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The safety of gluten-free foods is essential for celiac disease (CD) patients to prevent serious complications. Enzyme-linked immunosorbent assays (ELISAs) are recommended for gluten analysis to monitor the compliance of gluten-free products to the Codex threshold of 20 mg gluten/kg. However, due to the specific features of each gluten ELISA test kit, the results often deviate systematically and largely depend on the characteristics of the antibody. This comprehensive study assessed the specificities and sensitivities of three monoclonal (R5, G12, and Skerritt) and two polyclonal antibodies to the alcohol-soluble prolamin and alcohol-insoluble glutelin fractions of gluten from wheat, rye, and barley, all of which harbor CD-active epitopes. Reversed-phase high-performance liquid chromatography served as independent reference method to quantify gluten protein concentrations and allow comparisons of different gluten fractions within one kit and between kits. Wheat prolamins were detected quite accurately by all antibodies, but high variability between antibody specificities and sensitivities was observed for rye and barley prolamins and rye glutelins, and the largest discrepancies were found for wheat and barley glutelins. The gluten content (sum of prolamins and glutelins) was either overestimated up to six times (rye) or underestimated up to seven times (barley). Overestimation of gluten contents may unnecessarily limit the availability of gluten-free products, but underestimation represents a serious health risk for CD patients. It is important to consider these differences between antibodies used in kits and consider what each kit is capable of measuring, especially with samples where the source of gluten is unknown.

This book presents the latest work in the development of gluten free products, including description of the disease, the detection of gluten and the labeling of gluten free products, as well as exploring the raw materials and ingredients used to produce gluten free products.Identifying alternatives to the unique properties of gluten has proven a significant challenge for food scientists and for the 1% of the world's population suffering from the immune-mediated entropathy reaction to the ingestion of gluten and related proteins commonly referred to as \"Celiac Disease\". This book includes information on the advances in working with those alternatives to create gluten free products including gluten free beer, malt and functional drinks. Food scientists developing gluten free foods and beverages, cereal scientists researching the area, and nutritionists working with celiac patients will find this book particularly valuable.Written by leading experts, presenting the latest developments in gluten-free productsAddresses Coeliac Disease from a food science perspectivePresents each topic from both a scientific and industrial point of view

Coeliac disease is a well‐defined condition that is estimated to affect approximately 1% of the population worldwide. Noncoeliac gluten sensitivity is a condition that is less well defined, but is estimated to affect up to 10% of the population, and is often self‐diagnosed. At present, the only remedy for both conditions is a lifelong gluten‐free diet. A gluten‐free diet is often expensive, high in fat and low in fibre, which in themselves can lead to adverse health outcomes. Thus, there is an opportunity to use novel plant breeding strategies to develop alternative gluten‐free grains. In this work, we describe the breeding and characterization of a novel ultra‐low gluten (ULG) barley variety in which the hordein (gluten) content was reduced to below 5 ppm. This was achieved using traditional breeding strategies to combine three recessive alleles, which act independently of each other to lower the hordein content in the parental varieties. The grain of the initial variety was shrunken compared to wild‐type barleys. We implemented a breeding strategy to improve the grain size to near wild‐type levels and demonstrated that the grains can be malted and brewed successfully. The ULG barley has the potential to provide novel healthy foods and beverages for those who require a gluten‐free diet.

Wheat wild relatives are important sources for the genetic enhancement of cultivated wheat. Here, we evaluated the gluten composition, grain protein content, and several quality-related gluten indices across 47 synthetic wheat lines or amphiploids resulted from the crosses between emmer wheat, durum wheat, T. timopheevii , Ae. crassa , Ae. ventricosa and Ae. tauschii . The grain protein content ranged from 15% to 23.5%, in 79% of the studied lines. Lines exhibiting high protein contents generally demonstrated normal gluten strength. This characteristic primarily resulted from the inclusion of emmer wheat, durum wheat, or T. timopheevii as one of the parental lines in their pedigree. About 18% of the lines, which mainly resulted from ( T. durum  ×  Ae. tauschii ) × common wheat crosses demonstrated strong gluten properties. The analysis of high molecular weight glutenin subunits (HMW-GSs) revealed a greater diversity for the Glu-B1 locus than those from Glu-A1 and Glu-D1 . The most frequently identified HMW-GSs included Null, 1, and 2* at the Glu-A1 locus; 21 + 19, 7 + 8, 14 + 15, 6 + 8, 14 + 18, 21 + 15, 13 + 16 + 9, and 6 + 22 at the Glu-B1 ; and 3 + 10 or 3 + 10.5, 2 + 12 or 2 + 12.5, and 5 + 10 or 5 + 10.5 at the Glu-D1 . Subunits associated with the bread-making quality of wheat, particularly observed in durum wheat ×  Ae. tauschii cross combinations. Cluster analysis based on gliadin and glutenin subunits did not accurately reflect the genomic composition of the lines, though some lines with similar genomic backgrounds were clustered together. These results suggest the potential of our synthetic wheat lines to enhance the nutritional and baking quality of wheat flour.

Celiac disease (CeD) is an autoimmune disorder induced by consuming gluten proteins from wheat, barley, and rye. Glutens resist gastrointestinal proteolysis, resulting in peptides that elicit inflammation in patients with CeD. Despite well-established connections between glutens and CeD, chemically defined, bioavailable peptides produced from dietary proteins have never been identified from humans in an unbiased manner. This is largely attributable to technical challenges, impeding our knowledge of potentially diverse peptide species that encounter the immune system. Here, we develop a liquid chromatographic-mass spectrometric workflow for untargeted sequence analysis of the urinary peptidome. We detect over 600 distinct dietary peptides, of which ~35% have a CeD-relevant T cell epitope and ~5% are known to stimulate innate immune responses. Remarkably, gluten peptides from patients with CeD qualitatively and quantitatively differ from controls. Our results provide a new foundation for understanding gluten immunogenicity, improving CeD management, and characterizing the dietary and urinary peptidomes.

Coeliac disease is a common small intestinal enteropathy which manifests following ingestion of gluten in genetically susceptible individuals. Since gluten was identified as the driving factor in coeliac disease, the gluten-free diet (GFD) has remained the mainstay of treatment. While most individuals will display improvement in symptoms and signs of coeliac disease following institution of the GFD, up to 30% will continue to experience symptoms and/or have persisting intestinal inflammation. These individuals can be classified as having non-responsive coeliac disease (NRCD), which may be associated with dietary indiscretion, slow healing, refractory coeliac disease, and/or an alternative condition. The purpose of this review is to provide an overview of the causes of NRCD in adults, highlight a systematic approach to investigate these patients, and appraise the latest management aspects of this subset of coeliac disease.

Despite tremendous growth in the consumption of gluten-free (GF) foods, there is a lack of evaluation of their nutritional profile and how they compare with non-GF foods. The present study evaluated the nutritional quality of GF and non-GF foods in core food groups, and a wide range of discretionary products in Australian supermarkets. Nutritional information on the Nutrition Information Panel was systematically obtained from all packaged foods at four large supermarkets in Sydney, Australia in 2013. Food products were classified as GF if a GF declaration appeared anywhere on the product packaging, or non-GF if they contained gluten, wheat, rye, triticale, barley, oats or spelt. The primary outcome was the ‘Health Star Rating’ (HSR: lowest score 0·5; optimal score 5), a nutrient profiling scheme endorsed by the Australian Government. Differences in the content of individual nutrients were explored in secondary analyses. A total of 3213 food products across ten food categories were included. On average, GF plain dry pasta scored nearly 0·5 stars less (P< 0·001) compared with non-GF products; however, there were no significant differences in the mean HSR for breads or ready-to-eat breakfast cereals (P≥ 0·42 for both). Relative to non-GF foods, GF products had consistently lower average protein content across all the three core food groups, in particular for pasta and breads (52 and 32 % less, P< 0·001 for both). A substantial proportion of foods in discretionary categories carried GF labels (e.g. 87 % of processed meats), and the average HSR of GF discretionary foods were not systematically superior to those of non-GF products. The consumption of GF products is unlikely to confer health benefits, unless there is clear evidence of gluten intolerance.

Celiac disease is a chronic autoimmune disorder of the small intestine for which the sole effective treatment is a lifelong gluten-free diet (GFD). Gluten immunogenic peptides (GIP) serve as biomarkers for recent gluten intake and can be utilized to assess gluten consumption levels. The aim of this study was to compare levels of fecal GIP with levels of tissue transglutaminase IgA (tTG-IgA), as well as dietary compliance, during follow-up. This prospective, non-randomized, single-center study took place between August 2019 and August 2021 at Pediatric Gastroenterology Clinic at Gazi University Hospital in Ankara with the participation of 24 newly diagnosed celiac patients between 2 and 18 years (17 females, 7 males). Participants received GFD training from an expert dietitian, while any dietary transgressions were determined and assessed at 3 and 6 months. Levels of fecal GIP and blood tTG-IgA were analyzed at diagnosis, and again in follow-ups, using a sandwich enzyme-linked immunosorbent assay kit. Compliance with GFD was evaluated using a structured approach in terms of levels of GIP, tissue transglutaminase (tTG), Biagi score, as well as 24-hour food consumption records kept for 3 days (2 weekdays and 1 weekend). The mean age of participants was 8.3 ± 4.70 years. 23 patients (95.8%) initially had detectable GIP levels, while serum tTG-IgA was determined to be positive for all. After starting the GFD, GIP detection rates were measured as being 37.5% at 3 months, and 25% at 6 months, while tTG-IgA positivity rates were determined as being 41.7% and 37.5% respectively. While no significant correlation was found between GIP and tTG-IgA positivity. GIP detection at 3 months was moderately associated with dietitian assessments and Biagi scores (P < 0.05) but with no association at 6 months. Expert dietitian training with regular monitoring increases celiac disease patients complying with GFD. Repeated fecal GIP analysis demonstrated any dietary nonadherence or unintentional gluten exposure that had occurred during the previous 2 to 7 days. It is suggested that a combination of these two tools can improve assessment of dietary compliance in celiac patients. •Fecal GIP evaluation may be helpful in cases of doubt about diet compliance, especially in detecting unintentional exposures.•GIP testing can reveal dietary lapses in celiac patients who have been adhering to a gluten-free diet, regardless of whether they exhibit symptoms.•Expert dietitian training, combined with regular monitoring, significantly enhances compliance with the gluten-free diet (GFD).

Adherence to a gluten-free (GF) diet is the mainstay of therapy for celiac disease. Until now, those wishing to avoid gluten in restaurants had to rely on menu labels, word of mouth, intuition, and restaurant workers' advice, with a relative dearth of supporting data. We used crowd-sourced data from users of a portable gluten detection device to estimate rates of, and identify risk factors for, gluten contamination of supposed GF restaurant foods. We analyzed data from a portable gluten detection device (Nima), collected across the United States during an 18-month period by users who opted to share the results of their point-of-care tests. Data were sorted by region, time of day, median household income in the restaurant's vicinity, restaurant genre, and food items. We used the χ test for bivariate analysis and multiple logistic regression for multivariate analysis to identify predictors of gluten detection in restaurant food. There were 5,624 tests, performed by 804 users, in the examined period. Gluten was detected in 32% of GF labeled foods. Rates of gluten detection differed by meal, with 27.2% at breakfast and 34.0% at dinner (P = 0.0008). GF labeled pizza and pasta were most likely to test positive for gluten, with gluten detected in 53.2% of pizza and 50.8% of pasta samples. On multivariate analysis, GF labeled food was less likely to test positive for gluten in the West than in the Northeast United States (odds ratio 0.80; 95% confidence interval 0.67-0.95). This study of crowd-sourced data suggests that a substantial fraction of GF labeled restaurant foods contain detectable gluten. Although the highly sensitive Nima device may detect gluten at levels <20 parts per million (ppm), leading to gluten exposure of unknown clinical significance, our findings raise a potential concern. In addition, our findings of higher rates of gluten detection in pizza and pasta provide practical data when providing dining strategies for patients with celiac disease.

Background/Objectives Gluten-free diet is the lifelong therapy for patients with coeliac disease. A wide range of gluten-free products (GFP) is available, which mimics the characteristics of their gluten-containing counterparts (GCC). The aim of this study was to compare the macronutrient and dietary fibre composition of GFP and GCC currently available in Spain. Subjects/Methods A cross-sectional study analysing the nutritional differences between 621 GFP and 600 GCC based on labelling information was conducted. Food items were categorized in one of 14 food groups. The first six ingredients were noted for each food item. A linear regression model was used to explain differences in nutritional composition between GFP and GCC and three independent models were created for bread, pasta and biscuits. Results Results showed that GCC had higher protein content than GFP, especially in flour, bread, pasta and pizza. Bread had higher total and saturated fat contents in the GFP in which palm oil was the main fat used. Flours and starchy ingredients used in GFP formulation were mainly rice and corn flours and corn starch, and palm oil was the most commonly used fat. Conclusions In conclusion, GFP cannot currently be considered as equivalent substitutes for their GCC. The reformulation of the GFP with more healthy ingredients and ingredients is encouraged, using a healthy oil, pseudocereals and whole flour.