Hábitos alimentares e estado nutricional de pacientes com doença celíaca do sul do Brasil / Eating habits and nutritional status of patients with celiac disease in south brazil

ABSTRACT Background: Celiac disease is defined as a chronic autoimmune disease that affects the small intestine in genetically predisposed people, triggered by exposure to gluten. The only treatment for celiac disease to date is a lifelong gluten-free diet. Eating habits of celiacs play an important role in their nutritional status. Objective: To evaluate the eating habits and nutritional status of patients with celiac disease in Rio Grande do Sul. Methods: This is a cross-sectional study with patients diagnosed with celiac disease residing in Rio Grande do Sul (Brazil) over 18 years of age. An online questionnaire was applied with calls through social networks and also by the Associação dos Celíacos do Brasil - Rio Grande do Sul Section. Sociodemographic data, history of celiac disease, general medical history, reported weight and height and food consumption data (SISVAN food frequency questionnaire and general questions) were collected. Results: The sample consisted of 142 individuals with a mean age of 39.75±11.5 years, 94.4% were women and 93% were white. The patients showed care regarding a gluten-free diet, with the majority not ingesting gluten (82.2%) and being careful regarding cross-contamination by gluten in their homes (85.9%) and in restaurants (62, 4%). Most patients also had good eating habits, with frequent consumption of fruits, vegetables, meats, eggs and low frequency of processed foods and fats. Body weight before and after the diagnosis of celiac disease did not show significant changes (62.3±13.8 versus 63.6±11.7 kg; P=0.147); however, there was an improvement in the classification of nutritional status by body mass index (malnourished: 11.6% before versus 2.3% after; P=0.016). Conclusion: Most celiac disease patients in this study have good eating habits with a balanced gluten-free diet and improved nutritional status after diagnosis according to body mass index classification.

RESUMO Contexto: A doença celíaca é definida como uma doença crônica autoimune que afeta o intestino delgado em pessoas geneticamente predispostas, desencadeada pela exposição ao glúten. O único tratamento para doença celíaca até o momento é uma dieta isenta de glúten por toda a vida, levando em consideração que os hábitos alimentares de celíacos desempenham um papel importante em seu estado nutricional. Objetivo: Avaliar os hábitos alimentares e o estado nutricional de pacientes com doença celíaca do Rio Grande do Sul. Métodos: Trata-se de um estudo transversal com 142 pacientes com diagnóstico de doença celíaca residentes no Rio Grande do Sul (Brasil) e maiores de 18 anos. Para realização deste estudo, foi aplicado um questionário on-line com divulgação através de redes sociais e também pela Associação dos Celíacos do Brasil - Seção Rio Grande do Sul. Foram coletados dados sociodemográficos, histórico da doença celíaca, história clínica geral, peso e altura referidos e dados de consumo alimentar através de questionário de frequência alimentar do SISVAN e questões gerais. Resultados: A amostra foi constituída por 142 indivíduos com idade média de 39,75±11,5 anos, sendo 94,4% mulheres e 93% de etnia branca. Os participantes apresentaram cuidados em relação a dieta isenta de glúten, sendo que a maioria não ingere glúten (82,2%) e possuem cuidados em relação a contaminação cruzada por glúten em suas casas (85,9%) e em restaurantes (62,4%). A maioria da amostra também apresentou bons hábitos alimentares, com o consumo frequente de frutas, legumes, verduras, carnes, ovos e pouco frequente de industrializados e gorduras. O peso corporal antes e após o diagnóstico de doença celíaca não apresentou mudanças significativas (62,3±13,8 versus 63,6±11,7 kg; P=0,147); entretanto, houve melhora na classificação do estado nutricional pelo índice de massa corporal (11,6% versus 2,3% de desnutridos; P=0,016). Conclusão: A maioria dos pacientes com doença celíaca deste estudo apresentam bons hábitos alimentares com uma dieta isenta de glúten balanceada e com melhora do estado nutricional após o diagnóstico de acordo com a classificação do índice de massa corporal.

Clinical spectrum & changing presentation of celiac disease in Indian children

Background & objectives: Celiac disease (CD) is a genetic immune mediated disorder characterised by gluten intolerance. This single centre study, from north India was aimed to assess the clinical, serological and histological profile of CD in a large cohort of children and the changing trends in its presentation. Methods: A review of clinical details of CD children diagnosed between 2000 and 2019 and currently on follow up was performed. Information on demography, symptoms, associated conditions, serology, biopsy findings and gluten-free diet were analyzed. Results: The mean age (±standard deviation) of 891 children included in the study, at onset and at diagnosis was 4.0±2.7 and 6.2±3.1 yr, respectively. Growth faltering, abdominal pain, abdominal distension and diarrhoea were presenting symptoms in 70, 64.2, 61.2 and 58.2 per cent, respectively. A positive family history of CD was present in 14 per cent and autoimmune conditions in 12.3 per cent of children. Thyroid disorders were seen in 8.5 per cent of children and Type 1 diabetes mellitus (T1DM) in 5.7 per cent. The duration of breastfeeding had a weak positive correlation with age at onset and diagnosis of CD (P<0.001). Non-classical CD was significantly more common in children aged >10 yr and in those presenting after 2010 (P<0.01). T1DM and hypothyroidism occurred more frequently in non-compliant children. Interpretation & conclusions: This was the largest single centre study, pertaining to the presentation and follow up of CD in children. Infants and young children were more likely to present with classical symptoms of diarrhoea, abdominal distension and growth failure while older children presented with non-classical CD. There was a trend towards non-classical forms of CD in recent years.

Coeliac disease knowledge and treatment: Potential factors associated with adherence to gluten-free diet

@#Introduction: Lack of adherence to a strict gluten-free diet (GFD) is the main reason for poorly controlled disease in patients with coeliac disease (CD). This study aimed to assess the association between knowledge of CD and its medical diet to the adherence of GFD among adult patients with CD. Methods: A cross-sectional study was carried out with a total of 90 adult patients with CD (aged between 18-65 years). The data collecting instruments were a combination of four questionnaires as follows: assessment of knowledge of coeliac disease (AKCD), gluten-free diet knowledge scale (GFD-KS), coeliac disease adherence test (CDAT), and questions on potential factors influencing GFD adherence among patients. Results: An average knowledge score of five points out of seven was obtained from 46 participants (51%). Mean score for knowledge on gluten-free diet was seven points out of 17 in 59 participants (65%). Adequate adherence to GFD was observed in 56% of the participants. No association was found between knowledge of CD and GFD to the adherence of GFD (p>0.050). Participants who had higher adherence scores were discussing GFD with a specialist, obtaining educational materials, had enhanced symptoms associated with CD, and did not complain about the taste of GFD (p<0.050). Conclusion: Patients with CD has adequate knowledge of CD and adherence of GFD. No association was found between the knowledge of CD and GFD to the adherence of GFD. Further research might explore other potential factors influencing the adherence to GFD.

Does a Gluten-free Diet Improve Metabolic Syndrome Parameters? A Systematic Review

Abstract To review scientific evidence on the effects of a gluten-free diet on body composition and improvement of clinical and biochemical parameters of metabolic syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes - PRISMA guidelines were followed. A literature search was performed in the PubMed, ScienceDirect, Trip Database, Bireme and Scielo databases, without language restriction, until March 2021. The terms "gluten-free diet", "obesity", "metabolic syndrome", and "weight loss", and Boolean operators (AND/OR) were used. The clinical hypothesis was structured according to the acronym PICOT. Randomized clinical trials with adult and elderly humans without a diagnosis of celiac disease, consuming a gluten-free diet, evaluating associations of the effects of this diet on weight loss and metabolic syndrome components were considered eligible. To assess the risk of bias, the RoB2 was used. A total of 3,198 articles were identified and, after the screening and evaluation of pre-defined eligibility criteria, four studies were included in the qualitative analysis. Weight loss was not associated with a gluten-free diet. However, individuals under a gluten-free diet had lower mean waist circumference, fat percentage (-2.3%) and serum triglyceride levels. The impact of a gluten-free diet on metabolic syndrome parameters is still controversial. In individuals without gluten sensitivity or celiac disease, the consumption of a gluten-free diet appears to provide no nutritional benefit.

Evaluación del contenido, dializabilidad y aporte potencial de hierro, zinc y calcio en panificados libres de gluten elaborados a partir de premezclas comerciales / Evaluation of the content, dialyzability and potential contribution of iron, zinc and calcium in gluten-free bakery products made from commercial premixes

Resumen La población que debe consumir una dieta libre de gluten de por vida se encuentra en constante aumento. Es importante que la misma no sea deficiente en nutrientes, entre ellos, los minerales. En el presente trabajo se evaluó el contenido, dializabilidad, aporte potencial y porcentaje de cobertura del requerimiento diario de hierro, zinc y calcio en bizcochuelos, panes, galletitas y pizzas libres de gluten elaborados a partir de premezclas comerciales. Estos contenidos se compararon con un homólogo elaborado con harina de trigo enriquecida con sulfato ferroso. Se empleó un método in vitro con posterior cuantificación por espectroscopía de absorción atómica. Si bien se observó una amplia variación en los contenidos de los tres minerales para los cuatro grupos de alimentos elaborados a partir de premezclas, las dializabilidades porcentuales fueron bajas. Los porcentajes de cobertura de los requerimientos diarios de hierro, zinc y calcio resultaron muy bajos, a excepción del hierro de las pizzas cuyas coberturas por porción fueron considerables. Los resultados obtenidos para hierro en los homólogos reflejan el impacto del enriquecimiento de la harina de trigo con sulfato ferroso. Sería conveniente contemplar la utilización de harinas de pseudocereales para mejorar su calidad mineral, así como evaluar la implementación de políticas públicas para que la población que debe consumir alimentos libres de gluten tenga acceso a alimentos enriquecidos, como ocurre con la harina de trigo.

Abstract The number of people that must consume a gluten-free diet is constantly increasing. It is, however, important that this diet is not deficient in nutrients, in particular some key minerals. The present work focuses on the contents of iron, zinc and calcium in gluten-free sponge cakes, breads, cookies and pizzas made from commercial premixes. Other properties analysed were the dialyzability, the potential contribution and the percentage of coverage of the daily requirement of the mentioned minerals in each of the products. These properties were contrasted and compared with those of equivalent products elaborated with wheat flour enriched with ferrous sulfate. An in vitro methodology of mineral bioavailability was utilised, with subsequent quantification by atomic absorption spectroscopy. Even though a wide variation in the three minerals' content in each of the four products was observed, the percentage of dialysability was low. In terms of meeting the daily requirements, only the iron in the pizzas covered a considerable proportion. In all the other cases only very small parts of the daily requirements were covered. The results obtained for iron in the equivalent products reflect the impact of the enrichment of wheat flour with ferrous sulfate. It would be convenient to contemplate the use of pseudocereal flours to improve their mineral quality. In addition, it would be advisable to evaluate the implementation of public policies so that the population that should consume gluten-free foods has access to enriched foods, as is the case with wheat flour.

Resumo A população que deve consumir uma dieta sem glúten por toda a vida está aumentando constantemente. É importante que ela não seja deficiente em nutrientes, incluindo minerais. No presente trabalho foram avaliados o conteúdo, dialisabilidade, contribuição potencial e porcentagem de cobertura da necessidade diária de ferro, zinco e cálcio em bolos, pães, biscoitos e pizzas sem glúten elaborados com pré-misturas comerciais. Esses conteúdos foram comparados com uma contraparte feita com farinha de trigo enriquecida com sulfato ferroso. Foi utilizado um método in vitro com posterior quantificação por espectroscopia de absorção atômica. Embora se tenha observado uma grande variação no conteúdo dos três minerais para os quatro grupos de alimentos elaborados a partir de pré-misturas, as dialisabilidades porcentuais foram baixas. Os percentuais de cobertura das necessidades diárias de ferro, zinco e cálcio foram muito baixos, com exceção do ferro das pizzas cuja cobertura por porção foi considerável. Os resultados obtidos para o ferro nos homólogos refletem o impacto do enriquecimento da farinha de trigo com sulfato ferroso. Seria conveniente contemplar o uso de farinhas de pseudocereais para melhorar sua qualidade mineral, bem como avaliar a implementação de políticas públicas para que a população que deve consumir alimentos sem glúten tenha acesso a alimentos enriquecidos, como acontece com a farinha de trigo.

High protein, gluten-free cookies made with rice, beans and avocado

Cookies are versatile foods that can supply specific needs and can be used as food vehicles to increase the intake of various nutrients. The objective was to create a gluten-free butter cookie based on rice flour (Oryza sativa). A central composite design 22 was used for analyzing the substitution of rice flour for bean flour (Phaseolus vulgaris, L.) (0-60%) and the substitution of butter for avocado puree (Persea americana) (0-100%). Response Surface Methodology were used to analyze the data with a significance of 10% (p<0.1) and a minimum R2 of 0.6. Variables analyzed were protein content (%), fat content (%), spread ratio, weight loss (%), water activity, moisture content (%), and ash content (%). Increases in the percentage of substitution of bean flour and avocado puree increased the amount of protein, ash, and moisture significantly. Fat content increased significantly following the decrease in avocado substitution. The minimum weight loss was obtained on intermediate values of bean flour. Water activity and spread ratio were not affected by changes in the variables measured. Three different formulas were obtained for the optimization: 46% bean flour and 86% of avocado puree, a formulation with an appropriate moisture range by reducing the lipid oxidation (59% bean flour and 82% avocado puree), and a formulation with 100% avocado (40% bean flour and 100% avocado puree). Sensory evaluation results of optimized treatments indicated that the formula with 46% bean flour and 86% avocado puree presented the highest global acceptance. Results from this study showcase the possibility of producing gluten-free cookies with good protein content.

Las galletas son alimentos versátiles que pueden suplir necesidades específicas y ser utilizados como vehículos para aumentar la ingesta de distintos nutrientes. El objetivo fue elaborar galletas de mantequilla libres de gluten a base de harina de arroz. Se realizó un diseño central compuesto 22 donde se estudió la sustitución parcial de harina de arroz por harina de frijol (Phaseolus vulgaris, L.) (0-60%) y la sustitución de la mantequilla por puré de aguacate (Persea americana) (0-100%). Los resultados fueron analizados por la Metodología de Superficie de Respuesta con un nivel de significancia del 10% (p<0.1) y con un mínimo R2 de 0.6. Las variables de respuesta fueron: proteína (%), grasa (%), diámetro/altura, pérdida de peso (%), humedad (%) y cenizas (%). A valores altos de las dos variables estudiadas la cantidad de proteína, de cenizas y de humedad aumentó significativamente. La cantidad de grasa se incrementó al utilizar bajos niveles de puré de aguacate. Los menores valores de pérdida de peso se obtuvieron en niveles intermedios de harina de frijol. La relación diámetro/altura no fue afectada por las variables estudiadas. Al optimizar se obtuvieron 3 formulaciones diferentes: 46% de harina de frijol y 86% puré de aguacate; 59% de frijol y 82% de puré de aguacate y otra (no estadística) 40% de frijol y 100% de puré de aguacate. Los resultados del análisis sensorial de las muestras optimizadas indicaron que la formulación con mayor aceptación global fue la elaborada con 46% de harina de frijol y 86% de puré de aguacate, concluyendo que es posible elaborar una galleta libre de gluten y con una adecuada cantidad de proteína.

Dermatitis herpetiforme: manifestación específica de la enfermedad celiaca / Dermatitis herpetiformis: specific manifestation of celiac disease

Resumen La enfermedad celíaca es un trastorno sistémico con base autoinmune, secundario a la exposición continua al gluten en personas con susceptibilidad genética, que lleva a desarrollo de anticuerpos específicos, afectando principalmente el intestino delgado con la subsecuente enteropatía. Las manifestaciones clínicas incluyen síntomas digestivos y manifestaciones extra intestinales. En este último grupo se destacan las manifestaciones dermatológicas, específicamente la dermatitis herpetiforme, la cual es considerada específica de la enfermedad celíaca. Clínicamente, se presenta como un exantema papulovesicular pruriginoso. El diagnóstico se basa en la biopsia de piel con inmunofluorescencia directa y la presencia de anticuerpos anti-transglutaminasa tisular 2 y solo en casos específicos se debe complementar con otros estudios. El tratamiento se basa en dieta libre de gluten, que mejora la sintomatología, controla y previene las complicaciones de la enfermedad celíaca, como las neoplasias digestivas y el desarrollo de otras enfermedades autoinmunes.

Abstract Celiac disease is a systemic disorder with an autoimmune basis, secondary to continuous exposure to gluten in people with genetic susceptibility, which leads to the development of specific antibodies mainly affecting the small intestine with subsequent enteropathy. The clinical manifestations include digestive symptoms and extra intestinal manifestations. In this last group, the dermatological manifestations stand out, specifically dermatitis herpetiformis, which is considered specific to Celiac disease. It presents clinically as a pruritic papulovesicular rash. The diagnosis is based on a skin biopsy with direct immunofluorescence and the presence of anti-tissue transglutaminase 2 antibodies, only in specific cases it should be complemented with other studies. Treatment is based on a gluten-free diet, which improves symptoms, controls and prevents complications of Celiac disease, such as digestive neoplasms and the development of other autoimmune diseases.

Adherencia a la dieta sin gluten y calidad de vida en relación con la salud en los celiacos del Paraguay, 2021 / Adherence to a Gluten-Free Diet and Health-Related Quality of Life in Celiac Patients from Paraguay, 2021

Resumen Antecedentes: la calidad de vida en relación con la salud de las personas con enfermedad celiaca puede estar influenciada por la adherencia a la dieta sin gluten. Objetivos: describir las características demográficas y clínicas de los celiacos, evaluar la adherencia dietética con el cuestionario CDAT de Leffler y medir la calidad de vida autopercibida utilizando el cuestionario CD-QOL. Métodos y materiales: diseño observacional, transversal y prospectivo. Se aplicó una encuesta telemática a adolescentes y adultos de Paraguay diagnosticados con enfermedad celiaca, entre febrero y abril del año 2021, que accedieron a participar del estudio. La adherencia dietética se determinó con el cuestionario Celiac Dietary Adherence Test de Leffler y la calidad de vida con el CD-QOL de Dorn. Se midieron además variables demográficas y clínicas. La investigación fue aprobada por el Comité de Ética de la Universidad Privada del Este, en Paraguay. Resultados: la muestra estuvo constituida por 344 sujetos de estudio, de los cuales el 87 % pertenecía al sexo femenino. La edad media de los adolescentes fue de 15,1 años, y la de los adultos de 38±13 años. La adherencia a la dieta sin gluten se encontró en el 78 % (n=268) de los encuestados; fue buena en el 59 %, moderada en el 19 % y mala en el 22 % de los encuestados. La calidad de vida fue buena en el 30 % (n=103) de los sujetos y mala en el 70 % (n=241). Se encontró asociación entre los sujetos sin o mala adherencia a la dieta con la mala calidad de vida (p<0,006). Conclusión: en los celiacos estudiados, la mala adherencia a la dieta sin gluten se asocia con menor calidad de vida en relación con la salud.

Abstract Background: The health-related quality of life of people with celiac disease may be influenced by adherence to a gluten-free diet. Objectives: To describe the demographic and clinical characteristics of celiac patients, to evaluate dietary adherence with the Leffler CDAT questionnaire, and to measure self-perceived quality of life using the CD-QOL questionnaire. Material and Methods: Observational, cross-sectional, and prospective design. A telematic survey was applied to adolescents and adults in Paraguay, diagnosed with celiac disease, between February and April 2021, who agreed to participate in the study. Dietary adherence was determined with the Celiac Dietary Adherence Test of Leffler and quality of life with the test CD-QOL of Dorn. Demographic and clinical variables were also measured. The research was approved by the Ethics Committee of the Universidad Privada del Este, in Paraguay. Results: The sample consisted of 344 study subjects of which 87% belonged to the female sex. The mean age of the adolescents was 15 ±1 years, and that of the adults was 38 ±13 years. Adherence to a gluten-free diet was found in 78% (n=268) of those surveyed, it was good in 59%, moderate in 19%, and bad in 22%. The quality of life was good in 30% (n=103) of the subjects and bad in 70% (n 241). It was found an association between subjects with no or bad adherence to the diet with bad quality of life (p<0.006). Conclusion: In the celiac patients studied, poor adherence to the gluten-free diet is associated with worse health-related quality of life.

Sorghum, germinated millet and chia cookies: development, chemical composition and sensory analysis

The objective of this work was to develop cookies using sorghum, germinated millet and chia flours. Four formulations (F) were used: F-sorghum (100% sorghum flour); F-Sorghum + chia (50% sorghum flour and 50% chia flour), F-millet (100% millet flour) and F-millet + chia (50% millet flour and 50% chia flour). The germinated millet flour was submitted to microbiological analysis. All cookies were evaluated in relation to chemical and sensory analyses, according to AOAC and hedonic nine-point scale, respectively. The statistical analysis was performed by the variance analysis and Tukey test at 5% probability. The F-millet formulation showed the least humidity content (4.59 ± 0.25g/100g), while chia containing cookies showed lesser concentrations of carbohydrates (F-sorghum + chia: 44.35 ± 4.34g/100g and F-millet + chia: 41.03 ± 1.40g/100g) and higher ash content (F-sorghum + chia: 3.80 ± 0.02g/100g and F-millet + chia: 3.42 ± 0.24g/100g) and of protein (F-sorghum + chia: 15.38 ± 0.44 g/100g and F-millet + chia: 18.06 ± 0.53 g/100g). The caloric value and the lipids content did not differ among formulations. The sensory analysis had 57 evaluators. The cookies produced with chia and germinated millet had higher rates for flavor, texture and general impression. In general, all tested biscuits had good sensory acceptance and nutritional quality being an alternative to increase the consumption of bioactive compounds and antioxidants(AU)

El objetivo fue desarrollar galletas utilizando harina de sorgo, mijo germinado y chía. Se utilizaron cuatro formulaciones (F): F-sorgo (100% harina de sorgo); Sorgo F + chía (50% harina de sorgo y 50% harina de chía), mijo F (100% harina de mijo) y mijo F + chía (50% harina de mijo y 50% harina de chía). La harina de mijo germinada se sometió a análisis microbiológico. Las galletas fueron sometidas a análisis químico y sensorial, según la AOAC y una escala hedónica de nueve puntos, respectivamente. El análisis estadístico se realizó mediante análisis de varianza y prueba de Tukey al 5% de probabilidad. La formulación F-mijo tuvo menor contenido de humedad (4,59 ± 0,25 g/100g), mientras que las galletas que contenían chía tuvieron concentraciones más bajas de carbohidratos (F-sorgo + chía: 44,35 ± 4,34 g/100g y F-mijo + chía: 41,03 ± 1,40 g / 100g), mayor contenido de cenizas (F-sorgo + chía: 3,80 ± 0,02 g/100g y F-mijo + chía: 3,42 ± 0,24 g/100g) y proteínas (F-sorgo + chía: 15,38 ± 0,44 g/100g y F mijo + chía: 18,06 ± 0,53 g/100g). El valor calórico y el contenido de lípidos no difirieron entre las formulaciones. El análisis sensorial contó con 57 evaluadores. Las galletas producidas con chía y mijo germinado tenían notas más altas de sabor, textura e impresión general. Las galletas testadas tuvieron buena aceptación sensorial y calidad nutricional, siendo una alternativa para incrementar el consumo de compuestos bioactivos y antioxidantes(AU)

Características clínicas, demográficas y acceso a los productos sin gluten de pacientes con enfermedad celíaca registrados en la FUPACEL / Clinical and demographic characteristics, and access to gluten free products of patients with celiac disease registered in the FUPACEL

La enfermedad celíaca (EC) es una enfermedad inflamatoria autoinmune que afecta la mucosa del intestino delgado que lleva a un estado de mal absorción en pacientes genéticamente susceptibles desencadenada por la ingesta de gluten. Tiene síntomas inespecíficos, complicaciones asociadas y no existe a nivel nacional una ley de apoyo económico para las personas con dificultad para seguir una dieta libre de gluten. El objetivo de este estudio observacional, descriptivo, de corte transversal fue describir las características clínicas, demográficas y acceso a productos sin gluten de 237 pacientes con enfermedad celíaca registrados en la Fundación Paraguaya de Celiacos (FUPACEL) en el 2020 y que aceptaron responder una encuesta en línea publicada en la página oficial de la FUPACEL. El 70,4% de los participantes era del sexo femenino, la edad de diagnóstico fue en el 34,5% entre 20-30 años, 48 % tenía algún familiar con EC, el 69,1% presentó distensión abdominal como sintomatología inicial, 16,8% presentó hipotiroidismo como patología asociada, y 42% fue hospitalizado al menos una vez. El 82,7% de los encuestados respondió que la dieta era suficiente como tratamiento, 48% tenía un trabajo y podía solventar los gastos, sin embargo, el 79,3% opinó tener acceso limitado a los productos sin gluten, el 92% que los alimentos sin gluten eran costosos y que se necesitaba una ley de apoyo económico para solventar los gastos. La mayoría reconoció que la dieta sin gluten como tratamiento era suficiente, sin embargo, por su alto costo se necesita una ley de apoyo económico para las personas con enfermedad celiaca

Celiac disease (CD) is an autoimmune inflammatory disease that affects the mucosa of the small intestine that leads to a state of malabsorption in genetically susceptible patients triggered by the ingestion of gluten. It has nonspecific symptoms, associated complications, and there is no national financial support law for people with difficulty following a gluten-free diet. The objective of this observational, descriptive, cross-sectional study was to describe the clinical, demographic characteristics and access to gluten-free products of 237 patients with celiac disease registered in the FUPACEL in 2020 who accepted to answer a online survey published in the official FUPACEL webpage. Seventy-point four percent of the patients were female, their age of diagnosis was between 20-30 years in 34.5%, 48% had relatives with CD, 69.1% presented abdominal distension as initial symptoms, hypothyroidism was present in 16.8% as associated pathology, and 42% were hospitalized at least once. Eighty-two-point seven percent of those surveyed answered that diet was sufficient as a treatment, 48% had a job and could afford expenses, however, 79.3% said they had limited access to gluten-free products, 92% that gluten-free foods were expensive and a financial support law was needed to cover the costs. Most recognized that a gluten-free diet as a treatment was sufficient, however, due to its high cost, a law of financial support is needed for people with celiac disease

Factores que limitan la adherencia a la dieta y la calidad de vida en enfermos celiacos chilenos durante COVID-19 / Factors that limit adherence to diet and quality of life in Chilean celiac patients during COVID-19

La enfermedad por coronavirus (COVID-19) es altamente contagiosa y las medidas de confinamiento dinámico han demostrado que reducen significativamente el número de contagios, sin embargo, pueden alterar la disponibilidad de alimentos afectando la adherencia a la dieta libre de gluten (DLG) y la calidad de vida (CV) en la enfermedad celiaca (EC). El objetivo de este estudio fue evaluar los factores que limitan, la adherencia a la dieta libre de gluten y la calidad de vida en personas con enfermedad celiaca en periodo de pandemia por COVID-19. Métodos Se aplicaron encuestas on-line respecto a adherencia a la DLG, CV y acerca de los factores que han generado dificultad para llevar una DLG en este escenario. Resultados Se analizaron 216 encuestas de enfermos celiacos, mayores de 15 años, de los cuales un 91% eran mujeres con un promedio de edad de 36 + 10,7 años y con 5,8 + 6,0 años de enfermedad. El 56,48% tenía una excelente adherencia a la DLG y un 43,52% una buena CV. El costo elevado de los alimentos sin gluten fue la pregunta con mayor porcentaje de respuesta, asociándose con regular y mala adherencia a la DLG (valor p=0,001) y con pobre CV (valor p=0,023). Conclusión En periodo de pandemia por COVID-19, el costo de los alimentos se asocia con adherencia regular y mala a la DLG y con pobre CV(AU)

Coronavirus disease (COVID-19) is highly contagious and dynamic confinement measures have shown to significantly reduce the number of infections, however, they can alter the availability of food, affecting adherence to a gluten-free diet (GFD) and quality of life (QoL) in celiac disease (CD). The objective of this study was to evaluate the limiting factors, adherence to a gluten-free diet and quality of life in people with celiac disease in a COVID-19 pandemic period. Methods. On-line surveys were applied regarding adherence to the GFD, CV, and factors that have generated difficulty in carrying out a GFD in this setting. Results. 216 surveys of celiac patients over 15 years of age were analyzed, of which 91% were women with an average age of 36 + 10.7 years and with 5.8 + 6.0 years of the disease. 56.48% had excellent adherence to the GFD and 43.52% had a good QoL. The high cost of gluten-free foods was the question with the highest response percentage, associated with regular and poor adherence to the GFD (p-value = 0.001) and with poor QoL (p-value = 0.023). Conclusion. In a COVID-19 pandemic period, the cost of food is associated with regular and poor adherence to the GFD and with poor QoL(AU)

Refractory celiac disease type 2: how to diagnose and treat?

SUMMARY Refractory celiac disease is an uncommon condition which might be associated to poor prognosis. It is often treated with immunosuppressive medications, with poor results. It is divided in type 1 and type 2, the latter carrying a high risk for lymphoma and mortality. A case of a 41 year old female patient with refractory celiac disease type 2 is reported. She was treated with oral budesonide for six months, achieving histological remission.

Proximate composition and kinectics drying of sweet pine nuts compared to typical nuts of Araucaria angustifolia / Composição proximal e cinética de secagem de pinhões doces e pinhões típicos de Araucaria angustifolia

ABSTRACT: The objective of this research was to determine the proximate composition and kinetics drying of sweet pine nuts compared to typical pine nuts of Araucaria angustifolia. This study is based on the proximate components, color, and duration of pine nuts drying of both types, and the influence of temperature and cutting geometry on the dehydration process. Sweet pine nuts had lower calorific value and carbohydrate content, but higher lipid, dietary fiber, protein, and ash contents when compared to typical pine nuts. Color of sweet pine nuts is light pink whereas the typical pine nut is yellowish-white. Sweet pine nuts were also softer. Drying kinetics of the seeds fit well into the logistic and Thompson models. To accelerate drying rates, we recommend slicing pine nuts into thin cross-sections and drying them at temperatures of 60 °C for typical pine nuts and 70 °C for sweet pine nuts.

RESUMO: O objetivo deste trabalho foi determinar a composição centesimal e a cinética de secagem de pinhões doces em comparação com pinhões típicos de Araucaria angustifolia. Este estudo baseia-se na composição centesimal, cor e duração da secagem dos pinhões de ambos os tipos e na influência da temperatura e da geometria de corte no processo de desidratação. Os pinhões doces apresentaram menor valor calorífico e conteúdo de carboidratos. Por outro lado, apresentaram maior teor de lipídios, fibras alimentares, proteínas e cinzas quando comparados aos pinhões típicos. A cor dos pinhões doces é rosa claro, enquanto o pinhão típico é branco amarelado. Os pinhões doces também são mais macios. A cinética de secagem das sementes se enquadra bem nos modelos logístico e de Thompson. Para acelerar as taxas de secagem, recomendamos fatiar os pinhões em seções finas e secá-los a temperaturas de 60 °C para pinhões típicos e 70 °C para pinhões doces.

Enrichment of Gluten-free Cakes with Grape Molasses and Bioactive Rich Ingredients

Abstract In this study, the sugar used in the gluten-free cake was substituted with 75% grape molasses. In addition, the gluten-free flour mixture used in the cake formulation was prepared as a combination of rice flour (75%), chickpea flour (15%)and carrot flour (10%). This mixture was replaced separately with 5% grape seed, pomegranate seed, flaxseed, poppy seed and turmeric to improve the nutritional composition of gluten-free cakes. Supplemented cakes contained higher ash, crude protein, total phenolic content and antioxidant activity values than gluten-free control sample. Cake samples containing pomegranate seed and flaxseed had higher contents of Ca, P and K than control cakes. In addition, flaxseed and poppy seed containing cakes were found richer in terms of Mn and Mg than control. Utilization of grape molasses together with grape seed, pomegranate seed, flaxseed, poppy seed and turmeric in formulation caused a reduction in volume index of cake samples. The hardness values of the gluten-free cakes were generally higher than that of the control. Cakes containing flaxseed and poppy seed scored higher in sensory analysis than other substituted samples. Based on these results, the use of grape molasses with flaxseed and poppy seed can be recommended for the production of gluten-free cakes with acceptable sensory properties and high total phenolic content and antioxidant activity.

Aporte de energía, macronutrientes y fibra de alimentos farináceos libres de gluten elaborados a partir de premezclas comerciales / Energy, macronutrients and fiber contribution of gluten free farinaceous products produced from commercial premix

Resumen La dieta libre de gluten (DLG) es el único tratamiento frente a la enfermedad celíaca, la alergia al trigo y la sensibilidad al gluten no celíaca. Se reporta a la DLG como una dieta desbalanceada, escasa en fibra y alta en grasas y carbohidratos. El objetivo del estudio fue evaluar el aporte de energía, de macronutrientes y de fibra de alimentos libres de gluten (bizcochuelos, panes estilo inglés, galletitas dulces y pizzas) elaborados a partir de diferentes premezclas comerciales, disponibles en el mercado local. Además, los resultados fueron comparados con un homólogo comercial elaborado con harina de trigo. Para la determinación de la composición centesimal se aplicó la metodología oficial AOAC 2016. El valor energético se calculó utilizando los factores de Atwater. Los resultados obtenidos para los bizcochuelos fueron: 6,0-8,3 g% de proteína; 9,2-11,3 g% de grasas; 1,5-2,3 g% de fibra dietaria; 40,0-53,1 g% de carbohidratos y 285-339 Kcal% de valor energético. Para los panes: 3,0-6,6 g% de proteína; 3,1-12,7 g% de grasas; 2,7-4,0 g% de fibra dietaria; 36,8-50,1 g% de carbohidratos y 217-290 Kcal% de valor energético. Para las galletitas: 3,5-8,5 g% de proteína; 25,9-31,0 g% de grasas; 0,9-5,9 g% de fibra dietaria; 53,9-60,1 g% de carbohidratos y 483-527 Kcal% de valor energético. Para las pizzas: 7,4-9,3 g% de proteína; 7,3-11,2 g% de grasas; 2,8-8,0 g% de fibra dietaria; 19,1-29,6 g% de carbohidratos y 172-240 Kcal% de valor energético. Los alimentos elaborados con premezclas formuladas únicamente con harina de arroz y féculas contribuyen poco a cubrir el valor diario recomendado de fibra. Los que contienen otras fuentes farináceas (harina de sorgo, trigo sarraceno y teff) reflejan un mayor contenido de fibra. La presencia de harina de arveja, soja y teff refleja un aumento del contenido proteico. Los alimentos estudiados frente a su homólogo comercial con harina de trigo presentan, en general, igual o menor aporte proteico, similar aporte energético y de carbohidratos y un mayor aporte de grasas y fibra dietaria.

Abstract The gluten free diet (GFD) is the only treatment for celiac disease, wheat allergy and non-celiac gluten/wheat sensitivity. GFD is reported as an unbalanced diet, low in fibre and high in fat and carbohydrates. The aim of this study was to evaluate energy, macronutrients and fiber contribution of gluten-free cereal products (pound cake, tin loaf, cookies and pizza) coming from different commercial premixes, available at the local market. Also, the results were compared with a commercial equivalent made with wheat flour. For centesimal composition determination, AOAC Official Method 2016 was applied. The energy was calculated using Atwater factors. The results obtained for pound cake were: 6.0-8.3g% protein; 9.2-11.3g% fat; 1.5-2.3g% dietary fibre; 40.0-53.1g% carbohydrate and 285-339Kcal% energy. For tin loaf: 3.0-6.6g% protein; 3.1-12.7% fat; 2.7-4.0g% dietary fibre; 36.8-50.1g% carbohydrate and 217-290Kcal% energy. For cookies: 3.5-8.5g% protein; 25.9-31.0g% fat; 0.9-5.9g% dietary fibre; 53.9-60.1g% carbohydrate and 483-527Kcal% energy. For pizza: 7.4-9.3g% protein; 7.3-11.2g% fat; 2.8-8.0g% dietary fibre; 19.1-29.6g% carbohydrate and 172-240Kcal% of energy. Products made with premix that only contains rice flour and starches contribute little to meeting recommended daily intake. The ones that contain other farinaceous sources (sorghum flour, buckwheat and teff) show higher dietary fibre content. The presence of pea flour, soybean and teff show an increase of protein content. The analysed products present same or lower protein intake, similar energy and carbohydrate intake and higher fat and dietary fibre intake, compared to their commercial equivalent made with wheat flour.

Health control for celiac patients: an analysis according to the Pender Health Promotion model / Control de la salud en celíacos: un análisis según el modelo de Promoción de la Salud de Pender / Controle de saúde de celíacos: análise segundo o modelo de Promoção da Saúde de Pender

ABSTRACT Objectives: to describe the health control habits that influence the daily life of celiac patients and to analyze the practice of actions related to health control and its determinants, from the perspective of the first component of the Pender Health Promotion Model. Method: a cross-sectional study conducted through interviews with instrument with 83 individuals from Ceará and diagnosed with celiac disease. Data was analyzed using the characteristics and individual experiences component of Pender's theoretical model. Results: of the celiac patients, 96.4% did not follow the gluten-free diet; 80.7% had inappropriate behaviors to reduce risk factors; 72.3% made ineffective choices in daily life to achieve health goals and; and 25.3% could not keep the gluten free diet in their daily life. Conclusion: according to the theoretical model, celiac patients did not adhere to the proper diet and presented factors inherent to daily life and social issues, characterized as barriers to an effective health control.

RESUMEN Objetivos: describir los hábitos de control de la salud que influyen sobre la vida diaria de los celíacos y analizar la práctica de acciones relacionados con el control de la salud y sus factores determinantes, bajo la óptica del primer componente del Modelo de Promoción de la Salud de Pender. Método: estudio transversal realizado a través de entrevistas con instrumento con 83 individuos del estado de Ceará diagnosticados con la enfermedad celíaca. Los datos se analizaron mediante el componente de características y experiencias individuales del modelo teórico de Pender. Resultados: de los celíacos, el 96,4% no seguía la dienta sin gluten; el 80,7% presentaba comportamiento inadecuados para reducir factores de riesgo; el 72,3% realizaba elecciones ineficaces en la vida diaria para alcanzar las metas de salud y el 25,3% no lograba mantener la dieta sin gluten en su vida diaria. Conclusión: de acuerdo con el modelo teórico, los celíacos no respetaban la dieta adecuada y presentaron factores inherentes a la vida diaria y a las cuestiones sociales, caracterizados como obstáculos para un control eficaz de la salud.

RESUMO Objetivos: descrever os hábitos de controle de saúde que influenciam no cotidiano dos celíacos e analisar a prática de ações relacionadas ao controle da saúde e seus determinantes, sob o prisma do primeiro componente do Modelo de Promoção da Saúde de Pender. Método: estudo transversal, realizado com 83 indivíduos com diagnóstico de doença celíaca, do Estado do Ceará, através de entrevistas com instrumento. Os dados foram analisados mediante o componente características e experiências individuais do modelo teórico de Pender. Resultados: dos celíacos, 96,4% não seguiam a dieta isenta de glúten; 80,7% possuíam comportamentos inadequados para reduzir fatores de risco; 72,3% faziam escolhas na vida diária ineficazes para atingir as metas de saúde; e 25,3% não conseguiam manter a dieta isenta de glúten na sua vida diária. Conclusão: de acordo com o modelo teórico, os celíacos não aderiam à dieta adequada e apresentaram fatores inerentes ao cotidiano e às questões sociais, caracterizados como barreiras para o controle eficaz da saúde.

Detección de trazas de soja y de leche en productos libres de gluten: desarrollo de dos enzimoinmunoensayos competitivos / Detection of traces of soy and milk in gluten-free products: development of two competitive enzyme immunoassays / Detecção de vestígios de soja e leite em produtos livres de glúten: desenvolvimento de dois enzimoimunoensaios competitivos

Resumen El objetivo del presente trabajo fue el desarrollo de dos enzimoinmunoensayos competitivos (EIC) para la detección de trazas de soja y de leche en productos libres de gluten. Como anticuerpos primarios se utilizaron antisueros policlonales de conejo específicos contra proteínas de soja o de leche. Se determinaron las concentraciones óptimas de antígenos a inmovilizar en la placa y las concentraciones de anticuerpos primarios a utilizar en la competencia. Las curvas de calibración se ajustaron utilizando concentraciones crecientes de un extracto de producto de soja y de un extracto de leche descremada en polvo. El producto de soja y la leche descremada se extrajeron con buffer Tris-HCl 0,0625 M con dodecilsulfato de sodio al 3% y sulfito de sodio 0,1 M al 2%. Se evaluaron los parámetros de validación: linealidad, límites de detección y de cuantificación, recuperación y precisión en el día y entre días, los cuales resultaron adecuados. Se analizaron 9 productos libres de gluten con los EIC desarrollados y con kits de ELISA comerciales. Ambos EIC se comportaron de manera similar con respecto a los kits comerciales. Los EIC permitieron confirmar la presencia de leche en las muestras que la declaraban. En algunas muestras que no declaraban ni leche ni soja, ambos EIC detectaron su presencia (resultados confirmados con los kits comerciales). Los EIC desarrollados poseen menor costo que los kits y, por lo tanto, éstos podrían utilizarse como métodos de screening. Cuando esta metodología resulte negativa, debe confirmarse con un método más sensible (comercial) para garantizar la ausencia de proteínas de soja o de leche.

Abstract The aim of this study was to develop two competitive enzyme immunoassays (CEI) to detect the presence of traces of soy and milk in gluten-free products. Specific rabbit polyclonal antiserums against soy protein and other against elemilk protein were used as primary antibodies. Optimal antigen concentrations to be immobilized on the plate and primary antibody concentrations to be used in competition were determined. The calibration curves were fitted using increasing concentrations of an extract of soy product and of defatted milk powder. The soy product and the defatted milk were extracted with Tris-HCl buffer 0,0625 M with 3% sodium dodecyl sulfate and 2% sodium sulfite 0.1 M. The validation parameters were evaluated: linearity, limit of detection and quantification, recovery and precision on the day and in between days. They were appropriate. Nine commercial samples of gluten-free products were analyzed with these developed CEI and commercial ELISA kits. It was observed that both CEI behaved similarly with respect to the commercial kits. The enzyme immunoassays confirmed the presence of milk in samples that declared it. In some samples that did not declare the presence of milk or soy, both enzyme immunoassays detected their presence -these results were confirmed using commercial kits. The developed CEI have a lower cost than the commercial kits, so these could be used as screening methods. When this methodology is negative, it should be confirmed with a more sensitive (commercial) method to ensure the absence of soy or milk protein.

Resumo O objetivo do presente trabalho foi o desenvolvimento de dois enzimoimunoensaios competitivos (EIC), para a detecção de vestígios de soja e leite em produtos livres de glúten. Antissoros policlonais de coelho específicos contra proteínas de soja ou de leite foram utilizados como anticorpos primários. Foram determinadas as concentrações ótimas de antígenos a serem imobilizados na placa e as concentrações de anticorpos primários a serem utilizadas na competição. As curvas de calibração foram ajustadas usando concentrações crescentes de um extrato de produto de soja e de um extrato de leite em pó desnatado. O produto de soja e o leite desnatado foram extraídos com tampão Tris-HCl 0,0625 M com dodecil sulfato de sódio a 3% e sulfito de sódio 0,1 M a 2%. Os parâmetros de validação foram avaliados: linearidade, limite de detecção e quantificação, recuperação e precisão no dia e entre os dias, os quais resultaram adequados. Nove produtos livres de glúten foram analisados com os EIC desenvolvidos e com kits de ELISA comerciais. Os dois EICs se comportaram de maneira semelhante em relação aos kits comerciais. Os EIC permitiram confirmar a presença de leite nas amostras que o declararam. Em algumas amostras que declaravam nem leite nem soja, ambos os EIC detectaram sua presença (resultados confirmados usando kits comerciais). Os EIC desenvolvidos têm um custo menor que os kits, portanto, eles poderiam ser utilizados como métodos de triagem. Quando esta metodologia é negativa, deve ser confirmada com um método mais sensível (comercial) para garantir a ausência de proteínasda soja ou do leite.

La dieta libre de gluten, ¿se diferencia de la alimentación general?: Estudio comparativo entre niños celíacos y no celíacos / Does the Gluten Free Diet differ from the general diet?: Comparative study between celiac and non-celiac children

Introducción: la enfermedad celíaca (EC) es una patología multisistémica, precipitada por la ingesta de gluten que requiere de la eliminación de por vida de los alimentos que lo contienen con el fin de mejorar la sintomatología. Sin embargo, esta supresión alimentaria podría alejar a quienes la padecen de los requerimientos nutricionales recomendados. El objetivo del presente estudio fue conocer la ingesta promedio de macronutrientes en los/as niños/as celíacos/as con dieta libre de gluten (DLG) y compararla con la alimentación de niños/as no celíacos/as. Materiales y método: el estudio se llevó a cabo en población celíaca y no celíaca (grupo control) de 6 a 11 años de ambos géneros. En ella se realizó la evaluación del consumo alimentario a través de dos recordatorios de 24 hs. Se utilizó como análisis estadístico la prueba Bayesiana de Estimación de una Diferencia de Medias - Método Exacto. Resultados: se estudiaron 40 celíacos y 40 no celíacos. No se observaron diferencias significativas en el nivel socioeconómico, ni en el estado nutricional. Se observó que la mayoría de los celíacos sobrepasaron las recomendaciones de hidratos de carbono y proteínas, al igual que el grupo control. Conclusión: la DLG realizada por los niños de 6 a 11 años presenta un mayor y excesivo consumo de hidratos de carbono y grasas en comparación con las IDR.

Introduction: Celiac Disease (CD) is a multisystem pathology, caused by gluten intake, and requires the elimination of gluten food for life to improve symptoms. However, this dietary suppression could keep celiac away from the recommended nutritional requirements. The objective of the present study was to know the average intake of macronutrients in celiac children with a gluten-free diet (DLG) and compare it with the diet of non-celiac children. Materials and Methods: the study was carried out in celiac and non- celiac population (control group) of 6 to 11 years old, of both genders. In it, the evaluation of food consumption was made through two 24-hour reminders. The Bayesian test of Estimation of Difference of Means - Exact Method was used as statistical analysis. Results: 40 celiac and 40 non-celiac were studied. There were no significant differences in socioeconomic status or nutritional status. It was observed that the majority of celiacs exceeded carbohydrate and protein recommendations, as did the control group. Conclusion: the GFD performed by celiac children aged 6 to 11 years old presents a grater and excessive consumption of carbohydrates and fats compared to RDI.

Conhecimento de estudantes de Gastronomia acerca da doença celíaca / Knowledge of Gastronomy students about celiac disease

Objetivo: Avaliar o conhecimento de estudantes do curso de Gastronomia acerca da doença celíaca. Métodos: Estudo descritivo realizado com estudantes de um curso de Tecnologia em Gastronomia de Dourados-MS. Coleta de dados realizada em abril de 2019, por meio da aplicação de questionário organizado em três seções: (1) Sociodemográfica; (2) Conhecimento acerca da doença celíaca e dieta isenta de glúten; e (3) Conhecimento sobre cuidados especiais em preparações culinárias para celíacos. Resultados: Participaram 60 estudantes, com média de idade de 31,5 anos, sendo a maioria do sexo feminino (70%) e tendo se autodeclarado branca (73,3%). A maioria já ouviu falar da doença celíaca e glúten (61,7% e 100%, respectivamente), todavia 66,1% responderam erroneamente ou não souberam responder sobre o conceito da doença. Somente 15,5% acertaram que glúten é uma proteína. Apenas 24,5% dos estudantes mencionaram corretamente todos os cereais que contêm glúten e 5,4% indicaram corretamente todas as opções de substitutos para os cereais com glúten. Embora a maioria tenha relatado práticas convergentes sobre cuidados especiais em preparações isentas de glúten, um número expressivo de estudantes errou ou não soube responder sobre o compartilhamento de óleo, utensílios/equipamentos entre alimentos com e sem glúten (31,6% e 41,7%, respectivamente). Aproximadamente um terço dos estudantes (31,6%) não considera necessário verificar a presença de glúten no rótulo dos alimentos. Conclusão: Os estudantes de Gastronomia apresentaram conhecimento insatisfatório acerca da doença celíaca, dieta isenta de glúten e práticas culinárias para evitar a contaminação cruzada por glúten, o que pode implicar futuramente a qualidade dos serviços prestados na área de alimentação por esses profissionais e, consequentemente, na qualidade de vida dos celíacos. Os achados indicam a necessidade de reforma do currículo e criação de diretrizes curriculares para os cursos de Tecnologia em Gastronomia no Brasil. (AU)

Objective: To evaluate the knowledge of Gastronomy students about celiac disease. Methods: This is a descriptive study conducted with students from a Technology in Gastronomy course in Dourados, Mato Grosso do Sul, Brazil. Data collection was carried out in April 2019 through the application of a questionnaire organized in three sections with open and closed questions: (1) Sociodemographic issues; (2) Knowledge about celiac disease and gluten-free diet and (3) Knowledge about special care in culinary preparations for people with celiac disease. Results: Sixty students with an average age of 31.5 years old participated, most of them female (70%) and self- declared white (73.3%). Most of them have heard of celiac disease and gluten (61.7% and 100%, respectively) although the majority (66.1%) answered wrongly or was not able to answer about the concept of celiac disease. Only 15.5% believed that gluten is a protein. Only 24.5% of students correctly mentioned all the gluten-containing cereals and 5.4% correctly indicated all options to replace them. Although most of the students reported converging special care practices in gluten-free preparations, a significant number of students were wrong or not able to answer about sharing oil, utensils, and equipment for gluten and gluten-free foods (31.6% and 41.7% respectively). Approximately one-third of the students (31.6%) did not consider it necessary to verify the presence of gluten on food labels. Conclusion: The Gastronomy students present unsatisfactory knowledge about celiac disease, gluten-free diet, and culinary practices to prevent cross-contamination by gluten, which may affect the future quality of food services provided by these professionals and, consequently, in the quality of life of celiac consumers. The findings indicate the need to reform the curriculum and create curricular guidelines for Technology in Gastronomy courses in Brazil. (AU)