- Diet and Congestive Heart Failure
- Salt-Free Herb Blends
- Eating for diabetes and heart health
- What’s the connection between diabetes and CVD?
- What is a healthy, balanced diet?
- Make simple switches
- Heart health Q&A
- Go Heart-Healthy
- Go Heart-Healthy
- Choose the right fats–in moderation
- Choose a healthy cooking method
- Homemade and fresh is best
- More flavor with less fat, sugar and salt
- Trim the fat
- Substitute Healthier Ingredients In Your Favorite Recipes
- Heart Healthy Diet to Improve Cardiovascular Health, Lower Diabetes Risk
- Diabetes Forecast
- 1. Forget Frying
- 2. Cook Healthier
- 3. Choose the Right Cooking Fat
- 4. Heat the Pan First
- 5. Rely on Herbs and Spices
- 6. Shake Salt Last
- 7. Add Flavor
- 8. Try Ingredients in Tubes
- 9. Don’t Disguise Your Food
- 10. Double Up
- 11. Be Smart About Sauces
- 12. Pick Lean Meats
- 13. Wise Up About Well Done
- 14. Exercise Portion Control
- 15. Switch to Whole Grains
- 16. Prepare in Advance
- 17. Try New Things
- Heart-Healthy Foods to Include in Your Diabetes Diet
- A Well-Balanced Diet for Diabetes and Heart Health
- Heart-Healthy Foods to Look For
- Keeping your heart healthy when you have diabetes
- Blood pressure basics
- Cholesterol basics
- Strict Blood Sugar Control After Heart Surgery May Not Be Necessary
Diet and Congestive Heart Failure
When Checking Labels:
Use the nutrition information included on packaged foods. Be sure to notice the number of servings per container. Here are tips for using this information.
- Nutrient List The list covers nutrients most important to your health.
- % Daily Value This number shows how foods meet recommended nutrient intake levels for a 2,000 calorie reference diet. Try to eat no more than 100 percent of total fat, cholesterol and sodium.
- Daily Values Footnote Some food labels list daily values for 2,000 and 2,500 calorie daily diets.
- Calories Per Gram Footnote Some labels give the approximate number of calories in a gram of fat, carbohydrate and protein.
- Sodium Content Always check the sodium content. Look for foods with a sodium content less than 350 milligrams for each serving.
When Cooking or Preparing Food:
- Shake the habit. Remove the salt shaker from the kitchen counter and table. A 1/8 teaspoon “salt shake” adds more than 250 milligrams of sodium to your dish.
- Be creative. Instead of adding salt, spark up the flavor with herbs and spices, garlic, onions and citrus juices. See the recipes for salt-free herb blends, below.
- Be a low-salt cook. In most recipes, you can cut back on salt by 50 percent or even eliminate it altogether. You can bake, broil, grill, roast, poach, steam or microwave foods without salt. Skip the urge to add salt to cooking water for pasta, rice, cereal and vegetables. It is an easy way to cut back on sodium.
- Be careful with condiments. High-sodium condiments include various flavored salts, lemon pepper, garlic salt, onion salt, meat tenderizers, flavor enhancers, bouillon cubes, catsup, mustard, steak sauce and soy sauce.
- Stay away from hidden salt. Canned and processed foods, such as gravies, instant cereal, packaged noodles and potato mixes, olives, pickles, soups and vegetables are high in salt. Choose the frozen item instead; or better yet, choose fresh foods when you can. Cheeses, cured meats (such as bacon, bologna, hot dogs and sausages), fast foods and frozen foods also may contain a lot of sodium.
When Eating Out:
A low-sodium diet does not need to spoil the pleasure of a restaurant meal. However, you will have to be careful when ordering. Here are some tips for meals away from home:
- Move the salt shaker to another table. Ask for a lemon wedge or bring your own herb blend to enhance the food’s flavor.
- Recognize menu terms that may indicate a high sodium content: pickled, au jus, soy sauce or in broth.
- Select raw vegetables or fresh fruit rather than salty snacks.
- Go easy on condiments such as mustard, catsup, pickles and tartar sauce. Choose lettuce, onions and tomatoes. Remember that bacon and cheeses are high in sodium.
- Request that the cook prepare foods without adding salt or MSG. Or ask for sauces and salad dressings on the side since they are often high in sodium. For a salad, use a twist of lemon, a splash of vinegar or a light drizzle of dressing.
Salt-Free Herb Blends
Instead of seasoning your food with salt, enhance the flavor of food with these salt-free herb and spice combinations. To make 1/2 cup, combine the ingredients in a jar. Cover tightly and shake. Keep in a cool, dry place. Then rub or sprinkle them on food for flavor.
For chicken, fish or pork:
- 1/4 cup ground ginger
- 2 tablespoons of each: ground cinnamon, ground cloves
- 1 tablespoon of each: ground allspice, anise seeds
Mixed Herb Blend
For salads, pasta salads, steamed vegetables, vegetable soup or fish:
- 1/4 cup dried parsley flakes
- 2 tablespoons dried tarragon
- 1 tablespoon of each: dried oregano, dill weed, celery flakes
For tomato-based soups, pasta dishes, chicken, pizza, focaccia and herbed bread:
- 2 tablespoons of each: dried basil, dried marjoram, thyme, crushed dried rosemary, crushed red pepper
- 1 tablespoon of each: garlic powder, dried oregano
Easy Dip Blend
For mixing with cottage cheese, yogurt, or low-fat sour cream:
- 1/2 cup dried dill weed
- 1 tablespoon of each: dried chives, garlic powder, dried lemon peel and dried chervil
Congestive heart failure, or CHF, is a condition in which the heart is unable to pump enough blood to meet the body’s needs. Sometimes called just “heart failure,” the term is a little misleading. Heart failure doesn’t mean that the heart has failed or that it no longer works; rather, it means that the heart is struggling to pump enough blood throughout the body.
Causes of CHF
There are many causes of CHF, and these include:
• Blocked blood vessels that supply the heart with blood
• High blood pressure
• Cardiomyopathy, or weakened heart muscle
• Congenital heart diseases
• Infection of the heart muscle
• Toxic amounts of certain drugs, such as alcohol and cocaine
• High blood lipids (cholesterol and triglycerides)
• Family history of heart failure
While maybe not a direct cause, certain lifestyle factors can contribute to or worsen CHF, such as being overweight or obese, smoking, drinking excessive amounts of alcohol, a high sodium intake, and lack of physical activity.
You may be surprised to learn that having diabetes puts you at risk for CHF. Heart failure is one of the most common complications of diabetes, and while many factors play a role, the two main culprits are hyperglycemia (high blood sugars) and insulin resistance (strongly linked with Type 2 diabetes). Data from the well-known Framingham Heart Study showed that the frequency of heart failure is twice as high in men with diabetes and five times as high in women with diabetes compared to a control population.
Symptoms of CHF
How do you know if you have CHF? Symptoms that may indicate congestive heart failure are:
• Shortness of breath
• Feeling very tired and/or weak
• Swelling in your ankles, feet, or legs (called edema)
• Swelling of the stomach
• Sudden weight gain (due to fluid retention)
• A cough that doesn’t go away
• Coughing up blood-tinged mucus
• Having to urinate often
• A rapid or irregular heartbeat
• Chest pain
• Nausea or a lack of appetite
Of course, these symptoms can be due to other medical issues, so it’s important to get them checked out by your doctor.
The Heart Failure Society of America suggests this easy way to remember symptoms of CHF: Think of the acronym “FACES,” which stands for Fatigue, Activities limited, Chest congestion, Edema, and Shortness of breath.
For a more complete overview of CHF, see the article here.
The good news about CHF is that it may improve with proper treatment. However, if this condition isn’t treated, it can lead to serious complications, including kidney and liver damage, heart valve problems, and irregular heartbeat. It probably goes without saying that well-managed diabetes can improve the outlook of CHF, as well.
Medicine: Treatment of CHF likely includes the use of certain types of medicines, including drugs for high blood pressure such as ACE inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, and diuretics. Other drugs may be used, too, like digoxin. It’s common to take several types of medicines for CHF.
Surgery: Surgery could be needed to treat an underlying condition, such as a faulty heart valve or blocked arteries. In severe cases of CHF, a heart transplant may be performed.
Smoking cessation: Smoking lowers oxygen levels in the body, raises blood pressure, and makes your heart have to work harder. Talk with your doctor about ways to stop smoking.
Weight loss: Losing weight can be hard. However, being overweight puts an extra burden on a heart that’s already struggling to do its job. Start off with trying to lose a small amount of weight. Work with a dietitian or consider trying a safe and healthy program to lose weight (if you’re not sure what’s safe, check with your doctor or dietitian).
Weight monitoring: You’ll likely need to weigh yourself regularly to check for fluid retention and the need to alter your treatment plan. Your doctor should give you guidance on how often to monitor your weight. For accurate weights, weigh yourself at the same time each day (morning is best after you’ve urinated), wearing no clothes or the same clothes. Keep track of your weights, too.
Fluid intake: Depending on the stage of CHF, you might need to limit how much fluid you drink. For example, your doctor may advise you to limit your fluid intake to 2000 ccs per day — that’s about two quarts. Fluids obviously include any type of beverage, but also includes things like soup, ice, gelatin, ice cream and sherbet, and popsicles.
Sodium intake: Eating too much salt and sodium can cause you to retain fluid. Find out how much sodium you should be consuming from your doctor or dietitian. To cut sodium from your diet, avoid using salt on foods or in cooking; avoid foods with visible salt on them, such as saltine crackers or salted nuts; and limit your intake of canned or processed foods (soups, canned vegetables, luncheon meats, boxed rices, etc.). Try to eat fresh or frozen foods, and choose no-salt-added or lower-sodium versions of foods whenever possible.
Dietary supplements: Some research shows that people who have CHF may be lacking in certain nutrients, which can affect health and quality of life. Coenzyme Q10, L-carnitine, vitamin D, and hawthorn are sometimes suggested as being helpful for CHF. Because dietary supplements can interact with medicines, don’t take them without first talking with your doctor.
Alcohol: You may not be able to drink alcoholic drinks if you have CHF. Alcohol can interfere with medicines, and can weaken your heart. Ask your doctor about drinking alcohol.
Physical activity: CHF can make you feel tired, but it’s helpful to stay active. Physical activity can strengthen your body, making it easier for your heart to do its job. However, you need to find out what types of activity and how much you can safely do from your doctor.
Sleep: Getting quality sleep can sometimes be hard if you have trouble breathing — propping your head up may help. If you are waking up to urinate often, ask your doctor about changing the time that you take your diuretic.
Blood sugars: Work with your diabetes team to help you manage your blood sugars as best you can. Your diabetes medicines may need to be changed, for example, or you may need to make a few tweaks to your eating plan. Checking your blood sugars regularly is important, too.
Stress: No doubt, having CHF can be extremely stressful. But it’s important to try and manage stress, not only for a better quality of life, but also because stress triggers certain hormones in the body that can put a burden on your heart — and raise your blood sugars, too. Seek out ways to help you better deal, such as yoga, meditation, deep breathing, socializing, support groups, or counseling.
For more information about CHF, visit the Heart Failure Society of America’s website.
Want to learn more about heart failure and diabetes? Read “Living Well With Heart Failure,” by certified diabetes educator Joy Pape.
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.
Even small changes to your cooking can help you reduce your risk for heart disease. You can protect your heart and blood vessels by:
- Making food choices that include healthy fats and cutting back on those with less healthy fats.
- Getting to and maintaining a healthy weight; it’s hard work, but well worth it.
- Especially if you have high blood pressure, cutting down on foods that are high in sodium can make a difference.
Choose the right fats–in moderation
Foods like packaged (store bought) snacks, sweets, baked goods, fried foods, red meat and processed meats like bacon and sausage are high in saturated fat that raises your bad cholesterol.
Fresh vegetables, whole grains, and fruit are low in fat and high in vitamins, minerals and dietary fiber that can reduce your risk of heart disease. Nuts, avocados, and plant-based oils (like olive, peanut and safflower oils to name a few) provide you with healthy fats. When cooking, pay attention to the amount of oils and butter you add to lower the total calories to help with weight management. Butter is high in saturated fat, so try to cut back on the amount you use.
Include those omega-3s
Foods high in omega-3 fats are especially beneficial for your heart health and include “fatty” fish like salmon, albacore tuna, herring, rainbow trout, mackerel, and sardines.
Other foods that provide omega-3 fatty acids include soybean products, walnuts, flaxseed and canola oil. Try to include these in your eating plan on a regular basis, but do pay attention to your portions because a small amount goes a long way.
Choose a healthy cooking method
You can cut down on the calories and unhealthy fats in your meals by broiling, baking, roasting, steaming, or grilling foods. When you fry foods, it increases the unhealthy fat and overall calorie content.
It is okay to use some fat when cooking, but don’t overdo it.
Homemade and fresh is best
Preparing foods at home gives you more control over what you are eating. Restaurant foods are almost always larger portions with more fat, sugar, and salt added to them.
Use the Diabetes Food Hub to get some ideas for healthy foods you can cook at home. It doesn’t have to be complicated, and it can save time and cost less, too.
More flavor with less fat, sugar and salt
Try using herbs and spices for flavor instead of salt, butter, lard, or other unhealthy fats. Here are a few ideas to add flavor to your food:
- Squeeze fresh lemon juice or lime juice on steamed vegetables, broiled fish, rice, salads or pasta.
- Try a salt-free herbs and spices. Fresh herbs are also a great choice.
- Onion and garlic add lots of flavor without the bad stuff.
- Try marinades for meat with healthy plant based oils, herbs and spices.
Trim the fat
Cut away visible fat from meat and poultry. Roast food on a rack to let the fat drip off. Choose cuts of meat that are lean and peel the skin off poultry before you eat it.
Substitute Healthier Ingredients In Your Favorite Recipes
Instead of regular ground beef…
Try 90% lean ground beef or better yet, try lean ground turkey breast.
Why? Fewer calories, less saturated fat and less cholesterol.
Instead of sour cream on tacos or in dips…
Try plain yogurt (regular or Greek)
Why? Fewer calories and less saturated fat
Instead of butter or margarine when cooking
Try oils like olive, safflower, and other plant-based oils or reduce how much butter you use
Why? less of the bad fats and more heart-healthy fats
Instead of snack foods like crackers, chips, candy or backed goods…
Try fruit with plain yogurt, fresh vegetables and hummus, a slice of whole wheat toast, and natural peanut butter, or nuts
Why? Less sodium, less saturated fat and zero trans fat
Instead of regular mayonnaise…
Try mustard on sandwiches, or try yogurt or a combination of yogurt and less mayonnaise if used in dressing, sauces, and dips
Why? Fewer calories, more nutrients
Instead of bologna, salami or pastrami…
Try sliced low-sodium turkey or roast beef. Or better yet, cook fresh chicken or turkey on the weekend and use throughout the week for meals
Why? Less total fat, less saturated fat and less sodium
Heart Healthy Diet to Improve Cardiovascular Health, Lower Diabetes Risk
Here’s some good news about foods to improve diet and your health, just to change things up from the usual gloom and dietary doom. Making certain food choices may actually help you fight disease and lower your risk of developing chronic diseases such as diabetes, heart disease, and obesity.
Making sure you include four disease-fighting foods in your diet is highly recommended based on a trio of studies1-3 being presented at the American Society for Nutrition meeting this week in Boston and a fourth study4 published in Nutrition & Diabetes.
What foods may elicit better health? Mushrooms, eggs, pecans, and plant sterols (found in plants, but more commonly found as a margarine spread).1-4
But first some perspective: “It’s important to keep in mind if you want to improve your diet to substitute rather than add,” says Alice Lichtenstein, DSc, Gershoff Professor of Nutrition Science and Policy and director and senior scientist at the Cardiovascular Nutrition Laboratory at Tufts University in Boston. She was not involved in the studies but reviewed them for EndocrineWeb.
What Can We Learn from These Food Studies?
Eggs Are Actually Good for our Heart and Overall Health
Reinforced by the results of this study,1 and supported by a growing body of evidence,5,6 eggs not only do not boost blood cholesterol as has been thought for decades, rather eating eggs seems to improve blood glucose as well as lead to increased low-density lipoprotein (LDL, the type of cholesterol known to clog arteries), and increase high-density lipoprotein (HDL, the blood cholesterol that protects against cardiovascular disease.)
One large egg a day actually appears to reduce the risk of diabetes without driving up your serum cholesterol,1 says Shirin Pourafshar, PhD, a National Institutes of Health postdoctoral fellow in nephrology at the University of Virginia, Charlottesville.
She randomly assigned 42 adults, ages 40 to 75 years, who had either prediabetes or type 2 diabetes, to eat one large egg a day or an equivalent amount of egg substitute for 12 weeks. Blood samples were analyzed for changes in levels of blood cholesterol and blood glucose.1 At the end of the three months, the group eating eggs had a 4.4% reduction in blood glucose.1 They also showed less insulin resistance, which is a good response indicating improved control over blood sugar levels.
Dr. Pourafshar said that participants’ blood was also evaluated for a protein carried in high-density lipoprotein (HDL), the heart-protecting cholesterol, finding the group eating a daily egg had a higher level of this circulating protein, which adds to the good news. And there were no negative effects on total cholesterol or low-density lipoprotein,1 the type of blood cholesterol that leads to clogged arteries.7 The Egg Nutrition Center funded the egg-related study but had no role in the data analysis.
Adding back the eggs: The egg, ideally, should be boiled, not fried, says Dr. Pourafshar. When eggs are scrambled or used to make an omelet or frittata, either olive oil or avocado, which are both high in heart-promoting monounsaturated fats, should be used. And resist the urge to add bacon or ham, adding instead vegetables.
Taking Dr. Lichtenstein advice—eating eggs should be done in place of breakfast foods, like cold cereals or sugary energy bars.
Snack on Pecans to Lessen Diabetes Risk, Improve Heart Health
Eating a handful of pecans a day, about 1.5 ounces (or 21 halves) appears to help people with overweight or obesity reduce their risk of heart disease and improve their insulin levels,2 according to a second study.
“We are suggesting that you swap ” for other snacks, such as chips or salami, says Diane McKay, PhD, FACN, program director and assistant professor of nutrition at Tufts University, who led the study.
She and her research team asked 26 men and women who were diagnosed with overweight or obesity to eat a handful of pecans in place of less heart-healthy snack for four weeks, then to eat the regular diet provided to them without the nuts for the next four weeks.2 The researchers provided all the food for the study participants over the eight weeks. Funding for the study was provided by the National Institutes of Health and a pecan industry group donated the nuts but had no role in the study.
Adding the pecans produced better outcomes, says Dr. McKay. “We did see a statistically significant improvement in their insulin levels, and less insulin resistance,” she says. She suspects it has to do with the type of fat in pecans, which like olive oil, is mostly monounsaturated fat, which is known to protect against cardiovascular disease.
Advice: Choose a handful of pecans instead of, but not in addition to, those potato chips or tortilla chips, she says, that is easy to grab to satisfy your mid-afternoon hunger, or consider adding a handful of chopped pecans to your salad and drizzle with lemon juice or balsamic vinegar and avocado oil, instead of the creamy salad dressing. This is a better way to balance the flavors and calories in choosing a source of heart-healthy fat, protein, and fiber instead of a fat-laden dressing to improve your health.
Add Some Mushrooms to Reduce Inflammation
Mushrooms may reduce excess inflammation in your body,3 which is a very a good thing as it is linked to thyroid problems, heart disease, and other health ailments.8,9
Gaoxing Ma, a PhD student at Nanjing Agricultural University in China, isolated two complex carbohydrates—PPEP-1 and PPEP-2—which are fiber-like substances, from edible mushroom genus Pleurotus eryngli.3 In the lab, he stimulated cells to become inflamed, and then exposed them to these specialized mushroom polysaccharides. This study is the first to introduce the potential for the complex carbohydrates in edible mushrooms to be singled out as part of a healthy heart diet.
“In the lab, cells exposed to two polysaccharides from edible mushrooms had less inflammation,” he tells EndocrineWeb.
Advice: The study is preliminary,3 he says, but adds to the growing evidence that mushrooms may be a functional food (prebiotic) that promotes good gut health, thereby reducing overall inflammation.10,11
Some May Benefit from Adding Plant Sterols for a Cardiovascular Health
Plant sterols, which occur naturally in foods but are particularly in high in vegetable oils (eg, canola, olive)—as well as nuts (particularly in almonds), wheat germ and wheat bran, and Brussels sprouts—are added to margarine spreads (ie, Promise, Benecol), and seem to lower LDL-cholesterol,4 according to findings reported in Nutrition & Diabetes.
The researchers gave 151 participants, all with either type 2 diabetes or at increased risk of diabetes, a spread with either added plant sterols or no plant sterols After six weeks those eating the plant sterol-fortified spread, with 2 grams of the plant sterols, showed a 4.6% reduction in LDL-cholesterol compared to the group eating a margarine without the added plant sterols.4
Advice: Remember that ”plant sterols cannot take the place of statins,” says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE, a certified diabetes educator and transitional program coordinator at the Kovler Diabetes Center in Chicago, Illinois, who was not involved in the study.
“The evidence is clear that these sterols do provide a benefit, but most people will be unable to get the 2 grams of plant sterols in their diet without using fortified products like these types of margarine,” she tells EndocrineWeb. Two tablespoons have 2 grams, she says, for those who want to consider switching out their usual spread for one that provides a cholesterol-lowering boost.
According to the European Atherosclerosis Society Consensus Panel on Phytosterols,12 plant sterols have a clear lipid-lowering effect without any adverse effects. However, the use of products like the fortified margarine is best used by those who at low to moderate risk for cardiovascular disease but cannot take a statin and those with an inherited form of hyperlipidemia.
The study was supported by Unilever (which makes Promise margarine).4
Will It Matter if You Eat More of These Heart Healthy Foods?
While including eggs, pecans, mushrooms, and possibly plant sterols, might improve your diet and ultimately your health, proceed with caution about these findings, Dr. Lichtenstein advises.
Adding mushrooms to your diet to fight inflammation doesn’t mean to sauté them in butter, for instance. Similarly, eating salted or honey-coated nuts will defeat the purpose, too, she tells EndocrineWeb.
It’s all in the way you choose to incorporate these foods by choosing these types of foods in place of foods that prompt increases in blood glucose, blood cholesterol, and increasing body fat, such as salami, most cold cereals, milk chocolate, and snack foods that add sugar, salt, and empty calories.
“When you see these studies, it may not be what is added to the diet, but what is removed from the diet,” she adds. It’s crucial to remember these studies are mainly talking about replacing unhealthy fare with healthier choices.
For the overall diet, Dr. Lichtenstein advises one with plenty of fruits and vegetables, whole grains, legumes, fish, low-fat dairy, lean meat and poultry and liquid vegetable oil.
“No one food has the magical properties to improve or fix our health,” Hess-Fischl adds. “We need to focus on the meal as a whole, which is not a new concept, but is one that needs to be embraced by everyone.”
None of the experts interviewed had any financial conflicts to disclose.
Last updated on 06/17/2019 Continue Reading Big Breakfast Beats Traditional 6-Meal Diabetes Diet View Sources
- McKay DL. Incorporating pecans into a typical American diet improves cardiometabolic risk factors in overweight and obese adults with central adiposity. Presented at: Nutrition 2018, American Society for Nutrition meeting, June 9-12, 2018 in Boston, Massachusetts.
- Ma G. Anti-inflammation effect of dietary bioactive components (oral 38). Presented at: Nutrition 2018, American Society for Nutrition meeting, June 9-12, 2018 in Boston, Massachusetts.
- Pourafshar S. Eggs and lipids. Presented at: Nutrition 2018, American Society for Nutrition meeting, June 9-12, 2018 in Boston, Massachusetts.
- Trautwein EA, Koppenol WP, de Jong A, et al. Plant sterol lower LDL-cholesterol and triglycerides in dyslipidemic individuals with or at rigk of developing type 2 diabetes; a randomized, double-blind, placebo-controlled study. Nutr Diabetes. 2018;8:30.
- Blesso CN, Fernandez ML. Dietary cholesterol, serum lipids, and heart disease: Are eggs working for you or against you? Nutrients. 2018;10(4):e426. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946211/. Accessed June 11, 2018.
- Ratliff J, Leite JO, de Ogburn R, Puglisi MJ, VanHeest J, Fernandez ML. Consuming eggs for breakfast influences plasma glucose and ghrelin, while reducing energy intake during the next 24 hours in adult men. Nutr Res. 2010;30(2):96-103.
- American Heart Association. The good and the bad: HDL, LDL, and triglycerides. Available at: https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides#.Wx6FRFMvxTY. Accessed May 14, 2019.
- Jayachandran M, Xiao J, Xu B. A critical review on health promoting benefits of edible mushrooms through gut microbiota. Int J Mol Sci. 2017;18(9).e1934.
- Muszyńska B, Grzywacz-Kisielewska A, Kała K, Gdula-Argasińska J. Anti-inflammatory properties of edible mushrooms: A review. Food Chem. 2018;243:373-381.
You’ve probably heard about a diabetes-friendly diet. It’s a cornerstone of good blood glucose management. But what your doctor may not have told you is that a heart-healthy diet is also important. People with diabetes are at an increased risk for heart disease, and a typical American diet—even if you control your calories and carb intake—ups that risk significantly. Fortunately, a balanced eating plan can help you keep blood glucose in control and protect your heart.
Cutting out fast food and highly processed junk food will go a long way toward better health, but you may need to adjust your home-cooking methods, too. Foods loaded with saturated fat are associated with high LDL (“bad”) cholesterol, too much salt plays a role in high blood pressure, and eating too many starches can lead to high blood glucose levels and weight gain—all of which play a role in cardiovascular disease. The good news, says John La Puma, MD, a chef, host of PBS’s Eat and Cook Healthy, and founder of the healthy-cooking site ChefMD.com, is that dietary changes can lower your chances of having a heart attack or stroke by reducing injury to the arteries caused by high cholesterol.
Joe Piscatella is living proof that a healthy diet can protect your heart. At 32, he had 95 percent blockage of his left coronary artery and, though he had bypass surgery for it, one cardiologist told him he wouldn’t live to see 40. That was 36 years ago. “I became a believer in lifestyle changes if for no other reason than because I couldn’t change my DNA, but I could change the way I lived,” says Piscatella, who has written a number of books about heart disease and cooking for heart health, including The Road to Heart Health Runs Through the Kitchen. “We’re talking about heart disease and diabetes,” he says. “We’re talking about diseases and conditions that can have major changes on your life.”For those of us who haven’t earned our chef’s whites through years of culinary school, the experts dish their tips for heart-healthy cooking.
1. Forget Frying
It’s no secret that fried food is the American equivalent of ambrosia, but the hard truth is that it’s incredibly unhealthy. (Frying is, after all, dunking your food in a vat of fat.) Eating a lot of fried foods is linked to high blood pressure, increased LDL (“bad”) cholesterol, and other risk factors for heart disease. That said, a 2012 study in the journal BMJ found no link between fried-food consumption and coronary heart disease risk, which researchers attributed to the healthy oils the Spanish participants used. So while frying isn’t an optimal cooking method, if you’re going to fry, pick olive or sunflower oil over vegetable oil, butter, or shortening.
2. Cook Healthier
One of the simplest ways to transform your diet into one that benefits your heart is to pick the right cooking method. Tops for health are steaming, stir-frying, roasting, and grilling.
Steam: Using steam to cook foods is one of the healthiest cooking techniques. It’s a particularly nice way to cook fish, and steamed veggies are among the easiest side dishes to prepare. If steamed food tastes bland, add herbs, spices, or an acid, such as citrus juice, to the dish for a pop of flavor. Marc Anthony Bynum, a chef in Long Island, N.Y., who works with the American Heart Association, pairs steamed broccolini with caramelized onions and chopped thyme.
Stir-fry: Because stir-frying requires such high heat and so little oil, it’s a good option for cooking meats and veggies—provided you don’t drown them in sauce. “Stir-fry” food in water and you’re essentially steaming it.
Roast: Possibly the most flavorful way to cook vegetables is by roasting them. Drizzled with a little olive oil, carrots, asparagus, green beans, red peppers, and even red cabbage sweeten to perfection.
Grill: This is especially great for meats because it doesn’t require additional fat (that is, you don’t need to coat meat in oil before placing it on the grill) and allows the fat in meat to drain, so you’re eating the lowest-fat version.
3. Choose the Right Cooking Fat
You don’t have to cut fat out of your diet entirely to follow a heart-healthy meal plan. Instead, pay attention to the type of fat you’re using. Saturated and trans fats have been implicated in heart disease, so focus instead on unsaturated fats. That means replacing palm oil, butter, and lard (all high in saturated fat) with olive, canola, or avocado oils (high in monounsaturated fat). Or ditch trans fat–laden vegetable shortening and some margarines for safflower or sunflower oils (packed with polyunsaturated fat). You can also use healthy fats to infuse flavor, such as making salad dressing with almond oil or stir-frying vegetables in peanut oil.
4. Heat the Pan First
It may sound strange, but your dinner will be lower in fat if you add food to a pan of already-hot oil. When a pan is still heating and the oil you’ve added is cold, it’s more likely to seep into your food. On the flip side, “if it’s already hot, it will sear the meat,” and less will soak in, Bynum says.
5. Rely on Herbs and Spices
You could say Americans have a bit of a salt addiction. A recent Institute of Medicine report found that adults consume about 3,400 mg of sodium per day—well above the government-recommended 2,300 mg or less per day and more than twice the recommended 1,500 mg or less per day for people over age 50, those with high blood pressure, and those of African descent. And while most sodium comes from processed foods, there’s no reason to go overboard in the kitchen. Instead of using salt to flavor your foods, cook with herbs and spices. Try rosemary on your potatoes, basil on your tomatoes, and dill on your salmon.
6. Shake Salt Last
Many chefs add seasoning as their dish cooks. But many chefs also cook high-sodium meals. If you’re at high risk for heart disease or have heart problems, nixing the sodium can help your health. That’s because the more sodium you consume, the greater risk you have for high blood pressure. Piscatella and La Puma suggest salting food after it’s done cooking because you’re less likely to go overboard. “, you sort of lose track of how much you’ve added,” La Puma says. “I like people to salt their own foods because not everyone has the same taste.” Piscatella also uses this trick with shredded cheese, which he adds, sparingly, at the table.
7. Add Flavor
For a tangy punch, vinegar, wine, and citrus fruits brighten even the most robust flavors. Reduce the amount of cheese and sour cream on your taco, then squeeze a lime over it. Drizzle balsamic vinegar over berries instead of adding sugar for dessert. And simmer fish in white wine.
8. Try Ingredients in Tubes
Get big flavor with small portions by buying tubes of sun-dried tomato, olive, anchovy, or harissa (hot red pepper) pastes. “Just a dash will enliven dishes,” La Puma says.
9. Don’t Disguise Your Food
The simplest of preparations make for the healthiest of meals, so naturally a diet that benefits your heart health should avoid “dressed up” foods. What does that mean? Stop hiding your meat, vegetables, or pasta under creamy sauces, dressings, piles of cheese, bread crumbs, or other toppings. Those additions may be tasty, but they won’t do your ticker any favors. Instead, experiment with herbs, spices, and acidic foods or enjoy the food for its own delicious flavor.
10. Double Up
You can make dishes more flavorful, La Puma says, by using two forms of an ingredient. Add extra tomato flavor to pizza by using marinara sauce and topping the pie with fresh tomato slices. Or double up a dish’s basil flavor by using fresh and dried versions of the herb.
11. Be Smart About Sauces
Many sauces spoil a healthy diet because they’re loaded with cream, cheese, butter, and other heart-unfriendly ingredients. But some sauces add both flavor and key nutrients. “Many cultures, especially Latino cultures, make sauces from vegetables or nuts instead of cream or cheese or oil,” says La Puma. He likes to blend various vegetables into a smooth sauce, such as a roasted tomatillo, onion, serrano chili, and oregano blend that he pours over grilled mahimahi. Or try baking fish in salsa and spooning basil pesto over chicken.
12. Pick Lean Meats
Because diabetes puts you at risk for cardiovascular disease, you’ll want to limit the amount of red meat (think beef, lamb, and pork), and thus saturated fat, that you eat. It’s been linked numerous times to an increased risk of heart disease. Switching to leaner proteins, such as poultry, is ideal, and fish is even better. Because of its high omega-3 fatty acid content (salmon, sardines, herring, and mackerel are especially high in omega-3s), fish can improve your blood pressure and cholesterol, and lower your overall risk for cardiovascular disease. Of course, you can still indulge in red meat on occasion. When you do, pick lower-fat cuts, opting for fresh meat over processed goods such as sausages and hot dogs. Look for leaner cuts of beef, such as tenderloin, eye round roast, and top sirloin steak—or opt for bison, which is similar in taste but leaner.
13. Wise Up About Well Done
It’s one thing to enjoy well-done meat, but skip spots so charred they’re blackened. According to a study in the February 2013 issue of the International Journal of Food Science and Nutrition, food cooked to a crisp (think burned hot dogs or the darkened edge of a brownie) produces advanced glycation end products (called AGEs), which are associated with the kind of plaque formation seen in heart disease.
14. Exercise Portion Control
If you’ve been cooking for some time, you may be used to using too much of some ingredients. For instance, Bynum says cooking an entire chicken breast requires only 1 teaspoon of oil, but most people coat the pan in more than twice as much. Nonstick pans can help you further reduce the amount of oil you need. “To be conscious of what you’re eating, you really need to measure it,” Bynum says. You may be surprised to learn just how much a tablespoon of butter is or just how large your usual “sprinkle” of cheese is.
15. Switch to Whole Grains
Fiber-rich whole grains are a smart part of a heart-healthy diet and an easy swap to make. Piscatella suggests starting small by going fifty-fifty, such as by blending brown rice with white before switching completely to brown. And don’t forget lesser-known whole grains, such as quinoa, bulgur, millet, and kamut. Bynum’s quinoa, tomato, spinach, and goat cheese salad is a delicious way to add whole grains to your diet.
16. Prepare in Advance
If you’re not a full-time chef, you may wonder how you’ll find time to cook healthy meals daily. While home cooking may require less of a commitment than you think, there’s another alternative: Cook ahead of time. La Puma suggests cooking meals all in one day, then reheating them during the week.
17. Try New Things
Just as you may have to give up a few favorites in order to follow a more heart-friendly diet, you may discover new meals and foods you enjoy. So don’t be afraid to branch out and try recipes and dishes that may sound strange. Roasted radishes, for instance, are surprisingly sweet. Grilling gives romaine depth of flavor and your salad added interest. Watermelon and balsamic are better partners than you might imagine. And kale leaves, when drizzled with olive oil and baked, make for surprisingly addictive, guilt-free chips.
Heart-Healthy Foods to Include in Your Diabetes Diet
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Although diabetes is known for affecting your blood sugar, the condition actually affects your whole body — including your heart. In fact, people with diabetes are almost twice as likely to die from a heart attack or stroke as people who don’t have diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases. “High blood sugars damage nerves and blood vessels throughout the body,” says Megan Porter, RD, CDE, a dietitian and certified diabetes educator in Portland, Oregon. “When these become damaged, they are unable to perform their normal functions.” This can lead to heart-related problems such as high blood pressure, high cholesterol, and heart disease.
The good news is that because diabetes and heart health are so closely linked, there are many steps you can take to help improve both health conditions. In addition to monitoring your diabetes, taking any prescribed medications for diabetes and heart issues, and getting regular exercise, eating a healthy diet can help you manage your diabetes and your heart health.
A Well-Balanced Diet for Diabetes and Heart Health
While there’s no specific diet for people with diabetes, an overall balanced diet similar to the Mediterranean diet can help you keep your blood sugar within a healthy range.
In fact, in a study published in 2013 in the New England Journal of Medicine, researchers found that when people at high risk for heart disease — including some with diabetes — followed a Mediterranean diet, their risk of stroke or cardiovascular death was cut by 30 percent compared with that of a similar group that followed a low-fat diet. Those who followed the Mediterranean diet included olive oil and nuts, while those who followed the low-fat diet did not. Results showed that the Mediterranean diet had a favorable effect on blood pressure, weight, insulin sensitivity, cholesterol, and inflammation.
Porter recommends that you keep the following dietary guidelines in mind when managing diabetes and heart health:
- Eat 5 or more fruits and vegetables daily
- Aim for most of your grains to be whole grains, such as whole-grain bread and whole- grain cereal
- Enjoy legumes and beans weekly
- Have nuts and seeds around for an easy snack between meals
- Substitute oily fish and skinless poultry for most meat selections
- Aim for only 1 to 2 high-fat, red meat servings weekly
- Enjoy 2 to 3 servings of low-fat or fat-free dairy choices daily, such as a glass of milk, yogurt, or low-fat cheeses
- Limit or avoid processed foods, meats, and items with added sugars, such as baked goods, sodas, and other drinks with added sugars
Heart-Healthy Foods to Look For
When it comes to getting the most benefit for both diabetes and heart health, foods high in fiber and healthy fats are the winners. Foods that are particularly beneficial include:
- Legumes such as lentils, split peas, and beans These are high in soluble fiber, which is great for both diabetes and heart health. “Foods high in soluble fiber help remove cholesterol from the blood and also break down into sugar slowly,” says Porter, “making a person feel fuller for longer and leading to a slower rise in their blood sugars.”
- Oatmeal Like legumes, oatmeal is high in soluble fiber. Fruits and vegetables also contain fiber, so for an extra boost, try slicing some fruit, like a banana, and adding it to your oatmeal.
- Fatty or oily fish such as salmon, sardines, and tuna These fish are high in omega-3 fatty acids, a type of unsaturated fatty acid that can help reduce inflammation in the body.
- Flaxseed This type of seed, which comes from the flax plant, is high in fiber and alpha-linolenic acid, a type of omega-3 fatty acid. Flaxseed can be a good way to get omega-3s if you don’t like fish. However, it’s best to check with your doctor before adding flaxseed to your diet, as it can affect diabetes medication such as insulin, according to the University of Maryland Medical Center, in Baltimore.
- Walnuts, almonds, and macadamia nuts In general, nuts are packed with protein, and these particular nuts are also high in omega-3 fatty acids and unsaturated fats, which can help lower bad cholesterol. But since nuts are high in calories, be sure to eat them only in small portions.
- Avocados Putting avocado on toast may be trendy these days, but the health benefits of this fruit have long been known. Avocados contain fiber and healthy fats, as well as vitamins and minerals. A study published in 2013 in Critical Reviews in Food Science and Nutrition found that avocados had heart-health benefits similar to those of nuts but with less than half the calories.
- Berries Not only can blueberries and strawberries satisfy your sweet tooth, but they may help your heart as well. A study published in 2013 in Circulation found that women who ate three or more servings of blueberries and strawberries each week lowered their risk of heart attack by 32 percent.
- Olive oil, vegetable oil, and canola oil Cooking with these types of oil can help boost your intake of healthy fats. They are rich in monounsaturated and polyunsaturated fats, which, Porter says, can help reduce cholesterol.
Filling up on these healthy foods and following healthy-eating guidelines, with plenty of fruits and vegetables, can help you feel more satisfied — all while improving your health. “Heart-healthy foods can help reduce overall blood sugars,” says Porter, “and a diet rich in plant-based foods can also assist in keeping blood pressure under control.”
Keeping your heart healthy when you have diabetes
Somali: Sida wadnahaaga looga dhigo mid caafimaad qaba marka aad qabtid sonkor dhiig/sonkorow
As someone with diabetes, you no doubt know how important it is to reach your blood glucose goal. Good glucose control can help you avoid problems with your heart, blood vessels, eyes, kidneys and nerves. But blood glucose control alone is not enough to keep you safe from complications.
Blood pressure and cholesterol goals
Diabetes is a risk factor for cardiovascular disease (CVD), the leading cause of early death among people with diabetes. CVD refers to a diseased heart (cardio) and diseased blood vessels (vascular). CVD can cause heart disease, stroke, vision loss, kidney failure and nerve damage.
Two conditions that can lead to CVD are high blood pressure and high levels of low-density lipids (LDL cholesterol or “bad” cholesterol).
Understanding blood pressure and cholesterol and reaching recommended goals can help prevent CVD and reward you with a healthier heart.
Blood pressure basics
Blood pressure is pressure on the walls of your blood vessels as your heart pumps blood through your body.
If your blood vessels become clogged and narrowed, your blood pressure will increase. It may also increase if you are overweight, have kidney problems, or drink too much alcohol. High blood pressure can run in families.
High blood pressure can lead to heart attack or stroke, eye problems and more severe kidney problems.
Blood pressure is written as two numbers separated by a slash, such as 120/80. This is often called a blood pressure reading.
- The top number shows the maximum pressure on your arteries when your heart contracts and forces blood through your body.
- The bottom number shows the minimum pressure on your arteries when your heart relaxes and refills with blood.
Blood pressure goal
Allina Health recommends a blood pressure of 130/80 or less.
What can help control blood pressure?
If your blood pressure is high, your provider may ask you to take a medicine called an ACE (angiotensin converting enzyme) inhibitor. This type of blood pressure medicine is best for people with diabetes. In addition to lowering your blood pressure, it may help keep your kidneys healthy.
Your health care provider may also suggest that you:
- lose weight
- eat more fruits and vegetables
- reduce the amount of salt you eat
- drink less alcohol
- get regular physical activity
It is important that you get your blood pressure checked each time you visit your health care provider.
Cholesterol is a fat-like substance in your blood. Your body makes some cholesterol to help it function properly. You may also get cholesterol from some of the foods you eat and you may inherit a tendency toward high cholesterol.
When your blood cholesterol level is too high, the cholesterol builds up on the walls of your arteries. Over time, this can:
- block the flow of blood to your heart, depriving it of oxygen (A partial blockage may result in chest pain. A total blockage will cause a heart attack.)
- block the flow of blood to your brain, depriving it of oxygen. (A total blockage will cause a stroke.)
The American Heart Association and American College of Cardiology recommend taking a statin medicine to protect your arteries and reduce your risk of heart disease.
What can help control cholesterol?
You can help control your cholesterol level in the following ways:
- Eat foods low in saturated fat, trans fat and cholesterol.
- vegetables and fruits
- whole grains
- fat-free or low-fat dairy products
- lean protein such as chicken breast, turkey breast, fish, legumes (beans, lentils, peas) and soy
- healthful oils (olive oil, canola oil, etc.) and nuts
Limit sweets, sugar-sweetened beverages and red meats. Limit or avoid eating “tropical” oils such as coconut, palm kernel and palm oils.
- Lose weight if you are overweight. This can lower your LDL level and raise your HDL cholesterol level.
- Be physically active three to four times each week for a total of at least 150 minutes. This can also lower your LDL level and raise your HDL level.
- Take any medicine to lower your cholesterol as prescribed. Eating more healthful foods and increasing your activity level are often not enough to reach your cholesterol goals.
You may have a high cholesterol level and not yet have any signs of disease. Your health care provider will recommend how often to have your cholesterol level checked.
Low dose aspirin
Research shows that if you have diabetes and have heart disease or have had a stroke, taking a low dose of aspirin every day may reduce your risk of more complications (problems).
Aspirin helps prevent blood clots that can block the flow of blood and lead to heart attack or stroke.
But taking aspirin is not safe for everyone, so it is important to talk with your health care provider before you start taking aspirin every day.
Important: Taking aspirin with blood thinners may increase your risk for bleeding.
Strict Blood Sugar Control After Heart Surgery May Not Be Necessary
Patients undergoing coronary artery bypass grafting (CABG) surgery may not have to follow a strict blood sugar management strategy after surgery, according to a study in the October 2014 issue of The Annals of Thoracic Surgery.
- Liberal management of a patient’s blood sugar levels following CABG surgery leads to similar survival and long-term quality of life as achieved through stricter blood sugar management.
- The findings applied to all patients, regardless of diabetes status.
- The results may encourage hospitals to consider more lenient blood sugar control in all patients after heart bypass surgery.
Previous research has shown that hyperglycemia (high blood sugar) after CABG and other cardiac surgery is associated with increased morbidity and mortality; however, more recent studies have shown that liberal maintenance of blood glucose levels (<180 mg/dL) after CABG surgery can be safer and more advantageous in both diabetic and non-diabetic patients.
A. Thomas Pezzella, MD, Niv Ad, MD, and colleagues from Inova Heart and Vascular Institute in Falls Church, VA, used data from patients enrolled in one of their previously published studies to assess long-term survival and health-related quality of life based on glucose control following first-time isolated CABG surgery.
“The study randomly assigned heart bypass surgery patients, with and without diabetes, to two types of blood sugar control. In one group, blood sugar control was tightly controlled, which was the standard procedure at our hospital. The second group had blood sugar controlled more loosely,” said Dr. Ad. “The original study only focused on how blood sugar control affected complications in the hospital, so we were interested in following those same patients over time to see if blood sugar control had any impact after discharge from the hospital.”
The new study found that survival after heart bypass surgery was not affected by the level of blood sugar control in the hospital while recovering from surgery, as long as blood sugar was kept below 180 mg/dL. The new study also found that health-related quality of life significantly improved in all patients from baseline to 6 months, whether or not they had strict blood sugar control.
“We hope that these results will encourage more hospitals to consider a less strict control of blood sugar in all patients after heart bypass surgery, which could reduce the chances for hypoglycemic events in the hospital, as well as secondary complications from drops in blood sugar,” said Dr. Ad.
Reassurance for Patients
In an invited commentary in the same issue of The Annals, Harold L. Lazar, MD, from Boston Medical Center, said that the study provides some assurance to heart surgery patients. “Since most groups are moving away from aggressive blood sugar control because of a higher incidence of hypoglycemia low blood sugar, this study’s results will provide some affirmation that, at least for overall survival, there is no difference between the two techniques,” said Dr. Lazar.
“One limitation of the current study is that Pezzella and colleagues report only on survival. We don’t know if there were differences in cardiac-related issues, such as heart attacks, recurrent angina, need for repeat coronary revascularization procedures, or long-term readmissions for acute coronary syndromes,” said Dr. Lazar. “This is important for future research since many of these patients have other comorbid diseases that are not related to their heart.”
Additional co-authors on the study include Sari. D Holmes, PhD, Graciela Pritchard, BS, and Alan M. Speir, MD, all from Inova Heart and Vascular Institute in Falls Church, VA.
Notes for editors
“Impact of Perioperative Glycemic Control Strategy on Patient Survival After Coronary Bypass Surgery” (DOI: 10.1016/j.athoracsur.2014.05.067); The Annals of Thoracic Surgery published by Elsevier. http://www.sciencedirect.com/science/article/pii/S0003497514012491
Full text of the article is available to credentialed journalists upon request; contact Cassie McNulty [email protected] at +1 312 202 5865
About The Annals of Thoracic Surgery
The Annals of Thoracic Surgery is the official journal of STS and the Southern Thoracic Surgical Association. Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 6,800 cardiothoracic surgeons, researchers, and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society’s mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.
A healthy diet can be good for your heart as well as your waistline.
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“You can definitely reduce your risk of developing cardiovascular disease by eating certain foods every day,” says preventive cardiology dietitian Julia Zumpano, RD, LD. “There is a great variety of fruits and vegetables that are good for your heart.”
“Try to eat foods that are in their natural form, as they come from the ground,” Zumpano says, recommending what she calls the “whole-foods diet.”
That diet includes, of course, heart-healthy foods such as nuts, fish, whole grains, olive oil, vegetables and fruits, but don’t be afraid to treat yourself occasionally with a glass of red wine or a piece of dark chocolate, Zumpano says. She suggests using this list as a guide to create meals and snacks with a healthy focus. Just a few simple swaps could make a big difference for your cardiovascular health.
12 foods that are good for your heart
- Eat fish high in omega-3s, such as salmon, tuna, mackerel, herring and trout.
- A handful of healthy nuts such as almonds or walnuts will satisfy your hunger and help your heart.
- Berries are chock full of heart-healthy phytonutrients and soluble fiber. Try blueberries, strawberries, blackberries or raspberries in cereal or yogurt.
- Seeds. Flaxseeds contain omega-3 fatty acids, fiber and phytoestogens to boost heart health. Take them in ground or milled form to reap the greatest benefit. Chia seeds also provide omega 3, fiber and protein and can be eaten whole.
- Oats are the comfort-food nutrient powerhouse. Try toasting oats to top yogurt, salads or to add into a trail mix if you are not a fan of them cooked.
- Legumes. Dried beans and lentils ― such as garbanzo, pinto, kidney or black beans, are high in fiber, B-vitamins, minerals and other good stuff. Veggie chili, anyone?
- A 4-ounce glass of red wine (up to two for men and one for women per day) can help improve good (HDL) cholesterol levels.
- Soy. Add edmame beans or marinated tofu in a stir-fry with fresh veggies for a heart-healthy lunch or dinner.
- Red, yellow and orange veggies such as carrots, sweet potatoes, red peppers, tomatoes and acorn squash are packed with carotenoids, fiber and vitamins to help your heart.
- Green veggies. Popeye was right ― spinach packs a punch! So does kale, Swiss chard, collard/mustard greens and bok choy. Use these sandwiches and salads instead of lettuce. Broccoli and asparagus are filled with mighty nutrients such as vitamins C and E, potassium, folate, calcium and fiber.
- Fruits such as oranges, cantaloupes and papaya are rich in beta-carotene, potassium, magnesium and fiber.
- Dark chocolate is good for your heart health. The higher the percentage of cocoa the better! (The fiber and protein increase with higher cocoa and the sugar decreases). If you are a fan of milk chocolate. start with at least 70% cocoa.