Despite the risk, bread can be one of the hardest foods to give up. Fortunately, there are breads on the market that don't raise blood sugar to extreme levels.
Whole-grain breads with high-fiber ingredients, like oats and bran, may be the best option for people with diabetes.
Making bread at home with specific, diabetes-friendly ingredients may also help reduce the impact bread has on blood sugar levels.
Nutrition and diabetes
Diabetes has two main types: type 1 and type 2.
Bread products tend to be high in carbohydrates.
People with type 1 diabetes have difficulty producing insulin, which is a hormone that "captures" blood sugar (or glucose) and transfers it into cells. Glucose is the preferred energy source for cells.
Type 2 diabetes is the most common form of diabetes. This type of diabetes is also the easier form to prevent and manage with lifestyle changes and medication. According to the World Health Organization, over 422 million people have type 2 diabetes worldwide.
In the earlier phase of type 2 diabetes, the pancreas can produce insulin, but cells have become insensitive to its effects. This is sometimes due to poor diet, genetics, and lifestyle habits. Because of this, cells can't access blood sugar following a meal.
Nutrition plays a crucial role in diabetes control. It's only through putting proper dietary planning into practice that good blood sugar management can be accomplished. A good diet must also be combined with lifestyle changes and medication.
A carbohydrate is one of the three major nutrients essential to human health. However, carbohydrates also raise blood sugar and can reduce effective diabetes control. This is mainly because carbohydrates break down into blood sugar.
The key to keeping blood sugar in check following a meal is to choose food items that contain quality carbohydrates. Quality carbohydrates are those that rate low or medium on the glycemic index.
Improving the glycemic index of bread
The glycemic index is a measurement of individual foods and their effects on blood sugar. There are three basic categories of the glycemic index: low, medium, and high.
Low-glycemic foods are those that contain little to no carbohydrates. These include:
- Green vegetables
- Nuts and seeds
- Small berries
Medium-glycemic foods include:
- Most fruits
- Whole grains like brown rice, oats, and whole wheat
High-glycemic foods include:
- White bread
- Refined grains
- White potatoes
For people who want to make their own diabetes-friendly bread and are using a standard bread recipe, there are ingredients that can be added to the mix to lower the glycemic index of the final product. High-fiber, high-protein, and high-fat ingredients may be important additions to reduce the impact the bread has on blood sugar.
These ingredients include things like:
- Flaxseed meal
- Chia seeds
- Wheat bran
Bakers will usually want to replace one-fourth of regular flour with an equal proportion of the other, healthier ingredients. For example, if a favorite bread recipe calls for 2 cups of flour, half a cup of flour can be replaced with half a cup of flaxseed meal. Swapping out all-white flour for whole-wheat pastry flour is also a good idea.
Once the bread is baked, the glycemic index can be reduced further. People can spread on healthy fats like avocado or flaxseed oil to replace mayonnaise and other sugary, high-glycemic spreads.
Commercial bread found at most grocery stores is usually made with white flour. Refined white flour is absent of fiber and can send blood sugar skyrocketing. Even bread marketed as "wheat bread" may be made with refined wheat and not whole grain.
Some brands that identify their bread as "seven grain" or "nine grain" only use those grains on the crust while the majority of the bread is still made with refined white flour.
Breads containing whole grains are usually high in fiber.
It's this deceptive form of advertising that can lead many people with diabetes to choose the wrong bread for their health concerns.
Here are four types of breads that, along with an overall healthy lifestyle, may be healthier options for diabetes control:
Fiber-enriched whole-grain bread
Fiber is a type of carbohydrate that the body can't digest. It keeps bowels regular and assists in promoting a feeling of fullness. Fiber is also a significant nutrient that helps control blood sugar.
Breads with soluble fiber added to them may be a helpful way to manage blood sugar via the diet.
People should keep in mind that fiber-enriched whole-grain breads are still relatively high in carbohydrates. Eating these products in moderation is important.
Multi-grain sandwich bread
While high in carbohydrates, a multi-grain bread is typically made with whole, unrefined grains. These grains are generally high in naturally occurring fiber (not enriched), an important ingredient for lessening the impact that carbohydrates have on blood sugar.
When choosing whole-grain bread, people should find one that includes ingredients like oats, quinoa, buckwheat, whole-grain wheat, brown rice, bran, and barley.
In addition to being lower on the glycemic index (compared with wheat flour), many whole grains offer a number of other nutrients, like zinc, vitamin E, and protein.
Low-carbohydrate tortillas make a flexible alternative to bread.
Sandwich bread isn't the only option. Tortillas can provide a tasty, versatile, and sometimes healthier choice for sandwiches.
As the diabetes epidemic continues to escalate worldwide, companies are pushing out a wider range of low-carbohydrate tortillas to appeal to health-conscious consumers.
Many of the low-carbohydrate tortillas available on the market have added fiber to reduce the carbohydrate count. Some tortillas are simply made with low-carbohydrate ingredients, like whey and soy protein powders.
People can use low-carbohydrate tortillas as they would use bread, wrapping their favorite sandwich ingredients in the tortilla. Tortillas can also be used for mini pizzas, homemade burritos, and tacos.
Perhaps the best choice for diabetes-friendly bread is one made without flour or grains. While flourless sprouted-grain breads are available and are a good source of fiber, they are still rich in carbohydrates.
Grain-free breads made with ingredients like almond flour, coconut flour, and flaxseed meal can be found in specialty health food stores. Check the nutrition facts, since they may also be higher in calories.
There are also many recipes for making grain-free bread on the Internet. A search term like "grain-free bread recipe" will bring up some low-carbohydrate bread recipes. These breads tend to be more expensive to make and purchase and often yield a smaller amount compared with traditional bread recipes, however.
Unless specified by a doctor or dietitian, patients with diabetes don't necessarily need to eliminate bread or bread products from their diet. Using low-carbohydrate or multi-grain, whole-grain bread options may be the best bet for keeping bread in the diet without posing a great health risk.
Continuing an exercise program, using doctor-prescribed medications, and consuming mostly low-glycemic foods are also the most effective ways for controlling blood sugar while allowing people with diabetes to continue eating the foods they enjoy.