tzu; Chang, Wen; Hsieh, I-Shan; Chern, Yijuang; Soong, Bing-Wen

    2015-01-01

    Huntington’s disease (HD) is a neurodegenerative disorder caused by the huntingtin (HTT) gene with expanded CAG repeats. In addition to the apparent brain abnormalities, impairments also occur in peripheral tissues. We previously reported that mutant Huntingtin (mHTT) exists in the liver and causes urea cycle deficiency. A low protein diet (17%) restores urea cycle activity and ameliorates symptoms in HD model mice. It remains unknown whether the dietary protein content should be monitored closely in HD patients because the normal protein consumption is lower in humans (~15% of total calories) than in mice (~22%). We assessed whether dietary protein content affects the urea cycle in HD patients. Thirty HD patients were hospitalized and received a standard protein diet (13.7% protein) for 5 days, followed by a high protein diet (HPD, 26.3% protein) for another 5 days. Urea cycle deficiency was monitored by the blood levels of citrulline and ammonia. HD progression was determined by the Unified Huntington’s Disease Rating Scale (UHDRS). The HPD increased blood citrulline concentration from 15.19 μmol/l to 16.30 μmol/l (p = 0.0378) in HD patients but did not change blood ammonia concentration. A 2-year pilot study of 14 HD patients found no significant correlation between blood citrulline concentration and HD progression. Our results indicated a short period of the HPD did not markedly compromise urea cycle function. Blood citrulline concentration is not a reliable biomarker of HD progression. PMID:25992839

  6. High Protein Diet and Huntington's Disease.

    Chiung-Mei Chen

    Full Text Available Huntington's disease (HD is a neurodegenerative disorder caused by the huntingtin (HTT gene with expanded CAG repeats. In addition to the apparent brain abnormalities, impairments also occur in peripheral tissues. We previously reported that mutant Huntingtin (mHTT exists in the liver and causes urea cycle deficiency. A low protein diet (17% restores urea cycle activity and ameliorates symptoms in HD model mice. It remains unknown whether the dietary protein content should be monitored closely in HD patients because the normal protein consumption is lower in humans (~15% of total calories than in mice (~22%. We assessed whether dietary protein content affects the urea cycle in HD patients. Thirty HD patients were hospitalized and received a standard protein diet (13.7% protein for 5 days, followed by a high protein diet (HPD, 26.3% protein for another 5 days. Urea cycle deficiency was monitored by the blood levels of citrulline and ammonia. HD progression was determined by the Unified Huntington's Disease Rating Scale (UHDRS. The HPD increased blood citrulline concentration from 15.19 μmol/l to 16.30 μmol/l (p = 0.0378 in HD patients but did not change blood ammonia concentration. A 2-year pilot study of 14 HD patients found no significant correlation between blood citrulline concentration and HD progression. Our results indicated a short period of the HPD did not markedly compromise urea cycle function. Blood citrulline concentration is not a reliable biomarker of HD progression.

  7. Symptoms and biomarkers associated with celiac disease

    Kårhus, Line L; Thuesen, Betina H; Rumessen, Juri J.

    2016-01-01

    OBJECTIVES: To identify possible early predictors (symptoms and biomarkers) of celiac disease, compare symptoms before and after screening, and evaluate the diagnostic efficacy of serologic screening for celiac disease in an adult Danish population. METHODS: This cross-sectional population......-positive individuals 19 months after the clinical evaluation to obtain information on their symptoms and their experience with participation in the screening. RESULTS: Before screening, participants subsequently diagnosed with celiac disease did not differ from the rest of the population with respect to symptoms...... with having been diagnosed and 71% felt better on a gluten-free diet. CONCLUSION: There were no differences in the prevalence of symptoms between participants with and without screening-detected celiac disease, confirming that risk stratification in a general population by symptoms is difficult. The majority...

  8. Gluten-Free Recipes

    ... Tofu and Shrimp Curry Irish Soda Bread Jalapeño Poppers Key Lime Pie Key Lime Pie Shooters Knorr’s ... Dill Dip Gruyere Crustinis Hot Chili Dip Jalapeño Poppers Knorr’s Vegetable Dip Lemon Dipping Sauce Meatballs for ...

  9. Mediterranean Diet and Prevention of Chronic Diseases

    Romagnolo, Donato F.; Selmin, Ornella I.

    2017-01-01

    A large body of research data suggests that traditional dietary habits and lifestyle unique to the Mediterranean region (Mediterranean diet, MD) lower the incidence of chronic diseases and improve longevity. These data contrast with troubling statistics in the United States and other high income countries pointing to an increase in the incidence of chronic diseases and the projected explosion in cost of medical care associated with an aging population. In 2013, the MD was inscribed by UNESCO in the “Representative List of the Intangible Cultural Heritage of Humanity.” The 2015–2020 Dietary Guidelines for Americans included the MD as a healthy dietary pattern. Therefore, specific objectives of this article are to provide an overview of the nutritional basis of this healthful diet, its metabolic benefits, and its role in multiple aspects of disease prevention and healthy aging. Whereas recommendations about the MD often focus on specific foods or bioactive compounds, we suggest that the eating pattern as a whole likely contributes to the health promoting effects of the MD. PMID:29051674

  10. The molecular basis for oat intolerance in patients with celiac disease.

    Helene Arentz-Hansen

    2004-10-01

    Full Text Available BACKGROUND: Celiac disease is a small intestinal inflammatory disorder characterized by malabsorption, nutrient deficiency, and a range of clinical manifestations. It is caused by an inappropriate immune response to dietary gluten and is treated with a gluten-free diet. Recent feeding studies have indicated oats to be safe for celiac disease patients, and oats are now often included in the celiac disease diet. This study aimed to investigate whether oat intolerance exists in celiac disease and to characterize the cells and processes underlying this intolerance. METHODS AND FINDINGS: We selected for study nine adults with celiac disease who had a history of oats exposure. Four of the patients had clinical symptoms on an oats-containing diet, and three of these four patients had intestinal inflammation typical of celiac disease at the time of oats exposure. We established oats-avenin-specific and -reactive intestinal T-cell lines from these three patients, as well as from two other patients who appeared to tolerate oats. The avenin-reactive T-cell lines recognized avenin peptides in the context of HLA-DQ2. These peptides have sequences rich in proline and glutamine residues closely resembling wheat gluten epitopes. Deamidation (glutamine-->glutamic acid conversion by tissue transglutaminase was involved in the avenin epitope formation. CONCLUSIONS: We conclude that some celiac disease patients have avenin-reactive mucosal T-cells that can cause mucosal inflammation. Oat intolerance may be a reason for villous atrophy and inflammation in patients with celiac disease who are eating oats but otherwise are adhering to a strict gluten-free diet. Clinical follow-up of celiac disease patients eating oats is advisable.

  11. The Effects of Egg and Diacetyl Tartaric Acid Esters of Monoglycerides Addition on Storage Stability, Texture, and Sensory Properties of Gluten-Free Sorghum Bread.

    Bize, Magali; Smith, Brennan M; Aramouni, Fadi M; Bean, Scott R

    2017-01-01

    The impact of whole egg addition (as is) at 20%, 25%, or 30% (flour basis) on sorghum bread quality was evaluated. The use of the antistaling agent diacetyl tartaric acid esters of monoglycerides (DATEM) at 0.5% (flour basis) at each of the egg addition levels was also studied. Evaluated quality factors included color, specific volume, and crumb structure. Texture analysis was performed to evaluate the rate of quality loss based on changes in crumb hardness values over time. A trained sensory panel evaluated bread quality attributes by descriptive analysis. Sorghum breads with egg had larger specific volumes than the control, while DATEM had a negative effect on the volume of sorghum gluten-free bread. Inclusion of egg in the bread formula improved cell structure and produced darker crust (P bread hardness and slowed the rate of quality loss over a 12-d storage period. Descriptive analysis confirmed the findings of texture analysis. Control breads were significantly harder (P bread at days 0 and 4. This research demonstrates that addition of eggs to a gluten-free sorghum bread formulation results in improved storage stability and better overall quality and acceptability of the product. © 2016 Institute of Food Technologists®.

  12. Influence of different hydrocolloids on dough thermo-mechanical properties and in vitro starch digestibility of gluten-free steamed bread based on potato flour.

    Liu, Xingli; Mu, Taihua; Sun, Hongnan; Zhang, Miao; Chen, Jingwang; Fauconnier, Marie Laure

    2018-01-15

    The effects of hydrocolloids (hydroxypropylmethylcellulose (HPMC), Carboxymethylcellulose (CMC), xanthan gum (XG), and apple pectin (AP)) at different concentrations on dough thermo-mechanical properties and in vitro starch digestibility of gluten-free potato steamed bread were investigated. Results showed that hydrocolloids addition significantly increased the gelatinization temperature (from 52.0 to 64.2°C) and water absorption (from 56.22 to 66.50%) of potato dough. Moreover, hydrocolloids may be interacted with protein and starch, the density of potato protein bands was decreased by hydrocolloids addition, the reason might be that higher molecular weight complexes might be formed between proteins-hydrocolloids or proteins-proteins, thus change the protein solubility. Furthermore, steamed breads with hydrocolloids presented higher specific volume and lower hardness, and the rapidly digestible starch and estimated glycemic index were significantly decreased from 45.51 to 20.64, from 69.54 to 55.17, respectively. In conclusion, HPMC and XG could be used as improvers in the gluten-free potato steamed bread. Copyright © 2017. Published by Elsevier Ltd.

  13. The impact of extrusion on the nutritional composition, dietary fiber and in vitro digestibility of gluten-free snacks based on rice, pea and carob flour blends.

    Arribas, C; Cabellos, B; Sánchez, C; Cuadrado, C; Guillamón, E; Pedrosa, M M

    2017-10-18

    Consumers and the food industry are demanding healthier products. Expanded snacks with a high nutritional value were developed from different rice, pea and carob flour blends. The proximate composition, starch (total and resistant), amylose and amylopectin, dietary fiber (soluble and insoluble) contents, and the in vitro protein digestibility of different rice-legume formulations, were evaluated before and after the extrusion process. Compared with the corresponding non-extruded blends (control), the extrusion treatment did not change the total protein content, however, it reduced the soluble protein (61-86%), the fat (69-92%) and the resistant starch contents (100%). The total starch content of all studied blends increased (2-19%) after extrusion. The processing increased the in vitro protein digestibility, reaching values around 88-95% after extrusion. Total dietary fiber was reduced around 30%, and the insoluble fraction was affected to a larger extent than the soluble fraction by the extrusion process. Because of its balanced nutritional composition, high dietary fiber content, as well as low energy density, these novel gluten-free snack-like foods could be considered as functional foods and a healthier alternative to commercially available gluten-containing or gluten-free and low nutritional value snacks.

  14. REVIEW OF CELIAC DISEASE PRESENTATION IN A PEDIATRIC TERTIARY CENTRE.

    Oliveira, Gracinda Nogueira; Mohan, Rajiv; Fagbemi, Andrew

    2018-01-01

    Celiac disease is an immune-mediated disorder with a multiform presentation and therefore a challenging diagnosis. Our purpose is to identify the epidemiological, clinical, laboratory and histologic characteristics of children with celiac disease at diagnosis and on follow-up. Children with previously established or newly diagnosed celiac disease, admitted in a tertiary centre in a two-year period (2014-2016) were recruited. Data was collected retrospectively from electronic medical records and clinical notes, and subsequently analysed with SPSS version 20.0. A total of 159 patients, out of 312, were included. Age ranged from 1 to 17 years (mean ± SD: 8.5±4.5 years, 69% girls). Disease presentation was classical in 60%, non-classical in 25%, subclinical in 10% and 5% classified as potential celiac disease. Non-classical and subclinical profiles had a higher mean age at presentation but not statistically significant (P-value 0.24). The most frequent gastrointestinal features at presentation were abdominal pain (58%), diarrhea (43%) and bloating (27%). A positive family history for celiac disease was present in 24% (n=35). We found anaemia in 23%, low ferritin in 63% and a moderate to severe deficiency of 25-hydroxyvitamin D in 62%. celiac disease -specific serologic testing and esophagogastroduodenoscopy were performed in 99%. Histology revealed modified Marsh 2 or 3 enteropathy in 94%, the remaining had normal histology but positive human leukocyte antigen typing. Clinical improvement at 12 months of gluten-free diet was complete in 51% and partial in 49%. IgA tTG normalized after 12-30 months of gluten-free diet in 45%. On growth assessment at diagnosis and after 12-28 months of gluten-free diet, 100% had height increase (mean ±SD: 7.11±4.43 cm) and 96% weight gain (mean ±SD: 5.60±4.91 kg). Our findings outline the diverse clinical presentations of pediatric celiac disease that should be considered irrespective of age. Increased clinician's awareness will

  15. A young man with hemoptysis: Rare association of idiopathic pulmonary hemosiderosis, celiac disease and dilated cardiomyopathy

    Gopi C Khilnani

    2015-01-01

    Full Text Available Idiopathic pulmonary hemosiderosis (IPH is a rare cause of recurrent diffuse alveolar hemorrhage (DAH with no specific treatment. Herein, we discuss a case of hemoptysis, who had IPH and other rare associations. A 19-year-old man presented with recurrent hemoptysis, generalized weakness and progressive dyspnea for 3 years. Earlier, he was diagnosed with anemia and was treated with blood transfusions and hematinics. On examination he had pallor, tachycardia and was underweight. Investigations revealed low level of hemoglobin (7.8 g/dl and iron deficiency. An electrocardiography (ECG showed sinus tachycardia, interventricular conduction delay and T-wave inversion. Echocardiography revealed dilated cardiomyopathy with left ventricular dysfunction. Computed tomography of the chest demonstrated bilateral diffuse ground glass opacity suggestive of pulmonary hemorrhage. Pulmonary function tests showed restrictive pattern with increased carbon monoxide diffusion. Bronchoalveolar lavage and transbronchial lung biopsy showed hemosiderin-laden macrophages. Patient could recall recurrent episodes of diarrhea in childhood. Serum antitissue transglutamase antibodies were raised (291.66 IU/ml, normal <30 IU/ml. Duodenal biopsy showed subtotal villous atrophy consistent with celiac disease. He was started on gluten-free diet, beta blockers and diuretics. After two years of treatment, he has been showing consistent improvement. Screening for CD is important in patients with IPH. Cardiomyopathy forms rare third association. All three show improvement with gluten-free diet.

  16. Pão sem gluten enriquecido com a microalga Spirulina platensis Elaboration of gluten-free bread enriched with the microalgae Spirulina platensis

    Felipe da Silva Figueira

    2011-12-01

    Full Text Available Com a finalidade de oferecer pão sem glúten para consumidores com síndrome celíaca, em razão da intolerância ao glúten, elaboraram-se produtos com farinha de arroz em substituição à farinha de trigo. Para aumentar o conteúdo proteico dos pães adicionou-se a microalga Spirulina platensis seca, na faixa de 2 a 5% (base farinha. Os pães foram avaliados pelo volume específico, dureza do miolo uma e 24h após o forneamento e a cor do miolo. Verificou-se que o volume específico e a dureza dos pães não sofreram alteração com a adição de até 4% da alga, porem mostraram redução de 22% nos valores de volume e aumento de 113% na dureza quando se adicionou-se 5% (em base de farinha. Quando comparados ao pão não enriquecido, a adição de Spiriulina platensis provocou uma melhoria da qualidade nutricional dos pães, confirmada pelo aumento significativo de 39,04% do conteúdo protéico, alem de vários aminoácidos essenciais (treonina, metionina, isoleucina e leucina. Com relação a cor, os pães com Spirulina apresentaram redução de luminosidade com o aumento de adição de microalga, sendo também observada tendência de aumento de tonalidade verde. Na avaliação sensorial, não se verificou diferença significativa quanto a preferência entre os pães adicionados com 3% e 5% de Spirulina na formulação.With the objective of offering a product for people with celiac disease, due to their gluten intolerance, gluten-free bread made with rice flour was elaborated, in substitution of the wheat flour. To increase the protein content of the bread, dried Spirulina platensis, a microalga, was added to the products in the range from 2 to 5% (flour basis. The bread samples were evaluated according to their specific volume (V/W, crumb hardness, measured with a texturometer, and the crumb color. It was shown that the specific volume and crumb hardness were not affected by the addition of up to 4% of alga, but a decrease of 22% in the

  17. The food-gut human axis: the effects of diet on gut microbiota and metabolome.

    De Angelis, Maria; Garruti, Gabriella; Minervini, Fabio; Bonfrate, Leonilde; Portincasa, Piero; Gobbetti, Marco

    2017-04-27

    Gut microbiota, the largest symbiont community hosted in human organism, is emerging as a pivotal player in the relationship between dietary habits and health. Oral and, especially, intestinal microbes metabolize dietary components, affecting human health by producing harmful or beneficial metabolites, which are involved in the incidence and progression of several intestinal related and non-related diseases. Habitual diet (Western, Agrarian and Mediterranean omnivore diets, vegetarian, vegan and gluten-free diets) drives the composition of the gut microbiota and metabolome. Within the dietary components, polymers (mainly fibers, proteins, fat and polyphenols) that are not hydrolyzed by human enzymes seem to be the main leads of the metabolic pathways of gut microbiota, which in turn directly influences the human metabolome. Specific relationships between diet and microbes, microbes and metabolites, microbes and immune functions and microbes and/or their metabolites and some human diseases are being established. Dietary treatments with fibers are the most effective to benefit the metabolome profile, by improving the synthesis of short chain fatty acids and decreasing the level of molecules, such as p-cresyl sulfate, indoxyl sulfate and trimethylamine N-oxide, involved in disease state. Based on the axis diet-microbiota-health, this review aims at describing the most recent knowledge oriented towards a profitable use of diet to provide benefits to human health, both directly and indirectly, through the activity of gut microbiota. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  18. Double-Blind Randomized Clinical Trial: Gluten versus Placebo Rechallenge in Patients with Lymphocytic Enteritis and Suspected Celiac Disease.

    Mercè Rosinach

    Full Text Available The role of gluten as a trigger of symptoms in non-coeliac gluten sensitivity has been questioned.To demonstrate that gluten is the trigger of symptoms in a subgroup of patients fulfilling the diagnostic criteria for non-coeliac gluten sensitivity (NCGS, which presented with lymphocytic enteritis, positive celiac genetics and negative celiac serology.Double-blind randomized clinical trial of gluten vs placebo rechallenge.>18 years of age, HLA-DQ2/8+, negative coeliac serology and gluten-dependent lymphocytic enteritis, and GI symptoms, with clinical and histological remission at inclusion. Eighteen patients were randomised: 11 gluten (20 g/day and 7 placebo. Clinical symptoms, quality of life (GIQLI, and presence of gamma/delta+ cells and transglutaminase deposits were evaluated.91% of patients had clinical relapse during gluten challenge versus 28.5% after placebo (p = 0.01. Clinical scores and GIQLI worsened after gluten but not after placebo (p<0.01. The presence of coeliac tissue markers at baseline biopsy on a gluten-free diet allowed classifying 9 out of the 18 (50% patients as having probable 'coeliac lite' disease.This proof-of-concept study indicates that gluten is the trigger of symptoms in a subgroup of patients fulfilling the diagnostic criteria for NCGS. They were characterized by positive celiac genetics, lymphocytic enteritis, and clinical and histological remission after a gluten-free diet.ClinicalTrials.gov NCT02472704.

  19. Type 1 diabetes mellitus, coeliac disease, and lymphoma: a report of four cases.

    O'Connor, T M

    2012-02-03

    INTRODUCTION: Patients with Type 1 diabetes mellitus have a high prevalence of coeliac disease, symptoms of which are often mild, atypical, or absent. Untreated coeliac disease is associated with an increased risk of malignancy, particularly of lymphoma. We describe four patients with Type 1 diabetes mellitus and coeliac disease who developed lymphoma. CASE REPORTS: Two patients were male and two female. In three patients, coeliac disease and lymphoma were diagnosed simultaneously. Enteropathy-associated T cell lymphoma occurred in two patients, Hodgkin\\'s disease in one, and B cell lymphoma in one. Response to treatment was in general poor, and three patients died soon after the diagnosis of lymphoma was made. CONCLUSION: As the relative risk of lymphoma is reduced by a gluten-free diet, a high index of suspicion for coeliac disease should exist in all Type 1 diabetic patients with unexplained constitutional or gastrointestinal symptoms.

  20. Effects of hemp (Cannabis sativa L.) seed oil press-cake and decaffeinated green tea leaves (Camellia sinensis) on functional characteristics of gluten-free crackers.

    Radočaj, Olga; Dimić, Etelka; Tsao, Rong

    2014-03-01

    A mixture, simplex centroid, 2 components experimental design was used to evaluate the addition of hemp seed oil press-cake and decaffeinated green tea leaves, as functional ingredients to assess nutritional characteristics and antioxidant properties of gluten-free crackers. All samples with added hemp flour had much better nutritional qualities than the brown rice flour crackers in terms of higher protein, crude fibers, minerals, and essential fatty acids content. Likewise, all samples with added decaffeinated green tea leaves had much better antioxidant properties than crackers with no added green tea leaves. All crackers with added hemp flour had a significantly increased fiber content (39% to 249%) and decreased carbohydrate content (8.4% to 42.3%), compared to the brown rice flour crackers. All samples had antioxidant properties, even without the addition of green tea leaves. Optimization of the responses was conducted based on the maximized values for protein, fibers, omega-3 fatty acids content, as well as for the antioxidant activity and overall score. The suggested values for the addition of the hemp oil press-cake was 20% (total flour weight) with 4 g of decaffeinated green tea leaves that would provide protein content of 14.1 g/100 g; fibers content of 8.4 g/100 g; omega-3 fatty acids content of 3.2 g/100 g; antioxidant activity measured via 2,2-diphenyl-1-picrylhydrazyl value of 30.3 μmol TE/g d.w.; and an overall score of 8.9. This formulation has demonstrated potential application in the baking industry and marketing of these gluten-free crackers as a value-added functional product. Hemp seed oil press-cake as a by-product of cold-pressed oil processing and brown rice flour were used to design a functional gluten-free snack-type product-savory crackers. All crackers were high in minerals, fibers, and omega-3 fatty acids with a desirable omega-6/omega-3 fatty acids ratio. Green tea leaves were added to improve antioxidant activity, which greatly

  1. Living with coeliac disease: a grounded theory study.

    Rose, C; Howard, R

    2014-02-01

    Coeliac disease can be controlled only through adherence to a gluten-free diet. This diet is highly restrictive and can be challenging to maintain. It has been linked with elevated levels of psychological distress, including depression, anxiety and social phobia. Narratives on living with coeliac disease were written by 130 adult members of Coeliac UK (mean age 52.7 years; mean time since diagnosis 10.2 years; 67% sample female; 28% male). Qualitative analysis using grounded theory methods identified five key categories: living with widespread ignorance; social invisibility; creating a coeliac community; a changed identity; grief - and accepting the trade-off. A psychosocial model of living with coeliac disease was constructed from the findings, the central category of which was the changed identity of those diagnosed with the condition. Grief was experienced in relation to a loss of the former diet, changed personal and social identities, loss of social confidence and loss of social activities. Grief was generally mitigated over time as adjustments were made to changes in identity and lifestyle. Creating (or becoming part of) a coeliac community was a strategy enabling those with coeliac disease to re-establish their identities and increase social recognition and acceptance of the condition. Gluten-free living entails a substantial restriction of food choice. The losses and changes entailed impact on the personal and social identities of those living with coeliac disease, and on the behaviour of others towards them. Psychosocial interventions focussed on facilitating coping and adjustment may benefit those experiencing difficulties. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  2. Food that makes you different: the stigma experienced by adolescents with celiac disease.

    Olsson, Cecilia; Lyon, Phil; Hörnell, Agneta; Ivarsson, Anneli; Sydner, Ylva Mattsson

    2009-07-01

    For adolescents with celiac disease (CD), a gluten-free diet (GFD) is crucial for health, but compliance is problematic and noncompliance is common even among those aware of the risks. To better understand their lives with the disease, Swedish CD adolescents were invited to take part in focus group discussions. Data were analyzed for recurrent stigma-related themes across the groups. Adolescents described an awareness of being different from others that was produced by meal appearance and the poor availability of gluten-free food. The GFD often required discussions and special requests, so eating in public had the effect of making an invisible condition visible, and thereby creating a context for felt or enacted stigma. Maintaining invisibility avoided negative consequences of stigma, and other strategies were used to reduce the costs of visibility. The results of the study show that the GFD can produce stigma experiences in adolescence, and that dietary compliance (or lack thereof) can be understood in terms of dealing with GFD concealment and disclosure.

  3. Celiac disease causing severe osteomalacia: an association still present in Morocco!

    Tahiri, Latifa; Azzouzi, Hamida; Squalli, Ghita; Abourazzak, Fatimazahra; Harzy, Taoufik

    2014-01-01

    Celiac disease (CD), a malabsorption syndrome caused by hypersensitivity to gliadin fraction of gluten. CD can manifest with classic symptoms; however, significant myopathy and multiple fractures are rarely the predominant presentation of untreated celiac disease. Osteomalacia complicating celiac disease had become more and more rare. We describe here a case of osteomalacia secondary to a longstanding untreated celiac disease. This patient complained about progressive bone and muscular pain, weakness, fractures and skeletal deformities. Radiological and laboratory findings were all in favor of severe osteomalacia. Improvement of patient's weakness and laboratory abnormalities was obvious after treatment with gluten free diet, vitamin D, calcium and iron. This case affirms that chronic untreated celiac disease, can lead to an important bone loss and irreversible complications like skeletal deformities.

  4. Rationale for Using Social Media to Collect Patient-Reported Outcomes in Patients with Celiac Disease.

    Park, Kt; Harris, Merissa; Khavari, Nasim; Khosla, Chaitan

    2014-02-01

    Patients with celiac disease (CD) are increasingly interconnected through social media, exchanging patient experiences and health-tracking information between individuals through various web-based platforms. Social media represents potentially unique communication interface between gastroenterologists and active social media users - especially young adults and adolescents with celiac disease-regarding adherence to the strict gluten-free diet, gastrointestinal symptoms, and meaningful discussion about disease management. Yet, various social media platforms may be underutilized for research purposes to collect patient-reported outcomes data. In this commentary, we summarize the scientific rationale and potential for future growth of social media in patient-reported outcomes research, focusing on college freshmen with celiac disease as a case study and provide overview of the methodological approach. Finally, we discuss how social media may impact patient care in the future through increasing mobile technology use.

  5. Osteoarticular manifestations of celiac disease and non-celiac gluten hypersensitivity.

    Dos Santos, Stéphanie; Lioté, Frédéric

    2017-05-01

    Celiac disease is a chronic inflammatory autoimmune enteropathy based disorder that is triggered by the ingestion of gluten in genetically susceptible individuals. The global prevalence of 1% to 2% represents only the tip of the iceberg. The diagnosis is confirmed by positive specific antibody, anti-transglutaminase or anti-endomysium, specific lesions of the small intestine and a response to strict gluten-free diet. The diagnosis is difficult and often delayed because the clinical variability is very large, ranging from digestive clinical presentation "classic" to "atypical" symptoms, often extra-intestinal, that are sometimes attributed to a concomitant disease or a complication. Among them, there are frequent musculoskeletal manifestations such as osteoporosis and osteomalacia. In the absence of risk factor, osteoporosis, in a premenopausal women or in a man less than 55 years, more is if it is severe and refractory to medications, need to rheumatologists on the track of celiac disease in the absence of digestive symptoms. Osteomalacia is related to secondary hypovitaminosis D malabsorption. Supplementation by calcifediol, water-soluble vitamin D, may be indicated. Celiac disease is associated with an autoimmune disease in almost 1/3 of the cases. Knowing these potential associations allows earlier diagnosis in patients whose only manifestation, a concomitant disease. Anemia, chronic fatigue or unexplained polyarthralgia are symptoms associated with celiac disease to look for specific antibodies. The aim of early diagnosis is to prevent the emergence of other systemic disorders and avoid complications such as bone fractures and cancer, especially intestinal lymphoma. Non-celiac gluten intolerance is a new entity defined by symptomatology similar to that of celiac disease induced by the ingestion of gluten and disappearing after crowding-out, among patients without specific antibodies and without intestinal lesion of celiac disease. This entity is a cause, at

  6. Models for Correlating the Composition of the Gut Microbiota with Inflammatory Disease Parameters Using Animal Models

    Krych, Lukasz

    own study, to be directly linked with the host’s health/disease status. In the same manuscript we also demonstrated an alternative method of constructing DNA standards for uncultivable bacteria by cloning 16S rRNA gene into a competent E.coli strai. A sizeable part of this thesis was devoted....... In the last two manuscripts presented here we have inspected ways of introducing dysbiosis using antibiotic treatment and diet, to subsequently evaluate potential impacts on the immune system and diabetes development. Treatment of NOD mice with vancomycin during infancy and adulthood resulted in dramatic...... changes in relative distribution of bacterial taxa in both groups, with the dominance of A. muciniphila to up to 90%. However, only neonatally treated mice had a significantly lower cumulative diabetes incidence.We also tested how a gluten-free diet, known to protect against T1D, modulated the bacterial...

  7. The mediterranean diet model in inflammatory rheumatic diseases

    P. Spinella; F. Oliviero; C. Sales

    2011-01-01

    The Mediterranean diet is based on a pattern of eating that’s closely tied to the Mediterranean region, which includes Greece and southern Italy. Essentially, the traditional diet emphasizes foods from plant sources, limited meat consumption, small amounts of wine and olive oil as the main fat source. The beneficial effects of the Mediterranean diet has been proven not only to cardiovascular diseases but also for diabetes, obesity, arthritis and cancer. Its anti-inflammatory and protective pr...

  8. The Mediterranean diet, its components, and cardiovascular disease.

    Widmer, R Jay; Flammer, Andreas J; Lerman, Lilach O; Lerman, Amir

    2015-03-01

    One of the best-studied diets for cardiovascular health is the Mediterranean diet. This consists of fish, monounsaturated fats from olive oil, fruits, vegetables, whole grains, legumes/nuts, and moderate alcohol consumption. The Mediterranean diet has been shown to reduce the burden, or even prevent the development, of cardiovascular disease, breast cancer, depression, colorectal cancer, diabetes, obesity, asthma, erectile dysfunction, and cognitive decline. This diet is also known to improve surrogates of cardiovascular disease, such as waist-to-hip ratio, lipids, and markers of inflammation, as well as primary cardiovascular disease outcomes such as death and events in both observational and randomized controlled trial data. These enhancements easily rival those seen with more established tools used to fight cardiovascular disease such as aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, and exercise. However, it is unclear if the Mediterranean diet offers cardiovascular disease benefit from its individual constituents or in aggregate. Furthermore, the potential benefit of the Mediterranean diet or its components is not yet validated by concrete cardiovascular disease endpoints in randomized trials or observational studies. This review will focus on the effects of the whole and parts of the Mediterranean diet with regard to both population-based and experimental data highlighting cardiovascular disease morbidity or mortality and cardiovascular disease surrogates when hard outcomes are not available. Our synthesis will highlight the potential for the Mediterranean diet to act as a key player in cardiovascular disease prevention, and attempt to identify certain aspects of the diet that are particularly beneficial for cardioprotection. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Shwachman-Diamond syndrome with autoimmune-like liver disease and enteropathy mimicking celiac disease.

    Veropalumbo, Claudio; Campanozzi, Angelo; De Gregorio, Fabiola; Correra, Antonio; Raia, Valeria; Vajro, Pietro

    2015-02-01

    Liver abnormalities that normalize during infancy as well an enteropathy are reported in Shwachman-Diamond syndrome (SDS). The pathogenesis of both conditions is unknown. We report two SDS cases with autoimmune-like (antismooth muscle and/or antinuclear antibody positivity) liver disease and antigliadin antibody positive inflammatory enteropathy. Hypertransaminasemia did not resolve after immunosuppressive therapy and/or a gluten-free diet. These transient autoimmune phenomena and gut-liver axis perturbations may have played a role in transient SDS hepatopathy and enteropathy. Our report may stimulate other studies to define the relationship between the SDS genetic defect and intestinal permeability as the pathogenic mechanism underlying SDS related liver and intestinal inflammation. Copyright © 2014. Published by Elsevier Masson SAS.

  10. Reduced Bone Mineral Density in Children With Screening-detected Celiac Disease.

    Björck, Sara; Brundin, Charlotte; Karlsson, Magnus; Agardh, Daniel

    2017-11-01

    The aim of the study was to assess whether bone mass and metabolism are impaired in genetically at-risk children with screening-detected celiac disease. Included were 71 children with screening-detected celiac disease diagnosed at 10.0 ± 0.7 (mean ± standard deviation) years and 142 matched controls and 30 children with screening-detected celiac disease diagnosed at 3.3 ± 0.4 years of age presently on a gluten-free diet for 6.9 ± 1.1 years and 60 matched controls. All participants were assessed for bone mineral density (BMD) of total body and spine by dual x-ray absorptiometry, serum 25(OH) vitamin D3, parathyroid hormone (PTH), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-15, interferon gamma, and tumor necrosis factor alpha. At diagnosis, screening-detected celiac disease children as compared to controls had a mean -0.03 g/cm reduced BMD of both total body and spine (P = 0.009 and P = 0.005, respectively), a mean -11.4 nmol/L lower level of 25(OH) vitamin D3 (P celiac disease as compared to controls (P celiac disease have reduced BMD, lower levels of vitamin D3, higher levels of PTH, and signs of systemic inflammation compared with controls. These differences were not found in celiac disease children on a gluten-free diet, indicating that children with screening-detected celiac disease benefit from an early diagnosis and treatment.

  11. A rare association of celiac disease and aplastic anemia: case report of a child and review of literature.

    Badyal, Rama Kumari; Sachdeva, Man Updesh Singh; Varma, Neelam; Thapa, Babu Ram

    2014-01-01

    An association between severe aplastic anemia and other autoimmune diseases is rare and has been described in adults for eosinophilic fasciitis, thymomas, systemic lupus erythematosus, and thyroid disorders. Herein we report a patient with celiac disease who was not strictly following a gluten-free diet and presented with progressive pallor, fever, and weakness of 1 month's duration. On investigation, he had pancytopenia, which on subsequent evaluation revealed aplastic anemia. An association between aplastic anemia and celiac disease has rarely been reported. To the best of author's knowledge, only 1 pediatric case of celiac disease associated with aplastic anemia has been published. This is the second report to suggest such an association in children.

  12. Unexplained infertility as primary presentation of celiac disease, a case report and literature review

    Mohammadreza Ghadir

    2011-01-01

    Full Text Available Background: Celiac sprue (gluten sensitive enteropathy is an autoimmune disease which is hereditary and its pathology mainly bases on immunologic intolerance to gluten. It has a vast variety of signs and symptoms and its clinical features range from a silent disease to a typical gastrointestinal disorder. In this study we reviewed and summarized some other related issues about this disease and its relation with infertility.Case: The case is a 26 years old lady who had referred to a gynecologist because of infertility for 2 years and later it revealed that she has celiac sprue.Conclusion: Screening for its silent or subtle types especially among suspicious cases such as unexplained infertility seems to be a cost effective action. Meanwhile, in time administration of a gluten-free diet can lead to an almost complete cure

  13. Is gluten a cause of gastrointestinal symptoms in people without celiac disease?

    Biesiekierski, Jessica R; Muir, Jane G; Gibson, Peter R

    2013-12-01

    The avoidance of wheat- and gluten-containing products is a worldwide phenomenon. While celiac disease is a well-established entity, the evidence base for gluten as a trigger of symptoms in patients without celiac disease (so-called 'non-celiac gluten sensitivity' or NCGS) is limited. The problems lie in the complexity of wheat and the ability of its carbohydrate as well as protein components to trigger gastrointestinal symptoms, the potentially false assumption that response to a gluten-free diet equates to an effect of gluten withdrawal, and diagnostic criteria for coeliac disease. Recent randomized controlled re-challenge trials have suggested that gluten may worsen gastrointestinal symptoms, but failed to confirm patients with self-perceived NCGS have specific gluten sensitivity. Furthermore, mechanisms by which gluten triggers symptoms have yet to be identified. This review discusses the most recent scientific evidence and our current understanding of NCGS.

  14. Non-celiac gluten sensitivity: people without celiac disease avoiding gluten-is it due to histamine intolerance?

    Schnedl, Wolfgang J; Lackner, Sonja; Enko, Dietmar; Schenk, Michael; Mangge, Harald; Holasek, Sandra J

    2018-04-01

    Food intolerance/malabsorption is caused by food ingredients, carbohydrates (mainly lactose and fructose), proteins (gluten), and biogenic amines (histamine) which cause nonspecific gastrointestinal and extra-intestinal symptoms. Here we focus on possible etiologic factors of intolerance/malabsorption especially in people with non-celiac gluten sensitivity (NCGS) or the so-called people without celiac disease avoiding gluten (PWCDAG) and histamine intolerance. Recognizing the recently described symptoms of NCGS (PWCDAG) we review correlations and parallels to histamine intolerance (HIT). We show that intestinal and extra-intestinal NCGS (PWCDAG) symptoms are very similar to those which can be found in histamine intolerance. After a detailed diagnostic workup for all possible etiologic factors in every patient, a targeted dietary intervention for single or possibly combined intolerance/malabsorption might be more effective than a short-term diet low in fermentable oligo-, di- and monosaccharides and polyols (FODMAP) or the untargeted uncritical use of gluten-free diets.

  15. Mixture Design Applied to the Development of Chickpea-Based Gluten-Free Bread with Attractive Technological, Sensory, and Nutritional Quality.

    Santos, Fernanda G; Fratelli, Camilly; Muniz, Denise G; Capriles, Vanessa D

    2018-01-01

    The aim of the study was utilized chickpea to create appealing, nutritious, and palatable gluten-free bread (GFB). The performance of chickpea flour (CF) in single and composite GFB formulations was studied with a mixture design and response surface methodology. Six simplex-centroid designs for 3 ingredients were used to identify the ideal proportions of CF in various blends with cassava starch (CS), maize starch (MS), potato starch (PS), and rice flour (RF) achieving the best physical properties. For each design, 3 single, 3 binary, and 3 ternary formulations were prepared. The results showed that CF alone is suitable for bread production, resulting in GFB with higher volume and crumb firmness and lower crumb moisture than single formulations of other raw materials. However, the interactions between CF and PS or CS enhanced the loaf volume and decreased the crumb firmness values. The GFB prepared with only CF was accepted (overall acceptability score of 7.1- on a 10-cm scale). Nevertheless, the composite formulations prepared with CF75:PS25 or CF75:CS25 (flour basis) received overall acceptability scores of 8.2, like those of their white GFB, prepared with RF50:PS50 blend (flour basis), and wheat bread counterparts, used as positive controls. Compared to white GFB, both composite formulations presented nearly a twofold increase in ash and protein contents and a threefold increase in total fiber content. These results show that blends of CF75:PS25 or CF75:CS25 can be used to develop GFB with a good physical and sensory properties, as well as an enhanced nutritional composition. Gluten-free bread (GFB) made with 75% chickpea flour (CF) blend with 25% potato or cassava starch showed improved total minerals, protein and dietary fiber content and bread quality characteristics. Therefore, CF is a valuable ingredient for food technologists in manufacturing better-tasting and healthy GFB, which is important for consumers with gluten-related disorders since GFB often lack

  16. [Role of Mediterranean diet on the prevention of Alzheimer disease].

    Miranda, Arnoldo; Gómez-Gaete, Carolina; Mennickent, Sigrid

    2017-04-01

    Type 2 diabetes and obesity are possible risk factors for Alzheimer’s disease and these can be modified by physical activity and changes in dietary patterns, such as switching to a Mediterranean diet. This diet includes fruits, vegetables, olive oil, fish and moderate wine intake. These foods provide vitamins, polyphenols and unsaturated fatty acids. This diet should be able to reduce oxidative stress. The inflammatory response is also reduced by unsaturated fatty acids, resulting in a lower expression and a lower production of pro-inflammatory cytokines. The Cardiovascular protection is related to the actions of polyphenols and unsaturated fatty acids on the vascular endothelium. The Mediterranean diet also can improve cardiovascular risk factors such as dyslipidemia, hypertension and metabolic syndrome. These beneficial effects of the Mediterranean diet should have a role in Alzheimer’s disease prevention.

  17. Is the diet important for psoriasis?

    Agnieszka Owczarczyk-Saczonek

    2014-09-01

    Full Text Available Psoriasis is a systemic disease, associated with the occurrence of metabolic disorders (obesity, diabetes, hyperuricemia, lipid disorders and rapid development of atherosclerosis; therefore diet can be an important adjuvant therapy. A low-calorie diet is an important complement treatment of patients with psoriasis, particularly those with concomitant obesity. There are a lot of studies indicating that obesity is a risk factor for psoriasis and vice versa. Visceral adipose tissue produces numerous proinflammatory cytokines (TNF-α, IL-6, Il-8, Il-17, Il-18, the same ones that participate in development of psoriatic lesions. Important factors in the diet are the essential polyunsaturated omega-3 fatty acids. They have an anti-inflammatory effect because they inhibit the production of proinflammatory cytokines (I-1b, IL-6, IL-8, TNF-α and adhesion molecules (ICAM-1, VCAM-1. In addition, supplementation of omega-3 and natural antioxidants in the diet may help to reduce "oxidative stress" and systemic inflammation. The use of a gluten-free diet is controversial, but in patients with positive anti gliadin antibodies it seems justified. An essential element of the procedure is to avoid alcohol and all its forms and stimulants that have pro-inflammatory effects. We should advise our patients to avoid grapefruit juice during treatment with cyclosporine and limit the supply of simple sugars, animal fats and alcohol during treatment with retinoids. Dietary recommendations for patients with psoriasis are an important part of a holistic approach to patients who expect comprehensive care, not just the prescription.

  18. Celiac Disease Diet: How Do I Get Enough Grains?

    Celiac disease diet: How do I get enough grains? I have celiac disease, and I find it difficult to get enough ... Michael F. Picco, M.D. Because people with celiac disease must avoid gluten — a protein found in foods ...

  19. Diet, nutrition and the prevention of hypertension and cardiovascular diseases

    Reddy, K.S.; Katan, M.B.

    2004-01-01

    Cardiovascular diseases (CVD) are growing contributors to global disease burdens, with epidemics of CVD advancing across many regions of the world which are experiencing a rapid health transition. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases

  20. Symptoms and biomarkers associated with celiac disease: evaluation of a population-based screening program in adults.

    Kårhus, Line L; Thuesen, Betina H; Rumessen, Jüri J; Linneberg, Allan

    2016-11-01

    To identify possible early predictors (symptoms and biomarkers) of celiac disease, compare symptoms before and after screening, and evaluate the diagnostic efficacy of serologic screening for celiac disease in an adult Danish population. This cross-sectional population-based study was based on the 5-year follow-up of the Health2006 cohort, where 2297 individuals were screened for celiac disease; 56 were antibody positive and thus invited to clinical evaluation. Eight were diagnosed with biopsy-verified celiac disease. A follow-up questionnaire was sent to antibody-positive individuals 19 months after the clinical evaluation to obtain information on their symptoms and their experience with participation in the screening. Before screening, participants subsequently diagnosed with celiac disease did not differ from the rest of the population with respect to symptoms, but had significantly lower total cholesterol. Tissue transglutaminase IgA antibodies with a cut-off of 10 U/ml had a positive predictive value of 88%. The majority of participants were satisfied with their participation in the screening program. Individuals with celiac disease were generally satisfied with having been diagnosed and 71% felt better on a gluten-free diet. There were no differences in the prevalence of symptoms between participants with and without screening-detected celiac disease, confirming that risk stratification in a general population by symptoms is difficult. The majority of participants diagnosed with celiac disease felt better on a gluten-free diet despite not reporting abdominal symptoms before diagnosis and participants in the clinical evaluation were generally satisfied with participation in the screening program.