The Hidden Heart Health Hazard Everyone is Afraid
to Talk About!
Heart Hawk here,
your friendly heart health consumer advocate and champion of prevention.
You have a hidden heart health hazard. Virtually every American does,
too, but is unaware of how important it can be or is afraid to talk
about it - before it’s too late.
It is one of the most studied health phenomena in the world, yet this
insidious killer gets away with murder. But, the good news is you can
stop this killer all by yourself - without a doctor!
The killer is blood sugar. That’s right, blood sugar,
the blood sugar that keeps you alive, the blood sugar that nature
created to power everything in your body, the same blood sugar that will
kill you just the same if you have too little or too much.
“Everything in moderation.” With blood sugar, lack of moderation can be
deadly. Blood sugar moderation becomes increasingly problematic as we
neglect diet or as we simply get older. The bigger problem is that,
despite the fact that faulty blood sugar metabolism is extremely easy to
detect (you can do it yourself at home), doctors often don’t do the
test. In fact, even when they do the test, it often is the WRONG test!
Now, let’s get down to the nuts and bolt of the problem and how to
personally solve it.
Because blood sugar control is so important, your body has developed a
regulatory mechanism to provide exquisitely precise control over blood
sugar to keep it in a narrow range. When you eat any carbohydrate, the
digestion process converts carbohydrates to glucose, which then enters
the blood stream. The pancreas quickly releases the hormone, insulin,
that allows your body to use the glucose or to store it as fat for later
use. This system served early man well in a time when food often became
scarce: excess carbohydrates, insulin triggered, fat stored for future
use when no food available. The liver also plays a role by storing a
small portion of this glucose for rapid release as glycogen. It is a
very precise and responsive system - until we abuse it!
Like most any tightly regulated system, it can go out of control if
things happen too fast or the inputs are simply too much. Think of a
furnace. On a cold day it keeps your house within a tight temperature
range of just a few degrees. But if you open all the doors and windows
for a few moments and it gets cold rapidly, the furnace can’t keep up
with the sudden influx of cold air. If you leave the doors and windows
open, the furnace can’t keep up.
The same is true of blood sugar. Sugars like lactose, glucose, maltose,
and sucrose (table sugar; first cleaved to yield glucose and fructose)
enter the blood almost immediately and increase blood sugar.
Wheat flour, cornstarch, and other and processed grains also increase
blood sugar. Even fruit and some vegetables are loaded with - you
guessed it - sugar! (The unique exception is fructose, a unique sugar
that doesn’t increase blood sugar but nonetheless is an insidious evil
player that triggers other distortions.)
These foods are rated from 0 (think water) to 100 (think pure glucose)
with a measure called glycemic index. If you eat just a little of a high
glycemic index food, or much more of even a low glycemic index food,
your blood sugar can skyrocket. Of course, that exquisite control system
of yours will work like mad to lower blood sugar to keep you out of
danger. But that system it is not indestructible and you can literally
wear it out. Like a 150,000-mile car hobbling along, it may fail
altogether but, more often, it just gets get weaker and weaker if you
drive it too roughly with lots of “jack-rabbit” starts and stops - and
this is where the your doctor and the whole traditional medical system
can fail you as well.
Doctors like to work with precise numbers that allow them to diagnose
diseases. For example, if blood sugar rises above 200 mg/dl one hour
after eating, or if fasting blood sugar exceeds 126 mg/dl, your doctor
will diagnose you with diabetes. This is what happens when your pancreas
fails and does not make enough insulin, or the insulin it makes becomes
ineffective. But, does this mean if your test numbers are 199 mg/dl (one
hour after eating) and 125 mg/dl (fasting) you are not sick - NO, not by
a long shot!
Every time your blood sugar shoots up or stays high too long, a little
more damage is done to your organs - retina, lens of the eye (forming
cataracts), kidneys, artery lining, heart. This is where the second
problem occurs. The majority of doctors only test your fasting blood
sugar - a potentially misleading value. It is easy to imagine how blood
sugar could hit the roof after drinking several cans of sugar-sweetened
cola. But what about giving your pancreas an eight-hour rest with no
glucose to process (i.e., an overnight fast)? Blood sugar could return
to well below 126 mg/dl. But imagine what all that excess blood sugar
was doing to your body for all those hours it was still too high.
“You don’t need that test”
Now for the solution. The first step is to determine how well-tuned your
engine - your pancreas - is. What would be ideal is if you can convince your
doctor to do what is called an Oral Glucose Tolerance Test (OGTT). You
will be directed to show up without eating breakfast. You will drink a
flavored glucose solution (containing up to 75 grams of pure
glucose), then undergo a series of blood draws over a period of two
hours. This is the only test that accurately gauges how well your
control system is operating “under fire.”
What if your doctor’s response to a request for an OGTT is “You don’t
need that test”? If you cannot convince your doctor to test you
properly, then ask for a hemoglobin A1c, or HbA1c, a gauge of your
average blood glucose for the past 90 days.
HbA1c represents the percentage of red blood cells that are glycosylated,
i.e., the amount of hemoglobin bound by a glucose molecule. Once
glycosylated, a red blood cell remains glycosylated until it is removed
from the bloodstream during its life of about 90 days. Normally, this
value is 5% or less, i.e., 5% or less of all hemoglobin is glycosylated.
Any value greater than 5% represents increasing percentages of red blood
cells that are glycosylated.
The following equation allows you to get a sense of what your average
glucose has been based on your HbA1c:
Mean Plasma Glucose (mg/dl) = [35.6 × HbA1c (%)] - 77.3
For example, a HbA1c of 5.5% equates to an average blood glucose of
118.6 mg/dl, suggesting that blood sugars have been too high at times.
Each 1% increase of HbA1c corresponds to an increase in blood glucose of
35 mg/dl.
There are a few issues to be aware of with HbA1c:
• Fasting is not required, nor is time of day a factor.
• Don’t test HbA1 if you’ve made any substantial diet change in the past
60 days, since it will yield misleading HbA1c values.
• If you have vitamin B12 or folate deficiency or high homocysteine
(greater than 10 mmol/L), HbA1c will be falsely elevated.
• Iron deficiency anemia will falsely increase HbA1c.
• Avoid taking vitamins C and E for 48 hours prior to a HbA1c test, as
these nutrients interfere with the measurement.
A truly ideal HbA1c is 5.0% or less. HbA1c values in the 6.0-7.0% range
are in the pre-diabetic range, while values greater than 7.0% are in the
diabetic range.
Diabetics are generally advised to keep HbA1c below 7.0%. Though this
may seem high, it is meant to avoid the dangers of excessively low blood
sugar that can develop with oral diabetic drugs and insulin injections.
However, long-term studies in people with established diabetes (e.g.,
the Diabetes Control and Complications Trial, or DCCT) suggest that
HbA1c values of greater than 6.0% are associated with increasing risk
for heart attack.
What if your doctor won’t perform a HbA1c or a glucose tolerance test?
That’s when you might consider testing your HbA1c yourself using a
fingerstick blood spot test.
If your HbA1c proves abnormal, then you might use it to prod your doctor
into ordering a glucose tolerance test - finally!
The goods news is that most blood sugar problems can be solved with
dietary modification and exercise. The key: reduction of foods that
increase blood sugar and insulin, especially sugars, wheat, cornstarch,
and other carbohydrates. HbA1c can be reassessed in future to gauge your
response, looking to see whether you’ve reduced it.
Don’t become another statistic of a healthcare system blinded by the
WRONG numbers. Take matters into your own hands. Get the right test - even
if you have to do it yourself. It’s simple, quick, easy and the benefits
may be immense - benefits like saving your life or the life of someone you
care about!
Copyright 2009 Track Your Plaque, LLC