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Gluten free products and human health

by luciano

Highlighted:
1 – In gluten-free products it was founded nutrient deficiencies for essential minerals such as iron, zinc magnesium and calcium, and on another hand high content of saturated lipids were detected Industrial gluten-free products in many cases contain palm and palm kernel oil
2 – Despite improvements in the formulation of GFPs in recent years, their macronutrient profile suggested they contained marked differences and cannot be considered nutritionally equivalent when compared with their gluten-containing counterparts
3 – Good fats include monounsaturated and polyunsaturated fats. Bad ones include industrial-made trans fats. Saturated fats fall somewhere in the middle
4 – In 2015, the FDATrusted Source declared that trans fat is not “generally recognized as safe” and had to be phased out by 2018.
5 -A recent study, published in The Lancet Diabetes & Endocrinology, evaluated for the first time the association between emulsifiers and the risk of developing type 2 diabete

A – Nutritional quality and costs of gluten-free products: a case-control study of food products on the Norwegian marked. 2021. Mari C. W. Myhrstad, Marlene Slydahl, Monica Hellmann, Lisa Garnweidner-Holme, Knut E. A. Lundin et al.

Background: Celiac disease is a chronic autoimmune disease triggered by gluten exposure in genetically predis- posed individuals. A life-long intake of a gluten-free (GF) diet is required for its management. Wheat, rye and barley are eliminated in a GF diet and the nutritional adequacy of the diet has been questioned. In Norway, cereals and bread constitute a key role of the diet and are the main source of fiber intake. Gluten restrictions may therefore offer important implications for nutrient adequacy especially linked to fiber intake in people with celiac disease.
Objective: The aim of the study was to investigate the nutritional quality and price of GF products and com- pare with gluten-containing counterparts available at instead of in the Norwegian market.

….omissis

The current study clearly shows that GF products compared to equivalent gluten-containing products contain less protein and fiber, and more carbohydrate, saturated fat and salt. Furthermore, GF compared to gluten-containing products are more expensive. To our knowledge, this is the first study comparing GF products at the Norwegian market with gluten-containing counterparts.

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B – Review on chemical composition of gluten-free food for celiac people. Antonella Maggio, Santino Orecchio and Salvatore Barreca. Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università di Palermo, Viale delle Scienze, I-90128 Palermo, Italy. Integr Food Nutr Metab, 2019. Published: January 25, 2019.

Abtract: Gluten free food lead to possible nutrient unbalance resulting in improper nutritional quality of diet. The aim of this review is to show and discuss the composition of main components of common gluten free products in order to provide doctors and nutritionists the necessary data to compile balanced diets for users of gluten-free products and to determine their contribution to the daily intake of nutrients and micro elements. Special emphasis has been addressed to metal contents, fatty acid profiles and fibers.

……omissis

Conclusions
Most of the nutritional data reported in literature, are based on food labels. Few data were obtained by direct chemical analysis of food. In this context, will be necessary to encourage the use of chemical analytical practices in order to provide doctors and nutritionists the necessary data to compile balanced diets for users of gluten-free products and to determine their contribution to the daily intake of nutrients and micro elements. Special emphasis has been addressed to metal contents, fatty acid profiles and fibers.
Literature analysis has highlighted that, the most gluten free food, show a deficit of nutrients in term of concentrations. At this regard, an inadequate nutritional value of the GF-diet was observed from several authors. In detail, it was founded nutrient deficiencies for essential minerals such as iron, zinc magnesium and calcium, and on another hand high content of saturated lipids were detected.
Furthermore, the dietary-therapeutic approach should encourage the use of naturally gluten free products such as pseudo-cereals and fruits concerning to metal contents, and fish or seafood regarding fatty acids, especially for sutured and unsatured fatty acid ratio.
Moreover, alimentary education should become part of the therapeutic pathway to understand the importance of labels, choice of food and combination of macro and micronutrients.

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C – Fatty Acid Composition of Gluten-Free Food (Bakery Products) for Celiac People. Antonella Maggio and Santino Orecchio. Dipartimento di Scienze e Tecnologie Biologiche, Chimiche e Farmaceutiche, Università di Palermo, Viale delle Scienze, I-90128 Palermo, Italy; antonella.maggio@unipa.it. Correspondence: santino.orecchio@unipa.it; Tel.: +39-91-2389-7968. Foods. Published: 20 June 2018

Abstract: The aim of this study (first analytical approach) was to obtain data concerning the fatty acid composition of gluten-free foods (bakery products) for celiac people. The study included 35 different products (snacks, biscuits, bakery products, pasta, flours, etc.) from several manufacturers. After extraction and esterification, the fatty acid composition was determined by Gaschromatography (GC–MS) Monounsaturated fatty acids (MUFAs) were found to be the major constituents (57%), followed by saturated fatty acids (SFAs) (30%), and polyunsaturated fatty acid (13%). Only 15 of the 35 gluten-free samples analyzed appeared to provide adequate energy intake, while, in 11 samples, saturated fatty acids were found to supply more energy than that recommended by the European Food Safety Authority EFSA. Moreover, data analyses showed that, although gluten-free commercial products are high added-value foods, industrial products in many cases contain palm and palm kernel oils, whereas the local producers generally use the finest raw materials, such as olive oil.

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D – Gluten-Free Products: Do We Need to Update Our Knowledge? Claudia Marmol-Soler. Foods 2022.
It can be concluded that reviewing the nutritional composition of GF foods from time to time is highly relevant since these products, which are in great demand, undergo constant changes in their composition with the aim of improving their nutritional quality. Despite improvements in the formulation of GFPs in recent years, their macronutrient profile suggested they contained marked differences and cannot be considered nutritionally equivalent when compared with their gluten-containing counterparts. Therefore, it is strongly recommended that food companies continue with the reformulation of these products in order to increase their nutritional quality, adapt to market demands, and accordingly provide balanced nutrition to those patients with CD.

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E – The truth about fats: the good, the bad, and the in-between
April 12, 2022. Avoid the trans fats, limit the saturated fats, and replace with essential polyunsaturated fats . Harvard Medical School. https://www.health.harvard.edu/

You may wonder isn’t fat bad for you, but your body needs some fat from food. It’s a major source of energy. It helps you absorb some vitamins and minerals. Fat is needed to build cell membranes, the vital exterior of each cell, and the sheaths surrounding nerves. It is essential for blood clotting, muscle movement, and inflammation. For long-term health, some fats are better than others. Good fats include monounsaturated and polyunsaturated fats. Bad ones include industrial-made trans fats. Saturated fats fall somewhere in the middle.
All fats have a similar chemical structure: a chain of carbon atoms bonded to hydrogen atoms. What makes one fat different from another is the length and shape of the carbon chain and the number of hydrogen atoms connected to the carbon atoms. Seemingly slight differences in structure translate into crucial differences in form and function.
Bad trans fats
The worst type of dietary fat is the kind known as trans fat. It is a byproduct of a process called hydrogenation that is used to turn healthy oils into solids and to prevent them from becoming rancid. Trans fats have no known health benefits and that there is no safe level of consumption. Therefore, they have been officially banned in the United States.
Early in the 20thcentury, trans fats were found mainly in solid margarines and vegetable shortening. As food makers learned new ways to use partially hydrogenated vegetable oils, they began appearing in everything from commercial cookies and pastries to fast-food French fries. Trans fats are now banned in the U.S. and many other countries.
Eating foods rich in trans fats increases the amount of harmful LDL cholesterol in the bloodstream and reduces the amount of beneficial HDL cholesterol. Trans fats create inflammation, which is linked to heart disease, stroke, diabetes, and other chronic conditions. They contribute to insulin resistance, which increases the risk of developing type 2 diabetes. Even small amounts of trans fats can harm health: for every 2% of calories from trans fat consumed daily, the risk of heart disease rises by 23%.

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F- Hydrogenated oil comes in two forms: partially or fully hydrogenated. One use of hydrogenated oil is to preserve the shelf life of food. Partially hydrogenated oil contains trans fat that can raise cholesterol and result in health complications. Food manufacturers use hydrogenated oil as a preservative. They also use it for enhancing flavor and texture.
In 2015, the Food and Drug Administration (FDA)Trusted Source said that partially hydrogenated oil is not safe, and removing it from food could prevent thousands of heart attacks each year.
Partially hydrogenated oil (trans fat)
In the past, manufacturers added partially hydrogenated oils to processed foods.
According to the FDA, foods that used to contain large amounts of artificial trans fat include:
most baked goods
stick margarine
frosting
coffee creamers
snack foods
In 2015, the FDATrusted Source declared that trans fat is not “generally recognized as safe” and had to be phased out by 2018.
However, trans fat may still be present in some foods. According to the American Heart Association (AHA)Trusted Source, trans fat occurs naturally in certain animals, such as cows.
Fully hydrogenated oil
Fully hydrogenated oil also uses a process to take a liquid oil and transform it into a solid at room temperature. As the name suggests, the oil is fully or nearly completely hydrogenated, which reduces the amount of trans fat in the final product. Unlike partially hydrogenated oil, the FDATrusted Source still allow products to use fully hydrogenated oil as of 2018. In 2020, the FDA released certification that states fully hydrogenated rapeseed oil is safe for sparing use in food products. Though hydrogenated oils may be safe, it does not mean they are necessarily good for a person to consume. Products that contain them are often highly processed with added sugar and salt.
From: https://www.medicalnewstoday.com/articles/325266#summary

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G- Nutritional quality and costs of gluten-free products: a case-control study of food products on the Norwegian market. Mari C.W. Myhrstad et al. 2021
Results: The GF products contained less protein and fier, and higher content of saturated fat, carbohydrate and salt compared to the gluten-containing products. The total amount of fat was not different between the groups. A similar pattern was found within several of the food categories. More gluten-containing products met the nutrition claim “high in fier” (fiber > 6 g/100 g) compared to the GF products. The price of the GF products was higher; ranging from 46%–443% more expensive than the gluten-containing products.

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H – Macchine alimentari – Prodotti e tecnologie per alimenti senza glutine. Anno XVII -1 – Genn. Feb 2015
Idrocolloidi. (H1) Tra le ultime novità che possono soddisfare queste esigenze troviamo, come sopra citati, gli idrocolloidi, che si stanno affermando con maggiore forza nel settore bakery. Queste sostanze, infatti, permettono di ottenere prodotti con lunga shelf life, inserimento di farine integrali e fibre, l’assenza di grassi trans e non ultimo l’assenza di glutine. Gli idrocolloidi, come il termine fa presagire, sono molecole in grado di legare acqua in grandi quantità; tra i più usati nei prodotti da forno vi sono la gomma di xantano, la pectina, le cellulose modificate e i frutto- e galatto-oligosaccaridi. Alcune di queste sostanze sono considerate fibre alimentari, in grado di stimolare il senso di sazietà e avere effetti positivi sulla funzionalità intestinale: la loro presenza si può configurare, pertanto, co- me aggiunta di sostanze benefiche al prodotto. Spesso gli idrocolloidi ottengono il loro effetto tecnologico-funzionale nel prodotto anche se aggiunti agli impasti in piccole quantità, per esempio minori dell’1% del totale degli ingredienti in polvere. Negli impasti di pane e altri prodotti da forno gli idrocolloidi aiutano, in fase produttiva, a migliorare la lavorabilità dell’impasto grazie all’effetto di rapida ed uniforme idratazione dello stesso. Il volume, la struttura e la sofficità dei prodotti finiti sono migliorati. La fragilità è minore, per esempio nel caso di prodotti da forno “spumosi” con elevata presenza di bolle d’aria o presenza di pezzi in sospensione (cioccolato, frutta o frutta secca): tali bolle o pezzi sono stabilizzati all’interno del sistema grazie agli idrocolloidi. In fase di conservazione, poi, c’è un aumento della shelf life dei prodotti grazie al mantenimento di sofficità per tempi più prolungati: la differenza rispetto ai prodotti privi di idrocolloidi è tanto più evidente con il passare del tempo. Pare, infine, che la presenza di idrocolloidi sia anche in grado di influenzare le dimensioni dei cristalli di ghiaccio all’interno degli impasti per pane o altri prodotti semi-cotti durante la loro surgelazione, permettendo di ottenere un prodotto scongelato di migliore qualità.
Omissis…
(H2) Ci sono operazioni unitarie che sono di difficile attuazione per alimenti che non prevedono l’uso di glutine, come per esempio le fasi di estrusione, trafilatura o laminazione che avvengono nella pasta oppure in alcuni prodotti da forno: le sollecitazioni che avvengono in queste fasi necessitano di elasticità da parte dell’impasto, pertanto sono fondamentali formulazioni in grado di sostenere il processo in continuo di un impianto magari pre-esistente.
Omissis….
(H3) Se si confrontano dei cracker senza glutine, si riscontrano formulazioni estremamente semplici, con farine di mais e riso, ed altre più complesse, con l’aggiunta di fecola di patate, destrosio, emulsionanti ed addensanti. Dal punto di vista nutrizionale, è chiaro che l’alimento potrebbe risultare, rispetto al medesimo prodotto convenzionale, maggiormente ricco di zuccheri ed in parte di grassi. Il pane in cassetta, più difficile da realizzare in quanto lievitato, mostra formulazioni piuttosto complesse a base di mais, riso o grano saraceno, amidi, fibre vegetali, proteine, zuccheri, addensanti (tra cui idrocolloidi), emulsionanti, acidificanti. Tale ricettazione implica, a livello nutrizionale, o un aumento di carboidrati di circa il 10- 15% rispetto al prodotto convenzionale della medesima categoria oppure un aumento di grassi, soprattutto saturi, di circa il 30-50%.
Nel campo dolciario, le considerazioni sono più o meno le medesime, in quanto a livello nutrizio- nale, rispetto ai prodotti convenzionali, permangono valori più elevati di carboidrati, soprattutto zuccheri, e grassi, principalmente saturi, per sop- perire alla carenza di viscoelasticità della parte proteica.

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I – Emulsionanti e rischio diabete: lo studio di Lancet
Dopo essere stati accusati di contribuire al rischio di obesità, cancro e malattie cardiovascolari, un’analisi recente condotta sullo studio prospettico di coorte NutriNet Santé li identifica come fattori che aumentano il rischio di diabete di tipo 2.
Sebbene le Autorità Sanitarie considerino sicuro il loro uso in quantità definite, basandosi su criteri di citotossicità e genotossicità, di recente stanno emergendo prove dei loro effetti negativi sul microbiota intestinale, che a sua volta innescano infiammazione e alterazioni metaboliche.
Un recente studio, pubblicato su The Lancet Diabetes & Endocrinology ha valutato per la prima volta l’associazione tra emulsionanti e rischio di sviluppare diabete di tipo 2. Gli Autori hanno analizzato i dati di oltre 104 mila adulti arruolati dal 2009 al 2023 a cui è stato chiesto di compilare registri dietetici di 24 ore ogni 6 mesi. L’obiettivo era valutare l’esposizione agli emulsionanti.
L’1% del campione, ha sviluppato diabete di tipo 2 durante il follow up di 6-8 anni.
Dei 61 additivi identificati, sono sette gli emulsionanti ‘attenzionati’ associati a un potenziale aumento del rischio di diabete (occhi, quindi, alle etichette!):
E407 (carragenine totali);
E340 (esteri di poliglicerolo);
E472e (esteri di acidi grassi);
E331 (citrato di sodio);
E412 (gomma di guar);
E414 (gomma arabica);
E415 (gomma di xantano);
oltre ad un gruppo chiamato ‘carragenine’.
Gli additivi emulsionanti sono stati assunti nel 5% da frutta e verdure ultra lavorate (come verdure in scatola e frutta sciroppata), nel 14.7% da torte e biscotti, nel 10% da prodotti lattiero-caseari.
Tre conseguenze sottolineate dal prof. Angelo Avogaro, Presidente SID
1. La necessità di contenere il consumo di cibi ultra-processati;
2. l’appello a una maggiore attenzione alle etichette;
3. la necessità di chiedere una regolamentazione più stringente allo scopo di proteggere i consumatori.
“Sebbene siano necessari ulteriori studi a lungo termine, le alterazioni del microbiota intestinale, fanno ritenere che potrebbe essere necessario rivedere gli RDA (Recommended Daily Allowance, livelli giornalieri di assunzione). Precedenti prove che legavano l’assunzione di carragenina all’infiammazione intestinale hanno portato l’JECFA a limitarne l’uso nelle formule e negli alimenti per neonati. Stiamo assistendo a un preoccupante aumento del diabete di tipo 2 anche tra bambini e adolescenti” sottolinea la Prof.ssa Raffaella Buzzetti, Presidente eletto SID.
References
Food additive emulsifiers and the risk of type 2 diabetes: analysis of data from the NutriNet-Santé prospective cohort study. The Lancet Diabete and Endocrinology, volume 12, issue 5, p339-349, May 2024

Serum levels of sCD14 and LBP as marker of non celiac gluten sensitivity

by luciano

Non-celiac gluten sensitivity is difficult to identify due to the lack – until now – of markers that can identify it. To date, in fact, the only way to diagnose it is diet by exclusion; not an easy method also because the symptoms of non-celiac gluten sensitivity overlap with those of other gastrointestinal disorders. The study presented below has highlighted a strong correlation between non-celiac gluten sensitivity and the presence of two specific markers: new perspectives are therefore opening up for a better and more accurate diagnosi

“A new study may explain why people who do not have celiac disease or wheat allergy nevertheless experience a variety of gastrointestinal and extra-intestinal symptoms after ingesting wheat and related cereals. The findings suggest that these individuals have a weakened intestinal barrier (leaky gut), which leads to a body-wide inflammatory immune response.
The study, which was led by researchers from Columbia University Medical Center were reported in the journal Gut. In the study, the researchers examined 80 individuals – 40 individuals with celiac disease, and 40 with gluten-sensitivity. Despite the extensive intestinal damage associated with celiac disease, blood markers of innate systemic immune activation were not elevated in the celiac disease group. This suggests that the intestinal immune response in celiac patients is able to neutralize microbes or microbial components that may pass through the damaged intestinal barrier, thereby preventing a systemic inflammatory response against highly immunostimulatory molecules.
The gluten-sensitivity group was markedly different. They did not have the intestinal cytotoxic T cells seen in celiac patients, but they did have a marker of intestinal cellular damage that correlated with serologic markers of acute systemic immune activation. The results suggest that the identified systemic immune activation in NCWS is linked to increased translocation of microbial and dietary components from the gut into circulation, in part due to intestinal cell damage and weakening of the intestinal barrier.
Importantly, the researchers found that the gluten sensitive subjects who followed a diet that excluded wheat and related cereals for six months were able to normalize their levels of immune activation and intestinal cell damage markers. This suggests that by testing for leaky gut syndrome it may be possible to identify individuals who would benefit from the dietary changes.

What are the new findings?
▸ Reported sensitivity to wheat in the absence of coeliac disease is associated with significantly increased levels of soluble CD14 and lipopolysaccharide-binding protein, as well as antibody reactivity to microbial antigens, indicating systemic immune activation.
▸ Affected individuals have significantly elevated levels of fatty acid-binding protein 2 that correlates with the markers of systemic immune activation, suggesting compromised intestinal epithelial barrier integrity.
How might it impact on clinical practice in the foreseeable future?
▸ The results demonstrate the presence of objective markers of systemic immune activation and gut epithelial cell damage in individuals who report sensitivity to wheat in the absence of coeliac disease.
▸ The data offer a platform for additional research
directed at assessing the use of the examined markers for identifying affected individuals and/or monitoring the response to treatment, investigating the underlying mechanism and molecular triggers responsible for the breach of the epithelial barrier,
and evaluating novel treatment strategies in affected individuals.

In summary, the results of this study on individuals with sensitivity to wheat in the absence of coeliac disease demonstrate (1) significantly increased serum levels of sCD14 and LBP, as well as antibody reactivity to microbial antigens, indicating systemic immune activation; (2) an elevated expression of FABP2 that correlates with the systemic immune responses to bacterial products, suggesting compromised intestinal epithelial barrier integrity and increased microbial translocation; and (3) a significant change towards normalisation in the levels of the immune activation markers, as well as FABP2 expression, in response to the restrictive diet, which is associated with improvement in symptoms. Our data establish the presence of objective markers of systemic immune activation and epithelial cell damage in the affected individuals. The results of the multivariate data analysis suggest that a selected panel of these may have use for identifying patients with NCWS or patient subsets in the future. It is important to emphasise that this study does not address the potential mechanism or molecular trigger(s) responsible for driving the presumed loss of epithelial barrier integrity and microbial translocation. Further research is needed to investigate the mechanism responsible for the intestinal damage and breach of the epithelial barrier, assess the potential use of the identified immune markers for the diagnosis of affected individuals and/or monitoring the response to specific treatment strategies, and examine potential therapies to counter epithelial cell damage and systemic immune activation in affected individuals”. https://www.metsol.com/blog/leaky-gut-maybe-cause-gluten-sensitivity-non-celiac-individuals/

(1) – LBP is a 65-kDa soluble acute-phase protein mainly produced by hepatocytes5, intestinal epithelial cells6, and visceral adipocytes7. Recent studies demonstrated that serum LBP level correlates positively with obesity8, metabolic syndrome9, type 2 diabetes10,11, and atherosclerosis12,13

(2) – Soluble CD14 subtype (sCD14-ST) is is a glycoprotein expressed on the surface of monocytes and macrophages.

More…..This prospective observational study evaluated soluble CD14 subtype (sCD14-ST) as an early diagnosis and monitoring biomarker for neonatal sepsis in controls, patients with sepsis, or systemic inflammatory response syndrome (SIRS)

Gluten-Free Diet

by luciano

Highlight

-Omissis…….GFD implied a reduction in bacterial populations generally regarded as beneficial for human health such as Bifidobacterium and Lactobacillus, and an increase in those of opportunistic pathogens such as Escherichia coli and total Enterobacteriaceae.
-Omissis…Hansen et al. showed that minimal amounts of gluten are sufficient to affect the microbiota population, lowering the Bifidobacteria count in patients adhering to a low-gluten regimen.
-Omissis…Some changes in the abundance of 8 families of bacteria were observed during the GFD period: Veillonellaceae, Ruminococcus bromii and Roseburia faecis, decreased, whereas Victivallaceae, Clostridiaceae, ML615J-28, Slackia and Coriobacteriaceae increased during GFD. Veillonellaceae, a pro-inflammatory family of Gram-negative bacteria known for lactate fermentation, increase in diseases such as IBD, irritable bowel syndrome and liver cirrhosis.
-Omissis.…This review appraised the current knowledge about the gut microbiota in health as well as CD and NCG/WS and the related effects evoked by GFD in these two most common conditions. The evidence so far acquired has demonstrated that diseases are often characterized by an imbalance in the microbial intestinal population composition, leading to dysbiosis, a condition promoting inflammation and metabolic impairment.

Research reviewed

1 – Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects. Published online by Cambridge University Press: 18 May 2009. Giada De Palma , Inmaculada Nadal , Maria Carmen Collado and Yolanda Sanz
…omissis. “Therefore, introduction of a GFD implied a reduction in bacterial populations generally regarded as beneficial for human health such as Bifidobacterium and Lactobacillus, and an increase in those of opportunistic pathogens such as Escherichia coli and total Enterobacteriaceae. These changes could be related to reductions in polysaccharide intake, since these dietary compounds usually reach the distal part of the colon partially undigested, and constitute one of the main energy sources for beneficial components of the gut microbiota(Reference De Graaf and Venema27). In addition, reductions in Bifidobacterium and Lactobacillus populations relative to Gram-negative bacteria (Bacteroides and Escherichia coli) were previously detected in untreated CD children and particularly in treated CD patients with a GFD(Reference Nadal, Donat and Ribes-Koninckx7). These findings indicate that this dietary therapy may contribute to reduce beneficial bacterial group counts and increase enterobacterial counts, which are microbial features associated with the active phase of CD(Reference Nadal, Donat and Ribes-Koninckx7, Reference Collado, Donat and Ribes-Koninckx28) and, therefore, it would not favour completely the normalisation of the gut ecosystem in treated CD patients”.

2 – Effect of Gluten-Free Diet on Gut Microbiota Composition in Patients with Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity. Giacomo Caio, Lisa Lungaro, Nicola Segata, Matteo Guarino, Giorgio Zoli, Umberto Volta, and Roberto De Giorgio. Nutrients. 2020 Jun; 12(6): 1832. Published online 2020 Jun 19. doi:10.3390/nu12061832

“Celiac disease (CD) and non-celiac gluten/wheat sensitivity (NCG/WS) are the two most frequent conditions belonging to gluten-related disorders (GRDs). Both these diseases are triggered and worsened by gluten proteins ingestion, although other components, such as amylase/trypsin inhibitors (ATI) and fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), seem to be involved in the NCG/WS onset. Therefore, the only effective treatment to date is the long-life adherence to a strictly gluten-free diet. Recently, increasing attention has been paid to the intestinal barrier, a dynamic system comprising various components, which regulate the delicate crosstalk between metabolic, motor, neuroendocrine and immunological functions. Among the elements characterizing the intestinal barrier, the microbiota plays a key role, modulating the gut integrity maintenance, the immune response and the inflammation process, linked to the CD and NCG/WS outbreak. This narrative review addresses the most recent findings on the gut microbiota modulation induced by the gluten-free diet (GFD) in healthy, CD and NCG/WS patients”.
Omissis…..7. Gluten-Free Diet Effects on Healthy Human Microbiota.
The overall literature search on databases including the terms “gluten free diet”, “GFD”, “gluten free diet AND healthy”, “microbiota”, “microbiome”, “microbiome AND healthy patients”, “microbiota AND healthy patients” produced 2775 results. Of these, excluding duplicates, three fulfilled our inclusion criteria. In 2009, De Palma et al. [101] explored whether a month of GFD affects the microbiota composition of ten healthy subjects. Enumeration of fecal bacteria by fluorescence in situ hybridization (FISH) using 16S rRNA-targeted oligonucleotide probes showed that GFD causes a decrease in the count of Bifidobacterium, Clostridium lituseburense and Faecalibacterium prausnitzii. Quantitative PCR (qPCR) characterization of fecal microbes following GFD revealed a reduction in the number of Bifidobacterium, Lactobacillus and Bifidobacterium longum and an increase in the Enterobacteriaceae and Escherichia coli counts. They propose that the depletion in Bifidobacterium and Lactobacillus, generally considered as probiotics, could be caused by the reduced availability of polysaccharides introduced with the GFD that serve as a substrate for gut microbiota. Moreover, the reduction in Faecalibacterium prausnitzii, along with the concomitant increase in the opportunistic pathogens Enterobacteriaceae and Escherichia coli in the fecal mucus of active Crohn’s disease patients was found to trigger the inflammatory insult [89,102,103]. Moreover, Hansen et al. showed that minimal amounts of gluten are sufficient to affect the microbiota population, lowering the Bifidobacteria count in patients adhering to a low-gluten regimen [104]. Indeed, the authors performed a randomized, controlled, cross-over trial study involving 60 non-CD Danish adults who followed a low-gluten diet (2 g gluten per day) for eight weeks and then switched to a high-gluten diet (18 g gluten per day) for another eight weeks, including a washout period of at least six weeks of normal diet (12 g gluten per day) between the two diets. Notably, GFD was associated with an increase of unclassified species of Clostridiales and an unclassified species of Lachnospiraceae, whereas E. hallii and A. hadrus (both butyrate-producers), Dorea (hydrogen producer) and the hydrogen-consumer and acetate-producer Blautia, in addition to two species of the Lachnospiraceae and four species of Bifidobacterium, were found to decrease. These microbial changes could be ascribed to the low-gluten diet availability of arabinoxylan and arabinoxylan-oligosaccharides, as these food components are abundant non-starch polysaccharides of cereal grains, which serve as energy substrates for the bacterial species mentioned above [105,106,107,108,109,110]. Bonder et al. [111] investigated the gut microbiota of 21 healthy volunteers on a GFD for four weeks, tested with a total of 9 stool samples for each person (one at baseline, four during the GFD and four when they returned to their usual diet). The microbiome profile was then characterized using 16 sRNA sequencing and investigated for taxonomic and implied functional compositions. Overall, the bacterial profile remained relatively stable in healthy individuals on GFD. However, some changes in the abundance of 8 families of bacteria were observed during the GFD period: Veillonellaceae, Ruminococcus bromii and Roseburia faecis, decreased, whereas Victivallaceae, Clostridiaceae, ML615J-28, Slackia and Coriobacteriaceae increased during GFD. Veillonellaceae, a pro-inflammatory family of Gram-negative bacteria known for lactate fermentation, increase in diseases such as IBD, irritable bowel syndrome and liver cirrhosis [88,112,113], while they decrease in autistic patients [114]. Compared to a normal diet, the abundance of Ruminococcus bromii, known to degrade the resistant starch in the human colon [115] and the cellulose, producing short chain fatty acids (SCFA) and hydrogen gas [116], was affected by the different starch composition of GFD. Coriobacteriaceae (Slackia genus in particular) and Clostridiaceae were associated with CD, IBD and colorectal cancer [117,118,119]. Thus, gluten withdrawal alters mostly bacterial species, utilizing carbohydrate and starch as energy substrates. The effects of GFD on the abundance of bacterial populations in healthy patients are illustrated in Figure 1.

……omissis. Growing evidence indicates that the interplay between gut microbiota and intestinal epithelial barrier function play a critical role in priming and maintaining a competent immune system. All together, these factors generate a gastrointestinal ecosystem, which, in concert with the classic repertoire of gut physiology, prevent the detrimental effect of various noxae. Offending foods belongs to those harmful substances able to perturb the gastrointestinal ecosystem, thereby leading to disease states. In this wide research area that is still far from being clarified, even classic dietary factors, such as wheat and related gluten and amylase trypsin inhibitors, can play a role in symptom generation in genetically susceptible or sensitive patients. This review appraised the current knowledge about the gut microbiota in health as well as CD and NCG/WS and the related effects evoked by GFD in these two most common conditions. The evidence so far acquired has demonstrated that diseases are often characterized by an imbalance in the microbial intestinal population composition, leading to dysbiosis, a condition promoting inflammation and metabolic impairment. In CD, the depletion of probiotic species, i.e., Lactobacillus and Bifidobacteria and the relative increase of pro-inflammatory bacteria, e.g., Veillonaceae genus, represent microbiota fingerprints likely contributing to disease onset, which is common to CD patients. In all the groups analyzed, GFD was shown to reduce bacterial richness while affecting gut microbiota composition in a different manner depending on health (asymptomatic subjects) and disease state (CD and NCG/WS). Indeed, in healthy subjects, GFD causes the depletion of beneficial species, e.g., Bifidobacteria, in favour of opportunistic pathogens, e.g., Enterobacteriaceae and Escherichia coli. Conversely, in CD and NCG/WS, GFD evoked a positive effect on gastrointestinal symptoms by helping to restore the microbiota population and by lowering pro-inflammatory species. In conclusion, these studies shed light on the complex interactions occurring between diet, gut barrier and gut microbiota. Multiple aspects are still to be explored along the microbiome-diet axis, including investigations into the yet-to-be-defined species that constitute large fractions of the microbiome [84], as well as the role of strain-specific microbial determinants and the difficulties in capturing detailed dietary information in large diverse metagenomics cohorts. In addition to general investigations of the complex link between diet, microbiome and health, further studies are particularly needed to specifically improve our knowledge of the effects that GFD could exert on the bacterial species involved within CD and NCG/WS”.

3 – The influence of a short-term gluten-free diet on the human gut microbiome. Marc Jan Bonder et al. Genome Medicine (2016)

“Abstract.

Background: A gluten-free diet (GFD) is the most commonly adopted special diet worldwide. It is an effective treatment for coeliac disease and is also often followed by individuals to alleviate gastrointestinal complaints. It is known there is an important link between diet and the gut microbiome, but it is largely unknown how a switch to a GFD affects the human gut microbiome.

Methods: We studied changes in the gut microbiomes of 21 healthy volunteers who followed a GFD for four weeks. We collected nine stool samples from each participant: one at baseline, four during the GFD period, and four when they returned to their habitual diet (HD), making a total of 189 samples. We determined microbiome profiles using 16S rRNA sequencing and then processed the samples for taxonomic and imputed functional composition. Additionally, in all 189 samples, six gut health-related biomarkers were measured.

Results: Inter-individual variation in the gut microbiota remained stable during this short-term GFD intervention. A number of taxon-specific differences were seen during the GFD: the most striking shift was seen for the family Veillonellaceae (class Clostridia), which was significantly reduced during the intervention (p = 2.81 × 10−05 ). Seven other taxa also showed significant changes; the majority of them are known to play a role in starch metabolism. We saw stronger differences in pathway activities: 21 predicted pathway activity scores showed significant association to the change in diet. We observed strong relations between the predicted activity of pathways and biomarker measurements.

Conclusions: A GFD changes the gut microbiome composition and alters the activity of microbial pathways”.

Key words: gut, microbiota, Free-Diet, Lactobacillus, Bifidobacteria, pro-inflammatory bacteria, opportunistic pathogens, Enterobacteriaceae, Escherichia coli

Lactis LLGKC18 caused degradation of the main gluten allergenic proteins

by luciano

The research “Fermentation of Gluten by Lactococcus lactis LLGKC18 Reduces its Antigenicity and Allergenicity” highlighted “ A significant decrease of the gliadins, glutenins, and ATI antigenicity was observed after fermentation of gluten by Lc. lactis LLGKC18”

Abstract: “Wheat is a worldwide staple food, yet some people suffer from strong immunological reactions after ingesting wheat-based products. Lactic acid bacteria (LAB) constitute a promising approach to reduce wheat allergenicity because of their proteolytic system. In this study, 172 LAB strains were screened for their proteolytic activity on gluten proteins and α-amylase inhibitors (ATIs) by SDS-PAGE and RP-HPLC. Gliadins, glutenins, and ATI antigenicity and allergenicity were assessed by Western blot/Dot blot and by degranulation assay using RBL-SX38 cells. The screening resulted in selecting 9 high gluten proteolytic strains belonging to two species: Enterococcus faecalis and Lactococcus lactis. Proteomic analysis showed that one of selected strains, Lc. lactis LLGKC18, caused degradation of the main gluten allergenic proteins. A significant decrease of the gliadins, glutenins, and ATI antigenicity was observed after fermentation of gluten by Lc. lactis LLGKC18, regardless the antibody used in the tests. Also, the allergenicity as measured by the RBL-SX38 cell degranulation test was significantly reduced. These results indicate that Lc. lactis LLGKC18 gluten fermentation can be deeply explored for its capability to hydrolyze the epitopes responsible for wheat allergy.” Kamel El Mecherfi et al. Probiotics and Antimicrobial Proteins volume 14, pages 779–791 (2022) Cite this article Published: 03 June 2021

Einkorn Wheat and Intestinal Microbiota

by luciano

The state and health of the intestinal microbiota is at the center of many studies aimed at studying the role of the microbiota in diseases and how to intervene for preventive or curative purposes.
The set of microorganisms that populate our digestive system (microbiota) includes good bacterial strains but harmful ones can sometimes also be present. Indigenous strains (those that characterize our microbiota) hinder the colonization of the intestine by new microbes, including pathogenic ones. Vitamin K, for example, is synthesized by good bacteria present. Indigenous bacteria digest and ferment the favonoids contained in fruits and vegetables, promoting the production of substances that have protective effects on cardiovascular health. An essential function that our bacteria perform is to produce short-chain fatty acids, especially butyric acid. These acids protect the intestine from inflammation and the onset of tumors.
La ricerca “In Vivo Effects of Einkorn Wheat (Triticum monococcum) Bread on the Intestinal Microbiota, Metabolome, and on the Glycemic and Insulinemic Response in the Pig Model” ha questo tema come focus.
Highlighted:
Abstract: “Einkorn wheat (Triticum monococcum) is characterized by high content of proteins, bioactive compounds, such as polyunsaturated fatty acids, fructans, tocols, carotenoids, alkylresorcinols, and phytosterols, and lower α-, β -amylase and lipoxygenase activities compared to polyploid wheat. These features make einkorn flour a good candidate to provide healthier foods. In the present study, we investigated the effects of einkorn bread (EB) on the intestinal physiology and metabolism of the pig model by characterizing the glycemic and insulinemic response, and the microbiota and metabolome profiles. Sixteen commercial hybrid pigs were enrolled in the study; four pigs were used to characterize postprandial glycemic and insulinemic responses and twelve pigs underwent a 30-day dietary intervention to assess microbiota and metabolome changes after EB or standard wheat bread (WB) consumption. The postprandial insulin rise after an EB meal was characterized by a lower absolute level, and, as also observed for glucose, by a biphasic shape in contrast to that in response to a WB meal. The consumption of EB led to enrichment in short-chain fatty acid producers (e.g., Blautia, Faecalibacterium, and Oscillospira) in the gut microbiota and to higher metabolic diversity with lower content of succinate, probably related to improved absorption and therefore promoting intestinal gluconeogenesis. The observed changes, at both a compositional and metabolic scale, strongly suggest that EB consumption may support a health-promoting configuration of the intestinal ecosystem.”

omissis……

“Einkorn wheat (Triticum monococcum) was one of the first crops domesticated approximately 12,000 years ago in the Near East, alongside emmer wheat (Triticum dicoccum). Typically, einkorn was cultivated on marginal agricultural land, being able to survive in harsh environments and poor soils where other types of wheat could not survive. Spelt wheat (Triticum spelta) represents a hexaploid series of the Triticum genome constitution, which is characterized by great adaptation to a wider range of environments [1]. When compared to polyploid wheats, it has a higher content of proteins and some well recognised bioactive compounds, such as polyunsaturated fatty acids, fructans, tocols, carotenoids, alkylresorcinols, phytosterols, and lower α-, β -amylase and lipoxygenase activities [2]. These compositional traits make einkorn flour a good candidate to provide healthier foods. Specifically, the presence of antioxidant compounds and the protein profile are expected to be related to reduced cardiovascular disease and hypoallergenic effects, respectively. In particular, einkorn was shown to express few T-cell stimulatory gluten peptides, with important implications for celiac disease [3]. In vitro digested einkorn breads evidenced their higher carotenoid level as compared to modern wheats and showed a greater anti-inflammatory effect than the control (wheat bread) in Caco-2 intestinal epithelial cells [4]. Given the crucial role of the gut microbiota in the metabolism of dietary compounds, including the bio-activation of plant polyphenols into health-promoting metabolites and the production of short-chain fatty acids (SCFAs, mainly acetate, propionate, and butyrate) from fiber fermentation, as major orchestrators of the host physiology [5].”

omissis….

“Specifically, for einkorn, one of the most representative ancient grains, in vitro results evidenced a good healthy potential because of its effects on blood concentrations of glucose and insulin with a view to using einkorn-based foods in metabolic diseases [7,8], but none has considered changes in the microbiota structure as well as in the intestinal repertoire of metabolites, potentially influencing multiple metabolic and immunological pathways that are relevant to host health. In an attempt to bridge this gap, here we explored the gut microbiota and metabolome of pigs fed with an einkorn versus wheat-based bread. “

omissis……

Conclusions. “In summary, through the pig model we demonstrated a beneficial impact of EB on several aspects of the host physiology, including insulin release, fecal consistency, and microbiota and metabolome profiles, both in feces and intestinal contents. According to our findings, the consumption of EB could reduce the AUC of the first insulin peak, thus prolonging the sense of satiety. Moreover, it could modulate the intestinal ecosystem, at both the compositional and metabolic scale, towards a configuration specifically enriched in health-promoting bacteria and showing distinct metabolic signatures potentially contributing to maintaining the host homeostasis. The use of the pig model allowed, unlike in clinical human trials, the sampling of the mucosa and the content of the small intestine, thus widening the knowledge on the complexity of the food-microbiota-host interaction along the gastrointestinal tracts. The observed positive effects could be driven by the synergistic interaction of many factors, including, inter alia, the fermentation process, the food matrix, and the flour components, which result in gut-mediated effects. The evaluation of the beneficial effects of a real food is far more complex than using purified compounds, as a direct cause-effect relationship can seldom be ascribed to a single component. It is indeed foods, and not the single components, which create the diet, and exploring their complexity can better reflect their overall role on health. Although further studies and clinical trials are needed, the results that are herein reported represent a first contribution to unravel the anti-inflammatory potential of einkorn-based foods.”

“In Vivo Effects of Einkorn Wheat (Triticum monococcum) Bread on the Intestinal Microbiota, Metabolome, and on the Glycemic and Insulinemic Response in the Pig Model”. Francesca Barone et al. Nutrients 2019, 11, 16; doi:10.3390/nu11010016

Note:
A – Pigs have significant anatomical and physiological similarities with humans, particularly with regard to the intestinal structure, with comparable transit time and analogous digestive and absorptive processes [9,10]. Furthermore, like humans, they are true omnivores, unlike other potential mammalian models, such as dogs, cats, ruminants, rabbits, and rodents, which have evolutionarily developed alternative digestive strategies. Finally, both pigs and humans are colon fermenters and have similar colonic microbiota composition. All of these features make the pig one of the most important models in the field of nutrition [11,12]. Through the pig model, in the present study we investigated the impact of a 30-day nutritional intervention with einkorn or wheat bread on the intestinal ecosystem, by means of next-generation sequencing of the 16S rRNA gene and metabolomics of fecal samples, as well as samples from ileal and colonic compartments. The effects of einkorn vs. wheat bread on animal physiology, blood parameters, postprandial glycemia, and insulin response were also evaluated.

B – The metabolome refers to the complete set of small-molecule chemicals found within a biological sample. The biological sample can be a cell, a cellular organelle, an organ, a tissue, a tissue extract, a biofluid or an entire organism. The small molecule chemicals found in a given metabolome may include both endogenous metabolites that are naturally produced by an organism (such as amino acids, organic acids, nucleic acids, fatty acids, amines, sugars, vitamins, co-factors, pigments, antibiotics, etc.) as well as exogenous chemicals (such as drugs, environmental contaminants, food additives, toxins and other xenobiotics) that are not naturally produced by an organism.
The metabolome refers to the complete set of small-molecule chemicals found within a biological sample. The biological sample can be a cell, a cellular organelle, an organ, a tissue, a tissue extract, a biofluid or an entire organism. The small molecule chemicals found in a given metabolome may include both endogenous metabolites that are naturally produced by an organism (such as amino acids, organic acids, nucleic acids, fatty acids, amines, sugars, vitamins, co-factors, pigments, antibiotics, etc.) as well as exogenous chemicals (such as drugs, environmental contaminants, food additives, toxins and other xenobiotics) that are not naturally produced by an organism.