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Living with type 2 diabetes? Here's how you can reduce the risk of heart problems through food and lifestyle changes

You can tell a lot about a person by looking into their fridge, according to conventional wisdom… So let’s crack open the door to a discussion about the importance of food in our lives, especially in the context of managing type 2 diabetes and cardiovascular risk factors.

Your most important relationship

If the fridge line above is true, it’s not surprising. You find a similar idea expressed in the old adage “we are what we eat”, not to mention the fact that what we eat is tightly bound up with our relationships to friends and family. And those are surely important aspects of our lives, whether we are very social or not.

Perhaps the matter can be boiled down to this: Diet and lifestyle are essential areas of life. So you have to find an approach that works!

The better your approach, the greater your chances of making diet and lifestyle drivers of happiness and health – metabolic as well as cardiovascular.

Living with type 2 diabetes

Living with a chronic illness such as type 2 diabetes means juggling multiple things at the same time and taking regular action to manage the symptoms of the condition. Regular health check-ups and medical treatment suggested by the doctor can help manage symptoms of type 2 diabetes.  However, there are two more components that can help: Healthy diet and lifestyle and physical exercise.

Graphical illustration showing an apple, a bike and a pen

No matter how you manage your symptoms, daily adjustments are a long-term strategy – not a quick fix.

Bear in mind that your body and health are not transparent to yourself. Some issues and symptoms cannot be felt, and daily adjustments are a long-term strategy – not a quick fix with a guaranteed outcome. That’s why it is highly important that you talk things over with your doctor about how you manage your condition.

So don’t make your health a DIY project! It’s simply too risky.

The body’s difficulty in regulating blood sugar levels is, as you know, the principal symptom of type 2 diabetes1. This tends to affect the heart and blood vessels2, which raises an interesting question:

Is there a connection between managing the diabetes symptoms themselves and reducing the risk of a cardiovascular event, such as stroke or heart attack?

The short answer is – fortunately – yes2.

Make two friends with one gift…

Whether you adjust your diet, pursue physical activity, here’s the good news: It’s possible to do so in a way that allows you to simultaneously manage your diabetes symptoms and reduce your risk of a cardiovascular event.

To sum up: People with type 2 diabetes may engage in three categories of active symptom-management: diet and lifestyle; physical exercise and medicine. Each of these allows you to simultaneously manage diabetes symptoms and reduce the risk of a cardiovascular event3,4.

In terms of the available medical options, your healthcare provider can tell you more.

And if you wish to learn more about how to approach physical exercise while living with type 2 diabetes, click here or here.

This blog, however, is about food, diet, diabetes and – especially – cardiovascular health. So let’s dig in…

Bon appétit – here are the foods that make your heart sing

To promote your health living with type 2 diabetes and simultaneously reduce your risk of adverse cardiovascular events, your goal should be a varied or balanced diet – with only a few items struck from the menu completely.

Now, a person living with type 2 diabetes has essentially the same nutritional needs as someone without the condition. This means that no special or additional foods are necessary for those with diabetes5.

The difference, rather, is that people with type 2 diabetes have more to gain – for reasons having to do with their heart as well as their blood sugar – by avoiding some of the foods that others can enjoy without particular worry.

So, for instance, try to avoid foods that are high in saturated fat and trans fats. Saturated fat is commonly found in animal products, while trans fats are found in fried food, cakes and sweet treats.

It’s not that fat – all fat – is simply bad and should be avoided altogether. Rather, studies suggest that if you replace saturated fats and trans fats with unsaturated fats, it can benefit your cardiovascular health6,7. Unsaturated fats are found in avocado, nuts, olive oils and vegetable oils.

How to start making good diet decisions with small choices

And try to avoid too much sugar and salt. (That’s to say nothing of tobacco and alcohol which you also need to cease consuming – or only consume with great caution.)

What’s wrong with salt, you ask? Well, your body naturally seeks to dilute the salt you eat by holding on to water. So, by eating salt you literally bind water to your body. This extra water increases your blood volume, making your heart work harder simply because it has to push more liquid through your blood vessels.

Over time, this is quite rough on the blood vessels, which can turn stiff, raising the risk of stroke, heart attack, and heart failure8.

Taken all together, the dietary pointers presented here will help you to better manage your blood sugar, cholesterol, blood pressure and weight – all of which are risk factors of cardiovascular disease.

A shopping list laying next to various vegetables.

Stock your kitchen well

Suppose you put this list of foods in your pocket next time you went grocery shopping:

✔    Vegetables, fruits and nuts
✔     Wholegrain options of bread, pasta and rice
✔     Fish and low-fat meat
✔     Eggs and other non-dairy sources of proteins
✔     Milk and cheese

A rough shopping guide there, with hopefully something for everyone’s taste!

Why wholegrain variants, you ask? Well, as Phyllisa Deroze writes, darker foods are generally to be preferred over lighter, paler variants if you’re living with type 2 diabetes.

The reason has to do with a useful rule of thumb: Lighter-coloured foods are associated with faster-acting, less complex carbohydrates, which have the effect of causing your blood sugar levels to rise and fall quickly – not remain steady and well-regulated over longer stretches of time9,10.

So pick spinach over iceberg lettuce, brown rice over white rice, sweet potatoes over white potatoes, wholegrain bread over wheat bread and so on.

Nutrients matter – but so does language

Try not to think of health-promoting food choices as your “diet”, neatly distinct from foods that are somehow wrong or forbidden. Don’t force yourself to sign up to what sounds like an imposition and an unappealing limitation.

Why not say “meal plan”? It’s a more optimistic and less forbidding word. The nourishment you’re going to require is not exactly set in stone, after all. You might find you need to rethink your approach a week from now if something isn’t working out for you.

With that said, try to see the list not so much as a limitation, but a clarification of what you can safely eat. With that in mind, be explorative…

Woman looking at a tablet while chopping carrots.

Cook for your health, your heart – and your friends! They are going to love your new-found creativity in the kitchen.

The best is yet to come

By “explorative”, here’s what we mean: As soon as you finish this blog post, open a new tab in your browser and begin looking for food and cooking inspiration. Settle on a fixed but manageable number of new delicious recipes that you have to try every week. Two? Three or four? Invite a good friend over to rate and applaud your new-found creativity in the kitchen.

In short, caring for your heart and managing your type 2 diabetes doesn’t mean the end of great food. Food can still be a delightful, satisfying and fun part of your life. There are countless new foods and recipes waiting to be discovered!

Hungry for more?

Now, food and health are subjects we’ve covered before in this space. If all you need is a quick general introduction, here’s a useful 2-minute read.

Or, if you haven’t already read it, check out this piece on what a person with type 2 diabetes should know about food, by type 2 patient advocate Phyllisa Deroze.

Don’t close the fridge door on the new and healthier you!

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References
  1. International Diabetes Federation. IDF Diabetes Atlas (10th edition). Available at: https://diabetesatlas.org/ Last accessed: February 2024.
  2. Diabetes UK. Diabetes and stroke. Available at: https://www.diabetes.org.uk/guide-to-diabetes/complications/stroke. Last accessed: February 2024.
  3. CDC. Benefits of Physical Activity. Available at: https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm#:~:text=To%20maintain%20your%20weight%3A%20Work,they%20need%20for%20weight%20management. Last accessed: February 2024.
  4. Yu E, Malik VS, Hu FB. Cardiovascular Disease Prevention by Diet Modification: JACC Health Promotion Series. J Am Coll Cardiol. 2018 Aug 21;72(8):914-926.
  5. Diabetes UK. What is a healthy, balanced diet for diabetes?. Available at: https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/what-is-a-healthy-balanced-diet. Last accessed: February 2024.
  6. Li Y, et al. Saturated Fats Compared With Unsaturated Fats and Sources of Carbohydrates in Relation to Risk of Coronary Heart Disease: A Prospective Cohort Study. J Am Coll Cardiol. 2015 Oct 6;66(14):1538-1548.
  7. Hayes J, Benson G. What the Latest Evidence Tells Us About Fat and Cardiovascular Health. Diabetes Spectr. 2016 Aug;29(3):171-5. 
  8. Strazzullo, et al. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. The BMJ. 2009;339:b4567. 
  9. Diabetes UK. 10 tips for healthy eating if you are at risk of type 2 diabetes. Available at: https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/preventing/ten-tips-for-healthy-eating. Last accessed: February 2024.
  10. Diabetes UK. Simple vs Complex Carbs. Available at: https://www.diabetes.co.uk/nutrition/simple-carbs-vs-complex-carbs.html. Last accessed: February 2024. 

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