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Karen Chapman Novakofski

Professor of Nutrition

Marilyn Csernus

Extension Educator, Nutrition and Wellness

 

February-March, 2017

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In This Issue

Diabetes - The Medical Perspective

Diabetes and Heart Disease: What You Need to Know

Heart disease continues to be the leading cause of death in the United States for both men and women. The good news is that it is often preventable. The link between diabetes and heart disease is well established. Diabetes is recognized as a major risk factor for heart disease. Having diabetes increases your risk of heart disease two to four times. So, why is this? What about having diabetes makes heart disease more likely? Heart disease risk factors such as high cholesterol, high blood pressure, and smoking damage blood vessels. Blood vessels of people with diabetes appear to be even more susceptible to damage from these factors. It may be that poorly controlled blood glucose over time contributes to the increased risk of damage to blood vessels.

Your best defense against heart disease is well-controlled diabetes and establishing targets of care for heart disease and diabetes. 

Blood Glucose (Sugar) Levels

A target range for fasting, after meals and hemoglobin A1C levels (3-month average blood sugar) should be established with your health care provider. When blood glucose is high, it can increase cholesterol and make controlling blood pressure harder. Low blood sugar levels can also damage the heart, especially if you already have heart disease. Your body responds to low blood glucose by increasing heart rate.

You should always determine your personal blood sugar target levels with your health care provider. The following are general recommendations from the American Diabetes Association:

Fasting Blood Glucose checked 8 hours without food: 80-130 mg/dl

 After Meal Blood Glucose checked 2 hours after eating: less than 180 mg/dl

A1C checked every 3 months if uncontrolled, or every 6 months if at goal: less than 7%

Blood Pressure

Uncontrolled blood pressure damages blood vessels. This increases the risk of having a stroke, heart failure, or a heart attack. Blood pressure should be checked at every office visit. Your health-care provider may recommend a type of medication called an ACE-inhibitor or ARB to help control blood pressure. Along with controlling blood sugar, these drugs also protect your kidneys.

A blood pressure goal for most people with diabetes and no additional risk factors: less than 140/90.

Goal for people with diabetes plus at least one of the following risk factors: high cholesterol, smoking, history of premature heart disease in your family, obesity, and having protein in the urine: less than 130/80 mmHg.

Weight

Risk of heart disease increases in people who are overweight or obese. Your health-care provider assesses your weight status using body mass index (BMI). BMI compares your weight with your height. Losing and maintaining a 7% weight loss can decrease risk of heart disease, especially for those with diabetes. Your registered dietitian can help with an individualized meal plan to help you meet and maintain your weight loss goals.

Cholesterol

Cholesterol build-up in your arteries can lead to a heart attack or stroke. We hear a lot about “good” and “bad” cholesterol levels. High- density lipoprotein (HDL) is known as “good” cholesterol and low -density lipoprotein (LDL) is known as “bad” cholesterol. An easy way to remember the difference is L for “lousy” cholesterol or H for “healthy” cholesterol. Eating less animal fat and more plant based fats will lower LDL. Regular physical activity increases HDL. To decrease risk of heart disease the goal is LDL below 100 mg/dl and HDL above 40 mg/dl for men and 50 mg/dl for women.

Physical Activity

Regular physical activity is beneficial in managing blood sugar, weight, and decreasing heart disease risk. Both physical activity and resistance training are important. Aim for 150 minutes a week. For some, additional monitoring and medication adjustment may be necessary to maintain safe blood glucose levels. Always discuss your exercise plan with your health-care provider.

Diabetes and Food

Eating well to manage diabetes goes hand-in-hand with eating to decrease risk of heart disease. Both the American Diabetes Association and the American Heart Association make similar recommendations for a healthy meal plan. Both consist of lean protein, fruits, and vegetables, whole grains, low fat dairy and healthy fats.

By choosing lean sources of protein such as lean meat, poultry with skin removed, and seafood you will be cutting down on unhealthy saturated fats. Beans, legumes and nuts are also healthy protein sources.

Fruits and vegetables provide disease fighting antioxidants and dietary fiber. The most familiar antioxidants are vitamin C, E and beta- carotene. Eating a diet with a variety of colorful fruits and vegetables provide disease-fighting antioxidants. Soluble fiber aids in maintaining healthy cholesterol levels. Oats, barley, peas, beans, carrots, apples, pears, and citrus fruits are good sources of soluble fiber. Whole-grains are healthier choices than processed grains because whole-grains are rich in nutrients and dietary fiber. Instead of white bread, rice or pasta try whole wheat bread, brown rice and whole-grain pasta. Choose whole grain cereals rather than processed cereals.

Whole milk dairy products contain unhealthy saturated fat. Low fat milk, yogurt and cheeses supply all the nutrients of full-fat dairy products except for the extra fat. The lower carbohydrate, higher protein content of non-fat Greek yogurt make it a good choice.

Olive, canola and peanut oil, avocados and nuts are all heart healthy fats. Replacing animal fats with these fats or other plant-based oils will help reduce heart disease risk. Using soft tub margarine spreads instead of butter is a heart-healthy change. Trans-fats are produced when a liquid oil is processed into a solid fat. Trans-fats are such a risk for heart disease that the Food and Drug Administration has ruled that food companies have to stop adding trans-fats to food products by 2018. The American Heart Association recommends eating no more than 2 grams of trans-fats per day.

An easy way to cut back on sodium intake is to buy fresh, frozen, or low sodium canned vegetables. Draining and rinsing canned vegetables decreases sodium content by 30-40%. Most sodium comes from processed foods. Fast-food and restaurant foods tend to be high in sodium. Meals prepared at home generally have a lower sodium content. Plan your meals around lean protein, fruits, vegetables, low-fat dairy, and heart-healthy fats without added sodium.

Recipes to Try

Quick Chicken Stir-Fry

4 servings

Ingredients

  • 1 16-ounce coleslaw mix
  • 2 10-ounce cans chicken, drained
  • 1 8-ounce can sliced water chestnuts, drained
  • 1 tablespoon olive oil

Directions

  1. Add oil to large skillet or wok and tilt pan to spread oil. Turn burners to medium high.
  2. Add coleslaw, stirring gently for about 3 minutes.
  3. Add chicken and water chestnuts, stirring until heated, another 2 to 3 minutes.
Nutrition Facts per serving
Calories 270
Fat 6 grams 
Protein 39 grams
Calories from fat  58
Carbohydrate 14 grams
Cholesterol  63 mg 
Fiber  5 grams
Sodium 490 mg

Beet and Orange Salad with Walnuts and Feta Cheese

14- 1 ½ cup servings

Ingredients

  • Salad
    • 4 cups mixed baby lettuce
    • 1 - 15 ounce can sliced beets
    • 1 small fresh orange, peeled, divided into segments and cut in half
    • 2 ounces low fat feta cheese, crumbled
    • ¼ cup walnuts, roasted and chopped
  • Dressing
    • 2 tablespoons olive oil
    • 1 tablespoon orange juice
    • 1 tablespoon raspberry blush vinegar
    • 1 teaspoon Splenda
    • 1 tablespoon non-fat Greek yogurt
    • Salt and pepper to taste

Directions

  1. Preheat oven to 350 ° Fahrenheit. Place walnuts in a single layer on a cookie sheet. Bake about 8 minutes.
  2. Arrange lettuce onto 4 serving plates.
  3. Next layer beets, orange segments and feta and walnuts
  4. Combine all dressing ingredients in a jar with a tight fitting lid. Shake or whisk together until ingredients are well mixed.
  5. Drizzle dressing evenly over salad.
Nutrition Facts per serving
Calories 200
Fat 14 grams
Protein 6 grams
Calories from fat 122
Carbohydrate 15 grams
Cholesterol  4 mg
Fiber  3 grams
Sodium 323 mg

Sample Menu

BREAKFAST

Oatmeal ½  cup
Whole Wheat Toast 1 slice
Soft tub Margarine Spread 1 teaspoon
Vanilla Non-fat Greek Yogurt 6 ounces
Fresh Blueberries ¾ cup
Skim milk 1 cup
Nutrition Facts
Calories 646
Carbohydrates 75 Grams
Carbohydrate Choices 5

LUNCH

Quick Chicken Stir Fry 1 serving
Brown Rice 2/3 cup
Sliced Apple 1 small
Skim Milk 1 cup
Nutrition Facts
Calories 580
Carbohydrates 71 Grams
Carbohydrate Choices 5 Choices

DINNER

Grilled Salmon 4 ounces
Beet and Orange Salad with Beets and Feta Cheese 1 serving
Baked Potato 1 medium
Soft Tub Margarine Spread 1 teaspoon
Skim Milk 1 cup
Nutrition Facts
Calories 720
Carbohydrates 60 Grams
Carbohydrate Choices 4 Choices

Total:

Calories 1954
Carbohydrates 206 Grams
Carbohydrate Choices 14 Choices

*Recipes from Recipes for Diabetes at extension.illinois.edu/diabetesrecipes/ or this newsletter


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