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Short Summary
Main recommendation: Aim for the lowest hemoglobin A1C you can personally reach, not just a number under the 5.7 pre-diabetes cutoff or the 6.4 target he attributes to the American Diabetes Association. Dr. Ken Berry argues that plaque buildup in arteries rises as A1C rises, even in people without diabetes, and says lowering daily carbohydrate intake is how to lower A1C and, based on his clinical observations, how he believes plaque can regress.
Key Points
- A new study in the Journal of the American College of Cardiology, "Glycated Hemoglobin and Subclinical Atherosclerosis in People Without Diabetes," is cited as the basis for this view.
- Plaque buildup was measured in people without diabetes, and the amount of plaque tracked directly with A1C, after controlling for smoking, family history, blood pressure, and lipid disorders.
- Berry says A1C cutoffs such as 6.5 for diabetes and 5.7 for pre-diabetes are arbitrary and do not guarantee protection from arterial plaque.
- Even an A1C of 5.6, which many authorities call perfect, still showed plaque in the study, according to Berry.
- Berry says he has seen plaque in carotid and coronary arteries regress in patients who kept lowering carbohydrate intake.
Details Worth Noting
- Concrete instructions: To lower A1C and reverse plaque, eliminate junk foods such as cake, candy, and cookies, and eliminate soft drinks and fruit juices.
- Concrete instructions: Reduce fruit that is high in sugar, especially grapes and bananas, because their nutritional value does not justify the carbohydrate load.
- Concrete instructions: Keep long-term daily carbohydrates low. Berry says some people may do well under about 100 grams a day of good-quality carbohydrates, while others, including himself, may need to eat as close to zero carbohydrates as possible.
- Study data: Berry says in the study, people with an A1C of 4.8 had 'all but 54%' with no plaque buildup, and those with an A1C of 6.1 had no plaque in only about 18%.
- Berry's concluding guidance is that the goal is not a specific number like 5.6 but the lowest achievable A1C based on genetics, personal biochemistry, and diet.
- Berry is a family physician with 21 years of clinical experience. These are his views on a single study, not professional medical advice for any individual.
Bottom Line
The video frames a low A1C and a low-carbohydrate diet as the strongest way to limit arterial plaque, and it challenges standard target numbers as too lenient, though its conclusions rest mainly on one study and the speaker's own clinical observations.
