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Wheat is a valuable source of essential nutrients, providing carbohydrate-based energy and fiber, protein, B vitamins, calcium, magnesium, phosphorus, potassium, zinc, and iron. In low and medium-income countries, grain-based foods still make up the central part of the diet. The wheat seed can be ground into flour or semolina, for example, which form the essential ingredients of bread, pasta, noodles, and other food products, essentially the primary source of nutrients for most of the world population.
The domestication of wheat revolutionized the human diet as this cereal provided a significant source of energy. Globally, wheat accounts for the largest harvested area of any crop  and provides more protein and calories than any other cereal crop . Wheat is nutritious, simple to transport and store, and can be transformed into several types of food. The most valuable modern wheat species are hexaploid bread wheat ( Triticum aestivum L.) and tetraploid durum wheat ( T. turgidum L. var. durum ), which have distinct genomes, grain composition, and end-use quality attributes. Wheat adapts to all climatic conditions common in agricultural fields (except for the hot tropics), so globally, it is harvested all year round .
Wheat is a valuable source of essential nutrients, providing carbohydrate-based energy and fiber, protein, B vitamins, calcium, magnesium, phosphorus, potassium, zinc, and iron . In low and medium-income countries, grain-based foods still make up the central part of the diet. The wheat seed can be ground into flour or semolina, for example, which form the essential ingredients of bread, pasta, noodles, and other food products, essentially the primary source of nutrients for most of the world population . Conversely, the lack of grains too often signifies hunger and malnutrition. The characteristic that has given wheat an advantage over other temperate crops is the unique viscoelastic properties of dough formed from wheat flours, which allow it to be processed into such an array of forms . Dough viscoelasticity depends on the structures and interactions that occur between grain storage proteins that form the gluten protein complex .
Gluten, which is now an almost ubiquitous ingredient in the food industry, is implicated in several immune-mediated disorders, such as celiac disease (CD). Both CD and other intolerances are of increasing concern , and the prevalence of CD is predicted to rise . These disorders demand a gluten-free diet (GFD), but a GFD can itself be associated with digestive problems due to insufficient intake of dietary fiber and other nutrients .
2. The Health Benefits of Wheat
3. Wheat/Gluten-Related Disorders
Wheat/gluten-related diseases can be classified into three different disorders: autoimmune, allergic, and neither autoimmune nor allergic. Celiac disease is the most prominent autoimmune gluten-related disorder (CD). It is a condition of the small intestine caused by gluten and gluten-related proteins and influenced by environmental and genetic factors . An IgE and non-IgE mediated immune response characterize wheat allergy (WA), resulting in an allergic reaction in some individuals upon contact, inhalation, or uptake of foods containing wheat but not necessarily other grains as barley or rye. However, IgE-cross reactivity to other cereals is possible in some people . Patients with non-celiac wheat/gluten sensitivity (NCWGS) experience identical symptoms to CD, but they do not test positive for CD .
The binding of gluten peptides to T cells triggers Celiac Disease (CD) in some individuals expressing human leukocyte antigen (HLA) DQ2 or DQ8 in cells specialized in presenting antigens. Specific CD4+ T cells then recognize the presented peptides releasing inflammatory cytokines, leading to changes in the architecture of intestinal mucosa with atrophy and flattening of villi that can lead to total villous degeneration and enteropathy. Moreover, gliadin peptides are responsible for the activation of innate immunity of the intestinal epithelial cells .
Gluten ataxia (GA) is a form of cerebellar ataxia, affecting mainly Purkinje cells, and is caused by antibodies released when digesting gluten that mistakenly attacks part of the brain in individuals that are sensitive and genetically susceptible . The clinical symptoms of GA are identical to those of other ataxias. They include gait ataxia (100%), lower limb ataxia (90%), gaze-evoked nystagmus (84%), upper limb ataxia (75%), ocular signs like dysarthria (66%), and other movement disorders including chorea, myoclonus, opsoclonus myoclonus, and palatal tremor .
Dermatitis herpetiformis (DH), repeatedly associated with CD, is an autoimmune, chronic, and recurrent cutaneous-intestinal disorder detected in genetically susceptible individuals . Anti-tTG antibodies that also recognize epidermal transglutaminase (ETG) can be produced after exposure to gluten. ETG is homologous to tTG in terms of structure and is the primary antigen in DH . IgA antibody deposition in dermal papillae causes pruritic, vesiculobullous, and localized lesions in DH patients. DH affects the extensor surfaces such as knees, buttocks, elbows, and scapular areas .
Allergens cause allergic reactions, and wheat is one of the five most frequent foods causing them in children. After milk and eggs, wheat is the most common allergen in Japan, Germany, and Finland . In children and adults, wheat allergy (WA) prevalence is approximately 1% depending on age and region . In contrast to CD, distinct wheat components such as water-insoluble proteins (gliadin and glutenin) and water/saline-soluble proteins (albumin and globulin) contribute to the development of WA .
4. Gluten-Related Misconceptions
The entry is from 10.3390/foods10081765
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