The million-dollar question: is “gluten-free” food safe for patients with celiac disease?

Abstract The gluten free (GF) diet is the only treatment for celiac disease (CD). While the GF diet can be nutritious, increased reliance on processed and packaged GF foods can result in higher fat/sugar and lower micronutrient intake in children with CD. Currently, there are no evidence-based nutrition guidelines that address the GF diet. The objective of this cross-sectional study was to describe the methodological considerations in forming a GF food guide for Canadian children and youth (4-18 years) with CD. Food guide development occurred in three phases: 1) evaluation of nutrient intake and dietary patterns of children on the GF diet, 2) pre-guide stakeholder consultations with 151 health care professionals and 383 community end users, and 3) development of 1260 GF diet simulations that addressed cultural preferences and food traditions, diet patterns and diet quality. Stakeholder feedback identified nutrient intake and food literacy as important topics for guide content. Except for vitamin D, the diet simulations met 100% macro- and micronutrient requirements for age-sex. The pediatric GF plate model recommends intake of >50% fruits and vegetables, <25% grains and 25% protein foods with a stronger emphasis on plant-based sources. Vitamin D fortified fluid milk/unsweetened plant-based alternatives and other rich sources are important to optimize vitamin D intake. The GF food guide can help children consume a nutritiously adequate GF diet and inform policy makers regarding the need for nutrition guidelines in pediatric CD.

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Gluten-free food database: the nutritional quality and cost of packaged gluten-free foods

PeerJ ◽

10.7717/peerj.1337 ◽

2015 ◽

Vol 3 ◽

pp. e1337 ◽

Cited By ~ 63

Author(s):

Benjamin Missbach ◽

Lukas Schwingshackl ◽

Alina Billmann ◽

Aleksandra Mystek ◽

Melanie Hickelsberger ◽

...

Keyword(s):

Celiac Disease ◽

Nutritional Quality ◽

Health Benefits ◽

Food Products ◽

Free Food ◽

Food Composition ◽

Nutrient Composition ◽

Bakery Products ◽

Gluten Free ◽

Approximation Process

Notwithstanding a growth in popularity and consumption of gluten-free (GF) food products, there is a lack of substantiated analysis of the nutritional quality compared with their gluten-containing counterparts. To put GF foods into proper perspective both for those who need it (patients with celiac disease) and for those who do not, we provide contemporary data about cost and nutritional quality of GF food products. The objective of this study is to develop a food composition database for seven discretionary food categories of packaged GF products. Nutrient composition, nutritional information and cost of foods from 63 GF and 126 gluten-containing counterparts were systematically obtained from 12 different Austrian supermarkets. The nutrition composition (macro and micronutrients) was analyzed by using two nutrient composition databases in a stepwise approximation process. A total of 63 packaged GF foods were included in the analysis representing a broad spectrum of different GF categories (flour/bake mix, bread and bakery products, pasta and cereal-based food, cereals, cookies and cakes, snacks and convenience food). Our results show that the protein content of GF products is >2 fold lower across 57% of all food categories. In 65% of all GF foods, low sodium content was observed (defined as <120 mg/100 g). Across all GF products, 19% can be classified as source high in fiber (defined as >6g/100 g). On average, GF foods were substantially higher in cost, ranging from +205% (cereals) to +267% (bread and bakery products) compared to similar gluten-containing products. In conclusion, our results indicate that for GF foods no predominant health benefits are indicated; in fact, some critical nutrients must be considered when being on a GF diet. For individuals with celiac disease, the GF database provides a helpful tool to identify the food composition of their medical diet. For healthy consumers, replacing gluten-containing products with GF foods is aligned with substantial cost differences but GF foods do not provide additional health benefits from a nutritional perspective.

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Gluten content in labeled and unlabeled gluten-free food products used by patients with celiac disease

European Journal of Clinical Nutrition ◽

10.1038/s41430-020-00854-6 ◽

2021 ◽

Author(s):

Wajiha Mehtab ◽

Vikas Sachdev ◽

Alka Singh ◽

Samagra Agarwal ◽

Namrata Singh ◽

...

Keyword(s):

Celiac Disease ◽

Food Products ◽

Free Food ◽

Gluten Free ◽

Gluten Content

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Skepticism Regarding Vaccine and Gluten-Free Food Safety Among Patients with Celiac Disease and Non-celiac Gluten Sensitivity

Digestive Diseases and Sciences ◽

10.1007/s10620-017-4879-1 ◽

2017 ◽

Vol 63 (5) ◽

pp. 1158-1164 ◽

Cited By ~ 5

Author(s):

Loren G. Rabinowitz ◽

Haley M. Zylberberg ◽

Alan Levinovitz ◽

Melissa S. Stockwell ◽

Peter H. R. Green ◽

...

Keyword(s):

Celiac Disease ◽

Food Safety ◽

Free Food ◽

Gluten Sensitivity ◽

Gluten Free

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Sensory evaluation of gluten-free chicken pasty made with cassava (Manihot esculenta Crantz)

International Journal for Innovation Education and Research ◽

10.31686/ijier.vol5.iss9.819 ◽

2017 ◽

Vol 5 (9) ◽

pp. 54-60

Author(s):

INEZ HELENA VIEIRA DA SILVA SANTOS ◽

Maiara Bruna Nunes da Silva ◽

Gleyson Marques de Menezes ◽

Thatiana Wanessa de Oliveira ◽

Maurício Reginaldo Alves dos Santos ◽

...

Keyword(s):

Celiac Disease ◽

Free Product ◽

Free Food ◽

Production Costs ◽

Attractive Alternative ◽

Gluten Free ◽

Manihot Esculenta Crantz ◽

Autoimmune Reaction ◽

General Aspects ◽

The Cost

Celiac disease is a condition in which genetically predisposed people have an autoimmune reaction to gluten proteins found mainly in wheat. Celiac disease patients have few and expensive options of gluten-free food products. The aim of this study was to produce a gluten-free alternative to the wheat chicken pasty, a food largely consumed in South American countries. The main ingredient used for the elaboration of gluten-free pasty was cassava, a cheap and quite available raw ingredient, which after cooked results in a soft mass. This product was compared to the traditional wheat version by means of a sensory analysis, considering general aspects, consistency, flavor and aroma, and also a comparison of the production costs of the two products. General aspects, flavor and aroma did not differ significantly between the two products. Consistency was the only characteristic that differed significantly between them, the evaluation being more favorable to the cassava pasty. These results validate the gluten-free product regarding its sensory acceptability. The cost of production of the gluten-free product was lower than that of the traditional one. This product can be a cheap and attractive alternative for celiac disease patients.

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Case Study: Nutritional Strategies of a Cyclist With Celiac Disease During an Ultraendurance Race

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.22.4.304 ◽

2012 ◽

Vol 22 (4) ◽

pp. 304-310 ◽

Cited By ~ 3

Author(s):

Katherine Elizabeth Black ◽

Paula Skidmore ◽

Rachel Clare Brown

Keyword(s):

Celiac Disease ◽

Endurance Performance ◽

Free Food ◽

Gluten Free ◽

Dietary Recommendations ◽

Dietary Recall ◽

Nutritional Guidelines ◽

Lack Of Sleep ◽

Limited Food

Food intolerance is becoming increasingly prevalent, and increasing numbers of athletes have celiac disease. This poses challenges as dietary recommendations for exercise are largely based on gluten-containing carbohydrate-rich foods. The K4 cycle race covers 384 km around the Coromandel Peninsula, New Zealand. Lack of sleep, darkness, and temperature variations pose a number of nutritional challenges. Limited food choices present those with celiac disease with even greater challenges. This case study describes the intakes of one such athlete during training and competing in the K4. Nutritional intakes were obtained during training using weighed-food records and during the race via dietary recall and the weighing of foods pre- and postrace. As simple substitution of gluten-containing foods for gluten-free foods leads to increased energy intake, alternatives need to be considered. During the race, insufficient energy was consumed to meet the nutritional guidelines for endurance performance. This was probably due to the nature of the course, racing conditions, the consistency of gluten-free food, and, toward the end of the race, sensory-specific satiety.

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Development of Gluten-Free Food Products Incorporated by Germinated and Popped Finger and Pearl Millets

The Indian Journal of Nutrition and Dietetics ◽

10.21048/ijnd.2018.55.3.18666 ◽

2018 ◽

Vol 55 (3) ◽

pp. 291

Author(s):

E. S. Chauhan ◽

Sarita .

Keyword(s):

Celiac Disease ◽

Food Processing ◽

Finger Millet ◽

Phosphorus Content ◽

Food Products ◽

Good Alternative ◽

Free Food ◽

Crude Fiber ◽

Gluten Free ◽

Nutrient Contents

Recently, celiac disease is a prominent syndrome in developing countries and there is a growing demand for gluten-free foods. Availability of millets is easy and provides many opportunities for developing gluten-free foods. In this study food processing such as germination and popping were carried out to improve nutrients in millets and gluten-free food products were developed incorporating them at 10, 20 and 30%. Germinated Finger Millet Flour (GFMF) had ash (2.7 g/100g), fat (2.0 g/ 100g), crude fiber (4.5 g/100g), protein (8.7 g/100g), carbohydrate (69.2 g/100g), calcium (359.6 mg/100g) and iron (4.5 mg/100g). Popped pearl millet flour (PPMF) contained ash (2.2 g/100g), fat (5.9 g/100g), crude fiber (2.8 g/100g), protein (14.4 g/100g), carbohydrate (64.7 g/100g), calcium (51.2 mg/100g) and iron (8.9 mg/100g). Popping also enhanced ash, protein, carbohydrate, iron and phosphorus content in millets. Two products named fortified sweet pancake and millet dense halwa were prepared by incorporating GFMF and GPMF. Choco phirni and fritter snacks were developed by incorporating PFMF and PPMF. Sensory scores of the products revealed that 10% incorporation of all developed food products were best accepted. Thus incorporation of processed finger and pearl millets in developed food products helped in improving the nutrient contents and thus is a good alternative for celiac patients.

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Cereal-Based Gluten-Free Food: How to Reconcile Nutritional and Technological Properties of Wheat Proteins with Safety for Celiac Disease Patients

Nutrients ◽

10.3390/nu6020575 ◽

2014 ◽

Vol 6 (2) ◽

pp. 575-590 ◽

Cited By ~ 54

Author(s):

Carmela Lamacchia ◽

Alessandra Camarca ◽

Stefania Picascia ◽

Aldo Di Luccia ◽

Carmen Gianfrani

Keyword(s):

Celiac Disease ◽

Free Food ◽

Gluten Free ◽

Technological Properties ◽

Wheat Proteins

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Market trends and new development of gluten‑free products

Khleboproducty ◽

10.32462/0235-2508-2021-30-3-21-25 ◽

2021 ◽

Vol 30 (3) ◽

pp. 21-25

Author(s):

I.A. Nikitin ◽

◽

D.A. Velina ◽

Sh. Mutallibzoda ◽

V.S. Belova ◽

...

Keyword(s):

Celiac Disease ◽

Free Food ◽

Growth Potential ◽

Gluten Free ◽

Free Products ◽

Gluten Intolerance ◽

Protease Enzyme ◽

New Development ◽

Confectionery Products ◽

Food Market

A review of the gluten‑free food market was carried out, which showed that the growth potential of the Russian market is quite high. Three main types of diseases associated with a reaction to gluten have been identified: autoimmune celiac disease (celiac disease), allergic enteropathy (immunological reaction to wheat protein) and non‑ autoimmune non‑allergic gluten intolerance (gluten intolerance without celiac disease). Scientists from P. M. THEM. Sechenov, it was shown that the wheat protease enzyme Triticain‑α‑GM from Triticum aestivum opens up new possibilities for its use in oral therapy of gluten intolerance. The use of this enzyme will be studied in the technology of production of bakery and flour confectionery products, which in the future will make it possible to develop products that are safe for people with various types of gluten intolerance.

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