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AbstractBackgroundObjectivesMethodsResultsConclusionThe gluten-free diet (GFD) may aid weight loss, but its effects on non-celiac individuals are not well-studied.This pilot study compared the GFD’s effectiveness to a low-calorie diet (LCD) for weight loss in non-celiac Iranian women over an 8-week exercise program.A total of 126 women participated, 61 followed the LCD with exercise and therapies, while 65 adhered to the GFD with the same exercises. Data on demographics and body measurements were gathered via a survey.The GFD group showed significant reductions in body weight (p = 0.04), waist circumference (p = 0.006), and abdominal circumference (p = 0.0004). In contrast, the LCD group exhibited a significant reduction in waist circumference only (p = 0.03). A significant inverse correlation was found between non-alcoholic fatty liver disease (NAFLD) and the rate of weight reduction (r = −0.33, p = 0.006).Combining the GFD with exercise and therapies may effectively promote weight loss, especially in Iranian women. [ABSTRACT FROM AUTHOR]

Background: Coeliac disease (CeD) is a chronic immune-mediated disease triggered by exposure to dietary gluten in genetically predisposed individuals. The burden of CeD on patients and the healthcare system remains poorly evaluated in Germany. Objectives: To assess the healthcare resource utilisation (HCRU) and costs of diagnosed CeD patients in a German claims database. Design: A retrospective CeD case–control study was conducted using German claims data between 2017 and 2021. Methods: CeD diagnosis was defined by at least one inpatient or two outpatient diagnostic codes (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification (ICD-10-GM) K90.0) within four quarters (irrespective of calendar year) for CeD during the study period. Controls (non-CeD patients) were matched in a ratio of 5:1 by age, Charlson Comorbidity Index, sex and region. HCRU (hospitalisations, outpatient visits, medication use, sick leaves) and healthcare costs (outpatient services, inpatient services, outpatient pharmaceuticals, sick leaves and aids and remedies) were compared between CeD patients and controls. Results: From the 3,352,188 patients with continuous enrolment during the study period (2017–2021), 8258 (0.25%) patients were identified as having a CeD diagnosis. The mean number of hospitalisations and outpatient visits within 5 years was 1.8- and 1.5-fold higher among matched CeD patients (n = 8243) compared to their controls (n = 41,215), resulting in an excess healthcare cost of €5251. Inpatient expenses were the main cost driver and accounted for 31.5% of total incremental costs. Conclusion: The current study showed that CeD patients have considerably higher HCRU and related costs compared to matched controls. Our findings suggest the need for improved treatment options for CeD patients in addition to a gluten-free diet. Plain language summary: Coeliac disease in Germany: costs and care insights from health insurance data Coeliac disease (CeD) is a serious illness where the body reacts to gluten found in food. In Germany, the effects of CeD on patients and the healthcare system are not well-known. We aimed to find out how much healthcare resources and money were used to treat people with CeD in Germany. Health insurance data from 2017 to 2021 were analysed. Out of a population of about 3 million individuals observable in the database, over 8,200 patients with CeD were identified and compared to those without CeD but had similar age, sex, region of residence, and other illnesses. The study revealed that over five years, patients with CeD had more hospital visits and outpatient appointments compared to those without CeD. This led to an extra cost of €5,251 per patient. Most of this cost came from hospital stays. This suggests that better care and treatments are needed for CeD patients beyond just following a gluten-free diet. Improving care for CeD patients might enhance their quality of life and help to reduce healthcare costs in the long run. [ABSTRACT FROM AUTHOR]

Celiac disease (CeD), also known as gluten enteropathy, is an immune-mediated inflammatory enteropathy triggered by intolerance to gluten. It presents with a spectrum of symptoms, including both gastrointestinal and extraintestinal manifestations, as well as neurological symptoms. A review of the literature indicates that 10–22% of patients with CeD present with neurological symptoms. The objective of this study is to assess the influence of a gluten-free diet (GFD) on brain bioelectrical activity and neurological symptoms in children with CeD. Methods: The study was conducted using a multidisciplinary approach, encompassing a comprehensive array of clinical data gathered alongside laboratory test results, questionnaires, and electroencephalogram (EEG) assessments. The study population included 85 children: 18 newly diagnosed cases of CeD patients (NDC), subsequently reassessed after 6 months on a GFD as a celiac disease on diet (CDD); 27 CeD patients on a GFD for over 12 months (CDD2); and 40 healthy individuals in the comparison group (CG). Results: It was observed that over half of the NDC group exhibited neurological symptoms, particularly headaches. Following a six-month period on a GFD, there was a notable reduction in symptom severity. In comparison to the CG, the NDC patient group exhibited a higher prevalence of abnormalities in EEG recordings (p = 0.032), including focal sharp waves or slow waves. Conclusions: The results demonstrate that a GFD has a positive impact on the neurological condition of children with CeD. The clinical improvements correspond with EEG normalization, which supports the hypothesis that dietary intervention plays a role in mitigating CeD-associated neurological dysfunction. [ABSTRACT FROM AUTHOR]

Coeliac disease (CeD) is a common immune-mediated disorder of the small intestine, triggered by ingested gluten in genetically susceptible individuals. The only current treatment is strict lifelong adherence to a gluten-free diet. A lack of representative human models for CeD has hindered our understanding of its pathophysiology and the development of novel treatments. Human intestinal organoid and organ-on-chip systems, which incorporate patient-specific genetics and relevant cell types, represent promising personalised research models for intestinal function in health and disease. Co-culturing of intestinal organoids with other relevant cell types and stimuli, such as immune cells and gut microbiota, offers valuable insights into the intercellular interactions that drive the inflammatory response to gluten in CeD. Coeliac disease (CeD) is an immune-mediated disorder characterised by gluten-triggered inflammation and damage in the small intestine, with lifelong gluten-free diet (GFD) as the only treatment. It is a multifactorial disease, involving genetic and environmental susceptibility factors, and its complexity and lack of comprehensive human model systems have hindered understanding of its pathogenesis and development of new treatments. Therefore, it is crucial to establish systems that recapitulate patient genetic background and the interactions between the small intestinal epithelial barrier, immune cells, and environment that contribute to CeD. In this review, we discuss disease complexity, recent advances in stem cell biology, organoids, tissue co-cultures, and organ-on-chip (OoC) systems that facilitate the development of comprehensive human model systems, and model applications in preclinical studies of potential treatments. [ABSTRACT FROM AUTHOR]

Celiac disease is attributable to a combination of genetic predisposition and exposure to dietary gluten, with immune system involvement. The incidence is increasing globally, and the societal economic burden of celiac disease stretches beyond the cost of gluten-free food. This enteropathy that affects the small intestine has been related to different disorders and comorbidities. Thus, the implications of suffering from this disease are multidimensional and need further consideration. Celiac disease is a serious condition that remains under-recognized, resulting in an increased need for programs for better management. This review aims to summarize the current evidence regarding celiac diseases, with special emphasis on clinical implications, diagnosis, dietary management, socioeconomical aspects, and future perspectives. [ABSTRACT FROM AUTHOR]

Background/Objectives: Numerous studies have highlighted the nutritional imbalances that are commonly observed in children and adolescents diagnosed with celiac disease (CD) who follow a gluten-free diet (GFD). However, the development and timeline of these nutritional deficiencies remain unclear. The aim of the present study is to investigate the short-term (≥6 months to <12 months) and long-term (≥12 months) association between adherence to a GFD and nutrient intake as well as micronutrient blood status in children and adolescents aged from 0 to 18 years with CD. Methods: A systematic review was conducted in PubMed and Scopus for observational studies published up to June 2024. Results: A total of 15 studies (case–control, cross-sectional, and prospective studies) with 2004 children and adolescents were included. Their quality was assessed using the ROBINS-E tool. Despite the lack of high-quality data and the heterogeneity of the methods used in the included studies, the results of the cross-sectional/case–control studies show that, in the short term, children and adolescents with CD consumed excessive amounts of protein and carbohydrates compared to controls. After long-term adherence to a GFD, significant changes in the diets of children and adolescents with CD persisted. Fat intake was higher, while protein intake remained excessive compared to controls. Based on prospective studies, vitamin C and iodine intake improved both in the short and long term after adherence to a GFD. However, most other nutrients either remain inadequate or continue to decline, indicating that it is difficult to meet nutrient requirements despite dietary adjustments. Conclusions: Gaps in adherence to dietary recommendations appear to be widespread in children and adolescents with CD, emphasizing the need for improved diet quality and regular monitoring. [ABSTRACT FROM AUTHOR]

Going gluten‐free and dairy‐free has become increasingly popular in the past 10 years, yet little research has examined the drivers of this dietary preference beyond medical reasons. This research investigates how the feeling of low power contributes to the growing popularity of free‐from products (e.g., gluten‐free, fragrance‐free). Five studies, using various statistical analyses (including regressions, analysis of variance, mediation, and moderation analysis) across both surveys and experiments, provide converging evidence that the feeling of low power increases preferences for free‐from products, driven by heightened perceived threat. Consistent with this account, low‐power individuals' increased preference for free‐from products is attenuated (1) when their perceived threat is reduced through self‐affirmation, and (2) when advertising appeals highlight health benefits in a gain (vs. loss) frame. This research contributes to both the special diets and power literatures, offering practical implications for marketers of free‐from products by revealing a potential market segment and suggesting message framing strategies to better persuade consumers. [ABSTRACT FROM AUTHOR]

Background: Chronic Nonbacterial Osteomyelitis (CNO) is a rare auto-inflammatory disease that mainly affects children, and manifests with single or multiple painful bone lesions. Due to the lack of specific laboratory markers, CNO diagnosis is a matter of exclusion from different conditions, first and foremost bacterial osteomyelitis and malignancies. Whole Body Magnetic Resonance (WBMR) and bone biopsy are the gold standard for the diagnosis. Although the association with Inflammatory Bowel Disease (IBD) has been reported in the literature, cases of CNO in celiac patients have never been described before. Case presentation: We report about a girl of 3 years and 8 months of age who presented with severe bone pain, slight increase of inflammatory markers, micro-hematuria and high calprotectin values. Her personal medical history was uneventful, apart from low weight growth. She had never complained of abdominal pain or other gastro-intestinal symptoms. WBMR showed the classical features of multifocal CNO, and biopsy confirmed the diagnosis. Celiac disease (CD) was suspected on the basis of antibody screening, and confirmed by gut biopsy. With gluten-free diet the patient achieved rapid and complete symptom remission together with healing of all the bone lesions proven by WBMR. Three years after the onset of the disease the girl is healthy and totally asymptomatic, still on clinical and radiological follow-up. Conclusions: Based on our experience, the diagnostic work-up of new cases of CNO should include the screening test for CD and, according to the literature, the possibility of IBD should also be properly ruled out. When CNO and CD coexist, gluten-free diet, combined with antinflammatory therapy, could be able to completely reverse bone lesions, shortening the duration of medical treatment. Because the diseases' onset is seldom simultaneous, patients with CNO and IBD deserve a properly extended follow-up. Finally, the analysis of the relationship between CNO and autoimmune intestinal diseases provides a unique opportunity to understand the pathophysiological pro-inflammatory network underlying both types of disorders and it is necessary to make the most suitable therapeutic choice. [ABSTRACT FROM AUTHOR]

Background: Childhood autoimmune disorders involve the immune system attacking its own tissues, leading to varied symptoms, while autoinflammatory disorders result from innate immune system dysregulation, both requiring extensive diagnosis and multidisciplinary management due to their complexity. Case presentation: We present a unique clinical case of a teenager with a combination of autoimmune and autoinflammatory disorders. The initial manifestation of hip pain, coupled with progressive symptoms over several years and findings in multiple magnetic resonance imaging (MRI) scans, culminated in the diagnosis of chronic recurrent multifocal osteomyelitis (CRMO). Subsequently, the patient was diagnosed with type 1 diabetes (T1D), celiac disease, and juvenile idiopathic arthritis. The therapeutic course proved challenging, marked by unsuccessful attempts with nonsteroidal anti-inflammatory drugs (NSAIDs), and biphosphonates. However, a stable clinical status was ultimately achieved upon the introduction of methotrexate, concomitant with insulin therapy for diabetes and the implementation of a gluten-free diet for celiac disease. Conclusions: Our case showed that the combination of autoimmune and autoinflammatory diseases, brought not only a challenging diagnostic process, but also complicated treatment. [ABSTRACT FROM AUTHOR]

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

Background/Objectives: A reliable assessment of gluten-free diet (GFD) adherence is essential for managing celiac disease (CD). This study aimed to validate the Hellenic version of the Celiac Disease Adherence Test (H-CDAT) to evaluate adherence levels and explore the impact of dietary adherence on health-related quality of life (HRQoL)—both of which have never been objectively assessed in Greek CD patients. Methods: The study included 102 adult CD patients who completed H-CDAT, diet-related questions, and the 36-Item Short Form Health Survey (SF-36). Results: H-CDAT demonstrated good psychometric properties and showed multiple strong correlations with HRQoL dimensions. H-CDAT adherence was Good in 38.2%, Moderate in 42.2%, and Poor in 19.6% of patients, despite their perception of effective adherence, with 51% never having visited a dietitian for guidance on a GFD. Patients scored significantly lower across most HRQoL dimensions compared to the general Greek population. When stratified into the three adherence categories, striking differences emerged between Good and Moderate adherence across both physical and mental health domains, highlighting that moderate adherence is not sufficient for optimal health outcomes. Conclusions: These findings emphasize the critical role of strict GFD adherence in improving overall health and underscore the importance of dietetic intervention for achieving optimal patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Non-celiac gluten/wheat sensitivity (NCGWS) is a syndrome for which pathogenesis and management remain debated. It is described as a condition characterized by gastrointestinal and extra-intestinal symptoms rapidly occurring after gluten ingestion in subjects who have had celiac disease or wheat allergy excluded. To date, the diagnosis of NCGWS is challenging as no universally recognized biomarkers have been yet identified, nor has a predisposing genetic profile been described. However, the research is moving fast, and new data regarding pathogenic pathways, patients' classification, potential candidate biomarkers, and dietary interventions are emerging. Methods: This literature review aims to address the state of the art and summarize the latest updates in this field from 2019 to date. Results and Conclusions: Clinical studies regarding NCGWS in the last five years are reported to shed light on this complex condition and to guide specialists towards a more in-depth, prompt, and objective diagnosis. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to examine the dietary compliance of children and adolescents with celiac disease (CD) and their diet quality (DQ) and dietary acid load (DAL) and to determine the relationship of these dietary parameters with health-related quality of life (HRQoL). Design/methodology/approach: Ninety-one children and adolescents with CD and 144 healthy peers were included in this cross-sectional study. Anthropometric measurements were conducted by researchers. DQ and DAL were calculated from participants' 24-h dietary recall records. HRQoL was assessed using the Pediatric Quality of Life Inventory, and compliance with a gluten-free diet (GFD) was obtained using the GFD score. Data was collected through a face-to-face questionnaire. Findings: Of celiac patients, 53.1% were strictly compatible with the GFD, and 35.8% were non-compliant with the diet. The DQ scores of participants with CD were higher than their healthy peers, and the DAL scores were lower (p < 0.01). Finally, no relationship was found between the DQ and DAL with HRQoL scores in celiac patients (p > 0.05). However, better dietary compliance with the GFD was associated with improved HRQoL (p < 0.05). Practical implications: While DQ and DAL had no association with HRQoL, better dietary compliance improved the HRQoL of celiac patients. This may help develop solutions to the problems experienced by celiac patients, thereby improving the management of CD. Originality/value: To the best of the authors' knowledge, this study is the first to investigate the association of DQ and DAL with HRQoL in children with CD. [ABSTRACT FROM AUTHOR]

Objectives: Concurrent type 1 diabetes (T1D) and celiac disease (CeD) pose challenges in insulin dosage adjustments and gluten-free dietary adherence. Urine testing for gluten immunogenic peptides (GIP) is a new method to detect gluten exposure within the last 3–12 h. Our aims were to compare gluten-free dietary adherence between T1D + CeD and CeD individuals and evaluate urinary GIP testing in an outpatient setting. Materials and methods: This observational cross-sectional study included three adult groups: (1) T1D and CeD, (2) CeD only, and (3) T1D only. T1D participants were recruited from outpatient clinics, the CeD group via social media. One urine sample (12 pm–7 pm) was analyzed using a qualitative immunographic GIP test. CeD participants completed 'Celiac Dietary Adherence Test' (CDAT) and 'Celiac Symptom Index' (CSI) questionnaires. IgA anti-transglutaminase 2 (IgA-TG2) and IgG anti-deamidated gliadin (IgG-DGP) serology were also analyzed. Results: 197 participants, mean (SD) age 43 (15) years, were included. Female percentages were: CeD: 90%, T1D + CeD: 64%, and T1D: 47%. Positive urinary GIP was found in 15% (14/96) of T1D + CeD and 0% (0/50) of CeD (p = 0.002). As expected, most T1D only participants had positive urinary GIP (86%, 44/51). CDAT and CSI scores did not differ between T1D + CeD and CeD groups. Positive IgA-TG2 and/or IgG-DGP levels were found in 12% of T1D + CeD and 6% of CeD participants (p = 0.38). Conclusions: A single GIP urine test revealed higher gluten exposure in T1D + CeD versus CeD only, questioning dietary adherence in this population. Urinary GIP tests can be useful for clinical follow-up. Created with [ABSTRACT FROM AUTHOR]

Objectives: Diagnosis of coeliac disease based on serology only has been allowed since 2018 in Finland for adults meeting specific criteria. We studied the patient experiences and perceptions of this novel diagnostic option. Methods: Altogether 194 adult patients were questioned on socio‐demographic and health-related characteristics, quality of life and various coeliac disease-related issues. The results were compared between patients diagnosed with intestinal biopsy or based on serology only. Results: Altogether 69 (36%) of the patients were diagnosed without duodenal biopsies. They were younger (median 43 vs. 51 years, p = 0.046), diagnosed more recently (2021 vs. 2020, p < 0.001) and more often in primary health care (78% vs. 43%, p = 0.001), had fewer esophageal symptoms at diagnosis (17% vs. 30%, p = 0.046) and considered the diagnostic process easier (49% vs. 30%, p = 0.032) than those diagnosed by duodenal biopsy (n = 125). The no-biopsy group received less often dietician follow-up (4% vs. 17%, p = 0.012), reported more persistent symptoms (36% vs. 21%, p = 0.026) and experienced more stress due to the diet (68% vs. 47%, p = 0.039). Symptom persistence or stress were not associated with year of diagnosis or dietician follow-up. The groups were comparable in socio-economic characteristics, general health, quality of life, diagnostic delay, dietician guidance at diagnosis, and dietary adherence. Conclusions: The non-invasive approach resulted in de-centralized diagnosis and easier patient-experienced diagnostic process of coeliac disease, but was associated with increased risk for persistent symptoms and stress due to gluten-free diet. These results highlight the significance of appropriate patient guidance and support regardless of the diagnostic strategy. KEY SUMMARY: Established knowledge on this subject Finland was the first country to allow the diagnosis of coeliac disease without duodenal biopsies and based on serology only to selected adult patients. Feasibility of no-biopsy diagnosis of coeliac disease for adults has been debated globally. Patient perceptions and acceptance of the diagnostic process are important as coeliac disease is treated with life-long, strict gluten-free diet. New findings of this study One-third of adult coeliac disease patients reported being diagnosed without duodenal biopsies, based on serology only in the period 2019–2022. No-biopsy diagnoses were made more often outside hospital settings and the patients found the diagnostic process less challenging than those diagnosed based on biopsy findings. No-biopsy diagnosis was associated with more common persistent symptoms and stress due to gluten-free diet, and less common dietician follow-up. The findings highlight the significance of adequate patient support and guidance regardless of diagnostic process. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of adding bamboo fiber on the basic physical properties of gluten-free and low-carbohydrate bread. The control bread was made from buckwheat, flax, and walnut flour. Bamboo fiber was introduced to the bread recipe in proportions ranging from 0 to 10% (every 2%). The results showed that adding from 4 to 6% bamboo fiber to the control bread resulted in a slight rise of around 3% in volume, but a larger addition resulted in a drop in volume. The pH changes were also not significant; after more than 6% addition, the pH increased by about 2%. After adding more than 4% fiber, the color of the crumb changed noticeably (∆E >3), owing mostly to a significant increase in the lightness (L*) coefficient. The incorporation of the fiber had the greatest impact on the textural parameters when the storage time was increased to 48 h. The addition of 6% fiber resulted in unfavorable alterations in the hardness. In conclusion, our findings demonstrate that bamboo fiber can serve as a beneficial component for enriching gluten-free and low-carbohydrate bread, but its proportion should not exceed 4%. This developed bread with 4% addition of bamboo fiber can be classified as a functional bread for special diets; in addition to its very low carbohydrate content (15.3%), it was also characterized by a high fiber content (12.2%) and a low caloric value (176.7 kcal/100 g FM). [ABSTRACT FROM AUTHOR]

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

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

Background/Objectives: Citrulline, an amino acid produced by small bowel enterocytes, has been proposed as a potential marker of intestinal absorptive capacity. The aim of this study is to evaluate whether measuring citrulline levels could be useful for celiac disease (CD) patients, both at the time of diagnosis and during follow-up. Methods: A multicenter prospective study was conducted. Citrulline levels were measured and compared in 93 pediatric patients classified into three groups. Group A: 28 patients with newly diagnosed CD. In this group, an additional measurement was performed after 3–6 months on a gluten-free diet (GFD). Group B: 32 patients with a prior CD diagnosis and on a GFD for at least 6 months. Group C: 33 healthy controls. Citrulline levels were correlated with clinical and laboratory variables, including serological markers. Statistical analysis: t-tests for paired groups and independent groups, Pearson and Spearman correlation tests. Results: Newly diagnosed CD patients had lower citrulline levels compared to those on a GFD for more than 6 months (27.13 vs. 32.42 µmol/L; p > 0.05). Citrulline levels were nearly identical between healthy controls and CD patients on a GFD for more than 6 months (32.48 vs. 32.42 µmol/L; p > 0.05). Starting a GFD led to a significant increase in citrulline levels in group A (from 27.13 to 37.43 µmol/L, p < 0.001). Conclusions: Plasma citrulline could serve as a valuable marker for mucosal recovery in the follow-up of diagnosed celiac patients adhering to a GFD. [ABSTRACT FROM AUTHOR]

Following a gluten-free diet (GFD) is known as the main effective therapy available for celiac disease (CD) patients, which in some cases is not enough to heal all patients presentations completely. Accordingly, emerging researchers have focused on finding novel therapeutic/preventive strategies for this disorder. Moreover, previous studies have shown that celiac patients, especially untreated subjects, are at increased risk of developing viral and bacterial infections, which can become a challenge for the clinician. Viruses, such as Rotavirus, Reovirus, Adenovirus, Enterovirus, Rhinovirus, Astrovirus, Hepatitis virus, COVID-19, Norovirus, and Herpesvirus, have been related to CD pathogenesis. Therefore, clinicians need to pay more attention to evaluate CD patients' viral infection history (especially nonresponders to the GFD), to look for effective preventive strategies and educate patients about important risk factors. In addition, there are still viruses whose role in CD pathogenesis has not been fully studied. In this review, current information on the association between CD and various viral infections was gathered to improve knowledge in this subject area and draw researchers'/clinicians' attention to unstudied/less studied viruses in CD pathogenesis, which might guide future prevention approaches. [ABSTRACT FROM AUTHOR]

Introduction: Irritable bowel syndrome (IBS) is a common condition that alters the quality of life of patients. A variety of dietary interventions have been introduced to address this debilitating condition. The low-FODMAP diet (LFD), gluten-free diet (GFD), and Mediterranean diet are examples showing efficacy. The aim of this network meta-analysis was to compare these interventions to find the best approach. Methods: We performed a systematic review of the available literature through 14 March 2024 in the following databases: Embase, PubMed, MEDLINE OVID, Web of Science, CINAHL Plus, and Cochrane Central. We only included randomized controlled trials (RCTs). We used a random effects model and conducted a direct meta-analysis based on the DerSimonian–Laird approach and a network meta-analysis based on the frequentist approach. Mean differences (MDs) with 95% confidence interval (CI) were calculated. The primary outcomes included IBS quality of life (IBS QOL) and IBS symptom severity scale (IBS-SSS). Results: We finalized 23 studies including 1689 IBS patients. In the direct meta-analysis, there was no statistically significant difference in any IBS score between GFD and either LFD or standard diet. Meanwhile, the LFD was statistically superior to the standard diet in the IBS-SSS (MD: −46.29, CI: −63.72–−28.86, p < 0.01) and IBS QOL (MD: 4.06, CI: 0.72–7.41, p = 0.02). On ranking, the Mediterranean diet showed the greatest improvement in IBS-SSS, IBS-QOL, distension, dissatisfaction, and general life interference, followed by the LFD alone or in combination with the GFD. Conclusions: We demonstrated the efficacy of dietary interventions such as the LFD and Mediterranean diet in improving IBS. There is a need for large RCTs with head-to-head comparisons, particularly for the Mediterranean diet. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic, systemic, immune-mediated, inflammatory skin disease associated with significant comorbidities. Globally, there are an estimated 60 million people living with psoriasis (PLwP). There is a growing body of evidence on the role of diet in psoriasis management, and demand for dietary advice is high. However, there are no specific, evidence-based dietary guidelines. This scoping review summarises the literature on use and effectiveness of diet in the management of psoriasis to improve understanding of the evidence and assist PLwP and healthcare professionals (HCPs) to discuss diet. The findings were categorised into three themes: (1) dietary intakes of PLwP, (2) the perceived role of diet in psoriasis management and (3) dietary approaches to manage psoriasis symptoms. In cross-sectional studies PLwP were reported to have higher fat and lower fibre intakes compared with controls, and lower psoriasis severity was associated with higher fibre intake. However, research is limited. PLwP perceive diet to have an impact on symptoms and make dietary modifications which are often restrictive. Systematic reviews and RCTs found certain dietary approaches improved symptoms, but only in specific populations (e.g. PLwP with obesity and PLwP with coeliac disease), and evidence for supplement use is inconclusive. The grey literature provides limited guidance to PLwP; focusing on weight loss and associated comorbidities. Larger, controlled trials are required to determine dietary approaches for psoriasis management, especially in PLwP without obesity and non-coeliac PLwP. Further understanding of diet modification, information acquisition and experiences among PLwP will enhance holistic care for psoriasis management. [ABSTRACT FROM AUTHOR]

Celiac disease is an immune-mediated condition triggered by gluten ingestion in genetically predisposed individuals. The global prevalence of celiac disease is significant, affecting approximately 1.4% of women and 0.7% of men, with incidence rates of 17.4 and 7.8 per 100,000 person-years, respectively. The clinical presentation of celiac disease may range from overt diarrhea and malabsorption to more subtle features such as nutritional deficiencies and extraintestinal manifestations. It is the most common cause of global malabsorption in Western countries. A life-long gluten-free diet is the only available treatment for celiac disease. Moreover, a gluten-free diet is often adopted by individuals without celiac disease, either to address non-celiac gluten sensitivity or for other reasons. This review aims to explore the current understandings of the nutritional consequences of untreated celiac disease and the impact of the gluten-free diet itself. Physicians and dietitians specializing in celiac disease should focus on providing a well-rounded nutritional scheme to address deficiencies caused by the disease and prevent the instauration of new nutritional imbalances. [ABSTRACT FROM AUTHOR]

Background and Clinical Significance: The use of point-of-care ultrasound (POCUS) in emergency departments is rapidly growing due to its ability to provide immediate and accurate diagnostic information at the bedside. Furthermore, it can provide precise and rapid information on the location of multidistrict effusions in patients with suspected lymphatic decompensation. Case Presentation: This unique clinical case report describes a patient who presented with massive, multidistrict chylous effusion secondary to acute lymphatic insufficiency, a rare and challenging condition. Due to a recent diagnosis of celiac disease, the patient had started a gluten-free diet ten days before the onset of symptoms, suggesting a possible causal link. Through comprehensive thoracoabdominal POCUS, the diagnosis was made promptly, avoiding delays in treatment and enabling timely decision-making. Conclusions: This case emphasizes the critical role of POCUS not only in expediting diagnosis but also in guiding invasive procedures, such as thoracentesis, by visualizing fluid accumulation and anatomical structures in real-time. Moreover, POCUS provides an invaluable tool for ongoing clinical ultrasound follow-up, facilitating continuous monitoring without exposing the patient to the risks of radiation, thus optimizing patient care and resource utilization. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Life-long adherence to gluten-free diet (GFD) and its assessment is essential for patients with celiac disease (CeD). We have developed and validated a tool for assessing adherence to GFD which can be used by both physicians and dietitians. METHODS: Phase 1: Development, content validation, and assessment of reliability of tool. Phase 2: Validation of tool against standard dietary evaluation (SDE) (gold standard), immunoglobulin A - anti-tissue transglutaminase antibodies (IgA anti-tTG Ab), and gluten immunogenic peptides in urine. Overall, 380 biopsy-confirmed patients with CeD (derivation cohort: n = 100 [phase 1], n = 210 [phase 2] and independent validation cohort, n = 70) were recruited. RESULTS: Of an initial 90-point questionnaire, 84 items (Celiac Disease: Compliance Assessment Test [CD- CAT.v1]) were retained after content validation and pilot testing. In phase 1, upon administering CD- CAT.v1 on 100 patients, a comprehensive 35-item tool (CD-CAT.v2; a 5 0.86) was obtained after removing items with low test-retest reliability and item-rest correlation values. In phase 2, upon administering CD-CAT.v2 on 210 patients, 22 items were removed having low correlation values (R < 0.4) with SDE. Finally, a 13-item tool (CD-CAT.v3; a 5 0.84) was obtained with high criterion validity with SDE (r = 0.806, P < 0.001), moderate convergent validity with celiac disease adherence test (r = 0.602, P = 0.007), and moderate to weak correlation with urine gluten immunogenic peptides (r 5 0.46, P = 0.001) and IgA anti-tTG Ab (r = 0.39, P = 0.008), respectively. The final 13-item tool also strongly correlated with SDE (r 5 0.78, P < 0.001) in an independent validation cohort of 70 patients with CeD. Principal component analysis identified 3 relevant subscales with a cumulative variance of 62%. The sensitivity and specificity of CD-CAT.v3 were 80% and 91%, respectively, with an area under curve of 0.905 with SDE. The obtained cutoff score of <19 from the receiver operating characteristic curve was further categorized as 13 5 excellent, 14–18 5 very good, 19–28 5 average, and >28 5 poor adherence to GFD. DISCUSSION: CD-CAT is a new and rapid tool for monitoring dietary adherence to GFD with high sensitivity and specificity, which can be administered by both physicians and dietitians. [ABSTRACT FROM AUTHOR]

Background & Aims: In coeliac disease, the clinical role of the urinary gluten immunogenic peptide is unclear. It has been suggested it can be a non-invasive marker of villous atrophy. Therefore, we present the largest cross-sectional clinical data in patients with coeliac disease to establish the diagnostic accuracy of the urinary gluten immunogenic peptide in identifying villous atrophy. Methods: Patients providing urinary gluten immunogenic peptide were identified between September 2018 and August 2023 at the National Health Service (NHS) England National Centre for Non-Responsive and Refractory CD. In our retrospective study, the results of the urinary gluten immunogenic peptide test collected within 7 days, self-reported adherence to a gluten free diet reported within 3 months, serology collected within 7 days (immunoglobulin A - tissue transglutaminase and endomysial antibody) and histology at the time of endoscopy were compared in individuals with coeliac disease who were either asymptomatic and undergoing remission biopsies (group 1), non-responsive coeliac disease (group 2) and refractory coeliac disease on immunosuppressive therapy (group 3). Associations between dichotomous variables were calculated using chi-squared test. Results: In group 1 the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting villous atrophy were 42.9%, 83.3.%, 64.3% and 67.6% respectively. In group 2 the sensitivity, specificity, PPV and NPV for detecting villous atrophy were 36.2%, 79.0%, 39.5% and 76.6% respectively. In group 3 the sensitivity, specificity, PPV and NPV for detecting villous atrophy were 56.3%, 70.6%, 73.0% and 53.3%. More patients on immunosuppression had a positive urinary gluten immunogenic peptide than those not on immunosuppression (43.3% vs 24.1%, p<0.001). Conclusions: The urinary gluten immunogenic peptide does not have a role in identifying villous atrophy. Therefore, to assess for villous atrophy an upper gastrointestinal endoscopy is still required. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD) is an inflammatory enteropathy that has been associated to obstetric and gynecological disorders. However, it is still not adequately tested by gynecologists due to the misconception that it is solely a gastrointestinal disease. This underestimation requires the development of targeted interventions. Purpose: This study aims to evaluate the association between CD and obstetric/gynecological complications, highlight the importance of informing patients about CD manifestations, and assess the patient satisfaction with the information provided by healthcare professionals on the disease. Methods: A digital survey was administered to celiac women via the Italian Celiac Association's website. Results: We analyzed 493 questionnaires. Obstetric and gynecological disorders led to the diagnosis of CD in 11.7% of interviewed. The study revealed that untreated CD patients are more predisposed to miscarriages (41.8% vs 34% before/after diagnosis, respectively, p = 0.111), anemia in pregnancy (71.4% vs 40.4% before/after diagnosis, respectively, p < 0.001) and the risk of low birth weight (newborns weighing < 1500 g were 4.0% before and 1.1% after the gluten-free diet, p = 0.028). Women with CD, both before and after gluten-free diet, had higher infertility rates (about 19%) than the general population. Additionally, 73% of interviewees were dissatisfied with the information they received from health professionals about the reproductive implications of CD. Conclusion: Our research contributes to a deeper understanding of the intersection between CD and reproductive outcomes, highlighting the main obstetric and gynecological problems related to it. It emphasizes the importance of patient's perspective and the need for greater awareness about celiac disease from healthcare workers. [ABSTRACT FROM AUTHOR]

Purpose: For patients with celiac disease (CeD), the only current management option is adherence to a strict gluten-free diet (GFD); however, many patients on a GFD continue to experience symptoms with a significant impact on quality of life. Potential new treatments for CeD are under development and a validated patient-reported outcome measure is required to evaluate their utility in clinical trials. The purpose of this article is to provide a history of the development of the Celiac Disease Symptom Diary (CDSD) 2.1© for use in clinical trials. Methods: Qualitative and quantitative studies were conducted from 2010 to 2021, including concept elicitation and cognitive debriefing interviews with adult and adolescent participants with CeD (N = 93) diagnosed via biopsy and/or serology and input from eight interviews with CeD clinical experts. During these studies, different iterations of the CDSD were presented to the US Food and Drug Administration and the European Medicines Agency, and modifications were made in line with their feedback. Results: These studies ultimately led to the development of CDSD 2.1©, a daily diary which focuses on key symptoms of CeD (abdominal pain, bloating, diarrhea, nausea and tiredness). This patient-reported outcome measure was readily understood by adult and adolescent participants with CeD and content validity was demonstrated in both populations. Conclusion: CDSD 2.1© is a content-valid patient-reported outcome measure developed in accordance with best practices and regulatory guidance. A thorough exploration of the psychometric properties of CDSD 2.1© for both adult and adolescent participants with CeD is ongoing to support utilization in clinical trials. [ABSTRACT FROM AUTHOR]

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Introduction: Celiac disease (CD) is an autoimmune enteropathy characterized by atrophy of the intestinal mucosa triggered by the ingestion of gluten in individuals with a genetic predisposition. CD manifests with heterogeneous array of symptoms, including a wide range of intestinal and extraintestinal symptoms and manifestations (EIMs). The mechanisms involved in the pathogenesis of EIMs in CD are not only related to intestinal mucosal damage and associated malabsorption but also to systemic inflammation. To date, the only effective treatment for CD is a lifelong gluten-free diet (GFD). Proper adherence to the GFD leads in most cases to a gradual resolution of intestinal atrophy and results in an improvement of the clinical manifestations associated with intestinal damage. Areas covered: This review, based on a Pubmed literature search, describes the extraintestinal complications associated with CD, emphasizing strategies for therapeutic management and responsiveness to the GFD. Expert opinion: CD is associated with different EIMs which can affect different organs. The main clinical interest is if these complications respond to the GFD, which occur at variable rate and not for all disorders associated with CD. Therefore, often complementary additional therapies are needed to achieve optimal symptoms resolution. [ABSTRACT FROM AUTHOR]

Introduction: Immune checkpoint inhibitors (ICI) are used to treat various malignancies. They block the inhibitory signals of tumor cells and enhance the inflammatory cascade, which results in tumor killing. However, this can lead to unchecked inflammation throughout the body, leading to various adverse effects. A rare gastrointestinal adverse effect of ICI therapy is the development of immune-mediated celiac disease. This entity has a similar clinical presentation to the more common ICI-induced enterocolitis. Our study aims to determine the clinical characteristics and optimal treatment strategies for this rare ICI toxicity and differentiate it from ICI-induced enterocolitis. Methods and Material: We conducted a retrospective analysis of eight cases of ICI-induced celiac disease and 24 cases of ICI-induced enterocolitis from the literature. Data on patient demographics, clinical history, therapeutic interventions and outcomes were collected. A comparative analysis was performed to identify the key differences between the two groups. Results: Patients with ICI-induced celiac disease were more likely to have a pre-existing autoimmune condition and HLA-DQ2 positivity. Significant differences in clinical manifestations, histological findings, and treatment outcomes were observed. Notably, weight loss, nutritional deficiencies and electrolyte abnormalities were more commonly associated with ICI-induced celiac disease. Regarding pathology, duodenal villous blunting was noted more commonly with ICI-induced celiac disease. Initiating a gluten-free diet led to a rapid improvement in patients with ICI-induced celiac disease, while immunosuppressive therapy did not have an impact. Conclusion: ICI-induced celiac disease is a rare and underrecognized gastrointestinal adverse effect of ICI therapy, often misdiagnosed as ICI-induced enterocolitis. Early recognition and treatment with a gluten-free diet can lead to rapid symptom resolution, sparing patients from unnecessary systemic immunosuppression and the discontinuation of antineoplastic immunotherapy. [ABSTRACT FROM AUTHOR]

The world of science is increasingly looking for answers to the question of how specific dietary components affect the risk of chronic diseases and assessing their potential to alleviate the severity of individual diseases. This research concerns both the assessment of the benefits of using individual dietary components and those of nutritional models. Endometriosis, due to its chronic and inflammatory nature, is also a topic of interest among scientists, who seek to support its course through proper nutrition. In endometriosis, great interest is focused on dietary patterns such as an anti-inflammatory diet, a gluten-free diet, a low-FODMAP diet, or a Mediterranean diet. An anti-inflammatory diet primarily focuses on fresh vegetables, fruits, seeds, nuts, whole grain products, and healthy sources of protein and fats, including mono- and polyunsaturated fatty acids, eliminating highly processed products, meat products, trans fats, and refined sugars. It is believed that this type of diet may contribute to reducing the severity of endometriosis symptoms and help reduce inflammation. The aim of the review is to identify the main trends in the field of diets supporting the treatment of endometriosis in the last 5 years. [ABSTRACT FROM AUTHOR]

Nowadays, the gluten-free diet (GFD) has become much more than the dietary treatment for celiac disease. Due to its presumed beneficial effects even in non-celiac subjects, it has become a new fashion statement and it is promoted by some healthcare professionals, social media and marketing strategists. On the other hand, regardless of a proper medical indication, a GFD may present side effects, such as poor palatability, high costs and socio-psychological adversities. Moreover, it can be an obstacle to correct clinical practice and may induce nutritional deficiency due to a low-quality diet. In addition, a GFD can trigger or exacerbate many irritable bowel syndrome (IBS)-like disorders in predisposed subjects: reactivity to dietary nickel, the increased consumption of FODMAP-rich foods and histamine intolerance seem to frequently play a relevant role. The possible intersections between high-risk foods in these categories of patients, as well as the possible overlaps among IBS-like disorders during GFD, are described. In conclusion, it is advisable to undergo a careful clinical evaluation by a gastroenterologist and a nutritionist (in some cases, also a psychotherapist) before starting and during a GFD, because both benefits and risks are possible. It is also important to take into account IBS-like disorders that can be exacerbated by a GFD and that are still underestimated today. [ABSTRACT FROM AUTHOR]

Background: Individuals with celiac disease (CD) often report the persistence of gastrointestinal symptoms despite adherence to a gluten-free diet (GFD). A diet rich in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) could cause symptoms in CD on a GFD, and conversely a low-FODMAP diet could positively influence the therapeutic management of CD and non-celiac gluten sensitivity (NCGS). The aim of this review was to explore the hypothetical impact of the FODMAD diet and the low-FODMAP diet (LFD) in CD and gluten-related disorders. Methods: A complete online search for FODMAP related to CD, NCGS, and the GFD was carried out using the Pubmed, Medline, and Cochrane databases. Results: Indeed, an LFD could successfully provide symptom relief in GFD-treated CD patients. Fructans, typical components of FODMAPs, have been associated with digestive symptoms in NCGS, and an LFD could improve the clinical picture. According to some evidence, an LFD could also improve the psychological status both in celiac patients on a GFD and in NCGS. However, an LFD should not have a significant impact on gut microbiota. Conclusions: Recent evidence supports the role of FODMAP restriction in CD patients with persistent symptoms on a GFD and in decreasing gastrointestinal disturbances in NCGS, although the GFD still represents the first-line therapy. [ABSTRACT FROM AUTHOR]

Gut microbiota in non-celiac gluten sensitivity (NCGS) has been poorly studied for its involvement in the disorder and site specificity. We investigated small intestinal, large intestinal and stool microbiota profiles in patients with NCGS and highly overlapping disorder irritable bowel syndrome (IBS) as well as effect of gluten-free diet (GFD) on microbiota in patients with NCGS. True NCGS patients were recruited based on serological response for anti-gliadin antibodies, 6-week gluten free diet (GFD) and symptom recurrence with gluten-rechallenge. Analyses using 16S rRNA gene amplicon and shotgun sequencing revealed community differences in core microbiome and diversity measures across sample types indicating dysbiosis mainly in mucosa-associated small intestinal microbiome of NCGS patients. Genera Elusimicrobiaum, Succinivibrio, Bacillus and Alcaligenes appeared as signatures in small intestine and stool in NCGS patients. Presence of differential taxa co-occurring at sampling sites, enabled recognition of site-specific microbial signatures. GFD led to a shift in mucosa-associated small intestinal core microbiome. Metagenome analysis revealed subtle differences in pathways for amino acid biosynthesis including L-ornithine. Mucosa-associated small intestine microbial structure was quite distinct in patients with NCGS in comparison to that with IBS.

Objectives: To assess the effects of a gluten-free diet on bone structure in children with celiac disease using fractal analysis on panoramic radiographs. Method and materials: A total of 49 patients with celiac disease aged 6 to 13 years, separated into two groups as previously and newly diagnosed, and a control group of 32 healthy individuals were evaluated. In previously and newly diagnosed patients with celiac disease, body mass index Z-scores were calculated, calcium, alkaline phosphatase, vitamin D3, and parathormone levels were measured, and bone mineral density Z-scores were obtained from dual energy x-ray absorptiometry. In all patients, the fractal dimensions of the right and left temporomandibular condyles were evaluated with the fractal analysis method on panoramic radiographs. Results: The mean values of serum biomarker levels and the body mass index and bone mineral density Z-scores for both celiac groups were within the normal reference range. No statistically significant difference was determined between right and left condyle fractal dimensions values in the three groups examined. In terms of both right and left condyle fractal dimensions values, there was a statistically significant difference between groups. The highest fractal dimensions values were determined in the previously diagnosed group. Conclusions: Differences in fractal dimensions values were observed among patients with celiac disease following the gluten-free diet. Utilizing fractal analysis on panoramic radiographs can prove valuable for dental practitioners in evaluating bone mineral density due to its cost-effect iveness, easy accessibility, and reduced radiation exposure for patients, enabling them to provide comprehensive oral health care and potential early interventions for patients with celiac disease. [ABSTRACT FROM AUTHOR]

Gluten proteins in cereal grains are often considered unsafe for health. Indeed, the dissemination of misinformation through various sources has led to a widespread misconception that the consumption of gluten by healthy individuals results in adverse health consequences and contributes to obesity. In recent years, many health-conscious consumers have started reducing or avoiding gluten consumption without a medical recommendation. Consequently, the adoption of gluten-free diets has expanded significantly. This study compared 39 gluten-free products and their gluten-containing counterparts for energy, sugar, dietary fiber content, and price. We found that, on average, gluten-free products available to United States consumers contained significantly less protein and more sugar and calories. Furthermore, on average, gluten-free products are more expensive than gluten-containing products. Our finding may serve as a guide for dietitians, nutritionists, and legislators in introducing a gluten-free prescription list for individuals with celiac disease, wheat allergy, and non-celiac wheat sensitivity. [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is a chronic illness. Blood testing for tissue transglutaminase antibodies is the initial screening test for the diagnosis of CD, and upper gastrointestinal endoscopy and duodenal/jejunal biopsy are used to confirm CD. Intussusception (IS) is the process in which a proximal segment of the bowel invaginates through the lumen of a distal segment. The association between pediatric IS and CD has been described but is still not widely recognized. Herein, we report a case of IS as the first manifestation of CD in a child. A 3-year-old girl presented to the emergency department with a 1-week history of marked abdominal distention and lethargy, but there was no history of fever, bleeding per rectum, or jaundice. A second-degree relative had a family history of CD. Clinical examination: The patient was a lethargic child with pale conjunctiva and bilateral lower limb edema. She was a febrile and had a normal hemodynamic status. The adipose tissue was diminished throughout the patient’s body; her weight was 8 kg (

Abstract Background Celiac disease is an autoimmune disorder triggered by dietary gluten in genetically predisposed individuals that primarily affects the small intestine. Studies have reported differentially abundant bacterial taxa in the gut microbiota of celiac patients compared with non-celiac controls. However, findings across studies have inconsistencies and no microbial signature of celiac disease has been defined so far. Results Here, we showed, by comparing celiac patients with their non-celiac 1st-degree relatives, that bacterial communities of related individuals have similar species occurrence and abundance compared with non-relatives, regardless the disease status. We also found in celiac patients a loss of bacterial species associated with fiber degradation, and host metabolic and immune modulation, as ruminiclostridia, ruminococci, Prevotella, and Akkermansia muciniphila species. We demonstrated that the differential abundance of bacterial species correlates to different dietary patterns observed between the two groups. For instance, Ruminiclostridium siraeum, Ruminococcus bicirculans, and Bacteroides plebeious, recognized as fiber-degraders, appear more abundant in non-celiac 1st-degree relatives, which have a vegetable consumption pattern higher than celiac patients. Pattern of servings per day also suggests a possible link between these species’ abundance and daily calorie intake. Conclusions Overall, we evidenced that a kinship approach could be valuable in unveiling potential celiac disease microbial traits, as well as the significance of dietary factors in shaping microbial profiles and their influence on disease development and progression. Our results pave the way for designing and adopting novel dietary strategies based on gluten-free fiber-enriched ingredients to improve disease management and patients' quality of life.