Gluten-containing Research Articles

Nutritional value of cereal-based gluten-free products and comparison to that of gluten containing counterparts in the Greek market

Nutritional value of the Gluten-free products (GFPs) has been highly debated. Aiming to assess the nutritional value of the cereal-based GFPs in the Greek market, information from the nutritional label and the ingredients list, of all GFPs and their gluten-containing (GC) counterparts available in a supermarket offering the greatest availability in the capital of Greece, were recorded. The sample consisted of 913 products: 351 GFPs and 562 GCPs, classified into 12 categories (e.g., breads, melbas, breakfast cereals, cereal bars, pasta, flours, cookies). With minor exceptions, comparisons among all food categories regarding nutrient profile and nutritional claims showed mixed results, though supporting an overly comparable nutritional profile of the GFPs. Still, a quarter of all GFPs presented an unhealthy nutritional profile. The findings of the present study are highly in agreement with those of relevant studies in the literature, that do not support an inferior nutritional profile compared to GC counterparts.

Gluten-free foods are expensive and nutritionally imbalanced than their gluten-containing counterparts.

Nutritional quality of gluten-free (GF) food products is very important, as patients with celiac disease consume these products for lifelong. There is paucity of data on the nutritional content and cost of GF food products compared with their gluten-containing (GC) counterparts from India (Asia). After a detailed market survey, packaged and labeled GF food products (n=485) and their packaged GC counterparts (n=790) from the supermarkets of Delhi (India) and e-commerce websites were included. Nutritional content and cost/100 g food (in US dollars) were calculated using the information on food label. Gluten-free food products were 232% (range: 118% to 376%) more expensive than their GC counterparts. Energy content of all GF food products was similar to their GC counterparts, except cereal-based snacks (GF: 445 kcal vs. GC: 510 kcal, p<0.001). The protein content was significantly lower in GF pasta and macaroni products (single-grain: GF: 6.5 g vs. GC:11. 5 g, p-0.002; multigrain: GF:7.6 g vs. GC:11.5 g, p-0.027), cereal flours (single-grain: GF: 7.6 g vs. GC: 12.3 g, p<0.001; multigrain: GF:10.9 g vs. GC: 14.1 g, p-0.009) and nutritional bars (GF: 21.81 g vs. GC:26 g, p-0.028) than their GC counterparts. Similarly, the dietary-fiber content of GF pasta and macaroni products, cereal flours, cereal premix and nutritional bars of GF foods was significantly lower than their GC counterparts. Gluten-free bread and confectionary items, biscuits and cookies and snacks had higher total fats and trans-fat content than their GC counterparts. Gluten-free cereal-based snacks had higher sodium content than their GC counterparts (GF: 820 mg vs. GC:670 mg; p<0.001). GF foods are significantly more expensive, contain less protein and dietary fiber and higher fat, trans-fat and sodium than their GC counterparts. Strategies must be developed to reduce the cost and improve the nutritional profile of GF foods.

Investigation of cost and availability of gluten-free food in Jeddah, KSA

ObjectiveThe prevalence of celiac disease (CD) in KSA is progressively increasing. Consistent adherence to a gluten-free (GF) diet is the only effective CD treatment. The availability and cost of GF food are important factors in adherence to a GFD. The objective of this study was to investigate the cost and availability of GF food in a sample of local stores and supermarkets across Jeddah province in KSA. MethodEleven supermarkets in Jeddah, KSA, ranging from high budget/quality supermarkets to low-budget stores, were visited. Eight food categories were evaluated, including flour, breakfast cereals, breads, pastas, and snacks (e.g., biscuits, cookies, snack bars, and chips). The availability and cost of GF and gluten containing (GC) items within these food categories were recorded. Each item included in these food categories was counted, and the overall average price was calculated. ResultsA total of 233 GF and 24 GC products were found. Supermarket 1 had the highest availability of GF foods (n = 90), followed by supermarket 2 (n = 34), supermarket 3 (n = 30), supermarket 4 (n = 23), supermarket 5 (n = 21), supermarket 6 (n = 18), supermarket 7 (n = 9), and supermarket 8 (n = 8). The median price per 100 g was significantly greater for GF than GC products (p < 0.05). The cost of GF products was significantly higher than that of GC products (p < 0.05); consequently, GF foods were twice as expensive as their GC counterparts. ConclusionThe availability of GF products was limited, and GF products were more expensive than standard GC products. High cost and limited availability are major roadblocks to GFD adherence among people with CD. Governmental organizations must cooperate with healthcare providers and food industries to ensure that GF foods are widely available and affordable for people with CD, to minimize financial pressure and improve health quality.

Effect of shape, gluten, and mastication effort on in vitro starch digestion and the predicted glycemic index of pasta.

Gluten-containing (GC) and gluten-free (GF) pasta consumption has been growing in recent years. The market offers a wide variety of pasta types, with differences in shape and formulation that influence the mastication process and, consequently, their nutritional behaviors (i.e. starch digestibility and glycemic response). This study investigated the effect of shape, gluten, and structural breakdown on in vitro starch digestibility and predicted the glycemic index (pGI) of GC and GF penne, spaghetti, and risoni. Pasta was cooked and minced to mimic short, intermediate, and long mastication efforts. Short mastication led to a higher number of big particles than intermediate and long mastications for all pasta samples, which was reflected in the different starch digestibility and pGI patterns. Multivariate analysis of variance showed that the three studied factors differently affected the in vitro starch digestion of pasta. Mastication effort, shape, and their interaction mainly affected the starch digestion rate and pGI. Gluten was the major factor in affecting the amount of digested starch. The results suggested that small shapes (i.e. risoni), the presence of gluten, and short mastication effort led to a lower pGI. The findings will be useful for the development of pasta products tailored to fulfill the needs of specific consumers following a rational food design approach.

Nutritional content and quality of processed gluten-free products

The present work aimed to compare the macro- and micronutrient contents of gluten-free (GF) and gluten-containing (GC) products from a wide range of stores in Jeddah, Saudi Arabia. A case-control study was conducted. Twelve major supermarkets in Jeddah, Saudi Arabia were visited, and the nutritional information labels of 92 GF and 46 GC products were compared. Results showed that GF products were significantly lower in protein (p = 0.004), total sugar (p = 0.01), calcium (p = 0.02), iron (p = 0.002), and vitamin D (p = 0.01) than GC products. Furthermore, GF breads, flours, and pastas had significantly lower amounts of protein than their GC counterparts (p &lt; 0.001, p = 0.03, and p &lt; 0.001, respectively). Fibre was significantly higher in GF than GC biscuits and breads (p = 0.04 and p = 0.01, respectively). However, GF pastas had significantly lower content of fibre per 100 g than GC pastas (p = 0.02). Overall, the nutritional quality of GF products was not significantly different from GC products. Although GF and GC biscuits and cookies were considered low nutritional value products, the nutritional quality scores of GF biscuits and cookies were significantly higher than their GC counterparts. GF products were lower in protein, total sugar, vitamin D, calcium, and iron than GC products. The nutritional quality of GF products did not differ from GC products. Food manufacturers should pay more attention to the nutritional content of GF products. Future studies are needed for the nutritional assessment of GF products, and how nutritional content may influence the diet quality of individuals with celiac disease who follow gluten-free diets.

PTPRK, an EGFR Phosphatase, Is Decreased in CeD Biopsies and Intestinal Organoids.

Celiac disease (CeD) is an immune-mediated enteropathy triggered in genetically susceptible (HLA-DQ2/8) individuals by a group of wheat proteins and related prolamins from cereals. The celiac intestine is characterized by an inversion of the differentiation/proliferation program of the enterocytes, with an increase in the proliferative compartment and crypt hyperplasia, which are the mechanisms that regulate the increased proliferation in CeD that arenot completely understood.The aim of this study is to understand the role of Protein Tyrosine Phosphatase Receptor Type K (PTPRK), a nodal phosphatase that regulates EGFR activation in the proliferation of the enterocytes from CeD biopsies and organoids. The levels of PTPRK were evaluated by RT PCR, western blot (WB) and immunofluorescence techniques in intestinal biopsies and organoids from CeD patients and controls. Additionally, pEGFR and pERK were evaluated by WB and proliferation by BrdU incorporation. PTPRK si-RNA was silenced in CTR organoids and was overexpressed in CeD organoids. PTPRK was reduced in Gluten Containing Diet-Celiac Disease (GCD-CeD) and Potential-Celiac Disease(Pot-CeD) biopsies (p &lt; 0.01-p &lt; 0.05) whereas pEGFR (p &lt; 0.01 p &lt; 0.01), pERK (p &lt; 0.01 p &lt; 0.01) and proliferation were increased. (p &lt; 0.05 p &lt; 0.05) respect to the controls.The CeD organoids reproduced these same alterations. Silencing of PTPRK in CTR organoids increased pEGFR, pERK and proliferation. The overexpression of PTPRK in CeD organoids reduced pEGFR, pERK and proliferation. modulation of PTPRK levels can reduce or increase pEGFR, pERK and proliferation in CeD or CTR organoids, respectively. The CeD organoids can be a good model to study the mechanisms of the disease.

The Update of the Italian Food Composition Database of Gluten-Free Products and Its Application in Food-Based Dietary Guidelines Menus.

Complete food composition databases (FCDBs) on gluten-free (GF) foods are needed to assess the nutrient intakes of celiac disease patients. The aim of the present work was to update the previously developed version of the Italian GF-FCDB and to apply it to a theoretical GF diet. The updated GF-FCDB includes the composition of 108 GF cereal-based foods, as sold, in terms of energy and macro- and micro-nutrients, imputed using food label information combined with the standard recipe approach. Three scenarios (i.e., refined, mixed, and wholegrain cereals) of the weekly guideline menu for the general Italian population were analyzed for energy and nutrient content in a theoretical dietary assessment using traditional gluten-containing (GC) foods and the corresponding GF substitutes. All GF menus were higher than the corresponding GC menus in polyunsaturated fatty acids, linoleic acid, and vitamin E. Zinc was lower in GF than in GC menus only in the wholegrain-cereal scenario. Thanks to the application of the updated GF-FCDB including a comprehensive list of micronutrients, we observed that it is possible for celiac disease patients to meet nutrient requirements by simply substituting GC with GF cereal-based products following recommendations for the general population.

Budesonide and the Gluten Containing Elimination Diet as Treatments for Non-responsive Celiac Disease in Children.

Non-responsive celiac disease (NRCD) is defined as patients having persistent symptoms and enteropathy (Marsh 3 histology) suggestive of active celiac disease (CeD), after following a gluten-free diet (GFD) for at least 12 months. NRCD is suggested to affect 15% of children with CeD but data are limited and there is no research to date describing treatment of children with this condition. The aim of this study was to describe our center's approach to identifying and treating NRCD with budesonide and the Gluten Containing Elimination Diet (GCED). We performed a retrospective, single center analysis over a 5-year period of patients with CD less than 18 years of age (inclusive) who underwent treatment for persistent symptoms and enteropathy despite following a GFD. We identified 22 patients with NRCD. Thirteen were treated with the GCED for 3 months with 46% achieving both histological and symptomatic resolution. Nine patients were treated with budesonide (6-9 mg), with 89% achieving both symptomatic and histologic resolution after a median 3-month treatment course. Further, 67% of patients who responded to the GCED and 100% of patients who responded to budesonide remained in remission for at least 6 months following treatment transition back to exclusive GFD. The GCED and budesonide can provide benefit for NRCD. Most patients with NRCD can return to a GFD after 3 months of treatment.

Effect of presence of gluten and spreads on the oral processing behavior of breads

Little is known about the oral processing behavior of gluten-free (GF) products. This study investigated the oral processing behavior of one commercial GF bread and one gluten-containing (GC) equivalent with and without spreads. Oral processing parameters were determined through video recording and the predominant texture attributes were accessed using a check-all-that-apply test. The GF bread was perceived crumbly, dry and sandy and had a longer eating duration than the GC bread, which was perceived soft, spongy, pasty and sticky. Results suggest that the structure of the GF bread was easily fragmented during mastication and a longer period in the mouth was required to prepare a cohesive bolus for swallowing. The addition of spreads increased softness perception but did not affect chewing behavior. Oral processing behavior of GF products should be further investigated to understand how eating rate, satiation responses and food intake can be modulated in GF products.

Cost, Nutritional Content and Number of Gluten-Free Staple Foods Available in Winnipeg, Manitoba, Canada.

Data has indicated that gluten-free (GF) foods are more expensive and have lower nutritional value than their gluten-containing (GC) counterparts. The aim of the present study was to compare the cost and nutrient content between GF and GC staple foods and determine whether the number and price of GF staple foods differed based on type of store or location within Winnipeg, Canada. Twelve grocery stores (2 chain stores/quadrant;1 local store/quadrant) in the four quadrants (northwest, northeast, southwest, southeast) of Winnipeg were visited to identify GF staple products (bread, flour, cereal, pasta) along with a GC comparator. A total of 819 GF products along with GC comparators were identified. The median cost of GF products ($1.50/100g) was 131 % greater than that of GC ($0.65/100g) (p < 0.0001). The greatest difference in cost was between GF and GC flour, with the least difference occurring between GF and GC cereal. GF products were 58, 36 and 100 % lower in iron, protein and saturated fat (p < 0.0001) than their GC comparators, respectively. The number of GF staple products was 370 % higher (p < 0.007) at chain stores than at local stores, whereas store location did not significantly affect the number of GF products available. The greatest difference in number of different GF foods based on store type was for cereals, with the least being for flours. These results confirm that GF staple foods are more expensive and have lower nutritional value (mainly due to lower iron and protein content) compared to GC foods.

Potential ways for gluten contamination of gluten-free grain and gluten-free foods: the buckwheat case

ABSTRACT Buckwheat has been reported to be responsible for gluten contamination in manufactured gluten-free foods (mGFFs) although it is inherently gluten-free (GF). It could happen through buckwheat grains contacting gluten-containing (GC) grains and surfaces contacted by GC grains during pre-manufacturing practices. To simulate grain contact, whole and broken GC grains (wheat, rye, barley, and oat) were mixed into buckwheat grains at the ratio of 2.5–10.0%. Grains were agitated in vessels with inner surfaces covered with buckwheat grain. Gluten was not detected in buckwheat grains contacting whole GC grains at all mixing ratios. It was not detected in the case of broken GC grains at the mixing ratio of 2.5% and oat grains at all mixing ratios. Gluten concentration increased with the increasing mixing ratio and the natural gluten concentration of broken GC grains. To simulate surface contact, GC grains were first agitated in galvanised steel vessels and then buckwheat grains were agitated together under the same conditions. Gluten was detected on galvanised steel surfaces contacted by whole and broken GC grains. It was not detected in buckwheat grains contacting the surfaces contaminated by whole GC grains. Gluten was detected in buckwheat grain in the case of the broken GC grains except for oats. Gluten concentrations increased with increasing natural gluten concentration of GC grains. Contamination of mGFFs could be linked to potential contact with buckwheat grain. This contamination issue could be resolved through regulations mandating the proof of being GF for ingredients used in the production of mGFFs.

Comparison of Commercial Gluten Containing and Gluten Free Pastas: Cooking Quality Parameters

Aims: Gluten-free food (GFF) consumers reportedly have problems with the lower cooking quality of gluten-free pastas (GFPs) compared to gluten-containing pastas (GCPs). This work is designed to compare the cooking quality of commercial GFPs and GCPs population wise for contributing to the resolution of the issue in the market. &#x0D; Study Design, Materials and Methodology: Cooking quality parameters of 10 commercial GFPs (maize based and maize-rice based) and 10 commercial GCPs (semolina), namely optimum cooking time (OCT), weight increase (WI), volume increase (VI), cooking loss (CL), and their microstructures were determined.&#x0D; Results: GCPs had shorter OCT, higher WI and VI, and lower CL than GFPs (P &lt; .05), representing higher cooking quality. GCPs showed more consistent cooking quality compared to GFPs. GCPs showed more consistent cooking quality compared to GFPs. GFPs made of maize showed higher cooking quality than GFPs made of maize and rice mixture (P &lt; .05). When considering the microstructure, GCPs has a smooth outer surface where the gluten network provides a framework that holds embedded starch granules. On the other hand, GFPs has a protruding surface where gelatinized starch provides a framework that holds embedded protein patches, which results poor cooking quality. &#x0D; Conclusion: GCPs shows higher cooking quality compared to GFPs. They also exhibited a narrower range for cooking quality parameters indicating their more consistent behavior than those of GFPs. GFPs made of maize showed higher cooking quality than GFPs made of maize and rice mixture. &#x0D; Originality/value: To the best of the authors’ knowledge, this is the first work comparing the cooking quality of populations of commercial pastas (10 GFPs versus 10 GCPs) and embodied the issue.

Are Gluten-Free Diets More Nutritious? An Evaluation of Self-Selected and Recommended Gluten-Free and Gluten-Containing Dietary Patterns.

Gluten-free (GF) eating patterns are frequently perceived to be healthier than gluten-containing (GC) ones, but there has been very little research to evaluate this viewpoint. The effect of GF eating patterns on dietary composition was assessed using two independent approaches. One approach compared macronutrients and typical shortfall nutrients between MyPlate example menus developed with either GC or equivalent GF foods. In this analysis, the GF menus were significantly lower in protein, magnesium, potassium, vitamin E, folate, and sodium (p = 0.002–0.03), with suggestive trends towards lower calcium and higher fat (p = 0.06–0.08). The second approach was a meta-analysis of seven studies comparing information on the nutrient intakes of adults with celiac disease following a GF diet with control subjects eating a GC diet, and differences were evaluated using paired t-tests or Wilcoxon Signed rank tests. In this analysis, consuming a GF diet was associated with higher energy and fat intakes, and lower fiber and folate intakes compared to controls (p < 0.001 to p = 0.03). After adjusting for heterogeneity and accounting for the large mean effect size (−0.88 ± 0.09), the lower fiber remained significant (p < 0.001). These combined analyses indicate that GF diets are not nutritionally superior except for sodium, and in several respects are actually worse.

Canadian packaged gluten-free foods are less nutritious than their regular gluten-containing counterparts

BackgroundA strict gluten-free (GF) diet is required for the management of celiac disease (CD). The nutritional adequacy of this diet has been questioned due to the elimination of wheat, an important vehicle for micronutrient fortification and source of fibre. While novel and/or reformulated packaged GF products have rapidly entered the marketplace, providing alternatives to wheat-based staples, it is unknown whether these new products are nutritionally comparable.MethodsFrom a database of 3,851 foods collected across 21 grocery stores in Eastern Canada, we compared the nutrient content of 398 unique GF items with 445 gluten-containing (GC) equivalents. Wilcoxon rank tests were conducted on listed nutrient content (g, mg, µg) per 100 g of product and the nutrient contribution of iron, folate and fibre were evaluated using Health Canada’s nutrient claim regulations.ResultsGF staples (cereals, breads, flours, pastas) contained 1.3 times more fat and less iron (by 55%), folate (by 44%) and protein (by 36%), than GC counterparts (P < 0.0001). On average, GF pastas had only 37% of the fibre in GC pastas (P < 0.0001). Notably, GF and GC flours were equivalent in nutrient content. Despite GF and GC flours having similar nutritional content, the vast majority of the processed GF foods fell short in key nutrients.DiscussionPackaged GF foods in Canada are generally less nutritious than their GC counterparts, suggesting that GF diets should not be promoted to those who do not require it. The use of nutrient-dense GF flours in homemade foods may improve nutrient intakes on the GF diet.

Cross-Contamination with Gluten by Using Kitchen Utensils: Fact or Fiction?

A risk of cross-contamination exists when preparing a gluten-free (GF) meal in kitchen facilities that usually handle gluten-containing (GC) foods. Cross-contamination with gluten may occur during the preparation or cooking process; however, published data are lacking on gluten cross-contamination from kitchenware. This study was conducted to determine whether cross-contamination occurs through shared domestic kitchenware and, if so, which cleaning method is most reliable for avoiding this cross-contamination. Kitchenware (wooden spoon, colander, ladle, and knife) previously used to cook and/or prepare GC foods was used for the preparation of GF foods (bread and pasta). The gluten concentration of the GF foods was then determined using an established enzyme-linked immunosorbent assay. A PCR assay was also used to detect the presence of wheat ω-gliadin DNA in the food samples. Three cleaning methods were assessed to determine the concentrations of gluten and wheat DNA in GF foods cooked with utensils cleaned directly after the preparation of GC foods. Contrary to our expectations, gluten was not detected in relevant and quantifiable amounts in our samples (<20 mg/kg). The cleaning method used did not influence gluten concentrations: all samples contained <10 mg/kg. Based on PCR analyses, the only sample with lower cycle threshold ( CT) values (i.e., higher concentration of wheat DNA) was from the contaminated ladle used to serve GF pasta. This outcome led to the hypothesis that shared ladles pose a higher risk for contamination of GF foods than do shared wooden spoons, colanders, or knives. Cross-contamination with gluten in a kitchen environment may occur, but kitchen utensils used for preparing GC pasta and for cutting GC bread should not pose a relevant problem to patients with celiac disease, at least in a domestic environment.

Designing a Score-Based Method for the Evaluation of the Nutritional Quality of the Gluten-Free Bakery Products and their Gluten-Containing Counterparts

Gluten-free (GF) products are consumed both by individuals with celiac disease and by an increasing number of people with no specific medical needs. Although the technological quality of GF products has been recently improved, their nutritional quality is still scarcely addressed. Moreover, the few published studies report conflicting results, mostly because the information from product nutrition facts is the only considered factor. The aim of the present study was to develop a score-based method for the nutritional evaluation of 134 packaged Italian GF bakery products and to compare it with that of 162 matched gluten-containing (GC) food items. The score included the information from the nutrition facts and the presence/absence of some nutritionally relevant components in the ingredients list. Results indicated an overall low nutritional quality of the considered GF bakery products. Additionally, with the sole exception of GF bread substitutes, there was no difference in nutritional quality between GF and equivalent GC bakery products. Future research and development of GF bakery products may take advantage of this scoring method, as it may represent an easy approach to evaluate their nutritional quality. The present findings do not justify the consumption of packaged GF bakery products by people without any specific medical needs.

Gluten-Free Foods in Rural Maritime Provinces: Limited Availability, High Price, and Low Iron Content.

We investigated the price difference between gluten-free (GF) and gluten-containing (GC) foods available in rural Maritime stores. GF foods and comparable GC items were sampled through random visits to 21 grocery stores in nonurban areas of Nova Scotia, New Brunswick, and Prince Edward Island, Canada. Wilcoxon rank tests were conducted on price per 100g of product, and on the price relative to iron content; 2226 GF foods (27.2% staple items, defined as breads, cereals, flours, and pastas) and 1625 GC foods were sampled, with an average ± SD of 66 ± 2.7 GF items per store in rural areas and 331 ± 12 in towns. The median price of GF items ($1.76/100g) was more expensive than GC counterparts ($1.05/100g) and iron density was approximately 50% less. GF staple foods were priced 5% higher in rural stores than in town stores. Although the variety of GF products available to consumers has improved, higher cost and lower nutrient density remain issues in nonurban Maritime regions. Dietitians working in nonurban areas should consider the relative high price, difficult access, and low iron density of key GF items, and work together with clients to find alternatives and enhance their food literacy.

Effect of Gluten Containing Diet on Pristane Induced Lupus Prone Mice

Effect of Gluten Containing Diet on Pristane Induced Lupus Prone Mice

Identifying the Difference between Gluten Free and Gluten Containing Pizzas

Identifying the Difference between Gluten Free and Gluten Containing Pizzas

Spontaneous Gluten Dependent Blistering in DQ2 transgenic mice (130.9)

Abstract Background/Aim: Dermatitis Herpetiformis is the autoimmune skin manifestation of celiac disease, and similar to celiac disease, is tightly associated with HLA-DQ2 and HLA-DQ8. Previously we have generated a mouse model of DH using DQ8 transgenic mice on an NOD background. Herein, we describe a similar DH-like blistering disease that spontaneously develops in DQ2 transgenic mice. Methods: Transgenic mice that express DQ2 on a background deficient in endogenous MHC II (Aeo) were raised on a gluten containing (GC) chow or a gluten free chow . Results: When raised and maintained on a gluten containing chow, approximately 15% of these Aeo DQ2 mice spontaneously developed blisters on the ears and tails at about six months of age. Control Aeo mice that were also raised on a gluten containing chow did not develop this blistering disease during their lifetime. Hematoxilyn and eosin staining revealed subepidermal blisters. Immunohistochemistry revealed IgA deposits at the dermal/epidermal junction in perilesional ear tissue. However, when these mice were raised and maintained on a gluten free diet, these mice did not develop blisters. Conclusions: This blistering disease is a gluten dependent disease that has many of the elements typically associated with Dermatitis Herpetiformis, most especially the association with the DQ2 gene.