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Weight Loss and White Bread - Who is Afraid of a Ham and Cheese Sandwich?

By Richard Lipman M.D.  

Everyday we are all faced with claims that white bread will make you fat, whole wheat will decrease your cholesterol and whole grain breads will prevent heart disease and prolong your life. The problem is that NONE of this is true. There are no significant differences in micronutrients between the three breads. Whole grain breads, as opposed to other whole grain products do not prevent heart disease or cancer nor is there any evidence that eating whole wheat or whole grain breads increase or decrease weight loss.

Lose weight and eat sandwiches for lunch and toast and eggs for breakfast, even white bread? Bread causes no more weight gain than any other food with similar calories, carbs, protein and fat. The low carb craze is over!

Fearing the breads, most dieters will avoid the old fashion ham and cheese sandwich and pick low carb, but high calorie fried chicken or grilled meat with vegetables dripping in cheese and butter.

How did the low carb craze become so crazy that we are all afraid to eat a ham and cheese sandwich for lunch?

White bread, whole wheat or whole grain are nutritionally very equal. There are no proven advantages of eating whole grain bread, over whole wheat or even white bread in terms of weight loss, long term weight maintenance, cancer, heart disease or strokes. (Care must be taken in the use of terms: the issue is only about a slice or two of bread, not all of the whole grains! )

The confusion between whole grain bread and the other whole grain products: All of the studies documenting health advantages for eating whole grain products are based on eating three or more servings of whole grain products during a "normal" day. However this does not apply to whole wheat or whole grain breads. Whether its the physical size of the whole grain products that retard digestion and absorption, or some other property, what applies to whole grain products like brown rice, whole grain cereals, bran products does not apply to whole grain breads.

There is NO significant difference in calories, carbs, protein, cholesterol, fat or even fiber between these three types of bread. No weight loss advantages are present in whole grain breads. There is nothing to fear from even white bread How did all of the confusion come about?

  • Is it Madison Ave selling new products that perpetuates the bread myths?

  • What is the real difference between the three breads?

  • Is there really a difference if you are trying to lose weight?

  • Does whole wheat or whole grain bread protect your heart?

  • Will eating bread make you gain weight?

To answer these questions you need to know the differences between the flours that make the bread and the evidence that eating one has advantages over another.

Flour is the product obtained by grinding wheat kernels or "berries." The kernel consists of three distinct parts: bran, the outer covering of the grain; germ, the embryo contained inside the kernel; and endosperm, the part of the kernel that makes white flour. During milling, the three parts are separated and recombined to achieve different types of flours. Whole grain is composed of the entire kernel - the bran, germ and endosperm. White is milled from only the endosperm and whole wheat bread or "brown bread" is is a combination of the two.

What is white bread? The endosperm is separated from the rest of the ground grain. This inner starchy layer has much less vitamins, minerals and nutrients. After separation it is bleached white, and then the vitamins and minerals that were removed are added back to the flour making it "enriched." Not all of the nutrients are added back only the 3 B vitamins and folic acid. This refinement process gives it a smoother feel and longer shelf life.

What is "whole grain? Whole grain consists of the endosperm, brand and germ in about the same proportions as in the intact grain. There is no bleaching or refining. The Whole Grains Council developed a visual maker to signal products that contain significant amounts of whole grain. Every product that bears the stamp must have at least 8 grams of whole grain per serving. The FDA requires that whole grain foods must have the words "whole grain" listed as the number one or two position in the list of ingredients. The bran's and germs have all of the nutritious elements.

What is Whole Wheat? Whole wheat products have mixtures of refined white flour and whole gain flour,with added niacin, iron and other vitamins and minerals. It's done to make people think they are getting whole grain bread. It is all wheat, but not all whole grain. Molasses is added to give it the brown look. Refined white flour with brown coloring and extra vitamins and minerals is still not whole grain.Often there is a blending of 70% refined white flour and 30% whole grains. Example of this is Sara Lee and Wonder bread new whole wheat white breads.

Very Little nutritional difference in white, whole wheat and whole grain breads: Here is the surprise: The claims that there are "vast differences" in fiber, and protein does not bear out. Below is the average composition based on the US Department of Agriculture data: Bread Product (1 oz.)

White Bread 67 calories, 0.8 fat grams, 12 carbs, 1.1 sugar, 1.9 protein, 0.6 fiber whole wheat bread 65 calories, 1.0 fat grams, 11.8 carbs, 1.4 sugar, 2.3 protein, 1.2 fiber whole grain bread 67 calories, 1.0 fat grams, 13.0 carbs, 1.5 sugar, 2.4 protein, 1.4 fiber

Reviewing this data and even comparing the breads made by different manufactures, I find few differences other than a little more fiber. Certainly, it's "not vast amounts." Other studies report averages of 1 gram of fiber in white bread, and 2 grams of fiber in whole wheat. The mineral and vitamin content of whole grain and enriched white bread is almost identical because some of the missing nutrients are added back to the white bread after refining. Note the calories in these selections are a little high. There are many white, whole wheat and whole grain breads that are 40-45 calories per slice.

Does a 1 or 2 grams of fiber ) make any difference in the real world? Clearly NO Do Americans on "normal" diets have deficiencies in minerals and vitamins so that these minimal differences in a slice of bread make a difference? All of the recent data on vitamin and mineral research say, NO. Unless a person is pregnant,or an alcoholic, on some very unusual diet, or has an underlying gastrointestinal disease our normal foods have adequate amounts of minerals and vitamins. Extra vitamins and minerals are not needed from a vitamin pill and certainly not from a slice of two of bread which supply so little compared to our requirements. If it's not the vitamins, minerals, carbs, protein, fiber or fat, maybe its the glycemic index that is different among the breads?

The Glycemic index (GI) is a measure of the effects of carbohydrates on blood sugar. Carbohydrates that break down rapidly during digestion releasing glucose rapidly into the bloodstream have a high GI; carbohydrates that break down slowly, releasing glucose gradually into the bloodstream, have a low GI. For most people, foods with a low GI have significant health benefits. The concept was developed by Dr. David J. Jenkins and colleagues in 1980-1981 at the University of Toronto in their research to find out which foods were best for people with diabetes. A lower glycemic index suggests slower rates of digestion and absorption of the foods' carbohydrates and less effect on insulin and the conversion of carbs to fat. For example chocolate cake has a glycemic index of 80-100, candy 80 plus, vegetables less than 20.

The glycemic index of refined white bread and whole grain breads are almost the same:

Bread products: Gglycemic Index white bread 70 whole wheat bread 60-70 Whole grain bread 59-67

It looks like that white, whole wheat and whole grain breads are about the same. Is that true? There is very little differences between a slice or two of white, whole wheat or whole grain bread in terms of calories, protein, carbs, fiber, vitamins, minerals and glycemic index. Whether a turkey sandwich with lettuce and tomato is made with white bread, whole wheat or whole grain should not be much of an issue for the dieter. There are far more important issues to be concerned about.

At 45 calories a slice, and 10 carbs(there ary many with only 5-6 carbs), minimal sugar, breads make good foods to lose weight. It permits the dieter to eat sandwiches which are low in calories, have easy portion control and come with good side dishes. More about sandwiches in part 2 of this series.

Richard L. Lipman M.D., a board certified internist and endocrinologist has been treating weight and metabolic problems for 25 years [at the time of this article] in his Miami office. His book, The 100 Calorie Secret, describes how thousands of his patients lost weight and kept it off. Learn more weight loss and tips from a doctor who actually takes care of metabolic problems and obesity problems at [http://www.the100caloriesecret.com].

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