Last Tuesday, The Guardian reported that sales of bread are ‘in freefall’. Trade magazine Grocer reported that last year, 40% of Brits had rejected bread in favour of pitta and wraps. Many let go of bread altogether, carrying packed lunches of yesterday’s leftovers or salads they bought or made at home. The reasons people give for ditching bread are boredom, laziness, health and weight. Laziness seems unlikely though, because those who cannot be bothered to make a sandwich to take to work still have to eat something for lunch, and they might just go and buy a sandwich. Indeed, the UK sandwich market – “a major user for sliced bread” – has increased by 6%. Boredom is of course a possibility, but then bread is very versatile: a sandwich becomes interesting by its filling, and the possibilities are endless. Is stuffed pitta or a wrap (as such) really that much more interesting than a sandwich?
So, what about health reasons? Humans have been eating bread for thousands of years, apparently without suffering any consequences. Why now? Whether or not bread (or gluten, or wheat, or grains, or carbs) are good for us or not is hotly debated, and even experts don’t seem to be able to agree.
Bread, typically, is made from wheat or rye, both of which are gluten grains. Gluten is a protein that occurs in wheat and related grains (spelt, rye and barley). It makes dough sticky, allows bread to rise and still hold together, gives it its springy texture. The only undisputed gluten intolerance is Coeliac disease, an auto-immune condition, which some people are genetically predisposed to. When people with Coeliac eat gluten, their body mounts an immune response that attacks the villi (finger-like protrusions in the intestinal lining). The damaged villi can then no longer absorb nutrients properly, and the patient can experience a wide array of symptoms, reaching from gastro-intestinal disturbances to malnutrition. Strict avoidance of gluten is their only option.
Only 1% of the population is prone to Coeliac disease. Some experts believe that there are many, many more affected by gluten, either by gluten allergy (mediated either by IgE or IgG antibodies) or non-coeliac gluten sensitivity (NCGS), which is neither auto-immune nor an immune reaction. Other experts, however, refute that there is any such thing and that most people who think that they are sensitive to gluten are either imagining it or they are in fact sensitive to something else.
Most of our bread is made from wheat. Rye and spelt breads often contain wheat as well. Wheat features in our diets not just in the form of bread, but also pasta, cakes, biscuits, and other baked goods. Moreover, wheat flour may be used as a thickener for soups and sauces and is an additive in many foods that are not obviously ‘wheaty’.
Our favourite grain has, over the last century and especially since the 1950s, undergone quite considerable changes, which may explain why wheat is a problem for so many today, when it didn’t used to be. First of all, through cross-breeding and genetic manipulations new types of wheat were created, resulting in higher yields with a lower nutrient content. Monocultures led to depletion of the soils, lowering the nutrient content of the grain even further.
We also learned how to separate the nutritious components of the grain (bran and sperm) and the starchy, carb-containing endosperm. The resulting white flour is obviously less nutritious, but is no longer able to go rancid, thus increasing the shelf life of foods made with it. Flour is bleached and bread is made with yeast, which is a much cheaper and less laborious process than the fermenting of sourdough, using sprouted grains as in the olden days.
The American food writer Michael Pollan believes that wheat (and in fact gluten) bread does not pose a problem for most people, as long as they stick to sourdough (fermented) bread. He is joined in his opinion by British bread expert and enthusiast Andrew Whitley.
According to Lorisian Laboratories, about 45% of people experience adverse reactions to foods. A possible underlying reason is intestinal permeability (‘leaky gut’), a condition in which a damaged intestinal lining allows partially digested proteins to enter the bloodstream. The body then mounts an immune response, leading to a variety of symptoms. If the intestinal lining is compromised, the foods we eat most often are the most likely to cause a reaction, simply due to the frequent exposure. Wheat and gluten (and dairy) are among the most common culprits.
FODMAP is an acronym of “Fermentable Oligo-, Di-, Monosaccharides And Polyols”, all of which are short-chain carbohydrates, which are generally poorly absorbed by most people. Any FODMAPs not absorbed in the small intestine are subsequently fermented by bacteria in the colon, which leads to the formation of gas. Sensitive people may experience bloating, flatulence and even pain as a result. Grains – including wheat – are one source of FODMAPs, but there are many others. People who are sensitive to these types of carbs may experience.
Different people handle carbohydrates differently. If you have a family history of diabetes, heart disease or obesity, you may be sensitive to carbohydrates. Depending on their genetic make-up, some people have no difficulty metabolising carbohydrates without experiencing exaggerated insulin spikes, while in others even small amounts of carbs cause insulin to rise very high. Gene tests, which are now very affordable, can help you identify how sensitive you are and allow you to personalise your diet for your specific needs.
One of the major reasons for people to avoid bread is weight control. Over the last few years, more and more research has emerged implicating carbohydrates – particularly of the refined kind – in weight gain. It appears that the increase in carbohydrates in the Western diet is behind the obesity epidemic. Carbohydrates (and not fat) cause insulin – the ‘fat storing hormone’ - to rise. The job of insulin is to remove glucose from the blood stream, first supplying the cells with glucose for energy, then storing some as glycogen (a starch) in the liver and muscles for emergencies and, lastly, converting any excess into triglycerides, which are stored in fat cells, typically around the middle as abdominal fat and visceral fat around the organs. Insulin also makes sure that this fat stays there, not allowing the energy from it to be released again for use. Successful weigh loss programmes therefore seek to restrict or even eliminate carbohydrates to limit insulin release and to allow body fat to be burned for energy.
Is bread good or bad?
For the reasons given above, bread doesn’t seem to be desirable, certainly not in large amounts. But then again bread is not the only problem food: If you are sensitive to gluten, you would need to eliminate all other foods made from or containing gluten grains. If you are sensitive to wheat, ditto. If you cannot tolerate FODMAPs, you would have to avoid – hopefully just for a limited time – most other grains, too, as well as a number of other foods containing FODMAPs. If you are sensitive to carbohydrates, suffering from diabetes or heart disease or being pre-diabetic, you would have to restrict your carbohydrate intake as a whole.
Of course there are also huge differences in the quality of breads: Industrial processed bread is best avoided, as is white bread. White bread has been stripped of its nutrients, but is in its effect on your body’s metabolism not very far removed from sugar, leading to insulin spikes. Cheap industrial plastic-packed bread has been found to be one of the biggest sources of phthalates (hormone disrupting plastic softeners) in our diet.
If you are going to eat bread you are best off by going for either homemade or artisan bread, made of whole grains – ideally rye or spelt – and fermented (sourdough). If you are looking to lose weight, limit your intake to no more than one slice of wheat or one and a half slices of rye bread per meal (and no other carbs alongside them).
I want my clients to have a diet that is as varied as possible. Many people are cutting out foods unnecessarily in their quest to find the underlying reasons for their ailments. If you are not sure whether bread is right for you, why not give me a call and come and see me in clinic at The Body Matters?