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Bread and Type 2 Diabetes

Some research links bread to an increased risk of type 2 diabetes, which is marked by abnormally high levels of blood sugar that eventually result in damaged blood vessels and organs.

Eating any kind of carbohydrate raises blood sugar levels, triggering the release of insulin. Sugars and refined grains raise blood sugar quicker than complex carbohydrates, found in foods including vegetables and legumes.

"Complex carbohydrates are digested more slowly, and their ability to cause blood glucose level spikes is limited," says Hillary Wright, MEd, RD, director of nutrition counseling at the Domar Center for Mind/Body Health and author of The PCOS Diet Plan: A Natural Approach to Health for Women with Polycystic Ovary Syndrome.

That may be particularly important for people with type 2 diabetes. In type 2 diabetes, cells resist insulin, leading to elevated sugar in the blood and high insulin levels. The constant demand on the cells that make insulin can damage them, and the body may eventually stop making insulin.

Scientific research suggests that cutting back on refined grains, such as white bread, and eating more whole grains in their place reduces insulin resistance and may help to prevent type 2 diabetes. "Whole-grain bread has more fiber than refined, and fiber helps slow the absorption of carbohydrates consumed at the same meal or snack," Wright tells WebMD.

v "Bread has been getting a bad rap for a long time," says Shelley Case, RD, nutrition consultant and author of Gluten-Free Diet: A Comprehensive Resource Guide. "It's worse now because there's so much negative press about gluten, the protein found in wheat, rye, and barley." 

Some people cannot tolerate gluten because they have celiac disease. In celiac disease, the immune system mistakenly identifies gluten as dangerous, triggering a reaction that causes an attack on the body's own tissues. That damages tiny finger-like structures called villi in the intestines, making it hard to absorb nutrients from food. For people with celiac disease, avoiding any source of gluten -- found in many products besides bread -- is an absolute must.

Celiac disease is getting diagnosed more often these days. But many more people link their health problems, including stomach upset and fatigue, to gluten. A sensitivity to gluten, also known as gluten intolerance, may involve bloating, abdominal pain, and fatigue. But there aren't reliable medical tests for it.

It may be tempting to stop eating bread and other gluten-containing foods if you suspect they're bothering you. But it's important to first find out if you have celiac disease, and going gluten-free makes it harder to diagnose celiac disease, Case advises. If you're having symptoms that make you suspect that you can't tolerate gluten, tell your health care provider, and if you are considering going gluten-free, a registered dietitian can help you make sure you don't miss out on nutrients.

How Much Bread Is Too Much?

Bauer says it's possible to eat a healthy diet without bread, as long as you substitute foods such as beans, brown rice and other whole grains, fruit, and vegetables for the nutrients bread provides.

If there's no reason why you should go without bread, you should know how it fits into a balanced diet.

People on a 2,000-calorie eating plan need six servings a day (about 6 ounces) from the grain group, which includes all grains, including those used to make bread, plain rolls, pasta, oatmeal, breakfast cereals, tortillas, and grits. At least half of your grains should be whole grains, according to the 2010 Dietary Guidelines for Americans.

Keep portions in mind. For instance, a single bagel can pack 3-5 ounces of grains. That takes up much of your grain budget for the day, and if it wasn't a whole-grain bagel, it may be hard for you to meet healthy grain goals.

Nutrition experts agree: When you're eating bread, it's best to make it whole-grain bread, and to limit the amount. For example, "having bread in a sandwich is a good way to control your intake," as opposed to lingering over the bread basket at dinner, Bauer says.

How to Choose the Best Bread

Here are some bread-buying tips:

Go with the whole grain. Choose breads that list "whole" grain as the first ingredient, such as whole wheat, white whole wheat, or whole oats. "Wheat bread" is not necessarily a whole-grain product.

Downsize. To reduce portions, boost fiber intake, and improve whole-grain consumption, opt for whole-grain English muffins, bagel thins, and sandwich thins. Choose 2-ounce sandwich and hamburger buns.

Don't shop by color. Many whole-grain breads are darker than white bread, but food manufacturers may add molasses and food coloring to give their refined bread products a darker hue. Always check the ingredient label.

Bulk up. Choose whole-grain bread products with at least 3 grams of fiber per serving.

content aggregation:healthprior21

source:WebMD