Effect of Pectin, Guar and Carageenan on Quality Parameters and Staling of Gluten Free Pan Bread

The effect of low methyl pectin, guar and K-carrageenan at concentrations of 1, 2 and 3% and their combinations at concentrations of 2 and 3% on quality attributes and staling of gluten free bread was studied. Among investigated samples, control （starch） bread with no added

Coeliac Disease: Gluten Free Diet and… What Else?

Coeliac Disease (CD) is a permanent gluten intolerance, whose pathogenesis involves multiple factors including genetics and environment. CD has different representations and non-specific symptoms such as diarrhea, bloating, pain, flatulence and constipation may sometimes be misleading. Once diagnosed of CD, patients must adhere to Gluten Free Diet, which consists in the lifelong avoidance of gluten containing foods and of those naturally gluten free but at risk of contamination. This dietary approach is considered the only therapy in order to avoid symptoms exacerbation and to reduce the digestive mucosa inflammation, which has been related to higher risks of lymphoproliferative malignancy and other immunological disorders. However, being on a Gluten Free Diet is not as resolving as it may seem since it has several criticalities. First of all, excluding gluten means limiting food variety so that coeliac patients may have unbalanced intake of several nutrients and develop clinical or subclinical deficiencies. This can be due to scarce attention to qualitative and quantitative composition of diets and poor information about gluten-containing foods, which only patient-tailored dietetic protocol and long-term follow-up can achieve. Secondly, Gluten Free Diet may not result in complete remission of mucosal damage or in resolution of symptoms. Unintentional contamination of gluten or poor adherence to diet are the main culprits of the incomplete mucosal healing but other triggers may be involved. Recent research has focused on the role of FODMAPs in changing gut microbiota and on the improvement of Irritable Bowel Syndrome (IBS) symptoms after their dietary avoidance or reduction. Since CD and IBS may share many clinical presentations, further studies are needed to evaluate if a subgroup of CD patients whose symptoms are not improved by Gluten Free Diet could benefit from a new therapeutic approach consisting in both gluten/wheat and FODMAPs avoidance.

Celiac disease: Alternatives to a gluten free diet

Celiac disease is a chronic inflammatory disorder of the small intestine caused by the ingestion of gluten or related rye and barley proteins. At present, the only available treatment is a strict gluten-exclusion diet. However, recent understanding of the molecular basis for this disorder has improved and enabled the identif ication of targets for new therapies. This article aims to critically summarize these recent studies.

Antioxidant Activities of Selective Gluten Free Ancient Grains

Ancient grains were known for special nutritional values along with gluten free qualities. Amaranth, quinoa, teff, and buckwheat flours were evaluated for pasting properties, water holding capacities, phenolic contents, and antioxidant activities (free and bound). They all had higher water holding capacities than wheat flour. Amaranth, quinoa, and teff showed higher pasting viscosities than wheat flour. Buckwheat flour had the highest free, bound and total phenolic contents among the flours in all aqueous extracts. The bound phenolic contents were higher than the free phenolic contents regardless of the solvents with the exception of water extraction of quinoa and buckwheat. The free phenolic compounds for all four flours were highest in water extract, and least in 100% ethanol. Bound antioxidant activities were much higher than the free antioxidant activities regardless of solvents for all products. The free antioxidant activities from water and 50% ethanol were higher than 100% ethanol. In contrast, more bound phenolics were extracted with 100% ethanol than water and 50% ethanol. Our study suggested that the total phenolic contents and antioxidant activities of grains could be underestimated in the literature without considering the bound phenolic compounds. These ancient grains have nutrition, antioxidants, and textural qualities suitable for functional foods.

Effect of the Inulin Addition on the Properties of Gluten Free Pasta

In this work the influence of the soluble fiber content, such as inulin, on both the sensory quality of dry spaghetti based on maize and on the dough rheological properties were evaluated. The inulin was added to the dough up to an amount of 20%. Results showed that the samples with inulin at 5% and 7.5% showed the higher values of elongation and shear viscosity with respect to the other samples, therefore a higher firmness. Regarding the sensorial analysis, all dry sam- ples had a positive score of overall quality;in particular, the sample with 5% of inulin showed the highest score because of the highest resistance to break value. Moreover, the overall quality of the cooked spaghetti samples decreased with the increase of the amount of inulin. In fact, firmness, color and taste attributes decreased with the increase of the inulin amount influencing negatively the overall quality of the spaghetti samples.

Generalized Procrustes Analysis and External Preference Map Used to Consumer Drivers of Diet Gluten Free Product

In order to study correlations between sensory properties and acceptance, regular and gluten-free carrot cakes (sweetened with sucrose and sucralose) were evaluated. Appearance, aroma, flavor, texture and overall liking were analyzed by 120 carrot cake consumers using a 9-cm hedonic scale. Quantitative Descriptive Analysis (QDA) was carried out with 11 assessors among 16 attributes. Data were analyzed by ANOVA, Tukey test (p < 0.05), Internal Preference Map and Cluster analysis. Also texture parameters were analyzed by Partial Least Square (PLS) to be able to show the instrumental parameters influence. Generalized Procrustes Analysis (GPA) was used before an Ex-ternal Preference Mapping to reduce the scale effects and to obtain a consensus configuration. According to PLS correlation, the attributes hardness, fracturability, adhesiveness, chewiness and gumminess interfered on characteristics considered undesirable for texture acceptance and smoothness, elasticity, cohesiveness and water activity interfered as desirable features. It was noted that all cakes were well accepted, except cake sweetened with sucralose and mix done using cornmeal, rice flour, potato starch and corn starch (2:3:3:2). As for the instrumental aspects, cohesiveness and elasticity influenced positively the cake’s acceptance. Instead, smoothness and adhesion parameters weren’t so significant.

Resolution of metabolic syndrome after following a gluten free diet in an adult woman diagnosed with celiac disease

Adult celiac disease(CD) presents with very diverse symptoms that are clearly different from those typically seen in pediatric patients,including ferropenic anemia,dyspepsia,endocrine alterations and elevated transaminase concentration. We present the case of a 51-year-old overweight woman with altered basal blood glucose,hypercholesterolemia,hypertriglyceridemia and persisting elevated transaminase levels,who showed all the symptoms for a diagnosis of metabolic syndrome. Because she presented iron deficiency anemia,she was referred to the gastroenterology department and subsequently diagnosed with celiac disease after duodenal biopsies and detection of a compatible HLA haplotype. Gluten-free diet(GFD) was prescribed and after 6 mo the patient showed resolution of laboratory abnormalities(including recovering anemia and iron reserves,normalization of altered lipid and liver function parameters and decrease of glucose blood levels) . No changes in weight or waist circumference were observedand no significant changes in diet were documented apart from the GFD. The present case study is the first reported description of an association between CD and metabolic syndrome,and invites investigation of the metabolic changes induced by gluten in celiac patients.

High Protein Gluten Free Snack Foods Based on Whole Grain Flour and Vegetables

Novel snack foods comprised of various combinations of whole grains and vegetables were evaluated for consumer acceptability in sensory booths by seventy-one in-house volunteers. Specifically, snacks containing Buckwheat (B), Buckwheat + Peanut meal + Kale (BPK), Sorghum + Peanut meal + Okra (SPO), and Sorghum + Peanut meal + Okra + Jalapeno (SPOJ) were judged for appearance, aroma, flavor and texture on a scale from one to five, as well as on overall acceptability on a binary scale. Several combinations of ingredients were evaluated, with the final composition of snacks tested decided by consensus of laboratory personnel based on criteria of expected consumer acceptability of 70%. While all snacks were found to be statistically similar for appearance, aroma, and flavor, the texture of BWPK and SPO were rated significantly equal and more favorable than BW and SPOJ. Acceptability ratings were generally high;SPOJ (94%), BPK (93%), SPO (89%), and B (85%), with no significant difference, observed between SPOJ and BPK (p = 0.05). The snack foods evaluated are higher (up to triple) in protein, lower (as low as half) in fat, are gluten-free with no added sugar, and generally higher in nutritional content as compared to most traditional snack foods. While ideally suited for commercial production, these snacks can also be easily prepared at home with minimal equipment requirements, thus offering a healthy alternative for all consumers including vegetarians, vegans, and those hypersensitive to gluten.

Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders:a randomized clinical trial

Background:Genetic and environmental factors are both responsible for the etiology of autism spectrum disorders(ASD).Although epidemiological studies have been conducted to clarify the association between restriction diets and ASD,the conclusion remains unclear.This study was undertaken to investigate the effect of gluten free diet(GFD)on gastrointestinal symptoms and behavioral indices in children with ASD.Methods:In this randomized clinical trial,80 children diagnosed with ASD by the Autism Diagnostic Interview-Revised(ADI-R)were assigned into GFD(n=40)and regular diet(RD)(n=40)groups for 6 weeks.At the beginning and end of the intervention,the ROMEШquestionnaire for evaluating gastrointestinal symptoms and Gilliam Autism Rating Scale 2 questionnaire(GARS-2)for assessing psychometric properties were completed.Results:Of the 80 children,53.9%had gastrointestinal abnormalities.In the GFD group,the prevalence of gastrointestinal symptoms decreased significantly(P<0.05)after intake of GFD(40.57%vs.17.10%)but increased insignificantly in the RD group(42.45%vs.44.05%).GFD intervention resulted in a significant decrease in behavioral disorders(80.03±14.07 vs.75.82±15.37,P<0.05)but an insignificant increase in the RD group(79.92±15.49 vs.80.92±16.24).Conclusion:This study suggested that GFD may be effective in controlling gastrointestinal symptoms and ASD behaviors.

Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets

BACKGROUND Functional gastrointestinal disorders(FGIDs)are common during the pediatric age.FGIDs are not related to biochemical or structural abnormalities.However,since they have a high prevalence,several studies have evaluated an overlap between FGIDs and organic diseases.Individuals with celiac disease(CD)have been shown to be at an increased risk for functional abdominal pain,even if they adhere well to a gluten-free diet(GFD).Little information is available for the pediatric age group.The aims of our study were to evaluate the prevalence of FGIDS in CD children 1 year after diagnosis and to compare the prevalence of FGIDs in CD children on a GFD with processed foods compared with those on a GFD with natural products.AIM To assess the prevalence of FGIDs in children with CD after 1 year of follow-up and to compare the prevalence of FGIDs in children with CD on a GFD with processed foods and in children on a GFD with natural products.METHODS We recruited pediatric patients aged 1-18 years with a new CD diagnosis.Participants were randomized to two groups:Group A on a GFD with processed foods(diet 1);and group B on a GFD with natural products(diet 2).Clinical monitoring,diet assessment and the questionnaire on pediatric gastrointestinal symptoms-Rome IV version were performed at diagnosis(T0)and after 12 mo of follow-up(T1).Dietary intake was assessed using a 3-d food diary record.Data from the diaries were evaluated using WinFood nutrient analysis software.We assessed the prevalence of FGIDs at T1 and the correlation with the type of GFD.RESULTS We registered 104 CD children,with 55 patients in group A(53.0%)and 49 patients in group B(47.0%).Initially,30 of the 55(54.5%)CD children were symptomatic in group A,while 25 of 49(51.0%)were symptomatic in group B.At T1,in spite of a low or negative serology for CD,FGIDs prevalence was 10/55(18.0%)in group A and 8/49(16.3%)in group B,with no statistically significant difference between the two groups(P=0.780).At T1 the macro-and micronutrient intake was similar across the two groups with no significant differences in nutrient analysis.However,in both groups at T1 we found that a lower prevalence of FGIDs(P=0.055)was associated with an inferior caloric(odds ratio=0.99,95%confidence interval:0.99-1.00)and fat(odds ratio=0.33,95%confidence interval:0.65-0.95)intake.CONCLUSION Our results showed that CD children on a GFD have gastrointestinal symptoms with an elevated prevalence of FGIDs.Our study suggests that developing FGIDs may be linked to caloric intake and percentage of food fat,but it does not change between a GFD with processed foods or a GFD with natural products.However,long-term monitoring is required to evaluate a correlation between FGIDs and various types of GFDs.

Cardiovascular disease risk factor profiles in children with celiac disease on gluten-free diets

AIM:To describe the cardiovascular disease(CVD)risk factors in a population of children with celiac disease(CD)on a gluten-free diet(GFD).METHODS:This cross-sectional multicenter study was performed at Schneider Children’s Medical Center of Israel(Petach Tiqva,Israel),and San Paolo Hospital(Milan,Italy).We enrolled 114 CD children in serologic remission,who were on a GFD for at least one year.At enrollment,anthropometric measurements,blood lipids and glucose were assessed,and compared to values at diagnosis.The homeostasis model assessment-estimated insulin resistance was calculated as a measure of insulin resistance.RESULTS:Three or more concomitant CVD risk factors[body mass index,waist circumference,low density lipoprotein(LDL)cholesterol,triglycerides,blood pressure and insulin resistance]were identified in 14%of CD subjects on a GFD.The most common CVD risk factors were high fasting triglycerides(34.8%),elevated blood pressure(29.4%),and high concentrations of calculated LDL cholesterol(24.1%).On a GFD,four children(3.5%)had insulin resistance.Fasting insulin and HOMA-IR were significantly higher in the Italian cohort compared to the Israeli cohort(P<0.001).Children on a GFD had an increased prevalence of borderline LDL cholesterol(24%)when compared to values(10%)at diagnosis(P=0.090).Trends towards increases in overweight(from 8.8%to 11.5%)and obesity(from 5.3%to 8.8%)were seen on a GFD.CONCLUSION:This report of insulin resistance and CVD risk factors in celiac children highlights the importance of CVD screening,and the need for dietary counseling targeting CVD prevention.

Utilization of Different Hydrocolloid Combinations in Gluten-Free Bread Making

Coeliac disease (CD) is a common lifelong disorder with small bowel malabsorption and gluten intolerance. The only effective treatment for CD is a strict lifelong renunciation of gluten-containing foods. Currently, the cereal products designed to meet the requirements of CD patients, especially gluten-free bread, are scarce, of low quality and poor flavor. Therefore, preparation of high quality and affordable bread for coeliac patients was the main objective of this study. Three kinds of gluten-free bread were prepared, in which wheat flour was substituted with rice and corn flour at a ratio of 5:1, respectively. Gluten was substituted using different hydrocolloids: 1% xanthan and 1% carrageenan (Mix A), GFB A;1% xanthan and 1% pectin (Mix B), GFB B;and 1% carrageenan and 1% pectin (Mix C), GFB C. These three types of bread were compared to control bread produced from wheat flour (WB). Sponge and dough method with some modifications was used to produce the bread samples with a developed formula (0.8% yeast, 4.0% sugar, 2% salt, 7.0% shortening, 2.0% non-fat dry milk, and 1% sodium stearoyl lactylate (SSL)). Determination of the chemical composition, rheological properties and physical characteristics, as well as sensory evaluation of the bread samples, was undertaken. Results showed that the moisture content of WB bread (control) was significantly lower than that of all types of gluten-free bread, and there was no significant difference in ash, protein, and lipid contents among the gluten-free bread samples. GFB A, GFB B and GFB C displayed no significant differences in their specific volumes. The sensory evaluation showed that GFB C received the lowest sensory evaluation score. Therefore, GFB A and GFB B were the best gluten-free samples.

Rheological, Organoleptical and Quality Characteristics of Gluten-Free Rice Cakes Formulated with Sorghum and Germinated Chickpea Flours

Gluten-free bakery products are produced for people suffering from celiac disease due to sensitivity to gluten. So, the aim of this work was to study the effect of partial substitution of rice flour at 20%, 30% and 40% with sorghum and germinated chickpea flours on rheological, physical, sensory properties and staling rate of prepared gluten-free cake. Obtained results showed that germinated chickpea flour had the highest contents of crude protein (23.62%), lipids (4.89%) and crude fibers (5.76%) as compared to other grain flours. Gradual increase in gelatinization temperature and decrease in maximum viscosity and setback were fond of cake batters with increasing the substituting levels of rice flour from 20% to 40% with sorghum or germinated chickpea flours in comparison to rice flour batter. No significant difference was observed in specific volume between rice cake and cake containing 20% of germinated chickpea and sorghum flours which given 2.71, 2.62 and 2.56 cm3/g, respectively. Data also revealed that gluten-free cake lightness (L*) and total intensity significantly increased with 40% of sorghum flour followed by 30 and 20% of sorghum flour. Substitution of 40% rice flour with germinated chickpea flour resulted in significant high in redness (a*), yellowness (b*) and chroma of gluten-free cake being 11.95, 33.72 and 35.77, respectively followed by substituted levels 30% and 20% which attributed to their natural yellow pigments compared with other investigated samples. Overall acceptability of gluten-free cakes was improved after adding 20, 30% of sorghum flour and 20% of germinated chickpea flour which being 90.7, 88.6 and 87.5, respectively compared to rice flour cake (88.4). Rice flour cake was more freshness than wheat flour cake and other treatments during storage duration. After 6 days, rice cake had significant high freshness (306.2%) followed by gluten-free cake samples with 20% of sorghum or germinated chickpea flours which given 294.5% and 289.4%, respectively. Generally, it could be concluded that the quality and nutritional properties of gluten-free rice cakes could be improved when using 20%, 30% of sorghum flour and 20% of germinated chickpea flour as substitution levels of rice flour.

Gluten-Free Bread Enriched with Vegetable Flours

The effects of different vegetable flours (broccoli, cauliflower, artichoke, fennel, zucchini and mushroom) added to gluten-free bread on sensory quality, antioxidant properties and glycemic response were assessed. Among the vegetable flours, the addition of fennel flour significantly improved sensory bread quality. Artichoke flour has the highest phenolic (26.51 ± 1.92 mg/g dw) and flavonoid content (26.43 ± 1.93 mg/g dw). Even though the content of total phenol and flavonoids in vegetable flours was higher when compared to supplemented bread, the addition of artichoke and zucchini flours increased the total phenolic and flavonoid content and improved antioxidant activity. The incorporation of high level of vegetable flours (15%) also decreased the glycemic index of bread, in particular with artichoke and zucchini flours (59 ± 1.21 and 62 ± 0.49, respectively). To sum up, the results are very interesting because the addition of vegetable flours into gluten-free bread can improve nutritional and sensory properties of bread.

Study on Parameters of Consumer Preferences for Alternative Wheat Products (Gluten-Free Foods) in USA and India

Celiac Disease (CD) is an inherited, autoimmune disorder in which proteins from the grains wheat, rye and barley (collectively called gluten) damage the small intestine. The only treatment for CD is a strict, lifelong gluten-free diet. With a prevalence rate of about one in 100-133 people worldwide. Celiac disease is wide-spread across the globe. Unlike traditional allergies, which cause immediate reactions, gluten sensitivity is harder to pin down since it manifests gradually and in various forms like headaches, stomach cramps, bloating, anxiety, and depression. Due to complicated diagnosis procedure and lack of awareness, many cases are either misdiagnosed or not at all diagnosed in India and USA. In spite of high growth, gluten-free foods are facing problems to grain ground in Asian market, due to high price, lack of awareness about the products, large number of un-diagnosed cases and inefficient value chain for gluten-free products. One of the major issues in India and USA is very high prices of gluten-free foods as compared to regular food products. Globally, the market potential of gluten free products is estimated to be USD 4639.13 Million and USD 7594.43 Million in 2015 and 2020 respectively. The global gluten free food market is projected to grow with a CAGR between 9 percent and 10.2 percent during 2016-2022. The study on consumer preference of gluten-free foods would enable manufacturers of gluten-free foods to understand the current and evolving expectations of consumers and to design the products according. Study of two countries i.e., India and USA would enable manufacturers to understand the difference in choices and preferences related to gluten-free foods for both the nations. This study would help manufacturers of alternative wheat product to form the concrete marketing and product development strategy based on recent consumer behavior trends.

Teff, Buckwheat, Quinoa and Amaranth: Ancient Whole Grain Gluten-Free Egg-Free Pasta

This report demonstrates innovative ancient whole grains, gluten-free, egg-free pasta (no chemicals added) made using a kitchen counter-top appliance. Whole grain, fusilli pasta was prepared with teff, buckwheat, quinoa and amaranth flours. These ancient grains are called “Super Foods” due to their ideal essential amino acids and mineral profiles. Dough formulations contained 95% whole grain flour and 5% guar gum. Taste panels of 62 in-house volunteers judged amaranth pasta significantly (p ≤ 0.05) higher in color/appearance than other pastas tested. Odor/aroma of buckwheat pasta and texture/mouth-feel of teff pasta were significantly better than quinoa and amaranth pasta. Acceptance and taste/flavor of teff and buckwheat pasta were similar and significantly higher than quinoa and amaranth pasta (teff = buckwheat > quinoa > amaranth). The USDA food guide recommends that at least 1/2 of all the grains eaten should be whole grains. The FDA allows food Health Claim labels for food containing 51% whole gains and 11 g of dietary fiber per serving. Novel health promoting whole grain, good source of protein, gluten-free, egg-free (no chemicals added) pasta had acceptance of teff 87%, buckwheat 82%, quinoa 61% and amaranth 15%. Amaranth pasta needs improvement in several sensory attributes by fortification, processing and/or use of other cultivars for the desired results. Ancient whole grain, gluten-free, egg-free pasta would increase whole grain consumption and offer a healthy option to vegetarians as well as to gluten sensitive individuals.

Ancient Whole Grain Gluten-Free Flatbreads

This is the only report demonstrating innovative ancient whole grain gluten-free (no yeast or chemicals) products. Ancient whole grain gluten-free flatbreads were prepared with quinoa, teff, amaranth and buckwheat flours. Dough formulations contained flour, salt and water. Ingredients were mixed for 5 min using table top Kitchen Aid mixer at stir setting 1. Dough was equilibrated for 30 min. 65 g of dough was placed between two sheets of nonstick parchment paper and pressed to 17 cm round flatbreads in a Tortilla Chapatti Press. Each flatbread was cooked for two minutes (one minute each side) in using Flatbread Maker. Taste panels of 64 inhouse volunteers determined that Taste/Flavor of quinoa, teff and amaranth flatbreads were similar and significantly (P ≤ 0.05) better than those for buckwheat flatbread. The taste panel determined ancient whole grain gluten-free flatbreads had acceptance of quinoa 84%, teff 72%, amaranth 66% and buckwheat 38%. Each ancient whole grain gluten-free flatbread contained 25 - 30 g whole grain and 4 - 5 g protein. Quinoa, teff and amaranth one flatbread contained 2 - 3 g dietary fiber, whereas buckwheat flatbread contained 8 g dietary fiber. Consuming two whole grain gluten-free flatbreads with two meals (total = 4) would give 4 - 32 g of dietary fiber. The USDA food guide recom mends that at least 1/2 of all the grains eaten should be whole grains. The FDA allows food Health Claim labels for food containing 51% whole gains and 11 g of dietary fiber. The gluten sensitive individuals would enjoy tasty, health promoting, ancient whole grain easy to make flatbreads. These recipes offer consumers additional nutritious gluten-free choices and would lead to in crease in whole grain consumption.

Whole Grain Gluten-Free High Protein Vegetable Snacks of Buckwheat Peanut Meal and Kale

Whole grain gluten-free high protein vegetable snacks were evaluated. The snacks were Buckwheat-Peanut Meal-Kale (BPK), BPK-Garlic, BPK-Onion and BPK-Ginger. Peanut meal was utilized to increase the protein content of these snacks as well as to add value to this agricultural byproduct. Snack dough was prepared using water nearly 1:1 as other as is ingredients. About 20 g of snack dough was placed on preheated KrumKake Express 839 Baker and cooked for 2 minutes. Sixty-nine in-house volunteers judged Color/Appearance and Texture/Mouth feel to be similar for the snacks tested. Taste/Flavor for BPK, BPK-Garlic and BPK-Onion snacks was similar and significantly higher (p ≤ 0.05) than for BPK-Ginger snacks. Odor/Aroma for BPK-Garlic snacks was significantly higher than for BPK-Ginger snacks. Acceptance for BPK and BPK-Garlic snacks was significantly higher than for BPK-Ginger snacks. Ex-pansion 3.6 - 4.2, porosity 0.72 - 0.75 and water activity 0.35 - 0.38 suggests that the snacks tested were light, crispy and have good anti-microbial stability. Acceptance was BPK and BPK-Garlic 94%, BPK-Onion 86% and BPK-Ginger 78%. These snacks contained only 3 - 4 ingredients and could be made in any house hold kitchen and/or in commercial production. Acceptance of 78% - 94% is very desirable. These whole grain gluten-free high protein vegetable healthy nutritious tasty snacks offer choice for all consumers, including individual’s sensitive to gluten.

Cardiometabolic risk factors in children with celiac disease on a gluten-free diet

Celiac disease(CD) is an immune-mediated systemic condition evoked by gluten and related prolamines in genetically predisposed subjects. It is characterised by a variable combination of gluten-dependent clinical symptoms, CDspecific antibodies, HLA-DQ2 and HLA-DQ8 haplotypes, and enteropathy. The only therapy of CD consists of a life-long gluten free diet(GFD). Strict GFD adherence results in full clinical, serological and histological remission, avoiding long-term complications in CD patients. However, this diet is not without problems. Gluten free products have high levels of lipids, sugar and salt to improve food palatability and consistency, and subjects with CD show an excessive consumption of hypercaloric and hyperlipidic foods to compensate dietetic restriction. GFD may therefore have a negative impact on cardiometabolic risk factors such as obesity, serum lipid levels, insulin resistance, metabolic syndrome, and atherosclerosis. In adults, some studies have suggested that GFD have a beneficial effect on cardiovascular profile, whereas others have shown an atherogenic effect of GFD. In children, very few studies are available on the issue. Thus, the aim of the present narrative review was to analyze the current clinical evidence on the impact of GFD on cardiometabolic risk factors in children with CD.

Market Capturing and Business Expansion Strategy for Gluten-Free Foods in India and USA Using PESTEL Model

The ultimate goal for any business is to grow vertically and horizontally. Successful business is combination of careful analysis of external and internal factor of business environment and adoption of appropriate business strategy. In this study external factors of gluten-free market are studied in detail through PESTEL model (for external factors). The study would facilitate manufacturers to bring gluten-free foods from niche market to main stream market and to make it more affordable for all the sections of the society. The study focuses on markets of India and USA, since both of these nations have high potential for gluten-free foods and the demand further continues to increase every year.