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What are the best breads for people with diabetes?

When diagnosed with prediabetes or diabetes, bread seems to be the first food people cut out. Bread does not have to be so scary! In fact, a combination of bread and protein at meals can make for a great blood sugar friendly choice. Read on to learn about how you can continue to enjoy this delicious carb!



Best breads for people with diabetes  | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian



Can I eat bread if I have diabetes? 


YES. It’s absolutely okay to include bread as part of a healthy diet that supports blood sugar management. While bread is a source of carbohydrate, it’s important to remember that eating for better blood sugar does not necessarily mean you have to cut out all carbohydrate foods. 


It is normal to see some rise in blood sugar after eating bread - that’s okay! All individuals (even those without prediabetes or diabetes) will see some rise in blood sugar when eating carbohydrate foods. The goal is not necessarily to keep blood sugar completely flat across the day. Rather, we are looking for slower, more gentle rises in blood sugar rather than sharp spikes.




What are the best breads for people with diabetes?


The best bread options for blood sugar management include:


Sprouted bread

  • Sprouted breads (where the grains are allowed to germinate or sprout first before being made into bread) tend to be a little higher in protein and fibre. They usually average ~10-12 g net carbs/slice.



Sourdough bread

  • The fermentation process used in making sourdough bread results in lower pH (higher acidity) and an increase in resistant starches. Both of which contribute to slower digestion of the starch content, leading to a slower, gentler rise in blood sugar. 


Sourdough breads can sometimes vary in size - the larger rounded slices of a Rudolph’s brand sourdough always comes to mind. Bigger slices will naturally provide more carbohydrate, so be sure to pay attention to the Nutrition Facts Table to determine how much net carbs you are actually getting per slice.  



Whole grain bread

  • Look for whole grain or multigrain breads that include intact grain or seed kernels (as in you can visually see some of the grains and seeds). The intact grain kernels take longer to digest and are thus more blood sugar friendly. They usually average ~13 - 15 g net carbs/slice.



Low carb bread/Keto bread

  • There are a variety of low-carb bread options available on the market. As these options are often gluten free, the texture of these breads usually differs a bit from your regular breads (e.g. less chewy). While you don’t have to choose only low carb breads, some people find these to be easy options to maximize their carbohydrate budgets. 



Best bread options for people with diabetes  | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian



How many slices of bread can you eat in a day if you have diabetes?


There is not a daily limit to how much bread you can eat. You can technically enjoy bread with every meal as long as it fits within your personal carbohydrate targets (or carbohydrate budget).


Generally speaking, one to two slices of bread at a meal is very reasonable!




How to make any bread choice more blood sugar friendly?


You can make any meals or snacks involving bread more blood sugar friendly by eating it in combination with some protein. 


When we eat bread (or any carbohydrate food) by itself, it doesn’t take a lot of time for our body to digest and absorb the glucose (sugar). As a result, we see a faster, sharper rise in blood sugar. However, when a protein food is paired with the meal or snack, we can slow down the absorption of glucose, resulting in a slower, more gentle rise in blood sugar.


Easy protein pairings when enjoying bread:

  • Eggs

  • Peanut butter or other nut butter of your choice

  • Cheese

  • Cottage cheese

  • Ricotta

  • Tuna

  • Chicken

  • Leftover meat from dinner

  • Hummus

  • Chickpea salad

  • Tofu scramble


Pair bread with a source of protein for better blood sugar  | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian





References


Capurso A, Capurso C. The Mediterranean way: why elderly people should eat wholewheat sourdough bread—a little known component of the Mediterranean diet and healthy food for elderly adults. Aging Clin Exp Res. 2020; 32(1): 1–5. https://doi.org/10.1007/s40520-019-01392-3


Fardet A, Leenhardt F, Lioger D, Scalbert A, Rémésy C. Parameters controlling the glycaemic response to breads. Nut Res Rev. 2006; 19(1), 18–25. https://doi.org/10.1079/NRR2006118


Tricò, D., & Natali, A. Modulation of postprandial glycemic responses by noncarbohydrate nutrients provides novel approaches to the prevention and treatment of type 2 diabetes. Am J Clin Nutr. 2017, 106(2), 701–702. https://doi.org/10.3945/ajcn.117.157255


Meng, H., Matthan, N. R., Ausman, L. M., & Lichtenstein, A. H. (2017). Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations. Am J Clin Nutr. 2017, 105(4), 842–853. https://doi.org/10.3945/ajcn.116.144162




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