Transcript Bread: Separating fact from fiction

Bread and Health
Separating fact from fiction
© FAB and AHDB 2013
Learning Objectives
To review the evidence surrounding bread and its
health effects.
To understand the role of bread in a healthy, varied
diet.
To consider the following questions:
Are starchy foods, including bread, fattening?
I heard that bread causes bloating – is this true?
Are there people who should avoid bread?
Is it true that many people suffer from wheat
allergies?
• I heard that bread contains salt and that we
should reduce our salt intake – does this mean I
should reduce my bread intake?
•
•
•
•
© FAB and AHDB 2013
Myth or Fact?
“Starchy foods, including
bread, are fattening and are
best avoided.”
© FAB and AHDB 2013
Bread and body weight – the
facts
• Carbohydrate is the main
macronutrient provided by bread. One
gram of carbohydrate provides half the
energy (kilojoules) of one gram of fat!
• Because most starchy foods are high in
carbohydrate, and low in fat, they
generally provide less energy than
foods that are low in carbohydrate but
high in fat.
Energy per gram
37 kJ
17 kJ
Carbohydrate
© FAB and AHDB 2013
Fat
Bread and body weight – the
facts
• Carbohydrate is the body’s preferred fuel –
avoiding carbohydrate can leave the body
feeling less energetic and tired.
Energy
in
• Too much energy from any source will lead
to weight gain, (e.g. fat or carbohydrate).
• Having a diet which provides less energy,
and being physically active, is the best way
to maintain or achieve a healthy weight.
Energy
out
© FAB and AHDB 2013
Bread and body weight – the
facts
• Foods that contain carbohydrate (e.g. bread)
provide other important nutrients such as
fibre, calcium, iron, zinc, magnesium,
thiamine and folate, so avoiding these types
of foods means missing out on these
nutrients.
• People who have higher intakes of
carbohydrate as a proportion of energy,
particularly starchy carbohydrate, are
typically slimmer than those who have low
intakes.
© FAB and AHDB 2013
Myth or Fact?
“Low-carbohydrate diets are
the best way to lose weight.”
© FAB and AHDB 2013
Low-carbohydrate diets
• Low-carbohydrate diets have become
very popular among those trying to lose
weight. But they are not a healthy way to
lose weight.
• Although low-carbohydrate diets are
effective in reducing body weight in the
short-term, they are not more effective
than other approaches of weight loss in
the long run (such as a healthy and
balanced, energy-reduced diet).
© FAB and AHDB 2013
Low-carbohydrate diets
•
This means that trying to lose weight with
a low-carbohydrate diet is generally a
quick fix, rather than a long-term
solution.
•
But more importantly, low-carbohydrate
diets are not a healthy way to lose weight
as they are low in fibre and can be low in
important nutrients.
•
Common side effects of low-carbohydrate
diets are bad breath, constipation and
sluggishness.
© FAB and AHDB 2013
Low-carbohydrate diets
•
Rather than eliminating a food group
from the diet, it is better to maintain a
balanced diet and be physically active.
•
This will help to achieve or
maintain a healthy body weight.
© FAB and AHDB 2013
Myth or Fact?
“Bread commonly causes
bloating.”
“Modern bread definitely
causes bloating.”
© FAB and AHDB 2013
Bread and bloating – the facts
• There is no evidence that bread causes
bloating in healthy people, no matter if
produced in a traditional way or in a
modern way.
• Bread provides fibre, which is
fermented in the colon by bacteria
located there. This produces gas, which
some people may wrongly perceive as
‘bloating’, but it is actually a sign of a
well functioning gut (Weichselbaum,
2012).
© FAB and AHDB 2013
Weichselbaum E (2012) Does Bread cause bloating? Nutrition Bulletin
Volume 37, Issue 1, pages 30–36. Free to download from
http://onlinelibrary.wiley.com/doi/10.1111/j.1467-3010.2011.01943.x/abstract
Bread and bloating – the facts
•
Some people who typically have a
low fibre intake and suddenly
increase their intake, for example by
eating more wholemeal bread, may
produce more gas and suffer from
distension and discomfort – which
may be perceived as bloating.
•
This is normal and after a few days the
gut usually adapts to the larger
amounts of fibre and symptoms
disappear. Drinking plenty of fluid
and being physically active help to
avoid bloating.
© FAB and AHDB 2013
Bread and bloating – the facts
• People who have low fibre intakes are
more likely to suffer from
constipation. Many people perceive
constipation as ‘being bloated’.
• In this case, increasing fibre intake,
for example by eating more
wholemeal bread, can help alleviate
the symptoms.
© FAB and AHDB 2013
Myth or Fact?
“Some people have to avoid
bread and other cereal
products or eat specifically
formulated bread.”
© FAB and AHDB 2013
Conditions related to
bread – the facts
There are certain gastrointestinal
conditions where some cereal grains
should be, or must be, avoided.
© FAB and AHDB 2013
Conditions related to
bread – the facts
•
Wheat allergy
- This is a reaction of the immune
system to specific wheat proteins.
- Diagnosis is made using a skin test or
a blood test called a
radioallergosorbent test (RAST).
- It causes symptoms such as
respiratory and gastrointestinal
symptoms and dermatitis.
- Wheat allergy sufferers have to
exclude wheat from their diet.
© FAB and AHDB 2013
Conditions related to
bread – the facts
• Coeliac disease
- This is an intolerance to gluten, a
protein present in many grains.
- It is diagnosed following an intestinal
biopsy.
- Coeliac patients must avoid gluten to
avoid symptoms, which are mainly
digestive problems.
- Specifically formulated, gluten-free
bread and other products are available
for coeliac sufferers.
© FAB and AHDB 2013
Bread and bloating – the facts
• Coeliac disease is estimated to affect
1 in 100 people in the UK
• If somebody suspects that they have
one of these conditions, it is
important that they speak to a GP
and get properly tested rather than
simply avoiding cereal-based
products such as bread and therefore
risking insufficient nutrient intakes.
© FAB and AHDB 2013
Myth or Fact?
“Gluten-free bread is the
healthier choice for
everyone.”
© FAB and AHDB 2013
Gluten free bread – the facts
• Sales of gluten-free products have
grown by over 200% in the last few
years, which means that more and
more people now buy gluten-free
products (The Grocer, 2012*).
• Gluten-free products have been
specifically designed for people
suffering from coeliac disease, but
there is no benefit of avoiding gluten
for people who are not sensitive to it.
*Available at http://www.thegrocer.co.uk/fmcg/ambient/bakery/brown-bread-hardly-thebakery-sector-is-brimming-with-confidence/229163.article
© FAB and AHDB 2013
Gluten free bread – the facts
• There is no health benefit to healthy
individuals from swapping
conventional bread with gluten-free
bread.
• Gluten-free products are generally
more expensive than conventional
products.
© FAB and AHDB 2013
Myth or Fact?
“Many people suffer from wheat
allergies and the number of
wheat allergy sufferers is
increasing.”
© FAB and AHDB 2013
Bread and allergy – the facts
• Many people believe they have a food
allergy, but it is estimated that the actual
number of people who are allergic to food
is much lower.
• Around 20% of people believe they have a
food allergy, but it is estimated that only
2% actually suffer from food allergies.
This means that only 1 out of 10 people
who suspect they have a food allergy are
in fact allergic. It also means that 9 in 10
people who think they are allergic to
specific foods may be avoiding them
unnecessarily.
© FAB and AHDB 2013
Bread and allergy – the facts
• This is also the case for wheat allergy.
It is important that those who suspect
an allergy go to their GP and get
properly tested.
• Simply avoiding foods such as bread
because an allergy is suspected can
mean that people miss out on
important nutrients.
© FAB and AHDB 2013
Myth or Fact?
“Bread is high in salt and
should be avoided.”
© FAB and AHDB 2013
Bread and salt – the facts
• It is true that bread contains salt. Salt
has a functional role to play in bread
making (e.g. controlling yeast and as a
stabiliser) and is required for better shelf
life.
• In recent years, salt levels in bread have
been significantly reduced. In the UK,
bread now contains about 40% less salt
compared to bread in the 1980s. More
work is underway to further reduce salt
levels.
© FAB and AHDB 2013
Bread and salt – the facts
• Manufacturers have been
working for many years to
reduce the salt content of
bread.
• Between 2001 and 2011 the
salt content of bread was
reduced by about 20%.
Brinsden et al. (2013)
© FAB and AHDB 2013
Bread and salt – the facts
• Salt levels in bread can only be lowered to
a certain level, as there are technical
issues that arise when too much salt is
removed.
• Salt levels can be compared between
different bread brands and types by
checking the labels – these usually
provide information on salt or sodium
(which is a component of salt).
© FAB and AHDB 2013
Bread and salt – the facts
•
It is not advised to exclude bread
from the diet because it contains salt,
as bread also provides other
important nutrients. But it is
important to remember that bread
contains salt and counts towards the
total salt intake for the day.
•
Government recommendations state
that adults and children aged 11 years
and above should consume no more
than 6g salt each day (SACN 2003)
and younger children should have
less.
© FAB and AHDB 2013
Summary
 There are many misconceptions about the health effects of bread.
 Avoiding starchy foods in the diet is not a healthy way to control
body weight, and is unlikely to be effective in the long-term.
 There is no evidence that bread causes bloating in healthy people.
 Some people have to avoid bread or certain components of bread,
but only a small proportion of the population is affected.
 If a condition relating to bread or any other food is suspected it is
important to consult a GP rather than simply cutting out foods
from the diet.
 Although bread contains some salt, it also provides other
important nutrients, and it is therefore not a good idea to reduce
bread intake in order to reduce salt intake.
© FAB and AHDB 2013
Quiz
Time to test your knowledge!
Home
© FAB and AHDB 2013
END
Question 1
Which of the following should people with
Coeliac disease avoid consuming?
A. Gluten
© FAB and AHDB 2013
B. Soya
C. Milk
Correct!
Next
question
© FAB and AHDB 2013
Incorrect
Try again
© FAB and AHDB 2013
Next
question
Question 2
What percentage of the population believe
that they have a food allergy?
A. 40%
© FAB and AHDB 2013
B. 20%
C. 15%
Correct!
Next
question
© FAB and AHDB 2013
Incorrect
Try again
© FAB and AHDB 2013
Next
question
Question 3
What percentage of the population actually
suffer from a food allergy?
A. 2%
© FAB and AHDB 2013
B. 5%
C. 10%
Correct!
Next
question
© FAB and AHDB 2013
Incorrect
Try again
© FAB and AHDB 2013
Next
question
Question 5
True or False?
Eating bread causes bloating and weight
gain.
A. True
© FAB and AHDB 2013
B. False
Correct!
Next
question
© FAB and AHDB 2013
Incorrect
Try again
© FAB and AHDB 2013
Next
question
Question 6
Which of the following is not a common side
effect of a low-carbohydrate diet?
A. Constipation
© FAB and AHDB 2013
B. Bad breath
C. Hair loss
Correct!
End of quiz
© FAB and AHDB 2013
Incorrect
Try again
© FAB and AHDB 2013
End of
quiz
© FAB and AHDB 2013
www.grainchain.com
© FAB and AHDB 2013