Written by Melissa Duce MS, RDN, LD
There are plenty of nutrition-related myths floating around on the internet, especially on social media where health information is often crowd-sourced. I see conversations like these at least once a week on social media:
“I have celiac disease. Is sourdough bread safe to eat?"
“My sister has celiac disease, and she eats my sourdough bread all the time!”
"Any tips for traveling overseas with celiac disease? What can I eat?”
“I can't eat gluten, but I ate bread overseas without any flare-ups. The wheat there is just better quality.”
Most of us know to take everything we see and read on social media with a grain (or chunk) of salt. But these anecdotes and misguided advice are often represented as truth to a person seeking help. A real person, with real health issues, who may not have the resources or experience to recognize advice that is perhaps good-intentioned but not accurate. This is troubling because it has serious health implications for individuals with celiac disease or a wheat allergy.
Before I dive into an explanation, I’ll give you the punchline first. If you have been diagnosed with celiac disease or a true wheat allergy, no wheat gluten-containing products are safe for you to eat. This includes fermented bread products such as sourdough. This also includes wheat bread in Europe (still has gluten), Australia (still has gluten), or the Bahamas (still has gluten).
If you have non-celiac gluten sensitivity, wheat intolerance, IBS, or otherwise try to avoid gluten, you are free to experiment with different products. For reasons I’ll explain below, you may find that sourdough bread does not cause the same symptoms as standard bread, or that you can enjoy eating bread when you’re on vacation.
I don’t have celiac disease, but I can’t tolerate gluten.
I’ll come back to celiac disease (or you can just skip ahead), but for now, let’s talk about everyone else who experiences digestive symptoms after eating wheat. Gluten often takes the heat for causing digestive issues such as cramping, gas, bloating, and diarrhea, but it is just one of a few potential offenders present in wheat. Also on the list are:
Fructans. These are a type of carbohydrate found in many plant foods, including wheat products. Fructans remain mostly undigested as they move through the gut, leading to increased water and fermentation in the large intestine. This is actually a good thing, from a gut health perspective (see my previous blog post). However, this process can also lead to gas, bloating, and diarrhea, which can be especially pronounced and uncomfortable for some. Folks with IBS or IBD (ulcerative colitis, Crohn’s) may be more sensitive to fructans and can find these symptoms to be especially painful.
Alpha Amylase-Trypsin Inhibitors (ATIs). These are a family of non-gluten proteins present in wheat. We don’t hear about ATIs as frequently as gluten or even fructans, but ATIs have been found to trigger inflammation in the gut, even in individuals without Celiac disease. In fact, ATIs are believed to be a major trigger of non-celiac gluten sensitivity.
Whether it’s gluten, fructans, ATIs, or a combination of all three that are causing your symptoms, you may feel some relief from symptoms when you swap in gluten-free products for the wheat products in your diet, because removing the wheat gluten also removes the fructans and ATIs.
Why is sourdough different? Why was I able to eat anything I wanted on vacation, but can’t handle those foods at home?
If you have IBS or wheat/gluten sensitivity, then it is quite possible that sourdough bread or a fresh croissant on your trip to Paris may be enjoyed without digestive issues. There’s no magic here, though. It isn’t due to better wheat processing or higher-quality ingredients. There are several contributing factors:
Sourdough bread may be easier to digest because the fermentation process breaks down the fructans and ATIs in the dough. Fewer intact fructans and ATIs mean less digestive upset and inflammation.
ATIs vary by type and quantity among different wheat varietals. Different wheat varietals are better suited to grow in different parts of the world, so you may be eating a different type of wheat when you’re vacationing overseas. Environmental factors, such as heat and drought can also impact the amount of ATIs present in wheat. In other words, the wheat you eat in other countries could be lower in ATIs, which may help with tolerance.
Gut-brain connection. Our brain and our gut are in constant communication. An upset intestine sends a distress signal to the brain, and an upset brain sends a distress signal to the intestine, which is why stress and anxiety can significantly impact how we react to food. In contrast to the day-to-day grind, when you’re on vacation you may feel more relaxed and joyful. You may savor your food more, eating at a slower pace, instead of gulping down your food between appointments or in the car. And since we think of comfort when we travel, you may wear clothes with a looser fit or stretchier waistband. These factors can have a positive impact on how you’re able to digest and tolerate your food.
What if I have celiac disease?
If you have celiac disease, the only treatment is lifelong adherence to a gluten-free diet. By following a strict gluten-free diet, you will minimize the risk of digestive upset, chronic gut inflammation, vitamin and mineral deficiencies, development of other autoimmune conditions, and certain types of cancer.
Since rumors are often based on a kernel of truth, I do want to mention that food scientists have published studies (such as this one) that show some success in decreasing the gluten in sourdough bread through fermentation. BUT…It’s important to note that these studies were conducted in a lab, under controlled conditions, using carefully selected bacteria/yeast strains and meticulous protocol. These conditions are not the same as the conditions in a home kitchen, and there is no guarantee that the wild yeast in a homemade sourdough starter will produce the same results. It is exciting to think that the future may hold in terms of gluten-free options, but at this point, there is no special circumstance that would allow someone with celiac disease to freely enjoy a wheat product.
What’s the bottom line?
Whole-grain foods can and should be a part of a healthy diet. If you do not have celiac disease or a wheat allergy but often feel digestive discomfort after eating wheat products, give sourdough bread a try. You may find that it is much better tolerated (and makes a darn good sandwich).
It may also be worth it to try new foods and regional specialties in a low-stress, low-pressure environment, like when you’re on vacation or traveling. Now, there is a caveat. if you find travel stressful in general (like me), then you may want to check in with your stress level and your gut before diving into a pastry or baguette. Start with a small portion to see how it is tolerated. You want to enjoy your travels and not end up stuck in the hotel bathroom, after all!
For those with celiac disease, the good news is that gluten-free products will continue to increase in quality and quantity. And while there will always be misinformation online, there are also plenty of great resources. For example, this travel blog has fantastic tips for traveling the world gluten-free, including the countries that are the most celiac-friendly. And, if you read about or hear advice that seems questionable, reach out to your physician, a Registered Dietitian, or another qualified health professional for clarity. You can also email your questions to me at melissa@foodjoynutrition.com.
Looking for more support?
Sifting through the noise of online information and social media influencers is overwhelming, especially when coupled with a new diagnosis, a new diet, or just the everyday stressors that life brings. Working with a Registered Dietitian (like me!) can help ease the stress of planning your meals and managing symptoms, both at home and on your travels. To learn more, book a free discovery call, and let's talk!