Leavened or Unleavened, Wine or Juice, Practice Still Varies

Beyond theological disagreement over what the elements become, denominations differ in the concrete physical practice surrounding them: Western Catholic tradition uses unleavened wheat bread, reflecting the Last Supper's setting during Passover, while Eastern Orthodox practice generally uses leavened bread, reflecting a different reading of the same historical question, and various Protestant traditions have adopted their own local customs for both bread and cup.

A significant nineteenth century development split practice around the cup specifically: the temperance movement in the United States led directly to the invention of pasteurised, non alcoholic grape juice by Thomas Bramwell Welch, a dentist and committed temperance advocate, specifically so his own Methodist congregation could celebrate communion without using fermented wine, and unfermented grape juice remains standard in many Protestant, especially evangelical, congregations today even though it has no basis in the rite's ancient practice and represents a comparatively recent innovation rather than an ancient variant. Frequency of celebration also varies enormously, from a weekly or even daily rite in Catholic and Orthodox practice to a monthly or quarterly observance common in a number of Protestant traditions, reflecting genuinely different theological weight placed on the sacrament's regular repetition.