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Abstract: Background: Celiac disease (CD) is an autoimmune disease that results in inflammation and damage to the small intestine when gluten, a protein found in wheat, rye or barley is consumed. The only treatment for CD is lifelong adherence to the gluten-free diet (GFD). However, dietary intake can be high in saturated fat, sugar and lower in micronutrients such as folate. Currently, no comprehensive pediatric guidelines exist that address the nutritional limitations of the GFD. The purpose of this thesis was to describe the development and evaluation of a gluten-free (GF) food guide for children and youth (4-18 years) and to describe potential factors (e.g. home food environment, food literacy) that may influence food guide uptake by children and youth with CD, their parents and health care professionals.Methods: Guide development included a comprehensive evaluation of dietary intake and patterns in children/youth with CD, the development of GFD simulations (n=1260) and pre-and-post guide stakeholder consultations with 656 members of the CD community (children/youth, parents of children/youth with CD) and 231 health care professionals using focus group and survey methodology. Factors that may influence guide uptake were assessed in 16 households of youth with CD (home food environment, parental food literacy, youth dietary intake and food purchasing patterns) using validated surveys, dietary recalls and food receipt methodology.Results: The pediatric GF plate model was developed based on diet simulations that met 100% of macronutrient and micronutrient needs for age-sex with the exception of vitamin D. The GF plate model recommends intake of >50% fruits and vegetables (F&V), 25% protein foods and 35% dietary intake) were consumed taking up >1/3 of the plate.Conclusions: A GF food guide for children and youth was positively perceived by stakeholders and addresses an important gap in literature. Ongoing work will focus on guideline uptake in children/youth with CD on the GFD. Advocacy efforts for public health policies related to healthy and affordable food environments for diverse children and youth with CD and their families are equally warranted.

Due to climate change, water scarcity, increasing population and rising food prices, agriculture and food security has been affected worldwide. Cereal grains being a major part of world food supply also act as important energy source in human diet. In order to counter food insecurity, alternative grains are being explored, and millet being drought-resistant has the potential to serve as an alternative grain due to its comparable nutritional composition with other major cereals and its gluten free proteins. The evidence that gluten sensitivity is one of the increasing food intolerances is driving an increasing demand for gluten-free foods. However, gluten is a structure building protein essential for optimum dough development. Therefore, obtaining high-quality gluten-free bread (GFB) is a technological challenge. Due to lack of research about proso millet, this study investigates the physical properties of nine different cultivars to help in equipment design and significant difference was observed in dimensions, sphericity, volume, surface area, bulk density, porosity and angle of repose. This study also focused on characterization of proso millet starch and effect of acid and hydrothermal modification on native starch was observed. We were also interested in determining the rheological properties of millet based gluten free formulation with different hydrocolloids, and the quality attributes of bread made from them. Dough undergoes deformation during preparatory processes which was evaluated with the application of rheology. And the final baking parameters such as bread volume, texture, color allowed correlation between rheological and baking performance. This study has helped us to better understand millet potential in different industries including starch and bakery and in designing equipment and storage structures.

We sought to describe the weight status, weight change, food security, and consumer behaviors of individuals serologically positive for CD.There is a need for more research to describe the profile of participants with CD, identify their weight status and food procurement and preparation habits. Recent research points to the need for more evaluation of socioeconomic factors as related to celiac disease.This study included persons aged 6 years or older who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 – 2010. Serum samples from all participants were tested for immunoglobulin A (IgA) tissue transglutaminase antibodies and, if findings were abnormal, also for IgA endomysial antibodies. Weight and waist circumference were collected. Information about demographics, food security, weight status, and consumer behaviors were obtained by home interview.Two-thirds of the sample was found to be overweight or obese. Their weight status has remained stable within the past ten years. The majority of the sample was non-Hispanic white. Fifteen percent of the sample was found to be food insecure. Meal planning and preparation was shared with a spouse in about 50% of the sample.Individuals that are serologically positive for CD tend to be overweight or obese. They tend to eat out a few times a week and seem to prefer convenient foods for mealtime. Barriers such as food access, food affordability, access to medical testing, and issues of cross contamination can be a problem for this population.

The gluten-free diet is becoming increasingly popular as more people are diagnosed with and become aware of celiac disease. However, little is known about the nutritional quality of the diet, especially in terms of grain consumption and the nutrients provided by these foods. For the general population, grain consumption provides a large amount of daily vitamins, minerals, and fiber. Therefore, being able to describe the grain consumption of individuals with celiac disease may shed a crucial light on nutritional quality of the gluten-free diet. Data was obtained by means of a survey conducted at a Midwest hospital‟s annual celiac conference. The sample of convenience consisted of 220 people, 174 of which provided usable data. The survey focused on daily consumption of grain servings, types of grains consumed (cooked grains versus pre-prepared grain products), variety of grains consumed, and reasons for avoiding specific grains. Data from 174 usable surveys were used for statistical analysis. Over 80% of the sampled population consumes less than half of the daily recommended amount of grain servings. Only 1.1% consumes the recommended daily amount. Three-fourths of participants prefer pre-prepared grain products over grains. No matter the product type, rice (both brown and white) and corn make up the majority of grains or grain ingredients eaten regularly. Respondents identified many reasons for avoiding different grains, which can support both clinicians and the food industry, in efforts to improve the grain consumption of people with celiac disease.