As a dietitian, I’ve seen my fair share of patients who follow literally none of my advice. I get it–they’ve been eating the same foods for decades and decades. If they’ve made it this far, why should they listen to somebody droning on about the differences of white bread vs wheat bread or suggesting that chocolate cake might not be the best breakfast choice for their blood sugar?
On the other hand, I’ve had patients who seem to absorb everything they hear–from me and from some more questionable sources–and take it to an extreme. I once had a patient tell me that he couldn’t eat anything with carbohydrates–no corn, no potatoes, no beans…and bread? Completely out of the question!
He was somehow convinced that carbohydrates were entirely to blame for his diabetes, totally ignoring some of the more likely culprits: years of physical inactivity, poor overall diet quality, extra weight, and possibly even a genetic predisposition.
He’s not the only one eager to latch onto a target to hold accountable for his health issues. In fact, this disturbing trend has reached epidemic-scale proportions, and it’s nothing new.
Over the years, the abundance of misinformation out there has made it increasingly easy to find new ways to blame specific foods for our nutritional problems.
In the 1980s, a sudden fear of fat sent people scurrying to the supermarket to stock up on snacks laced with Olestra. Carb cutting skyrocketed to popularity at the turn of the century with the rise of the Atkins diet. More recently, the idea that gluten is somehow to blame for all of our problems has gained widespread acceptance among the population.
No, white bread does not cause cancer, despite the headlines.
White bread is another food that has constantly been pegged as “bad” or “unhealthy.” Take, for example, this 2016 study by Melkonian et. al, which found an association between high glycemic foods and lung cancer.
While there is already existing evidence, like this study by Dijogue et. al, that documents the potential role of insulin receptors in cancer by affecting cell growth, this new research sent the media into a frenzy.
“Eating a Lot of White Bread May Cause Lung Cancer.”
“Why White Bread Is Linked to Lung Cancer.”
“Is Your White Bread Giving You Lung Cancer?”
The headlines came rolling in, completely disregarding the actual content of the study but honing in on the latest target: white bread.
The study did not find any correlation between lung cancer and white bread specifically, but rather with high glycemic foods in general. Despite the fact that the glycemic index of white bread is surpassed by instant oatmeal, rice cakes, pretzels, and baked potatoes, white bread took the brunt of the blame when the story hit the press.
So is white bread inherently bad? You might be hard-pressed to find a dietitian that encourages frequent consumption of white bread vs wheat bread, but most seem to agree that plentiful portions of whole grains should be part of a healthy diet.
It doesn’t make sense to tie one bread to cancer while placing the other one in the bottom of the food pyramid.
Can white bread really be that bad for you? Should we all start grabbing the pitchforks and head to the nearest Wonder Bread factory? To answer those questions, we have to backtrack a bit. Let’s look at the anatomy of the grain.
Regardless if it’s white bread vs wheat bread, multigrain, or rye, all grains start off as a whole grain. The seed, also known as the kernel, is composed of three parts: the bran, the germ, and the endosperm.
The bran makes up the outer skin of the seed. It’s full of antioxidants, fiber, and B vitamins. It also holds between 50-80% of the minerals found in grains, like iron, magnesium, and zinc.
The germ is the sprouting section of the seed and is rich in B vitamins, minerals, antioxidants, a little protein, and heart-healthy fats.
The endosperm is the largest part of the kernel and acts as a food supply for the germ. It is mostly carbohydrates with a small amount of protein, vitamins and minerals.
The refining process strips the kernel of the bran and germ, leaving only the endosperm.
That’s right, refined grains lose out on all the vitamins, minerals, and fiber found in the germ and bran. In fact, up to 75% of phytonutrients are lost during the milling process. Refining also cuts out 25% of a grain’s protein and slashes the amount of at least 17 nutrients.
But before the modern milling process, there were other methods that turned grains into flour (and retained the nutrients).
One of the oldest methods, stone milling, worked by grinding grains between large stones. Steam roller mills were invented in Hungary and utilized to grind harder varieties of wheat. The first automated flour mills, powered by water, were created in the 18th century and were able to boost flour production while doing the work of seven men.
With industrialization came a need for increased efficiency. The roller mill was designed to produce large amounts of grains very quickly. Although it was great economically, this innovation in technology came with some dietary drawbacks.
Using this new process, the bran and germ were completely removed from the finished product. Stripping the grain of most of its fat allowed for a longer shelf life while cutting the fiber gave it a softer texture, but it came at an enormous nutritional cost.
Following the widespread implementation of the refining process came a surge in nutritional deficiencies. Cases of beriberi and pellagra, two crippling conditions caused by B-vitamin deficiencies, started cropping up across the United States.
In the early 1940s, the Committee on Food and Nutrition recommended enriching flour with thiamin, niacin, riboflavin, and iron. The FDA soon created a set of standards that specified the nutrients and amounts that should be added to enriched flours. In 1943, the War Food Order mandated that all white breads had to be enriched based on guidelines set by the FDA.
Thanks to these new rules, many nutritional deficiencies were virtually eradicated in the US.
Following the war, the fortification of white bread was no longer mandatory. Still, most manufacturers continued enriching flours voluntarily. By the late 1950s, between 80-90% of white breads in the US were fortified.
So what’s the real difference with white bread vs wheat bread?
These days, the vast majority of breads you’ll find in the grocery store are enriched with some of the vitamins and minerals removed through processing. What you’re missing out on, however, is the healthy fat, protein, and fiber that are taken out but not added back in.
The bioavailability is also lower for fortified items, meaning we may not be absorbing as much as we would from the original form. Most grains in the US, for example, use elemental iron powders to add in iron, which have a 65% rate of absorption compared to other forms.
Unfortunately, making the leap from white to wheat isn’t as straightforward as it should be.
While it may seem as simple as grabbing the bread labeled “wheat” at the store, that isn’t always the case. Making the switch does require a bit of savvy shopping.
Interestingly enough, many of the breads labeled “wheat” aren’t actually whole wheat, meaning they’re pretty much just white bread with a splash of caramel coloring and they don’t pack the same nutritional punch as their whole grain counterparts. This allows manufacturers to keep costs low and prey on the well-meaning health conscious consumer in order to inflate profits.
When you see products advertising that they are made with whole grains or labeled as “multigrain,” “honey wheat,” or “wheat bread,” that’s your cue to do a double take.
Check the ingredients label and make sure the first ingredient is a whole grain, such as whole wheat or 100% rolled oats. Since ingredients are arranged in order of quantity, this is your best bet for making sure you’re getting the real deal.
White Bread vs Wheat Bread: 3 Reasons Whole Wheat Wins.
We’ve covered which nutrients are lost during processing, but let’s break it down even further. Here are some of the big benefits that whole grains have over refined grains and how they can pay off in the long-run when it comes to your health:
#1. White Bread vs Wheat Bread: Wheat Bread is Higher in Fiber
Fiber is essential for many aspects of health, and unfortunately most of us don’t get enough of it. Even more unfortunate is that most of the fiber found in bran of the kernel is lost during the milling process.
Fiber moves slowly through the body undigested and can help promote satiety and, in turn, weight loss. For this reason, whole grains are recognized as a key component of any weight loss regimen. Science seems to agree; Albertson et al. even discovered an inverse relationship between consumption of whole grains and body mass index as well as waist circumference.
A study in the Journal of Nutrition added another point for whole grains in the white bread vs wheat bread debate. After a two-week dietary intervention where participants were separated into whole-grain wheat or refined wheat groups, they found that those consuming whole grains lost significantly more body fat than those eating refined wheat.
#2: White Bread vs Wheat Bread: Wheat Bread Helps Maintain a Healthy Heart
The unsaturated fats and insoluble fiber that come with whole grains can help keep the heart in tip-top shape. A systematic review published in the British Medical Journal reported that approximately seven servings of whole grains per day can add up to a significantly lower risk of cardiovascular disease, however “there was little evidence of an association with refined grains, white rice, total rice, or total grains.”
Other research has yielded similar findings. A prospective study in the American Journal of Clinical Nutrition found that intake of whole grains led to a decreased risk of myocardial infarction. A meta-analysis by Zong et al. also noted that cardiovascular mortality was cut with just 50 grams of whole grains per day and each additional serving reduced the risk even more.
#3: White Bread vs Wheat Bread: Wheat Bread Gives You Greater Glycemic Control
The glycemic index is a measurement of how fast carbohydrates are broken down into glucose in the bloodstream. Foods with a lower glycemic index are converted more slowly in the body and can keep blood glucose steady while preventing sugar spikes.
White bread clocks in with a glycemic index of 71, the same as the average “wheat bread.” 100% whole grain bread, on the other hand, comes in significantly lower with a glycemic index of 51.
Research has found some pretty substantial effects on the relationship between whole grains and diabetes. The same review by Aune et al. noting the cardiovascular benefits of whole grains also found that 210-225 grams a day considerably cut the risk of mortality from diabetes.
A review by Maki et al. recommended whole grains as a healthy breakfast component and noted that rapidly-digested carbohydrates were associated with an increased risk of type 2 diabetes.
A study by Jensen et al. even found that whole grain intake was linked with improved markers of glycemic control!
White Bread vs Wheat Bread: What’s the Consensus?
Like most things in life, moderation is key. Whole grains may be the healthier choice, but until they make whole-wheat pastries, pizzas, and donuts that taste just as good as the real thing, it might not be realistic to expect complete removal of refined grains from the diet.
To make things simple, opt for whole grains when possible. It might take some adjusting, but after a while you’ll find yourself instinctively reaching for the whole grains at the grocery store.
Ease into it by mixing some whole wheat pasta with your favorite white pasta. Use it as a chance to experiment with new grains, like quinoa, barley, and buckwheat. Most importantly, don’t beat yourself up for still savoring that occasional slice of white bread.
The most recent US Dietary Guidelines recommend making at least half your grains whole grains. This seems like a pretty good compromise, allowing us, literally, to have our (refined grain) cake and eat it too!
Where do you stand on the white bread vs wheat bread debate? Have you made a clean switch over to whole grains or are there certain foods made with refined grains that you just can’t give up? Share it in the comments!
- Melkonian SC et al., Glycemic Index, Glycemic Load, and Lung Cancer Risk in Non-Hispanic Whites. Cancer Epidemiol Biomarkers Prev. 2016 Mar;25(3):532-9.
- Albertson AM, Reicks M, Joshi N, Gugger CK. Whole grain consumption trends and associations with body weight measures in the United States: results from the cross sectional National Health and Nutrition Examination Survey 2001-2012. Nutr J. 2016;15:8.
- Kristensen M, Toubro S, Jensen MG, et al. Whole grain compared with refined wheat decreases the percentage of body fat following a 12-week, energy-restricted dietary intervention in postmenopausal women. J Nutr. 2012;142(4):710-6.
- Aune D, Keum N, Giovannucci E, et al. Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ. 2016;353:i2716.
- Helnæs A, Kyrø C, Andersen I, et al. Intake of whole grains is associated with lower risk of myocardial infarction: the Danish Diet, Cancer and Health Cohort. Am J Clin Nutr. 2016;103(4):999-1007.
- Zong G, Gao A, Hu FB, Sun Q. Whole Grain Intake and Mortality From All Causes, Cardiovascular Disease, and Cancer: A Meta-Analysis of Prospective Cohort Studies. Circulation. 2016;133(24):2370-80.
- Maki KC, Phillips-eakley AK, Smith KN. The Effects of Breakfast Consumption and Composition on Metabolic Wellness with a Focus on Carbohydrate Metabolism. Adv Nutr. 2016;7(3):613S-21S.
- Jensen MK, Koh-banerjee P, Franz M, Sampson L, Grønbaek M, Rimm EB. Whole grains, bran, and germ in relation to homocysteine and markers of glycemic control, lipids, and inflammation 1. Am J Clin Nutr. 2006;83(2):275-83.