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Bread on the Brain: Which Types of Bread Are Best for Diabetics?

Dec 3, 2020
  • Diet
  • Managing
  • Medical Information
Someone holding freshly baked bread in their hands.

Bread for Diabetics

Toasted cheese sandwiches. Freshly baked Ciabatta as a side to soup. Eggs on toast. Heavenly sourdough. Barbequed garlic bread. Fresh, char-grilled bruschetta. Peanut butter and jam on white bread. Hungry yet? If you’re finding yourself salivating, you’re not alone. There is a good reason for this. Bread’s nutritional makeup is such that it causes a spike in the reward center of our brains.

Also, bread is a common part of so many peoples’ daily diet. It forms an integral part of so many peoples’ cultures and traditions. As the old saying goes, bread is, well, the best thing since sliced bread!

However, bread is high in carbohydrates. For this reason, many people with diabetes wonder whether they should be eating it at all. In this article, we’re going to be covering the topic of bread for diabetics, looking at the pros and cons for people with diabetes and suggesting some pointers for incorporating bread in the healthiest way possible.

Understanding Cravings: Your Brain on Bread

So, what exactly happens in the brain that makes us keep coming back for more bread? Well, ordinary bread is high in carbohydrates, which is essentially sugar. When we eat the bread, our brain registers this in the thalamus and a signal for the taste gets processed in the cortex. As this happens, our brain’s reward system gets activated. This is the very same brain network that goes into overdrive when a person uses drugs or has sex. Once this system gets activated, it leaves us craving another hit.

How Does Bread Affect Blood Sugar?

The simple truth is that bread raises blood sugar. This is due to the high carbohydrate content. As mentioned, carbohydrates are sugars. Carbohydrates can be categorized into three different forms: monosaccharides, disaccharides and polysaccharides. You’ll notice that all three have the word “saccharide” in them. This is based on the Latin word for “sugar”. Therefore, any bread that contains high carbohydrates will raise your blood sugar.

Does this mean that people with diabetes shouldn’t eat bread at all? Well, not exactly. It just means that we need to be very thoughtful about how we choose to incorporate bread into our diets.

Are There Any Reasons to Avoid Bread?

The short answer is yes. The idea of low-carbohydrate (or keto) diets are becoming increasingly popular. It’s a fairly contentious topic within dietary communities, but good quality evidence is mounting that suggests we should be limiting carbohydrate intake. There is an assortment of good reasons to think about limiting the amount of bread that you eat:

  • Research suggests that limiting carbohydrates can help with overall weight loss.
  • More specifically, a low carb diet can help ensure that you’re losing more fat than muscle.
  • Limiting carbs can help you avoid developing other serious health complications that would otherwise put your heart health at risk.
  • Research shows that limiting carbs can help you, as a type 2 diabetic, have better control over your condition and achieve more stable blood-sugar levels.
  • Although more research is still needed in this regard, some studies have shown that limiting carbohydrates can also help people living with type 1 diabetes to improve their sugar control.
  • Do you ever find that you experience heartburn after eating bread? If so, you’re certainly not alone. Research has shown that limiting carb intake can help manage chronic acid reflux.
  • Interestingly, limiting the amount of bread that you eat can also have benefits for your brain. For example, a study found that a keto diet can help control epileptic seizures. It’s also possible that avoiding carbs can help manage Alzheimer’s disease, while also decreasing the risk of developing the condition in the first place.
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All Breads Are Not Equal: What Is the Glycemic Index?

It is important to understand that not all types of bread affect our blood-sugars in the same way. What is the glycemic index (GI)? This is a way of measuring how quickly the sugar in food gets absorbed by our bodies. For example, a food that has a high glycemic index will cause a sudden spike in blood-glucose. On the other hand, a low GI option leads to a more gradual rise in sugar.

White bread is generally highly processed and lacking in fiber, which gives it a high GI score. On the other hand, rye bread and whole wheat bread have lower GI values, meaning that they are better for people with diabetes. Pumpernickel is another good low GI option.

Ultimately, while choosing lower GI bread options is a good idea, low GI doesn’t mean low carb. Bread with a high carb count will always cause an increase in blood-sugar. We can lessen this effect by choosing low carb options.

Low Carb Bread

For a long time, people have been told that fat is bad and that this should be eliminated from diets to whatever extent possible. As mentioned above, in recent times, researchers and medical professionals have been awakening to the fact that fat is not necessarily the enemy, but that rather carbohydrate intake should be limited. This is a contentious topic within medicine and people remain divided. Nonetheless, there is no doubt that evidence is mounting to suggest the benefits of a low-carb lifestyle.

With this, we have seen an explosion in the low-carb/keto industry. For this reason, it is now fairly easy to buy keto-friendly bread. This form of bread contains high amounts of dietary fiber, which stops one’s blood-sugar from spiking. They also are often made with nut flowers (such as flax and almond), which have lower carb levels than carbs.

If You Fail to Plan, You’re Planning to Fail

Ultimately, people with diabetes are able to enjoy tasty treats, including bread, as long as you’re planning for it. For some, a temporary medication change might be needed; or alternatively, enjoy bread after a work-out, so that a sugar spike is less likely. Fortunately, though, given how widely available low-carb bread options are these days, it is possible for people with diabetes to enjoy bread without their blood-sugars suffering. Ultimately, though, whatever you choose to eat, it needs to be in the context of a proper nutritional plan and ideally under the guidance of a dietician.

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Daniel Sher
Daniel Sher
Daniel Sher is a clinical psychologist who has lived with type 1 diabetes for 30 years. He practices from Cape Town, where he supports people with type 1 and type 2 diabetes to thrive.
Resources
  • JCN (A proposed hypothalamic–thalamic–striatal axis for the integration of energy balance, arousal, and food reward)
  • PLOS ONE (Dietary Intervention for Overweight and Obese Adults: Comparison of Low-Carbohydrate and Low-Fat Diets. A Meta-Analysis)
  • PubMed.gov (Impact of low-carbohydrate diet on body composition: meta-analysis of randomized controlled studies)
  • PubMed.gov (Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors)
  • PubMed.gov (A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms)
  • Science Direct (Cognitive benefits of the ketogenic diet in patients with epilepsy: A systematic overview)
  • PMC (Dietary ketosis enhances memory in mild cognitive impairment)
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