Experiences with Gluten-Free Bread: A Qualitative Study Amongst People with Coeliac Disease Participating in a Randomised Controlled Trial.

BACKGROUND: Whole-grain bread can be an important source of fibre for people with coeliac disease (CeD) who must adhere to a gluten-free diet and avoid consuming wheat, rye and barley. Gluten-free bread frequently has a lower nutritional quality and different texture relative to gluten-containing counterparts. OBJECTIVE: The aim was to investigate experiences with gluten-free bread amongst people with CeD prior to and during a randomised controlled trial (RCT). DESIGN: We conducted individual interviews with 10 people with CeD participating in a RCT that aimed to investigate the effects of fibre-rich gluten-free products on metabolic regulation in people with CeD compared with benchmark gluten-free products. Five participants were in the control group (benchmark gluten-free bread) and five participants in the intervention group (fibre-rich gluten-free bread). The fibre-rich gluten free bread was formulated and prepared by the project group. The benchmark gluten-free bread was commercially available. The RCT lasted for four weeks. Interviews were conducted digitally between October 2021 and January 2022 and were thematically analysed. RESULTS: Participants in both groups appeared to avoid bread prior to the study, primarily due to the poor taste and chewy consistency of the available bread in food stores and bakeries. Participants preferred the fibre-rich intervention bread as opposed to the available bread in the food market. However, participants had to become accustomed to eating the fibre-rich whole-grain bread during the study, since they avoided eating store-bought bread that they experienced chewy and not filling. CONCLUSIONS: Participants asked for fibre-rich gluten-free bread products that are satiating and have a good texture. Palatable gluten-free bread products might be an important source of fibre for people with CeD.

Attitudes towards and experiences with sourdough and baker's yeast bread amongst participants in a randomised controlled trial: a qualitative study.

Background: Bread is an important source of dietary fibre. However, an increasing number of individuals exclude bread from their habitual diet for various reasons. In recent years, sourdough bread has increased in popularity, and clinical studies have indicated that sourdough bread may decrease gastrointestinal symptoms. Objective: To investigate attitudes towards and experiences with sourdough and baker's yeast bread amongst participants in a randomised controlled trial (RCT), the health effects and consumer aspects of bread (HELFAB) study. Design: We conducted individual interviews with 10 participants who stated to be sceptical about bread and who participated in an RCT to investigate the health effects of sourdough bread versus baker's yeast bread. The participants were interviewed on two occasions (before and after the RCT). Interviews were conducted digitally between September and December 2020 and were thematically analysed. Results: Half of the interviewed participants experienced gastrointestinal symptoms, such as pain in the stomach, when they consumed bread prior to the RCT. They often preferred sourdough bread to baker's yeast bread both before and after the study, since they found that sourdough bread was easier to digest. Participants who were sceptical about bread prior to the study became more positive about bread because of their experiences with the intervention breads. This finding was mainly related to the taste and consistency of sourdough bread. The participants often associated bread with healthiness, mainly due to the dietary fibre content in bread. Conclusions: Sourdough bread with increased dietary fibre may be an important source of dietary fibre for those who perceive gastrointestinal problems from baker's yeast bread. Participants in this qualitative study stated to change their attitudes towards bread, mainly due to perceived healthiness of the intervention bread.