People who have heart disease and diabetes often come to me in a state of panic. “Hmm…heart disease, so, low fat means no meat or cheese…diabetes, that means no potatoes rice or pasta…not to mention sweets.
Gee, can I eat anything?” Fortunately, the answer not only is “yes” but that you can eat everything. The key is not only what you eat, but how and when you it.
Diabetes and heart disease are like evil twins. They work together in all the worst ways. Diabetes significantly increases your chances to have a heart attack or stroke. Many people with diabetes also have high blood pressure and high cholesterol; factors that further increase that risk. Diabetes is so dangerous because over time, the high glucose levels caused by diabetes damage blood vessels and nerves. Because there are often no overt symptoms, these high blood sugar levels are not properly controlled. The result is that people with diabetes tend to develop heart disease at a younger age and are twice as likely to die from a heart attack or stroke than those without the disease.
So, what do you do? First, know where you stand. To reduce your risk for heart attack and stroke, have these number in target:
· Monitor your A1C–a test that measures your diabetes control over time, and lets you know if your current plan is working. Goal: for most people is less than 7.
· Blood Pressure–Goal: Less than 130/80.
· Cholesterol-LDL (the “bad cholesterol”: Less than 100.
· Triglycerides: Less than 150.
If any of your numbers are higher than those listed above, ask your health care provider how to lower them. There are a number of options, to include both medication and lifestyle changes, often with little effort, that can make a huge difference. Just don’t ignore them!
Next, let’s talk about the best foods for each condition.
Diabetes: It is best to eat healthy carbohydrate-rich foods, such as grains, starchy vegetables, fruit, milk and yogurt. It is important to eat three balanced meals. Eating between meals is optional, but is a good idea if you are hungry or have small meals. Wait, did I say carbohydrates are good for diabetes? Why yes I did. The key, again, is both how much and when.
Blood Pressure: Eat plenty of fruits and vegetables, along with low-fat or fat-free dairy foods. These work together to lower blood pressure. A low sodium intake (under 2300mg/day) reduces blood pressure even more. Read labels! You’d be amazed how much sodium is contained in pre-packaged foods.
Heart Disease: Avoid trans-fat. Limit saturated fat. Look for 0g trans fat on the nutrition facts label. Fat consumed from animals are generally high in saturated facts so aim for low fat and fat-free milk, yogurt, cheese, and lean meat. My husband never thought he would like fat-free milk or yogurt. Now he buys nothing else and even prefers the flavor.
Increase fiber. Fiber is only found in plant based foods. The less processed foods are, the more nutrients they will retain. Think whole fruit, rather than fruit juice, brown rice and whole grain bread instead of white.
So, let’s use all of this information to design great meals that are healthy for folks with both diabetes and heart disease.
Step 1: Fill half your plate with non-starchy vegetables. It can be fresh, frozen (without sauce), or canned (no salt added or rinsed and drained). Be careful not to add a lot of calories from sauces and dressing. There are a number of spices that can add some great zing to your vegetables.
Step 2: Grains-On a quarter of your plate choose grains, preferably whole grains (e.g. brown rice, quinoa or pasta), or starchy vegetables (beans, peas, potatoes or corn).
Step 3: Lean protein- On the last quarter, choose fish, chicken, lean beef or pork (look for loin or round in the name or lowest percentage of fat in ground meat), or eggs (limit yolks to3 per week), or tofu, and other meat substitutes. Fatty fish is great because it contains healthy omega-3 fatty acids. Because it contains protein and animal fat, cheese is included in this section. Try to keep your cheese portions small because of its high fat and sodium content. (I guess you have a good excuse to “cut the cheese”).
Step 4: In addition to your plate, have some fruit three times a day and some low or fat-free dairy (also three times a day). Try, when you can, to substitute fruit or yogurt for a dessert. Of course, sometimes you just have to splurge…go ahead! Just don’t do it a lot, use sensible portions and remember to enjoy every bite.
Step 5: Throw in some “heart-healthy” fats. These include nuts, seeds, avocado, olive and other vegetable oils and nut butters. All fats are high in calories, so keep your portions small.
Finally, it is important to throw in some physical exercise. Start a little at a time and don’t get discouraged. Aim for consistency.
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