1. Investigación

The only available treatment for celiac disease is life-long gluten exclusion. We conducted a cross-sectional age- and gender-matched study in 64 celiac adults on a long-term (>1 year) glutenfree diet and 74 non-celiac volunteers from Spain, using dietary, anthropometric, and biochemical parameters, as well as assessing bone mineral density and physical activity. Celiac adults had deficient intake (below 2/3 of the recommended intake) for folates, vitamin E, and iodine and low intake of calcium (below 80% of the recommended intake). Iron intake was also below 2/3 of the recommended intake in celiac women. Vitamin D intake was extremely low, and 34% of celiac patients had moderately deficient plasma levels. According to bone mineral density, celiac women may be more prone to osteopenia and osteoporosis. However, we found a perfectly analogous nutritional status scenario in celiac as compared to healthy volunteers, with the dietary deviations found being similar to those of the Spanish population, i.e., both groups followed a high-lipid, high-protein, and low-carbohydrate diet. Values for biochemical parameters were found within the reference ranges. Celiac disease had no influence on body weight, but body fat in celiac patients tended to be higher. According to our results, vitamin D, calcium, folates, vitamin E, iodine, and iron nutritional status should be specifically assessed and monitored in the celiac population.

Patients who follow a gluten-free diet (GFD) may be prone to nutritional deficiencies, due to food restriction and consumption of gluten-free products. The aim was to assess nutritional status in celiac children and adolescents on a long-term GFD. A cross-sectional age and gender-matched study in 70 celiac and 67 non-celiac volunteers was conducted, using dietary, anthropometric, biochemical parameters, and assessing bone mineral density and physical activity. Adequacy of vitamin D intake to recommendations was very low, in both groups, and intakes for calcium and magnesium were significantly lower in celiac volunteers. Celiac children and adolescents may have a higher risk of iron and folate deficiencies. Both groups followed a high-lipid, high-protein, low fiber diet. Median vitamin D plasma levels fell below reference values, in celiac and non-celiac participants, and were significantly lower in celiac girls. Other biochemical parameters were within normal ranges. Anthropometry and bone mineral density were similar within groups. With the exception of some slightly lower intakes, children and adolescents following a GFD appear to follow the same trends as healthy individuals on a normal diet. No e_ect of food restriction or gluten-free product consumption was observed.

Ready-to-eat foods have nowadays become a significant portion of the diet. Accordingly, nutritional composition of these food categories should be well-known, in particular its folate content. However, there is a broad lack of folate data in food composition tables and databases. A total of 21 fresh-cut vegetable and fruit packed products were analysed for total folate (TF) content using a validated method that relies on the folate-dependent growth of chloramphenicol-resistant Lactobacillus casei subspecies rhamnosus (NCIMB 10463). Mean TF content ranged from 10.0 to 140.9 lg/100 g for the different matrices on a fresh weight basis. Higher TF quantity, 140.9–70.1 lg/100 g, was found in spinach, rocket, watercress, chard and broccoli. Significant differences were observed between available data for fresh vegetables and fruits from food composition tables or databases and the analysed results for fresh-cut packed products. Supplied data support the potential of folate-rich fresh-cut ready-to-eat vegetables to increase folate intake significantly.

Currently, data concerning the amount of naturally occurring dietary folate in ready-to-eat foods is scarce, in spite of an increasing consumption. Total folate (TF) in 35 chilled ready-to-eat vegetable-based meals, expected to be good natural folate sources, was determined. A validated method that relies on a trienzyme extraction (αamylase, rat plasma conjugase as a substitute to chicken pancreas conjugase, and protease enzymes), and chloramphenicol-resistant Lactobacillus casei subspecies rhamnosus folate dependent growth was developed. No previous reports on folate data in refrigerated ready-to-eat foods from the Spanish market have been published. Vegetable burgers, containing pulses and green leafy vegetables, had the highest folate content (103.8 μg TF/ 100 g fresh weight). Refrigerated recipes including chickpeas, peas, broccoli, or artichokes had an average folate content of 75 μg TF/100 g fresh weight. A typical serving of targeted ready-to-eat meals (175 g) may provide up to 60% of the Dietary Reference Intake for an adult. No differences in TF were found after mild heat treatment, as recommended by the manufacturer before its consumption. Therefore, these products may be used to increase folate intake by choosing naturally rich dietary sources. Data will assist dietary studies in the assessment of population folate dietary intakes.

Gluten-free products (GFP) are a good choice for the replacement of cereals when following a gluten-free diet due to celiac disease (CD). However, commercial GFP are made with highly refined flours and may contain more fat, sugar, and salt, and less fiber and micronutrients than glutencontaining analogues, thus challenging the nutritional adequacy of the diet. The aim of this study is to assess the contribution of GFP to the diets of children and adolescents with CD. Food intakes were assessed in a cross-sectional study on 70 children and adolescents with CD (aged four to 18, 50% females), using three 24-h dietary records. GFP consumption reached 165 g a day and comprised mostly bread and fine bakery ware, followed by pasta. GFP contributed with a high percentage (>25%) to total energy, carbohydrates, fiber, and salt daily intakes and, to a lesser extent (<20%), to fat (including saturated fat), sugars and protein. Contribution of homemade products was testimonial. GFP contribution to total energy intake is significant and, consequently, relevant to the nutritional adequacy of the diet. Children and adolescents with CD could benefit from fat, saturated fat, and salt reduction, and fiber enrichment of processed GFP.

Introducción: Los productos ready-to-eat, ya cocinados, envasados y refrigerados, son cada vez más consumidos en nuestro país. Sin embargo, no existen estudios que cuantifiquen su disponibilidad comercial, composición e información detallada para poder estimar su impacto sobre las ingestas, particularmente de folatos, en los diferentes grupos de población. Objetivos: La finalidad de este trabajo de investigación ha consistido en conocer la disponibilidad actual de alimentos ready-to-eat de base vegetal y aportar datos sobre el contenido de folato total de los mismos. Métodos: La concentración de folato total se determinó en 17 productos precocinados refrigerados, con ingredientes vegetales, mediante el método microbiológico basado en el crecimiento del Lactobacillus casei subespecie rhamnosus resistente a cloranfenicol. La precisión del procedimiento analítico se comprobó mediante un material de referencia certificado y por una prueba de recuperación con ácido fólico tritiado. Resultados y discusión: El contenido medio de FT varió desde 13,6 hasta 103,8 µg/100 g de peso fresco, siendo superior en hamburguesas vegetales, recetas con garbanzos, guisantes o alcachofas con jamón. Los alimentos se sometieron al tratamiento térmico indicado por el fabricante previo a su consumo, observándose que no existen pérdidas de folatos durante este último procesado. El coeficiente de variación de los duplicados del mismo producto fue inferior al 15%. Conclusiones: Se presentan datos pioneros relativos al análisis de folatos en alimentos ready-to-eat en el mercado español, que ayudarán a evaluar la adecuación de la ingesta de folatos en la población. El contenido de folatos de estos productos, su facilidad de consumo y atractiva presentación, los convierte en fuentes potenciales de la vitamina.

Promoting folate intake from natural food sources is a healthy worldwide strategy for attaining safe levels of folate in overall nutritional status and avoiding potential harm from chronic excessive intakes of folic acid from fortified food products or supplements in certain population groups. Over recent years the consumption of ready-to-eat foods, such as packed vegetables or precooked meals, has become a significant part of the diet. Accordingly, the folate composition of these food categories must be investigated. There is a broad lack of folate data in food composition tables and databases, especially for ready-to-eat products. This context warrants the need for providing new data on total folate and individual forms of folate in ready-to-eat commercial products, either to complete food composition tables or databases and/or to achieve regulatory objectives, or to assess population dietary intakes. Currently, intake recommendations for folate in some European countries range from 400 to 500 mg/day for folate for women of childbearing age, 600 mg/day for the second half of pregnancy and 500 mg/day for women who are breastfeeding. For other population groups, the recommended daily intakes (RDI) for folate are established depending on the age and sex of the individuals (children around 150–200 mg/day, and adults and elderly, 300–400 mg/day), but vary considerably among European countries. Moreover, contradictory data exist concerning both recommended and real dietary intake of folate throughout Europe. Despite a wide variety of analytical methods available for food folate measurement (microbiological assay or high performance liquid chromatography (HPLC), with a previous enzyme extraction based on the use of amylase, protease and/or folate conjugase; HPLC coupled with mass spectrometry; alternative protein-binding and immunoassay methods), many procedural complexities continue to result in poor agreement among methods and laboratories. Given the uncertainty involved in accurately measuring folate, the available certified reference materials should be used by laboratories to check the accuracy of folate data. The challenge to improve quantity and quality of folate data in food composition databases exists in most developed countries, and particularly in Europe, in the absence of mandatory food fortification policies for folate.

We developed a new database to evaluate the nutritional composition of lactose-free products from Spain. The database includes dairy products and other products, all of which show the “lactose-free” declaration on their label, accounting for 327 products in total. Of these, 123 are dairy products, 16 are non-dairy products which include a dairy ingredient (5%) and 188 items (57% of the sample) are non-dairy products that do not contain any dairy ingredient. The main subgroups are yogurt (25%), milk (24%), and cheese (17%). Nineteen percent of the compiled products included nutritional claims on their labels. Most lactose-free products did not contain either added sugars or low- or no-calorie sweeteners (58%), while 34% included added sugars and only 6%, sweeteners or a combination of both (2%). We found that 19.5%, mainly within the milk subgroup, were fortified with vitamins A, D, E, K, B9 , and B12, P, and Ca. There were no significant differences in the nutritional composition between lactose-free products and traditional products. According to the NOVA classification, 55% of compiled lactose-free products were ultra-processed, and 20% processed. The array of lactose-free products marketed in Spain proves that there are enough, both in quantity and quality, to satisfy the dairy needs of lactose intolerants.

We developed a comprehensive composition database of 629 cereal-based gluten free (GF) products available in Spain. Information on ingredients and nutritional composition was retrieved from food package labels. GF products were primarily composed of rice and/or corn flour, and 90% of them included added rice starch. The most common added fat was sunflower oil (present in one third of the products), followed by palm fat, olive oil, and cocoa. Only 24.5% of the products had the nutrition claim “no added sugar”. Fifty-six percent of the GF products had sucrose in their formulation. Xanthan gum was the most frequently employed fiber, appearing in 34.2% of the GF products, followed by other commonly used such as hydroxypropyl methylcellulose (23.1%), guar gum (19.7%), and vegetable gums (19.6%). Macronutrient analysis revealed that 25.4% of the products could be labeled as a source of fiber. Many of the considered GF food products showed very high contents of energy (33.5%), fats (28.5%), saturated fatty acids (30.0%), sugars (21.6%), and salt (28.3%). There is a timid reformulation in fat composition and salt reduction, but a lesser usage of alternative flours and pseudocereals.