Bestsellers such as ‘Wheat Belly’ are making big headlines, especially in the USA, where up to 25% of completely healthy Americans now abstain from eating wheat. However, from a scientific point of view, almost nothing in these two books is tenable (see one scientific review about). The influence of wheat, or more precisely gluten, on coeliac disease is undisputed. Coeliac disease is a chronic disease of the small intestine that is based on a lifelong intolerance to gluten. Gluten is found in all types of wheat, i.e. bread wheat, durum, spelt, emmer, einkorn, Kamut® (khorasan wheat) as well as in rye and barley. The only treatment is to avoid these species for the rest of the life. However, only around 1% of the world's population has coeliac disease, which can be clearly diagnosed using a special antibody test and a colonoscopy. For more detailed information, we recommend the website of the Association of European Coeliac Societies (https://www.aoecs.org/). The second clearly defined and diagnosable clinical picture is wheat allergy. Although there are various forms of this allergy, the symptoms are typical of allergies, including anaphylactic shock. Less than 1% of the world's population suffers from it, but their disease can be clearly diagnosed with antibody tests.

There is also a much less clear but scientifically accepted condition known as non-celiac wheat/gluten sensitivity. The symptoms are very wide-ranging, from classic gastrointestinal complaints and discomfort to fatigue and others, and are said to affect up to 5% of the world's population. Spelt processors in particular are often exposed to this discussion, as numerous customers report symptoms when eating wheat, which are then supposedly better when eating spelt. Children are also often said to be affected. What is responsible for this has unfortunately not yet been scientifically clarified, contrary to many opinions in the press, books and on the Internet, and therefore there is no diagnostic technique. New hypotheses are constantly being put forward and then scientifically investigated for years. These two hypotheses in particular are currently being scrutinised by scientists. The first hypothesis claims that ATIs (α-amylase trypsin inhibitors) could be the trigger for this sensitivity. ATIs are proteins that occur naturally in wheat and other raw materials and are known to trigger allergies such as baker's asthma. Cell culture studies have also shown that ATIs could have an effect on the immune response (www.ncbi.nlm.nih.gov/pmc/articles/PMC3526354/). However, the cell culture studies and their results show no correlation to the amount of ATIs in flour and bread samples. Also, we humans do not eat wheat grains or flour directly, but mostly processed wheat in the form of bread or pasta. In this respect, the influence of processing on ATIs should also be examined more closely. It is also important to note that cell culture and animal experiments are only of limited significance for reactions in humans. In this respect, there is an urgent need for comprehensive human studies that go further than those published to date, which have used insufficient numbers of test subjects and inappropriate measurement criteria. Statements that modern wheat contains a lot of ATIs in contrast to ancient wheat species or wheat varieties are not correct; there seems to be a large variation in the varieties as well as a considerable environmental influence on the expression of ATIs (comparison of species, variety trend, future). Breeding has also not changed the ATI content in wheat across the last decades. Einkorn seems to have a significantly lower amount of ATIs and other potentially allergenic proteins of wheat.  More information on ATI can be found here.

An alternative hypothesis assumes that a group of carbohydrates and polyols, the so-called FODMAPs (fermentable oligo-, di- and monosaccharides and polyols), could also be responsible for wheat sensitivity. This group of substances is found in numerous foods, including wheat. However, scientific proof that FODMAPs trigger wheat sensitivity is still lacking. It is undisputed that FODMAPs can certainly increase bloating in patients with flatulence (including irritable bowel syndrome patients). However, a study we conducted together with a craft baker and miller showed that dough fermentation times of two hours are sufficient to significantly reduce FODMAPs. All of our 42 study breads were below the limit defined by science for a low-FODMAP diet, which also applies to the majority of wheat breads analysed in other scientific studies. In addition, FODMAPs appear to be important for the microbiome, i.e. the intestinal bacteria of healthy people. Interestingly, in a human study with 24 patients with possible wheat sensitivity, the test bread with extra FODMAPs was best tolerated. The same study also showed that these patients tolerated spelt and wheat bread in the same way, each with a medium irritable bowel syndrome score. The issue of wheat sensitivity therefore remains nebulous. However, it is also important to bear in mind that, as with medication, dietary changes also have the so-called placebo effect (I believe a medication works, then it also works in at least 30% of people) and nocebo effect (I believe a medication causes the side effects of the package leaflet, then this also occurs with increased probability), which accounts for up to 30% of the reactions in human studies! Here is an example. 

In professional baking today, some additives, enzymes and sugar substitutes are used, and some baked goods are also baked directly with minimal dough fermentation times. The fact that such process parameters can lead to changes in baked goods has recently been scientifically demonstrated once again. There is therefore an urgent need for research in the field of wheat sensitivity that takes a differentiated look at all possible causes. We are cooperating intensively in this area with leading researchers from the food and medical sectors. However, it is also important to realise that a maximum of around 5-10% of the world's population is affected by these diseases and that for the rest of the population, a diet with sufficient whole grains is important for a healthy life. More information on wheat, agriculture, additives and how to bake healthy but delicious bread can be found soon here.