Gluten-Free Diet Adherence Tools for Individuals with Celiac Disease: A Systematic Review and Meta-Analysis of Tools Compared to Laboratory Tests.

This systematic review aimed to find the tool that best predicts celiac individuals' adherence to a gluten-free diet (GFD). The Transparent Reporting of Multivariable Prediction Models for Individual Prognosis or Diagnosis (TRIPOD-SRMA) guideline was used for the construction and collection of data from eight scientific databases (PubMed, EMBASE, LILACS, Web of Science, LIVIVO, SCOPUS, Google Scholar, and Proquest) on 16 November 2023. The inclusion criteria were studies involving individuals with celiac disease (CD) who were over 18 years old and on a GFD for at least six months, using a questionnaire to predict adherence to a GFD, and comparing it with laboratory tests (serological tests, gluten immunogenic peptide-GIP, or biopsy). Review articles, book chapters, and studies without sufficient data were excluded. The Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies (CHARMS) was used for data collection from the selected primary studies, and their risk of bias and quality was assessed using the Prediction Risk of Bias Assessment Tool (PROBAST). The association between the GFD adherence determined by the tool and laboratory test was assessed using the phi contingency coefficient. The studies included in this review used four different tools to evaluate GFD adherence: BIAGI score, Coeliac Dietary Adherence Test (CDAT), self-report questions, and interviews. The comparison method most often used was biopsy (n = 19; 59.3%), followed by serology (n = 14; 43.7%) and gluten immunogenic peptides (GIPs) (n = 4; 12.5%). There were no significant differences between the interview, self-report, and BIAGI tools used to evaluate GFD adherence. These tools were better associated with GFD adherence than the CDAT. Considering their cost, application time, and prediction capacity, the self-report and BIAGI were the preferred tools for evaluating GFD adherence.

Andean Crops Germination: Changes in the Nutritional Profile, Physical and Sensory Characteristics. A Review.

Andean crops such as quinoa, amaranth, cañihua, beans, maize, and tarwi have gained interest in recent years for being gluten-free and their high nutritional values; they have high protein content with a well-balanced essential amino acids profile, minerals, vitamins, dietary fiber, and antioxidant compounds. During the germination bioprocess, the seed metabolism is reactivated resulting in the catabolism and degradation of macronutrients and some anti-nutritional compounds. Therefore, germination is frequently used to improve nutritional quality, protein digestibility, and availability of certain minerals and vitamins; furthermore, in specific cases, biosynthesis of new bioactive compounds could occur through the activation of secondary metabolic pathways. These changes could alter the technological and sensory properties, such as the hardness, consistency and viscosity of the formulations prepared with them. In addition, the flavor profile may undergo improvement or alteration, a critical factor to consider when integrating sprouted grains into food formulations. This review summarizes recent research on the nutritional, technological, functional, and sensory changes occur during the germination of Andean grains and analyze their potential applications in various food products.

Enhancing life with celiac disease: unveiling effective tools for assessing health-related quality of life.

Celiac disease (CD) is an autoimmune chronic enteropathy provoked by gluten ingestion in genetically predisposed individuals. Considering it´s only safe treatment is a lifelong gluten-free diet, the burden of living with the disease becomes evident, as well as the need to assess CD health-related quality of life (HRQOL). This review aims to identify and analyze the instruments used to evaluate the HRQOL of adults with CD. This integrative review using a systematic approach was designed to achieve high scientific standards. Accordingly, the search strategy was developed and executed as recommended by the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Detailed individual searches were developed to Pubmed, Science Direct, Scopus, Web of Science, and Google Scholar. After careful analysis of the papers, 43 studies were included, in which seven instruments were identified: Celiac Disease Questionnaire (CDQ) (n=21), Celiac Disease Specific Quality of Life Instrument (CD-QOL) (n=17), Celiac Disease Assessment Questionnaire (CDAQ) (n=4), CeliacQ-7 (n=1), CeliacQ-27 (n=1), Black and Orfila´s self-developed instrument (n=1) and the Coeliac Disease Quality of Life Questionnaire (CDQL) (n=1). The CDQ and CD-QOL were the two most applied instruments. Since the first focuses on the physical and mental symptoms related to the disease and the second focuses on the emotional repercussions of adhering to the GFD treatment for life (dysphoria), the CDQ application is an interesting option for countries that struggle with public policies for CD patients and patients with active CD. The CD-QOL could be used for countries with strict regulations for CD and gluten-free products and populations in remission. When comparing results among different populations, it is preferable to utilize culturally validated instruments, which have been applied across multiple countries, providing greater comparability between study findings.

Technological and textural properties of gluten-free quinoa-based pasta (Chenopodium quinoa Wild).

Quinoa (Chenopodium quinoa Willd.) is an Andean grain with a perfect nutritional composition that, by diversifying its transformation, becomes an attractive alternative for consumers looking for a high-quality, healthy diet with a source of vegetable proteins. The objective of this work was to elaborate and evaluate the technological and textural properties of quinoa paste in its entirety through the Star-Shaped Composite Central Design (CCD) of 5 process variables: Water Temperature (°C), Water Quality (ml), Mixing Time (min), Drying Temperature (°C), and Drying Time (min), with 5 levels each. At the same time, the yield and good cooking quality were studied to optimize the process. In the model of the equation for the cooking time response, a negative and significant influence of drying temperature was shown. On the other hand, for cooking loss, dough gain, a* and b* values, and texture had high values if the drying time was increased. On the contrary, the L-value decreases, which is positively significant. Meanwhile, the swelling index was only significantly positive within the technological properties. In addition, it was found that the optimal conditions for producing quality pasta were 25 °C: 1150 ml: 30 min: 70 °C and 80 min, respectively, with a desirability of 0.883. When the pasta was prepared with quinoa, the cooking time was 7 min, the cooking loss was 2.46 g/g, the mass gain was 23.6 g/g, the cooking yield was 7.99%, the swelling index was 2.9%, water absorption was 135%, and protein was 12.71 g and 0. 21 Pa in texture, these results being consistent with cited research. Likewise, the whiteness was 51.97 for the values a* 2.41 and b* 12.45; all this analysis is reflected in the final yield of the process at 78%. In conclusion, the results indicated that, by optimizing the conditions in the production of gluten-free quinoa pasta, it is possible to obtain a gluten-free product with high added value, excellent cooking quality, adequate technological properties, texture, and color acceptable to the consumer.

Division of Responsibility in Child Feeding and Eating Competence: A Cross-Sectional Study in a Sample of Caregivers of Brazilian Children with Celiac Disease.

The objective of this cross-sectional study was to assess eating competence (EC) and the adherence to the division of responsibility in child feeding (sDOR) of Brazilian caregivers of children with celiac disease (CD). It also examined the association between EC and sDOR, children's adherence to a gluten-free diet, and sociodemographic data. This study administered a survey set that included sociodemographic data, health-related data, eating habits, and the instruments ecSI2.0TMBR and sDOR.2-6yTM BR, validated for a Brazilian population. The sample comprised 50 caregivers of children with CD (between 24 and 72 months of age). The participants following a gluten-free diet (GFD) presented higher scores for all EC domains and the total EC. The total EC scores were higher for the participants over 40 y/o, frequently having meals as a family, with their children consuming more than three servings of fruit and at least one serving of vegetables daily and complying with a GFD. Different from the EC, the sDOR.2-6yTM scores did not differ between the participants complying with a GFD. The sDOR.2-6yTM mealtime structure domain scores were significantly associated with the EC eating attitude, food acceptance, contextual skills, and total. These findings support the need for greater attention to exploring the division of responsibility in feeding and EC in pediatric celiac disease, potentially enhancing intervention strategies for patients and their families.

Risk of Gluten Cross-Contamination Due to Food Handling Practices: A Mini-Review.

Celiac disease (CD) is an autoimmune disease triggered by the ingestion of gluten in genetically predisposed individuals, affecting 1.4% of the world population. CD induces an inflammatory reaction that compromises small intestine villi, leading to nutrient malabsorption, and gastro and extraintestinal manifestations. Although other treatment approaches are being studied, adherence to a gluten-free diet (GFD) is the only effective intervention to date. Despite this, about 50% of patients experience persistent inflammation, often associated with unintentional gluten ingestion through contaminated food. There are regulations for labeling gluten-free foods which specify a limit of 20 mg/kg (20 ppm). The risks of gluten cross-contamination above that level are present throughout the whole food production chain, emphasizing the need for caution. This review explores studies that tested different procedures regarding the shared production of gluten-containing and gluten-free food, including the use of shared equipment and utensils. A literature review covering PubMed, Scielo, Web of Science, VHL and Scopus identified five relevant studies. The results indicate that shared environments and equipment may not significantly increase gluten cross-contamination if appropriate protocols are followed. Simultaneous cooking of gluten-containing and gluten-free pizzas in shared ovens has demonstrated a low risk of contamination. In general, shared kitchen utensils and equipment (spoon, ladle, colander, knife, fryer, toaster) in controlled experiments did not lead to significant contamination of samples. On the other hand, cooking gluten-free and gluten-containing pasta in shared water resulted in gluten levels above the established limit of 20 ppm. However, rinsing the pasta under running water for a few seconds was enough to reduce the gluten content of the samples to less than 20 ppm.

Gluten-free lentil cakes with optimal technological and nutritional characteristics.

BACKGROUND: The celiac population usually struggle finding nutritive gluten-free (GF) baked goods. GF foods can be improved using legume flours. Eleven GF cake formulations were elaborated according to different percentages of lentil flour (LF), corn flour (CF) and rice flour (RF) using a simplex lattice design. Water holding capacity and particle size of flours were evaluated. Moisture, aw, pH, specific volume, texture profile, relaxation, color and alveolar characteristics were determined for crumbs of all formulations. An optimization process was used to enhance the technological and nutritional attributes, selecting the three best formulations containing LF: 46% LF + 54% RF (CLF+RF); 49% LF + 51% CF (CLF+CF); and 100% LF (CLF), evaluated in their proximal composition and sensory characteristics. Linear and quadratic models for predicting the behavior of GF lentil cakes were obtained. RESULTS: LF and CF could favor water incorporation and show more resistance to enzymatic digestion than RF. Formulations with LF showed an improvement in specific volume and alveolar parameters, while use of RF led to better cohesiveness, elasticity and resilience but with a deterioration in chewiness and firmness. CLF can be labeled as high in protein and fiber and presented the lowest amounts of lipids, carbohydrates and energy content. Consumer preference leaned towards CLF+RF. CONCLUSION: It was possible to elaborate GF cakes using LF, obtaining nutritive products that can be offered to people intolerant to gluten ingestion. © 2024 Society of Chemical Industry.

Effects of Teosinte Flour (Dioon mejiae) on Selected Physicochemical Characteristics and Consumer Perceptions of Gluten-Free Cocoa Cookies Formulated with Mung Bean (Vigna radiata) Flour.

Dioon mejiae, or teosinte, is a living fossil tree discovered in Olancho, Honduras, whose seeds have a desirable nutritional profile that can provide health benefits. As a result, the objective of this study was to evaluate the effects of teosinte flour obtained from seeds on selected physicochemical characteristics and consumer perceptions of gluten-free cocoa cookies formulated with mung bean (Vigna radiata) flour. Gluten-free cocoa cookies were prepared with different levels of teosinte flour (0%, 70%, 80%, 90%, and 100% by weight of mung bean flour) in substitution of mung bean flour. The cookies were evaluated for texture hardness, color (L*, a*, b*), moisture content, and water activity. Sensory acceptability of appearance, color, texture, aroma, flavor, and overall quality of cocoa cookies was rated by 175 consumers using a "yes/no" binomial scale. Overall liking was evaluated using a 9-point hedonic scale. Purchase intent was evaluated with a "yes/no" binomial scale. The levels of teosinte flour did not significantly affect the acceptability of appearance, color, texture, flavor, aroma, and overall quality, and neither the overall liking nor the purchase intent responses. However, the texture attribute had the lowest % acceptability response among all sensory attributes. The addition of teosinte flour did not affect water activity and color (L*, a*, b*), whereas it decreased the texture hardness (g force), producing softer cookies. Cocoa cookies stayed acceptable even at 100% teosinte flour addition (70% acceptability; mean overall liking = 5.69). Teosinte flour has an excellent nutritional profile that could be practically applied in baked goods.

Persistent Barriers of the Gluten-Free Basic Food Basket: Availability, Cost, and Nutritional Composition Assessment.

Gluten-related disorders are treated with a gluten-free diet. The "basic food basket" (BFB) consists of a list of basic foods consumed by low-income groups in society, including those lowest-cost versions within each food category. To evaluate the cost, availability, and nutritional quality of the BFB and gluten-free BFB (GF-BFB), foods were photographed, registering their cost, availability, and nutritional characteristics, in high quality and mid-range supermarkets, wholesalers, health shops, and corner shops, matching each regular BFB product with a gluten-free equivalent. Of the 1177 potential products, the selection of lowest-cost foods yielded 55 and 47 products (BFB and GF-BFB, respectively). Breads/cereals and drinks showed the highest differences (279% and 146%, respectively) while meats and sausages showed the lowest ones (18.6%). The GF-BFB cost represents 30.1% of the minimum wage, which covers the cost of 5.2 and 3.3 of the BFB and GF-BFB per month, respectively. Availability ranged between 22.7 and 42.4%. Lower availability was associated with poorer nutritional quality in the GF-BFB, which provides 5% less energy, 26% more fat, and 25% less protein than the BFB. Only 47% of gluten-free products declared their "gluten-free" condition. The results strongly suggest that the GF-BFB must be redesigned to be both gluten-free and nutritionally adequate.

Obtaining and evaluating of enzymatic extracts from hairless canary seed (CDC Maria) as gluten-free bread-improving agents.

In this study, enzyme extracts were obtained from hairless canary seeds (CDC Maria) and used as gluten-free bread improvers. The enzyme extraction was done with a specific protein buffer solution and subsequent centrifugation. The supernatant was called crude enzyme extract, a fraction of this extract was refrigerated (CE) and another fraction was lyophilized (CEL). The lyoprotective effect of corn fiber (CEL + CF), maltodextrin (CEL + M), and inulin (CEL + I) was evaluated. Each enzyme extract was added to a gluten-free bread at 0.25%, 0.5%, 0.75% and 1% (w/w). The quality of the gluten-free bread was determined by external and internal characteristically, physical and sensory analysis: analysis of the lamella thickness, the shape factor of pores, the final volume, the aeration percentage, the texture profile analysis, the pore size distribution and shelf-life time. The results showed that the formulation with CEL at 0.5% (w/w) significantly improved the gluten-free bread quality properties, generating an increase of the final volume and aeration percentage, a reduction of the firmness, chewiness and sample aging, and a finer and more uniform crumb structure when compared to a control sample (P < 0.001). This study revealed the potential of a food-improving additive obtained from a natural origin with a high-level production in Argentina.

Celiac Disease: Risks of Cross-Contamination and Strategies for Gluten Removal in Food Environments.

Celiac disease (CD) is the chronic immune-mediated enteropathy of the small bowel, manifesting when exposure to gluten occurs in genetically predisposed individuals. Nowadays, the only treatment considered safe for CD is a gluten-free diet (GFD). However, one of the problems faced by celiac patients is the cross-contamination of gluten-free food when preparing meals, in addition to utensils, surfaces and equipment. This study aimed to evaluate cross-contamination in gluten-free products and strategies for removing gluten from cross-contamination in cooking environments. The selection of papers for this integrative review was carried out by searching different databases. Gluten cross-contamination is a global concern for celiac patients in food environments. Although some practices are positive, such as gluten labeling on processed food in several countries, it is crucial to promote good practices in food services around the world. Only a few studies showed effective results in removing gluten from surfaces and utensils; furthermore, sampling was limited, making it difficult to identify appropriate procedures to reduce cross-contamination. The variation in contamination in different kitchen environments also highlighted that celiac patients must continue paying attention to the methods used to prepare gluten-free food. More research is needed, especially into methods of removing gluten from surfaces and utensils, to ensure food safety for celiac patients in many food environments.

Relationship Between Celiac Disease and Dental Caries in Children and Adolescents: A Systematic Review and Meta-Analysis

ABSTRACT Objective: To assess the relationship between celiac disease and the prevalence of dental caries in children and adolescents and also evaluate if dental enamel defects in celiac children predispose to dental caries. Material and Methods: Searches were performed in the following databases: PubMed, Scopus, Cochrane Library, Latin American and Caribbean Literature on Health Sciences, and OpenGrey. The risk of bias was assessed using the Newcastle-Ottawa Scale. DMFT/dmft and DMFS/dmfs data of observational studies that compared the prevalence of caries between children and adolescents with celiac disease and healthy individuals. Meta-analysis was performed using a random effects model. Heterogeneity between studies was estimated using Cochran's Q test, and inconsistency was measured using I2 statistics. Results: Of the 121 studies retrieved, 17 were selected, and 12 were included in the meta-analysis. The prevalence of caries in the primary dentition (dmft) did not differ between celiac patients and controls [SMD = -0.35; 95% CI (-0.83; 0.13); p = 0,15; I2 = 89%]. There was also no difference in the prevalence of caries in permanent teeth (DMFT) between groups [SMD = -0.44; 95% CI (-1.02; 0.14); p = 0.14; I2 = 95%]. Conclusion: Celiac disease is not a determinant factor in the development of dental caries in children and adolescents compared to the control group.

Potential Effects of the Different Matrices to Enhance the Polyphenolic Content and Antioxidant Activity in Gluten-Free Bread.

Gluten-related disorders, including celiac disease, wheat allergy, and non-celiac gluten sensitivity, have emerged as a significant phenomenon affecting people worldwide, with an estimated prevalence of nearly 5% globally. The only currently available treatment for this disease involves the exclusion of gluten from the diet, which is particularly challenging in the case of bakery products. Gluten-free bread (GFB) presents certain disadvantages when compared to traditional wheat bread, including inferior sensory attributes, technological characteristics, and lower protein and fiber content. Numerous studies have focused on strategies to improve these aspects of GFB. However, there are limited reviews regarding the content of the bioactive compounds of GFB, such as polyphenols. Polyphenols are molecules found in various foods that play a vital role in protecting the body against oxidative stress. This is particularly relevant for individuals with gluten intolerance or celiac disease, as they often experience increased oxidative stress and inflammation. Therefore, the objective of this review is to explore the use of different strategies for increasing the polyphenolic content and the antioxidant properties of GFB. Gluten-free cereals and pseudocereals are the most used matrices in GFB. Buckwheat can be a valuable matrix to enhance the nutritional profile and antioxidant properties of GFB, even more so when the whole grain is used. In the same way, the addition of various by-products can effectively increase the bioactive compounds and antioxidant activity of GFB. Furthermore, regarding the contribution of the phenolics to the bitterness, astringency, color, flavor, and odor of food, it is essential to analyze the sensory properties of these breads to ensure not only enriched in bioactive compounds, but also good consumer acceptance. In vitro studies are still in few number and are very important to execute to provide a better understanding of the bioactive compounds after their consumption.

Eating Attitudes of Patients with Celiac Disease in Brazil: A Nationwide Assessment with the EAT-26 Instrument.

Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically predisposed individuals. In this sense, a gluten-free diet is the only safe treatment available. Due to the restrictions resulting from this eating pattern, this treatment may impair the relationship of the people with CD with food, increasing the risk of a disordered eating attitude, which is associated with eating disorders. The EAT-26 is a validated instrument already applied worldwide in different populations, and higher scores are suggestive of eating attitudes prone to evolve into eating disorders. Studies carried out in other countries have already shown that people with CD are prone to developing eating disorders; however, no study has been carried out with this theme in the population with CD in Brazil. We carried out a nationwide cross-sectional study in three steps: (i) study design and instrument; (ii) recruitment of participants and ethics; (iii) statistical analysis. A total of 385 participants were included in our sample, 96.36% of them being women. The internal consistency of the applied self-administered Brazilian version of the EAT-26 online questionnaire presented a satisfactory Cronbach's alpha of 0.812, and in total, 36.1% of the respondents were classified with a disordered eating attitude. No differences were found among the scores of participants when divided by categories regarding gender, average monthly income, age, and educational level. However, scores classified as a disordered eating attitude were found in respondents with a body mass index classified as overweight and obese. Our study highlights that disordered eating attitudes are present in overweight and obese women with celiac disease; thus, public health politics are needed to prevent and treat these attitudes.

A Decade of Evidence of Sorghum Potential in the Development of Novel Food Products: Insights from a Bibliometric Analysis.

Due to the increasing interest in sorghum for human nutrition, recent literature reviews highlight its nutrient and bioactive contents, potential health benefits and its 'gluten-free' feature. Moreover, a current view of research advances on sorghum-based food products is needed to help both food scientists and industry identify current trends and forward-looking approaches. Studies on homemade processing are still scarce. Thus, this review aimed to provide the latest information regarding the use of sorghum to develop ready-to-eat products or food ingredients based on studies published in the last decade (2012-2022), which then guided discussions on recent advances and prospects. The articles were identified by searching the Elsevier Scopus database. Sorghum has great potential as a functional and sustainable food that can be used in daily meals as a substitute for common cereals like wheat, rice and corn. The studies in the review show that it is possible to process sorghum in a wide variety of ways to obtain ready-to-eat products and ingredients for food products and preparations, such as popping, lamination, extrusion and wet cooking. The studies also show promising approaches to use sorghum in acceptable and nutrient-dense bakery and pasta products, highlighting their gluten-free versions. However, more efforts to make these novel food products available to consumers should be made.

Comparison of weekly gluten immunogenic peptide measurement and conventional tools to assess adherence to the gluten-free diet in celiac disease: An observational prospective study.

BACKGROUND: Adherence to the gluten-free diet (GFD) is critical to achieving symptom control and mucosal healing in celiac disease (CeD), but its assessment is difficult. OBJECTIVES: We sought to compare stool gluten immunogenic peptides (GIPs) measurements over a 4-wk period with conventional tools commonly used to monitor compliance with a GFD. METHODS: Consecutive adult patients with CeD attending the Small Bowel Section of the Buenos Aires Gastroenterology Hospital were invited to this observational study and were instructed to collect stool samples on Fridays for 4 consecutive weeks. Weekly mean stool GIP concentration was measured was estimated. GIP results were compared with a self-assessment scale of adherence, specific CeD serology, the celiac symptom index, and the assessment by an expert dietitian. RESULTS: Fifty-three CeD patients were enrolled and those with stool GIP ≥0.65 µg/g/wk (n = 13; 24.5%) had higher serum concentrations of IgA deamidated gliadin peptides (DGPs) antibodies [69 (29-109) compared with 14 (13-29); P = 0.0005] and IgA tissue transglutaminase [42 (14-200) compared with 10 (7-16); P = 0.02], higher proportion of cases with IgA DGP antibodies >20 AU/mL (84.6% compared with 33.3%; P = 0.002), and a higher self-estimated adherence score [5 (4-9) compared with 9 (7-10); P = 0.003]. GIP did not correlate with celiac symptom index scores (55.6% compared with 30.8%; P = 0.9). Expert dietitian assessment identified 69% [odds ratio (OR): 5.25; 95% CI: 1.1-27.2; P = 0.01] of nonadherent cases when high stool GIP. Logistic regression analysis determined that IgA DGP (adjusted OR: 1.1; 95% CI: 1.01-1.11; P = 0.02) and males (adjusted OR: 28.3; 95% CI: 1.1-722.6; P = 0.04) were independently associated with excessive gluten exposure. CONCLUSIONS: Weekly stool GIP identifies gluten exposure that is not always detected by commonly used GFD adherence assessment methods. The higher the concentration of stool GIP, the better the predictive value of serology and dietitian interviews. Stool GIP is a useful and practical test for GFD monitoring, particularly for risky gluten exposure in real-life scenarios.

Evaluation of the Physical, Chemical, Technological, and Sensorial Properties of Extrudates and Cookies from Composite Sorghum and Cowpea Flours.

In recent years, there has been a growing demand for gluten-free and functional products, driven by consumer preferences for healthier and more diverse food choices. Therefore, there is a need to explore new ingredients that can be used as alternatives to traditional gluten-containing grains. Thus, this work evaluated the physical, chemical, technological, and sensorial properties of extrudates and cookies from composite tannin sorghum (rich in resistant starch) and white cowpea flours. Extrudates and cookies were produced from a composite flour made of sorghum and cowpea, at a sorghum:cowpea flour ratio of 70:30, 50:50, and 30:70. Then, raw flours, cookies, and extrudates were characterized (dietary fiber, resistant starch, proteins, antioxidant capacity, pasting properties, etc.). Results obtained for particle size distribution and bulk density indicated that the particles increased and the color changed with the addition of cowpea flour. The raw tannin sorghum flour had a higher resistant starch concentration (36.3%) and antioxidant capacity (211.2 µmolTE/g), whereas cowpea flour had higher levels of proteins (18.7%) and dietary fiber (20.1%). This difference in the raw flour composition contributed to the nutritional value of the extrudates and cookies, especially the cookies which undergo dry heat and had higher retention of resistant starch and antioxidants. Moreover, sorghum flour presented a higher tendency to retrograde (high setback), which was decreased by the addition of cowpea flour. Overall acceptance and intention to purchase were higher for extrudates with 100% sorghum flour (6.52 and 68.3%, respectively) and cookies with 70% cowpea flour (7.03 and 76.7%, respectively). Therefore, nutritious and functional gluten-free extrudates and cookies, of good acceptability, can be produced from composite tannin sorghum and white cowpea flours.

Sorghum (Sorghum bicolor L. Moench) Gluten-Free Bread: The Effect of Milling Conditions on the Technological Properties and In Vitro Bioaccessibility of Polyphenols and Minerals.

The absence of gluten proteins in sorghum allows for the production of baked goods that are suitable for celiacs. Previous studies have shown that the milling process affects the performance of sorghum flour in baked products, especially those that are gluten-free (GF). This study aimed to explore the effects of mill type (impact and roller) on flour properties and GF bread quality by assessing the technological quality, antioxidant activity, and mineral content of the bread. All particle populations of flour obtained via both millings presented a bimodal distribution, and the volume mean diameter (D 4,3) ranged from 431.6 µm to 561.6 µm. The partially refined milled flour obtained via polishing and impact milling produced bread with a soft crumb, fewer but larger alveoli in the crumb, and a structure that did not collapse during baking, showing the best performance in bread quality. In the in vitro bread digestibility assay, the total polyphenol content and antioxidant activity decreased during the digestion steps. High mineral (Cu, Fe, Mn, and Zn) contents were also found in a portion of the bread (120 g) made with whole sorghum flour; however, their potential bioavailability was reduced in the presence of a higher amount of bran.

Heavy Metal and Rice in Gluten-Free Diets: Are They a Risk?

A gluten-free diet (GFD) is the treatment of choice for gluten-related disorders. It has been associated with macro- and micronutrient deficiencies. Recently, consumption of arsenic-contaminated rice has raised concern because of the potential greater risk that it may represent for people on GFDs, whose rice consumption is high, since it is a fundamental cereal in GFDs. We reviewed the data published over the last 20 years in Medline and Scielo, in English, French and Spanish, on four metals (As, Hg, Cd, and Pb), to assess whether the evidence suggests that celiac disease or consumption of a GFD is associated with increased levels of blood/urinary metal concentrations. The review revealed a few articles that were directly related to the four metals and their relationships with a GFD. The evidence supports that rice-based products are a relevant source of As and other metals. Clinical studies and evaluations based on NHANES have indicated that persons on GFDs have higher As and Hg blood/urinary levels, suggesting that the diet and not the disease is responsible for it. The levels described are statistically significant compared to those of persons on complete diets, but far from toxic levels. The question of whether higher exposure to heavy metals associated with a GFD is biologically relevant remains unanswered and deserves study.

Technological and Sensory Quality of Gluten-Free Pasta Made from Flint Maize Cultivars.

The development of quality gluten-free products presents a major technological challenge in terms of structure, texture, and shelf life. However, there is insufficient information available to identify genotypes for obtaining gluten-free maize pasta of good acceptability and technological quality. The objective of this work was to evaluate the technological and sensory quality of gluten-free pasta made from different maize cultivars. The flint open-pollinated variety, flint inbred line, and three dent commercial hybrids were used. Grain and flour's physical characteristics and chemical composition were determined. Gluten-free pasta was made via extrusion, and its quality traits were studied. A sensory evaluation test was carried out. Flint cultivars showed the lowest values on swelling index (both 1.77) and water absorption (124.30 and 134.58%). Pasta swelling index showed a negative association r = -0.77 to sodium carbonate retention capacity (p = 8.5 × 10-5) and water retention capacity (p = 6.6 × 10-5). Evaluators' preference results showed a higher frequency of choices at the top level of preference (4) for the flint open-pollinated variety C6006. Thus, evaluators' choices showed a positive association between sample preference and firmness. Pasta preference and technological quality have a direct relationship with fast tests over grain, such as test weight and float index.