Analysis of ingredient lists of commercially available gluten-free and gluten-containing food products using the text mining technique

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.

Unprocessed wheat γ-gliadin reduces gluten accumulation associated with the endoplasmic reticulum stress and elevated cell death

Along with increasing demands for high yield, elite processing quality and improved nutrient value in wheat, concerns have emerged around the effects of gluten in wheat-based foods on human health. However, knowledge of the mechanisms regulating gluten accumulation remains largely unexplored. Here we report the identification and characterization of a wheat low gluten protein 1 (lgp1) mutant that shows extremely low levels of gliadins and glutenins. The lgp1 mutation in a single γ-gliadin gene causes defective signal peptide cleavage, resulting in the accumulation of an excessive amount of unprocessed γ-gliadin and a reduced level of gluten, which alters the endoplasmic reticulum (ER) structure, forms the autophagosome-like structures, leads to the delivery of seed storage proteins to the extracellular space and causes a reduction in starch biosynthesis. Physiologically, these effects trigger ER stress and cell death. This study unravels a unique mechanism that unprocessed γ-gliadin reduces gluten accumulation associated with ER stress and elevated cell death in wheat. Moreover, the reduced gluten level in the lgp1 mutant makes it a good candidate for specific diets for patients with diabetes or kidney diease.

Delving into the Role of Dietary Fiber in Gluten-Free Bread Formulations: Integrating Fundamental Rheological, Technological, Sensory, and Nutritional Aspects

The evidenced relevance of dietary fibers (DF) as functional ingredients shifted the research focus towards their incorporation into gluten-free (GF) bread, aiming to attain the DF contents required for the manifestation of health benefits. Numerous studies addressing the inclusion of DF from diverse sources rendered useful information regarding the role of DF in GF batter’s rheological properties, as well as the end product’s technological and nutritional qualities. The presented comprehensive review aspires to provide insight into the changes in fiber-enriched GF batter’s fundamental rheological properties, and technological, sensory, and nutritional GF bread quality from the insoluble and soluble DF (IDF and SDF) perspective. Different mechanisms for understanding IDF and SDF action on GF batter and bread were discussed. In general, IDF and SDF can enhance, but also diminish, the properties of GF batter and bread, depending on their addition level and the presence of available water in the GF system. However, it was seen that SDF addition provides a more homogenous GF batter structure, leading to bread with higher volumes and softer crumb, compared to IDF. The sensory properties of fiber-enriched GF breads were acceptable in most cases when the inclusion level was up to 7 g/100 g, regardless of the fiber type, enabling the labeling of the bread as a source of fiber.

Sourdough Biotechnology Applied to Gluten-Free Baked Goods: Rescuing the Tradition

Recent studies suggest that the beneficial properties provided by sourdough fermentation may be translated to the development of new GF products that could improve their technological and nutritional properties. The main objective of this manuscript is to review the current evidence regarding the elaboration of GF baked goods, and to present the latest knowledge about the so-called sourdough biotechnology. A bibliographic search of articles published in the last 12 years has been carried out. It is common to use additives, such as hydrocolloids, proteins, enzymes, and emulsifiers, to technologically improve GF products. Sourdough is a mixture of flour and water fermented by an ecosystem of lactic acid bacteria (LAB) and yeasts that provide technological and nutritional improvements to the bakery products. LAB-synthesized biopolymers can mimic gluten molecules. Sourdough biotechnology is an ecological and cost-effective technology with great potential in the field of GF products. Further research is necessary to optimize the process and select species of microorganisms robust enough to be competitive in any circumstance.

Use of Underexploited Flours for the Reduction of Glycaemic Index of Gluten-Free Biscuits: Physicochemical and Sensory Characterization

The type and the amount of starch present in bakery products affect their glycaemic index. The control of glycaemic index in our diet can be relevant to reduce the risk of type 2 diabetes and heart diseases. The use of alternative flours to rice, maize, and their starches may improve the nutritional quality of gluten-free baked goods by reducing the glycaemic index. This work aimed at the formulation of satisfactory gluten-free biscuits by using underexploited flour mixes (from cereals, pseudocereals, and legumes), at the evaluation of their physical properties, starch digestibility and subsequent estimation of the glycaemic index. The presence of chickpea flour increased biscuit hardness and gluten-free flours darkened biscuit surface. The greatest differences in starch composition and its digestion were found between gluten-free samples and wheat-containing control. Experimental biscuits had also a lower predicted glycaemic index compared to commercial products, whereas experimental formulations presented similar values between each other. Consumers’ acceptance and sensory profiling by Check All That Apply questionnaire were carried out. All formulations but one were above the acceptance threshold (50); crumbliness and easiness to swallow were drivers of acceptance, whereas sandiness exerted a negative impact on liking score.

Mediterranean Gluten-Free Diet: Is It a Fair Bet for the Treatment of Gluten-Related Disorders?

Gluten-free diet (GFD) is the current treatment of gluten-related disorders. It eliminates wheat, barley, and rye, while the exclusion of oats is still under debate. GFD is based on a combination of naturally gluten-free foods and gluten-free substitutes of cereal-based foods. Although effective as treatment of gluten-related disorders, today there is concern about how to improve GFD's nutritional quality, to make it not only gluten-free, but also healthy. The "Mediterranean diet" (MedD) refers to the dietary pattern and eating habits typical of populations living in the Mediterranean basin, which have been associated with low prevalence of several diet-related pathologies. Here we present a narrative review of the current knowledge about GFD and MedD, their characteristics and central food components. Based on the Mediterranean diet pyramid developed by the Italian pediatric society, we propose a combination between the MedD and the GFD, an attractive alternative to reach a gluten-free state that at the same time is healthy, with a clear benefit to those who practice it.

Chemical Composition and Glycemic Index of Gluten-Free Bread Commercialized in Brazil

Nowadays, the world is experiencing an increased demand for gluten-free products associated with the high prevalence of gluten-related disorders (GRD). As this market thrives, bread stands out as the most demanded and consumed product, highlighting the need to evaluate its nutritional quality. In this sense, this cross-sectional study aimed to assess the ingredients, chemical composition, and glycemic index of gluten-free bread (GFB) commercialized nationwide in Brazil. The labels were analyzed according to their ingredients and composition. In addition, centesimal composition analysis (moisture, carbohydrates, protein, ash, lipid, and fiber) was performed using the official methods, as well as the in vivo glycemic index. Significant differences between manufacturing lots of each brand and between different gluten-free bread samples were found. There is a mismatch from what is stipulated by the Brazilian legislation between analytical data and the data described on sample labels. Samples showed predominantly refined starch and high glycemic index profile. Most samples (75%, n = 6) of the non-whole gluten-free bread (n = 8) presented high glycemic index (GI). From four whole food/multigrain gluten-free bread samples, three of them (75%) presented medium GI. However, two samples presented GI near the value to be considered high. The results suggest a lack of production control, impairing the gluten-free nutritional label as a reliable information source and tool for dietary control. Therefore, it is necessary to standardize the process of gluten-free bread production and labeling, as well as to improve the nutritional characteristics of these products, aiming the give accurate information to consumers and provide a healthier product beyond the sensory characteristics.

Utilization of text mining as a big data analysis tool for food science and nutrition

Big data analysis has found applications in many industries due to its ability to turn huge amounts of data into insights for informed business and operational decisions. Advanced data mining techniques have been applied in many sectors of supply chains in the food industry. However, the previous work has mainly focused on the analysis of instrument-generated data such as those from hyperspectral imaging, spectroscopy, and biometric receptors. The importance of digital text data in the food and nutrition has only recently gained attention due to advancements in big data analytics. The purpose of this review is to provide an overview of the data sources, computational methods, and applications of text data in the food industry. Text mining techniques such as word-level analysis (e.g., frequency analysis), word association analysis (e.g., network analysis), and advanced techniques (e.g., text classification, text clustering, topic modeling, information retrieval, and sentiment analysis) will be discussed. Applications of text data analysis will be illustrated with respect to food safety and food fraud surveillance, dietary pattern characterization, consumer-opinion mining, new-product development, food knowledge discovery, food supply-chain management, and online food services. The goal is to provide insights for intelligent decision-making to improve food production, food safety, and human nutrition.

Micronutrient Analysis of Gluten-Free Products: Their Low Content Is Not Involved in Gluten-Free Diet Imbalance in a Cohort of Celiac Children and Adolescent

Data about the nutritional composition of gluten-free products (GFP) are still limited. Most studies are based on ingredient and nutrition information described on the food label. However, analytical determination is considered the gold standard for compositional analysis of food. Micronutrient analytical content differences were observed in a selection of GF breads, flakes and pasta, when compared with their respective gluten-containing counterparts. In general terms, lower iron, piridoxin, riboflavin, thiamin, niacin, folate, manganese and vitamin B5 can be underlined. Variations in biotin and vitamin E content differed among groups. In order to clarify the potential contribution of the GFP to the gluten-free diet's (GFD) micronutrient shortages, analytical data were used to evaluate GFD in a cohort of celiac children and adolescent. Participants did not reach recommendations for vitamin A, vitamin E, folic acid, vitamin D, biotin, iodine, and copper. It does not seem that the lower micronutrient content of the analyzed GFP groups contributed to the micronutrient deficits detected in GFD in this cohort, whose diet was not balanced. Nevertheless, GFP fortification for folate and biotin is proposed to prevent the deficiencies observed in GFD, at least in the case of pediatric celiac disease.

Recent practical researches in the development of gluten-free breads

Wheat bread is consumed globally and has played a critical role in the story of civilization since the development of agriculture. While the aroma and flavor of this staple food continue to delight and satisfy most people, some individuals have a specific allergy to wheat or a genetic disposition to celiac disease. To improve the quality of life of these patients from a dietary standpoint, food-processing researchers have been seeking to develop high-quality gluten-free bread. As the quality of wheat breads depends largely on the viscoelastic properties of gluten, various ingredients have been employed to simulate its effects, such as hydrocolloids, transglutaminase, and proteases. Recent attempts have included the use of redox regulation as well as particle-stabilized foam. In this short review, we introduce the ongoing advancements in the development of gluten-free bread, by our laboratory as well as others, focusing mainly on rice-based breads. The social and scientific contexts of these efforts are also mentioned.

Gluten-Free Diet: Gaps and Needs for a Healthier Diet

The gluten-free diet (GFD) is currently the only effective treatment in remitting the symptoms of coeliac disease (CD), a chronic systemic autoimmune disorder caused by a permanent intolerance to gluten proteins in genetically susceptible individuals. The diet entails the substitution of gluten-containing products with gluten-free-rendered products. However, over recent decades the nutritional profile of gluten-free (GF) food products has been increasingly questioned within the scientific community. The aim of this paper is to review the nutritional profile of gluten-free-rendered products currently available on the market, and discuss the possible relationship thereof with the nutritional status of coeliac patients on a GFD. Key inadequacies of currently available GF products are low protein content and a high fat and salt content. More adequate levels of dietary fiber and sugar than in the past have been reported. Population studies confirmed the above mentioned inadequacies. Further efforts are required to conceive adoptable interventions for product development and reformulation in order to achieve compliance with nutritional recommendations.

A Review on the Gluten-Free Diet: Technological and Nutritional Challenges

Consumers, food manufacturers and health professionals are uniquely influenced by the growing popularity of the gluten-free diet. Consumer expectations have urged the food industry to continuously adjust and improve the formulations and processing techniques used in gluten-free product manufacturing. Health experts have been interested in the nutritional adequacy of the diet, as well as its effectiveness in managing gluten-related disorders and other conditions. In this review, we aim to provide a clear picture of the current motivations behind the use of gluten-free diets, as well as the technological and nutritional challenges of the diet as a whole. Alternative starches and flours, hydrocolloids, and fiber sources were found to play a complex role in mimicking the functional and sensory effects of gluten in gluten-free products. However, the quality of gluten-free alternatives is often still inferior to the gluten-containing products. Furthermore, the gluten-free diet has demonstrated benefits in managing some gluten-related disorders, though nutritional imbalances have been reported. As there is limited evidence supporting the use of the gluten-free diet beyond its role in managing gluten-related disorders, consumers are urged to be mindful of the sensorial limitations and nutritional inadequacies of the diet despite ongoing strategies to improve them.

Tailoring rice flour structure by rubbery milling for improved gluten-free baked goods

Ever-growing demand for gluten-free products calls for the development of novel food processing techniques to widen the range of existing baked goods.

Current and Forward-Looking Approaches to Technological and Nutritional Improvements of Gluten-Free Bread with Legume Flours: A Critical Review

The gluten-free market currently offers a range of products which can be safely consumed by patients affected by celiac disease. Nevertheless, challenges for optimal formulation remain on the way in terms of appreciable texture, flavor, and adequate nutritional characteristics. Within that framework, legumes have recently attracted attention among scientists as structure- and texture-forming agents, as source of nutrients and bioactive compounds, and as a low-glycemic-index ingredient. This work aims at providing an updated and comprehensive overview of the advantages and disadvantages in the use of legumes in gluten-free breadmaking. It also shows how legumes can contribute to tackling the main technological, nutritional, and organoleptic challenges. From this critical analysis, it emerged that viscoelastic properties of gluten-free bread batter can be enhanced by the use of carob germ, chickpea, lupin, and soybean. Gluten-free bread organoleptic acceptability can be improved by incorporating leguminous flours, such as carob, chickpea, lupin, and soybean. Moreover, a better nutritional quality of gluten-free bread can be obtained by the addition of chickpea and soybean. Gaps and needs in the use of legumes in gluten-free breadmaking emerged and were gathered together to have a sound basis for future studies. The technological and nutritional potential of sourdough should be more extensively exploited. Moreover, in vitro and in vivo studies should be prompted to understand the health benefits of bread formulated with legumes. A holistic approach, interfacing food science, nutrition, and health might help to have, on the market, products with improved sensory properties and nutritional profile.

Development of gluten-free bread formulations containing whole chia flour with acceptable sensory properties

Increasing the variety of better‐tasting and healthier gluten‐free products is important for consumers with gluten‐related disorders. This work aimed to develop a gluten‐free bread formulation containing whole chia flour with acceptable sensory properties. A mixture design for three ingredients and response surface methodology were used to identify the proportions of potato starch, rice flour and whole chia flour to achieve the best physical properties and result in sensory‐accepted products. The physical properties and visual appearance showed that whole chia flour alone is not suitable for bread production. Nevertheless, it is possible to add up to 14% whole chia flour to a rice flour‐based gluten‐free bread formulation while negligibly diminishing the loaf volume, crumb firmness and crumb moisture. The best formulations were prepared from rice flour blends with 5, 10, and 14% whole chia flour, which received overall acceptability scores of 8.7, 8.1 and 7.9 on a 10‐cm scale, respectively, similar to those of their white gluten‐free bread and wheat bread counterparts. Incorporating 5%–14% whole chia flour in the formulation increased the levels of ash, lipid, protein and dietary fiber compared to those of the white gluten‐free bread.

How to improve the gluten-free diet: The state of the art from a food science perspective

The celiac disease is the most common food intolerance and its prevalence is increasing. Consequently, use of gluten-free diet has expanded, notwithstanding consumption as therapy for other gluten-related disorders or by wellbeing people without any medical prescription. Even the therapeutic efficiency has undoubtedly proven, several drawbacks mainly regarding the compliance, nutritional deficits and related diseases, and the alteration of the intestinal microbiota have described in the literature. Food science has been considered as one of the primary area of intervention to limit or eliminate such drawbacks. Efforts have approached shelf life, rheology and palatability aspects but more recently have mainly focused to improve the nutritional features of the gluten-free diet, and to propose dietary alternatives. The sourdough fermentation has shown the most promising results, also including a biotechnology strategy that has allowed the complete degradation of gluten prior to consumption.

Overview on the General Approaches to Improve Gluten-Free Pasta and Bread

The use of gluten-free products is increasing since a growing number of people are suffering from celiac disease and thereby need gluten-free diet. Gluten is responsible for the visco-elastic characteristics of wheat-based products; therefore, its lack makes the gluten-free products not similar to wheat-based product, with scarce textural properties. This reason constitutes the major industrial limitation. Thus, obtaining good-quality gluten-free products represents a technological challenge. This review reports the main strategies adopted to produce high quality gluten-free pasta and bread. They are mainly obtained by the utilization of specific ingredients (hydrocolloids, proteins or enzymes) to be incorporated into the standard formulation or the adoption of proper technological variables that can enhance above all the functional properties, the texture and the taste.

The gluten-free basic food basket: a problem of availability, cost and nutritional composition

The basic food basket (BFB), formed by the more economical products available, is used by less-affluent countries to establish the minimum daily food consumption to satisfy nutritional requirements in less-privileged individuals. There is no information about groups that depend on the BFB and in addition follow gluten-free diet (GF/BFB). We measured availability, cost, main ingredients and nutritional composition of GF/BFB. Data were collected in the area that was first in the social priority list in the capital city, matching BFB components with gluten-free equivalents (GF/BFB). GF/BFB characterized by being 42% less available, three times more costly (>500% higher for bread), with up to 69% lower protein content and with no fortifications, leaving at nutritional risk celiac individuals that depend on GF/BFB. Results raise concerns on the capacity of the GF/BFB to encourage adherence, maintain adequate nutritional status and quality of life in celiac patients.

Complementary Serologic Investigations in Children with Celiac Disease Is Unnecessary during Follow-Up

OBJECTIVES

To determine the frequency of nutritional deficiencies and thyroid dysfunction in children with celiac disease (CD) and during follow-up after initiation of a gluten-free diet. Laboratory investigations of hemoglobin, ferritin, calcium, folate, vitamin B12, vitamin D, and thyroid function are regularly ordered in children with CD despite sufficient evidence for these.

STUDY DESIGN

Between 2009 and 2014, test results of hemoglobin, ferritin, folate, vitamin B12, calcium, vitamin D (25[OH]D), free thyroxin, and thyroid stimulating hormone of children with CD regularly seen at the Leiden University Medical Center were investigated. Laboratory reference ranges were used to define abnormal results. Pearson χ(2) test for trend, unpaired t test, and 1-way ANOVA were used for statistical analysis.

RESULTS

Of the 182 children evaluated, 119 were newly diagnosed. On average, 17% of results per year were missing because of incomplete blood investigations. Iron deficiency (28%) and iron deficiency anemia (9%) were found at the time of diagnosis of CD. Folate (14%), vitamin B12 (1%), and vitamin D deficiencies (27%) were also seen. No hypocalcemia or thyroid dysfunction was found. At follow-up, iron deficiency, iron deficiency anemia, and folate and vitamin D deficiency were observed in 8%, 2%, 3%, and 25% of patients, respectively. Vitamin B12 deficiency, hypocalcemia, and thyroid disease were not found.

CONCLUSIONS

Complementary blood investigations are relevant at the time of diagnosis of CD but have little diagnostic yield during follow-up visits once the patient is placed on a gluten-free diet. Thus, we recommend that these variables only be assessed on indication, such as fatigue or abnormal growth.

Approaches to reduce the glycemic response of gluten-free products: in vivo and in vitro studies

This article aims to discuss the current approaches used to reduce the postprandial glycemic response (GR) of starchy gluten-free products (GFP) and to provide some further prospects.

Coeliac disease and gluten-related disorders in childhood

Gluten-related disorders such as coeliac disease, wheat allergy and noncoeliac gluten sensitivity are increasingly being diagnosed in children. Coeliac disease occurs frequently, affecting 1-3% of the Western population. The condition manifests at a very young age, more so in girls, and is related to the HLA genotype. Coeliac disease might be considered a public health problem and, as primary prevention is not possible, the debate on mass screening should be reopened. Wheat proteins, including gluten, are responsible for one of the most common food allergies in children: wheat allergy. Unlike coeliac disease and wheat allergy, noncoeliac gluten sensitivity is an unclear and controversial entity. These three gluten-related disorders are treated with a gluten-free diet. In coeliac disease, the diet should be strictly followed, whereas wheat allergy only requires wheat elimination and in noncoeliac gluten sensitivity occasional trials of gluten reintroduction can be done. A good diagnostic work-up is important for gluten-related disorders in childhood to avoid unnecessary restrictive diets in children. In this Review, we provide an overview of the pathogenesis, diagnosis and management of the most common gluten-related disorders in children.

The prevention of coeliac disease

Primary prevention of coeliac disease is currently not possible. Previously, a 'window of opportunity' was suggested for primary prevention, by introducing gluten between four and six months of age. However, results from recent prospective studies establish that the timing of gluten introduction and the duration or maintenance of breastfeeding do not influence the development of the disease. Secondary prevention is possible through early diagnosis and treatment. Since coeliac disease is severely underdiagnosed, the only way to achieve large-scale secondary prevention is by mass screening. Prospective studies indicate that important health problems, such as reduced foetal growth and birth weight, delayed growth in height and weight in children, and reduced bone mineral density in both children and adults can be prevented by mass screening. Adherence to a strict gluten-free diet may be considered as tertiary prevention.

Ongoing applicative studies of plant thioredoxins

Studies triggered by the discovery of the function of thioredoxin (Trx) in photosynthesis have revealed its role throughout biology. Parallel biochemical and proteomic analyses have led to the identification of its numerous putative targets. Recently, to verify the biological significance of these targets, in vivo studies using transformants in which Trx is overexpressed or suppressed are in progress, and the transformants themselves that are being used in such studies show their potential applicative values. Moreover, Trx's mitigation of allergenicity for some proteins offers promising prospects in the food industry. Practical studies based on redox regulation, once only on the horizon, are now achieving new dimensions. This short review focuses on the industrial applications of Trx studies, the current situation, and future perspectives. The putative targets obtained by the proteomics approach in comparison with in vivo observations of the transformants are also examined. Applicative studies of glutathione, a counterpart of Trx, are also discussed briefly.