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Cholesterol is an essential lipid produced by the liver. It has many functions, including hormone production and maintaining cell membrane function. Despite its bad press, cholesterol has many benefits.
Since cholesterol is fat, it can’t travel through the bloodstream on its own (think of oil and water). Therefore, it is carried through the body by molecules called lipoproteins. There are various forms, but the two important types to be aware of are high-density lipoproteins (HDL) and low-density lipoproteins (LDL).
HDL is considered the ‘good’ form because it takes cholesterol out of the blood and into the liver. LDL is considered the ‘bad’ form because it moves cholesterol from the liver and into the bloodstream. Also, high levels of LDL accumulate inside the walls of the arteries, causing them to become narrow and stiff, a condition called atherosclerosis.
This can cause damage to the blood vessels and create roadblocks to blood flow, leading to cardiovascular problems, heart attack, and stroke.
Bread is an important source of carbohydrates. This macronutrient is broken down by the body to produce glucose, our primary energy source. Insulin is a hormone that allows the glucose in the bloodstream to enter the cells in your body, where it will be utilized for energy. When there is excess glucose, insulin helps store it in the liver as glycogen. In moderation, bread is a healthy part of our diet.
However, consuming too much can result in high glucose levels, which can progressively lead to excess secretion of insulin. Eventually, the cell receptors become resistant to insulin.
This is medically known as insulin resistance, the main mechanism behind type 2 diabetes, leading to high levels of glucose accumulating in the bloodstream.
What is lesser known is that insulin is a primary player in fat metabolism, ensuring normal levels of free fatty acids in the blood. It does this by inhibiting the breakdown of fats in the tissues and stimulating fat uptake from the blood by the cells.
However, this changes in people with insulin resistance. As a consequence of the body cells not responding to the circulating insulin, more LDL cholesterol and triglycerides are released in the bloodstream, while HDL cholesterol levels are reduced.
Yes! You can still eat bread, but some types of bread are a lot healthier for you to eat if you have high cholesterol levels.
Most bread products are primarily made of wheat flour. They are tiny grains that have husks that have significant nutritional value.
If producers include the husk, it is considered wholemeal/wholewheat/wholegrain bread. If producers do not include the husk, it is white bread. Generally, bread that contains whole grains is better for you due to its higher fiber content.
Whole grains contain complex forms of carbohydrates which take longer to digest. Because they are processed over a longer period, the glucose spike tends to be more stable. Additionally, its soluble fiber content can reduce the absorption of cholesterol into the bloodstream and reduce the serum total cholesterol and LDL levels.
A systematic review¹ of many studies has concluded that there is a positive relationship between whole-grain consumption and lower levels of LDL and total cholesterol, with no significant impact on triglycerides or HDL compared to non–whole-grain diets.
Let’s look at what breads will work for you!
It is best to avoid all white bread. Because the husk is removed, it contains little nutritional value, can cause sharp spikes in glucose levels, and contribute to insulin resistance.
Wholemeal bread consists of the entire grain, which includes all three layers that contain the nutritional value — the bran, germ, and endosperm. There are several differences in wholemeal content between brands and types of wholemeal, so it is important to check the label.
Wholemeal bread with a higher whole grain content is better for you.
Sourdough bread is made by fermentation of dough using wild Lactobacillaceae and yeast. It can be made with regular white flour or with whole grains. A recent study² investigated the difference in cholesterol profile between whole grain sourdough bread and white bread, both in a normal and diabetic population over a six-week period for each type of bread.
Their results did not find any significant differences between the two different pieces of bread in both groups. However, whole-grain sourdough bread consumption has significantly increased LDL cholesterol and triglycerides in certain participants with specific genes (APOE E3/E3).
Oat bread is one of the whole grain types of bread made specifically from whole oats.
One study³ compared the lipid levels between oat bread and wheat bread over a six-week period with people with hypercholesterolemia (high cholesterol levels in the blood). They found that oat bread significantly reduced the total level of cholesterol. However, it did not have a meaningful impact on the condition of the blood vessels or improve their functions, possibly due to the short period of the study.
The study finally recommended that those with high cholesterol levels should consume oat bread to lower their high cholesterol, and with long-term consumption, this may reduce the LDL plaques in the vessels and improve the function of their walls, reducing the risk of cardiovascular disease.
Like many things, bread in moderation is a healthy food option. However, eating too much can result in high glucose levels circulating in the blood. This, in turn, can result in insulin resistance or type 2 diabetes. If this occurs, it can negatively impact your cholesterol levels.
There are many differences in how types of bread are made and their nutritional status. If you are worried about your cholesterol levels, a general rule of thumb is to choose bread with a high wholegrain level.
This article is no substitute for medical advice. If you are concerned about your cholesterol, please visit your doctor. They will have more options to reduce their cholesterol levels.
The effect of whole grain wheat sourdough bread consumption on serum lipids in healthy normoglycemic/normoinsulinemic and hyperglycemic/hyperinsulinemic adults depends on presence of the APOE E3/E3 genotype: a randomized controlled trial (2010)
Wholegrains and diabetes | Diabetes UK