# The Clean Label Concept: Novel Approaches in Gluten-Free Breadmaking
### Health Premises for Gluten-Free Diet  
Celiac disease is a lifelong autoimmune disease caused by a reaction to gluten. Symptoms of gluten intolerance include bloating, diarrhea, mouth ulcers, tiredness, anemia, osteoporosis, neurological or psychiatric problems and infertility. Occasionally, it can also manifest itself as a skin condition known as dermatitis herpeiformis [5; 6], which causes a red, raised rash, often with blisters. As the spectrum of symptoms is very broad, the diagnosis of celiac disease is not easy and involves a number of procedures. In 1969, the European Society for Pediatric Gastroenterology established diagnostic criteria, which have been widely followed since by adult as well as pediatric gastroenterologists worldwide [7]. These guidelines are updated on a regular basis and a new version of the protocol was published in 2020 [8].  
The only current treatment option for celiac disease is to adopt a gluten-free diet, avoiding cereals such as wheat, barley, rye, triticale, and in some cases oats (generally due to impurities containing gluten). While celiac disease is a well defined illness, there is perhaps less understanding of gluten sensitivity, which affects many people--who are said to suffer from non-celiac gluten sensitivity (NCGS) [6; 9; 10; 11] or non-celiac wheat sensitivity [12]. Some consumers are also allergic to the proteins found in wheat. Many proteins are implicated in causing such allergies. The up-to-date version of the WHO/IUIS Allergen Nomenclature Database describes 21 well classified wheat allergens. Symptoms are triggered by the immune system a short time after ingestion of wheat. Some of the most common symptoms are similar to those associated with other common allergies, such as hay fever or pet allergies, but can also include stomach problems (diarrhea, bloating) and in serious cases anaphylaxis [6; 13].  
However, it has to be noted that strict gluten-free diet may not provide the recommended amount of essential vitamins and minerals. According to [PERSON] [14] an investigation of newly diagnosed Australian patients revealed that following a gluten-free diet after just a year can lead to a deficiency of such ingredients. This may cause further illnesses such as i.e., anemia or cardiovascular disease. Due to the fact that gluten-free breads present on the market, to a large extent, are based on starch blends, patients may also be more prone to obesity (exceeded body mass index). Another consequence of the diet is the change in diversity and composition of the intestinal microbiota (reduction in Lactobacillus and Bifidobacterium specimens) [14; 15]. However, [PERSON] et al. [15] observed that there is no worldwide nutritional profile of gluten-free goods. Differences between products manufactured in various countries are observed. Between brands and food categories the same phenomenon is being noticed. Products with a similar nutritional profile to that of conventional baked goods (containing gluten) are also available on the market.  
Following a gluten-free diet is challenging for a number of reasons. Here, economic aspects (higher prices than gluten-containing breads), organoleptic aspects, less product choice both in shops and restaurants as well as time consumption, etc., should be mentioned. However, people who decide to follow the gluten-free diet for a variety of reasons, not always medical ones, find their symptoms, which most often include digestive problems, feeling unwell, and fatigue, to be alleviated.