The Health Benefits Of Sourdough Bread In Managing Irritable Bowel Syndrome

The Origin and Significance of Bread in Human Civilization

Bread is one of the grains that has been cultivated by humans from the pre-historic ages (Burnett and Burnett 2013). The processing of sourdough bread started accidentally in Mesopotamia and Egypt when people started making a paste of wheat so that it can be flattened and stored in a form of flat bread (Cauvain 2012). When yeast was accidentally introduced into the dough, the dough started leavening. Further, people also understood that if they incorporate a piece of previous day’s wheat paste into a fresh bread dough, leavening will occur. This is the process which is still used in bread industries for the production of sourdough breads. The origin of modern fine wheat white bread was around 1000 BC ago in Egypt, where humans discovered a new strain of wheat that allowed them to refine it to generate the white bread (Graham 2012). The development of beer breads also occurred in Egypt, from where the technique spread to Greece and further to the entire Europe (Yano 2012). In the Stone Age, there are evidences that people made solid cakes from stone-crushed barley and wheat. A millstone used for grinding corn has been found, which is thought to be 7,500 years old (Young 2016). According to botanists, wheat, oats, and other grains belong to the different order of Grasses however, no sign of the wild form of grass has yet been found from which wheat, as we know it, has developed. Similar to most of the wild grasses, cereal blossoms has both male and female elements (Graham 2012). The young plants are provided with a store of food to ensure their support during the period of germination, and it is in this store of reserve substance that man finds an abundant supply of food. The ability to sow and reap cereals may be one of the chief causes, which led man to dwell in communities, rather than to live a wandering life hunting and herding cattle (Yano 2012). The importance of bread in that era can be understood form the incident in Rome, where people valued bread more than meat and government started bread baking center just to provide the soldiers proper food and shelter (Hamdane et al. 2016). In later years bread earned tremendous importance in human life that in God’s prayers, in Royal kitchen bread started being served with every meal. It was scientifically proven that bread is a wholesome carbohydrate rich food source that provides enough energy to start an active day. Further, the introduction of mechanized slicing occurred in the year 1917, when the first mechanized slicer for bread was generated (Young 2016). Furthermore around this century, people discovered the chemicals that reduced the long fermentation period of bread and confined it within 8 to 10 hours. These chemicals were oxidants that decreases the fermentation time, as well as helped to create a superior loaf that enhances the taste and shelf-life of bread (Dall’Asta et al. 2013). There are more than 100 type of bread dough has been prepared by human by mixing the ingredients in different rations, however, few breads are being used by maximum individuals around the world. These are sourdough breads, white bread, Chorley bread, Canadian bread, cottage loaf and so on (Burnett and Burnett 2013). These type of breads have their own health benefits and complications. Each individual is sensitive to one kind of bread because of the chemical or ingredient that has been used in baking and leavening on the bread dough (Yano 2012).

Understanding the Relationship Between Bread and Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome or IBS is a digestive disorder in which the large intestine is affected (Jeffery et al. 2012). This disorder can become very chronic if the diet and nutrition of the person affected is not controlled. The signs and symptoms of IBS involves abdominal pain, bloating, cramping, constipation, diarrhea and it can be managed by controlling lifestyle, diet, stress (Mullin et al. 2014). Diet is an important aspect of IBS as this disorder is a functional abnormality instead physical abnormality and as each individual is allergic to any food product, consumption of that food can lead to irritable bowel syndrome (Lovell and Ford 2012). The association of IBS with bread and wheat is because of the presence of Gluten, which is the primary protein substance present in bread dough. Maximum people around the globe are sensitive to this substance of bread and this disorder is commonly known as celiac disease, in which people are unable to digest gluten (Mullin et al. 2014).

In the previous section, this assignment has discussed about the depth of bread in human civilization and the extent to which it is involved in the diet of each individual. However, do to sensitivity to the protein substance gluten several people are unable to consume the conventional bread. Therefore primary aim of this assignment is

• To understand the pathway through which gluten enhances the IBS syndrome in people having white bread.
• To assess the composition of sourdough bread so that it do not affect or enhances the IBS syndrome in people consuming breads.
• To conduct a comparison between sourdough and Chorley/white bread.
• To recommend techniques using which, the composition of white bread can be modified and made suitable for gluten sensitive people for consumption.

Hypothesis helps to create comparative analysis within two variables and helps to find the answer of the proposed question. For a better comparative analysis of this study, a hypothesis has been proposed. The hypothesis is as follows –

• H1: Sourdough bread helps to decrease the risk of IBS compared to Chorley or white bread.
• H0: sourdough bread does not decrease the risk of Bowel syndrome compared to white or Chorley bread.

Using this hypothesis, the research regarding sourdough bread will be conducted.

The methodology of this research article will be constructed based on the effectiveness of sourdough bread in enhancing health and the mechanism due to which it does not affect or increases the risk of IBS syndrome. Several research articles will be reviewed and novel investigation will be conducted in this section to determine or achieve the goals for this assignment.

The sourdough bread is considered as the healthiest bread among all kinds as it contains lactic acid (Gobbetti et al. 2014). This bread is fermented in the presence of lactobacillus and yeast and due to which the taste and composition of this bread varies from the white bread fermented in the presence of baker’s yeast. This composition was invented in Egypt nearly in 1500 BC and is one of the oldest forms of bread dough making process (Galle et al. 2012). The yeast used in the making of sourdough bread is named as wild yeast and is resistant to acid formation thereby in combination to lactobacillus it helps to leaven the dough prior to baking process (Rizzello et al. 2012). The nutritional quotient of sourdough bread is similar to other bread dough however, it contains higher amount of minerals such as iron, selenium, manganese, niacin, thiamin, as well as folate that enhances the immunological resistance of the consumer and helps to digest the food properly (Black et al. 2013).

Proposed Hypothesis

The health benefits of sourdough bread can be seen in human digestion, blood sugar control and maintaining the individuals nutritional content.  In a research conducted by Rizzello et al. (2013), the researcher was determined to find the pathway using which the sourdough bread enhances the body’s capacity to absorb this much mineralsin human body. It has been observed that the normal white bread contains phytic acids or phytate that is considered as anti-nutrient of human body (Black et al. 2013). This is because it binds to the minerals and hampers their ability to be absorbed by the human body (Galle et al. 2012). The sourdough bread is composed of lactobacillus and hence, due to the presence of lactic acid, the breads pH gets lowered and this bread helps to degrade the phytic acid present in the bread and hence, increases the human body’s ability to absorb more minerals. Gobbetti et al. (2014) also mention that sourdough bread has much less amount of phytate because of the unconventional fermentation process and hence, degenerates 50 to 70% phytate while leavening or baking process.

Diet is considered as one of the important aspect for managing IBS syndrome in patients who are also suffering from celiac disease or inability to consume gluten added food products. In a research conducted by Biesiekierskiet al. (2013), the researchers aimed to understand the effect of low fermentable oligosaccharides mono and di-saccharides and polyols in controlling the IBS syndrome. They researchers conducted this research and compared this diet with a conventional Australian diet having no restrictions. According to the demographics, the researches took 30 IBS patients and 8 healthy control clients andconducted one habitual week with each member and then randomly divided them in two groups for 21 days and after that crossing over of the usual diet was done. After the research completed, it was observed that the subjects with IBS who consumed the low carbohydrate foods, decreased their gastrointestinal disorders. Further they also reduced the symptoms such as bloating, passage of wind and pain after going through the low carbohydrate diet. In an another research conducted by Vazquez–Roque et al. (2013), the research determined that gluten free diet can help in determining better health outcome in patients affected with dominant bowel syndrome. For the purpose the researchers conducted a randomized controlled trail with 45 patients within which 23 patients of IBS were fed with gluten containing food and another 22 patients were fed with gluten free diet. The researchers collected results related to bowel functionality, mucosal permeability, and colonic transit and then witnessed the blood of each patients having gluten added food for the production of peripheral blood mononuclear cells after exposure to gluten and rice. After the research, the results determined that individuals consuming more gluten containing food were developing higher amount of bowel movement and they increased their SB permeability due to higher amount of ion outflow. However, not much difference were noticed in case of colonial permeability. Therefore, from the results it was determined that the presence of gluten altered the barrier to bowel movement in patient consuming higher amount of gluten and therefore they developed acute irritable bowel syndrome.

The Health Benefits of Sourdough Bread in Managing IBS

Another research was directed to understand the emergence of IBS in non-celiac individuals after consumption of gluten added food products and this research was aimed to understand the effect of gluten after its reduction from dietary reduction low fermentable and poorly absorbed and short chain carbohydrates (Halmos et al. 2014). For this purpose the researchers conducted a double blind cross over trial with 37 individuals having no history of celiac disease and then they were randomly assigned to different groups and then they were fed with gluten added and gluten free diet for two weeks. After the completion of the research it was determined that the group in which patients were fed with gluten free diet, the gastrointestinal performance were significantly and consistently improved, where as in the group where individuals were fed with gluten added food, eventually developed the signs and symptoms of irritable bowel syndrome (Böhn et al. 2015). Therefore, from these researches it is evident that gluten is primarily responsible for emergence of bowel syndrome and hence, the white bread, which contains gluten in higher amount, is not suitable for patients having symptoms of IBS.

While discussing the effect of gluten on bowel syndrome, the connection between IBS and gluten should be developed. Irritable bowel syndrome is the condition when the stomach gastric juices are not able to digest the food and due to that gas, bloating, constipation and diarrhea arises (Camilleri, Lasch and Zhou 2012). However, gluten sensitivity, celiac disease and IBS are linked to each other. Dietary influence is a major aspect of IBS syndrome. Gluten is an immunogenic protein and it is capable of inducing celiac disease and IBS in people having Gluten sensitivity (Biesiekierski et al. 2013). The human gut is accompanied with peptidase enzyme which is capable of digesting gluten, however after degrading gluten, the enzyme is unable to further degrade the under digested peptides. These peptides then triggers the innate immunity and this is the primary reason for the increased irritation in the IBS syndrome. Further it also develops the muscle contractility and alter barriers for IBS that enhances the symptoms of IBS (Halmos et al. 2014). Further recent studies has also indicated to the fact that alpha amylase and trypsin inhibitors also trigger the pathway for innate immunity and thereby causing irritable bowel syndrome. Further, researchers has indicated to the fact that consumption of lower gluten foods will help in controlling the condition as this is a functionality based disorder and hence, can be fixed by amending or changing diet (Camilleri, Lasch and Zhou 2012).

Effectiveness of Low Carbohydrate and Gluten-Free Diet in Managing IBS

This assignment has discussed reasons due to which, white bread having higher amount of gluten is responsible for triggering irritable bowel syndrome in patients (Rizzello et al. 2016). In this section, this paper will be discussing the difference between the white bread and sourdough bread and the specifications that makes the sourdough bread a healthier option than the Chorley or white bread. Sourdough bread is made up of flour, water and salt and the difference between a white bread and sourdough bread is the baking process (Houben, Höchstötter and Becker 2012). For the fermentation process, the sourdough bread is left for fermentation with wild yeast for days and after the leavening process the breads are beaked, and therefore, the lactic acid and fermentation process, helps to lower the gluten content of the bread (Dziki et al. 2014). On the other hand, white bread contains ingredients such as butter milk and sugar and the baking process is fulfilled with cultivated yeast. Further, due to the lack of acid content, the gluten cannot be denatured in the bread and hence it contains higher amount of gluten that triggers the IBS in many patients (Houben, Höchstötter and Becker 2012). In a general sized white bread, the one slice is weighed 42 grams and contains 119.7 calories. While discussing the nutrient values, it should be mentioned that the total fat in white bread is 2.4g in which mono saturated, poly saturated and saturated fatty acids are present (Bornhorst and Singh 2013). Further, it contains 3.3 gram of protein and 20.8 gram of carbohydrate. Whereas, the sourdough bread is composed of 6 gram of protein, 2 gram of fat and 32 gram of carbohydrate. Therefore, these differences let the sourdough bread with the advantage so that patients having sensitivity against gluten can also consume bread especially sourdough bread so that it cannot trigger their IBS syndrome (Rizzello et al. 2016).

Further, one more difference between sourdough bread and normal white and Chorley bread is its ability to be digested (Mofidi et al. 2012). The content of sourdough bread is full of gut bacteria, with lactobacillus that increases after leavening and fermentation process. There are several research studies that have been conducted and the researchers revealed that the sourdough bread contains pre-biotic properties (Axel et al. 2015). And hence, with consumption of sour dough bread, the individual consumes several good food bacteria, therefore supplementation of good bacteria increases. Therefore consumption of this Bactria improves the gut health, and eases the process of digestion. Moreover, as phytic acid in the sourdough acid degrades the presence of gluten, consumption of this bread also do not hampers the intestine by emerging the IBS syndrome (Novotni et al. 2012). However, there is a one disadvantage for people with gluten sensitivity. This sourdough bread is also made up of wheat, barley, or rye, which should be avoided by the patients of IBS syndrome as it also, has the ability to trigger such symptoms (Mofidi et al. 2012).

*The data was collected from the research of Rizzello et al. (2016).

** The values in the above table are for 100 grams of each type of bread

In this article, we have discussed several aspects of sourdough bread, the chemical composition of it, and thecomponent due to which people having sensitive digestion develops irritable bowel syndrome. The discussion was mainly targeted for usage of sourdough bread for the usage of people affected with bowel syndrome as the sourdough contains less amount of gluten which is mainly responsible for irritable bowel syndrome if any one consumed white or Chorley bread. The researches included in this section also indicated towards this fact that gluten free diet lowers the symptoms of IBS in acute IBS patients. The first research by Vazquez–Roque et al. (2013) made the participants of two groups with gluten free as well as gluten added diet. It was seen that gluten is responsible for inducing innate immunity as it enhances the concentration of TNF alpha, GM CSF and interleukin factor 10 which are potential inducer of irritation in large intestine of patients with IBS. Further, the data provided in the research indicated to the fact that implementation of gluten free diet helps to reduce the severity of the disease. Further withdrawal also decreases the adaptive as well as innate immunity responses in patients with IBS. In another research conducted by Biesiekierski et al. (2013), differentiates between celiac disease, gluten sensitivity and IBS syndrome. For this purpose, the researchers ask participants to eat less carbohydrate added food so they can ingest that minimal amount of gluten. Further, after two weeks it was observed that the gastrointestinal symptom of the individual who are on less carbohydrate diet improved and they had also improved their IBS symptoms. This study determined the effectiveness of gluten free or less carbohydrate food by inducting the process for 4 long weeks and the randomized control trial process helps to understand the nature of carbohydrate in generating irritation in people with IBS. The third research articles were aimed so that effect of gluten in emergence of IBS can be understood. Through this research the individualshaving no IBS were made consume gluten added food for 2 weeks and then it was observed that after the consumption of high gluten food, the individuals increased the symptoms of IBS that decreased once the gluten was removed from their diet. Further in this assignment, different aspects of sourdough bread such as its nutrition and composition related aspects has been discussed (Halmos et al. 2014). Further, the fermentation process that imparts few specific qualities such as higher lactic acid that decreases the gluten amount by degrading it was discussed. Further, the research also included the fact that low carbohydrate or gluten is also harmful for the health as the craze of low carbohydrate food has been increasing among younger generation nowadays. Therefore, through this discussion of sourdough bread, it is clear that patients with IBS are safe and secured to consume these breads on regular basis (Böhn et al. 2015).

There is several future implication of this study. The researchers have identified gluten as the inducers of immunological responses that enhances the irritability (Ottenbacher and Harrington 2013). However, it is unclear that gluten or its metabolic products that arises from the degradation of gluten by peptidase, leads to generation of specific secretary mechanisms.Further there is a hypothesis that the consistency of stool determines the fluid secretionhowever, there are still a lot of research which is left (Knorr-Cetina 2013). Further, there are no studies available on the effect of gluten on microbial colonization as it affects the digestion. Therefore, in future these interventions can be used prior and after consumption of gluten added food so that the effect of gluten on microbial concentration can be understood (Lerner and Matthias 2015). Further, the research can also be implemented in the process so that the carbohydrate molecule, which is responsible for gluten formation and irritation generation, can be identified and replaced so that people can consume such product without any concern. Besides these, the research on FODMAP food should also be conducted (Kim 2012). This is an important aspect as the FODMAP food or low carbohydrate foods, which are available nowadays contains secondary food products such as corn, soy sauce or other food items which also can lead to irritation of bowel syndrome. Further gluten is not a FODMAP product and gluten free does not mean the food is FODMAP therefore future research should be done on the development of FODMAP so that patients with IBS can have these food products to control their bowel syndrome (Ottenbacher and Harrington 2013). Moreover, the future research should be done on the replacement of wheat, rye and barley for the bread making process and products that can enhance the quality of the bread and decrease its ability to create irritable bowel syndrome should replace these (Knorr-Cetina 2013). Further researchers should also find any replacement of the gluten as gluten helps in dough formation. Hence, using the replacement the dough will be easily prepared and the people consuming the bread will not develop the IBS (Lerner and Matthias 2015).

Conclusion

While concluding the assignment, it should be mentioned that bread is a food product, which has been used by the human civilization from the Prehistoric ages. the bread found its roots in Mesopotamia and Egypt and from that around 1000 BC it took the form of new modern bread. Different processes of bread making has been changed or modified since then such as leavening, fermentation, dough preparation and cutting or slicing. Currently, each individual in the world in different forms uses bread. There are several types of breads such as sourdough bread, white bread Chorley bread but the usability depends on each person’s dietary habits, as dietary habits determines digestibility of that bread.  One such digestion related disorder of digestive system is irritable bowel syndrome, which is a functional disability that occurs due to Lifestyle, stress or diet related problems. It has been seen that the composition of the bread contains a protein substance known as gluten that induces innate and adaptive immunity in humans and thereby causing irritation in the large intestine. therefore people with IBS syndrome cannot use white bread as their food however due to process and fermentation related modifications the sourdough bread is suitable for use by the IBS affected patient. The primary reason behind this is the presence of lactic acid bacteria that increases the acidity of the bread dough making the gluten degraded prior to baking. In this discussion several researchers has been included that also determine that gluten free diet can increase or enhance the ability to digest food product without the occurrence of irritation.  In this write-up, the effectiveness of sourdough bread for the usage of IBS affected patient has been included. Further, the research has provided evidence that the sourdough bread enhances the body’s capacity to absorb mineral. It has been seen that the white bread contains high amount of phytic acid or phytate, which is an anti nutrient for the human body. As the sourdough, bread contains high amount of lactic acid the bread’s pH is lowered in the sourdough bread and hence the phytic acid is degraded in the process of fermentation. Therefore, it increases the human body’s capacity to absorb more nutrients. Furthermore, in different research papers researchers provided facts that no gluten or carbohydrate added foods can enhance or revert the symptoms of irritable bowel syndrome by managing the diet or duty of the affected People. Therefore, in this detailed analysis the effects of white bread containing gluten on the people with ABS syndrome has been discussed and provided with an alternative option such as sourdough bread that can be used by those affected people because it does not have the ability to enhance their IPS related symptoms because of low gluten. Finally, ion the discussion several future aspects has been mentioned related to finding FODMAP food, gluten, finding alternative of gluten for the binding process and replacing the flour with other carbohydrate rich food so that gluten can be totally eliminated from the process has been mentioned.

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