What is the Healthiest Flour? A Doctor's Dive into Wheat, Gluten-Free, and Healthy Alternatives for Baking

I made my first sourdough bread last week! Yes - I managed to survive an entire pandemic without once trying to make bread, and now I have joined the millions throughout human history partaking in this satisfying practice. Part of the reason is being inspired by "The Great British Bake-Off" and Paul Hollywood, one of the show's judges and a charismatic bread connoisseur.

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Another reason is I wanted to control my carbs by making them myself. You know what you eat only if you make it (or watch the chef very closely). If you're like me, you're constantly bombarded with mixed messages about gluten, wheat, oats, keto, low-carb, and similar nutrition advice for my supposed health and longevity. As a physician, I have made it my mission to be an interpreter of such messaging so that you get usable takeaways relevant to your personal health.

Let's get down to it. What flour is the “best" or "healthiest" flour? What even is gluten? Why would you want to avoid it?

In This Post:

• A short history of wheat and flour
• Refined vs. whole wheat flour
• What is gluten? Why is it meaningful for health?
• Going rogue - alternative flours
• Which is the best flour?

A Short History of Wheat and Flour

Some of you might remember the Fertile Crescent from middle school history class - it’s a region in the Middle East that includes parts of modern-day Iraq, Syria, Lebanon, Israel, and Jordan. It is here that we find the Natufian culture, a group of hunter-gatherers who lived around 12,500 to 10,000 years ago. As these ancient people gathered wild wheat seeds for food, some seeds would inevitably fall to the ground near their settlements. Over time, the seeds that were larger, easier to harvest, and had a better taste – were selected and grown agriculturally through the centuries.

Archaeologists have found well-preserved remains of a bakery in the ancient Egyptian city of Amarna, which existed around 1350 BCE. The bakery was complete with baking trays, ovens, and even a flour mill. The ancient Greeks and Romans also played a significant role in the spread and development of wheat and flour. The Greeks were known for their pastries and cakes, while the Romans were famous for their bread. In fact, the Roman government even subsidized grain distribution to its citizens, ensuring that everyone had access to this staple food.

Today, wheat remains the most widely cultivated crop in the world, with countless varieties being grown to suit different climates, tastes, and baking needs. Tough to break away from such an ancient and stalwart tradition!

Refined vs. Whole Wheat Flour

Let’s get into the details relevant to our health! When it comes to wheat flour, there are two main types: refined and whole wheat. The primary difference between these two types lies in how they are processed and the parts of the wheat kernel that are included in the final product.

Whole wheat flour is made by grinding the entire wheat kernel, which consists of three parts: the bran (outer layer), the germ (embryo), and the endosperm (starchy center). By using the whole kernel, whole wheat flour retains all the natural nutrients found in wheat, including fiber, vitamins (vitamin E, B vitamins including thiamin, niacin, and folate), minerals (such as iron, zinc, and magnesium), and phytochemicals (beneficial plant compounds that may help reduce inflammation and lower the risk of certain diseases).

Refined flour, also known as white flour, is made by removing the bran and germ from the wheat kernel and grinding only the endosperm—this process, known as refinement, strips away many nutrients and fiber in whole wheat flour. The remaining endosperm is then ground into fine, white flour.

You might be wondering - why the heck do we get rid of all these great nutrients in whole wheat?? Of course, it comes down to commercializability.

1. Longer shelf life: The bran and germ contain natural oils that can go rancid over time, leading to a shorter shelf life for whole wheat flour. Removing these components gives refined flour a longer shelf life, which is advantageous for food manufacturers and retailers.
2. Finer texture: True to its name, refined flour has a finer, softer texture compared to whole wheat flour, which can result in lighter, fluffier baked goods. This is because the bran and germ particles in whole wheat flour can interfere with the development of gluten, the protein network responsible for the structure of baked goods. Who here has had light, fluffy milk bread??
3. Appearance: White flour produces baked goods with a lighter color and a more uniform appearance, which is often preferred by consumers. Wonderbread, anyone?
4. Taste: Refined flour has a milder, less nutty taste compared to whole wheat flour, making it more versatile for use in a wider range of recipes. Controversial opinion, but I love nutty bread!

To address the reduced nutritional value of refined flour, some manufacturers enrich white flour with certain vitamins and minerals, such as iron, thiamin, niacin, and folic acid. However, enriched flour still lacks the fiber and many other beneficial compounds found in whole wheat flour.

What is Gluten? Why is it Meaningful for Health?

During World War II, the Netherlands experienced a severe food shortage, and bread became scarce. As a result, many people with celiac disease who had previously suffered from symptoms such as abdominal pain, bloating, and diarrhea suddenly found their symptoms improved. Dr. Willem Karel Dicke, a Dutch pediatrician, noticed this change and discovered the connection between wheat and celiac disease.

After the war ended and wheat became available again, Dr. Dicke observed that his patients' symptoms returned. He conducted experiments where he fed his patients different diets, some containing wheat and others without. Through these experiments, he discovered that gluten, the protein found in wheat, was the trigger for celiac disease symptoms.

Gluten is a protein found in wheat, barley, and rye. It acts as a binding agent, giving bread its chewy texture and helping it rise. While most people can tolerate gluten without any issues, some individuals may have gluten sensitivities or celiac disease, an autoimmune disorder triggered by gluten consumption.

Today, celiac disease is recognized as an autoimmune disorder that affects approximately 1% of the global population. When individuals with celiac disease consume gluten, their immune system responds by damaging the small intestine, leading to a range of symptoms and potential long-term health complications including the following:

1. Digestive issues: Abdominal pain, bloating, gas, diarrhea, or constipation.
2. Nutrient deficiencies: Malabsorption of nutrients due to intestinal damage can lead to deficiencies in iron, folate, and vitamin B12, among others.
3. Skin rash: Some people with celiac disease develop an itchy, blistering skin rash called dermatitis herpetiformis.
4. Neurological symptoms: Gluten sensitivity has been linked to neurological issues such as headaches, migraine, and peripheral neuropathy in some individuals.

In addition to those with celiac disease, some people may have non-celiac gluten sensitivity (NCGS) - AKA gluten sensitivity. These individuals experience similar symptoms to those with celiac disease when consuming gluten, but do not have the same intestinal damage or autoimmune response. NCGS is typically diagnosed via an elimination diet followed by an open challenge (monitored re-introduction of gluten). The exact mechanisms behind NCGS are not yet fully understood, and more research is needed in this area.

Going Rogue - Alternative Flours

So maybe you’re gluten-free-curious, or you have NCGS or celiac disease. Perhaps you’re looking for low-carb options because you’re interested in improving your insulin sensitivity (a topic we’ll address in many other articles!). Regardless of the reason, here’s a breakdown of gluten-free flours and alternatives, with my comments thrown in here and there.

Gluten-Free Flours:

1. Almond flour: Made from ground almonds, this flour is high in protein, healthy fats, and vitamin E. It has a slightly sweet, nutty flavor and works well in cakes, cookies, and crusts. I've baked with almond flour and it's filling! Not to mention, this is the highest calorie per gram flour, so be careful if you're aiming for a certain calorie intake per day.
2. Coconut flour: Produced from dried, ground coconut meat, this flour is rich in fiber and has a lower glycemic index compared to wheat flour. It has a subtle coconut flavor and is highly absorbent, so it requires more liquid in recipes. Coconut flour works well in breads, muffins, and pancakes. It is also quite high-calorie, and the flavor is quite noticeable, so you'll want to use it intentionally.
3. Rice flour: Milled from either white or brown rice, this flour is a staple in gluten-free baking. It has a neutral flavor and can be used to make noodles, breads, and thicken sauces. Brown rice flour has a slightly nuttier taste and retains more nutrients compared to white rice flour. This is higher carb than even wheat flour, so not a good option if you're going low-carb!
4. Oat flour: Made from ground oats, this flour is high in fiber and protein. It has a mild, slightly sweet flavor and can be used in various baked goods. Be sure to use certified gluten-free oats if you have celiac disease or gluten sensitivity, as regular oats may be cross-contaminated with wheat during processing.
5. Quinoa flour: Derived from ground quinoa seeds, quinoa flour is a complete protein containing all nine essential amino acids. It has a slightly earthy, nutty flavor and works well in breads, muffins, and pancakes. Quinoa flour can be used independently or blended with other gluten-free flour for improved texture. Fun random fact - I can't stomach quinoa! It's the weirdest thing. Maybe one day, we'll name quinoa intolerance as a rare condition 😀
6. Buckwheat flour: Despite its name, buckwheat is not related to wheat and is naturally gluten-free. This flour, made from ground buckwheat groats, is rich in fiber, protein, and antioxidants. It has a robust and nutty flavor and is commonly used in pancakes, noodles, and crepes. Buckwheat noodles, known as "soba,” are deliciously served in the Japanese style.
7. Chickpea flour: Also known as garbanzo bean flour, this flour is made from ground chickpeas and is a staple in many Middle Eastern and Indian dishes. It is high in protein, fiber, and iron. Chickpea flour has a slightly beany flavor and can be used to make flatbreads, fritters, and as a thickener in soups and sauces. This is the winner in terms of protein content per 100g!
8. Banana flour: Made from green, unripe bananas that are peeled, dried, and ground, this flour is rich in resistant starch, a prebiotic fiber that supports digestive health. It has a mild banana flavor and works well in breads, muffins, and smoothies. This is the highest-carb flour option, and lowest fat option.

Tips for Baking with Alternative Flours:

1. Start small: When experimenting with new flours, start by substituting a small portion of the regular flour in a recipe (e.g., 25%) to get a feel for how the flour behaves and tastes.
2. Adjust liquid and binding agents: Alternative flours may absorb liquid differently than wheat flour, so you may need to adjust the amount of liquid in your recipes. Some flours, like almond flour, may also require additional binding agents, such as eggs or xanthan gum, to achieve the desired texture.
3. Blend flours: Combining different alternative flours can help balance flavors and improve the texture of your baked goods.

Nutrition Facts of Various Flours (per 100g)

So What Flour is Best? Action Items You Can Take to Your Kitchen

As with anything else in health information, you might feel more overwhelmed after reading this post. But don’t worry - you really cannot go wrong if you follow the simple and familiar rule of moderation.

If you do not have symptoms due to celiac disease or gluten sensitivity, you probably don’t need to stress yourself about avoiding gluten. Unless you have a reason to avoid any speck of pro-inflammatory foods, such as an autoimmune disorder that isn’t well-managed, you don’t need to avoid gluten. I, like many millions of others who care about health, eat gluten-containing products with regularity but in moderation.

For myself, I care more about my insulin sensitivity and maintaining/improving my lean body mass. This means I eat wheat-containing products less than half the days in a week (on just one “cheat” meal if I can!). But this is because I want to leave enough calorie “room” in my daily diet for more meaningful nutrients like protein, healthy fats, and micronutrients (vitamins, polyphenols, and so forth).

But it is enjoyable to experiment with other types of flours! Just be aware that some are potentially “worse” for you, depending on your health goals. If you avoid high-calorie foods, you might want to skip almond flour. If you’re low-carb, definitely skip rice and banana flours. Hopefully, the table above is a neat cheat sheet for you as you experiment with baking.

Until next time - Cheers to your health!

Hillary Lin, MD

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