Hi guys!!! New question of the week for you… but first a “set up” story:
I was at my Mother in Law’s house today and she says to me… “the doctor told me I was pre-diabetic. He said my sugar level was 7 something. Is that bad?” to which I’m now thinking… Oh Lord, please help me! So I said “If he means your A1C, then yeah, that’s a high. They like it to be 6.0-6.5 normally.” So I’m thinking back to what an A1C of 7 “something” puts her average at, and I’m guessing it’s between 130-170 (guessing). So Gloria takes me out into the kitchen and she tells me they told her to cut out gluten. Now, I’m not the sharpest tool in the shed, but I’m guessing they meant carbs or glucose or something, but not gluten. She doesn’t have any kind of celiac or anything like that, I think she just got confused. So we are looking at the two kinds of bread she has. Regular everyday white Wonder bread style white bread, and a gorgeous loaf of 12 grain organic bread.
Here’s my question…
The super processed, gonna spike you for looking at it, white bread has 11 grams of carbs per slice.
The 12 grain, I’m so pretty please eat me bread has 22 grams of carbs per slice.
So, which is actually better in terms of the spike? Yes the white will spike almost immediately, but it only has 11 grams of carbs, vs. the 22 grams in the 12 grain. So is this a perfect example of quality of carb vs. quantity? It seems to me, the white would be better because of the lower total. Both loaves had only 1 gram of fiber. I realize the 12 grain would take LONGER to digest because of the quality, but I’m looking at the final number. Which would actually but my sugar up higher?
If you guys can explain this to me, I’d be REALLY grateful. Also- if you can explain why, that would help too. I’m hoping to apply the same concept to other foods as well, like regular pasta vs. whole wheat pasta, etc. Thanks!!!
It’s all a matter of portion size. You can bring the 12-grain bread down to the carb count of the Wonder bread by halving the portion size (which is probably correct anyway, as most whole-grain breads come out as 2-ounce slices rather than 1-ounce slices).
Also, some whole-grain breads are given extra sweetener to help the dough rise, so that could be an issue.
Finally: there is a school of therapy that believes that many of society’s ills are due to the consumption of wheat (in any or all forms); it is possible that your MiL’s doctor is of that group. Bread products are also one of the classes of food that gets first kick out the door in many low-carb diets. And bread, because it’s a complex carbohydrate, will often cause a longer curve in glycemic response, with greater area under the curve – in other words, it may elevate her blood glucose for a longer period of time than the same amount of carbs in fruit…
I should also ask, in re what other posters have mentioned, was this info coming from your MiL’s PCP? Many PCPs are woefully underinformed and out of date when it comes to diagnosing and treating glucose metabolism disorders
Well, according to diagnosis criteria, anytime we exceed an A1C of 6%, we are officially Diabetic, not pre-Diabetic. She’s at 7%… She’s already Diabetic.
If they both have the same amount of fiber (which fiber is the factor that gives fullness, and stability to blood sugars), then I would say the white bread is better. She should limit herself to one slice a serving, though, until she gets a better bread, like for example: Sara Lee’s 45 Calories & Delightful has only 9 carbs per slice, and Village Hearth Light has only 8 grams per slice, and they both have fiber… There are some others which are lower in carbs, but my local supermarkets are no longer carrying them.
Like Tom said, she’ll need to test with her glucose meter, cus we all react so very differently to bread, and various different carbs.
Thanks guys! Yes, the information came from her PCP. I was surprised when she said “pre diabetic” with an a1c of 7 something. I think doctors do a disservice to us when they say “pre diabetic”. It’s like saying someone is pre-pregnant… either you are or your aren’t. Just goes to show how important “re-education” is for our doctors.
In any event, thanks for the insight on the bread question. I think it may call for an experiment at some point, but my numbers are looking better and I don’t want to mess around “trying things out”. Thanks again guys!
Sounds like it might be a good idea to introduce your MiL to some of our diabetes networks; many have special areas for “pre-diabetes”.
When dealing with Type 2 diabetes, which is a progressive condition, one might consider “prediabetes” in the same realm as “prehypertension”: it needs watching and more careful monitoring and lifestyle adjustment (diet and exercise); there are conflicting schools of thought regarding when pharmaceutical therapy should be initiated.
I use the SaraLee 45 calorie and delightful brand when it comes to bread. I think the lowest carb amount that they have is something around 10 grams of carbs for 2 slices, after you subtract the fiber out. I absolutely think that this is super tasty, no clue that it is “diet” food.
I agree, I guess it’s less of a shock for some… but she needs a glucometer and she needs to be monitoring her levels while she figures out what she can and can’t get away with eating.
As far as the bread, I’d go for one slice of the 12 grain cut in half 
Then I’d be looking for bread with MUCH more fiber when I went to the store next time! Some of the “light” breads have loads of fiber and reasonable carb counts.
Hey Devon-
I think you have your hands full with explanations as it is without trying to explain this!
But here’s my 2 cents
Essentially you and the other posters got it all right…it comes down (in theory) to high glycemic vs. low glycemic foods- complex vs. simple carbs.
High glycemic foods tend to give the spike faster…because as you said they digest faster.
(There is some new debate whether there is really such a thing as a “fast acting carb”…I’m guessing the debate is amongst non-diabetic researchers!)
the lower glycemic, or more complex carb may still give you a high BG if (eaten in outside an appropriate portion)- but you’ll get there slower…again…in theory. EveryBODY is different.
The only way to truly know is to eat it and test (does she have a meter yet?)
Even though the prevailing wisdom is that our bodies don’t know /don’t care what or where the carb came from …(sugar is sugar is sugar right?). My experience is that it crap! My body DOES care what the carb is…the more complex the better (for me). I could never eat either of those bread choices in any real amount. The only bread I have found that I can eat is Ezekiel -flourless-found in the freezer or fridge section of most grocery stores. Flourless, 3 g fiber and 15g carbs. For those days when I MUST have a sandwich… It’s been a Godsend for me. Your MiL is so lucky to have you to help her thru this scary/confusing/overwhelming time. You are her angel!