Wheat consumption and prevalence of celiac disease: Correlation from a multilevel analysis

Impact of Esterification with Octenyl Succinic Anhydride on the Structural Characteristics and Glucose Response in Mice of Wheat Starch

In this study, we investigated the structural properties and digestibility of wheat starch treated with octenyl succinic anhydride (OSA). For the experiment, the samples were reacted with 2, 4, 6, 8, and 10% OSA (pH 8.5-9.0) for 2 h. A light micrograph showed that there was no difference in the morphology and Maltese cross between native and OSA-treated starch. The X-ray diffraction (XRD) patterns of the native and OSA-treated starches showed typical A-type diffraction. In addition, the Fourier transform infrared (FT-IR) spectrum showed a distinct carbonyl peak at approximately 1730 cm-1, indicating the stretching vibration of the C=O bond of the ester group. The degree of substitution (DS) and content of resistant starch (RS) increased with increasing concentrations of treated OSA because of the increase in ester bonds. In particular, RS was thermostable compared to the RS content in uncooked and cooked starch. Blood glucose levels and response in vivo decreased as the OSA concentration increased. Treatment of wheat starch with 8% OSA concentration produced 35.6% heat-stable resistant starch. These results suggest that starch modified with OSA can be used to produce functional foods for diabetes.

Epidemiology of Celiac Disease in Western Iran during 2019-2021

Celiac disease is a growing global public health concern. This epidemiological study is aimed at determining the prevalence of celiac disease in Kermanshah, Western Iran, from 2019 to 2021, as well as the frequency of gastrointestinal and nongastrointestinal manifestations associated with the disease. In this cross-sectional study, the medical records of all patients with a confirmed diagnosis of celiac disease between 2019 and 2021 were reviewed. The average population during the study period was 2,058,545. A researcher-developed checklist was used as the data collection tool, and descriptive statistics were employed for data analysis. During the study period, there were 113 patients diagnosed with celiac disease, with a mean age of 29.1 ± 16.6 years. The three-year prevalence of celiac disease was 5.49 (95% CI: 5.17-5.82) per 100,000 population. Among these patients, 70% (n = 78) was female. The most common gastrointestinal manifestations of the disease were abdominal pain (77.8%), constipation (59.3%), and diarrhea (54.9%). Iron-deficiency anemia (64.6%) and vitamin D3 deficiency (46.1%) were the most common nongastrointestinal manifestations. Growth retardation was observed in 39.0% of patients. This study demonstrated a higher prevalence of celiac disease in Kermanshah compared to global statistics. Given the association of celiac disease with other conditions such as diabetes, irritable bowel syndrome, growth retardation, and iron-deficiency anemia, healthcare providers should consider screening patients for celiac disease. Furthermore, community-based education is crucial in raising awareness about the significance of adhering to a proper diet and reducing wheat consumption.

Probiotic potential of gluten degrading Bacillus tequilensis AJG23 isolated from Indian traditional cereal-fermented foods as determined by Multiple Attribute Decision-Making analysis

The present study reported the characterization of gluten hydrolyzing strains of Bacillus sp. from fermented cereal dough. The strains were characterized for probiotic as well as technological attributes. A total of 45 presumptive gluten degrading isolates were obtained on gliadin agar plate assay. Based on hemolytic and antibiotic susceptibility pattern, only six isolates were considered safe which also indicated gliadinase activity on zymography. All the six strains were able to resist the pH 2.0, 0.25% bile and also possessed ability to adhere to the organic solvents and mucin. The cell free supernatant of five strains exhibited antimicrobial activities against Gram-positive and Gram-negative pathogens. A more than 50% survival of the isolated strains was obtained at a salt concentration of 2%, phenol concentration of 0.1% and temperature upto 45 °C. All the strains exhibited antioxidant activities and biofilm forming ability. Furthermore, the ranking of strains based on probiotic as well as other functional attributes was determined using multidimensional Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). A matrix of multidimensional indicators was prepared using alternatives and criteria, the analysis indicated the strain Bacillus tequilensis AJG23 as the potential probiotic candidate based on all screening criteria. Further work still needs to be done about the protective role of the potential strain against gluten sensitivity using in vitro models.

Identification and Growth Characteristics of a Gluten-Degrading Bacterium from Wheat Grains for Gluten-Degrading Enzyme Production

Immunogenic peptides from wheat gluten can be produced during digestion, which are difficult to digest by gastrointestinal proteases and negatively affect immune responses in humans. Gluten intolerance is a problem in countries where wheat is a staple food, and a gluten-free diet is commonly recommended for its treatment and prevention. Enzyme approaches for degradation of the peptides can be considered as a strategy for its prevention. Here, we isolated a gluten-degrading bacterium, Bacillus amyloliquefaciens subsp. plantarum, from wheat grains. The culture conditions for enzyme production or microbial use were considered based on gluten decomposition patterns. Additionally, the pH range for the activity of the crude enzyme was investigated. The bacterium production of gluten-degrading enzymes was temperature-dependent within 25 °C to 45 °C, and the production time decreased with increasing culture temperature. However, it was markedly decreased with increasing biofilm formation. The bacterium decomposed high-molecular-weight glutenin proteins first, followed by gliadin proteins, regardless of the culture temperature. Western blotting with an anti-gliadin antibody revealed that the bacterium decomposed immunogenic proteins related to α/β-gliadins. The crude enzyme was active in the pH ranges of 5 to 8, and enzyme production was increased by adding gliadin into the culture medium. In this study, the potential of the B. amyloliquefaciens subsp. plantarum for gluten-degrading enzyme production was demonstrated. If further studies for purification of the enzyme specific to the immunogenic peptides and its characteristics are conducted, it may contribute as a strategy for prevention of gluten intolerance.

Celiac Disease: Disease Models in Understanding Pathogenesis and Search for Therapy

Celiac disease is a complex polygenic systemic disorder caused by dietary gluten exposure that selectively occurs in genetically susceptible people. The potential celiac disease is defined by the presence of celiac disease-specific antibodies and compatible human leukocyte antigen but without histological abnormalities in duodenal biopsies. At present, the only treatment is lifelong adherence to a gluten-free diet. Despite its effectiveness, the diet is difficult to maintain due to its cost, availability of gluten-free foods, and hidden gluten. The need to develop non-dietary treatment methods is widely recognized, but this is prevented by the absence of a pathophysiologically relevant preclinical model. Nonetheless, in vitro and in vivo models have made it possible to investigate the mechanisms of the disease and develop new treatment approaches: The use of foods with neutralized gluten, microbiota correction, cocktails of specific endoproteinase, polymer gluten binders, specific inhibitors of transglutaminases and inflammatory cytokines, and a vaccine based on allergen-specific therapy.

Development of Protein- and Fiber-Enriched, Sugar-Free Lentil Cookies: Impact of Whey Protein, Inulin, and Xylitol on Physical, Textural, and Sensory Characteristics

Gluten-free (GF) diets often become nutritionally imbalanced, being low in proteins and fibers and high in sugars. Preparing GF foods with improved nutritional value is therefore a key challenge. This study investigates the impact of different combinations of whey protein (11.9%), inulin (6.0%) as dietary fiber, and xylitol (27.9%) as a sweetener used in the enrichment of green- and red-lentil-based gluten-free cookies. The cookies were characterized in terms of baking loss, geometric parameters, color, texture, and sensory profile. The results showed that these functional ingredients had different impacts on the lentil cookies made of different (green/red) lentils, especially regarding the effect of fiber and xylitol on the volume (green lentil cookies enriched with fiber: 16.5 cm³, sweetened with xylitol: 10.9 cm³ vs. 21.2 cm³ for control; red lentil cookies enriched with fiber: 21.9 cm³, sweetened with xylitol: 21.1 cm³ vs. 21.8 cm³ for control) and color (e.g., b* for green lentil cookies enriched with fiber: 13.13, sweetened with xylitol: 8.15 vs. 16.24 for control; b* for red lentil cookies enriched with fiber: 26.09, sweetened with xylitol: 32.29 vs. 28.17 for control). Regarding the textural attributes, the same tendencies were observed for both lentil products, i.e., softer cookies were obtained upon xylitol and whey protein addition, while hardness increased upon inulin enrichment. Stickiness was differently influenced by the functional ingredients in the case of green and red lentil cookies, but all the xylitol-containing cookies were less crumbly than the controls. The interactions of the functional ingredients were revealed in terms of all the properties investigated. Sensory analysis showed that the addition of whey protein resulted in less intensive "lentil" and "baked" aromas (mostly for red lentil cookies), and replacement of sugar by xylitol resulted in crumblier and less hard and crunchier products. The application of different functional ingredients in the enrichment of lentil-based gluten-free cookies revealed several interactions. These findings could serve as a starting point for future research and development of functional GF products.

Sources of dietary gluten in the first 2 years of life and associations with celiac disease autoimmunity and celiac disease in Swedish genetically predisposed children: The Environmental Determinants of Diabetes in the Young (TEDDY) study

BACKGROUND

High gluten intake is associated with increased risk of celiac disease (CD) in children at genetic risk.

OBJECTIVES

We aimed to investigate if different dietary gluten sources up to age 2 y confer different risks of celiac disease autoimmunity (CDA) and CD in children at genetic risk.

METHODS

Three-day food records were collected at ages 6, 9, 12, 18, and 24 mo from 2088 Swedish genetically at-risk children participating in a 15-y follow-up cohort study on type 1 diabetes and CD. Screening for CD was performed with tissue transglutaminase autoantibodies (tTGA). The primary outcome was CDA, defined as persistent tTGA positivity. The secondary outcome was CD, defined as having a biopsy specimen showing Marsh score ≥ 2 or an averaged tTGA level ≥ 100 Units. Cox regression adjusted for total gluten intake estimated HRs with 95% CIs for daily intake of gluten sources.

RESULTS

During follow-up, 487 (23.3%) children developed CDA and 242 (11.6%) developed CD. Daily intake of ≤158 g porridge at age 9 mo was associated with increased risk of CDA (HR: 1.53; 95% CI: 1.05, 2.23; P = 0.026) compared with no intake. A high daily bread intake (>18.3 g) at age 12 mo was associated with increased risk of both CDA (HR: 1.47; 95% CI: 1.05, 2.05; P = 0.023) and CD (HR: 1.79; 95% CI: 1.10, 2.91; P = 0.019) compared with no intake. At age 18 mo, milk cereal drink was associated with an increased risk of CD (HR: 1.16; 95% CI: 1.00, 1.33; P = 0.047) per 200-g/d increased intake. No association was found for other gluten sources up to age 24 mo and risk of CDA or CD.

CONCLUSIONS

High daily intakes of bread at age 12 mo and of milk cereal drink during the second year of life are associated with increased risk of both CDA and CD in genetically at-risk children.

Effect of ancient wheat pasta on gut microbiota composition and bacteria-derived metabolites: A randomized controlled trial

Background and aim

In recent years, many studies have suggested that ancient wheat products might have beneficial effects on cardiometabolic risk profile, but little is known about their effect on gut microbiota (GM). The aim of the present study was to evaluate whether a replacement diet with pasta made from ancient wheat (AD) could influence the GM composition and its metabolites' production compared to a replacement diet with pasta made from modern wheat (CD).

Methods

A randomized, double-blinded crossover trial with two intervention phases was conducted on 20 clinically healthy adults (9 females; 11 males; mean age 43.1 ± 12.5 years). Study participants were assigned to consume pasta made using semi-whole flour from organic wheat that was either from ancient or modern control wheat for 8 weeks in a random order. An 8-week washout period was implemented between the interventions. Stool samples were collected from all subjects at the beginning and at the end of each intervention period. GM composition, and short- (SCFAs) and medium- chain fatty acids (MCFAs) production was evaluated.

Results

Dietary interventions did not produce significant diversity in the GM composition at higher ranks (phylum, class, order and family), but only at genus level. In detail, the AD significantly (adj. p < 0.05) changed the abundance of Erysipelatoclostridium spp., Bacteroides_pectinophilus_group spp., CAG-873 spp., and Holdemanella spp. The CD significantly affected the abundance of Akkermansia spp., CAG-873 spp., Hungatella spp., Lachnospiraceae_UCG-008 spp., NK4A214_group spp., Frisingicoccus spp., Megasphaera spp., Synergistes spp., and Tyzzerella spp. Regarding the production of SCFAs and MCFAs, AD resulted in a significant increase of fecal acetic (+0.7%), isobutyric (+30.1%), 2-methylbutyric (+64.2%), and isovaleric (+22.5%) acids. On the other hand, CD resulted in increased levels of isobutyric (+71.4%), 2-methylbutyric (+116.2%), isovaleric (+99%), and valeric (+21.4%) acids, and a reduction of butyric (-31.6%) and hexanoic (-66.4%) acids.

Conclusion

A short-term replacement diet with both ancient and modern wheat pasta determined significant changes in GM composition at the genus level but notably the AD resulted in a greater beneficial impact on anti-inflammatory SCFAs.

How does a celiac iceberg really float? The relationship between celiac disease and gluten

Celiac disease (CD) is an autoimmune intestinal disease caused by intolerance of genetically susceptible individuals after intake of gluten-containing grains (including wheat, barley, etc.) and their products. Currently, CD, with "iceberg" characteristics, affects a large population and is distributed over a wide range of individuals. This present review summarizes the latest research progress on the relationship between CD and gluten. Furthermore, the structure and function of gluten peptides related to CD, gluten detection methods, the effects of processing on gluten and gluten-free diets are emphatically reviewed. In addition, the current limitations in CD research are also discussed. The present work facilitates a comprehensive understanding of CD as well as gluten, which can provide a theoretical reference for future research.

Wheat Breeding, Fertilizers, and Pesticides: Do They Contribute to the Increasing Immunogenic Properties of Modern Wheat?

Celiac disease (CD) is a small intestinal inflammatory condition where consumption of gluten induces a T-cell mediated immune response that damages the intestinal mucosa in susceptible individuals. CD affects at least 1% of the world’s population. The increasing prevalence of CD has been reported over the last few decades. However, the reason for this increase is not known so far. Certain factors such as increase in awareness and the development of advanced and highly sensitive diagnostic screening markers are considered significant factors for this increase. Wheat breeding strategies, fertilizers, and pesticides, particularly herbicides, are also thought to have a role in the increasing prevalence. However, less is known about this issue. In this review, we investigated the role of these agronomic practices in depth. Our literature-based results showed that wheat breeding, use of nitrogen-based fertilizers, and herbicides cannot be solely responsible for the increase in celiac prevalence. However, applying nitrogen fertilizers is associated with an increase in gluten in wheat, which increases the risk of developing celiac-specific symptoms in gluten-sensitive individuals. Additionally, clustered regularly interspaced short palindromic repeats (CRISPR) techniques can edit multiple gliadin genes, resulting in a low-immunogenic wheat variety that is safe for such individuals.