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Health & Medicine

2009-05-01 11:45:00

Diabetes - ongoing series

Answer: Diabetics are at an increased risk for heart disease as compared to the general population, so it’s important to control cholesterol levels. Since the body can manufacture all the cholesterol it needs, a healthy diabetes diet includes foods low in cholesterol—specifically LDL levels, which have been identified as the main cholesterol-induced risk factor. The LDL deposits in diabetics bond with the excessive glucose and stick to arteries more readily, increasing the chances of plaque deposits and damage to the arterial wall. A healthy amount of LDL in the blood is less than 100 mg/dL. Aside from lowering the LDL levels, raising HDL cholesterol (the “good” cholesterol) also lowers the risk of heart problems, since HDL is responsible for moving cholesterol from all parts of the body back to the liver for eventual removal from the system. People with diabetes have lower HDL levels to begin with. According to the American Diabetes Association (ADA), an HDL level of 40 mg/dL and above for men, and 50 mg/dL and above for women, is considered protective against heart disease. Lowering triglyceride levels is also instrumental. Triglycerides are fats carried in the blood stream that are associated with low HDL levels. The triglycerides should be below 150 mg/dl for both sexes. Since it is more difficult for the cells to interact with insulin in a person who is overweight, a low-fat diet is important for diabetics. The ADA makes some dietary recommendations for maintaining healthy cholesterol and triglyceride ranges: •Eat less fat, especially less saturated fat (found in fatty meats, poultry skin, butter, 2% or whole milk, ice cream, cheese, palm oil, coconut oil, trans fats, hydrogenated oils, lard, and shortening). •Choose lean meats and meat substitutes. •Switch to low-fat or fat-free dairy products. •Eat at least 5 servings of fruits and vegetables each day. •Cut back on foods that are high in cholesterol (such as egg yolks, high-fat meat and poultry, and high-fat dairy products). •Choose the kinds of fat that can help lower cholesterol, such as olive or canola oil. Nuts also have a healthy type of fat. •Eat fish two or three times a week, choosing kinds that are high in heart-protective fat (such as tuna and salmon). •Cook using low-fat methods (such as baking, roasting, or grilling foods or by using cooking sprays). •Eat more foods that are high in fiber (such as oatmeal, oat bran, dried beans and peas like kidney beans, fruits, and vegetables). •Eat less salt and sodium. The ADA’s Diabetes Food Pyramid groups foods according to their carbohydrate and protein content, as well as by frequency of use in meals. The aim is to have about the same carbohydrate content per serving. Paying attention to serving sizes is integral to maintaining healthy blood glucose levels; see the ADA’s website in references & resources. Here is the breakdown of recommended servings per day, from the website: •Grains and starches—6 to 11 servings per day. This group includes bread, cereal, rice, and pasta. The starchy vegetables potatoes, peas, and corn are included here, as are dried beans such as pinto beans and black-eyed peas, because they have a carbohydrate content equivalent to one slice of bread. They should be counted as carbohydrates for the meal plan. •Vegetables—at least 3 to 5 servings per day. Spinach, chicory, sorrel, Swiss chard, broccoli, cabbage, bok choy, brussel sprouts, cauliflower, kale, carrots, tomatoes, cucumbers, and lettuce all belong to this group. •Fruit—2 to 4 servings per day. The ADA emphasizes blackberries, cantaloupe, strawberries, oranges, apples, bananas, peaches, pears, apricots, and grapes. •Milk—2 to 3 servings per day. Again, the emphasis here is on low- or non-fat milk. •Meat and meat substitutes—4 to 6 ounces per day, divided between meals. Cut all the visible fat off the meat before cooking or eating, and keep the portion sizes small (a 3-ounce serving is the size of a deck of playing cards). Meat replacements include tofu, eggs, dried beans, cheese, cottage cheese, and nut butters. •Fats, sweets, and alcohol— Potato chips, candy, cookies, cakes, crackers, and fried foods belong to this group. Keep your servings of these foods small and save them for a special treat. Just remember, Diabetes and the diet do not have to be enemies. They can get along together just fine. In fact, the longer they get along together…the longer they will get along together. I will be back next month for more on this continuing series.