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Gluten-Free Food and Celiac Disease: 2nd Edition

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A special issue of Foods (ISSN 2304-8158). This special issue belongs to the section "Food Nutrition".

Deadline for manuscript submissions: 10 May 2025 | Viewed by 9749

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Special Issue Editors

Dr. Arrate Lasa

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GLUTEN3S Research Group, Department of Pharmacy and Food Science, University of the Basque Country, 01006 Vitoria, Spain
Interests: celiac disease; gluten free diet; nutritional assessment of celiac people; nutrition education; gluten free foods nutritional composition; innovative gluten free foods; dietary adherence in celiac disease; symptoms and their drivers in celiac disease
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Dr. Itziar Churruca

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Dr. Virginia Navarro

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Dr. Jonatan Miranda

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Special Issue Information

Dear Colleagues,

The only treatment for celiac disease (CD) is to follow a strict gluten-free diet throughout life, possibly leading to dietary imbalances and associated diseases. This could be due to the differences observed in the nutritional composition of gluten-free products compared to their homologues containing gluten. Although individualized dietary advice should be mandatory for people with celiac disease, they usually do not have this information. In addition, in the classic form of CD, gastrointestinal symptoms caused by the ingestion of gluten predominate. It could be assumed that the elimination of this protein from the diet leads to the total remission of symptoms; however, some patients continue to suffer from symptoms even when following a strict gluten-free diet.

On the other hand, celiac people sometimes feels misunderstood by society, so information needs to be provided to them to achieve their complete social inclusion.

This Special Issue will include research works aiming to improve the quality of life of celiac people from dietary interventions, the nutritional composition of gluten-free foods, and nutritional education among celiac people and their environment. It also aims to monitor dietary adherence and search for possible causes of their symptomatology.

Dr. Arrate Lasa
Dr. Itziar Churruca
Dr. Virginia Navarro
Dr. Jonatan Miranda
Guest Editors

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Keywords

celiac disease
gluten-free diet
nutritional assessment in celiac disease
symptoms and their drivers in celiac disease
dietary adherence in celiac disease
nutritional education
social aspects in celiac disease
gluten-free foods for nutritional composition
innovative gluten-free foods

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Published Papers (7 papers)

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Research

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18 pages, 2568 KiB

Open AccessArticle

Enhancing the Functional and Emulsifying Properties of Potato Protein via Enzymatic Hydrolysis with Papain and Bromelain for Gluten-Free Cake Emulsifiers

by Wen-Chieh Sung, Chui-Xuan Tan, Pei-Hsuan Lai, Shang-Ta Wang, Tai-Ying Chiou and Wei-Ju Lee

Foods 2025, 14(6), 978; https://doi.org/10.3390/foods14060978 - 13 Mar 2025

Viewed by 606

Abstract

In recent years, plant-derived food proteins have gained increasing attention due to their economic, ecological, and health benefits. This study aimed to enhance the functional properties of potato protein isolate (PPI) through enzymatic hydrolysis with papain and bromelain, evaluating the physicochemical and emulsifying characteristics of the resulting potato protein hydrolysates (PPHs) for their potential use as plant-based emulsifiers. PPHs were prepared at various hydrolysis times (0.25–2 h), resulting in reduced molecular weights and improved solubility under acidic conditions (pH 4–6). PPHs exhibited higher ABTS radical-scavenging activity than PPI. The foaming stability (FS) of bromelain-treated PPI was maintained, whereas papain-treated PPI showed decreased FS with increased hydrolysis. Bromelain-treated PPHs demonstrated a superior emulsifying activity index (EAI: 306 m²/g), polydispersity index (PDI), higher surface potential, and higher viscosity compared to papain-treated PPHs, particularly after 15 min of hydrolysis. Incorporating PPHs into gluten-free chiffon rice cake batter reduced the batter density, increased the specific volume, and improved the cake’s textural properties, including springiness, cohesiveness, and resilience. These findings suggest that bromelain-treated PPHs are promising plant-based emulsifiers with applications in food systems requiring enhanced stability and functionality. Full article

(This article belongs to the Special Issue Gluten-Free Food and Celiac Disease: 2nd Edition)

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22 pages, 2182 KiB

Open AccessArticle

Determination and Comparison of Fat and Fibre Contents in Gluten-Free and Gluten-Containing Flours and Breads: Nutritional Implications

by María Purificación González, Paloma López-Laiz, María Achón, Rocío de la Iglesia, Violeta Fajardo, Ángela García-González, Natalia Úbeda and Elena Alonso-Aperte

Foods 2025, 14(5), 894; https://doi.org/10.3390/foods14050894 - 5 Mar 2025

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Abstract

The absence of gluten is a technological challenge that requires the addition of components to replace the unique viscoelastic properties of gluten, thus altering the nutritional composition of gluten-free (GF) breads. Moreover, GF flours may have different compositions as compared to gluten-containing (GC) counterparts because of a different origin. This may impact the nutritional quality of GF diets. The aim of the study is to provide updated analytical data on moisture, fat, and fibre contents in GF flour and bread samples, and compare them with their GC counterparts, as well as to analyse ingredients and how they impact nutritional quality. A total of 30 different flours and 24 types of bread were analysed using AOAC methods. GF cereal flours contain more fat than GC flours (3.5 ± 2.1% vs. 2.5 ± 2.1%, p < 0.001), as well as GF flours from pseudocereals, except for wholemeal buckwheat (2.6 ± 0.1%). Fibre content is lower in GF flours (3.6 ± 3.1% vs. 7.1 ± 3.9%, p = 0.03), except for GF pseudocereal and legume flours. GF breads contain almost twice as much fat 6.6 ± 2.3% vs. 1.4 ± 0.2%, p < 0.001, and 4.2 ± 1.2%, p < 0.001) and fibre (7.3 ± 2.4% vs. 2.8 ± 0.5%, p < 0.001, and 4.9 ± 2.1%, p = 0.002) as GC breads. This is due to the raw materials themselves and to the addition of ingredients, such as regular and high oleic sunflower oil, and psyllium. Fibre ingredients and additives are more frequently used in ready-to-eat GF flours and breads, and more GF breads also contain fat-based ingredients, as compared to GC. Amaranth and chickpea flours are good alternatives to produce breads with better nutritional quality. Analysis of GF products for critical nutrients is peremptory because of continuing technological and nutritional innovation. Full article

(This article belongs to the Special Issue Gluten-Free Food and Celiac Disease: 2nd Edition)

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9 pages, 881 KiB

Open AccessCommunication

Evaluation of the Frequency of HLA-DQ2/DQ8 Genes Among Patients with Celiac Disease and Those on a Gluten-Free Diet

by Marek K. Kowalski, Danuta Domżał-Magrowska and Ewa Małecka-Wojciesko

Foods 2025, 14(2), 298; https://doi.org/10.3390/foods14020298 - 17 Jan 2025

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Abstract

Background: Celiac disease (CD) is a chronic, permanent, gluten-dependent disease that manifests itself with inflammation of the small intestine and malabsorption in genetically predisposed individuals with HLA-DQ2 and -DQ8 (human leukocyte antigen) histocompatibility antigens. Objective: The diagnostic criteria for celiac disease have undergone numerous modifications over the years. The aim of the study is to evaluate the frequency of HLA-DQ2/DQ8 genes in a group of patients with celiac disease diagnosed in 1980–2010 in order to verify the primary diagnosis of CD. Methods: The study group included 50 patients, 13 men and 37 women, who had been diagnosed with celiac disease many years ago based on histopathological criteria and improvement of health condition after receiving a gluten-free diet. The control group consisted of 31 healthy volunteers, 18 women and 13 men. All subjects underwent a genetic analysis assessing the presence of histocompatibility antigens HLA-DQ2.2, -DQ2.5, and -DQ8, along with the assessment of alleles encoding the α and β subunits of the antigens, according to European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines from 2020, using the EUROarray technique at EUROIMMUNE^®. Results: In the study group, 12 (24%) patients did not meet the genetic criteria. Among the remaining patients (Group 1) with celiac disease, the presence of HLA-DQ2.5 (50.0% vs. 9.68%; p < 0.01) and the co-occurrence of both alleles of HLA-DQ2 (31.6% vs. 6.45%; p < 0.05) were detected significantly more frequently than in the control group. Among patients with celiac disease, the prevalence of HLA-DQ8 was also slightly more frequent (13.2% vs. 3.23%; p > 0.05). Patients who did not meet the genetic criteria for celiac disease (Group 2) had a single string α-HLA-DQ2.5 significantly more often than control subjects (66.67% vs. 38.71%; p < 0.05). Conclusions: Among patients with celiac disease diagnosed before 2010, based on the 2020 ESPGHAN criteria, it is advisable to verify the previous diagnosis, taking into account genetic criteria. Full article

(This article belongs to the Special Issue Gluten-Free Food and Celiac Disease: 2nd Edition)

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14 pages, 980 KiB

Open AccessArticle

Gluten-Free Diet Adherence Evaluation in Adults with Long-Standing Celiac Disease

by Marek K. Kowalski, Danuta Domżał-Magrowska, Piotr Szcześniak, Magdalena Bulska, Daria Orszulak-Michalak and Ewa Małecka-Wojciesko

Foods 2025, 14(1), 76; https://doi.org/10.3390/foods14010076 - 31 Dec 2024

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Abstract

Background: Celiac disease (CD) is an autoimmune disease that results from the interaction of genetic, immune, and environmental factors. According to the 2020 European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines, an elimination diet (i.e., excluding products that may contain gluten) is the basic method of treating celiac disease. Following a gluten-free diet is extremely problematic, and patients often make unconscious deviations from the diet. According to the current Oslo definitions for celiac disease, depending on the clinical picture and adequate tests, several forms of celiac disease have been identified: typical, atypical, asymptomatic, potential, and refractory. Objective: The aim of the study was to assess the frequency of conscious diet mistakes and unconscious deviations from a gluten-free diet in a group of patients with long-standing celiac disease and their impact on the frequency of typical and atypical symptoms. Methods: The study included 57 people diagnosed with celiac disease between 1980 and 2010. After verifying the history of the disease according to the ESPGHAN guidelines from 2020, we excluded 19 patients who had Marsh grade 1 at the time of diagnosis or those without HLA DQ2 or DQ8 haplotypes detected. After verification, the study included 38 patients, 30 women and 8 men, with a verified diagnosis of typical celiac disease. The effectiveness of the gluten-free diet was assessed in all participants. Blood was collected to determine IgA anti-tissue transglutaminase II antibodies (anti-tTG) and IgG antibodies against deamidated gliadin peptides by ELISA. All survey participants provided data concerning current gastrointestinal and systemic symptoms, bowel habits, comorbidities, dietary habits, physical activity, and socioeconomic conditions. Results: A total of 25 patients (65.78%) declared strict adherence to the gluten-free diet. However, in this group, seven (18.4%) patients had significantly increased levels of anti-tTG antibodies (mean 82.3 RU/mL ± 78.9 SD at N < 20 RU/mL). Among the patients who consciously made dietary mistakes, six (46.2%) demonstrated increased levels of anti-tTG antibodies. The analysis did not reveal any difference between the frequency of intestinal and extraintestinal symptoms in patients making dietary mistakes and following the gluten-free diet. Conclusions: More than half of celiac patients unconsciously or consciously make dietary mistakes, which indicates an urgent need to increase their general knowledge of CD and the appropriate diet. Regardless of whether the gluten-free diet is followed, both typical and atypical symptoms of the disease have been observed among celiac patients. Full article

(This article belongs to the Special Issue Gluten-Free Food and Celiac Disease: 2nd Edition)

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Review

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31 pages, 1237 KiB

Open AccessReview

Celiac Disease—Narrative Review on Progress in Celiac Disease

by Marek K. Kowalski, Danuta Domżał-Magrowska and Ewa Małecka-Wojciesko

Foods 2025, 14(6), 959; https://doi.org/10.3390/foods14060959 - 11 Mar 2025

Viewed by 632

Abstract

Celiac disease is defined as a systemic immunological disorder caused by gluten (gliadin and other prolamin) in genetically predisposed individuals, who present with a variety of gluten-dependent symptoms, specific antibodies, the presence of the HLA DQ2 and DQ8 histocompatibility antigen, and enteropathy. Its prevalence, depending on the studied population and methodology, is estimated at 0.75–1.6% of the general population. During the complex immune reaction it induces, most cells involved in inflammatory processes are activated, which leads to the gradual atrophy of intestinal villi and the proliferation of enterocytes within intestinal crypts. The pathogenesis of celiac disease is extremely complicated and is still the subject of research. According to the current diagnostic guidelines, the following criteria should be taken into account: clinical symptoms (intestinal and extraintestinal), the presence of antibodies against tissue transglutaminase in the IgA class, the level of total IgA, and the presence of typical histological changes in duodenal biopsies. Diet-resistant celiac disease is one of the most important clinical challenges, causing serious complications. Currently, the basic method for treating celiac disease is an elimination diet (i.e., the exclusion of products that may contain gluten from the diet), however, new therapeutic strategies are still being sought, mainly based on supplementation with exogenous endopeptidases, modification of the immune response, and the use of zonulin inhibitors and transglutaminase 2 inhibitors. Clinical trials of new drugs are ongoing. The gradually expanding knowledge about the pathogenesis of celiac disease may allow for the development of new therapeutic strategies for both patients with a mild disease course, as well as those that are diet-resistant. Full article

(This article belongs to the Special Issue Gluten-Free Food and Celiac Disease: 2nd Edition)

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20 pages, 991 KiB

Open AccessReview

Global Approach to Follow-Up of Celiac Disease

by Gesala Perez-Junkera, Lorea Ruiz de Azua, Maialen Vázquez-Polo, Arrate Lasa, María Pilar Fernandez Gil, Itziar Txurruka, Virginia Navarro and Idoia Larretxi

Foods 2024, 13(10), 1449; https://doi.org/10.3390/foods13101449 - 8 May 2024

Cited by 2 | Viewed by 2143

Abstract

Celiac disease, an autoimmune disorder induced by the ingestion of gluten, affects approximately 1.4% of the population. Gluten damages the villi of the small intestine, producing symptoms such as abdominal pain, bloating and a subsequent loss of nutrient absorption, causing destabilization of the nutritional status. Moreover, gluten can trigger extra intestinal symptoms, such as asthma or dermatitis, but also mental disorders such as depression or anxiety. Moreover, people suffering from celiac disease sometimes feel misunderstood by society, mainly due to the lack of knowledge about the disease and the gluten-free diet. Thus, the treatment and follow-up of patients with celiac disease should be approached from different perspectives, such as the following: (1) a clinical perspective: symptomatology and dietary adherence monitorization; (2) nutritional assessment: dietary balance achievement; (3) psychological assistance: mental disorders avoidance; and (4) social inclusion: educating society about celiac disease in order to avoid isolation of those with celiac disease. The aim of this narrative review is to gain deep insight into the different strategies that currently exist in order to work on each of these perspectives and to clarify how the complete approach of celiac disease follow-up should be undertaken so that the optimum quality of life of this collective is reached. Full article

(This article belongs to the Special Issue Gluten-Free Food and Celiac Disease: 2nd Edition)

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Other

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13 pages, 541 KiB

Open AccessPerspective

Celiac Disease, Gluten-Free Diet, and Eating Disorders: From Bench to Bedside

by Yaohui Wei, Yating Wang, Yonggui Yuan and Jue Chen

Foods 2025, 14(1), 74; https://doi.org/10.3390/foods14010074 - 31 Dec 2024

Viewed by 1521

Abstract

Celiac disease (CD) and eating disorders (EDs) are complex chronic conditions in adolescents, sharing symptoms such as weight change, malnutrition, and gastrointestinal symptoms. CD, an autoimmune disorder triggered by gluten ingestion, is managed through a strict gluten-free diet that can unintentionally foster disordered eating behaviors due to dietary restrictions. Conversely, EDs may mask and complicate CD symptoms, leading to diagnostic delays and treatment challenges. Evidence reveals an increased risk of EDs in CD individuals and vice versa, indicating a potential bidirectional relationship. This review explores the mechanisms and clinical implications of this interplay and proposes integrated screening and care strategies to improve the quality of life for individuals with both conditions. Full article

(This article belongs to the Special Issue Gluten-Free Food and Celiac Disease: 2nd Edition)

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