Hemoglobin A1c, often shortened to A1c, is used to monitor blood sugar over a period of time. While some people need medications to lower their A1c, other strategies---especially your food choices---can help all diabetics to have a healthier A1c level.
A1c and the Glycemic Index
Hemoglobin is a protein inside red blood cells that carries oxygen to the other cells in the body. Because hemoglobin links to sugars like glucose, when your blood glucose level is high, the excess sugar links---or glycates---to the hemoglobin. That's why another name for hemoglobin A1c is glycated hemoglobin. A simple blood test is used to measure the A1c and can show what your average blood glucose has been over a period of time. The A1c is not used for daily insulin adjustments and does not replace daily self-testing of blood glucose. A person who does not have diabetes usually has an A1c of about 5 percent. The goal for diabetics is an A1c of 7 percent or less.
Foods are rated according to their glycemic index---how much they affect blood sugar. Simple carbohydrates, like table sugar or candy bars, have a high glycemic index and cause abrupt spikes in blood sugar levels. The sudden rise in blood sugar means more sugar is glycated to the hemoglobin molecule and may required extra insulin or other diabetic medication. However, as the medication lowers the blood sugar level, it can go too low, resulting in symptoms of hypoglycemia, or low blood sugar. These symptoms include dizziness, a shaky feeling or even fainting. The goal of diabetes management is to keep the blood sugar on a fairly even keel all the time. Proteins and complex carbohydrates, like legumes or whole grains, have a lower glycemic index and are unlikely to cause blood sugar spikes.
Satiety Index
The other important aspect of food for diabetics is satiety, which means eating foods that help you to feel full, or sated. High-satiety foods tend to decrease snacking and also help to maintain stable blood sugar levels because they are digested more slowly. Foods with a lower glycemic index also tend to be foods that promote satiety. Dr. Suzanne Holt, of Sydney University, was the first to develop the Satiety Index, a chart that indicates how full a particular food makes people feel when compared to white bread. Her research, published in September 1995 in the "European Journal of Clinical Nutrition," gave medical professionals another tool to help manage diabetes.
Eating for a Lower A1c
The key to improving the A1c is to eat low-glycemic, high-satiety foods and to watch portion control. The American Diabetes association recommends 10 "super foods" that meet this requirement. They are beans, dark green leafy vegetables, citrus fruits, sweet potatoes, berries, tomatoes, fish high in omega-3 fatty acids, whole grains, nuts, and low-fat milk or yogurt. These foods also tend to have a higher satiety index. For example, Dr. Holt's research found that compared to white bread, with a 100 percent satiety index, brown rice is 132 percent; baked beans 168 percent; whole meal bread 157 percent and potatoes a whopping 323 percent. Cake and doughnuts, on the other hand, have satiety indexes of 65 and 68 percent, and since they are high in sugar, each has a high glycemic index.
Considerations
While no single food can lower your A1c level, careful attention to portion control, glycemic index and satiety will help you achieve and maintain a healthy reading. Since diabetes is a complex disease that requires careful management, you should work with a knowledgeable health care professional.
