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Everything That Must Be Known About the Relationship of Gluten to Human Health

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Designing Gluten Free Bakery and Pasta Products

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Abstract

Gluten-related disorders (GRD) include celiac disease (CD) and other medical conditions like non-celiac gluten sensitivity (NCGS) and wheat allergy (WA) triggered by the ingestion of gluten-containing cereals and cured by the elimination of gluten-containing food from the diet. Gluten is the main structural protein complex in wheat with equivalent toxic proteins in rye, barley, spelt, einkorn, khorasan wheat, and triticale. Gluten is a mixture of proteins named prolamins, representing about 80% of the total protein content in grain. At present, the only accepted treatment for GRD is a strict gluten free diet (GFD). The protracted ingestion of gluten traces (10–50 mg/day) is sufficient to cause significant intestinal mucosa damage in CD patients. Following a strict GFD requires critical attention in the selection of gluten-free food, ingredients, and nutritional content. Gluten is a pervasive ingredient and cross-contamination of naturally gluten-free items is common. Data show that there is an unmet need for a strict and universal gluten-free labeling regulation all over the world. Several methods are available to measure traces of gluten in food items. However, no test is fully reliable so far. The GFD is a nutritionally safe intervention without any major risks but a suitable GFD must also be nutritionally adequate to prevent micronutrients and fiber deficiencies. Newly diagnosed CD patients are advised to receive dietary counseling on food labeling, and the most appropriate gluten-free foods.

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Abbreviations

Anti-tTG:

anti-tissue transglutaminase antibodies

ATIs:

Amylase-trypsin inhibitors

CD:

celiac disease

DGP:

anti-deamidated gliadin peptides antibodies

EATL:

enteropathy-associated T cell lymphoma

EFSA:

European Food Safety Authority (EFSA)

ELISA:

enzyme-linked immune sorbent assay

EMA-IgA:

IgA class anti-endomysial antibodies

ESPGHAN:

European Society for Pediatric Gastroenterology, Hepatology, and Nutrition

FDA:

Food and Drug Administration

FODMAPs:

fermentable oligosaccharides, disaccharides, monosaccharides and polyols

GFD:

gluten-free diet

GIP:

gluten immunogenic peptides

GRD:

gluten-related disorders

NCGS:

non-celiac gluten sensitivity

RCD:

Refractory celiac disease

T1DM:

type 1 diabetes mellitus

WA:

wheat allergy

WDEIA:

Wheat-dependent exercise induced anaphylaxis

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Authors and Affiliations

  1. Division of Pediatrics, DISCO Department, Polytechnic University of Marche, Ancona, Italy

    Francesca Di Sario & Carlo Catassi

  2. Celiac Disease Research Laboratory, Polytechnic University of Marche, Ancona, Italy

    Chiara Monachesi & Anil K. Verma

  3. Mucosal Immunology and Biology Research Center, Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Boston, MA, USA

    Carlo Catassi

Authors
  1. Francesca Di Sario
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  2. Chiara Monachesi
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  3. Anil K. Verma
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  4. Carlo Catassi
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Corresponding author

Correspondence to Carlo Catassi .

Editor information

Editors and Affiliations

  1. Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

    Marina F. de Escalada Pla

  2. Universidad Nacional de Entre Ríos, Gualeguaychú, Entre Ríos, Argentina

    Carolina E. Genevois

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Di Sario, F., Monachesi, C., Verma, A.K., Catassi, C. (2023). Everything That Must Be Known About the Relationship of Gluten to Human Health. In: de Escalada Pla, M.F., Genevois, C.E. (eds) Designing Gluten Free Bakery and Pasta Products . Springer, Cham. https://doi.org/10.1007/978-3-031-28344-4_1

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