Approximately 1 percent of the population has coeliac disease, an autoimmune condition in which gluten triggers intestinal damage and strict lifelong avoidance is medically necessary. Approximately 6 to 10 percent of adults report non-coeliac gluten sensitivity, a condition characterised by gastrointestinal and extra-intestinal symptoms without the autoimmune component or intestinal villous atrophy of coeliac disease. For the remaining 90 percent of adults, the evidence for eliminating gluten is not compelling.
What Drives Wheat-Related Symptoms in Non-Coeliacs
For many adults who believe they react to gluten, the actual trigger may be the FODMAPs in wheat, specifically the fructans that ferment rapidly in the colon and produce gas, bloating, and altered bowel habits in individuals with irritable bowel syndrome. Multiple double-blind trials designed to test gluten sensitivity found that when fructans were removed from the test substance, the majority of self-identified non-coeliac gluten-sensitive participants no longer responded to the gluten challenge.
Sourdough and Traditional Wheat Preparation
Traditional long-fermented sourdough bread produces a significantly different gut response from modern industrially produced bread. The long fermentation reduces FODMAP content by approximately 70 percent through bacterial fermentation of fructans. It partially breaks down gluten proteins, reducing their immunoreactivity. And it dramatically improves the glycaemic response compared to standard bread from the same flour. Many individuals who report wheat sensitivity tolerate genuine long-fermented sourdough without symptoms.