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This is an old revision of this page, as edited by Zefr (talk | contribs) at 18:09, 28 December 2015 (Non-celiac gluten sensitivity: this section is extensively over-described & speculative for an undefined syndrome, WP:UNDUE; apply context for the lay user per WP:NOTJOURNAL; reduce sourcing to reviews per WP:CITEKILL). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Revision as of 18:09, 28 December 2015 by Zefr (talk | contribs) (Non-celiac gluten sensitivity: this section is extensively over-described & speculative for an undefined syndrome, WP:UNDUE; apply context for the lay user per WP:NOTJOURNAL; reduce sourcing to reviews per WP:CITEKILL)(diff) ← Previous revision | Latest revision (diff) | Newer revision → (diff) This article is about a protein found in certain grains. For a type of sticky rice (which does not contain any gluten), see Glutinous rice. For food products made from gluten, see Wheat gluten (food).
Sources of gluten: Clockwise from top: high-gluten wheat flour, European spelt, barley, rolled rye flakes

Gluten (from Latin gluten, "glue") is a mixture of proteins found in wheat and related grains, including barley and rye. Gluten gives elasticity to dough, helping it rise and keep its shape and often gives the final product a chewy texture.

Gluten is the composite of two storage proteins, gliadin and a glutenin, and is conjoined with starch in the endosperm of various grass-related grains. Worldwide, gluten is a source of protein, both in foods prepared directly from sources containing it, and as an additive to foods otherwise low in protein. It is appreciated for its visco-elastic properties.

Gluten contains hundreds of proteins, which have low biological and nutritional value and high contents of prolamins (glutamines and prolines), as opposed to the grains of pseudocereals (gluten free), which are rich in proteins with high biological value (albumins and globulins).

The fruit of most flowering plants have endosperms with stored protein to nourish embryonic plants during germination. True gluten is limited to certain members of the grass family. The stored proteins of maize and rice are sometimes called glutens, but their proteins differ from true gluten.

Extraction

Gluten is extracted from flour by kneading the flour, agglomerating the gluten into an elastic network, a dough, and then washing out the starch. Starch granules disperse in cold/low-temperature water, and the dispersed starch is sedimented and dried. If a saline solution is used instead of water, a purer protein is obtained, with certain harmless impurities departing to the solution with the starch. Where starch is the prime product, cold water is the favored solvent because the impurities depart from the gluten.

In home or restaurant cooking, a ball of wheat flour dough is kneaded under water until the starch disperses out. In industrial production, a slurry of wheat flour is kneaded vigorously by machinery until the gluten agglomerates into a mass. This mass is collected by centrifugation, then transported through several stages integrated in a continuous process. About 65% of the water in the wet gluten is removed by means of a screw press; the remainder is sprayed through an atomizer nozzle into a drying chamber, where it remains at an elevated temperature a short time to evaporate the water without denaturing the gluten. The process yields a flour-like powder with a 7% moisture content, which is air cooled and pneumatically transported to a receiving vessel. In the final step, the collected gluten is sifted and milled to produce a uniform product.

Uses

Wheat, a prime source of gluten

Bread products

Gluten forms when glutenin molecules cross-link to form a submicroscopic network attached to gliadin, which contributes viscosity (thickness) and extensibility to the mix. If this dough is leavened with yeast, fermentation produces carbon dioxide bubbles, which, trapped by the gluten network, cause the dough to rise. Baking coagulates the gluten, which, along with starch, stabilizes the shape of the final product. Gluten content has been implicated as a factor in the staling of bread, possibly because it binds water through hydration.

The development of gluten (i.e., enhancing its elasticity) affects the texture of the baked goods. Gluten's attainable elasticity is proportional to its content of glutenins with low molecular weights as this portion contains the preponderance of the sulfur atoms responsible for the cross-linking in the network. More refining (of the gluten) leads to chewier products such as pizza and bagels, while less refining yields tender baked goods such as pastry products.

Generally, bread flours are high in gluten (hard wheat); pastry flours have a lower gluten content. Kneading promotes the formation of gluten strands and cross-links, creating baked products that are chewier (in contrast to crumbly). The "chewiness" increases as the dough is kneaded for longer times. An increased moisture content in the dough enhances gluten development, and very wet doughs left to rise for a long time require no kneading (see no-knead bread). Shortening inhibits formation of cross-links and is used, along with diminished water and less kneading, when a tender and flaky product, such as a pie crust, is desired.

The strength and elasticity of gluten in flour is measured in the baking industry using a farinograph. This gives the baker a measurement of quality for different varieties of flours in developing recipes for various baked goods.

Added gluten

Gluten, when dried and milled to a powder and added to ordinary flour dough, improves a dough's ability to rise and increases the bread's structural stability and chewiness. Gluten-added dough must be worked vigorously to induce it to rise to its full capacity; an automatic bread machine or food processor may be required for what is gluten kneading. Generally, higher gluten levels are associated with higher amounts of overall protein.

Imitation meats

Gluten is often used in imitation meats (such as this mock "duck") to provide supplemental protein and variety in vegetarian diets.
Further information: Wheat gluten (food) and the use of gluten in cooking

Gluten, especially wheat gluten, is often the basis for imitation meats resembling beef, chicken, duck (see mock duck), fish, and pork. When cooked in broth, gluten absorbs some of the surrounding liquid (including the flavor) and becomes firm to the bite.

Other consumer products

Gluten is often present in beer and soy sauce, and can be used as a stabilizing agent in more unexpected food products, such as ice cream and ketchup. Foods of this kind may raise a problem for a small number of consumers because the hidden gluten constitutes a hazard for people with celiac disease.

Gluten is also used in cosmetics, hair products, and other dermatological preparations.

Animal feed

The protein content of some pet foods may also be enhanced by adding gluten.

Adverse reactions

Main articles: Gluten-related disorders, Gluten-sensitive enteropathy-associated conditions, and Gluten-sensitive idiopathic neuropathies

Gluten-related disorders is the umbrella term for all diseases triggered by gluten, which include coeliac disease (CD), non-celiac gluten sensitivity (NCGS), wheat allergy, gluten ataxia and dermatitis herpetiformis (DH). Currently, their incidence is increasing in most geographic areas of the world. It can be explained possibly by the growing westernization of diet, increasing use of wheat-based foods included in the Mediterranean diet, the progressive replacement of rice by wheat in many countries in Asia, the Middle East, and North Africa, the development in recent years of new types of wheat with a higher amount of cytotoxic gluten peptides, and the higher content of gluten in bread and bakery products, due to the reduction of dough fermentation time.

Coeliac disease

Main article: Coeliac disease

Coeliac disease (American English: celiac) (CD) is a chronic, immune-mediated mainly intestinal process, caused by the ingestion of wheat, barley, rye and derivatives, that appears in genetically predisposed people of all ages. CD is not only a gastrointestinal disease, because it may involve to several organs and cause an extensive variety of non-gastrointestinal symptoms, and most importantly, it may often be completely asymptomatic. Added difficulties for diagnosis are the fact that serological markers (anti-tissue transglutaminase ) are not always present and many patients may have minor mucosal lesions, without atrophy of the intestinal villi.

CD affects approximately 1-2% of the general population, but most cases remain unrecognized, undiagnosed and untreated, and at risk for serious long-term health complications. Patients may suffer severe disease symptoms and be subjected to extensive investigations for many years, before a proper diagnosis is achieved. Untreated CD may cause malabsorption, reduced quality of life, iron deficiency, osteoporosis, an increased risk of intestinal lymphomas and greater mortality. CD is associated with some autoimmune diseases, such as diabetes mellitus type 1, thyroiditis, gluten ataxia, psoriasis, vitiligo, autoimmune hepatitis, dermatitis herpetiformis, primary sclerosing cholangitis, and more.

CD with “classic symptoms”, which include gastrointestinal manifestations such as chronic diarrhea and abdominal distention, malabsorption, loss of appetite, and impaired growth, is currently the least common presentation form of the disease and affects predominantly small children generally younger than two years of age.

CD with “non-classic symptoms” is the most common clinical type and occurs in older children (over 2 years old), adolescents and adults. It is characterized by milder or even absent gastrointestinal symptoms and a wide spectrum of non-intestinal manifestations that can involve any organ of the body, and very frequently may be completely asymptomatic both in children (at least in 43% of the cases) and adults.

Non-celiac gluten sensitivity

Main article: Non-celiac gluten sensitivity

Non-celiac gluten sensitivity (NCGS) is described as a condition of multiple symptoms that improves when switching to a gluten-free diet, after celiac disease and wheat allergy are excluded. Recognized since 2010, it is included among gluten-related disorders, but its pathogenesis is unknown. NCGS is the most common syndrome of gluten intolerance, with a prevalence estimated to be 6–10 times higher than that of celiac disease.

Patients with NCGS may develop gastrointestinal symptoms, which resemble those of irritable bowel syndrome or wheat allergy, and/or a variety of non-gastrointestinal symptoms, such as headache, anxiety or eating disorders.

Besides gliadin (main cytotoxic antigen of gluten), FODMAPs present in gluten-containing grains are under preliminary research for their potential role in causing gastrointestinal symptoms.

Wheat allergy

Main article: Wheat allergy

People can also experience adverse effects of wheat as result of a wheat allergy. As with most allergies, a wheat allergy causes the immune system to abnormally respond to a component of wheat that it treats as a threatening foreign body. This immune response is often time-limited and does not cause lasting harm to body tissues. Wheat allergy and coeliac disease are different disorders. Gastrointestinal symptoms of wheat allergy are similar to those of coeliac disease and non-celiac gluten sensitivity, but there is a different interval between exposure to wheat and onset of symptoms. Wheat allergy has a fast onset (from minutes to hours) after the consumption of food containing wheat and could be anaphylaxis.

Labelling

International standards

The Codex Alimentarius international standards for food labelling has a standard relating to the labelling of products as "gluten-free". It only applies to foods that would normally contain gluten.

Brazil

By law in Brazil, all food products must display labels clearly indicating whether or not they contain gluten.

Canada

One in 133 Canadians experiences adverse symptoms from gluten in celiac disease. Labels for all food products sold in Canada must clearly identify the presence of gluten if it is present at a level greater than 20 parts per million.

United Kingdom

In the United Kingdom, only cereals must be labelled; labelling of other products is voluntary.

United States

In the United States, gluten is not listed on labels unless added as a stand-alone ingredient. Wheat or other allergens are listed after the ingredient line. The US Food and Drug Administration (FDA) has historically classified gluten as "generally recognized as safe" (GRAS). In August 2013, FDA issued a final rule, effective August 2014, that defined the term "gluten-free" for voluntary use in the labeling of foods as meaning that the amount of gluten contained in the food is below 20 parts per million.

See also

References

  1. ^ Lamacchia C, Camarca A, Picascia S, Di Luccia A, Gianfrani C (Jan 29, 2014). "Cereal-based gluten-free food: how to reconcile nutritional and technological properties of wheat proteins with safety for celiac disease patients". Nutrients. 6 (2): 575–90. doi:10.3390/nu6020575. PMC 3942718. PMID 24481131.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  2. "Extracting Gluten from Flour". Chaos – it's not just a theory…. 20 June 2010. Retrieved 21 October 2012.
  3. "Wheat Starch and Wheat Gluten". GEA Westfalia Separator Group. Retrieved 19 October 2011.
  4. "Wheat". GEA Barr-Rosin. Retrieved 8 September 2009.
  5. Woychick, JH; et al. "The Gluten Proteins and Deamidated Soluble Wheat Protein". Retrieved 8 September 2009.
  6. Sahlstrom, S. & Brathen, E. (1997). "Effects of enzyme preparations for baking, mixing time and resting time on bread quality and bread staling". Food Chemistry, 58, 1, 75-80. Effects of wheat variety and processing conditions in experimental bread-baking studied by univariate and multivariate analysis.
  7. Edwards, N. M.; Mulvaney, S. J.; Scanlon, M. G.; Dexter, J. E. (2003). "Role of gluten and its components in determining durum semolina dough viscoelastic properties". Cereal chemistry. 80 (6): 755–763. doi:10.1094/CCHEM.2003.80.6.755. Retrieved 2007-08-14.
  8. Tosi, Paola; Masci, Stefania; Giovangrossi, Angela2; D'Ovidio, Renato; Bekes, Frank; Larroque, Oscar; Napier, Johnathan; Shewry, Peter (September 2005). "Modification of the Low Molecular Weight (LMW) Glutenin Composition of Transgenic Durum Wheat: Effects on Glutenin Polymer Size and Gluten Functionality". Molecular Breeding. 16 (2): 113–126. doi:10.1007/s11032-005-5912-1. Retrieved 2007-08-14.{{cite journal}}: CS1 maint: numeric names: authors list (link)
  9. ^ "Baking Technology, Bread". Bakersassist. Retrieved 2007-08-14.
  10. "Farinograph". Wheat Quality and Carbohydrate Research. North Dakota State University. 22 September 2014. Retrieved 8 December 2014.
  11. Oliver, JR; Allen, HM (January 1992). "The prediction of bread baking performance using the farinograph and extensograph". Journal of Cereal Science. 15 (1). Elsevier: 79–89. doi:10.1016/S0733-5210(09)80058-1. Retrieved 5 December 2014.
  12. Understanding Baking. 2002. {{cite book}}: Unknown parameter |authors= ignored (help)
  13. Rustic European Breads from your Bread Machine. 1997. {{cite book}}: Unknown parameter |authors= ignored (help)
  14. "Against the Grain". The New Yorker. 3 November 2014. Retrieved 8 December 2014.
  15. Bates, Dorothy, R.; Wingate, Colby. 1993. "Cooking with Gluten and Seitan." Summertown, Tennessee: The Book Publishing Co. 128 p
  16. Abramowski, Nicole (11 March 2011). "How to Make Seitan: An Illustrated Guide". Vegan Nom Noms. Retrieved 8 December 2014.
  17. "Gluten intolerance and skin diseases". Eur J Dermatol. 16 (1): 4–11. 2006. PMID 16436335. {{cite journal}}: Unknown parameter |authors= ignored (help)
  18. "Pet Foods". International Wheat Gluten Association. Archived from the original on 2007-10-07. Retrieved 14 August 2007.
  19. Ludvigsson JF, Leffler DA, Bai JC, Biagi F, Fasano A, Green PH, Hadjivassiliou M, Kaukinen K, Kelly CP, Leonard JN, Lundin KE, Murray JA, Sanders DS, Walker MM, Zingone F, Ciacci C (January 2013). "The Oslo definitions for coeliac disease and related terms". Gut (Review). 62 (1): 43–52. doi:10.1136/gutjnl-2011-301346. PMC 3440559. PMID 22345659.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  20. ^ Lionetti E, Gatti S, Pulvirenti A, Catassi C (Jun 2015). "Celiac disease from a global perspective". Best Pract Res Clin Gastroenterol (Review). 29 (3): 365–79. doi:10.1016/j.bpg.2015.05.004. PMID 26060103.
  21. ^ Tovoli F, Masi C, Guidetti E, Negrini G, Paterini P, Bolondi L (Mar 16, 2015). "Clinical and diagnostic aspects of gluten related disorders". World J Clin Cases (Review). 3 (3): 275–84. doi:10.12998/wjcc.v3.i3.275. PMC 4360499. PMID 25789300.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  22. Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M, Kaukinen K, Rostami K, Sanders DS, Schumann M, Ullrich R, Villalta D, Volta U, Catassi C, Fasano A (2012). "Spectrum of gluten-related disorders: consensus on new nomenclature and classification". BMC Medicine (Review). 10: 13. doi:10.1186/1741-7015-10-13. PMC 3292448. PMID 22313950.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)
  23. Volta U, Caio G, Tovoli F, De Giorgio R (2013). "Non-celiac gluten sensitivity: questions still to be answered despite increasing awareness". Cellular and Molecular Immunology (Review). 10 (5): 383–392. doi:10.1038/cmi.2013.28. ISSN 1672-7681. PMC 4003198. PMID 23934026.
  24. Guandalini S, Polanco I (Apr 2015). "Nonceliac gluten sensitivity or wheat intolerance syndrome?". J Pediatr (Review). 166 (4): 805–11. doi:10.1016/j.jpeds.2014.12.039. PMID 25662287. The increase in world-wide consumption of a Mediterranean diet, which includes a wide range of wheat-based foods, has possibly contributed to an alarming rise in the incidence of wheat (gluten?)-related disorders.1, 2
  25. ^ Volta U, Caio G, Tovoli F, De Giorgio R (September 2013). "Non-celiac gluten sensitivity: questions still to be answered despite increasing awareness". Cellular & Molecular Immunology (Review). 10 (5): 383–92. doi:10.1038/cmi.2013.28. PMC 4003198. PMID 23934026.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  26. Belderok B (2000). "Developments in bread-making processes". Plant Foods Hum Nutr (Review). 55 (1): 1–86. doi:10.1023/A:1008199314267. PMID 10823487.
  27. Gobbetti M, Giuseppe Rizzello C, Di Cagno R, De Angelis M (Apr 2007). "Sourdough lactobacilli and celiac disease". Food Microbiol (Review). 24 (2): 187–96. PMID 17008163.
  28. ^ Ciccocioppo R, Kruzliak P, Cangemi GC, Pohanka M, Betti E, Lauret E, Rodrigo L (Oct 22, 2015). "The Spectrum of Differences between Childhood and Adulthood Celiac Disease". Nutrients. 7 (10): 8733–51. doi:10.3390/nu7105426. PMID 26506381.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  29. ^ Fasano, A; Catassi, C (Dec 20, 2012). "Clinical practice. Celiac disease". The New England Journal of Medicine. 367 (25): 2419–26. doi:10.1056/NEJMcp1113994. PMID 23252527.
  30. Bold J, Rostami K (2011). "Gluten tolerance; potential challenges in treatment strategies". Gastroenterol Hepatol Bed Bench. 4 (2): 53–7. PMC 4017406. PMID 24834157.
  31. ^ Lundin KE, Wijmenga C (Sep 2015). "Coeliac disease and autoimmune disease-genetic overlap and screening". Nat Rev Gastroenterol Hepatol. 12 (9): 507–15. doi:10.1038/nrgastro.2015.136. PMID 26303674.
  32. ^ Fasano A (Apr 2005). "Clinical presentation of celiac disease in the pediatric population". Gastroenterology. 128 (4 Suppl 1): S68–73. doi:10.1053/j.gastro.2005.02.015. PMID 15825129.
  33. ^ Elli L, Branchi F, Tomba C, Villalta D, Norsa L, Ferretti F, Roncoroni L, Bardella MT (Jun 2015). "Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity". World J Gastroenterol. 21 (23): 7110–9. doi:10.3748/wjg.v21.i23.7110. PMC 4476872. PMID 26109797.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  34. ^ Ludvigsson JF, Card T, Ciclitira PJ, Swift GL, Nasr I, Sanders DS, Ciacci C (Apr 2015). "Support for patients with celiac disease: A literature review". United European Gastroenterol J. 3 (2): 146–59. doi:10.1177/2050640614562599. PMC 4406900. PMID 25922674.
  35. Lebwohl B, Ludvigsson JF, Green PH (Oct 2015). "Celiac disease and non-celiac gluten sensitivity". BMJ (Review). 5: 351:h4347. doi:10.1136/bmj.h4347. PMC 4596973. PMID 26438584.
  36. ^ Lundin KE, Wijmenga C (Sep 2015). "Coeliac disease and autoimmune disease-genetic overlap and screening". Nat Rev Gastroenterol Hepatol. 12 (9): 507–15. doi:10.1038/nrgastro.2015.136. PMID 26303674.
  37. Vriezinga SL, Schweizer JJ, Koning F, Mearin ML (Sep 2015). "Coeliac disease and gluten-related disorders in childhood". Nature Reviews. Gastroenterology & Hepatology (Review). 12 (9): 527–36. doi:10.1038/nrgastro.2015.98. PMID 26100369.{{cite journal}}: CS1 maint: year (link)
  38. Mooney, P; Aziz, I; Sanders, D (2013). "Non-celiac gluten sensitivity: clinical relevance and recommendations for future research". Neurogastroenterology & Motility. 25 (11): 864–871. doi:10.1111/nmo.12216. PMID 23937528.
  39. Nijeboer, P; Bontkes, H; Mulder, C; Bouma, G (2013). "Non-celiac gluten sensitivity. Is it in the gluten or the grain?". Journal of gastrointestinal and liver disorders. 22 (4): 435–40. PMID 24369326.
  40. ^ Fasano A, Sapone A, Zevallos V, Schuppan D (May 2015). "Nonceliac gluten sensitivity". Gastroenterology. 148 (6): 1195–204. doi:10.1053/j.gastro.2014.12.049. PMID 25583468.
  41. ^ Catassi C, Bai JC, Bonaz B, Bouma G, Calabrò A, Carroccio A, Castillejo G, Ciacci C, Cristofori F, Dolinsek J, Francavilla R, Elli L, Green P, Holtmeier W, Koehler P, Koletzko S, Meinhold C, Sanders D, Schumann M, Schuppan D, Ullrich R, Vécsei A, Volta U, Zevallos V, Sapone A, Fasano A (Sep 2013). "Non-Celiac Gluten sensitivity: the new frontier of gluten related disorders". Nutrients. 5 (10): 3839–53. doi:10.3390/nu5103839. PMC 3820047. PMID 24077239.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  42. Czaja-Bulsa G (Apr 2015). "Non coeliac gluten sensitivity - A new disease with gluten intolerance". Clin Nutr. 34 (2): 189–94. doi:10.1016/j.clnu.2014.08.012. PMID 25245857.
  43. Molina-Infante J, Santolaria S, Montoro M, Esteve M, Fernández-Bañares F (2014). " ". Gastroenterol Hepatol. 37 (6): 362–71. doi:10.1016/j.gastrohep.2014.01.005. PMID 24667093.
  44. Elli L, Roncoroni L, Bardella MT (Jul 2015). "Non-celiac gluten sensitivity: Time for sifting the grain". World J Gastroenterol (Review). 21 (27): 8221–6. doi:10.3748/wjg.v21.i27.8221. PMC 4507091. PMID 26217073.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  45. Volta U, Caio G, De Giorgio R, Henriksen C, Skodje G, Lundin KE (Jun 2015). "Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders". Best Pract Res Clin Gastroenterol. 29 (3): 477–91. doi:10.1016/j.bpg.2015.04.006. PMID 26060112.
  46. "What's the difference between celiac disease, gluten intolerance, non-celiac gluten sensitivity and wheat allergy?". The University of Chicago Celiac Disease Center. 2015. Retrieved 4 January 2015.
  47. "Food intolerance and coeliac disease" (PDF). Food Standards Agency. September 2006. Retrieved 8 September 2009.
  48. "Codex Standard For "Gluten-Free Foods" CODEX STAN 118-1981" (PDF). Codex Alimentarius. February 22, 2006.
  49. "General labeling for Packaged Foods (free translation)". ANVISA. July 2014.
  50. "About celiac disease". Canadian Celiac Association. 2014.
  51. "Health Canada's Position on Gluten-Free Claims". Health Canada. 29 June 2012. Retrieved 28 January 2015.
  52. "Guidance Notes on the Food Labelling (Amendment) (No. 2) Regulations 2004" (PDF). Food Standards Agency. November 2005.
  53. "Questions and Answers: Gluten-Free Food Labeling Final Rule". US Food and Drug Administration. 5 August 2014. Retrieved 4 January 2015.

Further reading

Barley
History
Types of barley
Agronomy
Trade
Parts of the plant
Basic preparations
As an ingredient
Associated human diseases
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Wheat
Types
Agronomy
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Plant parts and their uses
Stalk
Straw
Seed
Bran
Germ
Chaff (husk)
Endosperm
Gluten
Sprouts
Basic preparation
None
Berries or groats
Milling
Farina
Flour
Middlings
Semolina
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