Would You Prefer a 0.18 or a 0.50 Reduction in Your A1C?

This is a no-brainer, right? Of course, you'd prefer a reduction of 0.50 in your A1C if you had the choice and the opportunity to lower it at all. Here's some food for thought and some food hints to help you with this.

A few years back, there was incredible media attention paid to the benefits of high fiber diets. We were exhorted to use high fiber cereals and grains to reduce blood sugar, lose weight, and lower cholesterol levels. This was fine with me because I like most of the high fiber foods, often better than their low-fiber brethren. Give me a piece of whole wheat bread any time over white bread. And truth be told, I much prefer brown rice to the white variety.

However, it seems that the benefits of high fiber foods may have been a bit oversold by the media. Recently, a six month study from the University of Toronto showed only a 0.18 reduction in A1C levels for people who were placed on a high fiber diet. While better than nothing, I would certainly have thought the reduction would be higher based on the articles in the popular press. Over 200 Type 2 diabetics participated in the study.

This same study also tested A1C reduction for Type 2 diabetics who ate a diet based on the glycemic index. The glycemic index is a measurement of how quickly carbohydrates in foods break down in the body and increase a person's blood sugar levels. Carbohydrates that break down rapidly during digestion releasing glucose rapidly into the bloodstream have a high GI value. Carbohydrates that break down slowly, releasing glucose gradually into the bloodstream, have a low GI value. The glycemic index was originally developed at the University of Toronto in the 1980s and so it's no surprise that the same university is performing further research on it today. An excellent and very thorough article on the glycemic index can be found at http://www.bing.com/health/article.aspx?id=articles%2fwp%2fpages%2fg%2fl%2fy%2fGlycemic_index.html&q=glycemic+index

Predicting what foods score high or low on this index can be tricky. For example, when vinegar is added to food that ranks high on the index, the ranking comes down. Enzymes often used in brown breads, a food you'd consider to be lower on the index than white breads, increase the index value for the brown breads, making them similar to white breads when valued through the index. Recent studies have shown that the consumption of an alcoholic drink prior to a meal reduces the GI of the entire meal by approximately 15%. I was delighted to read this, but you have to admit it's counterintuitive to what people tend to believe regarding alcohol consumption and its effect on blood sugar levels.

Here are some examples of what's good and not so good by category in the glycemic index, good meaning a lower value on the index:

Breads: 9 grain multigrain, oat bran, pumpernickel, seeded Rye, sourdough, quinoa, and flaxseed. Avoid white bread and grainy breads.

Cereals: All Bran, Oat Bran, wheat bran, bulgur, and large flake oatmeal. Avoid corn flakes

Don't be surprised to learn whole books are written to help people grapple with how to eat and conformance to this index. I'm investigating the possibility of Bay Area digital's acquiring the rights to one of these books to produce in Daisy format. Please let me know if that's something you think is worthwhile to do.

Finally, let me put in a quick plug for my friends over at Extend Bar. Their snacks feature low glycemic index ingredients. I hope soon to have a link for them on this page and in my blog generally.