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

Lisa Garnweidner-Holme; Monica Hellmann; Christine Henriksen; Elisabeth Austad; Solveig Ivara Watters; Line Gaundal; Knut E A Lundin; Mari C W Myhrstad; Vibeke H Telle-Hansen

doi:10.3390/foods12234338

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

Foods. 2023 Dec 1;12(23):4338. doi: 10.3390/foods12234338.

Affiliations

¹ Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4 St. Olavs Plass, 0130 Oslo, Norway.
² Det Glutenfrie Verksted, Nordseterveien 26A, 1176 Oslo, Norway.
³ Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Boks 1072 Blindern, 0316 Oslo, Norway.
⁴ K. G. Jebsen Coeliac Disease Research Centre, University of Oslo, Boks 1072 Blindern, 0316 Oslo, Norway.
⁵ Institute for Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, 0318 Oslo, Norway.
⁶ Department of Gastroenterology, Oslo University Hospital, Rikshospitalet, 0424 Oslo, Norway.

Abstract

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.

Keywords: bread; coeliac disease; fibre-rich; randomised controlled trial.

Grants and funding

The GRAIN study was funded by Regionalt Forskningsfond (RFF), Forregion, Det Glutenfrie Verksted, the Norwegian Association of Coeliac Disease, UiO and OsloMet.