Abstract

It has been suggested that sourdough fermented products have beneficial health effects. Fungal proteases and selected sourdough lactic acid bacteria were used to produce wheat bread and pasta with a reduced-gluten content (<50% of traditional products). Fermentable oligo-, di- and mono- saccharides and polyols and amylase/trypsin inhibitors were also evaluated. The sensorial features of new products were similar to traditional ones. The efficacy of these new products in reducing the severity of symptoms in Irritable Bowel Syndrome (IBS) patients were compared to traditional bread and pasta using a randomized, crossover-controlled trial. While on a strict gluten-free diet, patients were randomized to consume a reduced- or normal-gluten diet for 2weeks; then, patients from both arms started the wash-out period of one week, and subsequently started the final 2-week period on a normal or reduced-gluten diet. Compared to normal-gluten content, the administration of a reduced-gluten content diet resulted in a decrease of the Visual Analogue Scale score (p = 0.042), while no differences were found in the IBS-Severity Score, Hospital Anxiety and Depression Scale, and IBS-Quality of Life. Data herein reported are novel encouraging findings that should spur a new avenue of research aiming to develop products specifically designed for IBS patients.

Highlights

  • Irritable bowel syndrome (IBS) is one of the most common gastrointestinal (GI) disorders, with a prevalence of about 20% worldwide [1]

  • The present study aims to define a protocol for manufacturing bread and pasta with reduced-gluten contents (

  • Samples of bread and pasta were analyzed for energetic value, according to the method described in the Regulation of UE n.1169 of the 25/10/2011 using the converting factor Awater (4 kcal g−1 for carbohydrates and protein; 9 kcal g−1 for lipids)

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Summary

Introduction

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal (GI) disorders, with a prevalence of about 20% worldwide [1]. This high prevalence combined with the presence of persistent. Recent meta-analyses showed an improvement of symptoms in more than the 50% of IBS patients during low-FODMAPs diet [22,23]. There isno randomized controlled trial evidence to support the pathogenic involvement of gluten, ATIs, and wheat germ agglutinins in IBS [24]. Results of the present trial might improve our understanding of the role of innovative sourdough biotechnology in the production of fermented cereal-based foods, and help to identifyfuture directions for the development of products designed for IBS patients

Sourdough Fermentation
Microbiological and Immunological Analyses of Fermented Wheat Flours
Wheat Bread and Pasta Making
Proximate Composition
Texture and Image Analysis
Color Measurement
Hydration Test
Cooking Loss and Water Absorption
Sensory Analysis
2.10. Patients and Study Design
Crossover
2.11. Randomization and Blinding
2.13. Outcomes
2.14. Statistical Analysis
Characterization of Sourdoughs
Texture and Color Characteristics
Sensory Characteristics
In vivo Gluten Challenge
Open Gluten-Free
Double Blind Cross over challenge
Discussion
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