Whole-Grain Bread Instead of White: What Studies Show

Key points

You do not need to cut bread out: it is enough to swap white for whole grain. In human trials, whole grains instead of refined flour raised energy expenditure by 92 kcal a day, and over 8 weeks weight and inflammation markers were lower. In large observational studies, three servings of whole grain a day are linked to a 19% reduction in the risk of coronary heart disease (7 cohorts, 316,491 people).

How to use it

Change one thing, not the whole diet: a breakfast sandwich on whole-grain bread instead of white. Three servings a day, as counted in the review, are, for example, two slices of whole-grain bread and a bowl of porridge from whole grain. Start with one swap and add the second a week later.

Read the ingredients: the first item should be whole-grain flour or whole grain. Dark colour alone promises nothing; it can come from colouring or malt.

You will get more fibre, so add it gradually and drink water: otherwise bloating is possible in the first days.

A real-life example

A woman of 52 eats two slices of white bread with cheese every morning. She keeps the sandwich but takes whole-grain bread. The food is the same size and familiar, and the share of whole grain in her day rises.

What the studies showed

In a controlled trial, 81 people aged 40 to 65 were kept for 6 weeks on a stable-weight diet: some received about 207 g of whole grain a day and 40 g of fibre, others refined grain and 21 g of fibre. On whole grain, resting metabolic rate was 43 kcal a day higher and 57 kcal more left in stool. The overall total across all components was 92 kcal a day (95% CI 28 to 156) (Karl J Am J Clin Nutr 2017. PMID 28179223^[1]).

In another trial, 50 adults at risk of metabolic syndrome ate a whole-grain diet (about 179 g a day) and a refined one (about 13 g) for 8 weeks each. On whole grain, body weight was lower, as were the inflammation markers IL-6 and C-reactive protein. Glucose control and gut bacteria did not change significantly (Roager H Gut 2019. PMID 29097438^[2]).

In a review of prospective studies, every 90 g of whole grain a day, about three servings, was linked to a 19% reduction in the risk of coronary heart disease (RR 0.81; 95% CI 0.75 to 0.87; 7 cohorts, 316,491 people). This is an association, not proof of cause (Aune D BMJ 2016. PMID 27301975^[3]).

In people without celiac disease, gluten was not linked to the risk of coronary heart disease: in 64,714 women and 45,303 men over 26 years, the highest fifth of gluten intake did not differ in coronary heart disease risk (HR 0.95; 95% CI 0.88 to 1.02). Avoiding gluten can reduce the share of whole grains in the diet (Lebwohl B BMJ 2017. PMID 28465308^[4]).

Who should see a doctor first

If you have celiac disease, gluten intolerance or wheat allergy, whole-wheat bread is not for you: discuss alternatives with your doctor. If you are on a diet for bowel or kidney disease, or have diabetes, agree the move to whole grain with your doctor and do not change prescribed treatment on your own. If you measure your glucose: see a doctor if the result is repeatedly below 3.0 mmol/L (54 mg/dL) or above 8.9 mmol/L (160 mg/dL); with diabetes targets are individual, and below 3.0 mmol/L (54 mg/dL) always means a doctor. See a doctor also for persistent bloating, abdominal pain or weight loss without a reason.

Bottom line

Do not drop bread, choose whole grain: the share of whole grain rises, the body spends a little more energy, and in observational data this is linked to a 19% reduction in the risk of coronary heart disease (7 cohorts, 316,491 people).