It’s fashionable these days to give up eating bread. More and more of us claim to suffer from wheat allergy so we shun bread and other wheat-based foods.
Genuine food allergy is in fact rarely to blame, say experts. But wheat sensitivity (also known as wheat intolerance) or simply trouble digesting wheat is increasingly common.
Bread-related gut symptoms
"Probably one-third of patients in my allergy clinic complain of digestive symptoms such as bloating, diarrhoea, vomiting and stomach pain after eating bread," says Isabel Skypala PhD, specialist allergy dietitian at the Royal Brompton and Harefield Foundation Trust.
She says allergy is unlikely to be the culprit, but bread-related symptoms are real and wheat could be to blame.
"Some people find certain foods are simply hard to digest and wheat appears to be one of those," she explains.
What to do if wheat triggers digestive symptoms
If your symptoms are severe and long-lasting, especially if you have blood in your stools (poo), vomiting or painful stomach cramps, see your doctor to rule out a medical condition.
If you have bloating or other minor symptoms after eating bread, Dr Skypala recommends that you try an elimination diet. This is where you completely cut out wheat from your diet for four weeks then bring it back in gradually to see if symptoms reappear.
"When you bring wheat-based foods back in, I recommend trying weetabix or pasta first for a few days before starting on bread. It’s better to start with wheat in a more pure form as bread has so many other ingredients," Dr Skypala says.
Is it wheat intolerance or sensitivity?
If your symptoms return, it confirms you’re sensitive to wheat and will also help to show you which foods are especially troublesome. Some people may only have problems with pasta, for example, while others are fine until they eat bread.
If you are sensitive to wheat, or you have trouble digesting it, the main way to relieve your symptoms is to embark on a wheat-free or partially wheat-free diet.
How to go on a wheat-free diet
Cutting out bread and other foods containing wheat shouldn’t harm your health, if you do it properly.
Wheat is one of our staple foods and lots of wheat products, such as breakfast cereals, are fortified with vitamins and minerals.
In the past there was a danger of running short of essential nutrients like the B vitamins and iron, if you cut out wheat. But nowadays there’s a good range of widely available wheat-free alternatives that won’t compromise a balanced diet.
"There are great wheat substitutes that you can buy off the supermarket shelf now. Go for gluten-free bread and try other types of grains such as quinoa, corn and rice," says Dr Skypala. "Just make sure you substitute other equally nutritious foods for the wheat-based ones you’re cutting out."
Be sure to cut out all wheat from your diet. Some sources of wheat are obvious, such as bread, but others are less so, such as soy sauce (see box).
The good news is that you might not need to cut out bread completely.
Some people with wheat sensitivity have no problems when they eat toast (cooked wheat tends to be easier to digest), sourdough bread, bread cooked with flour made from French wheat, or any bread from a specialist bakery rather than a supermarket.
"Bakeries in supermarkets use the Chorleywood bread-making process, which cuts out the second rising to speed up the baking. People seem to have more problems digesting supermarket breads, so I’d always recommend avoiding store-bought loaves," says Dr Skypala.
The anti-bloat FODMAP diet
A specific type of wheat-free diet may help certain people with wheat sensitivity.
Designed originally for people with irritable bowel syndrome, the FODMAP diet is now being recommended by dietitians to people who have problems digesting wheat.
It’s not a catchy name but FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are types of carbohydrates that aren’t easily broken down and absorbed by the gut.
Essentially, the diet entails cutting out fermentable foods that can cause bacterial growth, leading to diarrhoea and bloating. That means cutting out wheat and other fermentable foods such as onion, apple, pears, mushrooms, honey, cabbage and sometimes milk.
"The FODMAP diet has been hugely successful for people with IBS. Because it excludes wheat, many people with wheat sensitivity may also find it helpful," says Dr Skypala.
The FODMAP diet works best if it's coupled with special dietary advice from a dietitian. There are FODMAP-trained dietitians working . If you want to see an dietitian, ask your GP or consultant to refer you.