What do I need to know about buying the best bread?

99% of my patients eat bread almost daily, which itself is not surprising, since we live in a westernized area with a very low percentage of Asians. Yet no one I've asked understands the facts about their bread.  It is a complicated problem.  This article is an attempt to educate all of us, including myself.

What is the definition of "Whole grains"?  This depends on who you ask.  I'll go with the U.S.D.A.'s definition in the "Dietary Guidelines for Americans 2010" listed in the Appendix page 36: "Grains and grain products made from the entire grain seed, usually called the kernel, which consists of the bran, germ, and endosperm. If the kernel has been cracked, crushed, or flaked, it must retain nearly the same relative proportions of bran, germ, and endosperm as the original grain in order to be called whole grain (here's a picture)."  For a short list of whole grains, I refer you to Table A4-3 on page 16 (and here in 2006 page 20).  For longer lists, I refer you to a list from the state of Idaho and Wikipedia.  In a 2006 U.S.D.A. report, they concluded that the average American should increase their consumption of whole grains by 248% (page 19) to fulfill the Dietary Guidelines.  The percentage of wheat in the product is not legally defined. 

I find the labeling confusing for all the types of whole grain wheat products.  The U.S.D.A does not have a definition for "multigrain".  This term has no formal definition anywhere that I can find.  Here's a commentary which lists other terms that are undefined as misleading, such as stone ground and 100% whole wheat.   Do not get up-sold by the words natural, light, healthy, stone ground or good in the label. On a positive note, groats "are the hulled grain of various cereals, such as oats and wheat." Think of cereals are the plants that produce the grains.  Which grain is the best to eat?  There is no consensus.  In an equally-sized serving, the number of calories, vitamins and minerals, plus other healthy nutrients varies widely.  Here's one person attempt at rating grains.

It is important to study the label for the ingredients, fiber content, sodium content, and serving size.  You can mislead yourself easily by making erroneous assumptions.  For example, check if the serving size is 1 or 2 slices of bread.  What you should know is that your bread is made from whole grains from whatever grain you like to eat.

Of all the grains, The Allergy Dude favors rice and oats.  I'll explain why in a future installment.