Making Healthy Choices Nutrition

Making Healthy Choices
Nutrition

Health Guidelines

Healthy levels of glycated hemoglobin.
What causes the blood sugar to be high?
Glycemic Load of Foods
Check your blood glucose level.
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Maintaining Healthy Blood Sugar Levels

What is a healthy blood sugar level? A fasting blood sugar levels of 126 mg/dL or higher is the diagnostic criteria for diabetes. And, we all know that diabetes is linked to higher rates for heart disease, eye and kidney disease, and other serious health problems. New research indicates that even moderately elevated blood sugar levels can also increase the risk for heart problems and overall risk of dying even if you don't have diabetes.

The best test to determine a healthy blood sugar level is a glycated hemoglobin ( HbA_1c) test. This test indicates the average blood glucose concentration over the past three months. If glucose levels are high, more glycated hemoglobin is formed and remains in the blood.

Healthy levels of glycated hemoglobin ( HbA_1c) are less than 5%. Persons with glycated hemoglobin levels greater than 5% have higher rates of death from heart disease and from all causes, even when they don't have diabetes. A HbA_1c level of 7.0% or higher is a strong indication of diabetes.

The importance of this test in predicting heart disease is well documented in a four year prospective study of 4,662 men in Norfolk (U.K.). HbA_1c test results were found to be a better predictor of heart attack and risk of dying than even cholesterol, blood pressure, or excess body weight. Notice in the chart shown how the risk for death increases dramatically as these men's HbA_1c levels increase from the desirable level of less than 5% up to a level of 7% or higher.

A high glycated hemoglobin level (5.0% or higher) increases the risk of death from any cause by 40 to107% in non-diabetics, and nearly tripling the risk of death in diabetics. The risk for heart disease increases by 3 to 5 times (graph not shown) as glycated hemoglobin rises..

Does it matter if your blood sugar levels are in the "high normal" range? It certainly does. Researches found that for every 1% increase in glycated hemoglobin in the blood, the risk for heart disease increases by 40% and the risk of death from any cause is increases by 30%.

In this study, the higher the HbA_1c level the higher the risk of premature death. The lower the level, the lower the risk. Men with HbA_1c levels less than 5% were at lowest risk. The percent of non-diabetic men over age 45 with elevated HbA_1c levels, however, was 70%. The researchers concluded that the majority of people over 45 need to lower their blood sugar levels for improved health and longevity.

What causes the blood sugar to be high? Insulin resistance. This condition is common in people past the age of 45 who are overweight, sedentary, and eat refined foods. Lifestyle factors that can decrease insulin resistance and improve glucose levels include:

Losing excess fat weight. Losing even 10-15 pounds greatly improves insulin resistance and blood glucose levels.
Physical activity. Regular physical activity, such as walking 30 minutes daily, greatly improves insulin resistance, and lowers blood glucose and HbA_1c levels.
Healthy eating. Specifically, eating unrefined foods high in dietary fiber and avoiding high glycemic index food helps lower blood glucose levels.

High Glycemic Load Foods	Low Glycemic Load Foods
Pastry, cookies, snack crackers Sweets and sugars Soda pop White bread and white rice Snack foods Fast foods Refined carbohydrates Potatoes (limit potatoes if you are at high risk for diabetes. If lean and active, a moderate intake of potatoes is fine.)	Fresh fruits Vegetables Legumes, peas, beans, garbanzos, soy, tofu Soy milk Whole-grain breads and cereals, including oatmeal and brown rice Protein rich foods Healthy fats such as as nuts, seeds, olives, and avocado

Check your blood glucose level. If you are over 45, have your doctor check your fasting blood sugar and glycated hemoglobin (HbA_1c) level. A HbA_1c test result greater than 5% indicates you are at higher risk and need to take preventive actions listed above. It is also more important to reduce any other risk factors present such as high blood pressure, smoking, or high cholesterol. Ask your doctor for help if needed. If you already have diabetes, follow your doctor's guidance.

References
1. British Medical Journal, Jan. 6, 2001; vol. 322:1-6
2. NIH, National Cholesterol Education Program, Dietary Guidelines for Heart Health, 2001

Note: All health information and guidelines are intended for healthy populations to encourage healthy lifestyles. They are not intended to take the place of advice by your doctor. If you have health problems or questions ask your doctor for specific guidance.