title: Effect of bread gluten content on gastrointestinal function: a crossover MRI study on healthy humans.
abstract: Gluten is a crucial functional component of bread, but the effect of increasing gluten content on gastrointestinal (GI) function remains uncertain. Our aim was to investigate the effect of increasing gluten content on GI function and symptoms in healthy participants using the unique capabilities of MRI. A total of twelve healthy participants completed this randomised, mechanistic, open-label, three-way crossover study. On days 1 and 2 they consumed either gluten-free bread (GFB), or normal gluten content bread (NGCB) or added gluten content bread (AGCB). The same bread was consumed on day 3, and MRI scans were performed every 60 min from fasting baseline up to 360 min after eating. The appearance of the gastric chime in the images was assessed using a visual heterogeneity score. Gastric volumes, the small bowel water content (SBWC), colonic volumes and colonic gas content and GI symptoms were measured. Fasting transverse colonic volume after the 2-d preload was significantly higher after GFB compared with NGCB and AGCB with a dose-dependent response (289 (SEM 96) v. 212 (SEM 74) v. 179 (SEM 87) ml, respectively; P=0·02). The intragastric chyme heterogeneity score was higher for the bread with increased gluten (AGCB 6 (interquartile range (IQR) 0·5) compared with GFB 3 (IQR 0·5); P=0·003). However, gastric half-emptying time was not different between breads nor were study day GI symptoms, postprandial SBWC, colonic volume and gas content. This MRI study showed novel mechanistic insights in the GI responses to different breads, which are poorly understood notwithstanding the importance of this staple food.
authors.affiliation: 1Department of Pathophysiology and Transplantation,Gastroenterology and Endoscopy Unit,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,Università degli Studi di Milano,Milan,20122,Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Coletta
authors.affiliation: 2Campden BRI,Chipping Campden,Gloucestershire GL55 6LD,UK.
authors.forename: Fred K
authors.initials: FK
authors.lastname: Gates
authors.affiliation: 3Nottingham Digestive Diseases Centre and Nottingham Digestive Diseases Biomedical Research Unit,Nottingham University Hospitals,University of Nottingham,Nottingham NG7 2UH,UK.
authors.forename: Luca
authors.initials: L
authors.lastname: Marciani
authors.affiliation: 3Nottingham Digestive Diseases Centre and Nottingham Digestive Diseases Biomedical Research Unit,Nottingham University Hospitals,University of Nottingham,Nottingham NG7 2UH,UK.
authors.forename: Henna
authors.initials: H
authors.lastname: Shiwani
authors.affiliation: 3Nottingham Digestive Diseases Centre and Nottingham Digestive Diseases Biomedical Research Unit,Nottingham University Hospitals,University of Nottingham,Nottingham NG7 2UH,UK.
authors.forename: Giles
authors.initials: G
authors.lastname: Major
authors.affiliation: 4School of Physics and Astronomy,Sir Peter Mansfield Imaging Centre,University of Nottingham,Nottingham NG7 2RD,UK.
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Hoad
authors.affiliation: 4School of Physics and Astronomy,Sir Peter Mansfield Imaging Centre,University of Nottingham,Nottingham NG7 2RD,UK.
authors.forename: Gemma
authors.initials: G
authors.lastname: Chaddock
authors.affiliation: 4School of Physics and Astronomy,Sir Peter Mansfield Imaging Centre,University of Nottingham,Nottingham NG7 2RD,UK.
authors.forename: Penny A
authors.initials: PA
authors.lastname: Gowland
authors.affiliation: 3Nottingham Digestive Diseases Centre and Nottingham Digestive Diseases Biomedical Research Unit,Nottingham University Hospitals,University of Nottingham,Nottingham NG7 2UH,UK.
authors.forename: Robin C
authors.initials: RC
authors.lastname: Spiller
mesh_terms: D000328:Adult; D001939:Bread; D003106:Colon / Q000737:chemistry; D018592:Cross-Over Studies; D004063:Digestion / Q000187:drug effects*; D005260:Female; D005740:Gases / Q000378:metabolism; D005746:Gastric Emptying; D005766:Gastrointestinal Contents; D005767:Gastrointestinal Diseases / Q000209:etiology; D041981:Gastrointestinal Tract / Q000502:physiology*; D005983:Glutens / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D064368:Healthy Volunteers; D006801:Humans; D007421:Intestine, Small; D008279:Magnetic Resonance Imaging; D008297:Male; D019518:Postprandial Period / Q000502:physiology*; D012016:Reference Values; D013270:Stomach / Q000737:chemistry; D014867:Water / Q000378:metabolism
chemical_list: D005740:Gases; D014867:Water; D005983:Glutens
keywords: AGCB added gluten content bread; Bloating; Colonic volumes; GFB gluten-free bread; GI gastrointestinal; Gastric emptying; Gluten-free bread; MRI; NGCB normal gluten content bread; RP rice pudding; SBWC small bowel water content; WMB wholemeal bread