I was utterly stunned the other day: I got an A1C (hbA1C) read and it was less than 5.0! This is stellar actually and the odd thing is that I consume a high carb, pretty doggone low fat diet. I would guess that my average fat levels for the last two months were around 20%. So how did I do it?
Before I answer that question, let me just explain to anyone unfamiliar with A1C that it means "glycated hemoglobin" and is essentially a rolling average of your blood glucose levels for about the last 3 months. It's a incredible useful measurement that Mother Nature provided us and should be regularly monitored in my opinion at 3-4 times per year, since blood glucose levels are one of the primary aging mechanisms.
I had long wanted to get my A1C down to 5.0 for anti-aging purposes. Life Extension Foundations recommendations are just that in fact:
"Hemoglobin A1C (HbA1C) evaluates long-term blood sugar control and is one of the leading theories of aging. Serum glucose reacts with important proteins in the body rendering them nonfunctional in a process called glycation. Hemoglobin A1C is a reflection of this detrimental reaction...Life Extensionï¿½ believes an ideal HbA1C level to be <5.0." 
This destruction of proteins in the body, unchecked, can lead to long term damage. Note that prediabetes begins at 5.7 and diabetes at 6.5, and so I wanted to be well below these. And check out what the lab report said:
Notice that the lab report estimated my average blood glucose to be 94. This is pretty impressive when you consider that many men have fasting levels well above that in the U.S. And keep in mind that I am 55 with a history of adult onset diabetes on one side of my family.
Let me explain what was really strange about that 5.0 read: I had had a 5.6 read several months prior on 11/5/2015. This was a wake up call for me, because it was fairly close to the prediabetic range. My previous A1C was 5.3, and so it was quite disturbing that it had gone up. At 55 a rising A1C is not something you want to see, but I had been doing a lot of sitting - I have two jobs that require a ton of staring at a computer screen - and was under quite a bit of stress and lack of sleep. All of these are hard on insulin sensitivity, and so I knew I needed to change things.
MY PROTOCOL TO LOWER A1C: So here is what I did:
a) 15,000 Steps. Started aiming for 15,000 steps per day. I like this goal as it keeps me moving all day. I don't hit 15,000 every day but probably averaged 12-13,000.
b) Took Berberine. Actualy, I took goldenseal root from Vitamin Shoppe, which does not even have a guaranteed amount of berberine on it's label. However, I believe this worked due to the fact that my A1C dropped so significantly. CAUTION: Many experts recommend that you stop taking berberine after 8 weeks due to the fact it has mild antibiotic properties. In fact, this is how it seems to work - by somehow favorably altering gut bacteria. Part of metformin's superpowers can also be attributed to its mildly antibiotic properties. But the concern is that taking berberine indefinitely could lead to antibiotic resistant bacteria - always a scary proposition. So I stopped after 8 weeks.
c) Low Fat Diet. I followed a low fat diet more strictly. Yes, I know that low fat diets are much maligned here in the U.S. However, and contrary to the conventional wisdom out there, the latest thinking on insulin resistance is that the root cause is when the liver and muscle cells get literally stuffed with intramycellular lipids. This mostly comes from fat in the diet and researchers use high fat diets to induce insulin resistance all the time. It can also results from refined carbs as well. I had been cheating a little, and so I stuck to low glycemic low fat carbs almost exclusively. This undoubtedly cleared out the intramyocellular lipids and helped lower A1C. CAUTION: Most people who eat low fat diets consume a lot of wheat, white rice and other refined carbs. Success with a low fat diet requires one to consume low glycemic whole foods. See my pages on My Low Fat Paleo Diet.
CONCLUSION: Using natural and nutraceutical methods, I lowered my A1C from 5.6 to 4.9. Low fat diets, when done with low glycemic load foods, can be used effectively to lower A1C. Because this is the lowest A1C that I have had, berberine likely played a major role. And, finally, avoid the three S's: Sitting, Sleeplessness and Stress.