How to Choose the Best Bread for Heart Health
Those beauties above are kernels of wheat, and you know what? They’re actually quite nutritious!
In addition to energizing, slow-release carbohydrate (yes, really!) and heart (and gut) healthy fibre, they deliver a bit of protein, B vitamins, iron, zinc, magnesium, vitamin E, as well as other antioxidants and phytochemicals.
Much of the “Wheat Belly”-style criticism applies only to the (white) flour that results when those kernels are pulverized and deprived of their most nutrient-rich components, the bran and the germ.
White flour might make light, fluffy bread and other baked goods, but if it’s a central player in your diet, it can increase your risk of diabetes and heart disease, compared to eating more whole grains.
Whole grains, especially the intact ones, like those wheat berries, steel cut or rolled oats, barley, farro, or quinoa, are better for metabolic health, and might even help improve your mood and energy. (More on intact grains here from dietitian Rosie Schwartz.)
But relying entirely on intact grains probably isn’t going to happen for most of my readers anytime soon. Bread comes up in nearly every consult I do. We Canadians love our bread!
Can we get bread with the benefits of wheat and less of the health risks? Absolutely.
What to do?
First, enjoy a variety of whole grains, not just bread products. Experiment with some of those intact grains if you don’t already – you’ll thank me later!
Next, when choosing bread, take everything on the front of the package with a HUGE grain of salt. (Not literally haha!) Ignore words like organic, natural, harvest, and ancient grain. And don’t judge by seediness or colour! (Sometimes molasses is even added to make a bread look darker.)
Instead, get your reading glasses out and take a close look at the list of ingredients. They’re in order by weight, so really focus on the first three items. Everything else is small potatoes. 
Step 1 – Check the first ingredient
We’d like to see at least that first ingredient on the list be a whole grain. There’s more of that than anything else in the bag. You’re looking for words like:
- sprouted grain (best bet – see below why)
- rye (another superstar)
- whole grain (still very good, especially if combined with seeds)
- whole wheat (USA only – see below why in Canada this doesn’t impress)
- cracked wheat
On the other hand, the following words indicate white flour:
- wheat flour
- enriched wheat flour
- unbleached wheat flour
- organic wheat flour
If the first ingredient is a whole grain, then the bread is mostly whole grain, and you’re off to a good start.
Step 2 – Skim the rest of the list
Ideally though, you want an everyday bread that is 100% whole grain! How to tell? Skim the ingredient list, hunting for those words that indicate white flour. The further down the list, the less of it there is in the bag, relatively.
Easy, right? But the devil is in the details, so I answer frequently asked questions below, along with some specific bread examples.
About the product examples below
I couldn’t possibly mention all of the products available in our local market alone. Just 1-2 quick examples so you can recognize packages you’ve seen in the store.
These are just for teaching purposes. This post is not sponsored, and I have no affiliation with the food industry!
Also, always skim the ingredient list, even for the companies I highlight below. They might have mostly whole grain products, but a couple with refined grains as well. Check the manufacturer’s website for where to buy, and you can usually preview ingredients lists and nutrition facts there.
Finally, the guidance below applies to other bread products – buns, tortillas, bagels, english muffins, etc.
What are glycemic index and glycemic load?
Choosing the best bread for heart health inevitably means considering the impact of that food on blood sugar levels. Glycemic index gives us a measure of this for a set amount of a particular carbohydrate-containing food, and glycemic load factors in how much of it we eat (that’s what really matters).
Lower glycemic index (and load) diets are associated with decreased incidence of cardiovascular disease, at least in women. Plus, replacing high with low-glycemic-index carbohydrates can help improve blood sugar control for people with diabetes and prediabetes.
Plus, researchers in at least one study were able to show that a low glycemic load diet helped improve volunteers’ moods and lower ratings of fatigue. Yes please!
Given the popularity of bread, it’s one of our big contributors to glycemic load, so we’ll take that into account for sure.
What’s so great about sprouted grain?
Three reasons to love these breads:
- Generally low glycemic index.
- Sprouting makes the nutrients more bioavailable, so you’ll get more protein, fibre, iron, and other good stuff per slice.
- They’re easier to digest, which might be helpful if you find that wheat doesn’t generally agree with you, but you don’t have celiac disease.
Whole Grain Examples
Silver Hills – but still read the ingredient list! Some of their breads also have refined grains.
Food For Life/Ezekiel – these also have sprouted legumes and are quite low in sodium. Needs to be refrigerated (even at the grocery store).
Not so whole grain
Stonemill Honest Wellness Sprouted Flax Bread. Dietitian Rosie Schwartz tipped me off to this one. Take a look at the ingredients. What’s the first one? (Hint: Not sprouted grain!) Doesn’t seem so honest to me.
What about rye bread?
Rye generally has a lower glycemic index than even whole grain whole wheat breads, thanks to an unusually high level of fibre throughout – not just in the bran.
But many rye breads you’ll find in the grocery store are made with mostly white flour and a little rye. Again, check the ingredient list!
And when I number crunched the sodium, six of the seven rye breads I looked at, even the whole grain ones, were higher than average.
Whole Grain Examples
Not so whole grain
“Canadian” rye, light rye, Winnipeg rye, and Rubschlager. Mostly white flour.
What’s the difference between whole grain and whole wheat?
In the US, whole wheat is a true whole grain. The general term whole grain might also refer to other grains, like rye or barley, but either way, the product will use all of the components of those wheat kernels above – bran, germ, and endosperm.
In Canada, however, we have a bit of a loophole in the labelling regulations. Manufacturers can remove the germ portion of wheat flour and still label the product “whole wheat.” (!) Whole wheat is still nutritionally preferable to white, because it has the fibre-rich bran portion, in addition to the fluffy white endosperm, but it’s not a whole grain!
In Canada, if you want all the goodness of the wheat kernel, look for “whole grain whole wheat”. You might even see a label that reads “whole grain whole wheat including the germ.”
Whole grain examples
Not so whole grain
What is enriched wheat flour?
Because white flour is so lacking in nutrients, and so widely consumed, manufacturers are required to add certain nutrients to it, including, in Canada, the B vitamins niacin, riboflavin, thiamin, and folic acid as well as iron. (US requirements are similar.)
It’s still lacking in fibre and magnesium though – two nutrients critical for cardiometabolic health.
What about sourdough?
While sourdough is usually made with all or mostly white flour, the acid produced by the microbes in sourdough cultures usually means a lower glycemic index, increased bioavailability of certain nutrients. Some people also find it easier to digest. No wonder it’s popular!
If you’re a sourdough lover and eat it often, see if you can find a whole-grain sourdough you like.
What about multigrain, 12-grain, etc?
Multigrain literally just means more than one grain. Some multigrain breads have a white flour base with other grains like oats and rye added in.
These products are a step up from white bread, but they frustrate the heck out of me, because they masquerade as true whole grain bread. Breads with names like “Canadian harvest” are similar.
Whole Grain Examples
Not so whole grain
Most in-store bakery breads, such as this Italian Multigrain Bread from Superstore.
…or this Bake Shop Multigrain Bread from Save On Foods. (Safeway and Co-op in Calgary do this too.)
How about oat bread?
Oats are great! But like rye, they’re often combined with white flour, so check the label.
Whole grain example
Not so whole grain
(Also couldn’t find this on online, so quick pic by me at Costco.)
Label-reading for bread
Comparing brands of bread is notoriously hard because the serving sizes are all over the map. Some give you the nutrition for one slice, some for two. Some slices are big, some are thin-sliced and tiny. So keep that in mind when you’re comparing.
What about sugar?
If you’re reading the ingredient list, you’ll see that most bread has at least a little bit of sugar in it. The important question is “How much?”
Guidelines suggest limiting yourself to ideally about 25 grams or 6 teaspoons a day of “free sugar.” How much of your daily free sugar budget would a slice of bread eat up? On the low end, 0 to 1 gram. No big deal. But on the high end…
Higher sugar breads
Dave’s Killer Bread 21 Whole Grains and Seeds, with 5 grams or more than a teaspoon’s worth of bread per slice!
Similarly, the Kirkland 21 Whole Grains and Seeds loaf has 4 grams per slice. That’s like sprinkling a teaspoon of sugar on every slice!
Also any raisin bread will be on the high side.
What about salt/sodium?
An astute label-reader will also notice the sodium content. You really can’t make bread without some salt.
When I compared 43 different breads, the average sodium content was 168mg per slice, with a range from 70 to 370mg! Some of that variation is based on size of the slices, but still. Holy moly.
Guidelines typically recommend less than about 2000mg a day, so one slice of most is no big deal, but with the amount of bread and bread products we eat in Canada, bakery products are actually our largest source of sodium!
Particularly lower-sodium breads
Cobs Cape Seed Loaf (an all-around top-notch bread)
Country Harvest Ancient Grain & Red Fife.
Another way to limit sodium in bread is to buy thin-sliced or smaller-sized loaves.
Higher-sodium breads
Often it’s breads with rye: Mestemacher, Dimpflmeier Klosterbrot – Monastery Rye Bread, and Superstore in-house baked pumpernickel.
What about fat?
Don’t worry about the fat in whole grain breads! It’s mostly heart-healthy unsaturated fats coming from the wheat germ or seeds like flax or sunflower. More fat is actually a good sign!
What about fibre?
Yes, more fibre is definitely a plus in terms of heart (as well as gut) health. If you do a 100% whole grain bread it will usually be high in fibre (4-5 grams per slice), but if you prefer a mixed grain with some refined grain in it, the fibre count can help you find a better one.
What if I need a budget bread?
Healthier breads can often be expensive – sometimes up to $5-6 per loaf! If that’s an issue for you, watch the Country Harvest breads, which often go on sale at Superstore.
The Great Value 100% Whole Wheat Bread at Walmart was selling for just $1.67 at time of writing. It’s not fancy but it’s fine for heart health: whole grain whole wheat with reasonable sugar and sodium.
The best price I’ve seen for the sprouted grain breads is Silver Hills at Costco, as long as you don’t mind coming home with two loaves of bread at a time. Keep them in the freezer. (Costco also sells Dempster’s at a discount.)
What about gluten-free bread?
If you don’t need gluten-free bread for celiac disease, honestly, I wouldn’t go that route.
If you do, I’m not the best person to comment on that. Perhaps one of my gluten-free savvy colleagues could suggest options. Some dietitians specialize in gluten-free eating and they’re a great resource if you have to do that yourself. (You can find a dietitian by specialty here.)
What are some options if whole-grain bread is just not for you?
If don’t like whole-grain bread, first of all, try some of the various sprouted or 100% whole grain options I’ve highlighted in the article. There are so many different choices, you might just find something you actually like!
But if you’ve already done that and really just don’t enjoy them, don’t force it. Life is too short to eat food you don’t like.
Your next best bets:
- Mostly whole grain breads, where a whole grain is the first ingredient, followed immediately by “enriched wheat” (aka white) flour.
- Breads with whole grains and seeds immediately following “enriched wheat” at the top of the ingredient list.
- White sourdough or (mostly enriched wheat) rye, which at least will have a lower glycemic index than full-fledged white bread.
- High-fibre white breads, like this one from Cobs. Because the fibre comes from isolated plant components, we can’t really say with confidence that the “special sauce” tying whole grains to heart health made it in. However, that bread in particular does have a low glycemic index, so like all of these, better than regular white!
Worst case, if you’d really rather just have bona fide white bread, do that! It just might make sense to eat it less often, and/or in smaller amounts, than you might with the whole grain stuff. And make sure you get fibre and other bread nutrients by eating other (intact) whole grains as well as more whole plant-based foods like beans, lentils, nuts, and seeds.
And for the whole grain diehards out there, if you’re out to dinner once a month and they serve up hot freshly baked (white) bread, please, by all means, indulge! Healthy eating is not an all or nothing endeavour.
At the end of the day we’re always looking for your “Sweet Spot” right? Find the best balance for you between health considerations, enjoyment, and other factors like cost, convenience, and availability.
Let’s talk bread!
Did I miss your favourite bread? The same principles apply to any sliced bread at the grocery store. I tried to cover all of the breads mentioned by members of our free Sweet Spot Heart-Healthy Cooking Club on Facebook, as well as folks who chimed in on Twitter.
You can also ask about the ingredients at your local bakery. They should be able to tell you which breads are all or mostly whole grain flour. Just because it’s sold in a fancy shop, made by an artisan baker, and given a wholesome-sounding name doesn’t necessarily mean it’s whole grain.
I’d love to hear your thoughts on these and other breads, either in the Facebook group or via email if that’s easier for you.
