With low-carb, Paleo, and gluten-free diets on the rise, bread (and grains in general) has fallen out of favor. Even in France, the birthplace of the baguette, they’ve had to resort to a “Got Milk” style ad campaign to stop sales from crumbling. However, the loaf isn’t dead yet.

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To combat the trend of falling bread consumption, commercial bread bakers have been looking to formulate and market a healthier bread. In that quest, they’re using bread buzzwords such as “stoneground,” “gluten-free,” and “whole wheat.”

Nearly everyone has heard the advice to choose whole-grain bread over white bread (for the health benefits of whole-grain flour), but there’s still much discussion about even whole-grain options Putting the whole grain puzzle together: Health benefits associated with whole grains. Jonnalagadda, S. S., Harnack, L., Hai Liu, R. et al. The Journal of Nutrition, 2011; 141:1011S-1022S.. And the advantages of other types of bread are less clear-cut. WTF does “sprouted grain bread” even mean, and are the health benefits enough to justify the extra $2 per loaf?

Here are some common (and commonly misunderstood) bread buzzwords and what they really mean.

Whole Wheat Bread

“Whole Wheat”

White vs. Whole-Wheat Bread

Time to flash back to biology class: Wheat, in its natural, fresh-off-the-plant form, contains three components: the germ, endosperm, and bran layer. The germ contains loads of vitamins and minerals, while the endosperm is packed with protein and carbohydrate. The bran layer (the rough stuff... think bran muffin) is full of fiber Putting the whole grain puzzle together: Health benefits associated with whole grains. Jonnalagadda, S. S., Harnack, L., Hai Liu, R. et al. The Journal of Nutrition, 2011; 141:1011S-1022S.. Whole-grain flours are made by grinding up intact wheat kernels; white flours have to be “stripped” of all the good stuff before they get sent to the grinder. To make white flour, manufacturers remove the germ and bran (along with 80 percent of the fiber and most of the nutrients), then send the stripped grains through the mill. White flours usually get a dose of B vitamins, folic acid, and iron during processing; this fortification process replaces up some of the lost nutrient content, but the flour is still missing many healthy compounds such as antioxidants and phytonutrients Putting the whole grain puzzle together: Health benefits associated with whole grains. Jonnalagadda, S. S., Harnack, L., Hai Liu, R. et al. The Journal of Nutrition, 2011; 141:1011S-1022S..

The Whole-Wheat Hang-Up

Think you’re all set buying 100-percent whole-wheat bread? Not so fast. The FDA says that a grain-containing product labeled “100-percent whole-grain” must be made of germ, endosperm, and bran in proportions that equal those of intact grains. Food manufactuers exploit this loophole and often process grain as white flour, then add the germ and bran back in. Believe it or not, this still counts as “whole-grain” flour Putting the whole grain puzzle together: Health benefits associated with whole grains. Jonnalagadda, S. S., Harnack, L., Hai Liu, R. et al. The Journal of Nutrition, 2011; 141:1011S-1022S.. The reconstituted whole-grain flour often has dough conditioners and flavorings added, and probably loses some nutrients through processing too.

Stone-ground Bread

“Stone-Ground Flour”

These buzzwords recall a simpler era in bread baking, when windmills would grind grain using compression from stones. But today, like the term “natural,” the marketing buzzword “stone ground” is essentially meaningless.

When you read "stone ground" on bread, it just indicates that a grain has been passed through a stone mill at least once during the manufacturing process. So if the first step in making Wonder Bread were a quick trip of the wheat through a stone grinder, it could be considered made of stone-ground flour. The FDA doesn’t police this phrase, so food manufacturers are free to use this as they wish.

“Sprouted Wheat”

Sprouted wheat breads are the darling of the health food set. All sorts of health claims have been made about sprouted grains, including increased digestibility, higher protein content, and more enzyme activity. Are any of these claims legit?

Well, sprouting grains increases the activity of certain enzymes, which allows nutrients to be more available for digestion. It also lowers carbohydrate content, changes the amino acid profile, and raises protein content Cereal sprouts: Composition, nutritive value, food applications. Lorenz, K. Critical Reviews in Food Science and Nutrition, 1980; 13:353-385.. Sprouting ups the content of some nutrients such as antioxidants and fiber too Phenolic acid composition of sprouted wheats by ultra-performance liquid chromatography (UPLC) and their antioxidant activities. Hung, P. V., Hatcher, D. W., & Barker, W. Food Chemistry, 2011; 126:1896-1901.. Due to these differences, sprouted-grain breads are technically more nutritious than breads made using unsprouted flour. However, the differences are pretty small—eating sprouted-grain bread over plain ol' whole wheat won’t make much of a difference in a person’s nutritional intake.

Gluten Free Flour

“Gluten Free”

Is Gluten-Free the Way to Be?

Several celebs have gone gaga for the gluten-free diet—including Lady Gaga herself—but following this dietary trend really isn’t necessary unless you have celiac disease Non-celiac gluten sensitivity: Clinical relevance and recommendations for future research. Mooney, P. D., Aziz, I., & Sanders, D. S. Neurogastroenterology and Motility : The Official Journal of the European Gastrointestinal Motility Society, 2013; 25:864-871.. Although many report being sensitive to gluten, a condition known as non-celiac gluten sensitivity (NCGS), scientific evidence isn’t up to speed on exactly why or how this occurs (or if it is even a real condition) Non-celiac gluten sensitivity: Clinical relevance and recommendations for future research. Mooney, P. D., Aziz, I., & Sanders, D. S. Neurogastroenterology and Motility : The Official Journal of the European Gastrointestinal Motility Society, 2013; 25:864-871.. Claims of weight loss and increased energy from going gluten-free abound, but these effects are probably due to increased diet quality (think more fruits and veggies, fewer processed foods) rather than the elimination of the gluten protein.

The 411 on Gluten-Free Bread

For those without celiac disease, gluten-free breads may or may not be healthier. In general, a gluten-free diet is more likely to be low in vitamins and minerals such as vitamins B and D, zinc, iron, calcium, magnesium, and fiber Cereal-based gluten-free food: How to reconcile nutritional and technological properties of wheat proteins with safety for celiac disease patients. Lamacchia, C., Camarca, A., Picascia, S. et al. Nutrients, 2014; 6:575-590.. Eating gluten-free—without paying close attention to the quality and nutrient content of foods—can raise the risk for developing obesity and/or metabolic syndrome Cereal-based gluten-free food: How to reconcile nutritional and technological properties of wheat proteins with safety for celiac disease patients. Lamacchia, C., Camarca, A., Picascia, S. et al. Nutrients, 2014; 6:575-590.. Many gluten-free bread products are prepared with corn or rice starch, both of which have a high glycemic index and low fiber content Cereal-based gluten-free food: How to reconcile nutritional and technological properties of wheat proteins with safety for celiac disease patients. Lamacchia, C., Camarca, A., Picascia, S. et al. Nutrients, 2014; 6:575-590.. And because gluten-free grains don’t always play nice in forming bread dough, manufacturers of gluten-free breads often mix in fats or oils to dough increase palatability (which also ups the calorie content!) and additives like starches and gums to improve texture Cereal-based gluten-free food: How to reconcile nutritional and technological properties of wheat proteins with safety for celiac disease patients. Lamacchia, C., Camarca, A., Picascia, S. et al. Nutrients, 2014; 6:575-590..

However, there are a bunch of different flour options when it comes to GF baked goods. Some, such as oat flour and chickpea flour, have relatively good nutritional stats Nutritive value of oat flour and oat bran. Hahn JD, Chung TK, Baker DH. J Anim Sci. 1990 Dec;68(12):4253-60.. Others, like tapioca flour, are pretty much pure starch. Recognizing consumer demand, food scientists are currently hard at work to develop tasty, delicious, and nutritious gluten-free breads using some of the more nutritious flours and novel preparation methods. In the meantime, if you’re eating gluten-free bread, be a label-reader—watch out for long ingredient lists, additives, and low fiber contents.

Sourdough Bread

“Fermented Breads” and ”Yeasted Breads”

Old-School Bread Baking

Baking yeast bread is one of those intimidating kitchen projects that seems like you’d need a full weekend to accomplish (although it’s totally doable to DIY, as well as cheaper, healthier, and not as time-consuming as you’d expect). At its most basic, making yeast bread involves mixing together flour, water, commercial yeast, and salt, letting the mixture rise, and baking the risen dough. During the rising period, the yeast gobbles up some carbohydrates in the flour and digest them via fermentation. The end products are alcohol and carbon dioxide—which add flavor and volume to the dough.

Sourdough bread making involves similar steps, but the process starts with a “sourdough starter” or “sponge,” which is a mixture of live yeast, lactic-acid producing bacteria, flour, and water. Bacteria and wild yeast from the environment settle on the starter and start to ferment away, producing a mini-ecosystem packed with flavor-making potential. Both yeast and bacteria increase the acidity of the dough, which fends off harmful bacteria and gives sourdough its characteristic tangy taste.

The Health Factors

OK, now that we have Breadmaking 101 out of the way, let’s talk about the health benefits of yeasted bread. Some claim that sourdough bread made with a wild yeast starter is healthier and easier to digest than your standard loaf. While the wild yeast primarily contribute to the complexity of the flavor present in sourdough (and some would say its overall deliciousness), the long fermentation time required and acidity of the dough are what really contribute to its health benefits Taming wild yeast: Potential of conventional and nonconventional yeasts in industrial fermentations. Steensels, J., & Verstrepen, K. J. Annual Review of Microbiology, 2014; 68:61-80. Moderate decrease of pH by sourdough fermentation is sufficient to reduce phytate content of whole wheat flour through endogenous phytase activity. Leenhardt, F., Levrat-Verny, M. A., Chanliaud, E. et al. Journal of Agricultural and Food Chemistry, 2005; 53:98-102.. This process makes the nutrients in wheat flour more available for digestion and the simple sugars less available, which may help with blood sugar control, particularly for people with diabetes Sourdough-leavened bread improves postprandial glucose and insulin plasma levels in subjects with impaired glucose tolerance. Maioli, M., Pes, G. M., Sanna, M. et al. Acta Diabetologica, 2008; 45:91-96. Moderate decrease of pH by sourdough fermentation is sufficient to reduce phytate content of whole wheat flour through endogenous phytase activity. Leenhardt, F., Levrat-Verny, M. A., Chanliaud, E. et al. Journal of Agricultural and Food Chemistry, 2005; 53:98-102.. (Although portion control is still key for blood sugar issues.) Sourdough fermentation may also help make wheat bread easier for patients with irritable bowel syndrome (IBS) to digest Effect of Breadmaking Process on In Vitro Gut Microbiota Parameters in Irritable Bowel Syndrome. Adele Costabile, Sara Santarelli, Sandrine P. Claus, Jeremy Sanderson, Barry N. Hudspith, Jonathan Brostoff, Jane L. Ward, Alison Lovegrove, Peter R. Shewry, Hannah E. Jones, Andrew M. Whitley, and Glenn R. Gibson. PLoS One. 2014; 9(10): e111225. Ecological parameters influencing microbial diversity and stability of traditional sourdough. Minervini, F., De Angelis, M., Di Cagno, R. et al. International Journal of Food Microbiology, 2014; 171:136-146.. One study found that sourdough bread made with a long fermentation time produced fewer symptoms (such as bloating and gas) than conventionally made bread Ecological parameters influencing microbial diversity and stability of traditional sourdough. Minervini, F., De Angelis, M., Di Cagno, R. et al. International Journal of Food Microbiology, 2014; 171:136-146..

But Is It “Probiotic”?

Kombucha, kefir, yogurt, and... bread? Some claim that sourdough bread is a probiotic food since it is made with a fermented dough containing tons of gut-friendly bacteria (Lactobacillus, we’re looking at you!). While the baking process kills off the bacteria, which may reduce its probiotic properties, there’s some evidence suggesting that even dead probiotic bacteria still have some health benefits, including anti-inflammatory properties Live and heat-killed lactobacillus rhamnosus GG: Effects on proinflammatory and anti-inflammatory cytokines/chemokines in gastrostomy-fed infant rats. Li, N., Russell, W. M., Douglas-escobar, M. et al. Pediatric Research, 2009; 66:203-207.. But don’t swap out your yogurt for toast just yet; the scientific evidence on the health benefits of live probiotics is much stronger Probiotics and prebiotics in dietetics practice. Douglas, L. C., & Sanders, M. E. Journal of the American Dietetic Association, 2008; 108:510-521..

Food Lab

Additives and Shelf Stabilizers: Words to Avoid

While it’s best to avoid the usual culprits when it comes to additives (hydrogenated oils, food dyes, and high-fructose corn syrup, to name some common not-so-healthy ingredients in highly processed foods), there are a few bread-specific additives to watch out for.

The first is the so-called “yoga mat” chemical of the infamous Subway bread controversy. Also used to improve the stretchiness of rubber products like flip-flops and yoga mats, this chemical—azodicarbonamide, abbreviated as ADA or ADC—is added to some commercial bread products as a bleaching agent and flour-improver. When heated, ADA forms two icky byproducts, one that’s known to cause cancer and one that might cause cancer.

Another problematic item on the ingredient list is potassium bromate, a chemical added to fluff up bread and give it a tender texture, which has also been shown to cause cancer in animals and may hurt kidney function in humans Toxicity and carcinogenicity of potassium bromate—a new renal carcinogen. Kurokawa, Y., Maekawa, A., Takahashi, M. et al. Environmental Health Perspectives, 1990; 87:309-335.. It’s banned pretty much everywhere except in the U.S. and Japan.

Less scary-sounding but definitely unhealthy, added sugars such as dextrose appear in certain commercial breads. Dextrose contributes to the nice, toasty-brown color of baked loaves (and to Americans’ waistlines). Other names for sugar include sucrose or "evaporated cane juice." There’s no need to completely eliminate added sugars, but limiting them is a good idea.

The Takeaway

While commercial food producers splash all sorts of health-related claims on packaging, a lot of the front-of-package labeling is just to entice consumers. For your healthiest bread options, look for whole-grain breads with short ingredient lists (not too much longer than flour, water, yeast, and salt). Bonus points for buying from artisan bakers or making your own.

Fermented breads, a.k.a. sourdough made with a long fermentation time, could reduce blood sugar spikes or icky abdominal symptoms in some people. (Although keep in mind, portion control still key if you're trying to lose weight or have blood sugar issues.) And sprouted-grain breads may offer some nutritional advantages above and beyond the basic whole-grain loaf, but eating sprouted bread isn’t likely to lead to significant improvements in health (though you’ll get hippie street cred). As far as gluten concerns go, if you have celiac disease (or suspect other sensitivities), look for gluten-free bread made from beneficial ingredients like chickpea or oat flour. But if you’re a-OK with gluten, there’s no reason to break up with everyone's favorite comforting carb.

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