scholarly journals A Review on the Gluten-Free Diet: Technological and Nutritional Challenges

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1410 ◽  
Author(s):  
Dalia El Khoury ◽  
Skye Balfour-Ducharme ◽  
Iris J. Joye
Keyword(s):  
Food Industry ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Limited Evidence ◽  
Free Products ◽  
Sensory Effects ◽  
Product Manufacturing ◽  
Processing Techniques ◽  
Health Experts

Consumers, food manufacturers and health professionals are uniquely influenced by the growing popularity of the gluten-free diet. Consumer expectations have urged the food industry to continuously adjust and improve the formulations and processing techniques used in gluten-free product manufacturing. Health experts have been interested in the nutritional adequacy of the diet, as well as its effectiveness in managing gluten-related disorders and other conditions. In this review, we aim to provide a clear picture of the current motivations behind the use of gluten-free diets, as well as the technological and nutritional challenges of the diet as a whole. Alternative starches and flours, hydrocolloids, and fiber sources were found to play a complex role in mimicking the functional and sensory effects of gluten in gluten-free products. However, the quality of gluten-free alternatives is often still inferior to the gluten-containing products. Furthermore, the gluten-free diet has demonstrated benefits in managing some gluten-related disorders, though nutritional imbalances have been reported. As there is limited evidence supporting the use of the gluten-free diet beyond its role in managing gluten-related disorders, consumers are urged to be mindful of the sensorial limitations and nutritional inadequacies of the diet despite ongoing strategies to improve them.

scholarly journals New Software for Gluten-Free Diet Evaluation and Nutritional Education

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2505 ◽  
Author(s):  
Arrate Lasa ◽  
Idoia Larretxi ◽  
Edurne Simón ◽  
Itziar Churruca ◽  
Virginia Navarro ◽  
...  
Keyword(s):  
Life Quality ◽  
Nutritional Composition ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Nutritional Education ◽  
Macronutrient Composition ◽  
Free Products ◽  
Diet Adherence ◽  
Energy And Nutrient Intake

Following a gluten-free diet (GFD) is the only treatment for celiac disease. This diet must ensure the absence of gluten but also needs to be nutritionally balanced. Dietitians working in this field cannot properly evaluate energy and nutrient intake of celiac people because dietary programs available on the market do not contain the nutritional composition of gluten-free products (GFP). Here we present a new GFD evaluation software that contains more than 700 gluten-free rendered foodstuffs and their macronutrient composition. Apart from diet evaluation and design, the software represents a tool for nutritional education as well, since it shows diet appropriacy and indicates how to promote balanced self-care. Moreover, anthropometric and biochemical data or symptoms presence and diet adherence can be recorded and evaluated. This open free software, can be downloaded in its app format for mobiles and tablets. Software evaluation indicated its correct functionality and the importance of assessing a GFD with GFP instead of with their gluten-containing analogues. Thus, this software represents an essential e-Health tool, not only for proper GFD evaluation, but also for improving life quality of celiac and gluten sensitive people.

scholarly journals Evaluation of a gluten-free sourdough bakery product

2021 ◽  
Vol 17 (S1) ◽  
pp. 37-44
Author(s):  
Anikó Kovács ◽  
Raul Kolinka ◽  
Györgyné Kóczán ◽  
Zoltán Kókai
Keyword(s):  
Moisture Content ◽  
Food Industry ◽  
Brown Rice ◽  
Gluten Free ◽  
Free Products ◽  
Rice Sample ◽  
Bakery Product ◽  
Sensory Analyses ◽  
Bakery Industry

AbstractThe population of gluten sensitive people has been gradually rising in the last decades. The food industry, especially the bakery industry has to develop more gluten-free products to satisfy the consumer's demand. However, the quality of these products differs from the quality attributes of a standard glutenious bakery product. Therefore, the aim of our research was to develop a good quality gluten-free sourdough product with 3 different gluten-free flours: millet, brown rice and a commercially available mixture (Belbake). We investigated the differences in moisture content, the baking loss, the texture and the sensory properties of the products. According to our results in the case of the moisture content the brown rice sample had the highest, while the millet gave the lowest value. The baking loss measurement gave reverse results. In the texture analysis the brown rice sample was the softest, but the millet and the Belbake had better results in resilience and in springiness. Also, in the sensory analyses the Belbake product was found to be the best by the judges, however, there were no significant differences between them. In conclusion, the product development of a gluten-free sourdough bakery product was successful. Further research is needed to investigate the shelf life of the products.

scholarly journals Challenges of Monitoring the Gluten-Free Diet Adherence in the Management and Follow-Up of Patients with Celiac Disease

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2274
Author(s):  
Herbert Wieser ◽  
Ángela Ruiz-Carnicer ◽  
Verónica Segura ◽  
Isabel Comino ◽  
Carolina Sousa
Keyword(s):  
Celiac Disease ◽  
Clinical Symptoms ◽  
Poor Quality ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Free Products ◽  
Immunogenic Peptides ◽  
Immune Mediated ◽  
Strict Diet

Celiac disease (CD) is a chronic gluten-responsive immune mediated enteropathy and is treated with a gluten-free diet (GFD). However, a strict diet for life is not easy due to the ubiquitous nature of gluten. This review aims at examining available evidence on the degree of adherence to a GFD, the methods to assess it, and the barriers to its implementation. The methods for monitoring the adherence to a GFD are comprised of a dietary questionnaire, celiac serology, or clinical symptoms; however, none of these methods generate either a direct or an accurate measure of dietary adherence. A promising advancement is the development of tests that measure gluten immunogenic peptides in stools and urine. Causes of adherence/non-adherence to a GFD are numerous and multifactorial. Inadvertent dietary non-adherence is more frequent than intentional non-adherence. Cross-contamination of gluten-free products with gluten is a major cause of inadvertent non-adherence, while the limited availability, high costs, and poor quality of certified gluten-free products are responsible for intentionally breaking a GFD. Therefore, several studies in the last decade have indicated that many patients with CD who follow a GFD still have difficulty controlling their diet and, therefore, regularly consume enough gluten to trigger symptoms and damage the small intestine.

scholarly journals Methods for the Modification and Evaluation of Cereal Proteins for the Substitution of Wheat Gluten in Dough Systems

Foods ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 118
Author(s):  
Javier Espinoza-Herrera ◽  
Luz María Martínez ◽  
Sergio O. Serna-Saldívar ◽  
Cristina Chuck-Hernández
Keyword(s):  
Viscoelastic Properties ◽  
Food Industry ◽  
Protein Modification ◽  
Wheat Gluten ◽  
Research Area ◽  
Gluten Free ◽  
Relevant Research ◽  
Free Products ◽  
Comprehensive Review

The substitution of wheat gluten in the food industry is a relevant research area because the only known treatment for celiac disease is abstinence from this protein complex. The use of gluten-free cereals in dough systems has demonstrated that the viscoelastic properties of gluten cannot be achieved without the modification of the protein fraction. The quality of the final product is determined by the ability of the modification to form a matrix similar to that of gluten and to reach this, different methods have been proposed and tested. These procedures can be classified into four main types: chemical, enzymatic, physical, and genetic. This article provides a comprehensive review of the most recent research done in protein modification of cereal and pseudocereals for gluten substitution. The reported effects and methodologies for studying the changes made with each type of modification are described; also, some opportunity areas for future works regarding the study of the effect of protein modifications on gluten-free products are presented.

scholarly journals The impact of symptoms on quality of life before and after diagnosis of coeliac disease: the results from a Polish population survey and comparison with the results from the United Kingdom

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emilia Majsiak ◽  
Magdalena Choina ◽  
Dominik Golicki ◽  
Alastair M. Gray ◽  
Bożena Cukrowska
Keyword(s):  
Quality Of Life ◽  
United Kingdom ◽  
Coeliac Disease ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
The United Kingdom ◽  
Before And After ◽  
The Mean ◽  
The Uk

Abstract Background Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients’ quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. Methods The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. Results The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p < 0.001), the EQ-Index by 0.149 (SD 0.23) and the EQ-VAS by 30.4 (SD 28.3) points. Conclusions Duration of symptoms prior to the diagnosis of CD in Poland, although shorter than in the UK, was long with an average of 7.3 years from first CD symptoms. Faster CD diagnosis after the onset of symptoms in Polish respondents may be related to a higher percentage of children in the Polish sample. Introduction of a gluten-free diet improves coeliac patients’ quality of life. These results suggest that doctors should be made more aware of CD and its symptoms across all age groups.

scholarly journals Adherence to Gluten-Free Diet in Coeliac Paediatric Patients Assessed through a Questionnaire Positively Influences Growth and Quality of Life

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3802
Author(s):  
Deianira Pedoto ◽  
Riccardo Troncone ◽  
Margherita Massitti ◽  
Luigi Greco ◽  
Renata Auricchio
Keyword(s):  
Quality Of Life ◽  
Influencing Factors ◽  
Average Length ◽  
Study Data ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Diet Adherence ◽  
School Career

Assessment of adherence to gluten-free diet (GFD) represents the cornerstone in the management of coeliac disease. The primary aim of this study was to assess diet adherence through a questionnaire adapted to children. The secondary aim was to identify influencing factors and outcomes related to diet adherence. In this study, data about diagnosis, education, quality of life (QoL) and anti-transglutaminase (anti-TG2) titers of 160 coeliac children were collected. For the assessment of diet adherence, all participants completed the questionnaire modified from Leffler et al. (2009), while a random sample of 37 also underwent an extensive dietary interview. According to the questionnaire, diet adherence was excellent in 95 (59.4%), fair in 46 (28.8%) and low in 19 (11.9%) patients. Children diagnosed with biopsy showed better adherence than those with a biopsy-sparing approach (p = 0.036). Adherence to GFD tended to worsen during the follow up, with the average length of follow up being associated with lower scores of diet adherence (p = 0.009). Moreover, adherence to GFD decreased throughout school career, dropping from elementary until high school (p = 0.037). A positive correlation was observed between adherence to GFD and growth percentiles, which increased when higher scores of adherence were achieved. Diet adherence positively correlated with QoL (p = 0.001). In conclusion, the questionnaire displayed good sensitivity in detecting problems in diet adherence, being useful as a screening tool. Better comprehension of influencing factors and outcomes may allow the development of new strategies to improve diet adherence.

scholarly journals A Gluten Free Diet in the Management of Epilepsy in People with Coeliac Disease or Gluten Sensitivity

2020 ◽  
Vol 2 (3) ◽  
pp. 281-299
Author(s):  
Zoë Gilbey ◽  
Justine Bold
Keyword(s):  
Coeliac Disease ◽  
Small Sample ◽  
Gluten Free Diet ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Exclusion Criteria ◽  
Search Terms ◽  
Small Sample Sizes ◽  
Eeg Pattern

The aim of this review was to assess the effects of a gluten free diet (GFD) in the management of epilepsy in people with coeliac disease (CD) or gluten sensitivity (GS). A systematic approach was used to undertake a literature review. Five electronic databases (PubMed; Scopus; Google Scholar; Cochrane Epilepsy Group specialised register; Cochrane Register of Controlled Trails (CENTRAL) via the Cochrane Register of Online Trials) were searched using predetermined relevant search terms. In total, 668 articles were identified. Duplicates were removed and predefined inclusion and exclusion criteria were applied, and a PRISMA flow chart was produced. Data was extracted using Covidence software. Twelve studies on Epilepsy and CD involving a total of 70 participants were selected for analysis; narrative synthesis was used owing to the small sample sizes in the selected studies. None of the 12 studies meeting inclusion criteria investigated gluten sensitivity and epilepsy. All the included studies support a link between epilepsy and CD. GFD was effective in 44 out of 70 participants across the studies in terms of a reduction of seizures, reduction of antiepileptic drugs (AEDs) or normalisation of EEG pattern. A total of 44 participants showed a reduction in seizures (across eight studies) and complete cessation of seizures was reported in 22 participants. In general, the earlier the GFD is implemented after the onset of seizures, the better the likelihood of the GFD being successful in supporting control of seizures. Mechanisms linking gluten with epilepsy are not fully understood; possible hypotheses include gluten mediated toxicity, immune-induced cortical damage and malabsorption. Evidence suggests the effectiveness of a GFD in supporting the management of epilepsy in patients with CD, although the quality of evidence is low. There appears to be a growing number of neurologists who are prepared to advocate the use of a GFD. A multidisciplinary approaches and further research are recommended. It could be argued that when balancing potential treatments such as AEDs or surgery, a GFD has a low likelihood of harm.

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