First of all, let’s get this out of the way: Bread is NOT the enemy. If it were, well, then we wouldn’t be here today because our ancestors would have starved. Grains, corn, potatoes — these are crops that have sustained communities for centuries. (What our ancestors did not have were mounds of chemically processed foods made in a laboratory. Let that one sink in for a moment.)
OK, so while bread may not be the enemy, for people with diabetes, it’s definitely not our best friend, either. When you have diabetes, you must account for the effect of every gram of carbohydrate you eat on your blood sugar levels and determine how to balance your medication and activity to counteract the inevitable rise. Any product made with flour or any grain — even whole, high-fiber grains — will affect blood glucose.
If you’re also watching your weight, then it may seem like a no-brainer to just roll your cart right by that bread aisle without a second thought. However, keep in mind that leaving the bread aisle behind, you are also leaving behind an abundance of key vitamins and minerals such as fiber, iron, folic acid, and loads of other important nutrients. If you are balanced in your overall approach to nutrition and plan on taking a brief break from bread (as I never recommend cutting it out altogether long-term), then make sure you are replacing it with whole grains from other products, such as granola or steel-cut oatmeal.
Let’s talk about fiber and diabetes for a moment. The American Diabetes Association recommends that women eat roughly 25 grams of fiber each day and men eat about 38 grams per day. There are many health benefits to eating fiber, including lowered cholesterol levels, better blood sugar control, and improved weight management (because of the full feeling fiber causes). When a food or meal contains a significant amount of fiber, this helps to delay the absorption of the other carbohydrates, leading to more stable blood sugar levels. (Don’t confuse this with the effect that fat has on blood glucose — having fat along with carb-heavy meals may delay, but doesn’t avoid, a resulting blood sugar spike.)
Keep in mind that the terms “whole wheat,” “whole grain,” and “multi-grain” all mean different things. Whole wheat means that a food is made from the entire wheat kernel while whole grain means that a food is made from the entire kernel of any grain (or mix of grains). Multi-grain, on the other hand, means that a food is made from different types grains, but not necessarily whole grains. For more details on these terms, click here for information from Mayo Clinic.
So what is the best bread for diabetes? With endless varieties of bread making over-the-top promises to literally a dozen choices of English muffin, it is easy to feel overwhelmed. When selecting a bread, you should make sure that is has at least 3 grams of fiber per slice. If it says “whole wheat” and it only has 1 gram of fiber per slice, it most likely has color added to it to make it look brown. Also look for whole-food ingredients. The first three ingredients on any nutrition label will tell you what the majority of that food is made of. If sugar is one of those first three ingredients, I would stay away.
While breads with nuts or berries are absolutely delicious and, you would think, give you more nutritional bang for your buck, be aware. Yes, nuts provide lots of healthy fats, but if consumed as part of a high-carbohydrate, low-fiber bread, they’re just added calories that you don’t need.
One last important point is to make sure you understand how to read the serving size on the label so that you are taking the proper amount of insulin or other medication for the amount of carbohydrate you are eating. For example, most loaves of bread give the carb amount per slice, so you’ll need to do your own math if you’re making a sandwich. Sounds like common sense, but it’s easy to forget these things.
Overall, a low-carb diet absolutely can include a slice of a whole-grain, high-fiber toast for breakfast to help you start your day off right and full. Just follow my advice to ensure you can enjoy it without the negative effects on your blood sugar.
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Regina Shirley: Whether you have Type 1, Type 2, Type-somewhere-in-between, or a loved one with diabetes, Regina Shirley hopes that you can relate to her and that she can help you take this condition in stride. She will let you in on some of her challenges as a mom with Type 1 diabetes to an active toddler and a wife to a husband who is a foodie. She has been a Registered Dietitian for over a decade and has lived with Type 1 for over 25 years (complication free!). She has always participated in JDRF events and is on their National Speakers Bureau, and she also serves on the Outreach Committee of the Boston JDRF Chapter and speaks annually at their Type 1 Nation Summit. Shirley was the Fund-a-Cure Speaker for the New Hampshire JDRF Granite Gala in both 2009 and 2013 and has also contributed to the DECA (Diabetes Education & Camping Association) national nutrition guidelines manual for diabetes camps. Her alma mater, Framingham State University, invites her back each fall to guest lecture on the topic of diabetes, technology, and nutrition. She is the creator of a widely viewed blog called Serving Up Diabetes and works as a nutrition consultant for both individuals with or without diabetes and the restaurant industry.
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