DR MEGAN ROSSI: How bread can be good for you (especially if you make your own!)

Personally I am not a fan of cutting anything entirely from your diet — it’s rarely warranted medically and can leave you at risk of nutrition shortfalls.

But plenty of the people I see in clinic have chosen at one stage or another to cut one staple out of their diets: bread.

The low-carb movement, associations with weight gain and, of course, the gluten it contains have helped move bread to the dietary equivalent of the naughty step in many people’s eyes.

But bread can be a convenient source of nutrients and, let’s face it, a nice slice of freshly baked bread is one of life’s pleasures — and I don’t want to start denying people those.

For any of you who have turned your back on bread, let me explain why you might want to think again.

Grainy types of bread (sold as wholemeal, for example) can be a good way to include wholegrains (e.g. wheat, barley, oats, rye) in your diet and evidence is mounting that wholegrains can improve gut health, help with weight management and reduce your risk of serious diseases such as type 2 diabetes, heart disease and certain cancers.

The ‘whole’ grain consists of three parts: the bran (a fibre-rich outer layer); the germ (a nutrient-packed inner section), and the endosperm (the central starch-filled part).

The fibre content keeps you fuller for longer and feeds your gut microbes, which turn this fibre into short-chain fatty acids that help maintain the gut lining, regulate appetite hormones and reduce inflammation.

The evidence for including wholegrains is pretty compelling — one study involving 400,000 people found that those with the highest wholegrain intake had a 20 per cent lower risk of heart disease than those with the lowest intake. Another study, with 130,000 people, found that wholegrain intake was linked with lower body weight, reported the journal Nutrients in 2019.

Bread can be a convenient source of nutrients and, let’s face it, a nice slice of freshly baked bread is one of life’s pleasures — and I don’t want to start denying people those

The ideal is three portions of wholegrains per day — one portion equals one slice of bread, half a cup of cooked grains or 40g raw oats, for instance. Remember variety is key.

Bread can also provide many other nutrients, depending on the type you eat.

In nutrition terms, sourdough is hard to beat. It’s made using flour and water and left to ferment for up to 36 hours (rather than adding baker’s yeast as most bread is typically made).

The bacteria and wild yeast naturally present in the flour slowly ferment the bread and this unlocks nutrients such as zinc and B vitamins, so they’re easier to absorb than from other breads.

The fermentation process also lowers the levels of gluten in the bread (gluten being the protein in grains that provides the sticky quality you see in raw dough) — this may be of benefit to those with gluten intolerance (although it isn’t at low enough levels for people with coeliac disease, whose bodies react to the presence of gluten by attacking the gut).

Some research also suggests that sourdough provides less of a spike in blood sugar than other breads and in clinic I tend to find it a better option for those with diabetes.

But note, some mass-produced sourdough will have added yeast to reduce the fermentation time so it is cheaper to make — but this lowers the health benefits. A genuine sourdough should have a slightly sour taste and a chewy crumb.

I am a big fan of homemade bread — and let me explain why you might want to give baking your own a go. People assume making bread will involve lots of kneading and time. But my recipe (see box) is genuinely one of the simplest things I make.

The problem with most mass-produced bread is that it is highly processed — loaves tend to contain additives to keep them fresh and emulsifiers to give that soft, doughy texture.

These additives have passed rigorous safety tests — but this testing predates newer research that suggests some of them may disrupt our gut microbes and encourage gut inflammation (something my team at King’s College London is currently exploring in a human trial).

What’s more, sliced white bread — gulp, the nation’s favourite — is made from wheat that has had the nutritious, fibrous outer section of the grain stripped away.

Wholegrains contain around 75 per cent more nutrients than these refined versions.

White bread’s lower fibre content (two slices of wholegrain provide 6g fibre; white bread provides less than a quarter of that) means that the sugar in the bread has nothing to slow its digestion, so this tends to lead to greater spikes in your blood sugar — which often leads to feeling hungry again soon after eating. Making your own bread, on the other hand, means you don’t need additives and you can maximise its nutrition potential.

I was inspired to add carrot to my recipe (above) after reading a study by Auckland University of Technology, New Zealand in 2021, which showed that adding veg to bread leaves you feeling more satiated and cuts insulin release.

Of course, there are times when it isn’t feasible to make your own. In those cases, use this checklist to help you make the best choices:

1. Check the fibre to carbohydrate ratio. You want at least 1g fibre to every 10g carbohydrates.

2. Ensure there’s no added sugar — look out for names such as glucose or dextrose.

3. Opt for varieties with added seeds (e.g. pumpkin) and mixed grains (e.g. oats) — the more plant diversity in your diet, the better.

4. Check for food additives, aiming for no more than one, if any.

And how best to eat it? Rather than making it into a simple cheese and tomato sandwich, layer it up with at least three plants — for example, roasted peppers, tomatoes and beetroot work perfectly with a quality cheddar, keeping both your taste buds and gut microbes satisfied.

Try this: Fermented wheaten bread 

Makes 1 loaf

I fell in love with wheaten bread in Ireland and my father-in-law entrusted me with his foolproof recipe. With a few gut-loving tweaks, I present a game-changing loaf with a crunchy crust and a deliciously moist crumb — you’ll never need to buy bread again.

• 300g wholemeal flour
• 200g live thick yoghurt
• ½ tsp sea salt
• 1 tsp bicarbonate of soda
• 1 tbsp sesame seeds
• 1 tbsp pumpkin seeds
• 100g grated carrot
• 3 sprigs thyme leaves or 1 tsp dried thyme

Preheat the oven to 200c/180c fan/gas mark 6.

Mix half the flour with the yoghurt and 100ml of water. Cover the bowl with a clean tea towel and leave to ferment for around five hours.

When ready to bake, mix in the remaining ingredients, using a butter knife to combine. Be careful not to overwork the dough as this will make it tough.

Turn the dough onto a lightly floured baking tray and mould into a loaf shape. Score a cross on top with a knife.

Bake for 40 minutes, or until golden, and check that the base is dry and the loaf sounds hollow when tapped. Allow to cool completely.

Well wrapped, it will keep for two days at room temperature, five days in the fridge, or three months in the freezer. I freeze mine in individual portions so I always have a serving of delicious bread on hand (just defrost in the microwave for a minute).

AskMegan

I was recently diagnosed with coeliac disease and switched to a gluten-free diet. I have no idea how long I have had it, but it wouldn’t surprise me if it was all my life. Is there a way of knowing whether there has been permanent damage to the lining of my intestine?

Martin Rubenstein.

I’m sorry to hear that you have been living with undiagnosed coeliac disease for so long. You’re certainly not alone, around half a million people in the UK are believed to be unaware they have this autoimmune disease, where your body attacks its own tissues when you eat gluten. A biopsy is the only way to confirm that your gut lining has completely recovered.

The good news is that for most people who completely avoid gluten, their gut lining tends to heal within 12 months.

It is also worth discussing the health of your bones with your GP, because people who have been living with undiagnosed coeliac disease are at risk of osteoporosis. You may be referred to have a bone density scan to get a better look at the health of your bones.

While there is currently no cure for coeliac disease, there are a number of promising clinical trials under way testing drugs that block the body’s reaction to gluten (similar to peanut allergies). Fingers crossed.

Contact Dr Megan Rossi

Email drmegan@dailymail.co.uk or write to Good Health, Daily Mail, 2 Derry Street, London W8 5TT — please include contact details. Dr Megan Rossi cannot enter into personal correspondence. Replies should be taken in a general context; always consult your GP with health worries.