For many patients getting a diagnosis of prediabetes is surprising and eye-opening. Nothing has changed in their routine, yet their body is struggling metabolically to process the glucose that they are eating. Most times the body has simply hit a breaking point, especially if there are other chronic conditions, challenges, stress impacts, nutritional deficiencies or an accelerated aging process. Sometimes, the body needs more of a reset. Fortunately, given the right inputs and using some wisdom gained through research, there are ways of reversing this diagnosis.
Understanding HbA1c is at the core of understanding why you have received a prediabtes diagnosis. While glucose is an energy-fueling molecule, there is a narrow band of tolerance for glucose staying in the blood (it should be in the cells!). HbA1c indicates the percentage of red blood cells that are surrounded by glucose and research indicates that the body prefers <5.7% of the surface to be covered with glucose. Once it starts creeping up, even in the mid 5% range, the body is already struggling with managing glucose. HbA1c is a good marker of blood glucose as it is tailored to red blood cells, which typically have a life of 3 months in the blood. So, HbA1c can tell you how well your body has been managing blood glucose for the past 3 months.
According to the CDC, approximately 60% of calories in the American diet come from processed foods (1). Pre-packaged foods are usually packed with sodium, sugar, detrimental fats and other unsavory additives. Bottom line: there is no control over the ingredients and some of the ingredients contribute significantly to inflammation and metabolic distress. Per the Dietary Guidelines, women should consume no more than 6 teaspoons of added sugars per day, while men should consume no more than 8 (children should consume no more than 4), which translates to 24g and 32g of sugar respectively. For example, a Nutrigrain breakfast bar has 12g of sugar – half of the recommended intake for women in just one bar. It is very easy to tip the ingredient scales when consuming food that is not prepared by you. And thus, it is very easy to contribute to a diagnosis of prediabetes.
While we were not born with a user manual, the Harvard Healthy Eating Plate (https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/) emerged from research to create a pseudo one for our bodies. This plate suggests that ½ of your plate should be vegetables (and some fruit), ¼ of your plate should be lean protein and ¼ of your plate should be whole grains. Healthy fats are also included on this plate and they can include olive oil, avocado, nuts, olives, and full-fat fermented dairy. Eating with a vegetable forward mindset helps ensure adequate fiber, vitamins, minerals and other bioactive substances that help your body function optimally. Eating this way also changes your taste buds and leaves you more satiated. Dietary patterns across the world that favor longevity follow this model of eating for good reason.
Beyond quality ingredients, the way in which food is consumed is important. Fiber slows down the glucose response, which can lead to less glucose spikes and ultimately a lower HbA1c. The order in which you eat your food matters. For instance, with a meal of chicken, vegetables and rice, taking a bite of the rice first will send your glucose sky high, while eating a few forkfuls of vegetables will create a lower glucose response, ultimately contributing to a lower HbA1c. Eating protein first is also beneficial, but the best response comes from eating fiber first, as fiber slows the absorption of glucose into the bloodstream. So, consider an appetizer before dinner such as a green salad or some raw vegetables, or dig into your dinner with the vegetables first. Breakfast can sometimes be tricky, as you may not be accustomed to consuming a savory breakfast, however, it turns out that breakfasts like these are the most beneficial for blood glucose. Consider consuming an avocado with lemon and hummus, an egg scramble with vegetables, or canned fish with olives and nuts. Carbohydrates consumed should be complex such as those found in vegetables or whole grains and they should be an afterthought and not the main star of a meal. Additionally, dessert should be enjoyed with dinner (directly after) rather than a one-off cookie snack at midday. For even more glucose control, consume 1 tablespoon of vinegar in water right before your meal (using a straw).
A diagnosis of prediabetes can be managed with food and movement patterns. Speak to our in-house nutritionist about how to personalize your approach.
(1) https://www.cdc.gov/pcd/issues/2018/17_0265.htm
Prediabetes diagnosis, Glucose tolerance, HbA1c, Homemade food, Processed foods, Added sugars, Nutritional guidelines, Harvard Healthy Eating Plate, Dietary patterns, Fiber intake, Glucose response, Blood glucose control, Vinegar and glucose control, Prediabetes management, Nutritionist consultation
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