Plant-Based Antioxidants in Gluten-Free Bread Production: Sources, Technological and Sensory Aspects, Enhancing Strategies and Constraints.

The recognized contribution of antioxidant compounds to overall health maintenance and spotted deficiencies in celiac patients' diets has driven more intensive research regarding antioxidant compounds' inclusion in gluten-free bread (GFB) production during the last decade. The presented review gathered information that provided insights into plant-based antioxidant sources which are applicable in GFB production through the resulting changes in the technological, sensory, and nutritional quality of the resulting antioxidant-enriched GFB. The influence of the bread-making process on the antioxidant compounds' content alteration and applied methods for their quantification in GFB matrices were also discussed, together with strategies for enhancing the antioxidant compounds' content, their bioaccessibility, and their bioavailability, highlighting the existing contradictions and constraints. The addition of plant-based antioxidant compounds generally improved the antioxidant content and activity of GFB, without a profound detrimental effect on its technological quality and sensory acceptability, and with the extent of the improvement being dependent on the source richness and the amount added. The determination of a pertinent amount and source of plant-based antioxidant material that will result in the production of GFB with desirable nutritional, sensory, and technological quality, as well as biological activity, remains a challenge to be combated by elucidation of the potential mechanism of action and by the standardization of quantification methods for antioxidant compounds.

Spray-Drying Impact the Physicochemical Properties and Formation of Maillard Reaction Products Contributing to Antioxidant Activity of Camelina Press Cake Extract.

Spray-drying is one of the most popular techniques in the food industry for converting liquid material from a fluid state into a form of dried particles to produce encapsulated or instant products. Instant products are considered as convenient foods; moreover, the goal of encapsulation is to close the bioactive compounds in a shell, preventing them from being affected by environmental factors. The purpose of this study was to examine the influence of spray-drying conditions, in particular three inlet temperatures, on the physicochemical and antioxidant properties of powders obtained from Camelina Press Cake Extract (CPE). The CPE was spray-dried at 140 °C, 160 °C and 180 °C. The solubility, Carr and Hausner Indexes, tapped densities and water activity of the powders were analyzed. The structural changes were also detected using FTIR spectroscopy. Additionally, the characteristics of the initial and reconstituted samples and their rheological properties were evaluated. The antioxidant potential, total polyphenols and flavonoids content, free amino acids, and the Maillard reaction products contents in the spray-dried powders were also evaluated. The results indicate a cascade of changes between the initial and reconstituted samples, and important changes in the bioactive potential of samples. The inlet temperature significantly influenced the solubility, flowability and particle sizes of the powders, as well as Maillard products formation. The results of the rheological measurements illustrate the changes after the reconstitution of extracts. This study indicates the optimal parameters of CPE spray-drying, those that yield favorable physicochemical and functional values, which may open up a promising path for CPE valorization, indicating its potential and the possibilities of its use.

Effect of Flaxseed Oil Cake Extract on the Microbial Quality, Texture and Shelf Life of Gluten-Free Bread.

Extending the shelf life of gluten-free bread (GFB) is a challenge. Mainly due to the ingredients used and their characteristics, GFB has numerous drawbacks such as unsatisfactory texture and rapid staling beyond a low nutritional value. In the present study, flaxseed oil cake extract (FOCE) was used to replace water (25-100%) in GFB formulations in order to test FOCE's potential to reduce GFB staling and extend microbial stability. Texture (TPA test), water activity (LF NMR), acidity (pH measurements) and microbiological quality of GFBs were tested. Moreover, the content of a lignan with broad health-promoting potential, secoisolariciresinol diglucoside (SDG), in GFB with FOCE was analyzed. The results showed that the use of FOCE enriched experimental GFB in valuable SDG (217-525 µg/100 g DM) while not causing adverse microbiological changes. A moderate level (25-50%) of FOCE did not change the main texture parameters of GFB stored for 72 h, the quality of which was comparable to control bread without FOCE. Meanwhile, higher proportions of FOCE (75-100% of water replacement) shortened GFB shelf life as determined by water activity and texture profile, suggesting that GFB with FOCE should be consumed fresh. To summarize, FOCE at moderate levels can add value to GFBs without causing a drop in quality, while still fitting in with the idea of zero waste and the circular economy.

Nutritional facts regarding commercially available gluten-free bread worldwide: Recent advances and future challenges.

Recently, there has been an increase in demand for gluten-free (GF) products due to the growing number of gluten-intolerant and healthy individuals choosing to follow a gluten-free diet. Gluten-free bread (GFB) is a staple food product; therefore, many recent studies have reported the nutritional properties of GFB. However, an overview of the current ingredients and nutritional labeling of GFB worldwide has not yet been provided. This review aimed to gather the latest information regarding the most used ingredients in GFB formulations and the nutritional quality of these products from different countries, based on studies published in the last decade (2010-2020). Our analysis showed that GFB had a lower protein and a higher fat content than gluten-containing bread, and the dietary fiber content was highly variable between countries. Some studies have revealed a high glycaemic index in most products, which is associated with the extensive use of rice flour and starch as the main ingredients in GFB formulation. Label information presented significant differences from the data obtained through the chemical analysis of fiber and other nutritional components. Micronutrient fortification is not common in the GFB. The nutritional quality of commercial GFB is a crucial issue that needs to be addressed.

The Improved Quality of Gluten-Free Bread Due to the Use of Flaxseed Oil Cake: A Comprehensive Study Evaluating Nutritional Value, Technological Properties, and Sensory Quality.

The development of gluten-free bakery products, the quality of which is comparable to the quality of regular wheat-based products, remains a technological challenge. In this study, flaxseed oil cake (FOC), a by-product of flaxseed oil extraction and a source of nutritional and functional compounds, was used as an ingredient in the experimental bread formulation as partial replacement of starches (5%, 15%, and 30%). The gluten-free breads (GFBs) were evaluated for technological parameters, nutritional value, and sensory quality. Compared with the control, all FOC-enhanced GFBs were significantly (p < 0.05) richer in proteins, fat, and dietary fibre, with an increase that was proportional to the concentration of FOC in the formulation. At low-to-moderate levels (5% and 15%), FOC improved the specific volume, texture characteristics (reduced crumb hardness, gumminess, and chewiness), and appearance of GFBs, which allowed us to ameliorate its sensory features, but at 30% of FOC, the quality of the crumb texture decreased significantly (p < 0.005). Among the experimental GFBs, FOC15% exhibited improved technological characteristics and was rated by the sensory panel as the best in terms of overall quality. The results of the conducted research highlighted the benefits of incorporating FOC into GFB as a promising approach to developing a palatable, high-quality bakery product that may be a healthier option for individuals on a gluten-free diet, offering nutritional benefits. Nevertheless, it should be emphasised that the amount of FOC in GFB requires careful regulation.

Novel Gluten-Free Bread with an Extract from Flaxseed By-Product: The Relationship between Water Replacement Level and Nutritional Value, Antioxidant Properties, and Sensory Quality.

The food industry generates a great amount of food waste and by-products, which in many cases are not fully valorized. Press cakes, deriving from oilseeds extraction, represent interesting co-products due to their nutritional value, high biopolymers content, and the presence of bioactive phytochemicals. Gluten-free breads (GFBs) are products that have disadvantages such as unsatisfactory texture, low nutritional value, and short shelf life, so natural additives containing proteins and hydrocolloids are in demand to increase GFBs value. In this study, extract from flaxseed by-product (FOCE-Flaxseed Oil Cake Extract) was used to replace water (25-100%) in GFBs formulations and their nutritional value, antioxidant properties, and sensory features were investigated. The results showed that GFBs with FOCE had an elevated nutritional and nutraceutical profile (up to 60% more proteins, significantly increased K, Mg, and P levels). Moreover, the addition of FOCE improved the technological parameters (increased specific volume, number of cells and height/width ratio, reduced density, average size, and perimeter of cells), antioxidant potential, and overall sensory quality of GFBs. This study showed an encouraging way of using a by-product that, due to its high content of proteins, polysaccharides, minerals, and antioxidants, can add value to GFBs.

Application of Broccoli Leaf Powder in Gluten-Free Bread: An Innovative Approach to Improve Its Bioactive Potential and Technological Quality.

In comparison to conventional bread, gluten-free bread (GF) shows many post-baking defects and a lower nutritional and functional value. Although broccoli leaves are perceived as waste products, they are characterised by a high content of nutrients and bioactive compounds. The present study evaluated the nutritional value, technological quality, antioxidant properties, and inhibitory activity against the formation of advanced glycation end-products (AGEs) of GF enriched with broccoli leaf powder (BLP). Compared to the control, gluten-free bread with BLP (GFB) was characterised by a significantly (p < 0.05) higher content of nutrients (proteins and minerals), as well as improved specific volume and bake loss. However, what needs to be emphasised is that BLP significantly (p < 0.05) improved the antioxidant potential and anti-AGE activity of GFB. The obtained results indicate that BLP can be successfully used as a component of gluten-free baked products. In conclusion, the newly developed GFB with improved technological and functional properties is an added-value bakery product that could provide health benefits to subjects on a gluten-free diet.

High-Quality Gluten-Free Sponge Cakes without Sucrose: Inulin-Type Fructans as Sugar Alternatives.

Due to its structural and organoleptic functions, sucrose is one of the primary ingredients of many baked confectionery products. In turn, the growing awareness of the association between sugar overconsumption and the development of chronic diseases has prompted the urgent need to reduce the amount of refined sugar in foods. This study aimed to evaluate the effect of complete sucrose replacement with inulin-type fructans (ITFs), namely fructooligosaccharide (FOS), inulin (INU) or oligofructose-enriched inulin (SYN), with different degrees of polymerization on the technological parameters and sensory quality of gluten-free sponge cakes (GFSs). The use of ITFs as the sole sweetening ingredient resulted in the similar appearance of the experimental GFSs to that of the control sample. In addition, all GFSs containing ITFs had similar height, while their baking weight loss was significantly (p < 0.05) lower compared to the control products. The total sugar exchange for long-chain INU increased the crumb hardness, while the crumb of the GFS with FOS was as soft as of the control products. The sensory analysis showed that the GFS containing FOS obtained the highest scores for the overall quality assessment, similar to the sugar-containing control sponge cake. The results obtained prove that sucrose is not necessary to produce GFSs with appropriate technological parameters and a high sensory quality. Thus, it can be concluded that sucrose can be successfully replaced with ITF, especially with FOS, in this type of baked confectionery product.

Intestinal Permeability in Children with Celiac Disease after the Administration of Oligofructose-Enriched Inulin into a Gluten-Free Diet-Results of a Randomized, Placebo-Controlled, Pilot Trial.

Abnormalities in the intestinal barrier are a possible cause of celiac disease (CD) development. In animal studies, the positive effect of prebiotics on the improvement of gut barrier parameters has been observed, but the results of human studies to date remain inconsistent. Therefore, this study aimed to evaluate the effect of twelve-week supplementation of a gluten-free diet (GFD) with prebiotic oligofructose-enriched inulin (10 g per day) on the intestinal permeability in children with CD treated with a GFD. A pilot, randomized, placebo-controlled nutritional intervention was conducted in 34 children with CD, being on a strict GFD. Sugar absorption test (SAT) and the concentrations of intestinal permeability markers, such as zonulin, intestinal fatty acid-binding protein, claudin-3, calprotectin, and glucagon-like peptide-2, were measured. We found that the supplementation with prebiotic did not have a substantial effect on barrier integrity. Prebiotic intake increased excretion of mannitol, which may suggest an increase in the epithelial surface. Most children in our study seem to have normal values for intestinal permeability tests before the intervention. For individuals with elevated values, improvement in calprotectin and SAT was observed after the prebiotic intake. This preliminary study suggests that prebiotics may have an impact on the intestinal barrier, but it requires confirmation in studies with more subjects with ongoing leaky gut.

The Profile of Urinary Headspace Volatile Organic Compounds After 12-Week Intake of Oligofructose-Enriched Inulin by Children and Adolescents with Celiac Disease on a Gluten-Free Diet: Results of a Pilot, Randomized, Placebo-Controlled Clinical Trial.

The concentration of volatile organic compounds (VOCs) can inform about the metabolic condition of the body. In the small intestine of untreated persons with celiac disease (CD), chronic inflammation can occur, leading to nutritional deficiencies, and consequently to functional impairments of the whole body. Metabolomic studies showed differences in the profile of VOCs in biological fluids of patients with CD in comparison to healthy persons; however, there is scarce quantitative and nutritional intervention information. The aim of this study was to evaluate the effect of the supplementation of a gluten-free diet (GFD) with prebiotic oligofructose-enriched inulin (Synergy 1) on the concentration of VOCs in the urine of children and adolescents with CD. Twenty-three participants were randomized to the group receiving Synergy 1 (10 g per day) or placebo for 12 weeks. Urinary VOCs were analyzed using solid-phase microextraction and gas chromatography⁻mass spectrometry. Sixteen compounds were identified and quantified in urine samples. The supplementation of GFD with Synergy 1 resulted in an average concentration drop (36%) of benzaldehyde in urine samples. In summary, Synergy 1, applied as a supplement of GFD for 12 weeks had a moderate impact on the VOC concentrations in the urine of children with CD.

Daily oligofructose-enriched inulin intake impacts bone turnover markers but not the cytokine profile in pediatric patients with celiac disease on a gluten-free diet: Results of a randomised, placebo-controlled pilot study.

BACKGROUND: Bone metabolism disturbances are commonly observed in patients with newly diagnosed celiac disease (CD). The only available treatment for CD-the intake of a gluten-free diet (GFD)-has been found to be insufficient in effectively improving bone health in some patients. Therefore, there is an urgent need to modify the GFD so as to allow for the provision of all the necessary nutrients and improved absorption. Prebiotics intake reportedly improves the absorption of bone-related vitamin D and calcium as well as bone metabolism. The effect of prebiotic intake on bone health in CD patients has not been studied yet. This study aimed to evaluate the effect of oligofructose-enriched inulin intake on bone metabolism and immune response in children with CD on a GFD. METHODS: A total of 34 children with CD were randomised into two groups receiving 10 g of oligofructose-enriched inulin (Synergy 1) or a placebo (maltodextrin) for three months, together with a strict GFD. The children's bone metabolism marker levels and cytokine profiles were analysed before and after the intervention. RESULTS: After supplementation, the concentration of osteocalcin increased significantly in children receiving Synergy 1, while the concentration of bone alkaline phosphatase increased in both groups, independent of supplementation. After the intervention, the level of pyridinoline increased significantly in the placebo group, resulting in a concentration that was two times higher than that in the Synergy 1 group, in which it remained stable. Moreover, the plasma concentrations of N-terminal telopeptides of type I collagen decreased in both the groups, whereas the tartrate-resistant acid phosphatase 5b level increased particularly in the Synergy 1 group. The intervention did not lead to immunological response changes. CONCLUSIONS: The proposed supplementation beneficially altered bone metabolism, through increased bone formation rates and decreased bone resorption process rates. Supplementation of GFD with prebiotic oligofructose-enriched inulin may be a promising auxiliary therapy for bone metabolism improvements in children with CD.

Beneficial Effect of Oligofructose-Enriched Inulin on Vitamin D and E Status in Children with Celiac Disease on a Long-Term Gluten-Free Diet: A Preliminary Randomized, Placebo-Controlled Nutritional Intervention Study.

Prebiotics have been shown to improve absorption of some nutrients, including vitamins. This pilot study evaluated the effect of the prebiotic oligofructose-enriched inulin (Synergy 1) on fat-soluble vitamins status, parathormone, and calcium-related elements in pediatric celiac disease (CD) patients (n = 34) on a strict gluten-free diet (GFD). Participants were randomized into a group receiving 10 g of Synergy 1 or placebo (maltodextrin) together with a GFD. At baseline and after 3 months of intervention, 25-hydroxyvitamin D [25(OH)D], parathormone, vitamin E and A, calcium, phosphate, magnesium, total protein, and albumin were determined. Concentration of 25(OH)D increased significantly (p < 0.05) by 42% in CD patients receiving Synergy 1 in GFD, whereas no change was observed in placebo. Vitamin D status reached an optimal level in 46% of patients receiving Synergy 1. No significant difference in parathormone, calcium, and phosphate levels was observed. Concentration of vitamin E increased significantly (p < 0.05) by 19% in patients receiving Synergy 1, but not in the placebo. Vitamin A levels were not changed. Supplementation of GFD with Synergy 1 improved vitamin D and vitamin E status in children and adolescents with CD and could be considered a novel complementary method of management of fat-soluble vitamins deficiency in pediatric CD patients.

A Randomized, Placebo-Controlled, Pilot Clinical Trial to Evaluate the Effect of Supplementation with Prebiotic Synergy 1 on Iron Homeostasis in Children and Adolescents with Celiac Disease Treated with a Gluten-Free Diet.

Iron deficiency anemia (IDA) occurs in 15⁻46% of patients with celiac disease (CD), and in some cases, it may be its only manifestation. Studies in animal models have shown that prebiotics, including inulin, may help to increase intestinal absorption of iron. The aim of this study was to evaluate the effect of a prebiotic, oligofructose-enriched inulin (Synergy 1), on iron homeostasis in non-anemic children and adolescents with celiac disease (CD) in association with a gluten-free diet (GFD). Thirty-four CD patients (4⁻18 years old) were randomized into two groups receiving Synergy 1 (10 g/day) or a placebo (maltodextrin) for three months. Before and after intervention, blood samples were collected from all patients for assessment of blood morphology, biochemical parameters and serum hepcidin concentration. We found that serum hepcidin concentration after the intervention was significantly decreased by 60.9% (p = 0.046) in the Synergy 1 group, whereas no significant difference was observed in the placebo group. No differences in morphological and biochemical blood parameters (including ferritin, hemoglobin and C-reactive protein (CRP)) were observed after intervention in either group. Given that hepcidin decrease may improve intestinal iron absorption, these results warrant further investigation in a larger cohort and especially in patients with IDA.

Plasma profile and urine excretion of amino acids in children with celiac disease on gluten-free diet after oligofructose-enriched inulin intervention: results of a randomised placebo-controlled pilot study.

The circulating amino acid (AAs) concentrations are indicators of dietary protein intake and metabolic status. In celiac disease (CD), the AA imbalance is frequently observed. Prebiotics are found to alleviate nutrient deficiencies. Therefore, the aim of this study was to analyse the impact of oligrofructose-enriched inulin (Synergy 1), administered for 3 months as a gluten-free diet (GFD) supplement to children with CD, on the plasma and urine concentrations of AAs. CD children (N = 34) were randomised into two groups, receiving Synergy 1 (10 g/day) or placebo (maltodextrin) for 3 months. The AA profile and concentration was determined in plasma and urine before and after the dietary intervention by gas chromatography. 22 and 28 AAs were determined in plasma and urine samples, respectively. After the intervention, the plasma concentrations of several AAs (Ala, Pro, Asn, Glu, Tyr, Lys, His, Orn) increased significantly in both experimental groups, while Gln increased only in the Synergy 1 group. The urinary excretion of Asn, Lys and Aaa increased significantly in the Synergy 1 group, and the excretion of Asp and Met decreased (p < 0.05) in the placebo group. The Gln:Glu ratio in urine increased in both groups after the intervention. An increased urinary excretion of AAs observed in Synergy 1 group with a simultaneous increase in the content of circulating AAs could be attributed to higher absorption or intensified metabolism of AAs, and on the other hand further healing of the intestinal mucosa being the result of continuous treatment with GFD. Moreover, the observed changes in Glu concentration suggest that oligofructose-enriched inulin could improve the intestinal condition and permeability. To conclude, a prebiotic-supplemented GFD influences beneficially the overall AAs metabolism in CD children; however, further prospective cohort studies are needed to confirm the results obtained.

Broccoli by-products improve the nutraceutical potential of gluten-free mini sponge cakes.

This study describes the successful development of new gluten-free (GF) mini sponge cakes fortified with broccoli leaves. The aim of this study was to evaluate the effect of broccoli leaf powder (BLP) on the content of biologically active compounds and the antioxidant capacity of GF mini sponge cakes. Broccoli leaf powder was a good source of nutritional components, including proteins and minerals, as well as bioactive compounds such as glucosinolates and phenolics. Glucosinolate content was higher than expected, which points to a synergistic interaction between bioactive compounds and the food matrix. The incorporation of BLP into GF mini sponge cakes significantly (p<0.05) increased their antioxidant capacity. The overall sensory acceptance of GF mini sponge cakes was affected by increasing BLP content. The addition of 2.5% BLP as a starch substitute resulted in an optimal improvement in the nutraceutical potential of GF cakes without compromising their sensory quality.

The Effect of Oligofructose-Enriched Inulin on Faecal Bacterial Counts and Microbiota-Associated Characteristics in Celiac Disease Children Following a Gluten-Free Diet: Results of a Randomized, Placebo-Controlled Trial.

Celiac disease (CD) is associated with intestinal microbiota alterations. The administration of prebiotics could be a promising method of restoring gut homeostasis in CD. The aim of this study was to evaluate the effect of prolonged oligofructose-enriched inulin (Synergy 1) administration on the characteristics and metabolism of intestinal microbiota in CD children following a gluten-free diet (GFD). Thirty-four paediatric CD patients (mean age 10 years; 62% females) on a GFD were randomized into two experimental groups receiving Synergy 1 (10 g/day) or placebo (maltodextrin; 7 g/day) for 3 months. The quantitative gut microbiota characteristics and short-chain fatty acids (SCFAs) concentration were analysed. In addition, side effects were monitored. Generally, the administration of Synergy 1 in a GFD did not cause any side effects. After the intervention period, Bifidobacterium count increased significantly (p < 0.05) in the Synergy 1 group. Moreover, an increase in faecal acetate and butyrate levels was observed in the prebiotic group. Consequently, total SCFA levels were 31% higher than at the baseline. The presented trial shows that Synergy 1 applied as a supplement of a GFD had a moderate effect on the qualitative characteristics of faecal microbiota, whereas it stimulated the bacterial metabolite production in CD children.

A targeted metabolomic protocol for quantitative analysis of volatile organic compounds in urine of children with celiac disease.

Volatile organic compounds (VOCs) in biological samples have gained popularity for disease monitoring and diagnosis. Celiac disease (CD) is one of the many prevalent health conditions which are challenging to diagnose. The aim of this study was to optimize a solid phase microextraction followed by gas chromatography-mass spectrometry, for quantitative analysis of a wide range of VOCs in the urine of patients with CD. Multivariate design of experiment was used to optimize the extraction conditions for the analysis of 15 urinary VOCs. Based on the performed experiments, extraction using 2.98 g of sodium chloride and 21 µL of 6 M hydrochloric acid for 15 min at 30 °C, using a CAR/PDMS fiber in headspace mode was found to be the most effective procedure for the analysis of the selected biomarkers. It was also demonstrated that the proposed method could distinguish between children with CD and healthy children based on the profile of VOCs. It is believed that quantitative analysis of these biomarkers will extend our understanding of CD and could be used for monitoring in patients under treatment.

The effect of oligofructose-enriched inulin supplementation on gut microbiota, nutritional status and gastrointestinal symptoms in paediatric coeliac disease patients on a gluten-free diet: study protocol for a pilot randomized controlled trial.

BACKGROUND: A lifelong gluten-free diet (GFD) is regarded as the only proven and accepted therapy for coeliac disease (CD). However, even patients who strictly follow a GFD often suffer from intestinal symptoms and malabsorption. Selective modulation of intestinal microbiota with prebiotics could remedy various symptoms associated with CD. The use of prebiotics in the treatment of intestinal diseases remains insufficiently investigated. To our knowledge, this study makes the first attempt to evaluate the effect of prebiotic supplementation on gastrointestinal symptoms and nutritional status of children with CD. We hypothesized that adherence to a GFD supplemented with oligofructose-enriched inulin (Synergy 1) would deliver health benefits to children suffering from CD without any side effects, and that it would alleviate intestinal inflammation, restore and stabilize gut microbial balance and reverse nutritional deficiencies through enhanced absorption of vitamins and minerals. METHODS: A randomized, placebo-controlled clinical trial was designed to assess the impact of the Synergy 1 on paediatric CD patients following a GFD. We randomized 34 children diagnosed with CD into an intervention group receiving 10 g of the Synergy 1 supplement daily and a placebo group (receiving maltodextrin) during a 12-week nutritional intervention. Selected biochemical parameters, nutritional status and the characteristics of faecal bacteria will be determined in samples collected before and after the intervention. Analysis of vitamins and amino acids concentration in biological fluids will allow to assess the dietary intake of crucial nutrients. The compliance to a GFD will be confirmed by a Food Frequency Questionnaire (FFQ-6) and the analysis of serum anti-tissue transglutaminase and faecal gluten immunogenic peptides (GIP). CONCLUSION: The identification of the beneficial effects of the Synergy 1 supplement on children with CD could have important implications for nutritional recommendations for CD patients and for alleviating the harmful effects of the disease. TRIAL REGISTRATION: ClinicalTrials.gov Registration Number: NCT03064997 .

Administration of Inulin-Supplemented Gluten-Free Diet Modified Calcium Absorption and Caecal Microbiota in Rats in a Calcium-Dependent Manner.

In coeliac disease (CD), the risk of adverse calcium balance and reduced bone density is induced mainly by the disease, but also by a gluten-free diet (GFD), the only accepted CD therapy. Prebiotics through the beneficial impact on intestinal microbiota may stimulate calcium (Ca) absorption. In the present study, we hypothesised that the dietary inulin in GFD would influence positively the intestinal microbiota, and by that will stimulate the absorption of calcium (Ca), especially in the conditions of Ca malnutrition. In a six-weeks nutritional experiment on growing a significant (p < 0.05) luminal acidification, decrease in ammonia concentration and stimulation of short chain fatty acids formation indicated inulin-mediated beneficial effects on the caecal microbiota. However, the effect of inulin on characteristics of intestinal microbiota and mineral utilization depended on the dietary Ca intake from GFDs. Inulin stimulated bifidobacteria, in particular B. animalis species, only if a recommended amount of Ca was provided. Most benefits to mineral utilization from inulin consumption were seen in rats fed Ca-restricted GFD where it increased the relative Ca absorption. Administration of inulin to a GFDs could be a promising dietary strategy for beneficial modulation of intestinal ecosystem and by that for the improvement the Ca absorption.

Calcium in Gluten-Free Life: Health-Related and Nutritional Implications.

Calcium deficiency and metabolic bone diseases are a frequent co-morbidity of coeliac disease (CD). Gluten-free diet (GFD) is the only effective treatment of CD. However, CD patients on the strict GFD consume less than the recommended amounts of calcium. In this review, the main etiological factors responsible for calcium deficiency in CD were presented. Additionally, the research on the application of calcium supplements in the gluten-free breadmaking was reviewed, and its effect on the technological and sensory properties of baked products was indicated. Calcium-fortified gluten-free products could increase the calcium content in the diet of CD patients, supplying the amount of calcium they need for prophylactic or therapeutic use. Apart from this, the consumption of the naturally GF products as well as functional ingredients beneficially affecting calcium absorption need to be encouraged.