Dietary patterns drive loss of fiber-foraging species in the celiac disease patients gut microbiota compared to first-degree relatives.

BACKGROUND: Celiac disease is an autoimmune disorder triggered by dietary gluten in genetically predisposed individuals that primarily affects the small intestine. Studies have reported differentially abundant bacterial taxa in the gut microbiota of celiac patients compared with non-celiac controls. However, findings across studies have inconsistencies and no microbial signature of celiac disease has been defined so far. RESULTS: Here, we showed, by comparing celiac patients with their non-celiac 1st-degree relatives, that bacterial communities of related individuals have similar species occurrence and abundance compared with non-relatives, regardless the disease status. We also found in celiac patients a loss of bacterial species associated with fiber degradation, and host metabolic and immune modulation, as ruminiclostridia, ruminococci, Prevotella, and Akkermansia muciniphila species. We demonstrated that the differential abundance of bacterial species correlates to different dietary patterns observed between the two groups. For instance, Ruminiclostridium siraeum, Ruminococcus bicirculans, and Bacteroides plebeious, recognized as fiber-degraders, appear more abundant in non-celiac 1st-degree relatives, which have a vegetable consumption pattern higher than celiac patients. Pattern of servings per day also suggests a possible link between these species' abundance and daily calorie intake. CONCLUSIONS: Overall, we evidenced that a kinship approach could be valuable in unveiling potential celiac disease microbial traits, as well as the significance of dietary factors in shaping microbial profiles and their influence on disease development and progression. Our results pave the way for designing and adopting novel dietary strategies based on gluten-free fiber-enriched ingredients to improve disease management and patients' quality of life.

Noonan Syndrome and Celiac Disease in an Adolescent With Short Stature and Delayed Puberty.

Background/Objective: We present an adolescent male with Noonan syndrome (NS) and celiac disease (CD) who attained normal adult height with growth hormone (GH) treatment and gluten-free diet (GFD). Case Report: A 15 ½ year old healthy male presented with short stature and delayed puberty. His mother and maternal grandmother were short with heights 142.2 cm and 147.3 cm, respectively. Examination showed bilateral epicanthal folds and down slanting eyes like his mother, fifth finger clinodactyly, height 147.5 cm (<1%; standard deviation score, -2.96), growth velocity 2.5 cm/y, weight 48.2 kg (11%; standard deviation score, -1.24), Tanner 2 pubic hair and Tanner 1 genitalia. Midparental target height was 169.1 cm. He had normal screening studies for GH deficiency and thyroid disorders, prepubertal gonadotropins and testosterone levels, and normal total immunoglobulin A, and elevated antitissue transglutaminase immunoglobulin A 134.7units/mL (0-20). Bone age was 13 years. Genetic evaluation revealed heterozygous missense variant of BRAF gene in him and his mother confirming a diagnosis of NS. He was diagnosed with CD by intestinal biopsy. Patient was started on GH therapy and a GFD with subsequent improvement in growth velocit (6.8-12.3 cm/y) and advancement of puberty. The patient stopped GH therapy at 17 ½ years with a height 165.9 cm. Discussion: Coexistence of NS caused by BRAF missense variant and CD has not been previously reported. Our patient attained normal adult height with GH therapy and GFD. Conclusion: NS and CD can co-occur and addressing both these disorders can help patients attain normal height potential.

Chemical Composition, Health Benefits and Future Prospects of Hairless Canary Seed (Phalaris canariensis L.): A Review.

The increasing global population and the rise of health-conscious consumers have led to a growing demand for innovative foods and functional ingredients. Hairless canary seed (Phalaris canariensis L.), which has recently obtained regulatory food approval from Health Canada and the United States Food and Drug Administration (US-FDA), has the potential to meet these demands due to its unique nutrient profile and characteristics. Canary seed stands out among cereals and pseudo-cereals (gluten-free cereals) as it has the highest protein content and is gluten-free. Additionally, it contains significant amounts of tryptophan, an amino acid typically lacking in cereals. It is considered a true cereal grain that can be processed into flour, starch, and oil for various food and non-food applications. This article provides a comprehensive overview of the chemical composition, functional properties, and biological activities of canary seeds. It also explores the processing methods for incorporating these seeds into food and cosmetic products. Furthermore, suggestions for future research directions are presented to enhance the utilization of this plant. Overall, it is evident that Phalaris canariensis holds considerable potential as a sustainable crop that can be further developed.

Efficacy and Safety of a Low-FODMAP Diet in Combination with a Gluten-Free Diet for Adult Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.

BACKGROUND: Common gastrointestinal disease irritable bowel syndrome (IBS) is marked by symptoms like changed bowel habits, bloating, and stomach ache. A low-FODMAP combined gluten-free diet (LF-GFD) has been suggested as a possible therapy for IBS symptoms management. OBJECTIVE: This study sought to investigate whether a LF-GFD would help patients with IBS. METHODS: Strict inclusion and exclusion criteria from internet databases helped to identify clinical studies evaluating the intervention of LF-GFD in the treatment of IBS patients. Using measurements including the visual analog scale (VAS) for bloating and pain, the IBS symptom severity scale (IBS-SSS), and IBS quality of life (IBS-QoL), the main results evaluated were the efficacy of LF-GFD in reducing IBS symptoms. Furthermore assessed were the psychological impacts of LF-GFD utilizing the self- rating depression scale (SDS) and self- rating anxiety scale (SAS). RESULTS: A total of 437 patients (221 on LF-GFD diet and 216 on GFD) were involved in 4 randomized controlled trials and 4 cohort studies. The combined results indicated that LF-GFD reduced the VAS bloating ratings (RR = - 0.58, 95%CI - 0.92-0.23, P = 0.0010, I2 = 83%) and the VAS pain scores (RR = - 0.42, 95%CI - 0.66-0.19, P = 0.005, I2 = 58%). In addition, LF-GFD indicated a substantial enhancement in IBS-SSS scores (MD = - 1.42, 95%CI - 2.74-0.10, P = 0.03, I2 = 24%) and IBS-QoL ratings (MD = 3.75, 95%CI 0.98-6.53, P = 0.008, I2 = 33%). Moreover, the LF-GFD group showed a substantial drop in SDS (MD = - 2.56, 95%CI - 3.38-1.74, P < 0.00001, I2 = 65%) and SAS (MD = - 4.30, 95%CI - 6.53-2.24, P < 0.0001, I2 = 0%) scores compared to the GFD group. CONCLUSION: LF-GFD therapy significantly enhances clinical symptoms and reduces anxiety and depression in individuals diagnosed with irritable bowel syndrome.

Against the Grain: Consumer's Purchase Habits and Satisfaction with Gluten-Free Product Offerings in European Food Retail.

Across the world and within Europe, a growing number of consumers are choosing to buy gluten-free products. Motivations for a gluten-free diet and the consequences of consuming gluten are varied, from a medical necessity for those diagnosed with celiac disease to a range of health complications and discomfort for those who are gluten-intolerant. In this research, 7296 gluten-free consumers across 13 European countries responded to an online survey on the 33 types of gluten-free products purchased, how frequently they purchased them, their satisfaction with gluten-free quality and availability, the problems they have experienced, and the strategies they have employed to cope with these problems. The investigation examines whether and how these consumer attitudes and behaviors differ between those diagnosed with celiac disease, those who are gluten-intolerant, and those who are caregivers for others with a gluten-free diet. The results show that significant differences existed for all these habits and issues across the three gluten-free consumer groups. Specifically, caregivers purchased most of the gluten-free product types more frequently than the other two groups, experienced more availability problems, and were more likely to shop at multiple stores or make their own gluten-free products. Celiac-diagnosed consumers tended to buy gluten-free products more frequently than those who are gluten-intolerant, and they tended to be the most satisfied with the quality and range of gluten-free offerings. Despite purchasing frequency differences between the groups, the results suggest a similar hierarchy of gluten-free products that could provide the foundation for a European gluten-free food basket.

The Influence of Oat ß-Glucans of Different Molar Mass on the Properties of Gluten-Free Bread.

The influence of ß-glucans on the properties of gluten-free dough and bread is still not fully explained, with the literature suggesting both positive and negative effects. The aim of this study was to investigate the effect of the molar mass of oat ß-glucans on the properties of gluten-free bread. Gluten-free breads were baked under standardized conditions from a model gluten-free mix without and with a 1% or 2% share of oat ß-glucans of a low molar mass of 24,540 g/mol, a medium molar mass of 85,940 g/mol and a high molar mass of 1,714,770 g/mol. The share of ß-glucans affected the increase in water addition to the baking mix and dough yield proportionally to the molar mass and amount of ß-glucans. The ß-glucans of the highest molar mass, particularly at a 2% share, were most effective in increasing bread volume, reducing hardness and increasing the moisture content of the bread crumb on the day of baking, as well as reducing the increase in hardness and maintaining a high moisture content of the bread crumb after 1 day of storage, compared to bread without added ß-glucans.

Food Avoidance beyond the Gluten-Free Diet and the Association with Quality of Life and Eating Attitudes and Behaviors in Adults with Celiac Disease.

BACKGROUND: The only treatment for Celiac Disease (CeD), which affects about 1% of the population, is a gluten-free diet (GFD). Studies have indicated an association between the GFD, a diminished quality of life (QOL), and maladaptive eating patterns. This study aims to explore food avoidance behaviors in adults with CeD. METHODS: This cross-sectional study assessed 50 adults with biopsy-confirmed CeD who completed validated surveys evaluating demographics, psychological factors, QOL, eating pathology, and food avoidance. RESULTS: Overall CDQOL scores were good (mean: 62.7 out of 100). However, 58.0% of the participants self-elected to avoid one or more additional foods without diagnosed allergies or intolerances. Those avoiding one or more other foods had lower QOL scores (57.4 (23.2) vs. 70.2 (15.9)) compared to those only avoiding gluten (p = 0.034). The mean depression score (CESD) for the group avoiding foods beyond gluten was in the depressive range, unlike those avoiding only gluten (16.0 (4.9) vs. 13.6 (4.0), p = 0.078), with 77% of those avoiding more than gluten scoring above the CESD cut-off point of 15, indicating clinical depression. CONCLUSIONS: Over half of participants (58%) reported avoiding additional foods beyond the GFD, a behavior associated with decreased QOL and increased depression.

Textural improvement of pea protein-based high-moisture extrudates with corn zein and rice starch.

High moisture extrusion allows the production of plant protein-based products, including meat analogues. Building upon our previous findings showing that zein mixed with rice starch provides the necessary textural properties to formulations, different pea protein-based formulations with varying amounts of zein and rice starch or wheat gluten (as control) were produced using high moisture extrusion and the rheological, textural, and microstructural characteristics were evaluated and associated with the secondary structure of proteins. Samples containing wheat gluten presented desirable rheological and mechanical properties in terms of texturization, which was evidenced by the generation of a layered and three-dimensional viscoelastic network. The addition of rice starch to zein significantly increased the viscoelasticity of the samples due to enhanced development of non-covalent interactions that led to higher and more stable ß-sheets content and to the formation of a fibrous and layered microstructure and a 3D network nearly like those obtained with gluten. The sole replacement of pea protein by zein was not enough to develop these desired characteristics, demonstrating the importance of the non-covalent interactions between rice starch and zein for the generation of these properties. Overall, zein and rice starch improved texturization of pea protein-based gluten-free analogues made by high moisture extrusion.

Food insecurity impacts diet quality and adherence to the gluten-free diet in youth with celiac disease.

OBJECTIVES: Celiac disease (CD) is an autoimmune gastrointestinal disorder that requires a strict lifelong gluten-free diet (GFD). Gluten-free (GF) foods are more expensive and less readily accessible than gluten-containing foods, contributing to an increased risk for food insecurity (FI). The study aimed to determine associations between GF-FI, sociodemographic risk factors and child dietary adherence and diet quality (DQ). METHODS: A 26-item, cross-country online survey was administered through social media to parents of children with CD on the GFD. The survey elicited household and CD child sociodemographic and clinical characteristics (e.g., duration of CD), measures of household FI, child DQ and GFD adherence, and parents' concerns related to GF food. Household GF-FI was evaluated using the validated Hunger Vital Sign™ and the US Department of Agriculture Six-Item Short Form Household Food Security Survey Module. RESULTS: GF-FI occurred in 47% of households with children with CD with >30% reporting low to very low food security. Sociodemographic risk factors identified included lower income, renters, rural residency, single-parental households, and having children with additional dietary restrictions (p < 0.001). Regardless of FI status, a majority of households reported experiencing significantly higher GF food expenditure. GF-FI was associated with reduced adherence to the GFD, increased consumption of processed GF food, and lower intakes of fresh fruits and vegetables and GF grains among children with CD (p < 0.05). CONCLUSIONS: GF-FI is prevalent in this multiethnic cohort of households with CD children and is associated with worsening DQ and GFD adherence. Policy interventions are urgently needed to address GF-FI.

Coeliac Disease in Children-A Clinical Review Including Novel Treatment Agents.

Coeliac disease (CD) affects almost of 1% of the population, yet remains undiagnosed in the majority. Though the demonstration of enteropathy in duodenal biopsy was traditionally the essential criterion for the diagnosis of coeliac disease, the guidelines published by the European Society of Paediatric Gastroenterology and Nutrition (ESPGHAN) in 2012, and revised in 2020, paved the way to a no-biopsy approach to diagnosis. In a select group of children meeting certain criteria, a definitive diagnosis of CD can now be made without the need for duodenal biopsies. This is being increasingly applied in clinical practice. It is well established that untreated coeliac disease is associated with several chronic adverse health conditions. At present, a strict gluten-free diet remains the only effective treatment for CD. The advances in our understanding of the pathogenesis of CD have led to a search for alternative treatment agents. Several investigational agents are in various phases of clinical trials at present. In this review, we outline the clinical aspects of coeliac disease and summarise various investigational treatment agents.

Characteristics of Hospitalized Patients With and Without Celiac Disease on a Gluten-Free Diet.

BACKGROUND: Most people maintaining a gluten-free diet (GFD) do not have celiac disease (CD). Comorbidities and associated conditions in this population are largely unknown. AIMS: This study identified demographics, dietary patterns, and diagnoses for patients prescribed a GFD during hospitalization and compared patients with CD to those without CD. METHODS: We performed a retrospective cross-sectional study for hospital admissions with a GFD between Jan 1, 2010 and June 30, 2022, while excluding patients missing demographic data (n = 113). We compared patients with and without a CD diagnosis, including multivariable logistic regression to identify characteristics independently associated with a CD diagnosis. RESULTS: We analyzed 1527 hospitalized patients of all ages. A minority (n = 467, 30.6%) carried a CD diagnosis. Age, sex, body mass index, and Medicare/Medicaid enrollment and additional diagnoses associated with a GFD (e.g., IBS) were not significantly different. The CD cohort was more predominantly white (66.6% vs 58.4%, p = 0.007) and non-Hispanic (62.5% vs. 52.7%, p = 0.001). While hospitalized, patients with CD had fewer additional dietary restrictions (mean 0.33 vs 0.56, p < 0.001) and more frequent micronutrient supplementation (26.6% vs 21.4%, p = 0.03). CD was independently associated with malnutrition (OR 1.86, 95% CI 1.31-2.65) and inversely associated with a vegetarian diet (OR 0.35, 95% CI 0.15-0.81), reduced lactose diet (OR 0.25, 95% CI 0.13-0.50), and Hispanic ethnicity (OR 0.56, 95% CI 0.35-0.90) while controlling for other covariates. DISCUSSION: Two-thirds of hospitalized patients receiving a GFD do not have a diagnosis of CD. Among GFD inpatients, CD is associated with fewer dietary restrictions and independently associated with malnutrition.

[The importance of amaranth products in the diet of children with gluten intolerance].

The study of gluten intolerance is a modern area of medical science. With the advent of new diagnostic capabilities and data on the forms of the disease, wide opportunities have opened up in optimizing the timing and invasiveness reducing of intervention during diagnosis and further monitoring of the child's health. However, despite all efforts, the basic method of treating all forms of gluten intolerance remains strict adherence to a gluten-free diet (GFD). It is known that GFD itself, as well as low adherence to its observance can lead to nutritional disorders. Therefore, the expansion of the diet at the expense of foods with high nutritional value will greatly contribute to the optimization of diet therapy and compensation for food restrictions. The purpose of the review was to evaluate the possibility of using amaranth products in a GFD to fill the need for nutrients in children with gluten intolerance. Material and methods. The search for literature data was carried out using PubMed, eLIBRARY, scholar.google platforms mainly over the last 5 years, using the keywords: gluten intolerance, children, amaranth, gluten-free diet. Results. An analysis of modern literary sources has shown that amaranth is a product of choice in diet therapy when following a GFD, since it is a pseudo-grain crop. The article presents data confirming the high nutritional value of amaranth due to the protein component and the features of the lipid fraction. The features of the amino acid composition and squalene content in comparison with other plant crops are discussed. The article contains information on the preservation of the beneficial properties of amaranth in finished foods, in particular, the addition of amaranth flour instead of corn starch increases the protein content by 32% and fiber by 152% in gluten-free bread without affecting the taste. The advantages of the chemical composition of amaranth are shown in comparison with other pseudo-cereals. The research results prove the effectiveness of using amaranth products in GFD to eliminate deficiency states in patients, normalize physical development in children with gluten intolerance, and increase patient adherence to the diet. Conclusion. The composition of amaranth and the available studies on the effectiveness of amaranth products consumption convincingly prove the advisability of using it in nutrition, especially under dietary restrictions or increased need for nutrients in childhood.

[Assessment of tolerance of a new product (gluten-free grain snack) in children with food allergy to gluten].

The development of a technological scheme for the production of cereal snacks based on the extrusion process with preliminary enzymatic treatment of wheat flour and the use of hydrolysate as a partial replacement for gluten-free raw materials is an urgent task. The use of gluten-free cereal snacks in the diet opens up new possibilities for dietary therapy in patients suffering from various manifestations of food allergy to gluten, making their diet more diverse and meeting their individual needs. The purpose of the research was to clinically evaluate the tolerance of gluten-free cereal snacks in children with PA to gluten. Material and methods. The study included 21 patients (male and female) aged 3 to 17 years with a diagnosed food allergy, including gluten. All children received gluten-free cereal snacks according to their age: children from 3 to 7 years old (n=11) received 50 g (176 kcal) daily, and children aged 8 to 17 years old (n=10) received 100 g (352 kcal) daily for 14 days, in addition to a non-specific hypoallergenic diet excluding highly allergenic foods. On the first day of the study, the patients or one of their parents evaluated the organoleptic properties of the presented product (taste, color, smell) using a 5-point scale (1 - very bad, 5 - excellent), according to a specially designed questionnaire. The assessment of clinical symptoms over time related to skin, gastrointestinal tract, and nervous system was conducted using a second questionnaire, where parents kept a daily «observation log¼ reflecting the child's well-being and condition, as well as adverse events associated with taking the product. Clinical safety parameters were assessed based on the dynamics of complete blood count and blood immunological parameters (total IgE, specific IgE, and IgG4 antibodies to the studied allergens) at the beginning and end of the consumption period. Results. Daily examinations and patient questionnaires revealed no adverse reactions to the product. No significant differences in body weight were observed at the end of the study (p>0.05). In the results of clinical and immunological blood analysis before and after consuming gluten-free cereal snacks, no significant deviations were observed in the form of an increase in eosinophil count, total IgE, allergen-specific IgE and IgG4 antibodies in peripheral blood. This suggests a favorable clinical safety profile of the proposed product. Conclusion. The study found that consumption of the new product (gluten-free cereal snacks) was well-tolerated by children aged 3 to 17 years with various manifestations of food allergy: no adverse effects of the product or exacerbations of the underlying disease were observed during the 14-day period of gluten-free cereal snack consumption. Therefore, the studied gluten-free cereal snacks can be recommended for children aged 3 to 17 years with various manifestations of gluten FA, in combination with a gluten free diet.

Development and characterization of gluten-free fried dough (magwinya) using sorghum flour.

Magwinya, a deep-fried cereal dough, is usually produced using cake or bread wheat flour due to the naturally beneficial proteins found in wheat. In this study, sorghum flour, a gluten-free cereal grain, was used to produce magwinya. The aim was to develop and characterize gluten-free fried dough using sorghum flour. Xanthan and guar gum hydrocolloids were added to the sorghum flour in ratios of 0.5%, 1.0%, and 1.5% and 1.5%, 2.0%, and 2.5%, respectively, for magwinya production. The physicochemical characteristics of the magwinya were compared. The hardness of magwinya was significantly lower in sorghum: guar gum (SGG) samples due to their high moisture content. Ash and fiber content were also significantly higher in SGG samples. Increasing the level of SGG increased the volume (63.33-66.67 cm3). There was no significant difference in the weight of the samples. An increase in diameter (50.33-52.17 mm) was observed in SGG samples. Color analysis showed a significant increase in the L* (Lightness) of the crumb (46.28-49.12) compared to the crust (26.96-30.11) in the SX (sorghum: xanthan gum) and SGG samples. Redness (12.28-13.77) increased with levels, while yellowness (11.86-14.02) decreased with levels in SX and SGG crust. This study's findings are significant as they indicate that guar gum was the better binder for developing cereal fried dough (magwinya) from sorghum. These findings could have practical applications in the food industry, particularly in the development of gluten-free products and in the use of alternative grains like sorghum.

Higher cost of gluten-free products compared to gluten-containing equivalents is mainly attributed to staple foods.

The high cost of gluten-free products (GFPs) is being discussed as a potential barrier to adherence to a gluten-free diet, rendering monitoring of their pricing an ongoing demand in a market subject to continuous fluctuations. The current study aimed to assess the current pricing status of GFPs in the Greek retail market, with a focus on differences between staple and non-staple foods. The retail price and packaging weight of all available GFPs and their gluten-containing (GCPs) counterparts of a GFP-shopping basket (formulated based on the results of a preceding online survey) were recorded by visiting one store of the five most popular reported supermarket chains. The food categories were grouped into staple (e.g. breads, pasta and flours) and non-staple (e.g. chips, sweets and sauces) foods. Adjusting for supermarket chain and product type, a quantile mixed regression model was applied to assess the extent to which median product price (per 100 g) differed between GFPs and GCPs. The unique products recorded were 1058 (of which 408 GFPs), with a total of 2165 retail price recordings. While the overall median price/100 g of GFPs was not found to be significantly different from that of GCPs, the median price of staple GFPs was estimated to be higher than staple GCPs (+€1.03 [95% CI: €0.93; €1.13] per 100 g), whilst that of non-staple GFPs was slightly lower (-€0.20 [95% CI: -€0.37; -€0.02] per 100 g). In conclusion, the persisting higher cost of staple GFPs suggests the need for ongoing financial support for people with coeliac disease.

Assessment of Gluten-Free Products' Availability and Satisfaction in a Polish Population of Coeliac Disease Patients and Their Caregivers.

BACKGROUND/OBJECTIVES: Among the most important challenges associated with the gluten-free diet are the high costs and limited availability of gluten-free products, accompanied by the lower nutritional value of gluten-free products. The aim of the presented study was to assess gluten-free products' availability and satisfaction in a Polish population of coeliac-disease patients and their caregivers. METHODS: The study was conducted in a population of Polish female coeliac-disease patients and female family members/relatives of patients diagnosed with coeliac disease, being members of the Polish Coeliac Society and purchasing gluten-free products. A population of n = 819 was included in the studied group based on the inclusion and exclusion criteria (n = 547 of patients and n = 272 of family members/relatives of patients). The study was conducted as a part of an international project to assess the opinions of coeliac-disease patients about gluten-free products, as well as the availability and prices of gluten-free products in various countries, while an identical questionnaire was applied in all participating countries, with transcultural adaptation applied. Opinions concerning the availability of and satisfaction with gluten-free products were assessed based on a questionnaire of agreement with fixed statements about the accessibility, range and quality of gluten-free products in Poland, with a five-point Likert scale to declare the agreement. This was stratified by the following variables: age, place of residence, being diagnosed with coeliac disease, place of purchasing major grocery shopping, gluten-free products at least occasionally bought online, declared problem(s) with the availability and quality of gluten-free products. RESULTS: While comparing the studied sub-groups, it may be stated that some of them were more satisfied than the other sub-groups with the gluten-free products, including their availability and quality; namely, older respondents were more satisfied than younger ones (p < 0.05), respondents living in small towns/villages were more satisfied than those living in big cities (p < 0.05), respondents undertaking major grocery shopping in hypermarkets were more satisfied than those not doing this (p < 0.05), and respondents not buying gluten-free products online were more satisfied than those undertaking this at least occasionally (p < 0.05). At the same time, respondents diagnosed with coeliac disease were more satisfied with the availability and less satisfied with the quality of gluten-free products, while respondents with diagnosed family members/relatives were less satisfied with the availability and more satisfied with the quality (p < 0.05). CONCLUSIONS: The group of female coeliac-disease patients and female family members/relatives of patients diagnosed with coeliac disease was highly diverse in terms of their satisfaction with gluten-free products' availability and quality, whilst older respondents, respondents living in small towns/villages, respondents doing major grocery shopping in hypermarkets, and respondents not buying gluten-free products online were more satisfied. Respondents with family members/relatives diagnosed with coeliac disease declared serious efforts and sacrifice to purchase gluten-free products, which was associated with their higher satisfaction with quality and lower satisfaction with availability, while respondents diagnosed with coeliac disease chose easier options, resulting in their higher satisfaction with availability and lower satisfaction with quality.

Beyond the Grain: Navigating the Intersection of Gluten-Free Diets, Celiac Disease, and Cardiovascular Health.

Celiac disease (CD) is a complex autoimmune disorder triggered by gluten exposure in genetically susceptible individuals. This scoping review explores the intricate relationship between CD and cardiovascular manifestations, aiming to understand the impact of gluten-free diets (GFD) on cardiac health. A comprehensive search resulted in four pertinent studies revealing structural and functional abnormalities in the cardiovascular system of untreated CD patients. Among patients who did not adhere to a GFD, electrocardiogram abnormalities such as prolonged QT intervals and increased predisposition to arrhythmias were noted. Studies identified a significant prevalence of CD in patients with dilated cardiomyopathy or myocarditis, suggesting a potential association. GFD and immunosuppression were shown to improve cardiac function and reduce arrhythmias in CD patients exhibiting cardiovascular manifestations. However, limitations such as small sample sizes and incongruous cohorts make it difficult to assess the direct impact of GFD interventions on cardiac health. Future research should prioritize larger, longitudinal studies to fully understand mechanisms and treatment strategies. This review emphasizes the intricate interplay between CD and cardiac health, emphasizing the importance of early detection, comprehensive management, and further research for optimal clinical outcomes.

Advances in understanding and managing celiac disease: Pathophysiology and treatment strategies.

In this editorial, we comment on an article published in the recent issue of the World Journal of Gastroenterology. Celiac disease (CeD) is a disease occurring in genetically susceptible individuals, which is mainly characterized by gluten intolerance in the small intestine and clinical symptoms such as abdominal pain, diarrhea, and malnutrition. Therefore, patients often need a lifelong gluten-free diet, which greatly affects the quality of life and expenses of patients. The gold standard for diagnosis is intestinal mucosal biopsy, combined with serological and genetic tests. At present, the lack of safe, effective, and satisfactory drugs for CeD is mainly due to the complexity of its pathogenesis, and it is difficult to find a perfect target to solve the multi-level needs of patients. In this editorial, we mainly review the pathological mechanism of CeD and describe the current experimental and improved drugs for various pathological aspects.

Physical, textural, and sensory characteristics of gluten-free cupcakes developed with native and modified by hydrothermal treatment green plantain flours.

Gluten-free diets are characterized by lower nutritional quality. The use of green plantain flour in gluten-free formulations appears as an alternative to overcome this deficiency, considering that green plantains have a relevant content of bioactive compounds, dietary fiber, including resistant starch. The objective of this work was to evaluate the effect of the addition of native and modified by hydrothermal treatment green plantain whole flours in the form of gluten-free cupcakes. The density, yield, and microstructure of the dough, specific volume (SV), height, crumb analysis, color, texture, and sensory acceptability of the cupcakes were evaluated. Partial replacement (40%) of rice flour by native and modified flours produced darker, redder cupcakes, less yellowish and with less color intensity. Sensory analysis revealed higher acceptance for cupcakes with native and modified flours, compared to the control, for appearance, flavor, texture, aroma, and overall acceptance. The native flour was the most viable option, as the cupcake produced with it showed the best values for hardness and chewiness, without changing elasticity and SV, in addition to superior sensory acceptance than the control and similar to cupcakes with other modified flours. PRACTICAL APPLICATION: Pursuing to meet the market demand for gluten-free products, with the cake being one of the most requested products in this market, and taking in account that green banana, from different cultivars, has gained interest for the production of flours. The production of flour and bakery products is of great interest to the food industry, not only because of its flavor and properties but also due to the economic and sustainable viability of producing whole green plantain flour with the potential for application, promoting diversification and innovation in the gluten-free functional products market.

Sensory Evaluation and Consumers' Acceptance of a Low Glycemic and Gluten-Free Carob-Based Bakery Product.

Carob pulp flour has antidiabetic and antioxidant activities, is naturally sweet, and is rich in fibers. It is obtained from carob pod pulp from the evergreen tree Ceratonia siliqua L., which is grown in Mediterranean areas and is known for locust bean gum production. Despite its valuable effects on health, such as the modulation of the glycemic index, this ingredient has a tremendous impact on technological and hedonic features, mainly on color, flavor, and texture. In this paper, the qualitative features and consumers' acceptance of a carob-based gluten-free bakery product where rice flour was substituted at 40% with carob pulp flour were studied. A panel group of experts described the bread as dark, quite dense, sweet, aromatic, and with a limited bubble dispersion. On the other hand, the sensory assessment and the willingness to pay of consumers were assessed in two groups (a fully informed one about heathy attributes of the food and a blind one). The results indicated a moderate appreciation of the overall quality of the product (average score between 4 and 5 points on a 9-point Likert scale). The information about the food's healthy properties and the ability to maintain a low glycemic index did not enhance the consumers' perception of the product, while previous knowledge and involvement in the product consumption were perceived to have primary importance regarding the final consumers' choice. Finally, an accelerated shelf-life test was run on the packaged snack to evaluate the general quality and stability. The protective packaging helped in limiting bread decay and maintaining the textural characteristics.