Choosing the healthiest flour for your family your family will ensure that the food you prepare provides the most nutritional benefit. Different flour options can have various risks and benefits, both nutritionally and environmentally.
North America’s most commonly available flour is fortified, or “enriched,” wheat flour, made from modern wheat varieties. Fortification programs for wheat flour have been standard in North America since the World War II when nutrient deficiencies, such as folate deficiency, became commonplace because of wartime food scarcity. Today’s enrichment programs include folic acid, other B vitamins, and often iron.
What Does Enriched Flour Mean When it Comes to Healthiest Flour?
To make enriched flour, the fiber-rich bran and fatty, nutrient-dense germ of the grain are removed. These are the natural sources of fats, fat-soluble vitamins, fiber, B vitamins, and antioxidants, and they’re removed for consumer taste and texture preferences and to increase the flour’s shelf life. The flour is then typically bleached to achieve the pleasing whiteness the average consumer favors.
To meet the enrichment guidelines set by the U.S. Food and Drug Administration (FDA), every pound of flour then has thiamine, riboflavin, niacin, folic acid, and iron added. Enrichment is mandatory in the U.S. for commercially produced flours to help reduce deficiencies and prevent folate-deficiency-related neural tube defects in babies. Most developed countries have now initiated grain-fortification programs of their own.
While enrichment programs were highly successful during periods of food scarcity, the modern abundance of food and dietary supplements may be changing the picture for some populations. Folic acid, for example, is also found in multivitamins, prenatal vitamins, prescriptions, B-complex blends, breakfast cereals, many energy-boosting products, meal-replacement shakes and bars, commercial protein powders, and other products. Studies have shown that excessive levels of folic acid build up in the bloodstream as unmetabolized folic acid (UMFA). Adverse health outcomes, including cancer, food allergies, and infertility, have been linked to high blood levels of UMFA.

Folate vs. Folic Acid
It’s crucial to distinguish between naturally occurring folate – the form of vitamin B9 that occurs in dark-green leafy vegetables, beans, pulses, citrus fruits, and other whole foods – and folic acid. Folic acid is a lab-created, crystalline, shelf-stable form of folate used as a food additive, while natural folate degrades too quickly to be a food additive. Although folic acid is often treated as interchangeable with folate, they’re structurally different and go through different enzyme processes in your body. To use folate and folic acid, your body must convert them to the active form of vitamin B9, “L-5 methyltetrahydrofolate,” or “L-5-MTHF.” The Methylenetetrahydrofolate reductase (MTHFR) enzyme in your body is the final step for all types of folate in this conversion process.
Unfortunately, common genetic variances affect this process. Studies have shown that approximately 40 percent of the population carries a silent, or at least quiet, MTHFR genetic mutation affecting folate and folic acid activation.
What is MTHFR mutation?
MTHFR is the gene that codes for an enzyme of the same name that activates all forms of folate. MTHFR mutations affect the efficiency of this conversion and can impair body processes that need active folate. Active folate is vital for neurotransmitter formation, antioxidant production, cellular energy, cell division, and DNA methylation. Studies have shown that folic acid can increase symptoms associated with MTHFR, more drastically impair folate activation, and lead to higher blood UMFA levels for people with MTHFR
genetic mutations.
Most people with MTHFR gene mutations are unaware of it, although symptoms associated with MTHFR are increasingly common. These include anxiety, depression, cardiovascular disease, low thyroid function, decreased fertility, repeat miscarriages, and fatigue. Cardiovascular disease, chronic fatigue, autoimmune disease, cancer, and Alzheimer’s dementia are also associated with MTHFR gene variances.
If you suspect you might have a MTHFR mutation, speak with your doctor first about any genetic testing, dietary changes, or supplements you may need. You may find eliminating folic acid from food sources, such as enriched flour, and from supplements, prescriptions, and multivitamins helpful, as well as including foods high in natural folate, such as beans, pulses, dark-green leafy vegetables, asparagus, avocado, and citrus fruit.
Folic Acid Side Effects
Outside of those with the MTHFR genetic variant, there’s also the risk of unknowingly taking too much folic acid. The FDA has set the tolerable upper intake level for folic acid at 1,000 micrograms daily. However, it’s easy to exceed that threshold with the combination of vitamins, meal replacements, enriched foods, and fortified flour.
In a 2020 study of folate levels in newborn babies’ cord blood, every baby tested had measurable levels of UMFA. Excessive intake of folic acid has also been shown to promote some forms of cancer, decrease fertility, increase the risk of food sensitivities, and increase cognitive impairment in the elderly.
Healthiest Flour Substitutes for All-Purpose Flour
It’s still possible to find non-enriched flour by buying organic or 100 percent whole-wheat flour, for which enrichment isn’t mandatory. Check the labels on these products, because some companies may choose to enrich them so they’re perceived as “healthier.” But still, is this the healthiest flour for your family, or are there better alternatives? Folic acid isn’t the only issue involved in the health of grain products, and ancient grains and heirloom varieties of wheat offer different nutritional profiles from conventionally grown modern wheat.
Einkorn Flour, Emmer Flour, and Ancient Grains
Ancient grains and heirloom wheat varieties that haven’t been hybridized or genetically modified exist now in the same form as thousands of years ago. Typically, they’re higher in fiber, protein, vitamins, and other critical nutrients than modern grains, which are bred to have a greater proportion of starch and be easily harvested with modern machinery.
Ancient grains and heirloom wheat also typically contain more micronutrients, including vitamins and minerals. Heirloom varieties of grains are often grown in richer soil using older or organic farming practices. Modern wheat is primarily grown using modern fertilization and farming techniques. So, it’s difficult to determine if the grains themselves are more nutrient-dense or if higher micronutrient levels are a product of more balanced farming techniques.

Heirloom Wheat and Diabetes When it Comes to Healthiest Flours
Heirloom wheat and ancient grains may also help delay and reduce the progression of Type 2 diabetes. A study published in The Review of Diabetic Studies in 2015 compared 40 rats, each of whom was fed a diet based on one of five different grains – einkorn, emmer, spelt, rye, and refined wheat – for nine weeks. The researchers then measured hepatic enzymes produced by key regulatory genes involved in glucose and fat metabolism. Emmer and einkorn wheat down-regulated these genes, indicating a prevention or delay of diabetes Type 2. Spelt and rye were also shown to have less impact on blood sugar, relative to modern wheat.
Compared with enriched all-purpose flour, heirloom einkorn wheat is also higher in phenolic acids, which have powerful antioxidant effects; lower in gluten; higher in carotenoid forms of vitamin A; and higher in micronutrients, such as zinc and iron.
From a simple macronutrient perspective, the relative values of modern and heirloom wheats vary widely. The data in the following table is based on a 100g serving and is sourced from the USDA Agricultural Research Center FoodData search.
Grain Protein Fat Fiber Carbohydrate
Enriched all-purpose flour (modern) 10.9 g 1.48 g 0 g 77.3 g
100% Whole Wheat (modern) 15.1 g 2.73 g 10.6 g 71.2 g
EinkornWheat (heirloom) 12.5 g 3.12 g 12.5 g 53.1 g
Emmer Wheat (heirloom) 12.8 g 2.13 g 10.6 g 72.3 g
Kamut Wheat – uncooked (heirloom) 14.5 g 2.13 g 11.1 g 70.6 g
Choosing the Healthiest Flour for Your Family
Keep in mind any health conditions present within your family tree. If struggles with diabetes, insulin resistance, or other metabolic diseases are common, then the impact of different grains on your blood sugar will be an important factor to consider. If thyroid conditions, mental-health issues, Alzheimer’s dementia, or fertility troubles are represented, then avoiding fortified flour and other fortified products, as well as outside sources of folic acid, could be important. If some family members suffer from non-celiac gluten sensitivity, then a trial of einkorn or emmer wheat might prove valuable, although there’s still too much gluten content for true celiac disease.
Outside of the health benefits, the joys of contributing to the preservation of heirloom and alternative grain use in a world that’s becoming far less diverse can also make the exploration worthwhile.
Amy Neuzil is a naturopathic doctor (US), MTHFR mutant, and the host of the To Health With That! podcast. She helps people maximize their genes, eat a nutrient-dense diet, and bio-hack their health, especially with the MTHFR mutation. She also writes, teaches, and speaks about her passions, including MTHFR, women’s hormones, foraging, food production, and nutrition. Join her mailing list for bi-weekly information at tohealthwiththat.com
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