November is Diabetes Awareness Month and as a former employee of Diabetes Canada the importance of awareness raising around diabetes management is not lost on me.
Canadian public health data suggests that 1 in 10 Canadian adults are living with diabetes, with about 90% of that population living with type 2 and the majority of the remainder living with type 1.
From a professional perspective, I am most interested in the dietary management of what has come to be known as prediabetes.
Prediabetes refers to blood sugar levels that are beyond the normal range, but not yet high enough to to warrant a formal type 2 diabetes diagnosis.
An A1C of between 6-6.4%, for example, is one of the metrics that could be used as part of the diagnostic process for prediabetes.
Reducing A1C, which is essentially a measure of your average blood sugar levels over a 3 month period, is very often a measure used to determine the effectiveness of any management strategy ( dietary or otherwise) in the world of diabetes care.
I commonly work with people who have been informed by their doctor, very often based on an A1C measurement, that they are creeping towards prediabetes.
In my experience, such as a diagnosis tends to elicit more fear and concern in patients as compared to other common diagnosis such as high blood pressure, cholesterol or acid reflux.
The good news is that there are certain food groups , dietary components and dietary strategies that are particularly effective at improving blood sugar control and lowering A1C, thus reducing the risk of progressing to prediabetes or, at the very least, reducing the risk that prediabetes will end up in a formal type 2 diagnosis.
It’s important to be aware of these options if your blood sugar levels have been creeping upwards, so let’s take a closer look at what they are.
Reduce A1C With These Four Key Food Groups
The dietary management of diabetes significantly scales in complexity dependent on the type of diabetes, the presence/absence of medication and the overall health status of the individual.
In the case of prediabetes or slightly impaired blood sugar control on the verge of prediabetes, incorporating some of the key foods we are about to discuss with great regularity has the potential to play a meaningful role in the dietary management and reduction of your A1C.
These key foods include:
Legumes – The legume family of foods includes choice such as lentils, chickpeas, kidney beans and related foods. These foods, by some margin, are the richest source of dietary soluble fibre which has very strong positive effects on blood sugar management.
Case in point, the long-term consumption of these foods at the rate of about ~5 cups weekly has been shown to lead to significant reductions in A1C.
Although perhaps slightly less potent than those mentioned above, soy-based foods such as tofu, tempeh and edamame are also good sources of soluble fibre and may contribute to a dietary pattern that favours improved blood sugar control.
Tree Nuts – The consumption of ~ 50 grams per day of nuts has been shown to be an effective dietary strategy to contribute to lower A1C levels
It just so happens that tree nuts, like almonds, walnuts and hazelnuts, are also very effective in the management and reduction of blood cholesterol levels as well.
Soluble-Fibre Rich Fruit – Contrary to commonly held belief in certain circles, the exclusion of fruit is not a recommended strategy in diabetes management nor does it contribute to reductions in A1C.
In fact, the consumption of two fruits per day over a 3 month period contributes to a reduction in A1C levels.
Although all fruits fit, certain varieties such as avocado, orange, apple, pear, plum and banana are particularly high in soluble fibre which may confer additional benefits to blood sugar control.
Combining these foods with tree nuts, as per above, makes for an incredibly healthy and synergistic snack ( also owing to the fact that the vitamin C from fruit enhances the iron absorption from the nuts, which is particularly useful for vegans/vegetarians!)
Soluble-Fibre Rich Veggies: Let’s be honest here, your A1C never met a vegetable it didn’t like ( even if you have!).
It should come as no surprise that vegetable intake is strongly recommended as an A1C lowering dietary strategy and that plenty of evidence exists that the inclusion of all types of veggies, especially leafy greens, plays a meaningful role in diabetes prevention and management.
As with fruit, certain types of vegetables are higher in soluble fibre than others.
A sample of these selections include brussel sprouts, broccoli, asparagus,okra, eggplant and sweet potatoes.
Bonus Content – Other Soluble Fibre Rich Foods
Owing to its unique slowing effect on the digestion of food, soluble fibre is a dietary component that will almost inevitably contribute to enhanced blood sugar control over time.
If you’d like a list of foods highest in soluble fibre, you can find that here.
Some of the notable foods on this list include certain types of seeds and whole grains such as barley, quinoa, ground flaxseed and steel cut oatmeal ( which, as I explain in this article, is a superior choice for blood sugar management as compared to instant oats) among many others..
You may have also heard of a little something called psyllium fibre, which is a potent soluble fibre supplement extracted from a specific type of plant.
The introduction of psyllium fibre, which can be acquired on its own or within products like Kellog’s All Bran Buds and Metamucil, is an effective compliment for those attempting to reduce their A1C.
It also happens to contribute to improved digestive health and reductions in blood cholesterol levels, largely owing to its soluble fibre content.
Helping people with newly diagnosed prediabetes, or perhaps even more so those who are creeping towards those levels, has been one of the major cornerstones of my private practice over the last several years.
As a former Diabetes Canada employee, I take great pride in the fact that I’ve helped hundreds of people in this position bring their A1C down to more acceptable levels by incorporating many of the strategies discussed in today’s post.
If you find yourself in a position where you need help with this issue, know that working with a dietitian like myself is a highly effective option to consider.
I hope you’ve found today’s article both helpful and reassuring.
Until next time,
Andy De Santis RD MPH