The Role of Pseudocereals in Celiac Disease: Reducing Nutritional Deficiencies to Improve Well-Being and Health

Abstract

Celiac disease or gluten-dependent enteropathy is a chronic autoimmune pathology triggered by dietary gluten in genetic predisposed individuals, mediated by transglutaminase 2 IgA autoantibodies and associated with a deteriorating immune and inflammatory response. This leads to intestinal villous atrophy, impairing the intestinal mucosa structure and function of secretion, digestion, and absorption. The result is macro- and micronutrient deficiency, including fat soluble vitamins and minerals, and a consequent nutritional status depletion. A lifelong gluten-free diet is the only available treatment for celiac patients in order to assure normal intestinal mucosa and remission of gastrointestinal symptoms. However, a gluten-free diet can itself cause other nutritional deficiencies due to its restrictive nature regarding gluten-containing cereals. A group of gluten-free cereals, known as pseudocereals, is increasingly recognized as valuable options for gluten-free diets due to their high nutritional value. Amaranth, quinoa, millet, and buckwheat are examples of gluten-free nutrient-dense grains that can be used as alternatives to the conventional gluten-containing grains and improve the variety and nutritional quality of the celiac diet. Current work reviews the nutritional pitfalls of a gluten-free diet and analyses how pseudocereals can contribute to revert those deficiencies and optimize the nutritional value of this mandatory diet for the celiac population.

Metabolic characterization of selected probiotic consortia during gluten and wheat bread simulated digestion

“…Probably due to malabsorption, people on a GFD also reported mineral deficiencies [46][47] and, noteworthy, it these remain unchanged even adhering to GFD [48] . Based on these considerations, recent advances in nutrition suggested a regular intake of pseudo-cereals to fill this gap [49] . However, because of high phytic acid levels and high phytates/minerals ratio limit the mineral intestinal absorption (e.g., Ca, Fe and Zn) [50] , the introduction of cereals and pseudo-cereals to the diet needs to be carefully evaluated to tip the balance in favor of an increased mineral absorption [51] .…”

Substituintes da farinha de trigo na elaboração de produtos de panificação sem glúten - uma revisão

“…A Doença Celíaca (DC), também é mediada pela resposta imunológica, é uma intolerância causada pela ingestão do glúten que se desenvolve em pessoas geneticamente predispostas, é um processo inflamatório que envolve a mucosa do intestino delgado, levando a atrofia das vilosidades intestinais, má absorção e muitas manifestações clínicas como: no trato gastrointestinal, pele, fígado, sistema nervoso, sistema reprodutivo, ossos e sistema endócrino (Caeiro et al, 2022).…”

Body Mass Index during Gluten-Free Diet in Patients with Celiac Disease

“…The role of gluten in the pathomechanism regarding CD is essential since classical villus atrophy and malabsorption develop with the consumption of gluten-containing cereals. Therefore, the only effective treatment for CD is a strict, lifelong gluten-free diet (GFD), excluding gluten proteins in wheat, barley, rye, and other related grains [ 3 ].…”