Elucidation of the mechanism by which the internal structure of food controls the quality

Several of the existing food manufacturing processes are based on empirical knowledge, and not many are rationally designed and operated based on a sufficient understanding of the underlying phenomena. Drying and rehydration processes are one such example of this, and a new method for measuring the moisture distribution was developed, focusing on the fact that the brightness of food varies depending on its moisture content. Using this method, new mechanisms of water transfer inside food were proposed based on the rehydration process of noodles. In addition, as a new analysis method for understanding of extremely complex phenomena, we suggest the "artificial intelligence comprehensive and reverse analysis methods". As a future prospect, we discussed the possibility that this method could contribute to elucidating various unknown complex phenomena.

Celiac disease: Pathogenesis, disease management and new insights into the herbal-based treatments

Celiac disease (CD) is a gluten intolerance autoimmune disorder which its symptoms involve the gastrointestinal tract and sometimes the other organs. It is one of the most prevalent health problems rising in many populations as statistics show that in every 100 people about one person is suffering from CD. It has been observed that the persons who genetically contain the human leukocyte antigen (HLA) DQ2 and HLA DQ8 genes involved in the immune system haplotypes are more prone to develop an allergy to gluten. The only treatment currently available for CD is a strict gluten-free diet. However, recent research has shown promising new insights into the herbal-based treatments of CD. New insight on CD is now offering various prospects to manage its treatment, diagnosis, and serving in the development of advanced therapies. Several herbs and botanical extracts have demonstrated anti-inflammatory, immunomodulatory, and gut-healing properties that make them potential candidates for the management of CD. Here, we provide an updated review on pathogeneses and managements of CD. In particular, we summarize the current understandings of herbal-based treatments for CD and highlights their potential benefits.

Celiac disease in paediatric patients in the United Arab Emirates: a single-center descriptive study

Introduction

Celiac disease (CD) is an autoimmune disorder that is provoked by the consumption of gluten in genetically vulnerable individuals. CD affects individuals worldwide with an estimated prevalence of 1% and can manifest at any age. Growth retardation and anemia are common presentations in children with CD. The objective of this study is to estimate the prevalence of CD in multiple "at risk groups" and to characterize children with CD, presented to a tertiary hospital in Dubai, United Arab Emirates (UAE).

Methods

The study reviewed medical charts of all patients <18 years who had received serologic testing for CD. The study was conducted at Al Jalila Children's Specialty Hospital in Dubai, UAE, from January 2018 to July 2021. Extracted information from medical records included sociodemographics, laboratory findings, clinical presentation, and any associated co-morbidities. The European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria were used to identify patients with CD.

Results

During the study period, 851 paediatric patients underwent serological screening for CD, out of which, 23 (2.7%) were confirmed with CD. Of the 23 patients diagnosed with CD, 43.5% had no gastrointestinal symptoms. Diabetes type 1 (30.4%) followed by iron deficiency anaemia (30%) and Hashimoto thyroiditis (9%) were the most commonly associated comorbidities. The prevalence of CD among paediatric patients with autoimmune thyroiditis (12.5%) was 1.92-times higher than that among paediatric patients with diabetes type 1 (6.5%).

Conclusion

The results of this study show that almost three out of every 100 paediatric patients who were screened for CD were confirmed to have the condition. These findings highlight the importance of screening children who are at risk or present symptoms suggestive of CD, to ensure early diagnosis and appropriate management.

Effects of FODMAPs and Gluten on Gut Microbiota and Their Association with the Metabolome in Irritable Bowel Syndrome: A Double-Blind, Randomized, Cross-Over Intervention Study

BACKGROUND

A mechanistic understanding of the effects of dietary treatment in irritable bowel syndrome (IBS) is lacking. Our aim was therefore to investigate how fermentable oligo- di-, monosaccharides, and polyols (FODMAPs) and gluten affected gut microbiota and circulating metabolite profiles, as well as to investigate potential links between gut microbiota, metabolites, and IBS symptoms.

METHODS

We used data from a double-blind, randomized, crossover study with week-long provocations of FODMAPs, gluten, and placebo in participants with IBS. To study the effects of the provocations on fecal microbiota, fecal and plasma short-chain fatty acids, the untargeted plasma metabolome, and IBS symptoms, we used Random Forest, linear mixed model and Spearman correlation analysis.

RESULTS

FODMAPs increased fecal saccharolytic bacteria, plasma phenolic-derived metabolites, 3-indolepropionate, and decreased isobutyrate and bile acids. Gluten decreased fecal isovalerate and altered carnitine derivatives, CoA, and fatty acids in plasma. For FODMAPs, modest correlations were observed between microbiota and phenolic-derived metabolites and 3-indolepropionate, previously associated with improved metabolic health, and reduced inflammation. Correlations between molecular data and IBS symptoms were weak.

CONCLUSIONS

FODMAPs, but not gluten, altered microbiota composition and correlated with phenolic-derived metabolites and 3-indolepropionate, with only weak associations with IBS symptoms. Thus, the minor effect of FODMAPs on IBS symptoms must be weighed against the effect on microbiota and metabolites related to positive health factors.

Clipping Effect on the Grain Nitrogen and Protein Fractions of Ancient and Old Wheats Grown in a Mediterranean Environment

This study is the first to assess the effects of clipping, cultivar, season, and their interactions on the protein composition of six old and ancient wheat cultivars (n = 6). For this, nitrogen content, the proportion of wheat protein fractions, and the molecular weight distribution of the extractable and unextractable glutenin polymers were investigated as a function of cultivar and clipping in two consecutive seasons. The relationships between genotypic variation in grain nitrogen and protein fraction content under clipping and non-clipping conditions were also assessed. Clipping delayed and shortened the grain filling period of all of the cultivars. The protein composition of some cultivars behaved differently to clipping due to differences in the environmental conditions of S1 (exceptional dry season) and S2 (rainy season). In S1, clipping decreased the ratio of gliadins over glutenins (GLI/GLU) (<1) of Cappelli and Giovanni Paolo, while in S2, clipping improved the GLI/GLU of Giovanni Paolo, Monlis, and Norberto. The unextractable polymeric proteins were not affected by clipping. Khorasan was shown to be indifferent to clipping in S1 and S2. These results suggest that it is possible to have ancient/old wheats suitable for a dual-purpose system, in different climatic conditions, while maintaining good grain quality traits. The increased market demand for ancient and old wheats presents an economic opportunity for farmers who adopt the dual-purpose technique to cultivate these resilient crops again and increase their profit margins and revenues.

Effects of a Gluten-Free Diet in a Teenager Presenting With Psychosis

Nonceliac gluten sensitivity is a gluten-related disorder that results from immune-mediated reactions in predisposed people. It manifests usually with gastrointestinal symptoms; however, in rare cases, it might present with psychiatric symptoms that could be severe enough to impair functioning.  In this case report, we present a case of a 15-year-old girl, with no past psychiatric history, who presented to the Emergency Department (ED) with anxiety symptoms and paranoid delusion that did not improve on conventional treatment. However, a significant improvement was observed upon starting on a strict gluten-free diet (GFD). This case adds to the existing literature, suggesting a possible strong relationship between gluten ingestion and psychiatric disorders.

The role of gluten challenge in the diagnosis of celiac disease: a review

INTRODUCTION

Duodenal biopsy is the gold standard in the diagnosis of celiac disease, with increasing utilization of serology. A gluten challenge may be required, for example, when dietary gluten reduction precedes appropriate diagnostic evaluations. Evidence on the best challenge protocol is currently sparse. Pharmaceutical trials in recent years may have provided new insights into the challenge and advanced the development of novel sensitive histological and immunological methods.

AREAS COVERED

This review outlines the current perspectives on the use of gluten challenge in the diagnosis of celiac disease and explores future directions in this area.

EXPERT OPINION

Comprehensive elimination of celiac disease before dietary gluten restriction is essential to avoid diagnostic uncertainties. Gluten challenge continues to have an important role in certain clinical scenarios, although it is important to understand its limitations in the diagnostic evaluation. The evidence so far permits no unequivocal recommendation considering the timing, duration, and amount of gluten used in the challenge. Thus, these decisions should be made on a case-by-case basis. Further studies with more standardized protocols and outcome measures are called for. In the future novel immunological methods may help to shorten or even avoid gluten challenge.

The Oral Transglutaminase 2 Inhibitor ZED1227 Accumulates in the Villous Enterocytes in Celiac Disease Patients during Gluten Challenge and Drug Treatment

The enzyme transglutaminase 2 (TG2) plays a key role in celiac disease (CeD) pathogenesis. Active TG2 is located mainly extracellularly in the lamina propria but also in the villous enterocytes of the duodenum. The TG2 inhibitor ZED1227 is a promising drug candidate for treating CeD and is designed to block the TG2-catalyzed deamidation and crosslinking of gliadin peptides. Our aim was to study the accumulation of ZED1227 after oral administration of the drug. We studied duodenal biopsies derived from a phase 2a clinical drug trial using an antibody that detects ZED1227 when bound to the catalytic center of TG2. Human epithelial organoids were studied in vitro for the effect of ZED1227 on the activity of TG2 using the 5-biotin-pentylamine assay. The ZED1227-TG2 complex was found mainly in the villous enterocytes in post-treatment biopsies. The signal of ZED1227-TG2 was strongest in the luminal epithelial brush border, while the intensity of the signal in the lamina propria was only ~20% of that in the villous enterocytes. No signal specific to ZED1227 could be detected in pretreatment biopsies or in biopsies from patients randomized to the placebo treatment arm. ZED1227-TG2 staining co-localized with total TG2 and native and deamidated gliadin peptides on the enterocyte luminal surface. Inhibition of TG2 activity by ZED1227 was demonstrated in epithelial organoids. Our findings suggest that active TG2 is present at the luminal side of the villous epithelium and that inhibition of TG2 activity by ZED1227 occurs already there before gliadin peptides enter the lamina propria.

Attenuation of immune activation in patients with multiple sclerosis on a wheat-reduced diet: a pilot crossover trial

Background

Western lifestyle has been associated with an increase in relapsing-remitting multiple sclerosis (RRMS). In mice, dietary wheat amylase-trypsin inhibitors (ATIs) activate intestinal myeloid cells and augment T cell-mediated systemic inflammation.

Objective

The aim of this study was to assess whether a wheat- and thus ATI-reduced diet might exert beneficial effects in RRMS patients with modest disease activity.

Methods

In this 6-month, crossover, open-label, bicentric proof-of-concept trial, 16 RRMS patients with stable disease course were randomized to either 3 months of a standard wheat-containing diet with consecutive switch to a > 90% wheat-reduced diet, or vice versa.

Results

The primary endpoint was negative, as the frequency of circulating pro-inflammatory T cells did not decrease during the ATI-reduced diet. We did, however, observe decreased frequencies of CD14+ CD16++ monocytes and a concomitant increase in CD14++ CD16- monocytes during the wheat-reduced diet interval. This was accompanied by an improvement in pain-related quality of life in health-related quality of life assessed (SF-36).

Conclusion

Our results suggest that the wheat- and thus ATI-reduced diet was associated with changes in monocyte subsets and improved pain-related quality of life in RRMS patients. Thus, a wheat (ATI)-reduced diet might be a complementary approach accompanying immunotherapy for some patients.

Registration

German Clinical Trial Register (No. DRKS00027967).

Assessment of Physicochemical Parameters and Contaminants in Herbal Dietary Supplements Used in the Treatment of Inflammatory Bowel Disease

Inflammatory bowel disease is a complex disorder characterized by chronic gastrointestinal inflammation. Thus, patients prefer to use herbal dietary supplements containing turmeric, Indian frankincense, green chiretta, and black pepper in an attempt to cope better with their chronic condition. The dietary supplements' dosage forms and herbal ingredients were assessed in terms of the products' physicochemical parameters (weight uniformity, friability, disintegration, rupture test, tablet's breaking force, and powder flowability) in view of the USP-NF requirements. In addition, contaminants such as organic solvents and ethylene oxide were evaluated using gas chromatography. Assessment of gluten via an Enzyme-Linked Immunosorbent Assay was also performed. Most of the products met USP requirements. The high average weight of one multicomponent tablet sample with a high breaking force value can explain the observed negative results of the disintegration test. A total of 26% of samples tested positive for gluten, but the most alarming fact is that the ethylene oxide levels found in two samples were up to 30 times higher than the EU limit. Accordingly, dietary supplement quality control is of fundamental importance.

Investigating the Effects of NaCl on the Formation of AFs from Gluten in Cooked Wheat Noodles

To clarify the effect of NaCl concentration (0-2.0%) on the formation of amyloid fibrils (AFs) in cooked wheat noodles, the morphology, surface hydrophobicity, secondary structure, molecular weight distribution, microstructure, and crystal structure of AFs were investigated in this paper. Fluorescence data and Congo red stain images confirmed the presence of AFs and revealed that the 0.4% NaCl concentration promoted the production of AFs. The surface hydrophobicity results showed that the hydrophobicity of AFs increased significantly from 3942.05 to 6117.57 when the salt concentration increased from 0 to 0.4%, indicating that hydrophobic interactions were critical for the formation of AFs. Size exclusion chromatography combined with gel electrophoresis plots showed that the effect of NaCl on the molecular weight of AFs was small and mainly distributed in the range of 5-7.1 KDa (equivalent to 40-56 amino acid residues). X-ray diffraction and AFM images showed that the 0.4% NaCl concentration promoted the formation and longitudinal growth of AFs, while higher NaCl concentrations inhibited the formation and expansion of AFs. This study contributes to the understanding of the mechanism of AF formation in wheat flour processing and provides new insight into wheat gluten aggregation behavior.

Beyond the Gut: A Systematic Review of Oral Manifestations in Celiac Disease

BACKGROUND

Celiac disease (CD) is a chronic immune-mediated gluten-sensitive enteropathy, affecting about 1% of the population. The most common symptoms include diarrhea, abdominal pain, weight loss, and malabsorption. Extra-intestinal symptoms include oral manifestations. This systematic review aims to catalog and characterize oral manifestations in patients with CD.

METHODS

a systematic literature review among different search engines using PICOS criteria has been performed. The studies included used the following criteria: tissues and anatomical structures of the oral cavity in humans, published in English and available in full text. Review articles and papers published before 1990 were excluded.

RESULTS

209 articles were identified in the initial search. In the end, 33 articles met the selection criteria. The information extracted from the articles was classified based on the type of oral manifestation. Recurrent aphthous stomatitis (34.6%), atrophic glossitis and geographic tongue (15.26%), enamel defects (42.47%), delayed dental eruption (47.34%), xerostomia (38.05%), glossodynia (14.38%), and other manifestations including cheilitis, fissured tongue, periodontal diseases, and oral lichen planus were found in the celiac subjects of the studies analyzed. The quality of articles on the topic should be improved; however, oral manifestations in CD patients are widely described in the literature and could help diagnose celiac disease.

Correlation of Celiac Diseases with Candida Spp. Based on Anti-gliadin Antibodies

A variety of Candida spp. can be found as a natural commensal fungus in various parts of the human body. This fungus may be associated with various diseases such as celiac disease (CD). Gliadin, a component of the gluten protein complex that is mostly found in wheat, is the main inducer of CD. A number of studies have demonstrated that patients infected with Candida can develop CD, and vice versa. C. albicansis presumed to induce CD because it has a protein homologous to gliadin in its cell wall called Hwp1. Despite the non-specificity of the anti-gliadin test, the detection of antibodies against anti-gliadin (AGA) and anti-tissue transglutaminase (anti-tTG) are important in the diagnosis of CD. Some evidence is now available to support the hypothetical correlation between Candida spp. and CD, as high levels of AGA have been found in patients infected with candidiasis without CD. Further study is needed to confirm this relationship.

Inhibition of In Vitro Amylolysis of Wheat Starch by Gluten Peptides

The effect of gluten peptides (GPs) isolated from a gluten proteolysate on in vitro amylolysis of gelatinized wheat starch was investigated. GPs in a pepsin hydrolysate were fractionated into fractions with molecular weights (MWs) of 500-3000, 3500-7000, 10-17, and 35-48 kDa. The fractions containing peptides with MW > 10 kDa had a strong inhibitory effect on enzyme activity and amylolysis of starch, whereas GPs with MW <10 kDa had no inhibitory effect. Binding constants estimated by surface plasmon resonance showed that peptides in the fractions with MW > 10 kDa bound more strongly to α-amylase, in contrast to peptides of MW <10 kDa. Significant correlations were observed between digestion parameters and equilibrium binding affinity. We conclude that peptides with MW >10 kDa in a pepsin digest of gluten have a strong inhibitory effect on in vitro enzymatic hydrolysis of starch due to their strong binding affinity to α-amylase.

Correlation Analysis between Wheat Flour Solvent Retention Capacity and Gluten Aggregation Characteristics

Solvent retention capacity (SRC) is a test for the solvation of wheat flour. Its functional contribution was predicted according to the swelling behavior of different diagnostic solvents to different polymeric components of wheat. Ten commercial wheat flour varieties were used as raw materials in this study. The flour quality, gluten aggregation and solvent retention capacity, and their correlations were analyzed. The results showed that protein content, wet gluten content, dry gluten content and the swelling index of glutenin were positively correlated with torque maximum (BEM), torque 15 s before maximum torque (AM), torque 15 s after maximum torque (PM) and gluten aggregation energy (AGGEN). Moreover, they were significantly correlated with the solvent retention capacity. BEM, AM, PM and AGGEN were positively correlated with standard solvent water-SRC (WSRC) and lactic acid-SRC (LASRC). For supplemental solvents, ethanol-SRC (EthSRC) was positively correlated with AGGEN. Sodium dodecyl sulphate-SRC (SDSSRC) was highly correlated with peak maximum time (PMT). Metabisulfite-SRC (MBSSRC) and MBS + SDSSRC were also significantly correlated with BEM, AM, PM and AGGEN sodium metabisulfite. There were significant correlations between gluten aggregation characteristic, standard SRC solvent and supplemental solvent. This study provides a theoretical basis for the evaluation of wheat flour quality.

A combined use of different functional additives for improvement of wheat flour quality for bread making

BACKGROUND

Low-protein wheat flour can produce bread with poor texture and appearance, reducing its nutritional value and market appeal. This is a growing concern for both the food industry and consumers relying on wheat as a dietary staple. The present study evaluated the individual and combined effects of bacterial xylanase (BX), maltogenic α-amylase (MG), vital gluten (VG) and ascorbic acid (AA) with respect to improving weak flour properties for bread making.

RESULTS

BX, VG and AA improved gluten Index (GI), whereas MG was employed for optimizing amylolytic-activity in flour. VG increased the water absorption (WA) capacity of flour and prolonged dough development time (DDT). The dough stability (DST) was increased by BX and VG. BX and MG decreased crumb firmness (CF) and showed anti-staling effect. All additives reduced bake loss, increased loaf volume (LV) and retained or improved sensory attributes of bread. However, MG at 60 mg kg-1 (MG60), BX at 30 mg kg-1 (BX30), VG at 5% (VG5) and AA at 50 mg kg-1 (AA50) were found to be the most suitable for evaluating in combinations. Ternary combinations of MG60, BX30, VG5 or AA50 imparted significantly (P < 0.05) positive impacts on GI, WA, DDT, DST, CF, LV and sensory attributes compared to control, individual and binary combinations.

CONCLUSION

The PCA suggested that a combination of MG60 + VG5 was more similar to MG60 + BX30 + VG5, whereas, MG60 + BX30 and MG60 + AA50 were more related to MG60 + BX30 + AA50 combination, but all of these combinations showed the improvement in the characteristics compared to control flour. © 2023 Society of Chemical Industry.

Physicochemical and Rheological Characteristics of Commercial and Monovarietal Wheat Flours from Peru

In Peru, wheat (Triticum aestivum L.) is one of the main resources in the food industry; however, due to its low harvested area, it is the second most imported cereal. The quality of wheat flour was studied to verify that it has desirable characteristics for the preparation of bakery products. The quality of commercial and monovarietal wheat flours was assessed by measuring their physicochemical and rheological parameters, as well as the gluten content and wheat protein fractions. Eight commercial wheat flours and four monovarietal wheat flours (Barba negra, Candeal, Espelta, and Duro) from Peru were evaluated. Commercial wheat flours presented significantly higher levels of protein and gluten index compared to monovarietal wheat flours (p < 0.05). Between both groups, no significant differences were observed in the content of wet and dry gluten. Interestingly, monovarietal wheat flours presented a higher percentage of gliadins and albumins/globulins, as well as lower levels of glutenin, compared to commercial wheat flours (p < 0.05). According to the logistic regression models, the baking strength (W) was the most important parameter to evaluate the quality of commercial and monovarietal wheat flours. Our results show that monovarietal wheat flours show a lower quality compared to commercial wheat flours.

Preparation and Characterization of Gluten/SDS/Chitosan Composite Hydrogel Based on Hydrophobic and Electrostatic Interactions

Gluten is a natural byproduct derived from wheat starch, possessing ideal biocompatibility. However, its poor mechanical properties and heterogeneous structure are not suitable for cell adhesion in biomedical applications. To resolve the issues, we prepare novel gluten (G)/sodium lauryl sulfate (SDS)/chitosan (CS) composite hydrogels by electrostatic and hydrophobic interactions. Specifically, gluten is modified by SDS to give it a negatively charged surface, and then it conjugates with positively charged chitosan to form the hydrogel. In addition, the composite formative process, surface morphology, secondary network structure, rheological property, thermal stability, and cytotoxicity are investigated. Moreover, this work demonstrates that the change can occur in surface hydrophobicity caused by the pH-eading influence of hydrogen bonds and polypeptide chains. Meanwhile, the reversible non-covalent bonding in the networks is beneficial to improving the stability of the hydrogels, which shows a prominent prospect in biomedical engineering.

Greek Landrace Flours Characteristics and Quality of Dough and Bread

Besides organic growing, ancient wheats and landraces are attracting the attention of scientists who are reassessing the healthy and dietary properties attributed to them by popular tradition. A total of eleven wheat flours and whole meal samples were analyzed, of which, nine originated from the organic farming of five Greek landraces (one einkorn, one emmer, two durum, and one soft wheat) and a commercial organically grown emmer cultivar. Two commercial conventional flours of 70% and 100% extraction rate were examined for comparison purposes. Chemical composition, micronutrients, phenolic profile, and quantification, and antioxidant activity of all samples were determined. Moreover, dough rheology and breadmaking quality were studied; Flours from local landraces were higher in micronutrients, phenolic content, and antioxidant activity than the commercial samples. The 90% extraction flour of the landrace, besides the highest protein content (16.62%), exhibited the highest content of phenolic acids (19.14 μg/g of flour), whereas the commercial refined emmer flour was the lowest (5.92 μg/g of flour). The same milling of the einkorn landrace also showed a higher specific volume (1.9 mL/g vs. 1.7 mL/g) and lower bread crumb firmness than the whole meal commercial emmer sample (33.0 N vs. 44.9 N). The results of this study showed that the examined Greek wheat landraces could be considered as a possible source of microelements, phenolics, and antioxidants with a beneficial effect in human health, and by using an appropriate breadmaking procedure, they could produce high-quality breads.

Social and economic difficulties of patients with food intolerances

Introduction

The basic method of treating food hypersensitivity is the elimination diet, which is difficult for the patient in many ways.

Aim

To identify the main problems faced by patients with symptoms of food intolerance.

Material and methods

The survey was conducted from February 2021 to December 2021. The survey was posted in Polish thematic groups on Facebook, dedicated to people with food intolerances. The survey contained 34 questions about food intolerances and the use of elimination diets. Questions about the cost of the diet and difficulties in applying the elimination diet were included.

Results

There was no statistically significant relationship between the type of food intolerance and the body mass index of patients. It was found that people with lactose intolerance had a lower increase in food expenditure since the introduction of the diet than those without lactose intolerance. Almost half of the respondents did not find a difference in expenses. 21% of respondents noticed an increase of PLN 50-100/month, 19% - PLN 10-50/month, and only 6% above PLN 200/month. Circumstances where following an elimination diet is a particular challenge included intense private and professional lifestyle, prolonged stay away from home, and lack of time to prepare meals at home.

Conclusions

The difficulties in maintaining an elimination diet are dependent on the patient's work and lifestyle. The cost of equivalents of intolerant products is also an important factor to consider when analysing the source of problems in maintaining the diet.

Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity

A gluten-free diet (GFD) is the only available treatment for celiac disease (CeD), and it may also improve symptoms in non-celiac gluten/wheat sensitivity (NCGWS). In CeD, gluten triggers an immune reaction leading to enteropathy, malabsorption, and symptoms; in NCGWS, the mechanism leading to symptoms is unknown, and neither wheat nor gluten triggers enteropathy or malabsorption. A strict GFD is, therefore, necessary for CeD, but a gluten-restricted diet (GRD) may suffice to achieve symptom control for NCGWS. Regardless of this distinction, the risk of malnutrition and macro- and micronutrient deficiencies is increased by the adoption of a GFD or GRD. Thus, patients with CeD or NCGWS should undergo nutritional assessment and subsequent monitoring, based on evidence-based tools, under the care of a multidisciplinary team involving physicians and dietitians, for the long-term management of their nutrition. This review gives an overview of available nutrition assessment tools and considerations for the nutritional management of CeD and NCGWS populations.

Farmer vs. Industrial Practices: Impact of Variety, Cropping System and Process on the Quality of Durum Wheat Grains and Final Products

The consumption of artisanal and organic pasta made on-farm from ancient varieties is increasing in France. Some people, namely, those suffering from digestive disorders following the consumption of industrial pasta, consider these artisanal pasta to be more digestible. Most of them have linked these digestive disorders to the ingestion of gluten. We analyzed in this study the impact of industrial and artisanal practices on the protein quality of durum wheat products. The varieties recommended by the industry (IND) were compared to those used by farmers (FAR): the FAR being on average much richer in protein. However, the solubility of these proteins analyzed by Size Exclusion-High Performance Liquid Chromatography (SE-HPLC) and their in vitro proteolysis by digestive enzymes vary little between the two groups of varieties, while differences between varieties in each group are observable. The location of grain production and the tested cropping systems (zero vs. low input) have a low impact on protein quality. Yet, more contrasting modalities should be studied to validate this point. The type of production process (artisanal vs. industrial) is, among those studied, the factor having the greatest impact on protein compositionPasta produced by the artisanal method contains a higher sodium dodecyl sulfate (SDS)-soluble protein fraction and are more in-vitro proteolyzed. Whether these criteria are indicative of what happens during a consumer's digestion remains to be determined. It also remains to be assessed which key stages of the process have the greatest influence on protein quality.

Psychiatric and Neurological Manifestations of Celiac Disease in Adults

Celiac disease (CD), a chronic inflammatory disorder of the intestines, affects 0.7% to 1.4% of the world's population. CD causes diarrhea, abdominal discomfort, bloating, flatulence, and, in rare cases, constipation in the digestive tract. Since the identification of gluten as the disease-causing antigen, CD patients have been treated with a gluten-free diet, which is advantageous but has limitations for certain patient groups. CD is associated with mood disorders, such as manic-depressive disease, schizophrenia, and bipolar disorder, as well as other disorders such as depression and anxiety. The relationship between CD and psychological issues is not entirely understood. Here, we look at the most recent psychiatric data as they pertain to CD, as well as the relevant psychiatric manifestations that have been associated with this condition. Clinicians should examine mental health factors when a CD diagnosis is established. More research is needed to understand the pathophysiology of CD's psychiatric manifestations.