On the Rise

Bread is the most common food that my patients talk about. It seems to be causing digestive problems like bloating, headaches, fatigue, nausea, IBS etc. More often than not bread is avoided due to a self diagnosis of wheat/gluten intolerance without really knowing what grain is causing what symptom, and is it actually the grain but something else entirely that is causing the problem? So what's going on? - are we becoming a nation of wheat intolerant, gluten intolerant people or are we all hypochondriacs?!

Bread has been made since the dawn of civilisation - in fact, it can be argued that bread is the foundation stone of civilisation as we know it, and it still forms part of the staple diet of millions of people around the world. Changes in bread making have been quite drastic over the last 40 years. In 1961 The Chorleywood Bread Process was created which used chemical additives, intense energy and high quantities of yeast to produce the maximum amount of loaves in the shortest time. Mostly all bread in the UK is made by this method or one that uses similar additives.

Harmful elements

The trouble comes if dough is not allowed to ferment for several hours. Natural bacteria doesn't then have a chance to destroy harmful elements in the dough and therefore make important nutrients available to the human body. There is also the addition of genetically modified enzymes, added to flour and dough to make loaves larger and more "squishy", so they have a longer shelf life. Worryingly some recent research has suggested that transglutaminase, an enzyme used in baking and food manufacturing, may change the gliadin protein in wheat flour into a form that may be toxic to the human body. If you're thinking going organic will solve this problem, think again as even organic loaves made the same way can contain this, and cause the same problem.

Nutritional Quality

We have bred wheat to produce high yields in intensive growing conditions with little regard for its nutritional quality. Modern varieties have 30-50 per cent fewer minerals than traditional ones. Fast roller milling separates grain into its constituent parts so effectively that white flour has up to 88 per cent less of a range of minerals and vitamins than whole wheat. A recent study showed that organic stone-ground flour had 50 per cent more magnesium and 46 per cent more zinc than chemically grown roller-milled flour. So, what about refined flour - why is it so bad? Modern roller milling is extremely efficient at stripping away the nutrient rich outer layers of wheat grains, leaving behind not much more than starch and gluten. Additionally, the heat generated by the process actually destroys some of the compounds. Compared to whole wheat, refined white flour is highly depleted. These are the average amounts of vitamins lost: Vitamin E 93%, Vitamin B6 87% ,Vitamin B2 81% ,Vitamin B3 80%, Iron 70% and Calcium 56%.

To clear up any confusion, white bread is no longer bleached - they stopped that in the late 1990's. Soya flour is often added to whiten it. Wholemeal or wholegrain will guarantee you the benefit of grain, however a loaf labelled "brown bread," could be white flour coloured with caramel, so check labels carefully. Hopefully now you can see that bread is not all it appears. The ingredients needed to make bread are simply, flour, water, yeast and a little salt.

Being Added

Let's have a look at what other lovelies are now being added: E481 (sodium stearoyl-2-lactylate), E472e (mono- and diacetyl tartaric acid esters of mono- and diglycerides of fatty acids), E920 (l-cysteine), E282 (calcium propionate), E220 (potassium sorbate), E300 (ascorbic acid), E260 (acetic acid). Soya flour, vegetable fat and dextrose are just some of the other things that you might find in industrial bread. (to find out more about these additives please see my blog at www.katearnoldnutrition.co.uk).

Real Bread

To ensure that you are eating delicious "real" bread, made without additives, firstly try and use local bakeries - the bread is usually of better quality and you can chat with the baker and ask what is put in the loaf. If you don't know how to, go on a bread making course and learn to make proper real bread. Get a bread making machine and use really good ingredients - after the initial cost of the machine, each loaf should cost about 50 pence. Avoid breads that have the above ingredients where you can. You can buy additive free bread, slice it and freeze it, if you are concerned about it going off. Use companies that are still making bread in a real way. Try www.village-bakery.com or go to www.realbreadcampaign.org. for more information. For those of you who are really interested in this topic, I'd recommended this great book. Bread Matters: The State of Modern Bread and a Definitive Guide to Baking Your Own by Andrew Whitley or Bread: River Cottage Handbook No. 3 by Daniel Stevens, if you are looking to make your own bread.

Coeliac disease

If you think you have a problem digesting bread and have vague symptoms go and see your GP who can arrange a blood test - this will include tissue transglutaminase antibodies. More often than not it will come back negative.

Coeliac disease is not just a bit of bloating, it is actually classed as an autoimmune disease. Symptoms can include: bloating, abdominal pain, nausea, diarrhoea, excessive wind, heartburn, indigestion, constipation, any combination of iron, vitamin B12 or folic acid deficiency, tiredness, headaches, weight loss (but not in all cases), recurrent mouth ulcers, hair loss (alopecia), skin rashes, joint or bone pain, neurological (nerve) problems such as ataxia (poor muscle co-ordination), and neuropathy (numbness and tingling in the hands and feet). It is hard for GP's to diagnose as you can see the symptoms are varied and some quite common. If you are not coeliac that doesn't mean you don't have problems digesting grains. There are IgE allergy tests for rye, oats, barley, maize (corn) wheat etc which can be most useful to eliminate any underlying allergy problem.

Sadly these are not usually available on the NHS. Before you do this though check the loaf of bread in the bread bin. You might want to swap it and see if the symptoms go. There will be a bread out there that doesn't cause symptoms. Rotate bread types, pita or flattened breads often have less yeast, try rye, spelt, gluten free etc and more often than not you will find a bread that does suit you. If you guts are you good shape, you should be able to eat bread twice a day. It is not a good idea to start the day with a grain based cereal, then have a sandwich for lunch and then pasta in the evening - that may be too much. Keeping a food and symptom diary might help eliminate the problem. Bread is so useful it seems a shame to eliminate it totally from the diet.

If you would like further advice on IBS/bowel problems/allergy please contact Kate Arnold on 01323 737814