Celiac disease is an intolerance to wheat gluten, rye, and barley proteins. Patients of celiac disease are hence advised to maintain a gluten free diet. Baked products of “wheat flour fermented by use of sourdough lactobacilli and fungal proteases” have reduced levels of gluten. This study evaluated the safety of administration of baked goods made from a hydrolyzed form of wheat flour to patients with celiac disease. It was found that such wheat products were safe for patients suffering from celiac disease.
Celiac disease is an autoimmune disorder of the small intestine that occurs in certain genetically vulnerable people with symptoms like chronic diarrhea. With this disease, the lining of the small intestine is found to be hypersensitive to a protein called gluten, which is present in many grains including wheat. Usually patients of celiac disease are advised to consume a gluten free diet, thus putting restrictions on the type of food that they may have. This study investigated whether the processing of wheat used for bakery products reduced gluten percentage, thereby making it safe for patients with celiac disease.
- A total of 16 patients with a diagnosis of celiac disease were included in the study. Prior to the study, a small intestinal biopsy and blood tests for markers of immune reaction were carried out in all patients. Four were later excluded since they had damaged intestinal linings.
- Patients were divided into three groups. The first group included six patients who received natural flour baked goods. The second group included two patients who received baked food made from partially hydrolyzed wheat flour. While the third group consisted of five patients who received baked food from fully hydrolyzed wheat flour.
- Patients continued this diet for 60 days.
- After 30 days blood samples were collected from patients. At the end of 60 days, a blood sample was collected, as well as a biopsy of the intestinal lining, was performed in all patients.
- It was found that the amount of native gluten decreased significantly by process of fermentation.
- Two patients from the first group consuming natural wheat flour abandoned the study as they developed clinical symptoms. All six from the first group had increased blood levels of markers of immune reaction. Their biopsies showed significant deterioration and atrophy of the intestinal lining.
- Patients from the second group had no clinical complaints, but biopsy examination showed that their intestinal lining had changed.
- Patients from the third group had no clinical complaints during the 60 days. Their blood levels of markers of immune reaction were not raised and their biopsies after 60 days did not show changes in the intestinal lining.
Use of sourdough lactobacilli for fermentation of wheat flour before baking is a traditional, age-old way of making baked goods. It was abandoned with the introduction of industrial baking, which is based on fast chemical fermentation. This study showed that the traditional way of sourdough fermentation reduces toxicity of gluten in wheat flour. Products baked from this flour are safe for patients with celiac disease. It opens up the possibility of a new therapeutic diet for these patients beyond the current advice of “no gluten in diet”!
Results “provide the rationale for exploring therapies that could reduce the toxicity of gluten for celiac disease patients beyond the standard gluten-free diet.” Adoption of the traditional biotechnology way of fermenting the wheat flour (sourdough) to make baked products is a safe and effective method. This process reduced the toxicity of gluten for patients with celiac disease. Patients who consumed such products for 60 days continually did not develop clinical symptoms of the disease. Their intestinal lining and blood antibody levels were also found to be normal. Further, and more thorough, analysis of sourdough baking should be carried out to look at possible new avenues for people who suffer from celiac disease.
For More Information:
Clinical Gastroenterology and Hepatology, January 2011
By Luigi Greco; Marco Gobbetti
From the Department of Pediatrics and European Laboratory for the Study of Food Induced Diseases, University of Naples, Federico II, Naples, and the Department of Plant Protection and Applied Microbiology, University of Bari, Bari, Italy
*FYI Living Lab Reports Are Summaries of the Original Research.