Bread has been a part of the human diet for thousands of years. However, over the past few decades, the sandwich canvas has been associated with negative health outcomes such as weight gain, obesity, type 2 diabetes, inflammation and other disorders. In reality, some bread can be a healthy addition to a well-balanced diet; but not all bread is created equal. So what is the healthiest bread to eat?

While the quantity of varieties on the shelves can make shopping for bread overwhelming, looking for a few key signs on the packaging, the ingredients list and the nutrition facts panel can lead you to a delicious and nutrient-dense choice. In general, both the type of flour used and the way it’s processed are what determines if a bread is healthy or not. Your best bet: flours from nutrient-dense sources like sprouted whole grains that are processed through fermentation or with minimal ingredients; these are packed with essential vitamins and minerals, antioxidants and other plant compounds that can decrease inflammation and help control blood glucose levels.

How is bread made?

There are hundreds of ways to make bread. Most dough, regardless of bread type, consists of flour and water kneaded together and fermented either with a naturally occurring yeast and bacteria or with baker’s yeast. 

Mixing flour and water together forms a dough of proteins, starches and water molecules. When water is added, the proteins present in flour, gluten and gliadin, bond together to form a web of gluten threads that form a sort of mesh. At the same time, the yeast converts the starches in the flour into sugars, which in turn create carbon dioxide and ethanol, causing pockets of air bubbles to form in the dough. When the dough is heated, the gluten mesh traps the gas produced from the yeast and solidifies, giving bread its texture and structure.

In large-scale production, chemicals and additives such as gums, ascorbic acid (vitamin C) and malted barley are added to improve texture, enhance flavor and prolong shelf-life stability. 

How many carbs are in bread?

Carbohydrates in bread are a combination of starch, fiber and sugar. The type of carbohydrate matters. The average slice of bread has 12-20 grams (g) of carbohydrates. Most breads have <1 to 5g of sugar per slice; a small amount of sugar is needed for the baking process. Summing up the most important points about the carb content:

• Some breads have more sugars and starches, which are the breads to avoid.
  
  
• The breads that are high in fiber are the best breads to choose. 

How to choose the healthiest bread

Bread options pop up in the bakery, the middle aisles and in the frozen section of the market. The most important features you should find in your bread are:

Packaging 

• Organic bread is always a good choice, if available.
  
  
• Multi-grain, granary, 100% wheat, organic — are words that don’t mean the bread is made from whole grains. The front of the package can be deceiving; so take a look at the ingredients list. 

Ingredients Label

• What is the base flour made from? Sprouted grains or whole grains (such as wheat or other grains like rye, oats, barley, spelt, millet) should be the first ingredient you see listed. Different flours have different levels of digestibility based on their protein and starch content. Whole grains are nutrient-rich and, when eaten regularly, may protect against chronic diseases including type 2 diabetes, heart disease, stroke and certain cancers. Whole grains offer two times the amount of zinc and fiber than a white bread.
  
  
• Number of ingredients: the length of the list can often reveal how many additives and the type of processing in which the bread was made.
  
  
• Additives: some breads add flax seeds, a good source of omega-3 fatty acids and fiber.
  
  
• Other ingredients you often find in the healthiest breads:
• triticale
• flaxseeds
• apple cider vinegar
• olive oil
• garlic
• honey, molasses
• herbs, such as rosemary and thyme
• sea salt 

Nutrition Panel

• Calories: 110 calories or less per slice (70-90 calories is the best target)
• Fiber: 4g or more per slice
• Sugar: 2g or less per slice

What bread should you avoid

Color and texture

• A quick look provides immediate clues that indicate if the bread is highly processed. Start your search for the darker and more textured breads.
  
  
• Stay away from white bread, bread with consistent coloring, bread with a smooth and uniform texture.

Packaging

• “Made with” means that it probably isn’t 100%.
  
  
• Anything with “enriched,” “bleached” or “unbleached” as part of the first ingredient. “Enriched wheat” essentially means “white flour.” Be wary of “wheat” or even “100% whole wheat” — some breads will have this as an ingredient but aren’t truly made with whole-grain flour, and are still highly processed and refined.

Ingredients Label

• Long lists: bread can be made from just three ingredients.
  
  
• “Refined,” “bleached,” “all-purpose” and other white flours are empty calories. The nutrient-dense bran and germ have been removed, resulting in a flour containing mostly starch. While often enriched with nutrients, they’re not as high in fiber or nutritive value as sprouted or whole grain counterparts. 
  
  
• Wheat flour: this is different from whole wheat flour. Wheat flour is still refined and less nutrient-dense.  

Additives

• Added sugars: yeast needs a bit of sugar to become activated, so a little is okay. Anything over 2g per slice is too much. 
  
  
• No high-fructose corn syrup.
  
  
• Avoid flavored breads like cinnamon, banana, honey, or vanilla; they often contain added sugars and shelf-stabilizers.
  
  
• No ingredients you can’t pronounce: bread only needs three ingredients, so if you need to Google it, it’s likely a shelf-stabilizer. 
  
  
• No oils such as vegetable, canola, soybean or palm; those oils are high in omega-6 fats and consuming too much of them has been linked to inflammation, heart disease and chronic illness. 
  
  
• Stay clear of artificial flavors and coloring: caramel coloring is often added to breads labeled as “wheat” to make them look healthier.

Nutrition Panel

• Fiber: no less than 2g of fiber per slice
• Sugar: no more than 2g per slice

The top 6 healthiest breads to eat

1. Sprouted Grain Bread is the healthiest choice because sprouting increases the bioavailability of the bread’s nutrients and makes it easier to digest. Sprouting, done before the flour is made, involves soaking the grains (or whatever base is used to make the flour) in water and allowing small sprouts to grow. This process breaks down the proteins and starches into smaller molecules, meaning the bread is lower in gluten and carbohydrates so it has a lower impact on blood glucose levels. Sprouted bread can be a good source of protein: one slice can have 5g. Studies have shown that sprouting can also increase the concentration of fiber, which is beneficial to our gut health, blood glucose levels, and helps regulate bowel movements. 
   
   Ezekiel Bread is a type of sprouted bread that is made from a mix of sprouted whole grains, legumes, lentils and more. It is lower in phytic acid, which is a toxin that binds to nutrients and makes them difficult to absorb. Ezekiel bread includes higher amounts of fiber, protein (it’s a source of essential amino acids and is considered a complete protein) and contains higher levels of nutrients such as iron, folate, riboflavin, B3 and thiamine than even whole-grain varieties. 
   
   One disadvantage of sprouted breads is that they mold more quickly, so you’ll often find this bread in the frozen or refrigerated section. If not consumed within a few days of purchasing, storing it in cold conditions will keep it fresh. 

2. Sourdough is another healthy option because of its fermentation process. Sourdough is famous for needing a “starter,” which is an alternative to baker’s yeast that makes bread rise naturally and gives the bread its tangy, sourdough flavor. As the fermentation process takes place, nutrients become more bioavailable because, similar to sprouting, fermentation begins to break down the gluten proteins. Sourdough is also high in polyphenols, the fiber and plant compounds that benefit gut microbes. While more research is needed on the benefits of sourdough, initial studies are promising. 
   
   
3. Pumpernickel bread is a traditional German bread that has a dark chestnut color, dense texture and strong flavor. It’s usually made from a sourdough starter mixed with a coarse, wholegrain rye flour (meaning it’s packed with nutrients from the entire wheat kernel) baked slowly at a low temperature. Pumpernickel is bursting with nutrients (like manganese, selenium, phosphorus, B vitamins and copper) plus fiber (resistant starches that lower the glycemic effect and support gut health) and lignans (plant compounds that act as antioxidants in the body and have been shown to reduce the risk of heart disease, osteoporosis and protect against certain types of cancers). Be careful of added ingredients (often to “color” the bread) like molasses, caramel, coffee or cocoa powder.
   
   
4. Rye bread is a denser, heavier bread similar to pumpernickel because it’s lower in fat and gluten than wheat and other flours. Studies have shown that 100% rye breads have a lower impact on blood glucose levels than wheat breads because of the high amount of soluble fiber and lignan content. Rye berries have also been shown to contain compounds that fight against inflammation, diabetes, cardiovascular disease, weight gain and high blood pressure. Rye also contains high levels of phosphorus, zinc, magnesium, iron, vitamin B6, niacin and potassium. 
   
   
5. Flax bread is made from whole-grain flours and flax seeds. It’s one of the healthiest breads to eat because flax seeds are nutrient-dense and have been linked to a number of health benefits such as lowering cholesterol, reducing inflammation, protecting against artery plaque formation and controlling blood glucose levels in people with type 2 diabetes. Flax seeds are also a great source of alpha-linolenic acid (ALA), an omega-3 fatty acid found in plant food, and contain high amounts of lignans. One study showed that adding flax seeds to dough increased the bread’s antioxidant properties compared to loaves made with only wheat flour. 
   
   
6. Homemade bread can take more than six hours to make from start to finish — and even longer if you grind your own flour. Although it’s time consuming and exhaustive, choosing every ingredient and eating fresh homemade food will always result in fewer additives and unnecessary ingredients than foods from the grocery store. Homemade bread is typically much denser than bread from the market and often has a stronger, more yeasty flavor. 

NOTE: The healthiest versions of the breads on this list are those made with 100% whole grains.

Is gluten-free bread healthy?

According to the Cleveland Clinic, about 6% of the U.S. population is gluten intolerant, which can make those individuals feel bloated, gassy or tired after consuming gluten, a protein found in many foods, especially wheat. (Gluten intolerance is also called non-celiac gluten sensitivity.) So these individuals often seek out gluten-free breads. 

Problem is, gluten-free breads are often laden with added sugars, stabilizers and other chemicals that attempt to create a similar product to a wheat-based bread. Recall that the proteins in wheat form gluten which is what keeps starchy foods bonded together to prevent it from becoming too crumbly. Gluten-free flours produce flat breads unless a thickening agent is added to replace gluten’s role of trapping air bubbles in the dough. Common additives include xanthan gum, psyllium husk, cornstarch, agar agar or emulsifiers. 

Healthy gluten-free breads will be vastly different from their wheat counterparts because the gluten is what gives bread its consistency and texture. Following the same guidelines as glutinous bread, gluten-free breads can be a healthy option — although they will not provide the same nutrition benefits as a sprouted or whole grain cousin. 

The healthiest sprouted grain or flax bread brands

• Food for Life Ezekiel 4:9 Sprouted Grain Bread – all varieties except not their Cinnamon Raisin bread.
• Manna Organics – Sunseed, Multigrain, Millet Rice, or Whole Rye Bread.
• Alvarado St. Bakery – all varieties except not their Cinnamon Raisin bread.
• Silver Hills Sprouted Bakery – all varieties; the thin sliced Little Big Bread is the lowest calorie option. 
• Dave’s Killer Breads – any of the sprouted varieties that have less than 2g of sugar per slice.
• Trader Joe’s Sprouted Breads – any of their sprouted whole grain breads except not their Cinnamon Raisin bread.
• Angelic Bakehouse Breads and Wraps – all their breads and wraps are made with sprouted whole grains.
• Healthy Joy Bakes Omega Power Bread – two slices of this bread have a total of 18g protein and 8g fiber. The Omega Power Bread  is made with flaxseeds.

Key takeaways

Bread can be the best part of your meal, and you may not need to worry about spiking your blood sugar levels or destroying your caloric balance if you choose the healthiest ones. So, what is the healthiest bread to eat? Avoid white or processed breads because they are processed (and thus stripped of nutrients), don't provide satiety and contain chemicals and additives. The best breads to consume are made from whole and sprouted or fermented grains because these processes increase the nutrient bioavailability and offer additional benefits from compounds such as lignans. When shopping for bread, start with the darker, more textured loaves. Look for whole grain, sprouted, flax seed or a fermented variety. Opt for a bread with as short an ingredient list as possible, and with only ingredients you recognize. Find breads that offer high amounts of fiber and no or very low added sugars. And when you do eat bread, try to include some protein and fats in the meal so you can stay satiated and maintain a stable blood glucose level. Most importantly, enjoy it.