Urszula Krupa-Kozak

Pathologic bone alterations in celiac disease: Etiology, epidemiology, and treatment

Low bone mineral density (BMD), osteopenia, and osteoporosis are frequent complications of celiac disease (CD). The etiology of pathologic bone alterations in CD is multifactorial; however, two main mechanisms are involved: intestinal malabsorption and chronic inflammation. A strict gluten-free diet (GFD) is thought to be the only effective treatment for CD; but treating bone complications related to CD remains complex. The objective of this review is to elucidate the bones problems related to CD and to increase awareness of osteoporosis development, considered as a sign of atypical CD presentation. Currently, a question of whether GFD alone is an effective treatment to correct the bone alterations in patients with CD is under debate. This review presents factors contributing to pathologic bone derangement, recent research on the epidemiology of low BMD, osteoporosis, and fractures, and the treatment of bone problems in patients with CD. The roles of calcium and transport mechanisms are additionally presented.

Breadmaking performance and technological characteristic of gluten-free bread with inulin supplemented with calcium salts

The fortification of gluten-free bread containing inulin with different organic and non-organic calcium sources was investigated. Calcium lactate, calcium citrate, calcium chloride and calcium carbonate were used as calcium sources. Gluten-free bread composed of corn starch, potato starch, salt, yeast, pectin, sugar and sunflower oil was used as a reference. The calcium salts were supplemented to the gluten-free formula to provide equal content of elementary calcium (Ca+2). The Mixolab® device was used to analyse the behaviour of gluten-free dough subjected to a dual mechanical shear stress and temperature constraint. Calcium salts significantly modified the dough behaviour during heating and cooling. The addition of calcium carbonate and calcium citrate provoked an increase in dough consistency during heating and cooling compared with the other salt-enriched samples. The specific volume and texture parameters of gluten-free breads varied with the calcium salt used, but calcium carbonate and calcium citrate showed improved values. The higher calcium content of the enriched breads, compared with the control, confirmed the fortification. Sensory evaluation of the calcium-fortified breads confirmed that calcium carbonate followed by calcium citrate was the most recommended salt for obtaining calcium fortification of gluten-free breads.

Application of dairy proteins as technological and nutritional improvers of calcium-supplemented gluten-free bread.

Effect of dairy proteins on gluten-free dough behavior, and nutritional and technological properties of gluten-free bread was evaluated. Experimental doughs, containing dairy powders, showed low consistency. Obtained gluten-free breads were rich in proteins, and, regarding the energy value delivered by proteins, they could be considered as a source of proteins or high in proteins. Applied dairy proteins affected the technological properties of experimental breads causing a significant (p < 0.05) increase of the specific volume, crust darkening, and crumb lightness, depending on the dairy supplementation level, rather than the protein type. Dairy proteins incorporated at a 12% level, significantly (p < 0.05) decreased the hardness; nevertheless, the highest amount of proteins tested led to the opposite effect. These results indicate that milk proteins tested could be successfully added to gluten-free bread with beneficial effects on technological and nutritional properties.

Native and microwaved bean and pea starch preparations: physiological effects on the intestinal ecosystem, caecal tissue and serum lipids in rats

Dietary beans and peas provide fibre, resistant starch and other nutrients that are often lacking in the human diet. The influence of native starches of beans and peas (and microwaved preparations) on N utilisation, biochemical indices in blood serum and caecal ecosystem state (SCFA, bacterial enzymes, micro-organisms) was studied in vivo. The native pea starch contained more resistant starch compared with its bean counterpart (31 v. 17 %); however, processing decreased these amounts to 25 v. 10 %. N digestibility was found to decrease considerably in all experimental groups. A considerable reduction was observed in glucose and total cholesterol concentration in rat blood serum as a result of feeding both dietary legume starch preparations under microwave treatment. This indicates that starch of bean origin activated glycolytic bacterial enzymes; however, all the analysed starches were found to reduce the activity of beta-glucuronidase. In addition, both dietary bean starches significantly induced the formation of SCFA in the caecal digesta. As compared with the control group, a significant decrease in the pH of caecal and colonic digesta was demonstrated for both bean starch preparations. In comparison with the diet with native pea starch, its microwaved preparation reduced the concentrations of acetic, butyric and propionic acids among caecal SCFA and increased the pH of caecal and colonic digesta. The atherogenic index was significantly lower in rats fed microwaved pea starch. All investigated starch preparations increased the population of Bifidobacterium spp. in caecal digesta, but were also good substrates for opportunistic Enterococcus or Escherichia coli.

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.

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.

Influence of Chemically-Modified Potato Starch (RS Type 4) on the Nutritional and Physiological Indices of Rats

Influence of Chemically-Modified Potato Starch (RS Type 4) on the Nutritional and Physiological Indices of Rats A biological study was undertaken to analyse the metabolic effect of feeding rats with an experimental diet in which cellulose was substituted with 20% contribution of chemically-modified potato starches (subjected to oxidation, esterification, cross-linking and dual modification). Caecum digesta mass was significantly higher in rats fed the experimental potato starch preparations compared to control group. Luminal ammonia concentration and pH of caecal or colonic content were lower as an effect of diets with all the investigated preparations. Compared to the cellulose-containing diet (control), all modified potato starch preparations raised the content of SCFA in caecum digesta when fed to rats. Significant lowering of the levels of triacylglycerols and total cholesterol was noticed for all chemically-modified starch preparations. The activity of β-glucuronidase determined upon the administration of potato starch preparations into rat diets was significantly lower as compared to the control diet. The results indicate that the chemically-modified potato starch preparations are a good substrate for the intestinal microecosystem and may promote the beneficial status of the gastrointestinal tract of rats.

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.

Knowledge about coeliac disease: Results of survey conducted among persons screened using a self-administered transglutaminase-based test

Coeliac disease (CD) is an autoimmune, gluten-related disorder occurring in genetically predisposed individuals. The keystone to CD management is a gluten-free diet (GFD). Recently, media have been promoting the application of a GFD, however, this is necessary only in gluten-related disorders. The aim of the present study was to evaluate the knowledge on CD among individuals, who conducted a self-administered coeliac disease test. Three hundred adult volunteers took part both in the anti-tissue transglutaminase screening and the survey concerning knowledge on CD. Five positive CD tests were obtained, representing 1.67% of the analysed population. In general, the questionnaire respondents were familiar with the issue of CD. The majority of them correctly defined CD as gluten intolerance, and realized that it may occur at any age. Gastrointestinal problems were easily associated with CD, however, extraintestinal symptoms were less frequently recognized as a manifestation of this disease. A GFD was properly ...

Native wheat, potato and pea starches and their physically modified preparations tested in vitro as the substrates for selected Bifidobacterium strains

The wheat, potato and pea starches subjected to physical modification were studied in vitro as a substrate for selected Bifidobacterium strains (Bifidobacterium breve KN14, Bifidobacterium animalis KS20a1). The effects of these substrates on bifidobacterial growth, acidifying activity, metabolic end-products and changes in starch microstructure were assayed after 24-h fermentation. Physically modified starch preparations were better utilized substrates for growth of Bifidobacterium monocultures, in comparison with native starches. Lactic acid occurred in the highest concentration in the culture of B. breve KN14 (55–104 µmol/100 ml), whereas acetic acid was highest in the culture of B. animalis KS20a1 (329–378 µmol/100 ml). The microstructure pictures showed meaningful differences between native and modified starches stemmed from the enzymatic action of examined Bifidobacterium strains during fermentation. Obtained results confirmed the stimulation of growth and acidifying activity of selected Bifidobacterium strains by investigated physically modified starches in comparison with native starch.