Effect of unripe carob fruit on oxidative markers, intestinal permeability and microbiota in celiac patients

The aim of this study was to determine the sensory properties of gluten-free cookies rich in insoluble fiber and antioxidants made with unripe carob (UC) and to evaluate the effects on oxidative parameters, gastrointestinal symptoms, intestinal permeability and microbiota in adult celiac patients after consumption. This randomized, double-blind, placebo-controlled study was conducted with 20 individuals aged 19-64 years who were diagnosed with celiac disease within a maximum period of 1 year and were in the active period of the disease, had not been on a gluten-free diet before and were not on it, had a normal body mass index value, had consumed carob fruit and had no allergy. First, gluten-free diet treatment was explained to celiac patients who met the inclusion criteria and then celiac patients were randomly divided into two groups. In addition to the gluten-free diet, the study group (n=11) was asked to consume gluten-free cookies produced with the addition of UC flour daily for eight weeks, while the control group (n=9) was asked to consume standard gluten-free cookies identical in shape and size to the study group cookies during the same period, and the oxidative parameters, GI symptoms, intestinal permeability and microbiota of the patients were evaluated at the beginning and end of the study. When the results of the study were examined, it was found that both zonulin levels were lower in the UC consuming group compared to the beginning (p<0.05), and gastrointestinal symptoms were lower than in the control group (p<0.05). In addition, it was determined that microbial diversity may decrease in the control group over the eight-week period, while a stable diversity was seen in the study group over eight weeks; Lactobacillus and Bifidobacterium species values decreased in the control group and remained relatively stable in the study group. These results show that UC can increase the gluten-free fiber content of adult celiac patients and reduce some gastrointestinal symptoms by having a positive effect on intestinal permeability and microbiota, indicating that unripe carob can be a good alternative in a gluten-free diet.