Endocrine Abstracts

Background: Celiac disease (CD) is an autoimmune enteropathy triggered by gluten ingestion in genetically susceptible individuals. Its prevalence is ~7 times higher in type 1 diabetes (T1D) patients compared to the general population; in addition to adherence to a gluten free (GF) diet, these patients use carbohydrate counting to estimate their pre-meal insulin dosages. We aimed to (a) compare the nutritional composition between some GF and non GF carbohydrate-rich products available in the Greek market, and (b) calculate the GI of one commercially available, GF pasta.

Methods: We recorded the nutritional composition of 35 commercially available products (toasted bread, pasta and breakfast cereals). The in vivo GI was calculated for one specific GF pasta by comparing the plasma glycemic responses (area under the curve) in 10 healthy subjects (6 females, 4 males), after ingestion of (a) 50 g of glucose and (b) pasta containing 50 g of carbohydrate.

Results: Nutritional differences were identified between GF foods and their gluten counterparts (expressed as mean ± S.E.). Specifically, GF bread had lower energy and protein content per 100 g (1038±7 VS 1123±2 KJ and 4.0±0.1 vs 9.0±0.1 g respectively, P<0.05). GF pasta was higher in total carbohydrates but lower in simple carbohydrates and protein per 100 g (76.3±2.1 VS 68.3±1.5 g, 1.4±0.3 vs 3.3±0.1 g and 7.3±0.7 vs 12.3±0.2 g respectively, P<0.05). GF breakfast cereals’ were higher in energy, saturated fat and simple carbohydrates, but lower in total carbohydrates, fiber and protein per 100 g (1906 vs 1580±25 KJ, 4.2 vs 0.4±0.2 g, 25.0 vs 9.4±1.4 g, 70.8 vs 79.4±4.6 g, 2.1 vs 5.3±2.3 g and 6.4 vs 8.2±1.2 g respectively, P<0.05). The in vivo calculated GI of the studied GF pasta (80% corn and 20% rice flour) was 32±7 and its nutrient composition per 100 g was as follows: 78.5 g total carbohydrate, 0.5 g simple sugars, 1.2 g fiber, 6.5 g protein.

Conclusions: The present study revealed significant nutritional differences between GF and non GF products. The GI of the studied GF pasta was surprisingly low, probably due to the lower content in simple carbohydrates. T1D patients with CD should be aware of the high content of GF foods in total carbohydrates. All consumers should be advised to carefully read the food labels of GF products, as nutritional composition may vary considerably.