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University of Illinois Extension

Eating for Cardiovascular Health

Increased Risks for People with Diabetes

It is very important for people who have diabetes to make heart-healthy food choices because of their increased risk for cardiovascular complications. When compared to people without diabetes, people with diabetes have:

it is very important for people who have diabetes to make heart-healthy food choices

Women with diabetes are particularly susceptible to these complications, and have a greater risk of death from heart attacks and strokes than men with diabetes.

Why do People with Diabetes have Increased Risks?

blood pressure cuff

It is not completely known how diabetes influences the cardiovascular system. However, high blood glucose and high blood pressure in people with diabetes commonly cause changes in blood vessels. These changes may explain why people with diabetes have such high rates of heart disease, stroke, and poor circulation in the legs and feet. This also may be one reason for the high rates of impotence in men with diabetes.

Experts recommend that all people with diabetes should try to keep their blood glucose and blood pressure within their target range and should try to follow heart-healthy patterns of eating.

Heart-healthy Eating

Heart-healthy eating is a way of eating that will help to keep your heart and cardiovascular system functioning well.

Heart-healthy eating includes:

Eating less:

Choosing more unsaturated fats like:

A heart healthful eating plan for lowering blood pressure, blood cholesterol, and triglycerides is based on these American Heart Association dietary guidelines.

emphasize vegetables, fruits, and low-fat or fat-free dairy products

Total fat intake should be 25 to 35 percent of total calories.

Knowing Your Fats

In addition, a healthy diet includes

The goals of the American Heart Association Eating Plan are available at

What are the Risk Factors for Cardiovascular Disease?

Excess body weight

Having risk factors for a disease does not necessarily mean you will develop that disease. They just mean you are more likely than people not having those risk factors. Scientists identify these risk factors through large population-based studies that identify groups of people more or less likely to have certain characteristics. They may not always be true for individual people. For instance, you may know someone who is overweight, but doesn’t have diabetes or heart disease. However, for many people, having these risk factors is associated with a greater risk of developing cardiovascular disease:smoking is bad for your heart

What is Cholesterol?


Cholesterol is essential for life and is found in all cells. There are two types of cholesterol, one that our bodies make and dietary cholesterol. The cholesterol that our body makes is a fat-like substance produced by the liver. Dietary cholesterol is the cholesterol that other animals produce and that we ingest when we eat animal products like meat and milk. Both types of cholesterol are used to form cell membranes, and to manufacture hormones, bile acids, and vitamin D.

Cholesterol and other fats can’t dissolve in the blood. They have to be transported to and from the cells by special carriers composed of lipids and proteins called lipoproteins. The two lipoproteins to be most concerned about are low density lipoproteins (LDL), and high density lipoproteins (HDL).

What is HDL-cholesterol: The 'Good' Cholesterol

Some research indicates that HDL-cholesterol carries cholesterol away from the bloodstream and back to the liver, where it is passed out of the body. A high level of HDL seems to protect against cardiovascular disease, and a low level indicates a greater risk. HDL-cholesterol levels range from 40 to 50 mg/dl in the average man; from 50 to 60 mg/dl in the average woman. HDL-cholesterol less than 40 mg/dl is considered low and HDL-cholesterol greater than 60 mg/dl is desirable.

To achieve healthful HDL levels:

jogging ladies

What is LDL-cholesterol: The 'Bad' Cholesterol

garbanzo beans and peaches

When a person has too much LDL-cholesterol in the blood, it can slowly build up on the inner walls of the arteries, which supply blood to the heart and brain. Together with other substances it can form plaque, a thick, hard coating that can clog the arteries. A high LDL cholesterol level increases your risk of heart disease. An LDL level between 130-159 is considered borderline high risk for heart disease and an LDL level of 160 or over is considered a high risk.

However, if you are about to begin medication for lowering LDL levels, or are already taking a statin medication to lower LDL levels, your doctor may not be concerned about your LDL level reaching these target values. Recent recommendation focus on how much of a medication a person can tolerate, and the relative decrease in the LDL level rather than reaching an particular number. The person’s other risk factors and also important.

To achieve healthful LDL and/or total cholesterol levels:

What are Triglycerides?

Triglycerides are the chemical form in which most fat exists. Triglycerides are the human body's storage form of fat. Blood triglyceride levels above 150 mg/dl are considered high, and may also play a role in forming plaque. Being overweight, drinking large amounts of alcohol, having diabetes and hyperglycemia (high blood glucose) can cause high blood triglycerides. weird toes on a scaleTo reduce elevated triglyceride levels:

If you would like to find out your HDL, LDL, total cholesterol, and triglyceride levels, ask your health care provider for a lipid profile. A blood lipid profile is a blood test for your total cholesterol, HDL-cholesterol, and triglyceride level, (LDL-cholesterol is estimated from these numbers).

*Note: You need to fast for 12 hours before a blood lipid profile

How High is Too High?

The risk for heart disease is increased when there is too much cholesterol and/or triglycerides in your blood. However, the latest guidelines from the American College of Cardiology and the American Heart Association, developed in conjunction with the National Heart, Lung, and Blood Institute have recommended to not treat people to get to a certain blood level.1

However, your doctor may want to talk to you about medications to lower blood lipids if you fit in any of the following categories:

You can calculate your 10-year risk of atherosclerotic cardiovascular disease by going to this site: http://cvdrisk.nhlbi.nih.gov/

1 Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American College of Cardiology/American Heart Association. J Am Coll Cardiol 2013. Article. Circulation 2013

Dietary Factors that Increase Blood Cholesterol

nutrition label

Having high blood cholesterol, high LDL, or low HDL are risk factors for cardiovascular disease. There are five dietary factors that can increase your blood cholesterol levels, increase your LDL level, and/ or lower your HDL level:

Consuming too much dietary cholesterol, total fat, saturated fat, trans fat, or too many calories can raise your blood cholesterol levels and increase your risk for heart disease. Therefore, it is important to know what foods contain these factors, and how you can change your diet to decrease your risk.

Saturated Fat

Foods high in saturated fats raise blood cholesterol more than foods high in dietary cholesterol. “Saturated” is a word that refers to the chemical structure of some fats. Saturated fats are usually firm or hold their shapes at room temperature. For example, at room temperature butter is solid because it has more saturated fat, versus oil that is liquid, because it does not have a lot of saturated fat. The main sources of saturated fat in the typical American diet are:

These foods also contain saturated fat:

Tips for Reducing Saturated Fat Intake

Trans Fat

Foods high in trans fat also raise blood cholesterol. “Trans” is also a word that refers to the chemical structure of certain unsaturated fats when they have had hydrogen added to them to make them firm. Foods with the words “partially hydrogenated vegetable oils” in their ingredient list are likely to be high in trans fat. Baked goods, snack foods, fried foods, margarines, and shortenings often contain trans fats. The best way to find out if a food contains trans fat is to look on the Nutrition Facts label or look for partially hydrogenated fat in the ingredients list.

Tips for Reducing Trans Fat Intake

Total Fat

The total amount of dietary fat eaten has a large impact on blood cholesterol levels. Since many foods contain fat, the best way to find out how many grams of total fat you eat each day is to look at the Nutrition Facts labels of the foods you eat. Eating a lower fat diet tends to lower blood cholesterol and helps keep levels within a normal range. Only 20 – 35 percent of your daily calories should come from fat.

Tips for Reducing Total Fat Intake

The chart below will help you determine the amount of total fat and saturated fat grams that the American Heart Association recommends you eat depending on your calorie level.

Calorie Level Total Fat (grams) Saturated Fat (grams)
< 10% of total calories
Saturated Fat (grams)
< 7% of total calories
1200 40 < 13 < 9
1500 50 < 17 < 12
1800 60 < 20 < 14
2000 67 < 22 < 16
2200 73 < 24 < 17
2500 83 < 28 < 19
3000 100 < 33 < 23

Consuming Excess Calories

Eating too many calories leads to weight gain. Weight gain can raise your LDL cholesterol levels, triglyceride levels, and blood glucose levels.

Dietary Cholesterol

Dietary cholesterol is different than blood cholesterol. Dietary cholesterol is the cholesterol obtained from food. Only food from animal sources contains dietary cholesterol. Dietary cholesterol only has a slight effect on your total blood cholesterol level. A person's total fat intake, especially saturated fat, has a more significant effect on blood cholesterol levels than dietary cholesterol alone does. However, a person should still have a low-to-moderate intake of dietary cholesterol, which would be less than 300 mg for those without high blood cholesterol and 200 mg for those with high blood cholesterol.

Tips for Reducing Dietary Cholesterol Intake

What are Polyunsaturated and Monounsaturated Fats?

Polyunsaturated and monounsaturated fat are both unsaturated fats. “Poly” means many unsaturated chemical bonds and “mono” means one unsaturated chemical bond. These unsaturated fats are often found in liquid vegetable oils.

fancy oils

Tips for replacing saturated fats with unsaturated fats

How is Excess Body Weight Related to Cardiovascular Disease?

According to the American Heart Association, weight gain is an independent risk factor for coronary heart disease and stroke. This means that excessive body weight alone (without other risk factors) can increase your risk for cardiovascular disease. For this reason, maintaining a healthy body weight is a high priority. The two major American Heart Association guidelines for maintaining a healthy body weight are:

Sample Menus for Reducing Caloric Intake

Menu 1: Higher Calorie Menu 2: Lower Calorie
  • 2 eggs
  • 2 pieces white toast
  • 1 tablespoon butter
  • 3 strips bacon
  • ½ cup egg substitute
  • ¼ cup cooked mushrooms
  • ¼ cup cooked spinach
  • 2 pieces whole wheat toast
  • Fat free vegetable oil spray
  • Quarter pound burger with cheese
  • Medium french fries
  • 1 medium cola
  • Caesar Salad with grilled chicken
  • 1 medium diet cola
  • Pork cutlet and mashed potatoes frozen dinner.
  • 12 fluid ounces lemonade
  • Beef portabello and mashed potatoes frozen dinner.
  • 1 cup light ice cream
  • 12 fluid ounces lemonade.
Nutrition Information
  • Calories 2050 kilocalories
  • Total Fat 91 grams
  • Saturated Fat 30 grams
  • Carbohydrate 238 grams
Nutrition Information
  • Calories 1235 kilocalories
  • Total Fat 36 grams
  • Saturated Fat 15 grams
  • Carbohydrate 139 grams

salad with chicken

Body Mass Index (BMI)

BMI is a numerical value used by health care providers to determine if a person is underweight, normal weight, overweight, or obese. These weight categories (underweight, normal weight, overweight, and obese) are used to estimate a person’s overall risk for developing chronic diseases.

A body mass index calculator is available on the Center for Disease Control website: http://www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm

Visit this website to learn your BMI and what it means.

It is important to note that BMI categories are not gender specific, and that BMI is not a measurement of body composition (fat and lean mass). Talk with your health care provided about your BMI. If you are pregnant, under 18, or a competitive athlete, this tool may not be an accurate measure of health or disease risk.

What Dietary Changes can Help Lower Blood Pressure?

Blood pressure is the pressure exerted by blood flow on artery walls. Blood pressure can change from minute to minute with changes in posture, exercise or sleep. However, according to the American Heart Association blood pressure should normally be less than 120/80 mmHg for an adult. Blood pressure that stays between 120-139/80-89 is considered prehypertension and above this level (140/90 mmHg or higher) is considered high (hypertension).

Recently these target blood pressure goals were changed for those over who are 60 years of age and older. At this age, 150/90 mm Hg or higher is the point at which medications may be prescribed, or the target for lowering blood pressure is someone is already diagnosed with hypertension. Studies have found no benefit to reducing blood pressure to 140/90 in this age group.1

blood pressure cuff

Blood pressure is affected by multiple dietary factors. Many studies have shown that specific dietary changes can have powerful and beneficial affects on blood pressure.

A specific eating plan that may be prescribed to reduce high blood pressure is the "Dietary Approaches to Stop Hypertension" (DASH) diet. The DASH diet is rich in fruits, vegetables, and low fat dairy foods, and low in saturated and total fat. It also is low in cholesterol, high in dietary fiber, potassium, calcium, and magnesium, and moderately high in protein. This diet has been proven to lower blood pressure and prevent hypertension in some individuals. The DASH diet suggests:

  1. JAMA. 2014; 311(5):507-520. Published online Dec. 18, 2013.

How is Fiber Related to Cardiovascular Disease?

Fiber is a food component that comes from plants. Animal foods like meat, milk, eggs, and cheese do not contain any fiber. Foods that do contain fiber include:edamame

It is important that everyone consume foods rich in fiber, but for people with diabetes or high cholesterol, fiber can be an added benefit. Studies have shown that 25-35 grams of fiber daily can reduce your risk of having a heart attack by as much as 40 percent. Diets high in fiber can also reduce LDL cholesterol levels, and may even lower blood pressure. Some research has even shown that higher fiber diets can help lower high blood glucose levels.

Tips for Increasing Fiber Intake

Full Day Sample Menu for Increasing Fiber Intake

500 kcal
60 gm carbohydrates
12 gm fiber
  • 1 cup oatmeal
  • ¼ cup chopped walnuts
  • 8 ounces skim milk
  • 1/2 grapefruit
507 kcal
81 carbohydrates
11 gm fiber
  • 1 sandwich (2 ounces of meat on 2 slices of whole wheat bread)
  • 1 cup coleslaw
  • 15 baked chips
  • 1 banana
534 kcal
87 gm carbohydrates
12 gm fiber
  • 3 ounce chicken breast
  • 1/2 cup brown rice
  • 1/2 cup green peas
  • 1 medium apple
  • 1 cup shredded lettuce salad with 1 tablespoon low-fat dressing
  • 8 ounces skim milk
Nutrition Information
for Entire Day
1541 kcal
228 gm carbohydrate
44 gm fat
7 gm saturated fat
0 trans fat
77 gm cholesterol
35 gm fiber
1154 mg sodium

How can People with Diabetes Minimize their Risk for Cardiovascular Complications?

To reduce your risk for the cardiovascular complications of diabetes it is important to know the ABCs of diabetes.

This site was last updated June, 2014.
This is a source of information only, and is not medical advice.