Day 15: High Blood Glucose Levels
As we said, AGE’s are dependent on the amount of excess sugar and high glycemic foods that we eat, however, there is a second source of pre-made AGE’s that occur from the food browning process. That’s right, how a food is prepared for consumption is critically important for AGE’s. Bread crusts, browned meats are examples of AGE formation. Any foods prepared by frying (around 575 degrees) and by broiling (around 500 degrees) result in extensive damaging AGE levels. In fact, AGE’s occur anytime foods are prepared at temperatures above boiling (212 degrees).
The bottom line is that high levels of blood glucose increases the glycation of LDL, the key step in formation of the deadly foam cells that is the primary step in the formation of soft or vulnerable plaque, the real culprit behind a majority of heart attacks.
Blood glucose levels can be measured by a simple fasting blood glucose test. The results of this test are highly correlated to an independent test for glycation, Hemoglobin A1c. Hemoglobin A1c (HbA1c) is a direct measure of how much glycation is occurring in your blood.
Most doctors feel that acceptable levels of HbA1c are less than 5.8 percent, which correlates to a blood glucose level of about 115. Each 1% change in HbA1c seems to correlate with about a 30 point change in fasting blood sugar levels.
In patients without diabetes, the lower the HbA1c the better for heart disease. Studies have found that individuals without diabetes, but who had "high normal" HbA1c levels (approximately 5 percent to 6 percent), were at an increased heart disease risk, even after accounting for other factors such as age, cholesterol level, blood pressure and smoking. Non-diabetic persons with HbA1c levels of 6 percent or higher had almost a two-fold greater heart disease risk compared to persons with an HbA1c level below 4.6 percent. If you do not have diabetes, you can see the importance in making dietary and meal preparation choices that lower HbA1c levels.
In patients with diabetes, studies have found a strong association between HbA1c and an increasing heart disease risk. Each 1-percentage-point increase in the HbA1c level is associated with a 14 percent increase in heart disease risk. The American Diabetes Association indicates that HbA1c values should be less than 7 percent, however, research indicates that heart disease risk begins to increase at values below 7 percent.
There is one additional caveat here and that in patients without diabetes we believe that we need to work on aggressively lowering HbA1c levels to lower heart disease risk but that diabetes patients should actually accept high levels of HbA1c while suffering from diabetes rather than aggressively trying to lower this reading through higher levels of pharmaceuticals which carry with them additional, scarier negative reactions.
Tomorrow we will talk about homeocysteine as a risk factor in heart disease.
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