Diabetes, diet and heart health

The connection between diabetes and heart disease

There is a close link between diabetes and heart disease. When glucose levels are above target, over time this can cause damage to blood vessels and nerves that control the heart. This can lead to a buildup of fatty deposits in the arteries (especially if you have high levels of fat in your blood, and high blood pressure), increasing the risk of conditions such as heart attack and stroke.

People living with diabetes often have other risk factors that contribute to cardiovascular disease risk including:

• High blood pressure
• Higher LDL “bad” cholesterol and triglycerides (blood fats)
• Lower HDL “good” cholesterol
• Insulin resistance, which is linked with inflammation
• Being above a healthy weight

Principles of a heart-healthy diet

A heart-healthy diet focuses on nutrient-rich foods that keep your blood vessels healthy, improve cholesterol levels, and help maintain a healthy body weight. Many of these principles are the same as the dietary recommendations for diabetes.

1. Eat plenty of plant foods

Vegetables, fruits and wholegrains are fantastic sources of fibre, vitamins and minerals. Soluble fibre found in oats, barley and legumes can help lower cholesterol. Antioxidants found in fruits and vegetables can help prevent damage to your body’s cells, which reduces inflammation.

2. Choose healthier fats

The two types of healthier fats are monounsaturated and polyunsaturated fatty acids.

Healthy fats are found in:

• Oily fish including; salmon, sardines and mackerel
• Nuts and seeds
• Avocados
• Extra virgin olive oil.

Aim to include oily fish 2-3 times a week (fresh, frozen or tinned). Include nuts/seeds, avocado and/or olive oil in your diet every day.

3. Limit saturated fats

Saturated fat can raise LDL “bad” cholesterol levels. Higher levels of LDL cholesterol are linked with increased heart disease risk.

To reduce saturated fat intake, try to limit:

• Fatty cuts of red meat
• Processed meats such as sausages and bacon
• Butter and cream
• Deep fried foods
• Highly processed snack foods and baked goods

4. Reduce excess salt

Having a diet that’s high in salt is linked to higher blood pressure. Most of the salt we eat comes from processed or packaged foods. Salt is used to improve flavour and preserve food (keep it fresh for longer).  

Tips to reduce salt intake:

• Eat more whole foods, fewer processed
• Eat out less, do more home cooking
• Choose “reduced salt” or “no added salt” products where possible
• If eating packaged foods, aim for products that have less than 400mg sodium per 100g (the lower the better)
• Flavour meals with herbs, spices, garlic, and lemon/lime/vinegar instead of salt

So where does a heart-healthy eating pattern overlap with dietary recommendations for diabetes?

If you eat more fruit and vegetables, you will automatically increase your fibre intake. Fibre-rich carbohydrates are slower to digest and low GI which means they will cause a slow and steady release of glucose into the bloodstream. Adding healthy fats to your meals can further slow down digestion and lower GI.

Eating a higher fibre diet will keep you feeling fuller for longer, which can prevent the likelihood of overeating and help with managing weight. Replacing processed foods with whole foods can also help with weight management by reducing overall energy (calorie) intake. Losing weight (for those who are above a healthy weight) improves the body’s sensitivity to insulin and helps keep glucose levels within target range.

Alternatively, processed foods that are high in added sugar and made from refined carbohydrates will be high GI. This means they are quickly digested and more likely to cause a spike in glucose levels. Therefore, less processed food means better diabetes management.

The bottom line

There is a clear link between diabetes and heart disease. There is also overlap in the dietary management of the two conditions. Focusing on a diet that is mainly made up of wholefoods, low GI carbohydrates and healthy fats will support both diabetes management and cardiovascular health.

The good news is you don't have to change everything in your diet all at once. Making small changes that are sustainable will have a positive impact in the long term.