If you have type 2 diabetes, at some point someone has probably looked disapprovingly at your toast and told you, “You can’t eat that.” Ignoring for a moment the audacity of this know-it-all, most of the time the remark is simply untrue.
Contrary to popular belief, people with type 2 diabetes can, in fact, eat bread — the right kinds, in moderation. As a starting point, the American Diabetes Association (ADA) advises that breads made from whole grains like whole-wheat bread are fine in moderation for people with type 2 diabetes, although they should avoid white bread.
If you’ve been nervously avoiding the bread aisle at the supermarket until now, fear not. Once you get label-savvy, you’ll be able to find the healthiest, most satisfying bread for you.
Fiber Weiner strongly encourages people with diabetes to choose a high-fiber bread, with at least three grams of fiber per slice. “Aim for a whole-grain bread with ingredients like oats, quinoa, or bran,” she says. “They may contain a good portion of fiber, which will improve glycemic response.”
Carbs and Calories Count If you’re making a sandwich with two slices of bread, choose a variety that has no more than 15 grams (g) of carbohydrates and 100 calories per slice. If the bread is higher in carbs and calories, use just one slice for an open-faced sandwich (a romaine-lettuce leaf or another vegetable can double as the top “slice”).
Whole Grain Versus White Flour Maria Rodriguez, RD, CDE, program manager for the Mount Sinai Diabetes Alliance in New York City, says you can tell if any packaged loaf is 100 percent whole-grain by looking at the ingredient list: “The first ingredient will say ‘whole.’ You can also look for the whole-grain stamp.”
Whole-grain breads are ideal for anyone monitoring calories and carbohydrates. If you’re unenthusiastic about the usual versions, you’ve got plenty of other choices:
Spelt, Flaxseed, Chia-Seed, and Almond-Flour Breads These can deliver lots of fiber, protein, and healthy fat. But be sure to check labels: These loaves may also be higher in calories. If a slice contains more than 100 calories, have one instead of two.
Whole-Grain Wraps and Tortillas Look for wraps that are 100 percent whole-wheat, whole-corn, whole-rice, or lower-carb (many contain non-GMO ingredients), or try a lower-carb, high-fiber tortilla: “It may have half the carbohydrates and twice the fiber of a typical slice of bread,” Weiner says. (Just pay attention to calories per serving, since wraps and tortillas tend to be large.) Fill with scrambled eggs for breakfast, or lean protein and vegetables for lunch.
Organic Whole-Grain Bread Many companies are now turning organic ingredients into delicious and nutritious loaves. Some are sliced especially thin so they’re lower in carbohydrates per serving.
Sprouted Bread Ezekiel bread and the like can be great for people with diabetes. Instead of flour, these breads are made with whole grains that have begun to sprout and so have a lower glycemic response, according to a 2012 study.
Traditional Pumpernickel Bread Made with rye flour and often wheat flour, pumpernickel can have a lower glycemic index. For example, according to a 2018 article, pumpernickel bread has a glycemic index of 50, compared to 71 for white sandwich bread. Just avoid loaves containing molasses (sometimes used for coloring), which will increase the carbohydrate and sugar content.
Gluten-Free Corn and Rice Tortillas and Breads While these gluten-free choices aren’t always made with 100-percent whole grain, they’re ideal for people who have both diabetes and celiac disease. Here again, read the nutrition facts closely for ingredients and fiber content, since they can vary.
Breads to Avoid
The worst breads for someone with diabetes are made with refined carbohydrates, such as white flour. Processing grains to make white flour softens the texture, but it also strips away fiber, vitamins, and minerals and results in a higher glycemic index, according to the ADA.
Manufactures will often add back vitamins and minerals that were lost during processing, but that won’t increase the fiber content (unless they add that back, too). Understanding how to read labels will help you avoid breads that contain enriched wheat flour.
Other types of breads to avoid are those that list sweeteners — such as sugar, high-fructose corn syrup, dextrose, or molasses — among the first ingredients.
Lastly, avoid breads that contain raisins or other dried fruit, as these are higher in carbohydrates.
Dos and Don’ts: A Recap
Do:
Choose whole-grain varieties — the first ingredient on the label should be “whole.” Examples include whole wheat, whole oat, and whole rye.
Look for bread that contains at least 3 g of fiber per slice.
If you’re using two slices of bread to make a sandwich, make sure each slice has less than 100 calories. If your bread contains more than 100 calories per slice, use it for open-faced sandwiches, with just one slice.
Consider low-carbohydrate tortillas or pumpernickel, which can help reduce glycemic response.
Pair bread or low-carbohydrate tortillas with protein to reduce postprandial (after-meal) blood sugars and make you feel more full. Try nut butter, chopped egg, or sliced chicken with vegetables.
Don’t:
Don’t opt for white bread or other choices made with white flour, such as wraps, bagels, rolls, or Italian bread.
Don’t be fooled by labels that say “multigrain” or “seven grain.” If the first ingredient on the nutrition label doesn’t say “whole,” it’s not a whole-grain bread.
Don’t eat bread by itself without protein, as this can cause blood sugars to spike.
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