Metabolic osteopathy in celiac disease: importance of a gluten-free diet

Reduced bone mineral density (BMD) is frequently found in individuals with untreated celiac disease (CD), possibly due to calcium and vitamin D malabsorption, release of pro-inflammatory cytokines, and misbalanced bone remodeling. A gluten-free diet (GFD) promotes a rapid increase in BMD that leads to complete recovery of bone mineralization in children. Children may attain normal peak bone mass if the diagnosis is made and treatment is given before puberty, thereby preventing osteoporosis in later life. A GFD improves, but rarely normalizes, BMD in patients diagnosed with CD in adulthood. In some cases, nutritional supplementation may be necessary. More information on therapeutic alternatives is needed

Uveitis in celiac disease with an excellent response to gluten-free diet: third case described

To describe the case of a patient with celiac disease who achieved a complete response to a gluten-free diet. A 28-year-old woman presented with diarrhea, oral ulcers, and refractory uveitis of 2.5-years duration. She was treated with prednisone, mydriatic drops, and infliximab with no response. She was referred to our hospital at which point her previous diagnosis of uveitis was confirmed; she was also diagnosed with right-sided sacro-iliitis. The patient did not have arthritis or any skin conditions. Three tests for fecal parasites and a fecal leukocyte were negative. Endoscopy revealed atrophic appearance of the duodenal mucosa. Biopsy showed atrophy of the duodenal villi with intra-epithelial lymphocytes, hyperplasia of the crypts, and chronic inflammatory infiltrate. The search for antiendomysial antibody was > 1/1,280. The patient was started on a gluten-free diet and after 3 months demonstrated significant improvement of gastrointestinal symptoms and uveitis, as well as a reduction of antiendomysial antibodies (1/80). After 6 months, there was complete remission of gastrointestinal symptoms and total control of uveitis. The antiendomysial antibody was negative at that time. Clinical uveitis as a manifestation of celiac disease has been described in only two cases in the literature. This case study is the third to demonstrate that uveitis is a clinical symptom that can be addressed in patients with celiac disease.

Celiac disease diagnosis and gluten-free food analytical control

Celiac disease (CD) is an autoimmune enteropathy, characterized by an inappropriate T-cell-mediated immune response to the ingestion of certain dietary cereal proteins in genetically susceptible individuals. This disorder presents environmental, genetic, and immunological components. CD presents a prevalence of up to 1% in populations of European ancestry, yet a high percentage of cases remain underdiagnosed. The diagnosis and treatment should be made early since untreated disease causes growth retardation and atypical symptoms, like infertility or neurological disorders. The diagnostic criteria for CD, which requires endoscopy with small bowel biopsy, have been changing over the last few decades, especially due to the advent of serological tests with higher sensitivity and specificity. The use of serological markers can be very useful to rule out clinical suspicious cases and also to help monitor the patients, after adherence to a gluten-free diet. Since the current treatment consists of a life-long glutenfree diet, which leads to significant clinical and histological improvement, the standardization of an assay to assess in an unequivocal way gluten in gluten-free foodstuff is of major importance.

Identification and in vitro reactivity of celiac immunoactive peptides in an apparent gluten-free beer.

Gluten content from barley, rye, wheat and in certain oat varieties, must be avoid in individuals with celiac disease. In most of the Western countries, the level of gluten content in food to be considered as gluten-free products is below 20 parts per million measured by ELISA based on specific anti-gluten peptide antibody. However, in beverages or food suffering complex hydrolytic processes as beers, the relative proportion of reactive peptides for celiac patients and the analytical techniques may differ, because of the diversity of the resulting peptide populations after fermentations. A beer below 20 parts per million of gluten but yet detectable levels of gluten peptides by anti-gliadin 33-mer antibodies (G12 and A1) was analyzed. We identified and characterized the relevant peptides for either antibody recognition or immunoactivity in celiac patients. The beer was fractionated by HPLC. The relative reactivity of the different HPLC fractions to the G12/A1 antibodies correlated to the reactivity of peripheral blood mononuclear cells isolated from 14 celiac individuals. Peptides from representative fractions classified according to the relative reactivity to G12/A1 antibodies were identified by mass spectrometry. The beer peptides containing sequences with similarity to those of previously described G12 and A1 epitopes were synthesized and confirmed significant reactivity for the antibodies. The most reactive peptides for G12/A1 also confirmed the highest immunogenicity by peripheral blood mononuclear cell activation and interferon γ production from celiac patients. We concluded that preparative HPLC combined with anti-gliadin 33-mer G12/A1 antibodies were very sensitive and specific methods to analyze the relevant immunogenic peptides in hydrolyzed gluten.

Almond and peanut flours suppelmented with iron as potential ingredients to develop gluten-free cookies

Brazil is the second biggest worldwide producer of cookies and there are many varieties in the market; however, only a few are gluten-free. The objectives of this work were to formulate two gluten-free cookies added with iron, peanut or almond, and analyze their physicochemical, chromatic and sensory properties. Moisture, instrumental color (L*, a*, b* and C*), ash, proteins, lipids, iron, carbohydrates (estimated by difference), and water activity were determined. The acceptance of the products was assessed by 115 untrained taste panelists using a five-point hedonic scale. The data collected from the physicochemical analyses were submitted to Levene's, ANOVA, and Tukey's tests, which showed statistical difference (p < 0.05) in all the attributes for centesimal composition, water activity, and color of the cookies. Peanut and almond cookies could be considered sources of iron once they presented at least 15% of the daily recommended value of intake. They also garnered acceptance indexes of 80 and 85%, respectively, concluding that both formulations developed in this study were source of iron and contained high concentration of lipids and proteins with great sensory acceptance, suggesting their potential consumption by gluten-intolerants.

Development of gluten-free cookie from medicinal plants (Guaraná - Paullinea cupana and Catuaba - Anemopaegma mirandum) aiming at copper, iron, and zinc supplementation

Two flavors of cookies were developed (savory and peppery) containing a mixture of plants such as "guaraná" (Paullinia cupana) and "catuaba" (Anemopaegma mirandum). A test of acceptance and buying intention was applied to 48 consumers through a structured hedonic scale of 9 points. Afterwards, the centesimal compositions of these cookies were obtained as well as their total contents of copper, iron, and zinc through the method of atomic absorption spectrometry with flame. Sensorial tests indicated that the cookies presented good acceptance with potential to sensorial growth. The amount of fibers in the samples, 3 g/100 g, surpassed expectations since the product was not invented with the intention of being a source of this nutrient. The total amount of copper (0.41 mg.100 g-1), iron (4.50 mg.100 g-1), and zinc (1.32 mg.100 g-1) was considered good. The cookies produced can be considered good sources of fibers, copper, iron, and zinc. Furthermore, they are beneficial to people affected by celiac disease because they lack gluten. They also present functional properties. In addition, the medicinal plants used are considered energetic.

Obtention and characterization of gluten-free baked products

This work had as objective the development of gluten-free breads and muffins using rice flour and maize and cassava starches. From seven samples resulting from a Simplex-Centroid design, the sensory and instrumental analyses of specific volume, elasticity, and firmness were performed. For the sensory analysis, the optimized formulation contained 50% of rice flour and 50% of cassava starch, and for the instrumental evaluation, the optimal simultaneous point for the three conducted analyses were 20% of rice flour, 30% of cassava starch, and 50% of maize starch. A comparative analysis of specific volume, elasticity, firmness, and triangular test was performed with pre-baked, baked, and frozen bread. Physicochemical, nutritional, and microbiological analyses were performed for both bread and muffin according to the Brazilian legislation.

Macrocospic and physiochemical characterization of a sugarless and gluten-free cake enriched with fibers made from pumpkin seed (Cucurbita maxima, L.) flour and cornstarch

The Consumers' interest for products with caloric reduction has increased, and their development is a technological challenge. The consumption of cakes has grown in importance and the demand for dietary products has stimulated the use of sweeteners and the optimization of bakery products. The consumption of fibers is related to chronic diseases prevention. Pumpkin seeds (maximum Cucurbita, L.), rich in fibers, can be used as a source of fiber in food products. A gluten-free diet is not easy to follow since gluten free products are not always available. The objective of this work was to perform a physicochemical characterization of cakes prepared with flours blends (FB) based on Pumpkin Seed Flour (PSF). The cakes were elaborated with FB in the ratios of 30:70 (C30) and 40:60 (C40) of PSF and cornstarch (CS), respectively. The results showed gluten absence and near-neutral pH. The chemical analysis of C30 and B40 showed increase of ashes, lipids, proteins, and insoluble dietary fiber and a decrease in the content of carbohydrates and calories. The chemical composition of C40 presented the greatest content of lipids, proteins, and dietary fibers, the lowest content of calories, and the best physical parameters. Therefore, both products proved suitable for human consumption.

Multivariate study and regression analysis of gluten-free granola

This study developed a gluten-free granola and evaluated it during storage with the application of multivariate and regression analysis of the sensory and instrumental parameters. The physicochemical, sensory, and nutritional characteristics of a product containing quinoa, amaranth and linseed were evaluated. The crude protein and lipid contents ranged from 97.49 and 122.72 g kg-1 of food, respectively. The polyunsaturated/saturated, and n-6:n-3 fatty acid ratios ranged from 2.82 and 2.59:1, respectively. Granola had the best alpha-linolenic acid content, nutritional indices in the lipid fraction, and mineral content. There were good hygienic and sanitary conditions during storage; probably due to the low water activity of the formulation, which contributed to inhibit microbial growth. The sensory attributes ranged from 'like very much' to 'like slightly', and the regression models were highly fitted and correlated during the storage period. A reduction in the sensory attribute levels and in the product physical stabilisation was verified by principal component analysis. The use of the affective test acceptance and instrumental analysis combined with statistical methods allowed us to obtain promising results about the characteristics of gluten-free granola.

Application of extruded broken bean flour for formulation of gluten-free cake blends

The aim of this study was to determine the physical and microbiological characteristics of extruded broken beans flour, in addition to developing mixtures for gluten-free cake with these flours, evaluating their technological and sensory quality. Gluten-free formulations were prepared with 45%, 60% and 75% of extruded broken beans. All analyzes of the flours and mixtures for cakes were performed according to standard techniques found in the literature. Sensory analyzes of cakes applied the 9-point structured hedonic scale. Results were submitted to variance analysis and comparison of means test (Tukey, p<0.05). The use of extruded broken beans improved the water absorbed and water solubility index of the mixtures for gluten-free cake, and for the lower viscosity and retrogradation when compared to the standard formulation. All cakes were accepted (rate ≥ 7) for all the analyzed attributes. From the technological and sensory standpoints, the development of gluten-free cake mixtures is feasible with up to 75% of extruded broken beans.

Physical, chemical and sensory properties of gluten-free kibbeh formulated with millet flour (Pennisetum glaucum (L.) R. Br.)

Pearl millet flour was utilized in kibbeh formulations instead of whole-wheat flour. Physicochemical properties, oxidation stability and sensorial characteristics of control kibbeh made with whole-wheat flour (CT) were compared with kibbehs prepared with millet flour (roasted or wet) and stored for 90 days (–18 °C). Kibbeh prepared with millet flour presented good oxidation stability (TBARS concentration). Baked kibbehs (with roasted millet flour) presented good acceptability and kibbeh samples did not differ significantly (p > 0.05) from the whole-wheat flour sample, when global appearance, texture and flavor were evaluated. Millet flour could be a suitable ingredient for kibbeh formulations, maintaining their nutritional value and sensorial quality in addition to being a gluten-free product.

Stability of gluten free sweet biscuit elaborated with rice bran, broken rice and okara

Abstract A challenge to the food sector has been the development of new products incorporating co-products from the food processing industry with minimal impact on their pre-determined structures and adding nutritional quality. In order to add value and develop alternatives for the use of co-products generated during the agroindustrial processing, this work aimed to study the stability of gluten-free sweet biscuits developed with soybean okara, rice bran and broken rice. The formulations were elaborated with increasing percentages of these ingredients and compared with the standard (commercial sweet biscuit) for ten months. The analyses were: weight, diameters (internal and external), thickness, specific volume, instrumental parameters of color, texture, scanning electron microscopy, water activity, proximal composition and isoflavones. The experimental sweet biscuits had characteristics of color, weight, volume and diameters (internal and external) very similar to the commercial, whereas texture, lipids and energy value decreased, and aw, moisture and protein increased during storage. The sweet biscuits showed the same stability when compared to the standard, and the

Sensory response and physical characteristics of gluten-free and gum-free bread with chia flour

Abstract The aim of this study was to evaluate the physical quality and sensory acceptance of gluten-free breads with different percentages of chia flour (Salvia Hispanica L .). The chia flour was used to substitute rice flour and soy flour in order to replace the gum required in this type of bread. Four formulations were developed; a standard made with gum, and three formulations with 2.5%, 5.0% and 7.5% of chia flour. Analyses of specific volume, cooking losses and the rise in dough of the breads were performed. Sensory analysis included tests for affective acceptability and purchase intent. The results showed that the bread with 2.5% chia flour had specific volume and cooking losses similar to the standard. In terms of the rise in dough, the standard showed the highest values, followed by the bread made with 5.0% chia flour. The substitution of soy and rice flour with 2.5% of chia flour produced bread with sensory characteristics similar to the standard in all of the analyzed attributes; it also received higher purchase intent. Using chia flour at a concentration of 2.5%, compared to rice flour and soy flour, proved that it was possible to replace gum in the bread formulation.