Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstrasse 12, 70599 Stuttgart, Germany.
State Plant Breeding Institute, University of Hohenheim, Fruwirthstrasse 21, 70599 Stuttgart, Germany.
Nutrients. 2022 Jul 7;14(14):2800. doi: 10.3390/nu14142800.
Individuals with suspected non-celiac wheat sensitivity (NCWS) often report better tolerance of spelt ( ssp. ) compared to wheat ( ssp. ) bakery products. This experience has neither been validated nor explained on a molecular level. Therefore, we performed blinded wheat and spelt bread challenge in this patient group. Twenty-four adults with a history of NCWS but suspected spelt tolerance were challenged in a single-blinded crossover design over six weeks with six different study breads each at 300 g per day for 4 days followed by a washout phase of 3 days. Study breads comprised spelt and wheat breads made either after a traditional (T) or a current (C) recipe, resulting in four bread types plus a gluten-free bread with 1.5% added oligosaccharides (+FODMAP) and a gluten-free bread with 5% added wheat gluten (+Gluten). The main outcome parameter was the Irritable Bowel Syndrome-Severity Scoring System, which was higher than self-estimated by the participants after spelt bread consumption ( = 0.002 for T; = 0.028 for C) and lower for wheat bread ( = 0.052 for T; = 0.007 for C), resulting in no difference between wheat and spelt bread tolerance. The +FODMAP bread was better tolerated than both T breads ( = 0.003 for spelt; = 0.068 for wheat) and equally well tolerated as both C breads and +Gluten breads after normalization to the washout scores. Neither signs of inflammation nor markers for intestinal barrier integrity were influenced. Our data do not confirm, on an objective basis, the differences in expected symptoms resulting from wheat and spelt products, suggesting a strong nocebo effect for wheat and a placebo effect for spelt.
个体疑似非乳糜泻小麦敏感（NCWS）常报告对斯佩尔特（ssp.）面包产品的耐受性优于小麦（ssp.）面包产品。这种体验既没有得到验证，也没有从分子水平上得到解释。因此，我们在这群患者中进行了盲法斯佩尔特和小麦面包挑战。24 名有 NCWS 病史但疑似斯佩尔特耐受的成年人，在六周内采用单盲交叉设计进行挑战，每天食用 300 克 6 种不同的研究面包，每种面包连续食用 4 天，然后进行 3 天的洗脱期。研究面包包括用传统（T）或当前（C）配方制作的斯佩尔特和小麦面包，共制成 4 种面包类型，外加一种添加了 1.5%低聚果糖的无麸质面包（+FODMAP）和一种添加了 5%小麦面筋的无麸质面包（+Gluten）。主要结局参数是肠易激综合征严重程度评分系统（IBS-SSS），参与者在食用斯佩尔特面包后评分高于自我估计（T 组=0.002；C 组=0.028），而食用小麦面包后评分较低（T 组=0.052；C 组=0.007），因此斯佩尔特和小麦面包的耐受性无差异。+FODMAP 面包的耐受性优于 T 面包（斯佩尔特=0.003；小麦=0.068），与 C 面包和+Gluten 面包的洗脱评分归一化后耐受性相同。炎症迹象和肠屏障完整性标志物均不受影响。我们的数据从客观基础上不确认，来自小麦和斯佩尔特产品的预期症状差异，这表明小麦有强烈的负安慰剂效应，而斯佩尔特有安慰剂效应。
