This article is crossposted at Your Health is on Your Plate

Most of the time I feel like we’re really making progress.  Patients are looking younger, losing inches, feeling better and decreasing their medications.  Still, not a day goes by that Angie, Barb, Chuck, Doris, Elijah, Fritz, or Gayle doesn’t tell me proudly that they have switched to “wheat bread.”  I thought I covered that, I say to myself.  I thought we discussed the fact that practically all bread is made from wheat.  That buying “wheat bread” is the same as buying “bread.”  That the word “wheat” means nothing in terms of good nutrition unless it is prefaced by the word “whole,” as in “whole wheat.”  That someone is trying to confuse you, and they are succeeding.  That’s when I feel as if I’m climbing a mountain with a Wonder Bread truck tethered to my backpack.

If nothing is working, no matter how hard you try, it’s time to reexamine the fundamentals.  So let’s go back to the beginning, and take a careful look at the words that are being used to sell bread. The goal here is to understand what you are choosing to eat.

When I enter a Subway, the sandwich maker asks me, “White or wheat?”  What are my choices again?  White bread or wheat bread?  But white bread is made from wheat.  And wheat bread is made from wheat.  Both white bread (always) and wheat bread (usually) are made from the starchy core, or endosperm, of a wheat kernel.  So what’s the difference?  Near as I can figure, the major difference is the color.

I checked out the nutrition information for the white and wheat breads.  They both contain 200 calories, but white bread has less fat (0.5 versus 2.5 g), less carbohydrate (38 versus 40 g), less fiber (1 versus 3 g), and less protein (7 versus 8 g).  So how can they both have 200 calories?  Something isn’t adding up.  The only thing that white bread has more of is sodium, at 470 versus 360 mg.

What is white bread?  It’s bread made from wheat kernels that have had their bran fiber coat and oil-rich germ stripped out.  What is wheat bread?  Same.  So why are some wheat breads tan instead of white?  Usually because they have had caramel coloring added.  What else can we learn about “wheat bread?”  Well, manufacturers use a variety of descriptive words to make bread seem better for you, including “enriched,” “unbleached,” and sometimes even “organic.”  ”Enriched” was the name given to flour to which vitamins and minerals were added, after it became apparent that stripping grains caused anemia, beri-beri, and other nutritional deficiencies in the people who consumed them.

The only time bread is really made from whole grains is when the first ingredient is WHOLE wheat or WHOLE grain flour.  The very FIRST ingredient.  Not the second.  Why is it important for you to know this?  Because there is virtually no place in a nutritious diet for refined (i.e., enriched, stripped) flour.  Yes, it’s that serious.  The standard American diet (SAD), based as it is upon refined flour, is one of the major contributors to the diabetes and obesity epidemics.

Now, just for the record, I will restate that folks should eat very little (if any) grain at breakfast.  I’m not saying that we should never eat refined wheat products.  I’m not really the “never” type.  Like Julia Child, I prefer moderation.  I think people can handle a little bit of refined flour now and then.  But not at breakfast, except on very, very rare occasions like your birthday, or your niece’s wedding brunch.  It just doesn’t make any sense to waste large amounts of insulin at the very time of day it works worst.

Remember that some people need to be more strict about their intake of grains (like “wheat bread”) than others.  Who?  Those people who are 1) inactive, 2) more than 30 lbs. overweight, 3) pre-diabetic, or 4) diabetic.  This short list includes around 85% of Americans.  That means no toast, bagels, muffins, waffles, pancakes, cereal, biscuits, bread, grits, leftover mac & cheese, at all.  Even if they are made from whole grains.  Why?  Because grains are absorbed very rapidly, which raises your blood sugar quickly, which means that you need to release a huge load of insulin to catch the sugar.  And insulin works worst when we wake up in the morning.  We can’t afford to waste our insulin like that.  So don’t eat foods made from flour (which, as you have learned, is almost always wheat flour) for breakfast.  The remaining 15% of us can have a little bit, sometimes.  Not every day, unless we are very active.

As for “wheat bread,” don’t let anyone fool you.  Call it by its more correct name –  bread — and switch to whole-grain bread.  Avoid it for breakfast always, and don’t eat it every day in any case.  Send me your questions if you’re still confused.