The Healthy Gluten-Free Diet: Practical Tips to Prevent Metabolic Disorders and Nutritional Deficiencies in Celiac Patients

Rinninella, Emanuele; Cintoni, Marco; Raoul, Pauline; Triarico, Silvia; Dionisi, Tommaso; Gasbarrini, Giovanni; Gasbarrini, Antonio; Mele, Maria Cristina

doi:10.3390/gastroent12020015

Cited by 9 publications

(9 citation statements)

References 110 publications

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“…This information is relevant to provide nutritional tips and suggestions of new food approaches for CD patients to avoid metabolic disorders, including NAFLD. For instance, patients should be encouraged to increase their consumption of olive oil, legumes, unrefined cereals, fruits, and vegetable and introduce pseudocereals as a source of complex carbohydrates, protein, fiber, fatty acids, vitamins, and minerals [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Hepatic Steatosis in Patients with Celiac Disease: The Role of Packaged Gluten-Free Foods

et al. 2022

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Background: An increased risk of nonalcoholic fatty liver disease (NAFLD) in patients with celiac disease (CD) adhering to a gluten-free diet (GFD) was recently reported. The nutritional composition of packaged gluten-free foods (PGFF) has been proposed as a possible cause. This hypothesis has not been investigated further, since a systematic structural nutritional interview for all patients would be problematic in clinical practice. Methods: We administered a simple questionnaire based on a Recency, Frequency, and Monetary value (RFM) analysis (a cornerstone of direct marketing segmentation) to consecutive CD patients on a GFD for >6 months and verified its association with NAFLD. Subgroup analyses were performed to understand whether specific patterns of PGFF consumption were significantly associated with NAFLD. Results: Amongst 147 patients (female 82%, median age 42 years), 45 (30.6%) had NAFLD. Total RFM score (adjusted odds ratio = 1.223, 95% CI: 1.059–1.413, p = 0.006), body mass index, and total cholesterol and triglycerides were independently related to NAFLD, and “Bread and bakery” (p = 0.002), “salty convenience” (p = 0.005), and “sweet convenience” (p = 0.049) products were significantly related with NAFLD. Also, questions about the number of purchased PGFF in the last month (monetary value) and different categories of PGFF consumed in the last week (recency) were particularly able to identify NAFLD patients. Conclusions: The specific GFD dietary habits of CD patients were correlated with the degree of risk of NAFLD. Information was obtained through a questionnaire which could be used in clinical practice to favor a patient-tailored approach and in future studies to verify the reproducibility of our results in different geographical areas.

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Section: Discussionmentioning

confidence: 99%

Hepatic Steatosis in Patients with Celiac Disease: The Role of Packaged Gluten-Free Foods

et al. 2022

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“…It is well established that GF dietary products are low in minerals, vitamins, and fiber 8 , as a result, their nutritional content is of increasing concern. Indeed, the common nutritional deficiencies in celiac subjects are B vitamins, vitamin D, iron, zinc, magnesium, and fiber 11 . Several innovative ingredients have recently been discovered to address this major nutrient gap in GF products and make them more acceptable to consumers.…”

Section: Novel Ingredients In Gluten-free Cereal Productsmentioning

confidence: 99%

An overview on the incorporation of novel ingredients on nutritional, textural, and organoleptic properties of gluten-free cereal products

Allouch

Sfayhi

Doggui³

et al. 2022

Nor. Afr. J. Food Nutr. Res.

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Background: Celiac disease is an autoimmune disorder launched by gluten ingestion in genetically susceptible persons. This component leads to an inflammation of the small intestine which causes malabsorption of some important nutrients including calcium, iron, folic acid, and liposoluble vitamins. A gluten-free diet, that is strictly followed by affected patients throughout their whole lives, constitutes the unique effective treatment for celiac disease. Aims: Several gluten-free cereals, pseudo-cereals, legumes, starches (rice, corn, sorghum, millets, buckwheat, quinoa, teff, chestnuts, chia, potato starch, peas, etc.), and various gluten substitutes (xanthan and gum guar) were utilized to maintain the physical and sensory properties of gluten-free cereal products. This review examined recent advances in the formulation of gluten-free cereal-based products using innovative gluten-free flours. Conclusions: Consequently, this review presents and summarizes recent findings in the improvement of the technological, nutritional, and sensory properties of gluten-free cereal products. However, the preparation of cereal-based gluten-free products still remains a difficult process. Therefore, the diet must be not only exempt from gluten but also healthy to avoid nutrient, vitamins, and minerals deficiencies. Thus, a great deal of this review focuses on studying novel and healthy gluten-free ingredients which should fulfill all quality requirements for bakery and pastry products as well as satisfy the needs of celiac consumers. Keywords: gluten-free products, alternative flours, celiac disease.

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“…A gluten-free diet (GFD) is a special diet that eliminates foods containing wheat, rye and barley proteins, which was first introduced in 1941 by Willem Karl Dicke [ 1 ]. This diet recommends eating unprocessed foods that are naturally gluten-free, such as fruits, vegetables, meat, eggs and fish [ 2 , 3 ], but also foods that are certified as “gluten-free”. Gluten is the protein fraction found in wheat (gliadin), rye (secalin), barley (hordein) or their cross varieties and their derivatives [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, according to published research results, gluten-free diets are deficient in many essential nutrients, such as protein, fiber, vitamins and minerals, and they are higher in saturated fat, carbohydrates and salt compared to gluten-containing products. These qualities appear to promote the development of metabolic diseases in CD patients [ 3 , 12 , 13 , 14 ]. The final inconvenience of a gluten-free diet is its high cost [ 13 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…According to Myhrstad et al, the cost of this diet ranges from 46 to 443% more than a regular diet [ 13 ], and Fry et al reported that gluten-free products had a 159% higher price compared to regular gluten-containing foods [ 15 ]. Many scientists believe that the choice of naturally gluten-free raw materials is the best alternative both in terms of health and economy [ 3 , 17 ]. The most prominent autoimmune gluten-related disorder is CD, which is increasing worldwide in incidence by 1–2% [ 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Safety Assessment of Foods and Drinks Consumed by People on a Gluten-Free Diet

et al. 2022

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Naturally gluten-free foods and processed foods that do not contain information about the potential presence of gluten in them pose a hypothetical threat to people with food allergies and celiac disease. Patients who should follow a strict gluten-free diet do not always do so. Therefore, the aim of this research was to analyze certified “gluten-free” and naturally gluten-free products without labeled “may contain gluten” information in terms of their content of gluten proteins. The enzyme immunoassay AgraQuant Gluten G12 ELISA test kit was used for the analysis. Of all the products used in the research, only 5.8% were found to contain gluten above 20 ppm. Only one product labeled “gluten-free” was contaminated with gluten at 79.3 ppm (cider cake). In addition, our research also examined the gluten content of commercial beers containing barley malt not labeled as “gluten-free”. Research has shown that 60% of samples are not safe for those on a strict gluten-free diet. Our research clearly shows that many manufacturers, although they do not monitor their products for the presence of gluten in them, offer safe products, although they cannot be recommended in a gluten-free diet. Therefore, there is a strong need to increase the frequency of testing by food manufacturers for the presence of gluten in their products, so that the number of products approved for people on a gluten-free diet continues to increase.

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The Healthy Gluten-Free Diet: Practical Tips to Prevent Metabolic Disorders and Nutritional Deficiencies in Celiac Patients

Cited by 9 publications

References 110 publications

Hepatic Steatosis in Patients with Celiac Disease: The Role of Packaged Gluten-Free Foods

Hepatic Steatosis in Patients with Celiac Disease: The Role of Packaged Gluten-Free Foods

An overview on the incorporation of novel ingredients on nutritional, textural, and organoleptic properties of gluten-free cereal products

Safety Assessment of Foods and Drinks Consumed by People on a Gluten-Free Diet

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