scholarly journals 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

2018 ◽  
Vol 119 (5) ◽  
pp. 496-506 ◽  
Author(s):  
Dinka Rees ◽  
Grietje Holtrop ◽  
Gemma Chope ◽  
Kim M. Moar ◽  
Morven Cruickshank ◽  
...  
Keyword(s):  
Wheat Bread ◽  
Gluten Free ◽  
Double Blind ◽  
Low Protein ◽  
Gluten Peptides ◽  
Gi Symptoms ◽  
Haematological Profile ◽  
Habitual Diet ◽  
Wheat Products

AbstractThe 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.

scholarly journals Impact of FODMAP Content Restrictions on the Quality of Diet for Patients with Celiac Disease on a Gluten-Free Diet

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2220 ◽  
Author(s):  
Karla A. Bascuñán ◽  
Luca Elli ◽  
Nicoletta Pellegrini ◽  
Alice Scricciolo ◽  
Vincenza Lombardo ◽  
...  
Keyword(s):  
Nutritional Quality ◽  
Controlled Study ◽  
Gluten Free ◽  
Dietary Recommendations ◽  
Food Record ◽  
Double Blind ◽  
Gi Symptoms ◽  
Weighed Food Record ◽  
Nutritional Surveillance

Restrictive diets as gluten-free (GFD) or reduced in Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) are used to improve gastrointestinal (GI) symptoms in sensitive individuals. Aiming at comparing the nutritional quality and effects of a regular GFD regimen (R-GFD) and a low-FODMAP GFD (LF-GFD), in 46 celiac patients with persistent GI symptoms we conducted a randomized, double-blind intervention-controlled study. Patients received a personalized diet, either a strict GFD (n = 21) or a LF-GFD (n = 25) for 21 days. A validated food-frequency questionnaire before intervention and a 7-day weighed-food record after the intervention assessed the diets. Patients were 41.1 ± 10.1 years (mean ± SD), 94% women, with mean BMI 21.8 ± 2.9 kg/m2. On day 21, patients on R-GFD still showed poor nutritional adequacy compared to dietary recommendations, with decreased energy intake, even though an improvement in carbohydrates and folates was observed (all p < 0.025). In both groups, intake of iron, calcium, vitamin D, sodium and folates did not meet daily recommendations. As expected, consumption of legumes and grains was lower and that of fruits was higher in the LF-GFD group than in the R-GFD one (all p < 0.05). The nutritional quality of both diets was not different. When restrictive diets are useful to improve the persistent GI symptoms, careful nutritional surveillance and counseling is mandatory.

scholarly journals Efficacy of Lactobacillus paracasei HA-196 and Bifidobacterium longum R0175 in Alleviating Symptoms of Irritable Bowel Syndrome (IBS): A Randomized, Placebo-Controlled Study

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1159 ◽  
Author(s):  
Erin D. Lewis ◽  
Joseph M. Antony ◽  
David C. Crowley ◽  
Amanda Piano ◽  
Renu Bhardwaj ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Bifidobacterium Longum ◽  
Well Being ◽  
Lactobacillus Paracasei ◽  
Controlled Study ◽  
Double Blind ◽  
Gi Symptoms ◽  
Irritable Bowel

Specific probiotic strains can alleviate the gastrointestinal (GI) symptoms and psychiatric comorbidities of irritable bowel syndrome (IBS). In this randomized, double-blind, placebo-controlled study, the efficacy of Lactobacillus paracasei HA-196 (L. paracasei) and Bifidobacterium longum R0175 (B. longum) in reducing the GI and psychological symptoms of IBS was evaluated in 251 adults with either constipation (IBS-C), diarrhea (IBS-D), or mixed-pattern (IBS-M). Following a 2-week run-in period, participants were randomized to one of three interventions: L. paracasei (n = 84), B. longum (n = 83) or placebo (n = 81). IBS symptoms, stool frequency and consistency and quality of life were assessed by questionnaires. The differences from baseline in the severity of IBS symptoms at 4 and 8 weeks were similar between groups. Participants in this study were classified, after randomization, into subtypes according to Rome III. Within the L. paracasei group, complete spontaneous and spontaneous bowel movement frequency increased in participants with IBS-C (n = 10) after 8 weeks of supplementation (both p < 0.05) and decreased in participants with IBS-D (n = 10, p = 0.013). Both L. paracasei and B. longum supplementation improved the quality of life in emotional well-being and social functioning compared with baseline (all p < 0.05). In conclusion, L. paracasei and B. longum may reduce GI symptom severity and improve the psychological well-being of individuals with certain IBS subtypes.

Impact of a Gluten-Free Diet on Quality of Life and Health Perception in Patients with Type 1 Diabetes and Asymptomatic Celiac Disease

2021 ◽  
Author(s):  
Daniel I Weiman ◽  
Farid H Mahmud ◽  
Antoine B M Clarke ◽  
Esther Assor ◽  
Charlotte McDonald ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Celiac Disease ◽  
Health Perception ◽  
Lifestyle Changes ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Gi Symptoms

Abstract Context Celiac disease (CD) is a common comorbidity seen in patients with type 1 diabetes (T1D) and is frequently asymptomatic. As chronic conditions requiring significant lifestyle changes, there are limited reports assessing changes in health-related quality of life (HRQoL) during transition to a gluten-free diet (GFD) in patients with both T1D and who are asymptomatic for CD. Objective To prospectively assess HRQoL and health perception in children and adults with T1D and asymptomatic CD after randomization to GFD versus usual diet. Design, Setting, and Participants Patients with T1D aged 8-45 years without CD symptoms were serologically screened for CD, with positive results confirmed with intestinal biopsy. Participants were randomized in an open-label fashion to a GFD or gluten-containing diet (GCD) for 12 months. Generic and diabetes-specific HRQoL and self-perceived wellness (SPW) were assessed longitudinally. Results 2,387 T1D patients were serologically screened. CD was biopsy-confirmed in 82 patients and 51 participants were randomized to a GFD (N=27) or GCD (N=24). Excellent adherence to the assigned diets was observed. Overall, no changes in generic (P=0.73) or diabetes-specific HRQoL (P=0.30), or SPW (P=0.41) were observed between groups over 12 months. HemoglobinA1c (HbA1c) and GI symptoms were consistent predictors of HRQoL and SPW. Conclusions HRQoL and SPW were not significantly impacted by the adoption of a GFD over 12 months, but worsened with symptom onset and increased HbA1c. Our findings indicate that transition to a GFD can be made successfully in this population without adversely impacting quality of life.

scholarly journals New Protocol for Production of Reduced-Gluten Wheat Bread and Pasta and Clinical Effect in Patients with Irritable Bowel Syndrome: A randomised, Double-Blind, Cross-Over Study

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1873 ◽  
Author(s):  
Maria Calasso ◽  
Ruggiero Francavilla ◽  
Fernanda Cristofori ◽  
Maria De Angelis ◽  
Marco Gobbetti
Keyword(s):  
Irritable Bowel Syndrome ◽  
Controlled Trial ◽  
New Products ◽  
Depression Scale ◽  
Wheat Bread ◽  
Double Blind ◽  
Gluten Content ◽  
Traditional Bread ◽  
Irritable Bowel

It has been suggested that sourdough fermented products have beneficial health effects. Fungal proteases and selected sourdough lactic acid bacteria were used to produce wheat bread and pasta with a reduced-gluten content (<50% of traditional products). Fermentable oligo-, di- and mono- saccharides and polyols and amylase/trypsin inhibitors were also evaluated. The sensorial features of new products were similar to traditional ones. The efficacy of these new products in reducing the severity of symptoms in Irritable Bowel Syndrome (IBS) patients were compared to traditional bread and pasta using a randomized, crossover-controlled trial. While on a strict gluten-free diet, patients were randomized to consume a reduced- or normal-gluten diet for 2weeks; then, patients from both arms started the wash-out period of one week, and subsequently started the final 2-week period on a normal or reduced-gluten diet. Compared to normal-gluten content, the administration of a reduced-gluten content diet resulted in a decrease of the Visual Analogue Scale score (p = 0.042), while no differences were found in the IBS-Severity Score, Hospital Anxiety and Depression Scale, and IBS-Quality of Life. Data herein reported are novel encouraging findings that should spur a new avenue of research aiming to develop products specifically designed for IBS patients.

scholarly journals A193 GLUTEN-FREE DIET IMPROVES DYSPEPSIA-LIKE SYMPTOMS IN A PILOT STUDY OF PATIENTS WITH TYPE 1 DIABETES MELLITUS

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 64-65
Author(s):  
P M Miranda ◽  
G H Rueda ◽  
N Calo ◽  
C Seiler ◽  
Z Punthakee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Celiac Disease ◽  
Anxiety And Depression ◽  
Gluten Free ◽  
Upper Gi ◽  
Gi Symptoms ◽  
General Quality ◽  
Anxiety Levels

Abstract Background Patients with type 1 Diabetes Mellitus (T1DM) often suffer with gastrointestinal (GI) symptoms, such as abdominal pain, bloating, early satiety, nausea and vomiting. T1DM patients are at a higher risk to develop celiac disease, and those patient with both disorders benefit from a gluten-free diet (GFD). However, it is unknown whether GFD has any benefit in patients with T1DM without celiac disease who present with upper GI symptoms. Aims To investigate the role of GFD in the management of moderate to severe dyspeptic symptoms in non-celiac patients with T1DM. Methods We enrolled adult T1DM patients, in whom celiac disease was ruled out by serology and/or endoscopy, suffering with two or more of upper GI symptoms. The patients were instructed to undergo a strict GFD for a period of 1 month, under supervision of a dietitian. Glycemic levels were monitored by a continuous glucose monitoring device (CGM) for 2 weeks before, and for 2 weeks at the end of the GFD period. Upper GI symptoms, general quality of life, anxiety and depression were assessed using standardized questionnaires. Blood samples were collected to assess glycaemia (Hb1Ac) and lipid profiles. Scintigraphy and videofluoroscopy were used to assess gastric emptying. Results Seven patients finished the study so far. They reported a significant improvement in nausea (p&lt;0.05), sensation of fullness (p&lt;0.01), bloating (p&lt;0.01), feeling of excessive fullness after meals (p&lt;0.01) and having stomach visibly larger after meals (p&lt;0.01). 5 out of the 7 patients reported an improvement in general quality of life, based on PAGI-QOL (Patient Assessment of Upper Gastrointestinal Disorders – Quality of Life), and decreased anxiety levels (HADS, Hospital Anxiety and Depression Score). There was no significant change in mean glucose level, time in target, glucose variance and HbA1c levels after GFD. However, there was a trend for less time spent in hypoglycemia, namely in those patients who experienced frequent hypoglycemia prior to GFD. Overall, there was no change in serum lipid profile or gastric emptying. Conclusions One month of GFD improved dyspepsia-like symptoms, general quality of life and anxiety levels in T1D patients without concomitant celiac disease. GFD also improved the blood glucose management of patients with frequent hypoglycemia. Thus, this dietary intervention appears to improve upper GI symptoms in T1D patients but the results need to be replicated in a larger patient cohort. Funding Agencies CIHR

scholarly journals Selected Probiotic Lactobacilli Have the Capacity To Hydrolyze Gluten Peptides during Simulated Gastrointestinal Digestion

2017 ◽  
Vol 83 (14) ◽  
Author(s):  
Ruggiero Francavilla ◽  
Maria De Angelis ◽  
Carlo Giuseppe Rizzello ◽  
Noemi Cavallo ◽  
Fabio Dal Bello ◽  
...  
Keyword(s):  
Interleukin 2 ◽  
Wheat Bread ◽  
Peptidase Activity ◽  
Gluten Free ◽  
Gastrointestinal Digestion ◽  
Simulated Gastrointestinal Digestion ◽  
Gluten Peptides ◽  
Immunogenic Peptides ◽  
Gliadin Peptide ◽  
Probiotic Lactobacilli

ABSTRACT The aim of this study was to demonstrate the capacity of probiotic lactobacilli to hydrolyze immunogenic gluten peptides. Eighteen commercial strains of probiotic lactobacilli with highly variable peptidase activity (i.e., aminopeptidase N, iminopeptidase, prolyl endopeptidyl peptidase, tripeptidase, prolidase, prolinase, and dipeptidase), including toward Pro-rich peptides, were tested in this study. Ten probiotic strains were selected on the basis of their specific enzyme activity. When pooled, these 10 strains provided the peptidase portfolio that is required to completely degrade the immunogenic gluten peptides involved in celiac disease (CD). The selected probiotic mixture was able to completely hydrolyze well-known immunogenic epitopes, including the gliadin 33-mer peptide, the peptide spanning residues 57 to 68 of the α9-gliadin (α9-gliadin peptide 57-68), A-gliadin peptide 62-75, and γ-gliadin peptide 62-75. During digestion under simulated gastrointestinal conditions, the pool of 10 selected probiotic lactobacilli strongly hydrolyzed the wheat bread gluten (ca. 18,000 ppm) to less than 10 ppm after 360 min of treatment. As determined by multidimensional chromatography (MDLC) coupled to nanoelectrospray ionization (nano-ESI)-tandem mass spectrometry (MS/MS), no known immunogenic peptides were detected in wheat bread that was digested in the presence of the probiotics. Accordingly, the level of cytokines (interleukin 2 [IL-2], IL-10, and interferon gamma [IFN-γ]) produced by duodenal biopsy specimens from CD patients who consumed wheat bread digested by probiotics was similar to the baseline value (negative control). Probiotics that specifically hydrolyze gluten polypeptides could also be used to hydrolyze immunogenic peptides that contaminate gluten-free products. This could provide a new and safe adjunctive therapy alternative to the gluten-free diet (GFD). IMPORTANCE This study confirmed that probiotic Lactobacillus strains have different enzymatic abilities for hydrolyzing polypeptides, including the Pro-rich epitopes involved in the pathology of CD. Ten lactobacilli with complementary peptidase activities that hydrolyze gluten peptides during simulated gastrointestinal digestion were selected and tested. The results collected showed the potential of probiotic formulas as novel dietary treatments for CD patients.

scholarly journals Review On: Progress In Wheat Bread Improvement: Emphasis on Ingredient Functionality

2021 ◽  
Vol 4 (3) ◽  
pp. 01-03
Author(s):  
Gashaw Abebaw
Keyword(s):  
Food Processing ◽  
Functional Foods ◽  
Wheat Bread ◽  
Phenolic Antioxidants ◽  
Gluten Free ◽  
Appearance Quality ◽  
Amaranth Seed ◽  
Bakery Industry ◽  
Chestnut Flour

Bread is one of the oldest functional foods which its health effects have been investigated in many studies. The current communication presents a review of the in recent years on the topic and looks at possible future trends in the improved nutritional and health qualities which have been applied in the bakery industry, directing it further to the formulation design and production of functional pieces of bread. The results show that many beneficial ingredients such as dietary fibers, phenolic antioxidants, marine ingredients, and n-3 fatty acids can be used in the bread industry to increase its functionality and result in healthy products, low in calories, cholesterol, and celiac disease. Moreover, the use of psyllium seed, amaranth seed, chestnut flour, and prebiotics in gluten-free bread (GFB) baking may be the promising frontier to improve the overall appearance, quality, sensory properties, and shelf-life of gluten-free bread. To improve the quality of life of these patients from a dietary standpoint, food-processing researchers have been seeking to develop high-quality gluten-free bread. As the quality of wheat pieces of bread depends largely on the viscoelastic properties of gluten, various ingredients have been employed to simulate its effects, such as hydrocolloids, transglutaminase, and proteases.

Aerobic Exercise Training in Stroke Rehabilitation: Any Gap in Knowledge

2015 ◽  
Author(s):  
Tal-hatu Kolapo Hamzat ◽  
Nelson Echezona Ekechukwu
Keyword(s):  
Aerobic Exercise ◽  
Methodological Quality ◽  
Interval Training ◽  
Aerobic Exercise Training ◽  
Stroke Survivors ◽  
Secondary Complications ◽  
Stroke Outcomes ◽  
Haematological Profile ◽  
Cardio Respiratory Fitness

Background: Most stroke survivors live with residual physical impairments that may promote a sedentary lifestyle and resultant secondary complications, especially poor cardio-respiratory fitness. This systematic review was conceived to examine the extent of research on the effect of aerobic exercise on health outcomes of stroke survivors as a prelude to a clinical trial.Method: Electronic databases were searched with the last search performed in May, 2014. The methodological quality of studies was assessed using the PEDro scale. High-quality randomized controlled trials (RCTs) were considered level 1 evidence while lower-quality RCTs were considered level 2 evidence. Result: A total of 642 articles were generated from the search strategy; 10 articles fulfilled all criteria and were selected for this review. 50% of these studies recruited stroke survivors with ischaemic type of stroke while 30% had individuals with either ischaemic or haemorrhagic types. 70% of the studies had good scores while 30% had fair scores in methodological quality. The majority of the studies used VO2max as the outcome for assessing aerobic fitness; a few studies (10% each) assessed anthropometric outcomes and biochemical profile. No study assessed a haematological profile nor compared the effects of continuous and interval aerobic exercise on stroke outcomes. Conclusion: A gap in clinical trials on the effects of aerobic exercise on biochemical, haematological and anthropometric profiles of stroke survivors exists as well as in the comparative effects of continuous and interval training on stroke outcomes.

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