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Eating for diabetes and heart health

Managing one health condition through diet can be hard enough, but when you have diabetes there is an increased risk of cardiovascular disease (CVD), too.

But this doesn’t mean two separate sets of advice in terms of changes to your diet. Victoria Taylor, Senior Dietitian at the British Heart Foundation, explains.

What’s the connection between diabetes and CVD?

If your blood glucose levels are high over time, you are more likely to develop atheroma, a fatty material that builds up on the lining of the arteries. This can lead to a heart attack or stroke. Diabetes can also increase the damage done by some of the risk factors for CVD, including smoking, high blood pressure and high blood cholesterol.

The good news is that simple changes to your lifestyle, including diet, can help you to manage your diabetes as well as reduce your risk of CVD.

What is a healthy, balanced diet?

The basics of healthy eating are similar whether you have conditions like diabetes and heart disease or not. There is no one-size-fits-all approach to eating healthily but it is important to have a regular meal pattern and make healthy food choices, such as fruit and vegetables (at least five portions every day), wholegrains, oily fish, lean protein foods such as non-processed meat, poultry, pulses and nuts as well as lower fat milk and dairy products. Keep the fatty and sugary treats to small amounts and focus on the type of fats we use, as well as the amount of salt.

Make simple switches

A couple of easy changes in your diet can help.

1. From saturated to unsaturated fat

Having too much saturated fat can increase your blood cholesterol levels, so it’s important to reduce the amount you eat and instead get fats from unsaturated sources.

Three tips to help get you started:

  • Swap butter and ghee for unsaturated vegetable oils and spreads such as sunflower, olive, rapeseed or corn.
  • Trim visible fat from meat and remove the skin from chicken.
  • Choose lower-fat milk and dairy products and swap biscuits, cakes and chocolate for healthier snacks such as fruit.

Remember, fatty foods are high in energy (calories) and excess energy results in weight gain. To help you manage your weight, it’s also important to keep an eye on the total amount of fat you’re eating.

Different fat types have different effects on the body. Diets high in saturated fat are linked to higher levels of ‘bad’ cholesterol (LDL) in the blood. Having too much LDL increases the build-up of fatty deposits in your blood vessels, increasing your risk of heart disease. Eating unsaturated fats instead of saturated fat helps to maintain healthy cholesterol levels in the blood.

2. Cut down on salt

Too much salt is linked with high blood pressure, a major risk factor for CVD. In the UK, we consume more salt than we should – the recommendation for adults in the UK is to have no more than 6g a day – about a teaspoon.

Three tips to help get you started

  • Most of the salt we eat is already in processed foods. Check the labels and go for those with the lowest salt content. Learn how to read food labels to help you make healthier choices.
  • Remove the salt shaker from the table, to stop you adding extra salt.
  • Try adding flavour to your food using herbs, spices, black pepper and lemon juice in place of salt when cooking.

Heart health Q&A

I’ve read that butter is now good for me, is that true?

To help maintain healthy cholesterol levels it’s recommended you switch from saturated fat (butter, lard and ghee) to unsaturated fat (vegetables oils and spreads). This is consistent with UK Government dietary guidelines, which is based on research that has shown a link between increased consumption of saturated fat and raised cholesterol levels – a risk factor for heart disease.

Choosing unsaturated fats is also consistent with a Mediterranean-style diet, which is associated with a lower rate of heart disease. This diet is low in saturated fat but higher in unsaturated fats such as olive oil and those from oily fish, nuts and seeds.

CVD is complex and no single food or nutrient is solely responsible for addressing our risk through diet. If you have diabetes, try to make changes that can help you manage your blood glucose, blood pressure and cholesterol levels as well as keep your weight in check. Food choices that are low in sugar, salt and saturated fat can help to achieve this. Therefore, it’s important to pay attention to your overall diet, rather than focusing on one particular nutrient, eg sugar or fat, in isolation.

Should I eat foods that contain cholesterol – like eggs?

Foods such as eggs, kidneys and prawns, contain cholesterol and, in the past, were restricted as part of a heart-healthy diet. However, for most people, consuming cholesterol in this way doesn’t seem to have as great an effect on blood cholesterol levels compared to eating a diet high in saturated fat. These foods are therefore not restricted and can be included as part of a healthy, balanced and varied diet.

Is alcohol really good for my heart?

If you drink alcohol it’s important to stick to the UK Government guidelines, which recommend 3–4 units a day for men and 2–3 units a day for women. Try to have a couple of alcohol-free days each week too, and be aware of the effects that alcohol can have on your blood glucose levels. Some research suggests that small amounts of alcohol may be beneficial to your heart but there are safer and better ways to protect it. There is also no benefit in starting to drink alcohol if you don’t already do so.

Drinking more than what’s recommended can also have harmful effects on your heart. For example, it can cause abnormal heart rhythms, high blood pressure and damage to your heart muscle. Alcohol is also high in calories, which can mean you gain weight. In addition, drinking alcohol can also increase your appetite and lower your inhibitions, affecting your ability to make healthier lifestyle choices.

Will dark chocolate help lower my blood pressure?

Dark chocolate contains compounds known as polyphenols and there is some evidence to suggest that polyphenols may help reduce blood pressure. However all chocolate, including dark chocolate, contains sugar and fat, too, making it a high-energy food.

A small amount of chocolate every now and then is fine – but eating too much can affect your blood glucose levels and may mean excess calories, resulting in weight gain. Being overweight is a risk factor for CVD, so while you might enjoy eating chocolate, there are better sources of polyphenols, such as fruit and veg.


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