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Data on factors governing long-term adherence to a gluten-free diet (GFD) in celiac disease (CD) are scarce. We aimed to determine trends and clinical predictors of long-term GFD adherence in adult CD.Initial and long-term (3 years) GFD adherence, clinical characteristics at baseline and follow-up were collected retrospectively from celiac patients followed-up over 20 years (2000-2020). Predictors of long-term GFD adherence at diagnosis, and follow-up were evaluated by multivariate logistic regression.248 patients (37 ± 12 years, 186F, median time on a GFD 90 months) were included. Twenty-five (10.1%) had only short-term follow-up (3 years) while 223 (89.9%) had initial and long-term dietary assessment. 187/223 (83.9%) patients were initially adherent and 36/223 (16.1%) were not. 17/36 (47.2%) patients initially not adherent become adherent, while only 4/187 (2.1%) initially adherent patients became not adherent. In the long-term, 200/223 (89.7%) were adherent and 21/223 (9.4%) patients were not. Adherence improved more frequently than worsened (OR, 39.5; 95% CI, 11.4-178.5; P.01). Classical symptoms (diarrhea, weight loss) at diagnosis of CD predicted stricter long-term GFD adherence (OR, 3.27; 95% CI, 1.21-8.81; P = .02), while anemia (OR, 0.31; 95% CI, 0.12-0.82; P = .02) and dermatitis herpetiformis (OR, 0.23; 95% CI, 0.06-0.91; P = .04) predicted poorer long-term adherence. At follow-up, initial GFD adherence (OR, 42.70; 95% CI, 10.70-171.00; P = .04) was the major determinant of long-term GFD adherence.GFD adherence changes over time in10% of patients, generally improving when it does. Major determinants of long-term GFD adherence are classical symptoms at diagnosis and initial adherence to a GFD. Patients with anemia or dermatitis herpetiformis at diagnosis require stricter dietetic input.

Tef is a highly nutritious gluten-free Ethiopian cereal with food-feed potential. However, its productivity is affected by lodging, weed infestation, terminal drought, small seed size, and shattering. Following the recent availability of tef genome sequences, we highlight the need to harness the benefits that this underutilised crop offers to improve food security.

We studied the prevalence of functional abdominal pain disorders (FAPDs) and functional constipation (FC) in a large prospective cohort of children with celiac disease on a strict gluten-free diet (GFD).We performed a prospective cohort study, from 2016 through 2018, in a tertiary care center in Italy, of 417 patients (37% male; mean age, 13.7 y) with a diagnosis of celiac disease (European Society for Paediatric Gastroenterology Hepatology, and Nutrition criteria) who had been on a strict GFD for more than 1 year and had negative results from serologic tests after being on the GFD. Parents and children (10 y) were asked to fill in a questionnaire on pediatric gastrointestinal symptoms, according to Rome IV criteria. Patients' closest siblings (or cousins) who had negative results from serologic test for celiac disease were used as controls (n = 373; 39% male; mean age, 13.5 y).We found a higher prevalence of FAPDs among patients with celiac disease (11.5%) than controls (6.7%) (P.05); the relative risk (RR) was 1.8 (95% CI, 1.1-3.0). Irritable bowel syndrome (IBS) and FC defined by the Rome IV criteria were more prevalent in patients with celiac disease (7.2% for IBS and 19.9% for FC) than controls (3.2% for IBS and 10.5% for FC) (P.05 and P.001, respectively); the RR for IBS was 2.3 (95% CI, 1.1-4.6) and the RR for functional constipation was 2.1 (95% CI, 1.4-3.2). We found no differences in the prevalence of other subtypes of FAPDs. A logistic regression showed that younger age (P.05) and a higher level of anti-transglutaminase IgA at diagnosis (P.04) were associated with FAPDs (in particular for IBS) irrespective of GFD duration.Celiac disease is associated with an increased risk of IBS and FC. Strategies are needed to manage IBS and FC in patients with celiac disease.

Patients with celiac disease continue to be exposed to gluten despite efforts to maintain a gluten-free diet (GFD). Gluten exposure in those with celiac disease leads to pathological changes in the small intestine that may or may not be associated with gastrointestinal distress. While several studies have investigated a GFD, little is known about sources of gluten contamination that prevent proper maintenance of such a diet by celiac patients. In this study, we investigate common food practices that could lead to gluten cross-contact. Three different practices were examined for gluten cross-contact: gluten-free foods fried in a fryer also used for gluten containing foods, gluten-free bread toasted in a toaster also used for gluten-containing bread, and popular sandwich spreads applied with a knife used on gluten-containing bread (mayonnaise, jam, and peanut butter). We used the ALLER-TEK™ Gluten ELISA test kit and the sandwich ELISA RIDASCREEN Gliadin test kit, which is endorsed for determination of gluten content and used for the evaluation of food cross-contact. Using both kits gave the advantage of using the 401.2 antibody as well as the better established R5 antibody, providing increased confidence in our results. We found these practices resulted in small amounts of gluten cross-contact, although the majority of the results (93.6%) showed no significant cross-contact. Mayonnaise and peanut butter samples were contaminated with gluten above the limit designated by the FDA as gluten-free20 kg/mg (ppm).

Background Buckwheat consumption is associated with positive health effects in humans. Buckwheat has diverse nutrients with biological functions. Buckwheat storage protein is gluten free and is a major bio-factor responsible for the functions. The protein can be a source of allergens. It is important to understand the biological properties and food uses of buckwheat protein to develop buckwheat as a “healthy” grain. Scope and approach This review summarizes diverse biological activities of proteins and peptides from both common and Tartary buckwheat seeds. Strategies to reduce the symptoms of buckwheat protein allergy are discussed. The properties of the proteins and peptides in relation to the quality of buckwheat based products are also reviewed. Research gaps in better understanding and using buckwheat proteins and peptides for food applications are identified. Key findings and conclusions The protein isolates from buckwheat have been hydrolyzed into a range of peptides. These peptides showed diverse biological activities in vitro and in vivo. They include trypsin inhibition, antiaging, modulating gut microbiota, prevention of cardiovascular diseases, blood pressure lowering, immunomodulatory, antidiabetic, antimicrobial, anticancer and antioxidant capacities. Buckwheat has been processed into a range of products such as vinegar, beverages and breads. The quality of these products can be significantly affected by the protein and peptide properties. Overall, buckwheat proteins and peptides have potential to be developed into functional food products.

The cornerstone of the recommended treatment for Celiac disease (CeD) is a lifelong strict gluten-free diet (GFD). We aimed to identify prospectively the demographic, clinical, social and psychological profile associated with non-adherence to a GFD in adult CeD patients in Israel.An anonymous online questionnaire was sent via the Israeli Celiac association and through social networks. Only CeD patients≥18 years old were included. Socio-demographic, laboratory and clinical data as well as anxiety and depression scores were reported. Adherence to a GFD was assessed by a Biagi questionnaire.In total, 301 patients completed the questionnaire with a mean age of 37.5±14.9 years, 79.2% female. The most common presenting symptoms were: anemia (59.7%), abdominal pain (50.8%) and diarrhea (42.8%). According to the Biagi score, 82% of patients were found to be high adherent to a GFD (Biagi 3-4) and 18% were low adherent to a GFD (Biagi-0-2). Univariate analysis revealed that low adherence was associated with: younger age at the time of diagnosis (P0.001), longer duration of disease (P=0.011) non academic education (P=0.011), below average income (P=0.018), smoking (P0.001) and no gastroenterology follow up (P=0.038). However, in multivariate analysis, only a young age at diagnosis and smoking were significantly associated with non-adherence to a GFD (OR 0.924, 3.48, P-value0.001, 0.029, respectively). In further analysis, we identified that age 20 is the best cutoff value to discriminate between those with high adherence and those with low adherence.Young age, smoking, long disease duration, no academic education, low income and no gastroenterology follow-up were found to be associated with low adherence to GFD rate in a univariate analysis, however only the first two were found to be significant in the multivariate analysis. Additional intervention strategies might improve adherence and reduce future complications with a better quality of life.

The objectives of this scoping review were to identify and characterize studies examining nutrition assessment, interventions, and measures to monitor gluten-free diet (GFD) adherence/compliance in patients with celiac disease (CD). An electronic literature search of four databases (Cochrane Database for systematic reviews, CINAHL, Embase, and Ovid MEDLINE) was conducted to identify articles examining nutrition care in CD individuals. Except for narrative review, grey literature, and case study/report, all types of peer-reviewed articles published between January 2007 and August 2018 were eligible. There were a total of 10,823 records; 10,368 were excluded during the first round of screening due to irrelevancy and/or duplication. Of the 455 full-text articles that were assessed, 292 met the criteria and were included. Most of the studies were observational studies (n=212), followed by experimental trials (n=50), evidence-based practice guideline (EBPG)/report/statement (n=16), and systematic review (SR) (n=14). Nine original studies examined assessment, focusing mainly on different tools/ways to assess GFD adherence. The majority of the included original articles (n=235) were in the nutrition intervention category with GFD, oats, and prebiotics/probiotics as the top-three most studied interventions. There were eight SRs on GFD and five on oats. One SR and 21 original studies investigated the effectiveness of different measures to monitor GFD adherence/compliance. Although recent CD EBPGs were identified, different methods with varying levels of rigor, in terms of literature search and assessment of evidence strength, were used. Based on this scoping review, interventions focused on gluten-free diet and oats have been significantly covered by either SRs or EBPGs. Studies related to prebiotics/probiotics and education program/counseling focused interventions, as well as assessment, in CD patients have increased in recent years. Thus, it might be beneficial to conduct SRs/EBPGs focused on these topics to guide practitioners.

Background Unlike with bread dough, the gluten network is hardly developed in bakery products, meaning, generally speaking, it is not necessary to resort to food additives to substitute the wheat protein. Moreover, this kind of commercial product has greater variability in terms of formulation, meaning it is difficult to compare the various products due to both the ingredients’ functionality and the nutritional values. Scope and approach This article compares different types of commercial muffins and ‘Magdalenas’ (Spanish muffins), both with and without gluten, as an example of bakery products made with batters. The ingredients used in their formulation and their nutritional value were analysed with reference to relevant studies and research. Key findings and conclusions The differences between the nutritional values of muffins with and without gluten are less important than with other products, where gluten plays an essential role. However, the gluten-free products present the highest variability in nutritional values, compared to the products with gluten. This is related to the greater homogeneity of formulations containing gluten compared with those without gluten. In general, gluten-free products have a higher content of egg and thickening agents in their formulations.

Objective: It is unclear whether the institution of gluten-free diet (GFD) is beneficial in patients with type 1 diabetes (T1DM) and subclinical celiac disease (CD). Our primary objective was to evaluate the effect of GFD on the frequency of hypoglycemia, in patients with T1DM and subclinical CD. Our secondary objective was to investigate the effect of GFD on height, weight, glycosylated hemoglobin (HbA1c), insulin dose requirement, and bone mineral homeostasis. Methods: We carried out a prospective open label randomized controlled trial (RCT). Patients with T1DM and subclinical CD were randomized to receive GFD or a normal diet for 1 year. The primary outcome was the frequency of hypoglycemic episodes (blood glucose

Introduction and objectives: It is essential for patients with celiac disease (CD) to be on a gluten-free diet (GFD) but said diet has also been reported to increase the risk for metabolic syndrome. There is no evidence on the metabolic effects of a GFD in patients with nonceliac gluten sensitivity (NCGS) or in asymptomatic subjects. Therefore, the aim of the present study was to evaluate the metabolic effects of a GFD over a 6-month period in patients with CD, patients with NCGS, and in asymptomatic controls (ACs). Materials and methods: A prospective study was conducted that evaluated metabolic syndrome and its components of obesity, high blood pressure, hepatic steatosis, and hyperglycemia at the baseline and at 6 months. Results: A total of 66 subjects (22 CD, 22 NCGS, and 22 AC) were included in the study. At the baseline, 10% of the patients with CD presented with obesity, high blood pressure, hepatic steatosis, and metabolic syndrome. After 6 months, obesity and metabolic syndrome increased by 20% (p = 0.125). In the patients with NCGS, obesity increased by 5% after the GFD and 20% of those patients presented with de novo hepatic steatosis. The prevalence of obesity decreased by 10% in the controls after the GFD (30 vs 20%, p = 0.5) and none of the other components of metabolic syndrome were affected. Conclusions: The metabolic benefits and risks of a GFD should be considered when prescribing said diet in the different populations that opt for that type of intervention. Resumen: Introducción y objetivos: La dieta libre de gluten (DLG) es indispensable para los pacientes con enfermedad celíaca (EC). Sin embargo, también se ha descrito que esta dieta aumenta el riesgo de síndrome metabólico (SM). La evidencia respecto a los efectos metabólicos de una DLG en pacientes con sensibilidad al gluten no celíaca (SGNC) y en sujetos asintomáticos se desconoce. El objetivo de este estudio fue evaluar los efectos metabólicos de una DLG durante 6 meses en pacientes con EC, SGNC y controles asintomáticos. Material y métodos: Se realizó un estudio prospectivo en donde de forma basal y a los 6 meses se evaluaron los componentes del SM como obesidad, esteatosis hepática, hiperglucemia e hipertensión arterial. Resultados: Se incluyeron un total de 66 sujetos (22 EC, 22 SGNC y 22 controles asintomáticos). De forma basal el 10% de los pacientes con EC tuvo obesidad, SM, hipertensión y esteatosis hepática. Después de 6 meses el 20% de los pacientes desarrolló SM y obesidad (p = 0.125). En los pacientes con SGNC la obesidad después de la DLG aumentó en un 5%, mientras que el 20% tuvo esteatosis hepática de novo. En el caso de los controles la DLG disminuyó la prevalencia de obesidad en un 10% (30% vs. 20%, p = 0.5) sin afectar los otros componentes del SM. Conclusiones: Los beneficios y riesgos metabólicos de una DLG deben considerarse cuando se prescriben este tipo de dietas en las diferentes poblaciones que optan por este tipo de intervención.

Current treatment for celiac disease (CD) requires a life-long gluten-free diet (GFD).1 Among the top challenges are eating outside the home2 and over-reliance on processed foods, which are often high-fat, low-fiber, and high-sugar.3 Home cooking is a GFD management strategy that addresses both. Research not specific to CD suggests a variety of positive outcomes related to home cooking: healthier dietary pattern, positive self-management behaviors (eg, improved glycosylated hemoglobin and cholesterol levels), increased willingness to integrate complex dietary changes, and improved quality of life (QOL).4-6 In this study we assessed the feasibility and acceptability of a cooking-based nutrition education intervention to promote GFD adherence and QOL among adults with CD.

Regular or thermally treated egg white powder or soy protein isolate were included in the recipes of gluten-free (GF) breads based on rice flour (RF) or a mixture of potato and cassava starches (CS-PS) to improve bread texture and structure. Electrical resistance oven heating was combined with in-line measurements of batter height, viscosity and carbon dioxide release during fermentation and baking. Crumb firming during storage (6 days) of the different breads was studied by texture, moisture content, amylopectin (AP) crystal melting and proton nuclear magnetic resonance analyses. Drop shape tensiometry showed that both egg white types are highly surface active. Their use resulted in high gas cell stability and ultimately in high volume breads with fine crumb structure. Batters containing soy protein isolate, which had a lower surface-activity, had low stability. This resulted in low volume breads with inhomogeneous crumb structure. During the first 24 h of storage, the crumb firmness increase was mainly caused by AP retrogradation and later on by crumb-to-crust moisture migration. Crumb firming was less pronounced in CS-PS than in RF breads. Egg white decreased the extent of crumb firming while soy protein increased it. Most notably, differences in crumb firming between samples were largely related to differences in initial bread specific volume and crumb structure rather than to differences in AP retrogradation or moisture migration. Thus, inclusion of ingredients which improve bread volume and crumb structure in GF bread recipes may also strongly improve the shelf-life of such breads. ispartof: FOOD HYDROCOLLOIDS vol:95 pages:406-417 status: Published online

Objectives Excluding gluten containing foods from the diet is medically indicated for the management of coeliac disease, wheat allergy, gluten ataxia, non-coeliac gluten sensitivity, and dermatitis herpetiformis. However, the number of people following a gluten free diet (GF diet) far exceeds the number of people with an indication for such dietary restriction. It has been suggested that 70% of individuals who are recommended GF diets by complementary medicine practitioners have not had coeliac disease adequately excluded. The aim of this study was to describe the diagnostic and clinical management practices of naturopaths, Western herbalists and nutritionists (non-dietetic) associated with recommending GF diets. Design, subjects and outcome measures A cross-sectional 40-item questionnaire was developed and administered online to 145 Australian naturopaths, nutritionists (non-dietetic) or Western herbal medicine practitioners via professional associations and a practice based network (PRACI) between February and April 2017. Demographic data and practice information related to recommending GF diets was collected. Results A total of 56.5% (82/145) practitioners reported that in the majority of cases they did not undertake any recommended diagnostic process, and 48% (71/145) of practitioners referred to a general practitioner to exclude medical conditions related to gluten ingestion prior to recommending a GF diet. A total of 10% (15/145) ordered coeliac serology through local laboratories, and 17% (24/145) through functional pathology companies. Non-coeliac gluten sensitivity was diagnosed by 56% (82/145) through an elimination and reintroduction diet, and 61% (88/145) used a diet and symptom diary. IgG antibody tests were used by 23% (33/145) of practitioners, and 5% (7/145) used kinesiology prior to recommending a GF diet. Conclusion Clinical guidelines for the diagnosis of gluten related disorders are not followed by a substantial number of complementary medicine practitioners prior to recommending a GF diet. Strategies are required to improve the standard of practice in this area.

International audience; Agglomeration properties of gluten-free cereals such as corn, manioc, amaranth, buckwheat, and quinoa flours were investigated. The different states of agglomeration were identified by the evolution of rheological properties under water addition and shearing conditions using a Caleva® mixer torque rheometer. The Mi-Pro® high-shear granulator has been used to produce wet agglomerates, which were characterized by fraction distribution, water content, density, and agglomeration yield. Results show that all samples present the same rheological characteristics: four agglomeration states are identified. The most highly developed cohesion was obtained with the amaranth flour with a mean torque of 2.4 N.m. Wet agglomeration with Mi-Pro® granulator showed that all selected flours can be granulated except for manioc flour, which did not give agglomerates. Using corn flour leads to a better uniformity on the size distributions but less for amaranth, buckwheat and quinoa flours. This study shows that it is possible to agglomerate these gluten-free flours for the preparation of couscous, which may diversify the choice of couscous types for people suffering from celiac disease.

Sourdoughs are produced both in artisanal and industrial size. Sourdough manufacturers deliver the baking branch either with starters for production of in-house sourdoughs or with fully fermented sourdough products. In the latter case sourdough production is separated in time and space from the bread production. A big part of this convenience products are dried sourdoughs, which are mainly produced from rye and wheat flour, but also from other starch containing plants, like pseudocereals or legumes. The requirements regarding the raw materials used differ from that used for baking bread. The most applied drying techniques for sourdoughs are drum and spray-drying. Compared with other foods, sourdough and sourdough products have only a low risk regarding food safety due to pH

Maltogenic amylase (MAase) was encapsulated into maltodextrin (MD) with two dextrose equivalents (DEs). The encapsulated enzymes (EnEs) with different formulations have been used to make gluten-free breads. The EnE (encapsulated enzyme) into MD with a low value of DE (DE1 4–7) (EnE-LMD), and the lowest MD (1%) and the highest (82 mg mL−1) concentrations yielded the highest encapsulation efficiency (EE) (93.35 ± 5.05%). A similar treatment, i.e., MD with a high value of DE (DE2 16.5–19.5) (EnE- HMD) resulted in EE of 68.15 ± 18.07%, as the second high level of EE. The bread with EnE- LMD formulation had a higher quality (a lower weight loss, a higher uniformity of gas cells, and a better microstructure) in comparison with the breads with EnE- HMD and free enzyme (FE) formulations However, the breads with two formulations (EnE-LMD and EnE-HMD) had relatively the same firmness and moisture content. These two bread formulations were softer than that of the control, FE, and other formulations breads during storage.

The strict nature of a gluten-free diet (GFD) poses a challenge for patient adherence and for clinicians to provide comprehensive client-centered care. Evidence on the relationship between nutrition knowledge, food skills, dietary management, and adherence can guide healthcare professionals counseling patients following this diet. In this explanatory pilot study, a province-wide survey (phase I) with 68 community-dwelling Nova Scotians following a GFD was conducted to investigate relationships between personal, social, and health care factors and dietary adherence using a mixed-methods approach. A sub-sample of 19 survey respondents were interviewed (phase II) to explore contextual experiences related to GFD knowledge, food skills, dietary management, and adherence using a food literacy lens. Here, we report findings from phase I, in which 37 participants with self-reported celiac disease (CD) and 31 participants reporting non-celiac reasons for wheat restriction (NCWR) completed a detailed 41-item online questionnaire. Self-reported data combined for both CD and NCWR respondents showed 76% perceived their health status as good to excellent. Most (62%) reported not receiving GFD advice from a health professional. Respondents with higher frequency of intentional consumption of gluten were more likely to have fewer correct answers to a food label quiz (ρ = −0.44; P = .0002). Most participants (75%) made at least one error in identifying gluten-free and gluten-containing foods, which may lead to unintentional gluten consumption and/or unnecessarily restricting safe foods. Findings from this exploratory study suggest patients may lack adequate referrals and support within the health care system and the community, adding to individual challenges of GFD adherence.

Background Bone metabolism disturbances are commonly observed in patients with newly diagnosed celiac disease (CD). The only available treatment for CD–the intake of a gluten-free diet (GFD)–has been found to be insufficient in effectively improving bone health in some patients. Therefore, there is an urgent need to modify the GFD so as to allow for the provision of all the necessary nutrients and improved absorption. Prebiotics intake reportedly improves the absorption of bone-related vitamin D and calcium as well as bone metabolism. The effect of prebiotic intake on bone health in CD patients has not been studied yet. This study aimed to evaluate the effect of oligofructose-enriched inulin intake on bone metabolism and immune response in children with CD on a GFD. Methods A total of 34 children with CD were randomised into two groups receiving 10 g of oligofructose-enriched inulin (Synergy 1) or a placebo (maltodextrin) for three months, together with a strict GFD. The children's bone metabolism marker levels and cytokine profiles were analysed before and after the intervention. Results After supplementation, the concentration of osteocalcin increased significantly in children receiving Synergy 1, while the concentration of bone alkaline phosphatase increased in both groups, independent of supplementation. After the intervention, the level of pyridinoline increased significantly in the placebo group, resulting in a concentration that was two times higher than that in the Synergy 1 group, in which it remained stable. Moreover, the plasma concentrations of N-terminal telopeptides of type I collagen decreased in both the groups, whereas the tartrate-resistant acid phosphatase 5b level increased particularly in the Synergy 1 group. The intervention did not lead to immunological response changes. Conclusions The proposed supplementation beneficially altered bone metabolism, through increased bone formation rates and decreased bone resorption process rates. Supplementation of GFD with prebiotic oligofructose-enriched inulin may be a promising auxiliary therapy for bone metabolism improvements in children with CD.

Introduction A gluten free diet (GFD) is indicated for the medical management of coeliac disease as well as gluten ataxia, dermatitis herpetiformis, and wheat allergy. Complementary medicine practitioners (CMPs) recommend removing gluten from the diet, but it is not known what symptoms or conditions they recommend gluten free diets for. The aim of this study is to describe for what conditions Australian naturopaths, Western herbalists and nutritionists (non-dietetic) recommend a gluten free diet. Methods This was a sub-group analysis nested within a cross-sectional survey of practitioners recruited through the PRACI practice-based research network and relevant professional associations. A 40-item survey collected information on sociodemographic characteristics, practice and professional characteristics and specific questions on gluten related disorders between February and August 2017. Data was described using frequencies and percentages along with one-way ANOVA to determine group differences. Results One hundred and forty-five complementary practitioners responded to the survey. The gastrointestinal conditions most frequently prescribed a GFD for were non-coeliac gluten sensitivity (99%), medically diagnosed coeliac disease (95.2%), inflammatory bowel disease (73.1%) and irritable bowel syndrome (60%). The most frequently prescribed GFDs for extra-intestinal conditions were skin conditions (60%), children with developmental disorders (53.1%), mental health conditions (46.2%) and weight management. Discussion Results suggest that given the broad application of GFDs by CMPs, there may be therapeutic benefits for conditions other than known gluten related disorders. However, in the absence of appropriate investigations for gluten related disorders, the recommendation and positive response to a GFD may be inadvertently treating an undiagnosed gluten related disorder. In addition, a GFD may also be inadvertently managing other unknown intolerances that require different clinical management. Conclusion This research highlights the need for further investigation into the potential benefits resulting from prescribing GFDs for conditions where there is no established evidence for the exclusion of dietary gluten.

Summary Background & aims Non-celiac gluten sensitivity (NCGS) is characterized by intestinal and extra-intestinal symptoms triggered by ingestion of gluten. However, non-gluten triggers have recently been implicated, and a FODMAP (fermentable oligo-, di-, monosaccharides and polyols)-reduced diet can partially improve symptoms in NCGS. Our aim was to analyze the effect of a low FODMAP versus a gluten-free diet (GFD) on clinical symptoms, psychological well-being, intestinal inflammation and integrity, and stool microbiota. Methods Nineteen patients with NCGS and ten healthy controls consumed a gluten-containing standard diet before starting a two-week low FODMAP diet; after a five day transition period, participants ingested a GFD for another two weeks. The primary outcome measure was the improvement of clinical symptoms in NCGS patients under the different diets. Secondary outcomes were the determination of dietary effects on intestinal inflammation, psychological well-being, and differences in stool microbiota between NCGS patients and controls. Results The low FODMAP diet and especially the GFD led to a significant improvement of clinical and psychological symptoms in NCGS. A clear reduction in duodenal intraepithelial lymphocytes and mucin-producing Goblet cells was found after the GFD in these patients. Significant microbial differences between NCGS patients and controls were noticed in stool samples at every time point. Both diets caused microbial shifts in all participants, with a greater variability on genus level and metabolisms groups in NCGS patients. Conclusions Our findings suggest a multifactorial etiology of NCGS, due to a functional effect caused by FODMAPs, combined with a mild gluten-triggered immune reaction, and a microbiota dysbalance. ClinicalTrial.gov ID : NCT03268720 .

Zein was incorporated at 5% (w/w) to high amylose rice flours with different particle sizes (80–100, 100–140, and 140–250 μm) and the rice flour-zein composites were utilized to generate gluten-free noodles slit from sheeted doughs. Rice flours with smaller particle size showed higher starch damage whereas they had greater water hydration properties and higher pasting parameters. In addition, the fine particle size contributed to the elastic properties of the rice-zein composites. The ability of zein to generate a viscoelastic protein network at above its glass transition temperature, successfully produced gluten-free rice sheeted doughs regardless of particle size that could be slit into long and thin noodle strands without gluten. The rice-zein noodles with larger particle sizes had a rough surface while the noodle surface became smooth and flat at decreasing particle sizes. The noodle samples with rice flour having an intermediate particle size (100–140 μm) showed the highest values of maximum resistance and extensibility to extension that consequently contributed to the decreased cooking loss. This study provided a new opportunity for food manufacturers to improve the qualities of gluten-free rice noodles made from sheeted doughs by controlling particle size.

The effect of extrusion modification of red rice flour on rheological and textural properties of batter and cake, respectively was investigated. The applicability of the Cox-Merz rule on the rheological properties of batter was explored. In addition, the phytochemical properties of the rice flour and cake were determined. The flow behavior of the red rice flour batters could be well-described (r ≥ 0.93, p ≤ 0.01) by the Herschel–Bulkley and Mizrahi-Berk models. These viscoelastic batters exhibited higher storage modulus (G′) than the corresponding loss modulus (G″) during the frequency sweep. The Cox–Merz rule, after introducing two correction factors (α and β) for intercept and slope of the line, respectively, closely matched the steady-state shear properties and oscillatory viscoelasticity of the rice batters. The modification of rice flour also significantly changed the textural properties of the cake such as the peak force, failure energy and deformation modulus of the developed gluten-free cakes. The phytochemical properties of the rice flour and cake decreased with an increase in the extrusion temperature. The colour and sensory attributes of cakes prepared with extrusion-modified flour compared to native flour. It was concluded that the use of extrusion-cooked red rice flour is a suitable ingredient for developing gluten-free cakes.

Pasta industry has introduced in the market new pasta formulations to respond to consumers' nutritional/health needs. The resulting macromolecular, mesoscopic, and microscopic changes induced in pasta need to be evaluated. In this work, a multi-scale screening of physico-chemical properties was performed on commercial pasta formulations (wheat semolina, whole wheat semolina, veggie, gluten free). Pasta samples showed significantly (p ≤ 0.05) different properties: wheat semolina and whole flour samples had a more pronounced viscoelastic behaviour (Dynamic Mechanical Analysis), higher hardness (Texture Analysis) and higher mobility of the more rigid protons (1H Nuclear Magnetic Resonance); veggie pasta had the highest frozen water content and higher 1H T2 molecular mobility; gluten free pasta showed a larger rigid population (Population C). This study indicated the ability of a multi-scale approach in discriminating pastas' formulation. Besides physico-chemical properties, 1H NMR was particularly able to properly discriminate pastas’ formulations.

In this study, the fermented cassava-sweet potato-sorghum mixed flours have been used to produce GF bread using xanthan gum as substitute of gluten. The "constrained mixture design" was used to evaluate the effect of flour proportions on the rheological and textural properties of dough and bread. The pasting properties of flour blends reveal high peak viscosity (750–1076 cP) for blends containing more than 70% cassava flour. Sweet potato and sorghum flours lead to a drop in the peak viscosity in the blend when substituted at 30 and 20% respectively. According to the response surface of the Linear Visco elasticity (LVR G′), 5% of sorghum proportion appears as the critical threshold beyond which the decrease in the proportion of cassava flour makes it possible to increase the solid character of the dough (LVR G′ increases). Analysis of the textural properties (hardness, adhesiveness, elasticity, cohesiveness and chewiness) of the crumb of the fresh and stored breads allowed obtaining an optimal flour formulation made of 75% fermented cassava, 20% sweet potato flour and 5% sorghum. This study demonstrated feasibility of fermented cassava-sweet potato-sorghum mixed flours in GF bread making.

Background The gluten-free market is expanding rapidly. The reasons for this reflect a growing interest in adopting a gluten-free diet (GFD). This is partly explained by an increasing number of people diagnosed with Celiac Disease (CD), but also because of public perceptions that a GFD is a healthy diet option. However, products specifically marketed as gluten-free (GF) are reduced in several sensorial characteristics, are more expensive, and have lower nutritional values than comparable alternatives. Scope and approach The aim of this review is to provide an up-to-date set of factors that underpin consumers' preferences and adherence to GFD. After screening, 54 articles were considered for the review. Key findings and conclusions The review classifies the factors affecting GFD in eight groups: “Factors specific to the GFD”; “Socio-demographic factors”; “GF products' factors”; “Psychological Factors”; “Symptoms related to Celiac”; “Celiac Disease's factors”; “Quality of Life”; “Other Factors”. Results on the level of association and significance of the factors affecting adherence to GFD are mixed. Moreover, in the process of reviewing the literature, this review reveals that most of the studies that have investigated factors associated with adherence to GFD are focused primarily on celiac patients while neglecting the fact that many non-celiac adopt the diet. From this we discuss future research directions, and what questions remain unanswered in the domain of adherence to the GFD.

The fate of gluten proteins and (poly)peptides throughout the brewing process of reference and gluten-minimized all-malt beers was monitored on both pilot-scale and industrial-scale. Common process steps such as wort separation, cooking, wort and beer clarification already significantly reduce the mass of gluten proteins (72–99%). Nevertheless, gluten derived (poly)peptides remained present at high concentrations in the final reference beers (58–397 ppm). A lauter tun, with course husk material as filter bed, showed to be more effective in reducing the mass of gluten proteins than a mash filter (33% vs. 18%). The mass of gluten proteins and (poly)peptides could be further significantly reduced (16–89% and 33–81% respectively) depending on the use of tannins, AN-PEP (Prolyl-endopeptidase from Aspergillus niger) and silica gel. To render all-barley malt beers gluten-free (≤20 ppm) ( EC No. 41/2009, 2009 ) gluten-minimization treatments with AN-PEP and silica gel were combined successfully; these beers contained

Background Videocapsule endoscopy images are useful to detect pathologic alterations, including villous atrophy, in the small intestinal mucosa, which is helpful for diagnosing celiac disease. In prior work, quantitative videocapsule analysis was found useful to classify celiac versus control images. However, the effect of dark/extraneous substances on classification efficacy requires remediation. Method For quantitative analysis, data from the Medtronic SB2 and SB3 systems were pooled. Videocapsule images of the distal duodenum/proximal jejunum were acquired from 13 celiac and 13 control patients. Dark regions, extraneous fluids, and air bubbles were mostly removed by utilizing color masking. Two different red-green-blue (RGB) color masks were constructed from 20 to 30 reference pixels obtained from mucosal and from extraneous regions. Each image pixel was accepted or rejected for subsequent analysis based on whether its distance was closest to a mucosal or to an extraneous reference in RGB space. Four images were then randomly selected from each videoclip for processing (52 images from each group). After masking, celiac versus control images were plotted in a three-space consisting of mean and standard deviation in pixel brightness, and surface area remaining after masking. A linear discriminant function was used for classification. The paradigm was repeated with a second random data set for validation. Results Masking improved classification of celiac versus control images to nearly 80% accuracy as compared to 70–77% without masking. Celiac disease patients tended to have lesser mean pixel brightness and greater variability in brightness, in accord with prior work, and more masking was needed to remove extraneous features. Conclusions Color masking is useful to remove dim/extraneous features from videocapsule images and it results in improved classification/assessment to distinguish celiac with villous atrophy from control videocapsule image. This can be helpful to detect and map regions of pathology, to screen for celiac disease, and to determine the efficacy of a gluten free diet.

Wheat- and gluten-containing products are often blamed for triggering a wide range of gastrointestinal symptoms, and this has fueled demand for gluten-free products worldwide. The best studied ‘gluten intolerance’ is coeliac disease, an auto-immune disease that affects the small intestine. Coeliac disease occurs in 1% of the population and requires strict, life-long avoidance of gluten-containing foods as the only medical treatment. There is a larger group of individuals (around 10–15% of the population) who report a wide-range of gastrointestinal symptoms that respond well to a ‘gluten-free diet’, but who do not have coeliac disease – so called ‘non-coeliac gluten sensitivity (NCGS)’. The team at Monash University has identified other factors in gluten-containing foods that may be responsible for symptoms in this group of individuals with so-called, NCGS. We have evidence that certain poorly absorbed short chain carbohydrates (called FODMAPs) present in many gluten-containing food products, induce symptoms of abdominal pain, bloating, wind and altered bowel habit (associated with irritable bowel syndrome, IBS). Our research has shown that FODMAPs, and not gluten, triggered symptoms in NCGS. Going forward, there are great opportunities for the food industry to develop low FODMAP products for this group, as choice of grain variety and type of food processing technique can greatly reduce the FODMAP levels in foods. The use of sourdough cultures in bread making has been shown to reduce the quantities of FODMAPs (mostly fructan), resulting in bread products that are well tolerated by patients with IBS. Greater interaction between biomedical- and food-scientists will improve understanding about the clinical problems many consumers face, and lead to the development of food products that are better tolerated by this group.

Developing baked gluten-free (GF) products is difficult since gluten is essential for many organoleptic properties like texture and taste. Egg white proteins (EW) show strong cohesive behavior with excellent foaming capacity and stability, which may improve both organoleptic quality and nutritional value of GF bread. This work aimed to study the impact of two EW powders prepared by different methods (e.g. P110 and M200) on bread volume, shape, texture and their potential use in retarding the staling process. The two EW samples were used to substitute 5–15% of GF flour in a control GF bread formulation. Compared with control, breads with EW had larger specific volumes and more homogeneous texture. The rheological properties of GF bread batter were evaluated through temperature and frequency sweep tests. In general, addition of EW increased the elasticity of GF batter and improved the texture properties of resultant bread during storage. M200 with more water-soluble protein aggregates produced a more significant improvement in bread quality than general standardization sample P110. To elaborate the stabilizing mechanism of EW on bread network, the surface properties of the two EW samples including surface tension, zeta-potential as well as their conformational changes during thermal treatments were studied and compared.

Historically, a gluten-free diet was recommended only for those with celiac disease or IgE-mediated wheat allergy. With changes in food allergy labeling in the United States and the publication of several best-selling books, gluten-related disorders have come to the forefront of popular culture. As a result, there has been a dramatic increase in the number of gluten-free diet followers, many for nontraditional reasons. As "going gluten-free" has become mainstream, it is imperative that health care providers acquire the knowledge to identify true gluten-related disorders to effectively counsel their patients and minimize potential complications from following such a restrictive diet.

Background Gluten-free (GF) bakery products available in the market are often poor in nutritional value, flavor, mouthfeel and have double the price as compared to traditional products. Strict GF diet has raised long-term concerns about food choices and dietary habits of celiac disease (CD) patients. Scope and approach The limited intake of dietary fiber (DF) in GF diet along with other deficient nutrients is the main concern for the coeliacs, as the wheat flour is replaced with rice flour and commercially available starches, which results in lower DF intake. The population surveys indicated a lower intake of DF in coeliacs. The DFs from pseudo-cereals, GF cereals, fruits, vegetables, legumes and pulses are commonly used to complement the deficiency of GF products. Key findings and conclusions Addition of DF significantly affects the color, firmness, moistness, crumb staling and microstructural feature of GF products. The coeliacs are advised to complement the DF intake from pseudo-cereals, fruits, legumes and pulses. This article covers the challenges faced by the food industry while complementing GF products with DF and the effect of DF on the techno-functional properties of the products with reference to GF products.

In this study, functional, rheological and physicochemical characteristics were carried out for composite gluten-free (CGF) flours, dough and biscuits, respectively fortified with fermented and unfermented Agaricus bisporus polysaccharide (FABP and UABP) flours. Addition of both FABP flour and UABP flour improved functional properties, while addition of FABP flour decreased viscosity property. Incorporation of both polysaccharide flours in CGF biscuit dough revealed a significant increase in rheological moduli (G' and G″) and a decrease in tan (δ). Supplementation of UABP flour increased thickness, whereas supplementation of FABP flour increased diameter and spread ratio. All CGF biscuit formulations exhibited lower fracture strength and hardness compared to the control. Furthermore, both UABP flour and FABP flour formulation (F3) contained the highest nutrients in terms of protein, dietary fibers, amino acids and minerals among the CGF biscuit formulations. The sensory evaluation result showed that FABP flour formulation (F1) and UABP flour F1 were most acceptable.

Millet, buckwheat and oat are considered to be minor crops, hence chemical profiles for different cultivars are rare. The examination of a sum parameter, like the total antioxidant capacity (TAC) can thus be a first step to systematically assess the quality of different cultivars of mentioned gluten-free grains and thereby serve as an indicator for the selection of cultivars for food processing. TAC of 20 common buckwheat, 14 proso millet and six common oat cultivars was analysed using Folin-Ciocalteu assay and an optimized NIRS methodology. PLS regressions for milled and intact samples were established and yielded a R2(CV) of 0.892 and 0.929. The SEPs for milled and intact samples were approximately 1.7 and 1.6 mgGAE/g. Multivariate LOD and LOQ were also calculated. LODmax for intact and milled samples was 1.72 and 2.80 mgGAE/g. TAC varies considerably among cultivars of one species, emphasising the need for full chemical profiles. Values for LOD and LOQ show that established PLS-R models can be used to quantify TAC of buckwheat and oat cultivars. TAC of millet cultivars can be detected, however not quantified.

The future of organic agriculture will, to a large extent, depend on consumer demand. As a result, the last three decades have witnessed a considerable increase in the number of papers that have attempted to identify the determinants of organic food consumption and whether organic foods are competing with other ethical food products such as local foods, animal-friendly foods, healthier foods and free-from foods (e.g., dairy free, gluten free, nut free). This study went a step further and assessed the use of animal welfare and nutritional information to increase the demand for and the competitive power of organic foods using a non-hypothetical experimental auction. Overall, the results showed that the demand for organic animal products could be improved not only by selling better its superiority in terms of sustainability but also by promoting its advantages in terms of other attributes that are known to be highly valued by consumers such as animal welfare and nutritional content. Therefore, producers and marketers of organic animal products should be fully aware of the potential of their products and ready to exploit all their advantages if they want to improve their competitive power as well as their demand.

Cowpea and rice were evaluated for their suitability as an alternative to wheat in the production of ice cream baskets (ICB). The experiment was conducted according to a 23 full factorial design using water (WT; 10 or 15 mL), rice flour (RF; 15 or 20 g) and cowpea flour (CF; 15 or 20 g) as variables. The ICB consisted of 6.4–10% moisture, 10.1–11.9% protein, 75.2–78.4% carbohydrates, 2.2–3.7% lipids. The ash content was determined to be 1.2–1.5%, the energy content 368.7–382.0 for kcal and Aw 0.308–0.475. The ICB showed a bronze-orange color resulting from the presence of carotenoids (4.9–9.3 μg/g W) from the crude palm oil used. Texture and sensory analysis of the ice cream baskets revealed a crispy, brittle and hard nature. The highest acceptability (≥4) in the sensory evaluation was obtained for ice cream baskets produced with 20 g of rice flour, 20 g of cowpea flour and 15 g of water. Thus, the developed gluten-free ice cream baskets are an excellent alternative to wheat-based ones.

Plantain flour (Musa ssp., group AAB, sub-group clone Harton) was modified by acetylation, carboxymethylation, methylation, oxidation and phosphation, in order to determine which of these modifications produce a material with potential for the development of gluten-free products with improved nutritional properties. The structural, rheological and nutritional properties of the modified flours were investigated. The phosphated plantain flour, cross-linked with sodium trimetaphosphate (STMP), had a lower in vitro digestibility rate associated with resistant starch (RS) types RS2, RS4 and RS5. This latter was confirmed by the formation of the amylose-lipid complex as determined by XRD. All the flours tested had a C-type structure with the exception of the methylated plantain flour which produced a large quantity of reaction by-product (BaSO4). The phosphated plantain flour represents a raw material with great potential for the development of gluten-free food (bread and cookie) with functional properties, i.e. health benefits. Fil: Gutiérrez Carmona, Tomy José. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Ciencia y Tecnología de Materiales. Universidad Nacional de Mar del Plata. Facultad de Ingeniería. Instituto de Investigaciones en Ciencia y Tecnología de Materiales; Argentina

Dietary fiber from three gluten-free sources (quinoa, amaranth, and millet) was recovered via enzymatic, enzymatic-ultrasonic and ultrasonic extraction. Two raw materials were used for this study: commercially available flour and whole seeds. Various physicochemical and nutritional parameters were evaluated. Generally, the highest extraction yield was observed from enzymatic-ultrasonic extraction. In millet samples (ML-F and ML-W), ultrasonic extraction was characterized by yields than enzymatic extraction. Bulk density in millet samples achieved results exceeding 0.8 g · cm−1, indicating that apart from bigger particle size, millet dietary fiber particles were more dense and thus heavier. Amaranth samples had relatively higher amounts of soluble fractions of dietary fiber. The most prominent differences in color between raw material and dietary fiber were observed within quinoa samples. Results reveal that quinoa, amaranth, and millet could act as substantial sources of dietary fiber with various physicochemical properties.

Baked flour products are basic in people´s diet; the problem arises when celiac people tend to follow this kind of diet. In this work we exploit the benefit of American carob, Prosopis alba flour (PAF) in developing gluten-free muffins jointly with corn flour (CF) and rice flour (RF). All muffins obtained presented very good physical and sensory characteristics. The muffin with the highest amount of PAF presented low chewiness and was the most adhesive. Crumb structure of muffins with PAF presented alveoli of more irregular form although they occupied a greater proportion of area, leading to softer crumbs. Sample with high content of PAF presented the greatest score for sensory overall acceptability and the lowest for chewiness; also the intensive brown color was also well accepted by consumers. Nutritional analysis of the muffins indicate that those products with the highest content of PAF (66.6%) presented higher amount of proteins, ash and dietary fiber and lower of lipids. Also, these muffins presented a high amount of polyphenols and the highest antioxidant activity. Sensory and nutritional analysis showed that PAF contributed in a positive form to muffin´s quality, suggesting that this flour would be a suitable ingredient as mimetic of chocolate-based breads. Fil: Sciammaro, Leonardo Pablo. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de la Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; Argentina Fil: Ferrero, Cristina. Facultad de Ciencias Exactas, Universidad Nacional de la Plata; Argentina Fil: Puppo, Maria Cecilia. Facultad de Ciencias Agrarias y Forestales, Universidad Nacional de la Plata; Argentina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Investigación y Desarrollo en Criotecnología de Alimentos. Universidad Nacional de la Plata. Facultad de Ciencias Exactas. Centro de Investigación y Desarrollo en Criotecnología de Alimentos; Argentina

The influence of germination period (24–96h) on nutritional composition, antinutrients, free and bound polyphenols and muffin-making properties of Tartary buckwheat (TBW) flour was evaluated. The antioxidant activity of flour increased after germination for 72h due to more accumulation of free flavonoids and phenolic acids. Although free rutin was the main polyphenol, but the highest increment after germination was observed in kaempferol, catechins, vitexin and p-coumaric acid. TBW germination for 48–72h caused an increase in essential amino acids (lysine, leucine and phenylalanine) and GABA content of flour. Flour functionality in terms of water absorption and foaming capacity improved upon germination for 48h, though foaming stability declined upon germination. The incorporation of 24h–48h germinated TBW flour to rice-based batter decreased storage (G′) and viscous (G″) moduli; however, G′ and G″ increased with increased incorporation of TBW flour and these batters yielded muffins with the highest specific volume. Whereas, prolonged germination (96h) yielded exceptionally high G′ and G″ leading to a highly thick sticky batter that yielded muffins of lower specific volumes and higher firmness. The glycemic index of muffins incorporated with germinated (24–48h) TBW flour was lower than those made using ungerminated TBW. Prolonged germination for 96h increased the glycemic index of TBW incorporated muffins.

Physical, chemical, and antioxidant analysis of grain and flour of five sorghum hybrids with different pericarp color (brown, red, and white) and endosperm texture were conducted to prepare gluten-free bread. Specific volume, texture, and acceptance were assessed in the breads. All characteristics were correlated to identify the drivers of liking. Only the brown BRS 305 and 1,167,048 hybrids presented pigmented testa layer with higher total phenolic contents (TPC) and total condensed tannins (TAN). The former stood out for antioxidants (1493 mg/100 g of TPC, 609.9 mg/100 g of TAN). The negative effect of antioxidants and fibers on bread acceptance was highlighted. Red sorghum BRS 332 presented higher acceptance, besides an interesting content of antioxidants (218 mg/100 g of TPC and 21.4 mg/100 g of TAN). Proteins, carbohydrates, and soluble starch were drivers of liking. Their contents could be adjusted with other ingredients to improve formulations of higher antioxidant sorghum breads.

For proper industrialization of gluten-free (GF) foods, it is important to know their properties and behavior under process. This is even more important when using novel ingredients. The by-product of walnut oil (Juglans regia L.) extraction is a press cake rich in polyunsaturated fatty acids and other bioactive compounds. From this cake, walnut flour (WF) is obtained by milling. This study was focused on evaluating the effects of adding WF on the rheological, textural, thermal, and microstructural properties of batters. Different levels of addition of WF (0, 100, 150, 200 g/kg flours blend) were assayed. The pasting properties of the base flour mix (rice flour, cassava, and maize starches) were altered by WF addition. Likewise, increased WF concentration on batters increased their firmness, cohesiveness and, consistency and viscosity indexes. Regarding the molecular mobility of components of batters, a decrease in the relaxation times in NMR assays and in the amount of freezable water was found while the glass transition was not affected. Confocal scanning laser micrographs of batters showed a protein matrix with starch granules, oil droplets, and fiber fragments. Overall, these results showed that the addition of WF enhanced the quality of the GF batters.

The search of proteins that could act as both structural agents and nutritional enhancers in gluten free bread is still a challenge for the food industry. The present study evaluated the inclusion of 10% β-conglycinin concentrate (βCC) extracted from defatted soybean flour to rice flour to improve the structure and protein quality of gluten-free yeast-leavened bread. βCC breadmaking performance was compared to vital gluten functionality. Batter pasting properties and bread characterization in terms of color, texture, image analysis, microstructure a, nd protein quality were assessed. βCC and gluten led to batters with higher peak viscosity and breakdown, although only βCC was able to increase the setback. The inclusion of 10% βCC in rice flour formulations led to breads with improved color parameters and protein quality. The texture properties of βCC breads did not present significant differences compared to vital gluten breads. The crumb analysis showed that βCC led to lower cell density with highest mean cell area. The micrographs showed that βCC was able to create a net-like structure similar to the one created by gluten, confirming that βCC is capable of acting as structuring agent and protein quality improver in gluten-free formulations., Authors acknowledge the financial support of the Spanish Ministry of Economy and Competitiveness (Project AGL2014-52928-C2-1-R), Generalitat Valenciana (Project Prometeo 2017/189), the European Regional Development Fund and the joint project between research group from IATA-CSIC and the research groups of Nutriomics and CIDPRO from Tecnologico de Monterrey, Mexico. Johanan Espinosa-Ramírez acknowledges the support from CONACYT for the PhD scholarship (375643).

Objective: To describe a case in which a gluten-free diet led to a successful full-term delivery in a woman with recurrent miscarriages and nonceliac gluten sensitivity (NCGS).Methods: Reduced incidences of spontaneous abortions have been reported in patients with celiac disease who adhere to a gluten-free diet, but little is known about improvement in reproductive issues in women with NCGS. We present a case of a woman with multiple miscarriages who improved on a gluten-free diet.Results: A 33-year-old woman presented with history of hypothyroidism and recurrent first-trimester fetal loss. On exam, body mass index was 24.9 kg/m2, and she did not appear cushingoid. She was on levothyroxine, and thyroid function tests were within normal limits. Thyroid peroxidase antibody and anti-phospholipid antibody were negative. Although she denied gastrointestinal symptoms, undiagnosed celiac disease was considered, as she had family members with celiac disease. Anti-gliadin immunoglobulin (Ig)G antibody was elevated, while tissue transglutaminase IgA and anti-endomysial IgA were negative. Esophagogastroduodenoscopy and biopsy showed normal mucosa. These findings were consistent with a diagnosis of NCGS. A trial with a gluten-free diet was initiated. She became pregnant again and was able to carry the baby to full-term with delivery.Conclusion: While the exact effect of NCGS is yet to be determined, immunologic changes in placental function may account for recurrent fetal loss since gliadin is abundant in the extravillous trophoblast that attaches the placenta to the mother.Abbreviations: ACTH = adrenocorticotropic hormone; Ig = immunoglobulin; NCGS = nonceliac gluten sensitivity

We performed a systematic review of the literature to determine whether adherence to a gluten-free diet (GFD) leads to improved outcomes for patients with schizophrenia. We searched the AMED (Allied and Complementary Medicine; 1985–June 2016), MEDLINE (1946–June 2016), and Embase (1980–2016 week 24) databases using the terms “wheat” or “glutenin” or “gliadin” or “gluten” AND “schizophrenia.” A total of 9 studies met the inclusion criteria for this review: 1 randomized controlled trial, 7 crossover studies, and 1 open-label pilot study. Six of the included studies demonstrated beneficial effects including improved functioning and decreased symptom severity after the course of a GFD, whereas 3 studies found no benefits. All of the included studies found that a GFD is well tolerated and can be adhered to by patients with schizophrenia. The findings of this systematic review should be interpreted with caution due to limitations inherent to nonrandomized trials, as well as the heterogeneity in the study design and the length of the GFD applied in each study. Publication bias is another potential limitation. Further research is required to examine the biomarkers of gluten sensitivity and inflammation to effectively target those patients with schizophrenia who will benefit most from this dietary intervention.

Background Around 1% of world population is affected by celiac disease. Celiacs are constrained to follow a strict gluten free (GF) diet. Often their diet is unbalanced and lacks in many nutrients. In recent years, some breakthroughs have been made but there is still the need to provide better quality products to celiac people. Biscuits represent a good vehicle to distribute nutrients to celiac patients, because they are a convenient food appreciated by all groups of population. In addition, it is easier to produce gluten free biscuits than gluten free breads. Compared to bread, gluten plays a minor role in biscuits so a wider variety of flours might be employed. Scope and approach This paper focuses on the possibility to use alternative flours to rice and starches flours which may be employed in GF biscuits production. Furthermore, a discussion about technological, sensory and nutritional issues has been carried out. Moreover, to evaluate the composition of commercial GF biscuits, the frequency of occurrence of ingredients on the label of 282 biscuits present on Italian market is included as case study. Key findings and conclusions Many research showed that it is possible to formulate acceptable GF biscuits using alternative flours from cereals, pseudocereals and legumes, that may also enhance the nutritional quality, the antioxidant activity and the glycemic index of the biscuits. Malting, fermenting and germination can improve the overall quality of biscuits without affecting negatively technological properties. In Italian gluten free biscuits, maize starch and rice flour are the most frequent ingredients whereas alternative flours are still little employed.

Corn gluten meal is an underutilized byproduct due to its hydrophobic nature although it contains high amount of protein. The primary objectives of this study were to enhance the water holding capacity of this protein-rich byproduct with microfluidization technique and use it in bread-making formulations instead of gluten with the addition of different supplements. The increase in stability, surface area, and consequently water holding capacity with microfluidization resulted in the formation of compatible and homogeneous dough structure for gluten-free bread formulations. The dough exhibited linear viscoelastic behavior at strains lower than 0.5%. Elastic moduli were higher than viscous moduli for all formulations, meaning solid-like behavior. The addition of xanthan and citrus fiber resulted in higher moduli values. The decrease in particle size and the emergence of new tissues resulted in revealing of carotenoids like lutein and zeaxanthin, responsible for the yellow color of corn gluten meal. The breads produced from microfluidized samples had 1.19–1.27 times higher specific volumes than untreated samples of the same formulation. Similar improvements (1.03–1.22) were obtained with the addition of xanthan and citrus fiber. Both microfluidization treatment and the addition of supplements led to lower hardness, and higher cohesiveness and springiness values.

The microbial diversity and pasting properties of three sourdoughs produced from composite gluten-free flours were investigated using 16S rRNA gene clone libraries and the Rapid Viscoanalyser. Finger millet-pearl millet (FP), Pearl millet-sorghum (PS) and Finger millet-sorghum (FS) sourdoughs were produced. Eleven aerobic bacteria and twelve lactic acid bacteria (LAB) were randomly selected from the sourdoughs. Presumptive Bacillus subtilis and Pediococcus spp. were identified in all the sourdoughs after 48 h of fermentation, while yeast was not detected in any of the products. The LAB population and pH ranged from log 7.70 CFU g−1 to log 10.52 CFU g−1 and 3.8 to 4.2 respectively. The findings showed that well-developed sourdough could be produced from these composite flours by spontaneous fermentation. Significant differences were observed in the pasting properties of all the sourdoughs. Decline in the tendency to retrograde occurred in all sourdoughs, thereby justifying the lower staling rate of final products. This study enhanced the corpus of existing knowledge on the microbial diversity of gluten-free sourdough and provided a basis for the possible application of Pediococcus spp. and Weisella spp. as a starter culture(s) in fermented products.