Bread is always tricky: it’s always a quick reach, and let’s face it, a tasty, and filling option that can come in many varieties.
However, as you know, bread is a carbohydrate food that will affect blood sugar levels.
We speak with our diabetes expert, Susan Watkins, RD, CDE, to find out which breads will raise your blood sugar levels the least, and what to look for next time you are in the bakery section of your supermarket.
The good news is that bread can fit into a diabetic meal plan by using it in your total carbohydrate limit for that particular meal or snack.
How many carbohydrates you eat in one sitting has the biggest effect on blood glucose, not how much is consumed per day, Watkins points out, so the key, she says is to spread it out.
Also, it can be hard to control the portion size of bread for some people, especially if you buy it unsliced. So, be sure buy sliced bread or ask your bakery to slice up your loaf before you take it home.
The Varieties to Choose From
An important thing to watch for, according to Watkins, is bread that sounds healthy, such as “low-carb,” or “gluten-free,” varieties that really may not be the healthiest choice.
“Gluten-free has nothing to do with the carbohydrate or calorie content,” Watkins indicates. “Many times when gluten is removed, the bread becomes more dense and higher in both calories and carbohydrates.”
She cautions that eating gluten-free bread solely to lower blood sugar levels is not the way to go.
Another tricky one is multigrain bread.
“Sounds healthy, right?” Watkins says, “But this just means it has 1% or more of each different grain in the product. So, in reality, it can be a very processed, low fiber bread that is not good for your blood sugar,” she says.
Enriched bread is also one to look out for. Enriched bread is refined bread in which the outer coating, bran and the germ of the kernel are removed.
“During this process, most of the natural vitamins and minerals are removed — about twenty,” Watkins says. “Enriched means 4 are added back. So this would not be any better on blood sugar than typical white bread.”
Also, the diabetes educator says some types of bread that look brown actually contain coloring and it does not mean it is better for you than white bread, that’s why it’s always important to read the ingredients.
High fiber bread can help control blood glucose levels, as well as less processed or refined bread. For example, 100% whole wheat bread has more nutrients and fiber than white or processed wheat versions.
“This can have a slightly better effect on blood glucose levels,” Watkins says. “The problem is, to make it taste good, often sweeteners are added, so look in the ingredients list.”
But another possible benefit to 100% whole wheat breads is that it helps you to become full more quickly than white bread and can control your calories, body weight and therefore, your diabetes.
Sourdough bread, according to Watkins has surprisingly a low glycemic index compared to many other types of bread due to the lactic acid produced in the fermentation process.
A recent small Swedish study found that bread with lactic acid (that is in sourdough) lowered the rise in blood sugar 27% less than having mixed whole grain and white flour versions.
And the Winner Is…
Sprouted grain bread is Watkin’s personal all-time favorite.
Bread made from sprouted grain usually contains zero white flour and is made from fermented whole grains. This tends to leave the product lower in carbohydrate, higher in protein and fiber and gives it a better effect on blood glucose levels.
It also has a naturally high nutrient content (such as folate, iron, zinc, and magnesium). This type of bread has also been found to be easier to digest.
Ezekiel is an example of sprouted grain bread and tastes the best toasted! Beware to keep in the fridge, due to the minimal processing this bread can go bad quickly.
How about Bagels?
Bagels are boiled making them lower in fat then products like biscuits or croissants, indicates Watkins.
But because they are very dense, a quarter of a bagel is equal to 1 slice of bread. So an entire bagel is like having 4 slices of bread or 60 grams of total carbohydrates!
It would be wise to have half with a protein or purchase bagel thins, which are lower in carbohydrates.
To control blood sugar in general it is recommended that women stay around 30-45 total carbs per meal and men 45-60 (talk to your RD, CDE or MD about your exact goals as this number can vary per person).
It is recommended to have 15-20 grams total carbohydrates per snack. So a meal could include 2 slices of 15 gram (carb) bread with a protein, vegetables and a small fruit (this would equal about 45 grams).
Also, keep in mind the glycemic index.
“This is how quickly a food affects the blood sugar,” explains Watkins. “The lower the number the better for those with diabetes.”
However, as soon as you pair food with other items it changes the glycemic index.
Glycemic load is more important, that is how the entire meal together affects you.
“So by pairing high fiber foods, like vegetables, proteins, like chicken, or even good fats, like nuts or avocado, to your bread can help minimize the blood sugar spike and give you a well-rounded meal.”
Susan Watkins is a Registered Dietitian and Certified Diabetes Educator. She is the manager of the Center for Health Promotion at St. Joseph Health and the coordinator for St. Joseph’s ADA recognized diabetes program. She also manages their HMR weight program, which has been nationally recognized by U.S. World News and Report as a best, fast weight loss diet in the country for the last 3 years. In addition to diabetes, she creates programs and educates patients on a variety of conditions such as IBS, heart disease, kidney disease, and liver conditions.