Table 4.

Evaluation of the benefits of sourdough bread in human health and disease.

Product	Dose	Model	Findings	Reference
Two SDB (different fermentation times: 4 h and 24 h) compared with yeast-fermented bread	One slice of bread (80 g) at 3-week intervals	Clinical trial (36 healthy volunteers aged 20–31 years) Double-blind	Highest satiety with SDB fermented for 24 h. In both SDB: faster gastric emptying, lower glycemic responses, higher concentration of total free amino acids and better digestibility	Rizzello et al., 2019
SDB (>12 h fermentation) compared with yeast-fermented bread	Six slices of the study bread (150 g)/day for 7 days	Clinical trial (26 patients with IBS aged 18–65 years) Double-blind	Higher reduction in ATIs to their monomeric form Lower levels of FODMAPs	Laatikainen et al., 2017
Whole-grain rye SDB (40 h of fermentation) compared with yeast-fermented crispbread and unfermented rye crispbread	One slice (59.4 g)	Clinical trial (24 healthy adults aged 18–70 years) Single-blind, cross-over trial	Higher satiety and degradation of β-glucans	Zamaratskaia et al., 2017
SDB with low FODMAPs against regular rye SDB	3.5–4 slices (105–120 g) of each bread/day in the 1st week 7–8 slices of SDB (210–240 g) per day from the 2nd to the 4th week	Clinical trial (87 patients with IBS aged 18–65 years) Double-blind, placebo-controlled cross-over study	Control of IBS symptoms and reduction of gastrointestinal gas accumulation Increase in dietary fiber intake and good acceptance	Laatikainen et al., 2016
Whole-grain rye SDB compared with WB and rye-bran-enriched WB	6–10 slices (25–30 g/slice) In two 4-week test periods	Clinical trial (21 healthy subjects with mild gastrointestinal symptoms aged 38–65 years); Cross-over study	Lower postprandial insulin concentration Improvement in the first-phase of insulin secretion Increase in postprandial concentrations of SCFAs	Lappi et al., 2014
Wholegrain wheat SDB against WB	6 slices (for women) and 7 (for men) of SDB per day (162.5 g) for 6 weeks	Clinical trial (14 normoglycemic/normoinsulinemic adults and 14 hyperglycemic/hyperinsulinemic adults aged 43–70 years); Crossover study	Improvement in glucose iAUC in response to an OGTT within hyperglycemic/hyperinsulinemic subjects	MacKay et al., 2012
Endosperm rye SDB compared with standard WB	One portion (50 g) at intervals of 1–2 weeks	In vitro Starch and protein hydrolysis Clinical trial (16 healthy subjects aged 23 ± 3.7 years)	Higher levels of total fiber and phenolic acids and a higher starch hydrolysis rate Lower postprandial insulin response Beneficial changes in plasma amino acids and their metabolites	Bondia-Pons et al., 2011
Wholemeal wheat SDB (19.5 h fermentation) compared with WB, wholemeal wheat, and wholemeal wheat + xylanase	One slice with crust (50 g) of the test breads	Clinical trial (11 insulin-resistant subjects, aged 40–65 years)	Lowest postprandial glucose and insulin responses	Lappi et al., 2010
Two SDB compared with yeast-fermented wholemeal bread and yeast fermented WB	One slice (50 g)	In vitro Starch hydrolysis Clinical trial (8 healthy volunteers aged 23–25 years)	Significantly lower glycemic responses in SDB Resistant starch levels were higher in the SDB	Scazzina et al., 2009
Whole wheat SDB (3 h fermentation) compared with whole wheat barley bread and WB	One slice (50 g)	Clinical trial (10 overweight male subjects) Single-blind, cross-over	Lower overall glucose and GLP-1 responses Lower glucose iAUC	Najjar et al., 2008
SDB (24 h fermentation) with 4 flours compared with yeast-fermented 4-flour bread	A portion of 80 g for 2 days	Clinical trial (17 celiac sprue patients) Double-blind	Intestinal permeability not significantly different from baseline in 13 of the 17 patients	Di Cagno et al. (2004)

SDB, Sourdough bread; WB, white bread; IBS, irritable bowel syndrome; ATIs, alpha-amylase/trypsin inhibitors; FODMAPs, Fermentable, Oligo-, Di-, and Mono-saccharides and Polyols; SCFAs, short-chain fatty Acids; OGTT, oral glucose tolerance test; iAUC, incremental area under the curve; GLP-1, glucagon-like peptide 1.