how do i lower my hemoglobin a1c?
Hemoglobin A1C is the primary way we screen for, and measure diabetes. It is a measure of how 'sugar coated' your blood cells are. Blood cells look a little like donuts. People with chronically high blood sugars get sugar coated blood cells - think powder donuts - and those with normal blood sugar have, well, more like plain donuts.
We care about A1C when it goes above 5.6% - that indicates that there's an unhealthy amount of sugar coating your donuts, so to speak. We consider this prediabetes. Above 6.4%, we consider the patient diabetic.
If you've been told by your doctor (perhaps me) that you need to lower your A1C, don't worry. It's very doable. I've had patients with an A1C of 12 bring it down to 6 in just 3 months using just diet (with a bit of metformin thrown in).
There are 4 ways to do this (without meds)
:
1. Reduce foods that spike your blood sugar
2. Reduce foods that make your body diabetic (make you sensitive to sugar in the first place)
3. Increase foods that make you less diabetic (reduce your sensitivity to sugar, and INCREASE your sensitivity to insulin).
4. Move more.
Lets go over these one by one:
1. Reduce foods that spike your blood sugar: These are foods with carbohydrates, however, not all carbohydrates are created equal. Some carbohydates spike sugars more than others - beans, for example do not spike blood sugar as much as, say, Pepsi, though both are carbs. The 'junkier' the food - think pepsi, candy, cakes - the more they spike your sugar. These 'empty calories' need to be avoided, first and foremost. You'll find these foods on the "What Not to Eat" page.
What's less obvious is that non-sweet but still refined carbohydrates like white bread, most pasta, white rice, corn flakes, and bagels spike your sugar just as much as Pepsi. These are carbohydrates without fiber, and must also be avoided.
There are better-quality, fiber-rich carbohydrates, like whole grain breads, cereals, and pastas, that might not spike your sugar as much as their refined, fiber free versions. You can use the Carb to Fiber Ratio pictured above-right to determine how healthy a carb is. The more fiber, or the lower the carb/fiber ratio, the less it will spike your sugar. Watch out for healthy whole grains with added sugar, like most granolas, or Honey Nut Cheerios and other sweetened whole grain cereals.
2. Reduce foods that make you more diabetic: Diabetes starts with insulin resistance - a complex process caused by chronic overeating that results in your body's own natural insulin not working well. There are many causes for insulin resistance, but the one food that can immedaitely make you more insulin resistant is fat - specifically saturated fat. So, it's best to reduce or eliminate sources of saturated fat from your diet - these include animal foods, full or low-fat dairy, cheese, butter, cream, etc.
3. Increase foods that make you less diabetic: By this, I mean simply fiber-rich plant food. Basically everything on the "What to Eat" page. These foods tend to quicken your metabolism, decrease blood sugar spikes, and improve general health.
So, following a diet comprised of mostly whole, unrefined plant food can very effectively lower your A1C. The good news is this diet also reduces blocks in arteries, inflammation, cancer, and improves mood and well-being. It's the way to eat!
4. Move more: Anything you can do to increase your exercise helps, ideally to 150 minutes a week of moderate intensity movement (like a brisk walk), or 75 minutes a week of high intensity movement (jogging).
Medication can help this as well. If someone has an A1C over 8, I'll usually start a medication by mouth in addition to prescribing a whole-plant based diet. This page is not meant to replace any advice given by your doc - only to supplement it.
For more information on HOW to do this, please consider the excellent book, Dr. Neal Barnard's Program for Reversing Diabetes. You can also watch Dr. Barnard give a great talk on this here.
