High-Fiber Bread and Ulcerative Colitis: Is It Okay to Eat?

Co-written by Renata Cauchon-Robles

Let’s dive into the connection between high-fiber bread and ulcerative colitis, and how it may impact your IBD symptoms.

Fiber has a wide range of benefits, including how it feeds gut bacteria. It helps supply the body with short-chain fatty acids which are very important for the immune system and the mucosal layer in the intestines. When these are in good shape, you can absorb nutrients from food and fight off disease more easily.

Depending on your symptoms, certain types of fiber-rich foods may help or aggravate how you’re feeling. The goal with fiber-rich foods is to get the benefits without making your symptoms worse. This may require some delicate tweaking of your diet and paying attention to how your symptoms change. Read on as we zoom in on bread and how to choose which kind is best for your IBD journey.

Typical Fiber in Bread

All bread contains dietary fiber, carbohydrates, and plant proteins, though the amounts can vary widely. Common types of bread found in stores—such as white sandwich bread, multigrain, wheat, or sourdough—are often lower in fiber unless they’re specifically labeled ‘high fiber’ or made with whole grains.. In addition, bread gives the body B vitamins and important minerals like phosphorus, magnesium and calcium. Bread can work as a prebiotic in the gut, too. This preps your digestion to get the most out of your meal.

What is High-Fiber Bread?

Bread can be considered “high-fiber” if one serving — usually one to two slices — has at least 5.6 grams of fiber. The food industry often uses byproducts naturally high in fiber to replace a percent of the flour in the bread recipe. These additional ingredients can be added to meet the high-fiber threshold, and may come from soy, bran, seeds, beans, or other foods.

Whether high-fiber or no-fiber, you might be wondering…how does fiber affect Ulcerative Colitis?

Benefits of Fiber for UC

Fiber comes from plant foods like grains, fruits, vegetables, beans, etc. Your body doesn’t actually digest it, but it plays a big role in keeping your gut healthy. A 2020 clinical trial showed that a diet containing more fiber than the Standard American Diet improved symptoms for Ulcerative Colitis patients who were in remission.

Now that we’ve explored some of the benefits of fiber, now let’s talk about some of the things to watch out for with fiber and IBD.

Is High Fiber Bad for Ulcerative Colitis?

With IBD, sometimes the microbiome is imbalanced to a point where there aren’t enough bacteria—or enough of the right types, to tolerate fiber. When that’s the case, there aren’t the digestive tools to process fiber like your body needs, which can actually activate inflammation in the gut.

Research is still being done to understand the connection we see between IBD symptoms and low fiber diets. In addition, tolerance to fiber is something that may be highly individualized.

When to Avoid High-Fiber Bread

During a flare up of your IBD symptoms, it may be best to avoid new fibers your body isn’t used to.

For example, inulin is a type of fiber that may be added to high-fiber breads, such as gluten-free breads. It’s also added to some beverages that advertise being high fiber. Some research has shown that inulin can exaggerate colitis symptoms, so we recommend you consume it in moderation and pay attention to how your body responds.

When to Incorporate Fibrous Food

If foods high in fiber are increasing your symptoms, you might be wondering how you’re supposed to get the benefits?

As you start to feel better, find a way to reintroduce fiber from plant foods. They can help you manage inflammation and stabilize the gut. In general, it’s best to add fiber slowly and gradually, but don’t completely avoid it!

What Bread Can I Eat with Ulcerative Colitis?

The risk of IBD is known to increase with a typical Western diet. Bread does make up a large part of typical Western diets, where past studies have shown some link between Ulcerative Colitis symptoms and having bread for breakfast. In mice, inflammation has increased when they eat high amounts of rye and other wheat breads.

However, research has found that how we digest bread is related to the way bread is prepared. This is because the bacteria in our gut respond differently to the types of fiber that develop during the bread-making process.

Breads made from sourdough, whole-grain flour, or through a long-fermentation process have shown to support lowering inflammation and balancing gut bacteria in people with Ulcerative Colitis. Keep reading to learn how you can choose different types of breads based on your current symptoms.

Keto Bread and Ulcerative Colitis

Keto-approved breads minimize the net carbs in any bread product. This means that the bread may instead be made from almond flour or other flours and may have added fiber. Consider this type of bread if you are experiencing diarrhea, but pay attention to the ingredient list, because they often-use artificial sweeteners, emulsifiers, and other food additives that can cause intestinal discomfort, too.

Sourdough Bread and Ulcerative Colitis

There has been some mixed research on the impact of sourdough breads on colitis symptoms, but here are a couple great options that I recommend, and many of my clients like:

• Pacha Organic Gluten-Free Buckwheat Sourdough Bread
• San Luis Sourdough Plain Sourdough Deli Bread

Gluten-Free Bread and Ulcerative Colitis

Similar to the general population, some Ulcerative Colitis patients find that avoiding gluten—at least temporarily— can sometimes be a helpful strategy for reducing their IBD symptoms.

Some gluten free breads are made with oat bran. Consider this type of bread if you are feeling abdominal pain or reflux. It’s been found to increase the supply of short-chain fatty acids called butyrate which can help restore intestinal mucous barriers and improve immunity.

Take Home Message

Fiber is not your enemy; but there may be times in your IBD journey when high-fiber foods aggravate your symptoms. Working with a dietitian who specializes in IBD can help, paying attention to your body can help, and introducing fiber slowly during remission can be an effective strategy, too.

There are many benefits available from fiber, including anti-inflammatory effects, and improvements to immunity and the intestinal lining that can help make an IBD journey more pleasurable.

Learn More

• Discover the difference between soluble and insoluble fiber
• Learn how fiber affect’s Crohn’s disease
• Work with a dietitian to establish a personalized approach to fiber in your diet

References

1. Lluansí A, Llirós M, Oliver L, et al. In vitro Prebiotic Effect of Bread-Making Process in Inflammatory Bowel Disease Microbiome. Frontiers in microbiology. 2021;12:716307-716307.
2. Mann, E.R., Lam, Y.K. & Uhlig, H.H. Short-chain fatty acids: linking diet, the microbiome and immunity. Nat Rev Immunol 24, 577–595 (2024). doi:10.1038/s41577-024-01014-8
3. Code of Federal Regulations. Title 21, Section 101.54: Nutrient content claims for “good source,” “high,” “more,” and “added.” Electronic Code of Federal Regulations website. https://www.ecfr.gov/current/title-21/chapter-I/subchapter-B/part-101/subpart-D/section-101.54. Published December 4, 2024. Accessed December 9, 2024.
4. Ni Q, Ranawana V, Hayes HE, Hayward NJ, Stead D, Raikos V. Addition of Broad Bean Hull to Wheat Flour for the Development of High-Fiber Bread: Effects on Physical and Nutritional Properties. Foods. 2020;9(9):1192. doi: https://doi.org/10.3390/foods9091192
5. Fritsch J, Garces L, Quintero MA, et al. Low-Fat, High-Fiber Diet Reduces Markers of Inflammation and Dysbiosis and Improves Quality of Life in Patients With Ulcerative Colitis. Clin Gastroenterol Hepatol. 2021;19(6):1189-1199.e30. doi:10.1016/j.cgh.2020.05.026
6. Lluansí A, Llirós M, Carreras-Torres R, et al. Impact of bread diet on intestinal dysbiosis and irritable bowel syndrome symptoms in quiescent ulcerative colitis: A pilot study. PLoS One. 2024;19(2):e0297836. Published 2024 Feb 16. doi:10.1371/journal.pone.0297836
7. Di Rosa C, Altomare A, Imperia E, Spiezia C, Khazrai YM, Guarino MPL. The Role of Dietary Fibers in the Management of IBD Symptoms. Nutrients. 2022;14(22):4775. Published 2022 Nov 11. doi:10.3390/nu14224775
8. Loy L, Petronio L, Marcozzi G, Bezzio C, Armuzzi A. Dietary Fiber in Inflammatory Bowel Disease: Are We Ready to Change the Paradigm?. Nutrients. 2024;16(8):1108. Published 2024 Apr 10. doi:10.3390/nu16081108
9. Gubatan J, Kulkarni CV, Talamantes SM, Temby M, Fardeen T, Sinha SR. Dietary Exposures and Interventions in Inflammatory Bowel Disease: Current Evidence and Emerging Concepts. Nutrients. 2023;15(3):579. Published 2023 Jan 22. doi:10.3390/nu15030579
10. Mohammadi F, Shiri A, Tahmouzi S, Mollakhalili-Meybodi N, Nematollahi A. Application of inulin in bread: A review of technological properties and factors affecting its stability. Food Sci Nutr. 2022;11(2):639-650. Published 2022 Nov 14. doi:10.1002/fsn3.3141
11. Kurata JH. Dietary and Other Risk Factors of Ulcerative Colitis: A Case-Control Study in Japan. Journal of clinical gastroenterology. 1994;19(2):166-171.
12. da Silva M,Tolentino Bento, dos Santos AA. Proinflammatory Effects of Wheat and Rye in an IBD Model: Give Us Not Our Daily Bread. Dig Dis Sci. 2022;67(9):4324-4325. doi: https://doi.org/10.1007/s10620-022-07466-z
13. Holland K. There are keto-friendly breads, bagels, and bars: Are they healthy? Healthline Media. April 24, 2019. Accessed November 15, 2024. https://www.healthline.com/health-news/keto-breads-bagels-and-bars-can-they-help-your-health
14. Zimmermann, J., De Fazio, L., Kaden-Volynets, V. et al. Consumption of Yeast-Fermented Wheat and Rye Breads Increases Colitis and Mortality in a Mouse Model of Colitis. Dig Dis Sci 67, 4422–4433 (2022). https://doi.org/10.1007/s10620-022-07462-3
15. Weaver KN, Herfarth H. Gluten-Free Diet in IBD: Time for a Recommendation?. Mol Nutr Food Res. 2021;65(5):e1901274. doi:10.1002/mnfr.201901274
16. Hallert C, Björck I, Nyman M, Pousette A, Grännö C, Svensson H. Increasing Fecal Butyrate in Ulcerative Colitis Patients by Diet: Controlled Pilot Study. Inflammatory Bowel Diseases. 2003;9(2):116-121.
17. Wang Y, Wymond B, Belobrajdic D. Swapping white for high-fibre bread exceeds fibre target and improves microbiome diversity. Proceedings of the Nutrition Society. 2024;83(OCE1).