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Consuming cereals, including wheat, is much older than agriculture. Wheat selection, cultivation, and processing gradually developed in prehistorical times. The wheat species einkorn, emmer, and spelt wheat remained major human staples until the last century when durum wheat for pasta products, and especially bread wheat oust the ancient grains from the market. Wheat species may hybridize, resulting in new wheat species, some in preagricultural times, but others induced more recently. Traditional wheat cultivation with mixed species resulted in landraces well adapted to local environments. More than half a million accessions are stored in gene banks globally. Modern breeding applies the genetic flexibility of wheat. The bread wheat genome has been sequenced, and advanced wheat breeding and processing technologies have been developed, aiming, for example, at the development of celiac-safe food. Discussing wheat in the context of diversity and health requires a production chain-wide approach regarding gluten accumulation and health effects. The protein fraction of wheat grains includes several families of gluten genes: (1) high-molecular-weight glutenins, 6%–10% of the gluten fraction, (2) sulfur-rich alpha- and gamma-gliadins, and B- and C-type low-molecular-weight (LMW) glutenins, 70%–80% of the gluten fraction), and (3) sulfur-poor omega-gliadins and D-type LMW glutenins, 10%–20% of the gluten fraction. The glutenins form the three-dimensional network in wheat dough and are responsible for elasticity, while gliadins convey viscosity. The unique characteristics of wheat gluten are part of the reason why wheat is used as a very versatile component in many food products. Over 30% of supermarket packed processed foods contain bread wheat or derived ingredients. A connection between the consumption of processed foods and the incidence of chronic diseases is suggested, but consumption of whole grain (wheat) foods is advised to contribute to chronic disease prevention.

Cereals are among the oldest foods of humans. Wheat is one of these. In present times,several syndromes are, whether true or false, increasingly attributed to the consumption of wheat, with increasing costs for medical care and decreasing turnover for the food industry, especially the bakery sector. Many western societies show remarkable annual increases in their health care costs, often surmounting their economic growth rates. Governmental health policies should urgently revert towards the stimulation of disease prevention practices instead of maintaining the stimulation of expensive medical care.Here we review and discuss possible strategies to prevent or reduce the incidence of wheat-related conditions through application of breeding and food-related technologies. Breeding includes selection and crossing for low-immunogenic wheat varieties using varieties, accessions, and wild relatives, silencing the expression of gluten genes, and advanced genome editing techniques to eliminate gluten genes, such as CRISPR/Cas9 technology. Food-related approaches include the reduced application of vital gluten, exclusion of gliadin from isolated gluten by separation, increased use of sourdough fermentation and malting, utilisation of patient-specific gluten epitopesensitivityprofiles, introduction of the gluten contamination elimination diet (GCED)especially in individuals that are non-responsive to the gluten-free diet, to acquire more fundamental knowledge on immune modulating factors, and the design of an intervention study to learn about the medical and mental motives of people to switch towards a ‘gluten-free’ diet. Finally, we discuss the development, testing and promoting of efficient disease prevention measures within the societal context.

Cereals are among the oldest foods of humans. Wheat is one of these. In present times, several syndromes are, whether true or false, increasingly attributed to the consumption of wheat, with increasing costs for medical care and decreasing turnover for the food industry, especially the bakery sector. Many western societies show remarkable annual increases in their health care costs, often surmounting their economic growth rates. Governmental health policies should urgently revert towards the stimulation of disease prevention practices instead of maintaining the stimulation of expensive medical care.Here we review and discuss possible strategies to prevent or reduce the incidence of wheat-related conditions through application of breeding and food-relatedtechnologies. Breeding includes selection and crossing for low-immunogenic wheat varieties using varieties, accessions, and wild relatives, silencing the expression of gluten genes, and advanced genome editing techniques to eliminate gluten genes, such as CRISPR/Cas9 technology. Food-related approaches include the reduced application of vital gluten, exclusion of gliadin from isolated gluten by separation, increased use of sourdough fermentation and malting, utilisation of patient-specific gluten epitopesensitivity profiles, introduction of the gluten contamination elimination diet (GCED) especially in individuals that are non-responsive to the gluten-free diet, to acquire more fundamental knowledge on immune modulating factors, and the design of anintervention study to learn about the medical and mental motives of people to switch towards a ‘gluten-free’ diet. Finally, we discuss the development, testing and promoting of efficient disease prevention measures within the societal context.

With this White Paper, the current state of scientific knowledge on human disorders related to gluten and wheat is presented, with reference to other grains such as spelt, barley, rye, and oats. Backgrounds are described of coeliac disease (gluten intolerance), wheat allergies and any kind of wheat sensitivity, followed by strategies that are suggested to reduce disease prevalence and to mitigate symptoms. Research is proposed that focuses on the possibilities to modify raw materials and process technologies for the development of products that may give rise to reduced intolerance and sensitivity reactions to wheat proteins and related components. These strategies can be implemented at short, medium or long term and are of interest to the food sector, in particular the bakery, pasta and breakfast cereal segments.

In veel westerse landen groeit de aandacht voor tarwe en gluten. Ook mensen zonder tarweallergie of coeliakie lijken tarweproducten steeds vaker links te laten liggen. Samen met universiteiten en onderzoeksinstanties brengt het Nederlands Bakkerij Centrum de oorzaken, feiten en alternatieve mogelijkheden in kaart met als doel tot oplossingen voor de korte en lange termijn te komen.

Speltproducten zijn niet meer weg te denken uit het assortiment van elke bakkerij, waar broodtarwe nog steeds de basisgrondstof is. Toch groeit met de populariteit van speltgraan, ook de belangstelling voor andere in onbruik geraakte granen, zoals eenkoorn, emmer en haver. De smaak en de gezondheidsaspecten daarvan maken wetenschappers, voedingsdeskundigen, akkerbouwers, molenaars, bakkers én consumenten nieuwsgierig.

EDE - Ziekenhuis Gelderse Vallei in Ede houdt maandag 27 oktober samen met de Nederlandse Coeliakie Vereniging een voorlichtingsbijeenkomst. Het thema van deze avond is: 'Coeliakie van haver tot gort'. Aan bod komen de behandeling van coeliakie en de onderzoeken die daarbij horen maar ook het dagelijkse leven met coeliakie. Er is gelegenheid om vragen te stellen. In Nederland kunnen zo'n 160.000 mensen niet tegen gluten, zij hebben een glutenintolerantie, ook wel coeliakie genoemd. Gluten is een eiwit dat van nature voorkomt in diverse granen en dus ook in de producten die van deze granen zijn gemaakt. Patiënten met coeliakie krijgen door het eten van gluten ontstekingen in het slijmvlies van de dunne darm. De darmvlokken gaan daardoor kapot en het darmslijmvlies raakt beschadigd. Bij langdurige schade aan het darmslijmvlies worden belangrijke voedingsstoffen niet meer goed opgenomen. Klachten die dan kunnen ontstaan zijn buikpijn, een opgezette buik, diarree en vermoeidheid. Beschadigde darmvlokken herstellen zich zodra de patiënt geen gluten meer eet. Zelden zijn de beschadigingen blijvend. Na herstel van de darm blijven patiënten gezond zolang ze geen gluten binnenkrijgen. Maar een glutenvrij dieet vergt wel veel discipline.

Cereals, especially wheat, may cause several food-related diseases, of which gluten intolerance (coeliac disease, CD) is the best defined: specific immunogenic epitopes, nine amino acid-long peptide sequences, have been identified from various gluten proteins. These may activate T cells, causing inflammation of the small intestine and a wide variety of other symptoms. Here, we review several breeding-related strategies aiming at reduction or elimination of such epitopes from wheat, including variety selection, re-synthesis of hexaploids, deletion of specific chromosomal fragments, RNA-interference, mutagenesis and genome editing using CRISPR/Cas9. The related issue of genetic modification (GM) is discussed. These strategies should lead to wheat food products to be used in gluten-free diets for diagnosed CD individuals and/or to strongly reduce the burden from immunogenic gluten to the non-diagnosed CD population.

During the last decades, the prevalence of nutrition-related chronic diseases, such as diabetes type 2, obesity, coronary heart disease, hypertension, and food allergies and intolerances (such as celiac disease), as well as some types of cancer, has been gradually increasing, with a growing impact on healthcare costs. It is generally agreed that these diseases are a negative consequence of economic prosperity with the prevailing Western lifestyle, which is characterized by limited exercise; over-consumption of, in particular, highly refined processed foods and sugar-sweetened beverages; high hygiene; unlimited application of antibiotics; and stress. This Western lifestyle seems, among other things, to affect the proper functioning of the digestive and immune systems. Factors that can contribute to disease prevention should be identified and explored. A key aim of Wageningen University and Research Centre (Wageningen UR) is the improvement of quality of life, in which the prevention of chronic diseases plays an important part. And it’s in this context that this story of wheat and oats takes place (Gilissen et al., 2010).

Several tests are currently marketed for measuring the amount of gluten in food products and to determine whether products are gluten-free. Of these tests, the Codex Alimentarius approved the R-Biopharm R5 ELISA as the gluten detection standard. This test is based on recognition by a monoclonal antibody (mAb) of five amino acidlong peptide sequences, which are abundantly present in the gliadin proteins of wheat gluten. Another mAb-based test recognises specific peptide sequences of six amino acids (G12 ELISA, Romer Labs). Both tests enable estimating the total amount of gluten (gluten = gliadin x 2) in a wheat product. As the number and composition of coeliac disease (CD) epitopes vary between gliadins and glutenins, among varieties, and between wheat, rye and barley, there is no direct relationship between the estimated gluten content and the presence of CD epitopes. Many research groups have raised epitope-specific T cell clones (TCCs) from patient biopsies that can be used for detection of specific CD-immunogenic gluten epitopes. Such CD epitopes are specific nine amino acid-long peptide sequences rich in prolamin (P) and glutamin (Q) residues. Recently, a list of internationally agreed CD epitopes has been published [1]. Unfortunately, T cell-based tests are mostly qualitative, indicating the presence or absence of a particular epitope, and they are unable to quantitate the overall CD-immunogencity of a given wheat variety. Proper quantitation of CD epitopes is relevant because the amount of non-CDimmunogenic gluten proteins can differ among wheat varieties and genomes (ploidy levels) [2], and the CD-immunogenicity of individual epitopes can be different according to the patient’s sensitivity profile [3,4]. Already a single amino acid substitution in a T cell epitope, especially from proline (P) to serine (S), may abolish T cell binding and thus eliminate the epitope’s CD-immunogenicity [5]. Therefore, gluten detection in the context of coeliac disease should be in line with the internationally agreed list of CD-relevant epitopes. To overcome the shortcomings of mAb-based and T cell-based tests, new approaches are now under development, especially based on genomic and proteomic analysis, aiming at the identification of the profile of CD-immunogenic epitopes of individual wheat species and varieties (for breeding and selection), and at quantitation of CD epitope-containing gluten proteins or fragments in foods (for food diagnostics).

Allergy is an immunological disease caused by multiple factors and characterized by variability, specificity and complexity. "Multidisciplinary Approaches to Allergies" covers diverse aspects ranging from basic molecular mechanisms to societal issues within the framework of multidisciplinary approaches to allergies. It contains 29 chapters in 6 parts: General Allergy; Allergenic Sources and Allergens; Diagnosis; Therapies and Pharmacy; Hypoallergenic Products; Environment, Hygiene and Societal Issues.

Consumption of fruit and vegetables among 12-18 year olds is well below recommendations. In the Netherlands, this comprises a group of approximately 1.4 million individuals. The health promoting effects of a diet with sufficient fruit and vegetables is well recognized within this group, but it is a “non-issue”. Eating in general does not receive a lot of attention in this group. A variety of private partners is interested to produce vegetable products or put vegetable enriched products onto the market. However, knowledge about attitude and behaviour of the target group with respect to vegetable consumption is lacking. New products often fail to really penetrate the market. In two independent workshops with Food and Product designers, the social environment and the behaviour and attitude of 12-18 year olds with respect to vegetable consumption has been investigated and a start is made to develop products specifically targeted to this group. One of the conclusions is that the school environment often is not stimulating vegetable consumption. There is limited time available, it is often a chaotic moment in time and the physical environment is often insufficient to ensure the required attention for eating. Also most schools are not focussed on healthy eating but are, understandably, more concerned with education. During the workshops a larger number of new concepts have been developed and a selected number has been further developed into possible new products and solutions. The outcome of the workshops provides a source of information and inspiration for the design of vegetable products to be used in future food interventions with private partners. In twee onafhankelijke workshops is met Food en Product designers en "jongeren deskundigen" de leef- en belevingswereld van jongeren in kaart gebracht en een aanzet is gegeven voor ontwikkeling van nieuwe op jongeren gerichte groenteproducten.

Wageningen University & Research centre heeft samen met het Universitair Medisch Centrum Utrecht en Universitair Medisch Centrum Groningen een hypoallergene appel geïdentificeerd, de Santana, die sinds 2006 als zodanig verkrijgbaar is in de supermarkt. In 2011 is hier het ras Elise met een ander smaakprofiel en andere bewaareigenschappen als nieuwe hypoallergene appel bijgekomen. Hiermee is het aanbod verbreed. Daarnaast zijn appels genetisch gemodificeerd (GM) om te onderzoeken of de techniek van ‘gene silencing’ geschikt is om het meest voorkomende allergeen in appel, Mal d 1, uit te schakelen. Deze GM-appels zijn niet bestemd voor consumptie. Ten slotte is met een combinatie van DNA-onderzoek en veredelingsonderzoek een mogelijk laagallergene eiwitvariant van Mal d 1 geïdentificeerd die slechts één aminozuur verschilt van een hoogallergene variant. De kennis uit dit onderzoek wordt benut om de ontwikkeling van hypoallergene appelrassen en andere hypoallergene plantaardige producten te versnellen en daarmee de kwaliteit van leven van de allergische consument te verbeteren.

In 2009 a survey was conducted among a representative sample of around 500 young people between the ages of 12 and 18 in the Netherlands. The first section examined the eating patterns of the young people and their attitude towards nutrition. The second section examined their vegetable consumption and how they experience vegetables, as well as the factors which influence this. The final section consisted of a choosing experiment, in which the participants were asked to choose from among two or three vegetable products and evaluate them on the basis of a number of product characteristics. In 2009 is een enquêteonderzoek uitgevoerd onder een representatieve steekproefgroep van circa 500 jongeren tussen 12 en 18 jaar in Nederland. In het eerste onderdeel is het eetgedrag van de jongeren onderzocht en hoe ze tegen voeding aankijken. Het tweede onderdeel ging in op de groenteconsumptie en de groentebeleving van de jongeren en de factoren die daarop van invloed zijn. Het laatste gedeelte van de vragenlijst was een keuze-experiment waarbij de jongeren gevraagd werd te kiezen tussen twee of drie groenteproducten en deze te beoordelen op een aantal productkarakteristieken.

Plantenfysioloog Luud Gilissen van Plant Research International werkte aan het opzetten van een glutenvrije keten voor haver. Het succes daarvan leidde tot een nieuw initiatief met medewerking van meer bedrijven om een haverketen op grotere schaal op te zetten.

A significant increase has been observed in the prevalence of coeliac disease (CD) during the last decades. Increased consumption of wheat and in particular gluten is considered one of the major causes. CD is a food-related disease caused by certain gluten peptides from wheat, rye, and barley containing T-cell stimulating epitopes. The use of screening protocols in wheat breeding detecting the absence of CD-epitopes (e.g. Glia-a9 and Glia-a20) can result in the reduction of CD-epitopes in commercial wheat and wheat based products. This approach will lead to decreased exposure, especially in many CD-patients with silent or latent CD that have not yet been diagnosed. In the long-term, this may lead to a large-scale reduction of the incidence of CD and a significant improvement of the quality of life of CD-patients.

In dit rapport zullen verschillende mogelijke strategieën besproken worden die ingezet kunnen worden om de consumptie van groenten door jongeren te verhogen. De centrale vragen van dit onderzoek zijn: 1) Hoe kunnen groenten in het eetpatroon van jongeren een vaste plek van voldoende omvang krijgen? 2) Hoe kunnen groenten concurreren met minder gezonde voedingsproducten dan waar nu voor gekozen wordt? Eerst zullen de bevindingen die van belang zijn voor het opzetten van interventies besproken worden. Deze bevindingen komen voort uit literatuur, voorafgaand onderzoek en enkele recent (afgeronde) andere projecten.

Celiac disease is caused by an uncontrolled immune response to gluten, a heterogeneous mixture of wheat storage proteins, including the alpha-gliadins. It has been shown that alpha-gliadins harbor several major epitopes involved in the disease pathogenesis. A major step towards elimination of gluten toxicity for celiac disease patients would thus be the elimination of such epitopes from alpha-gliadins. We have analyzed over 3,000 expressed alpha-gliadin sequences from 11 bread wheat cultivars to determine whether they encode for peptides potentially involved in celiac disease. All identified epitope variants were synthesized as peptides and tested for binding to the disease-associated HLA-DQ2 and HLA-DQ8 molecules and for recognition by patient-derived alpha-gliadin specific T cell clones. Several specific naturally occurring amino acid substitutions were identified for each of the alpha-gliadin derived peptides involved in celiac disease that eliminate the antigenic properties of the epitope variants. Finally, we provide proof of principle at the peptide level that through the systematic introduction of such naturally occurring variations alpha-gliadins genes can be generated that no longer encode antigenic peptides. This forms a crucial step in the development of strategies to modify gluten genes in wheat so that it becomes safe for celiac disease patients. It also provides the information to design and introduce safe gluten genes in other cereals, which would exhibit improved quality while remaining safe for consumption by celiac disease patients.

Background: Gluten proteins can induce celiac disease (CD) in genetically susceptible individuals. In CD patients gluten-derived peptides are presented to the immune system, which leads to a CD4+ T-cell mediated immune response and inflammation of the small intestine. However, not all gluten proteins contain T-cell stimulatory epitopes. Gluten proteins are encoded by multigene loci present on chromosomes 1 and 6 of the three different genomes of hexaploid bread wheat (Triticum aestivum) (AABBDD). Results: The effects of deleting individual gluten loci on both the level of T-cell stimulatory epitopes in the gluten proteome and the technological properties of the flour were analyzed using a set of deletion lines of Triticum aestivum cv. Chinese Spring. The reduction of T-cell stimulatory epitopes was analyzed using monoclonal antibodies that recognize T-cell epitopes present in gluten proteins. The deletion lines were technologically tested with respect to dough mixing properties and dough rheology. The results show that removing the α-gliadin locus from the short arm of chromosome 6 of the D-genome (6DS) resulted in a significant decrease in the presence of T-cell stimulatory epitopes but also in a significant loss of technological properties. However, removing the ω-gliadin, γ-gliadin, and LMW-GS loci from the short arm of chromosome 1 of the D-genome (1DS) removed T-cell stimulatory epitopes from the proteome while maintaining technological properties. Conclusion: The consequences of these data are discussed with regard to reducing the load of Tcell stimulatory epitopes in wheat, and to contributing to the design of CD-safe wheat varieties.

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