- Have you been given bad advice by your doctor
about how to prevent plaque buildup in your arteries?
I'm afraid you might have.
And I'm gonna talk about some research in this video
that'll make it very, very clear to you
what the proper advice should be and should have been.
I'm Doctor Ken Berry, a family physician
with 21 years of clinical experience.
And this video is gonna help you understand
your hemoglobin A1C,
and what the goal for that number should be.
A new research article published
in the Journal of the American College of Cardiology,
entitled, "Glycated Hemoglobin
and Subclinical Atherosclerosis
in People Without Diabetes."
This is an excellent article that makes very, very clear
the power of having a very low hemoglobin A1C.
We already know that people
with diabetes have an increased risk
of buildup of plaque in their arteries,
in their heart and other places.
But what about people with pre-diabetes?
What about people with a normal hemoglobin A1C?
What I want you to understand in this video
is that every cutoff given to you by your doctor,
some doctors will say,
well if you're A1C's under 6.5,
you're not diabetic and that's fine.
Others will say, well it needs to be under 5.7,
that's the cutoff for pre-diabetes.
And if you're under 5.7, then you're perfectly safe.
The problem is these are arbitrary numbers,
basically picked out of thin air
that don't really give you the full story
behind your hemoglobin A1C,
and what you really want it to be.
I put a link to the full research article
down in the show notes below for all you nerds out there,
and I know who you are,
who'd like to read the full paper
for yourself and see the full implications
of what these researchers found.
Now, here's probably the most important chart
in the whole publication,
and what this is, is they lined up everyone in the study,
and there were a lot of people in this study.
The darker the shade of blue,
the more damage, or the more plaque buildup,
that's happening in that person's body.
Down at the bottom of this graph
is the actual hemoglobin A1Cs,
which is a measure of glycated hemoglobin
in a person's body.
So on the left-hand side,
you see that the very lowest A1C they talk about is 4.8,
which is very, very low,
and it's very hard for many of us to get it that low.
Over on the right-hand side is a hemoglobin A1C of 6.1,
which is high, but it's not, that's not diabetic.
You have to have a 6.5 or higher
to be considered a type two diabetic.
So all of the people in this study were not diabetics.
These are normal people walking the street
with no symptoms whatsoever,
and they're building up plaque in their arteries
depending on where their hemoglobin A1C currently is.
So let's look at people with a hemoglobin A1C of 6.
Now you can see on this chart,
there's a zero line that goes right across the middle.
If you fall under that line,
then you actually have no plaque buildup
in your arteries whatsoever.
And that would,
that would correlate
with a coronary artery calcium score of zero,
or a CAC score of zero.
And for people with an A1C of 6.1,
you can see that only 18% of them
had no plaque buildup in their arteries at all.
And they had a substantial amount of plaque buildup
in all of their other arteries that were studied,
and I'll show you which arteries they looked at in a minute.
So as we come down, go towards the left on this chart,
we notice that more and more people
with that level of A1C have no plaquing.
They would be under that bold black line
that goes right across the middle,
and less and less people have a measurable plaque buildup
in their arteries.
And the more you move towards the left of this chart,
the more zero CAC scores,
or no plaque buildup whatsoever you see,
and the last documented plaque buildup
that you see above that bold, dark line.
So for example, someone with a hemoglobin A1C of 5.6,
and that is considered not diabetic and not pre-diabetic,
and many authorities out there will say
this is a perfect A1C,
but I want you to look at this graph very closely,
and you'll see that it's not a perfect A1C.
It's much better than prediabetes or type two diabetes,
but in my estimation,
and based on the research in this study,
I really think the goal for all of us,
including you, should be at the lowest
hemoglobin A1C that you can personally attain.
And so if you've gotten your A1C down
from type two diabetic levels into the pre-diabetic range,
that's definitely less bad, but it's not perfection.
You're not safe there for the long haul.
You want to get your A1C even lower.
And so I think this gives you great evidence
that a hemoglobin A1C under 5.7
is a bit of an arbitrary cutoff.
That's not really a magical number whatsoever.
There is still gonna be plaque buildup in your arteries,
even with an A1C of 5.6.
And I'm not saying this to be negative
or to make you feel bad.
I want you to understand the goal is not an A1C of 5.6.
The goal is to have the lowest A1C
you can possibly attain,
based on your genetics, your personal biochemistry,
and your diet.
And here, you can see that for someone
with a hemoglobin A1C of 4.8, which is very low,
and very hard for some of us to attain,
all but 54% of these people had no plaque buildup
whatsoever in their arteries.
And then of the people
who did have some documented plaque buildup,
it was a very, very minimal amount.
So this A1C is much more protective
than even a 5.6,
and obviously much, much more protective
than anything above a 5.6.
This study controlled
for every other variable that you can think of,
from smoking to family history,
to having high blood pressure,
to having lipid disorders,
they controlled for all of this stuff.
And so the data you see on these charts
just tells you a direct relationship
between your level of A1C,
and the plaque buildup that's going on in your arteries.
Now on this chart, you see, for example,
they checked multiple different arteries.
They checked the carotid arteries.
And again, the bottom of that chart
with the red bars is the hemoglobin A1C, from 4.8 to 6.1.
They also check the infrarenal aorta.
They check the iliac and femoral arteries
that supply your pelvis
and your legs and your feet and toes.
And they then get a coronary artery calcium score,
which is very wise.
And you can see in all these graphs,
there is a direct relationship
between how high your hemoglobin A1C is,
and how much plaque you're building up in your arteries.
Now question, okay doctor,
I was a type two diabetic for a few years.
I reversed that to prediabetes,
and now I'm back to a normal A1C,
hopefully as low as you can get it,
is that plaque buildup that I had earlier in life
because of eating a high carbohydrate junk diet,
can I reverse that buildup of plaque?
And I would say to you
that I have personally seen in my clinical practice,
as have many other doctors who are colleagues
and friends of mine,
we have seen the plaque buildup in the carotids,
in the coronary arteries,
and in the other arteries actually regress,
as you continue to eat
a lower and lower carbohydrate diet,
in order to get your A1C as low as you
can physically get it to go.
And that's exactly how you lower your A1C.
And indeed, that's how you reverse
the plaque buildup in your arteries,
is you continue to lower the amount
of daily carbohydrates that you eat in your diet.
Of course, you're gonna eliminate all of the junk foods,
the cake, candy, cookie pies, just pure junk.
Of course, you're gonna eliminate that.
Of course, you're gonna eliminate the soft drinks,
and the fruit juices.
All those things have no nutritional value,
based on their carbohydrate content whatsoever,
but some of us even need to lower
other kinds of carbohydrates,
like just eating too much fruit,
especially grapes and bananas.
They're too high in sugar,
and they don't have enough nutrition
to validate or justify that amount of carbohydrate intake.
So why would you raise your A1C
to get the minuscule amount of nutrition
in a banana or a grape?
That's dumb, so don't do that.
For the long-term to keep your A1C as low as possible,
and to keep the amount of plaque buildup
in all your arteries as low as possible,
you have to eat a low, low carbohydrate diet.
And that amount is going to vary for different ones of us.
Some people might be able to eat
under a hundred total grams a day
of of good quality carbohydrates,
and have a very low A1C,
and therefore low amount of plaquing in the arteries.
Others of you, like me for instance,
may have to eat as close to a zero carb diet
as they can possibly get,
in order to have a good, healthy, optimal A1C,
and not build up plaque in their arteries.
So if your doctor tells you
that your hemoglobin A1C of 5.8 or 6.1 or 6.4
is okay, that's fine, that's the goal.
That is terrible, terrible advice
for your long-term health and vitality.
You want your A1C to be as low as you can possibly get it
to protect you from heart attack and stroke,
and all the other complications
that come from plaque buildup in your arteries.
So why do organizations
like the American Diabetes Association,
say that the goal is a hemoglobin A1C of 6.4 or lower?
That's a good question.
I have no idea of the logic behind that decision.
Maybe you should email them and ask them yourself.
This is Doctor Berry.
I'll see you next time.