Proper nutrition in celiac disease

Celijakija je autoimuna bolest koja zahvaća otprilike 1% svjetske populacije. Razvija se kod genetski predisponiranih osoba, kod kojih ingestija glutena uzrokuje oštećenje sluznice tankog crijeva, kroničnu upalu i malapsorpciju. Stoga oboljeli od celijakije često imaju manjak esencijalnih nutrijenata nužnih za pravilno funkcioniranje organizma. Tome dodatno doprinosi doživotna konzumacija isključivo bezglutenskih namirnica kao jedini način liječenja oboljelih s obzirom da su takve namirnice često siromašne prehrambenim vlaknima, mineralima i vitamina što se posebice odnosi na željezo i kalcij, te folnu kiselinu, vitamin D i ostale vitamine B skupine. Također, bezglutenske namirnice sadrže više lipida i ugljikohidrata zbog čega imaju višu kalorijsku vrijednost i viši glikemijski indeks što povećava rizik od pretilosti. Postojanje čitavog niza dugoročnih zdravstvenih posljedica neliječene celijakije poput osteoporoze, neuroloških poremećaja te razvoja drugih autoimunih bolesti kao što su dijabetes tip 1 i multipla skleroza ukazuje na važnost kako pravovremene dijagnoze tako i adekvatne prilagodbe prehrane. Stoga je u ovom radu dan pregled najnovijih saznanja o bezglutenskoj prehrani, njezinoj nužnosti kod oboljelih, kao i nedostacima uz naglasak na pravilan odabir nutritivno bogatih bezglutenskih namirnica. U svrhu dostupnosti bezglutenskih proizvoda visoke nutritivne kvalitete prehrambena industrija koristi se raznim tehnologijama obrade namirnica te obogaćivanjem deficitarnim nutrijentima što uključuje upotrebu pseudožitarica, kiselog tijesta, kao i uklanjanje glutena iz hrane te genetički inženjering pšenice.Celiac disease is an autoimmune disease affecting approximately 1% of the world's population. It develops in genetically predisposed individuals, in which gluten ingestion causes damage to the small intestinal mucosa, chronic inflammation and malabsorption. Therefore, patients with celiac disease often have a deficiency of essential nutrients necessary for the proper functioning of the body. This is further compounded by the lifetime consumption of only gluten-free foods as the only treatment for patients, since such foods are often poor in dietary fiber, minerals and vitamins, especially those related to iron and calcium, as well as folic acid, vitamin D and other B-group vitamins. Also, gluten-free foods contain more lipids and carbohydrates, which is why they have a higher calorie value and a higher glycemic index, which increases the risk of obesity. The existence of a range of long-term health consequences of untreated celiac disease such as osteoporosis, neurological disorders, and the development of other autoimmune diseases such as type 1 diabetes and multiple sclerosis indicates the importance of both timely diagnosis and adequate dietary adjustment. Therefore, this paper provides an overview of the latest findings on gluten-free nutrition, its necessity in those whose are affected, as well as the disadvantages, with emphasis on the proper selection of nutritionally rich gluten-free foods. In order to provide gluten-free products of high nutritional quality, the food industry uses a variety of food processing technologies and enrichment of deficient nutrients, which include the use of pseudo-cereals, sourdough as well as the removal of gluten from food and genetic engineering of wheat