Ancient and Modern Cereals as Ingredients of the Gluten-Free Diet: Are They Safe Enough for Celiac Consumers?

Francesca Colombo,Corinne Bani,Chiara Di Lorenzo,Patrizia Restani,Simone Biella

doi:10.3390/foods10040906

Abstract

Celiac disease is an autoimmune disorder that occurs in genetically predisposed individuals after consuming prolamins from some cereals. Although the products available for celiac subjects have increased significantly in quality and quantity over the last few decades, research still focuses on identifying new ingredients to improve the nutritional, sensorial and functional qualities of gluten-free products. In terms of toxicity for people with celiac disease, there is a wide variability between ancient and modern grains. The most contradictory results are related to the role of oats in the gluten-free diet. In order to clarify the role of minor cereals (such as oat) and ancient grains in the diets of celiac patients, this review discusses recent in vitro and in vivo studies performed on those cereals for which the toxicity for celiac subjects is still controversial. According to in vivo studies, selected oat varieties could be tolerated by celiac patients. On the other hands, although some wheat-ancient grains (Triticum monococcum, Triticum aestivum ssp. spelta and Kamut®) showed a reduced in vitro toxicity, to date, these grains are still considered toxic for celiac patients. Contradictory results underline the importance of studying the safety of “unusual” cereals in more detail.

Highlights

Cereals are widely available in diets all over the world
non-celiac gluten sensitivity (NCGS) is a condition characterized by intestinal and extra-intestinal symptoms associated with the consumption of gluten-containing foods in subjects who are not affected by celiac disease (CD) or wheat allergy (WA)
In vitro and ex vivo studies have provided contradictory results on the safety of T. monococcum for patients suffering from CD (Table 4), suggesting that its use in gluten free diet (GFD) should be excluded or at least considered with extreme caution

Summary

Introduction

A protein complex that plays an important role in the technological properties of cerealbased products. The cereals with the highest content of gluten-like proteins are wheat, barley and rye. Pseudo-cereals (e.g., buckwheat, quinoa) have received considerable attention, since they are a good source of macronutrients, such as carbohydrates and proteins, and of fibers, vitamins and minerals. Gluten-related disorders (GRDs) are becoming increasingly common. The main GRDs are celiac disease (CD), non-celiac gluten sensitivity (NCGS) and wheat allergy (WA). NCGS is a condition characterized by intestinal and extra-intestinal symptoms associated with the consumption of gluten-containing foods in subjects who are not affected by CD or WA. The prevalence of NCGS is not clearly defined; no specific biomarkers are available for the diagnosis of NCSG. The diagnosis is based on exclusion criteria (absence of CD and WA) and positive diagnostic challenges (double-blind, placebocontrolled gluten challenge) [3]

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Conclusion