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This project aims to verify the hypothesis that spelt products are more tolerable than bread wheat products in a target group of individuals with self-diagnosed wheat sensitivity. In addition, the influence of different manufacturing processes will be considered.
Wheat cereals are known to be capable of triggering wheat allergy and celiac disease. The prevalence of both diseases is about 1%. Recently, another clinical entity was described, the non-celiac wheat sensitivity (NCWS). The origin and mechanisms of NCWS are unclear at present, but the existence of this new disease entity has been proven by double-blind placebo-controlled challenge tests. Three different grain components have been proposed as triggers of NCWS, gluten, α-amylase trypsin inhibitors or fermentable carbohydrates (FODMAPs).
It is reported that individuals with self-diagnosed NCWS quite often tolerate spelt products much better, even though spelt shows a higher gluten content than bread wheat products. Therefore, the question arises whether this putative spelt tolerance can be confirmed on an objective basis and whether the underlying molecular mechanisms can be elucidated. So far, human study addressing such questions are lacking.
This project aims to verify the hypothesis that spelt products are more tolerable than bread wheat products in a target group of individuals with self-diagnosed wheat sensitivity. In addition, the influence of different manufacturing processes on wheat sensitivity will be revealed.
For this purpose, the trial involves individuals with self-diagnosed wheat sensitivity and spelt tolerance. Six different kinds of bread will be tested, including 4 wheat and spelt breads, each of them produced following a traditional or a conventional way. Aim of this part is to objective bread wheat and spelt intolerance in a defined population. To find out whether FODMAPs or gluten affect the tolerance of bread, two additional breads will be tested, a gluten-free bread with added gluten and a gluten-free bread with added FODMAPs.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gluten free bread with added gluten | Active Comparator | Bread will be eaten by the participants for 4 consecutive days. |
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| Gluten free bread with added FODMAPs | Active Comparator | Bread will be eaten by the participants for 4 consecutive days. |
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| Traditional manufactured wheat bread | Experimental | Bread will be eaten by the participants for 4 consecutive days. |
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| Traditional manufactured spelt bread | Experimental | Bread will be eaten by the participants for 4 consecutive days. |
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| Conventional manufactured wheat bread | Experimental | Bread will be eaten by the participants for 4 consecutive days. |
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| Conventional manufactured spelt bread | Experimental |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| bread | Other | Different types of bread |
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| Measure | Description | Time Frame |
|---|---|---|
| Change of IBS-SSS Total score | IBS-SSS Total score will be collected with a questionnaire | Study examinations are at baseline, after wash out phases (day 3, 10, 17, 24, 31, 38) and after bread intervention phases (day 7, 14, 21, 28, 35, 42).) |
| Measure | Description | Time Frame |
|---|---|---|
| Extraintestinal Symptoms | The study team will ask the participants for typical extraintestinal symptoms in NCWS like headache, foggy-mind, nausea, heartburn, exhaustion | Study examinations are at baseline, after wash out phases (day 3, 10, 17, 24, 31, 38) and after bread intervention phases (day 7, 14, 21, 28, 35, 42).) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Hohenheim | Stuttgart | 70599 | Germany |
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| ID | Term |
|---|---|
| D001939 | Bread |
| ID | Term |
|---|---|
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
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Bread will be eaten by the participants for 4 consecutive days.
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| Blood and fecal markers |
Change of blood- and fecal markers that will reveal inflammation or intestinal permeability (Anti-gliadin Immunglobulin G antibody, lipase, ferritin, zonulin, calprotectin and lactoferrin) |
| Study examinations are at baseline and after bread intervention phases (day 7, 14, 21, 28, 35, 42). |