Three Strategies for Heart Healthy Eating

This content originally appeared on diaTribe. Republished with permission.

By Constance Brown-Riggs

Constance Brown-Riggs, MSEd, RDN, CDCES, CDN, is a national speaker and author of several nutrition books for people with diabetes.

​Nutritionist and educator Constance Brown-Riggs, MSEd, RDN, CDCES, CDN, discusses the relationship between food and heart health, and how you can make eating choices to prevent heart disease.

If you have diabetes, you are at a much higher risk for heart disease. The good news is, there are steps you can take to lower your risk. What you eat is one of the most important steps to managing diabetes and reducing your chances of heart complications. What are the three main ways to do this? Choose heart-healthy fats, heart-healthy carbs, and reduce sodium in your diet.

Many people find that changing eating behavior is very hard. But it doesn’t have to be that way – not if you take the right approach. Some people use a food tracker to see how much of certain nutrients like carbohydrates, fat, salt, they are eating. And research shows that making small, gradual changes works best. Rather than drastically changing your eating habits in a day, start with setting just a few small, achievable goals that you can stick with. To help you get started, you will find tips and “small wins” throughout this article – these step-by-step changes can make your meals and recipes healthier for your heart.

Education is key to managing diabetes and heart health. Click here to learn about Diabetes Self-Management Education and Support (DSMES) services to help you live well and navigate your diabetes journey – and check out the Diabetes Food Hub for even more resources.

1: Choose Your Fat Wisely

Dietary fat often gets a bad rap. So, it might surprise you to know that fat plays a vital role in our health. We need fat to insulate our body, protect our vital organs, and transport and absorb vitamins A, D, E, and K.

Fat is also the most concentrated energy source for the body, providing nine calories per gram, more than double what is found in carbohydrates and protein. And when it comes to food, there is no denying fats’ ability to make food taste good.

Fats are made up of fatty acids that are linked together. There are three types of fatty acids: saturated, monounsaturated, and polyunsaturated. The predominant type of fat in a food determines which category the food falls into:

  • Saturated fat is usually solid at room temperature and is found mainly in foods that come from animals, such as meat, lard, bacon, poultry, dairy products, and eggs. Coconut oil, palm kernel oil, and palm oil are also saturated fats. This type of fat can cause your body to produce too much cholesterol (a natural substance that the body needs, but in limited quantities – read all about cholesterol here).
  • Monounsaturated fat is usually liquid at room temperature. Monounsaturated fat is mainly found in vegetable oils such as canola and olive oils, avocadoes, and peanuts. Monounsaturated fats are often called heart-healthy fats because they don’t cause higher cholesterol levels.
  • Polyunsaturated fats are usually liquid or soft at room temperature. Polyunsaturated fat is found mostly in vegetable oils such as safflower, sunflower, corn, and flaxseed. It’s also found in walnuts and fish like salmon, albacore tuna, herring, and mackerel. Polyunsaturated fats are also heart-healthy fats because they don’t increase cholesterol levels.
  • Trans fats are polyunsaturated fats that have been chemically changed to make them stay solid at room temperature. Hydrogenated vegetable oils such as vegetable shortening and margarine contain trans-fatty acids – as do the foods you make with these oils. Trans fats act like saturated fat in the body, raising your cholesterol levels. The American Diabetes Association recommends avoiding foods with trans fats as much as possible.

When it comes to the heart, monounsaturated and polyunsaturated fats are much better for you. Read “Dietary Fat: The Good, The Bad, and The In-Between” to learn more. Here are some tips for adding more heart-healthy fats to your diet:

Small Win:  Shift the fat you use from saturated to healthy oils, like olive and canola. Chef Wesley McWhorter, spokesperson for the Academy of Nutrition and Dietetics, says, “Don’t forget to add healthy fats in your recipes from things like avocado, beans, nuts, and seeds – which will also keep you full longer and prevent overeating.”

Small Win: Try a “protein flip.” Chef McWhorter suggests you keep the animal proteins and their fats that you love but shift the proportion of the ingredients. For example, instead of an all-beef burger, make a half vegetable burger by adding beans and veggies or mushrooms. “Blended burgers are great because the moisture from the mushrooms actually makes your burger taste better,” says McWhorter.

Tips for Choosing Heart-Healthy Fats

Healthy eating facts

Image source: diaTribe

Remember: Choose low-fat and reduced-calorie foods wisely because they can contain more added carbohydrate than the full-fat version.

2: Opt for Heart Healthy Carbohydrates

There are three main types of carbohydrates: sugar, starch, and fiber.

  • Sugar is called by many names – simple sugar, table sugar, cane sugar, brown sugar, turbinado, demerara, maple syrup, molasses, honey, and high-fructose corn syrup. Simple sugars are often referred to as fast-acting because they rapidly raise blood sugar levels. Sugars may be added to foods or occur naturally, like the fructose in fruit and lactose in milk.

Foods made with added sugars tend to have little or no nutritional value and are usually high in calories and fat. Simple sugars, especially high fructose corn syrup, raise triglyceride levels which is associated with heart disease. And when it comes to blood sugar levels, foods with added sugar like cookies, donuts, and cakes lead to blood sugar levels spiking which, when treated with insulin, can cause large, unpredictable blood sugar swings – also not good for the heart.

  • Starch is a complex carbohydrate. It’s made from lots of simple sugars that are linked together in long chains. Complex carbohydrate foods include whole-grain bread and cereal, starchy vegetables (green peas, corn, lima beans, potatoes), and dried beans (pinto beans, kidney beans, black-eyed peas, and split peas). Unlike fast-acting carbohydrates, starches are slowly broken down during digestion, resulting in a lower, steadier release of sugar into the bloodstream.
  • Fiber is also a complex carbohydrate. Fiber is the indigestible part of any plant food, including the leaves of vegetables, fruit skins, and seeds. Fiber helps to move food waste out of the body and may help lower cholesterol and keep your blood sugar in range. Dietary fiber is found in foods that come from plants, including fruits, vegetables, nuts, seeds, avocados, beans, peas, lentils, and whole grains.

Increase Fiber

Fiber is important for heart health and keeping your blood sugar in range. The American Diabetes Association recommends that people with diabetes eat at least 14 grams of fiber per 1,000 calories – or about 28 grams of fiber per day for women and 34 grams of fiber per day for men. However, increasing fiber too quickly can cause gas, bloating, and constipation. Before increasing your fiber intake, figure out approximately how much fiber you are currently eating.

Aim to increase your daily fiber intake slowly – on week one, increase your daily fiber intake by two or three grams, then the following week increase it by two to three more, until you’ve reached your goal. In addition, increase the amount of water you drink. This will help prevent constipation. If you begin to experience gas or bloating, slow down – instead of changing every  week, change your daily fiber by two to three grams every other week.

Small Win: McWhorter suggests swapping processed grains like pasta for whole grains like farro, millet, quinoa, or bulgur. Fiber is one of the best things for your heart, and whole grains are a great way to get more of it,” says McWhorter. “The good thing is there are so many delicious, whole grains out there.”

Tips for Choosing Heart-Healthy Carbs

Healthy eating facts

Image source: diaTribe

3: Slash the Sodium in Your Food

Your body needs sodium (or salt) for normal muscle and nerve functions and to keep your body fluids in balance. But, too much sodium in your diet can lead to high blood pressure, heart disease, and strokes, as well as bloating, puffiness, and weight gain. Most people eat about 3,400 mg of sodium a day – almost double what’s recommended by the American Heart Association. People with diabetes and prediabetes are encouraged to consume less than 2,300 mg of sodium per day – that’s about one teaspoon of table salt – to care for their hearts.

Despite what you may think, over 70% of dietary sodium comes from eating packaged and prepared foods – not from table salt added to food when cooking or eating. Reading the nutrition facts label on packaged and prepared foods is the best way to make informed decisions about how much sodium you eat.

Small Win: McWhorter suggests building flavor throughout the cooking process. “It’s important to focus on how to add flavor through herbs, spices, acid, and texture, which can help you reduce the sometimes, excessive saturated fat, sugar, and salt in your dishes. Don’t be afraid to experiment with new seasonings and get away from the typical ‘salt and pepper’ approach. Trust me – flavor matters,” McWhorter says.

Tips to Reduce Sodium

Healthy eating facts

Image source: diaTribe

Remember, homemade food typically contains less sodium than prepared food (whether it’s canned, frozen, packaged, or from a restaurant). This is also true for sauces like pasta sauce, barbeque sauce, teriyaki sauce, ketchup, and salsa. As much as possible, aim to buy fresh, unprocessed ingredients and turn them into your favorite dishes. For heart-healthy recipes, click here.

Overall, the key to a heart-healthy meal plan is variety: fruits and vegetables, lean protein sources, nuts, legumes, whole grains, and healthy fats like avocados or olive oil. When revamping meals, chef McWhorter recommends starting with the whole plate in mind. “Our meals are most often focused on the main protein versus the whole plate. What is left leaves little room for creativity and deliciousness for the fiber-rich and nutrient-dense vegetables, whole grains, nuts, and seeds that we really want (and need) on our plate,” McWhorter says. And remember to start with small wins on your path to heart healthy eating.

Learn more about nutrition here.

This article is part of a series to help people with diabetes learn how to support heart health, made possible in part by the American Heart Association and American Diabetes Association’s Know Diabetes by Heart initiative.

About Constance

Constance Brown-Riggs, MSEd, RDN, CDCES, CDN, is a national speaker and author of Living Well with Diabetes 14 Day Devotional: A Faith Based Approach to Diabetes Self-ManagementDiabetes Guide to Enjoying Foods of the World, a convenient guide to help people with diabetes enjoy all the flavors of the world while still following a healthy meal plan, and The African American Guide to Living Well with Diabetes. Learn more about Constance and follow her on Instagram Twitter, and Facebook.

Source: diabetesdaily.com

How Your Diet May Make Stress Even Worse (ADA 2021)

By now we’ve all heard that stress has huge effects on our physical health. The scope of the problem may still be surprising.

In a recent presentation at the American Diabetes Association’s annual scientific conference, Wake Forest’s Dr. Carol Shively exclaimed that “Stress accounts for more deaths annually than Alzheimer’s or diabetes.”

Stress is strongly linked to both major illnesses like diabetes, cancer, and heart disease, in addition to other major causes of death, such as accidents and suicide. High rates of stress also help explain why there are such appalling disparities in American health outcomes between the socioeconomically secure and disadvantaged communities.

Stress, which is so often due to factors that are entirely out of our hands, is not easy to alleviate. There are some options, but there may be one other modifiable factor that you haven’t thought much about: your diet.

Dr. Shively believes that diet can have a huge impact on how stress can affect our bodies. If stress and diet interact to create real physiological changes, perhaps the negative effects of stress can be ameliorated with dietary change.

Monkeys and Stress

How do you study chronic stress? Dr. Shively does it with the help of the cynomolgus monkey, or crab-eating macaque.

These monkeys are good experimental analogues to human beings, because their responses to stress, diet, and aging are fairly similar to our own.

Cynomolgus monkeys form linear and stable hierarchies. It is immediately obvious to researchers which monkeys are dominant, and which are subordinate. And scientists can say with some confidence that the subordinate monkeys are more stressed.

Subordinate monkeys are the subject of more aggression, spend more time alone, and spend more time in a state of apparent vigilance than do monkeys higher in the social order. They also receive less grooming, a kind of pampering that relaxes monkeys and lowers their heart rate and blood pressure, just like a nice massage. Physiological indications—such as high cortisol levels—confirm that the subordinate monkeys experience more stress.

Social stress of this sort has an undeniable effect on the physical health of these monkeys. Stress leads to increases in visceral fat and atherosclerosis, just like it does in humans, two significant risk factors for chronic disease and early death.

Two Diets

Dr. Shively wondered if different diets might alter the way that stress impacts the monkey’s metabolism.

In a first study, monkeys were assigned to either the Western diet or a Mediterranean diet. They enjoyed these diets for 31 months – on a human timescale, that would be about 8 years.

These two diets were matched for macronutrients, so monkeys in each group ate about the same amount of protein, fat, and carbs. The composition of those nutrients differed quite a lot, however. The Mediterranean fats were more often plant-based, with a very high percentage of healthy monounsaturated fats, such as olive oil, resulting in a much healthier ratio of Omega-6 to Omega-3 fatty acids. Western carbs were also more likely to come from refined sources, such as high-fructose corn syrup; the Mediterranean carbs were mostly found in fruits and legumes.

The results weren’t surprising. Monkeys on the Western diet ate more food, gained more weight, had higher insulin and triglyceride levels, and had fattier livers than monkeys on the Mediterranean diet. These are similar to the results with humans. The growth of the Western diet, after all, is almost universally seen by experts as a primary cause in the global explosion of obesity and type 2 diabetes. (The two groups of monkeys got the same amount of exercise, by the way.)

The Diet-Stress Connection

When Dr. Shively subjected the monkeys from the two different groups to stress tests, she found that her hypothesis had been confirmed. The monkeys consuming the Western diet got much more stressed, secreting significantly more cortisol in response to social stress.

“The Western diet exaggerates physiological responses to stress, the Mediterranean diet did not.”

A second study split monkeys into two different groups, not by diet, but by stress level. Actually, the monkeys do it by themselves: in any group of four monkeys, two are always dominant, and two subordinate. The subordinate monkeys reliably experience more stress, as explained above.

In this study, all monkeys were fed the same Western-style diet for 3 years. At the end of the study, subordinate monkeys had higher triglycerides, higher fasting glucose, higher levels of circulating insulin, and more insulin resistance than when they began the study. By contrast, the dominant monkeys barely experienced any metabolic change at all, despite eating the same foods.

Nearly 25% of the subordinate monkeys had high enough fasting glucose levels to qualify as pre-diabetic; not a single one of the dominant monkeys had the same condition.

This study suggests that the unhealthy diet was not itself enough to cause metabolic dysfunction—both stress and diet had to be present.

Takeaways

Animal studies always have to be taken with a grain of salt – we can’t generally assume that what happens in the body of a crab-eating macaque will happen quite the same way in our own.

Nevertheless, the similarities between monkey and mankind are striking. Both social stress and the Western diet cause some of the very same negative physiological effects in monkeys as they do in humans.

The diet-stress connection is not far-fetched. While it would be almost impossible to prove a causal relationship in studies of humans, other scientists have already explored the interactions between the Western diet, stress, and metabolism. And there is much work to be done on the topic to tease out causation and correlation and test other dietary approaches.

In the meantime, Dr. Shively’s work may give readers one more reason to set aside the junk food and reach for more wholesome choices. Stress already causes so much metabolic damage—and that damage that may only be compounded by what you eat.

Source: diabetesdaily.com

Losing Body Fat with Type 1 Diabetes The “Right” Way

Within 5 minutes of reading any diabetes blog or perusing through any Diabetes Facebook group, you will probably find more biased, scientifically unsupported diet advice than a poorly thought out midnight infomercial.

“Keto is best!”

“No, plant-based is best!”

“Wrong, apple cider vinegar and intermittent dieting is best!”

With so many opinions and biases, how, as people with type 1 diabetes, can we decide on the “right” diet?

Let’s get this out of the way quickly—there is no one golden way of easy results for everyone. Why? Because everyone is different with different goals and value sets and needs to achieve their individualized quality of life.

So when you are searching for the “right” way, just make sure that you are considering what is right for you in the sense of being able to adhere to it for a long period of time, making sure that it doesn’t make you miserable, and assessing the effectiveness toward your goals. The right way will accomplish those three things for you as long as you continue to put in the work.

The “Right” Blood Sugars

As people with diabetes, we can probably all agree that there are effective and ineffective blood sugars. We can’t be hypoglycemic before an activity as that will likely put us in danger and being hyperglycemic can reduce performance, affect function, and become dangerous as well. So, when it comes to fat loss, is there a “right” blood sugar?

Yes and no.

Of the hundreds of people with diabetes I’ve helped to lose thousands of pounds total, blood sugar management comes first.

If you are chasing blood sugars constantly, your diet will reflect that and your training will likely suffer, resulting in a negative cascading effect, leading away from progress.

I’ve found that we can tend to brush off the importance of getting better with our blood sugars (I’m also talking to myself here), because we want to lose fat and show people how hard dieting is, and prove our dedication to other people. But by skipping blood sugar management, we essentially toss all our hard work into the wind and hope for the best.

If you truly want to progress your physique and performance, you have to start asking the right questions:

  • How is this activity going to impact my insulin sensitivity?
  • Am I checking my sugar enough, especially when I start a new diet or exercise program?
  • Am I taking into account how much insulin on board I have before I exercise?
  • Am I talking with my diabetes management team to make sure that my insulin needs are adjusted with my diet and activity levels?

When things change, things need to change yet we tend to fall into the same rut of diabetes management.

Make sure you take into account your new level of intensity and duration and exercise as well as your caloric intake and specific nutrient intake to make sure that your insulin needs are optimized toward the new stimulus you are giving your body by starting a new exercise or diet program.

Here is a chart from JDRF PEAK showing the different blood sugar trends around varying types of exercise. This can help you plan your management accordingly.

Image credit: JDRF

The “Right” Nutrition Plan

All successful diets in terms of fat loss share one pivotal concept—burning more calories than you consume. For you to optimally lose body fat, you have to be in a calorie deficit regardless of whether you are eating keto, vegan, Whole30, or the “broke college kid diet”. It’s not opinion either, it is just the law of thermodynamics.

In abundance, you gain. In deficit, you lose.

So, the right nutrition plan puts you in a moderate caloric deficit where you aren’t starving or medically unsafe but you are also not eating enough to maintain your current weight (after all, what would be the point of that?).

Now, the right plan also has to account for adherence and not making you miserable.

If you truly enjoy carbs and you can manage your sugars well on a moderate- or high-carb diet while still in a caloric deficit, most likely a keto diet will make you miserable and will not be the right fit for you. While both a high-carb diet and a keto diet could be equally effective at losing body fat when equated for calories, we also must consider the real-life implications of quality of life during dieting.

The right diet is something that you can adhere to while also managing your blood sugars and at the same time putting you in a moderate caloric deficit so that you can continue to progress.

You can individualize your nutrition so that you can adhere to whatever kind of eating preferences you like, as long as you can maintain your blood sugars simultaneously.

Some people prefer low-carb, so that it minimizes blood sugar fluctuations.

Some people prefer high-carb and can still manage blood sugar fluctuations.

Regardless of what you choose, the fact remains that you have to stick with it consistently and you have to follow the rules above.

The “Right” Workouts

Personally, I love lifting heavy weights. Also personally, I hate when a coach tells a client that they have to work out the same way that they do.

There are many successful ways I have helped people with diabetes incorporate new workout programs:

  • Walking and progressing to walking with weights
  • Sprinting and high-intensity interval training (HIIT) workouts
  • Bodyweight and resistance band training
  • Water aerobics
  • Olympic weight lifting and bodybuilding
  • Walking your dog and doing 10 Squats every 5 minutes during that walk
  • Working out does not have to mean going to a gym. You can work out exactly where you are, even if you’re in an office just by standing up and sitting down a few times, despite maybe looking a little awkward.

There are three aspects of working out that are considered important and I try to encourage every person to incorporate each of these aspects into their program to have a more well-rounded approach:

  • Resistance training (added weight or bodyweight exercise)
  • Cardiorespiratory training (walking, jogging)
  • Flexibility (stretching yoga, etc.)

So whether you go to the gym and lift weights, or pick up a gallon of water and press it over your head, walk your dog every day and finish up with some stretching, if you use these three concepts and incorporate movements or activities that you like, you’ll find yourself doing the “right” workouts.

Now, extremely successful workouts involve a concept called progressive overload— that simply means that whatever you’re doing will eventually stop working if you keep doing the same thing over and over without any change or progression.

So my advice? Progress. If you walk 20 minutes every day maybe next week walk 25 minutes one of those days or even add five minutes to every day. If you constantly do the same exercises maybe change up the exercise or add weight or change how many repetitions that you do.

Change requires change.

Progression requires progression.

FitMeT1D Challenge

A Free Solution That Might Be Just “Right”

Over the last four years, I have worked with hundreds of people with diabetes and I found a creative way to build a community for free of just people with type 1 diabetes all working together towards a four-week fitness challenge called the Fit Me T1D challenge.

I provide our hundreds of members a modifiable exercise plan with an easily individualized and adaptable nutrition guide as well as a bunch of extremely helpful tips and tricks around diabetes management.

All of this happens in a private Facebook group and your fellow T1D members help you every step of the way.

It’s fun.

It’s challenging.

And hey—it’s free.

I feel like it’s my duty to give back to my fellow type 1s so if you’re interested in joining, we have our next challenge starting March 22nd. Feel free to sign up for free on FitMeT1D (more info at the link as well).

Source: diabetesdaily.com

How to Lose Weight and Be Active With Type 1 Diabetes

Editor’s Note: Cliff Scherb, Founder of the Glucose Advisors Consulting community and Tristar Athletes LLC, is a nutrition, health, and dosing expert. He consults virtually through the Glucose Advisors University, teaching the Scherb Method decision support system for insulin management, nutrition, weight loss, and activity. To inquire about program openings, courses, and general questions working with Cliff or Glucose Advisors, join the community or email him directly at cliff@glucoseadvisors.com.

Most of my career as a health expert, I have had the privilege of helping others. In the type 1 diabetes  (T1D) spotlight, I am one who walks the walk and talks the talk when it comes to general health and well being. Yes, most of my career has been spent as a more extreme endurance athlete – yet these days most of my endurance is spent behind a computer teaching others how to achieve their T1D goals, still active but more inclined to also be happily chasing my 1.5 year old daughter as she grows up.

Cliff Scherb

Photo credit: Cliff Scherb

Sitting more regularly and burning less energy overall each day has had some meaningful changes to my management methods. Let’s face it, if I continued to eat the same amounts of calories each day such as when I was racing and training, I would blow up like a balloon!

I have always maintained what I will call a “normal” lifestyle and stayed true to what most do in life who do not have T1D. Meaning I don’t bend my will to T1D and I’m not afraid of carbohydrates or feel compelled to eat only fats. I believe that you can do what’s best for you, and if it makes you happy to join one of these extremes, by all means do it.

The internet is full of advice for people with T1D and never before have we had the wealth of information at just a fingertip-length away. How you put that information together and use it to your benefit is what is not so easy to do. Knowing what is worth your time and what is not can mean the difference between brilliant blood sugar control and avoiding longer term complications. The following tips we use have helped our students stay on track.

Here are five things you can do as a person with T1D that can help to improve your blood sugar and to help maintain a lean body composition:

1. Consider an Insulin Pump

If you have the option and ability, the pump allows you to lower and raise your total daily insulin dose more easily. When there are periods of your day that do not include insulin, there is a greater opportunity to process fat stores. If you are using multiple daily injections you may want to speak with your doctor about moving away from long-acting insulins such as Lantus, which have close to a 24-hour duration. On an insulin pump, only short-acting insulin is used, which is out of the body more quickly and may help lower the total daily insulin dose.

2. Choose More Fiber

Consuming an adequate amount of fiber in your diet can help not only by giving you the feeling of fullness but also by not requiring any extra insulin. Considered a carbohydrate, it does not generally impact blood sugars and can be subtracted out of your total carbohydrate count at meals.

3. Choose Lean Proteins

Proteins are great at promoting blood sugar stability and also have fewer total calories per gram when compared to fats. Fat grams, while having the benefit of blood sugar stability, can promote insulin resistance (increased insulin demand) and have nearly twice as many calories.

4. Time Your Carbohydrates Earlier in the Day vs. Later at Night

This means having a larger carbohydrate-loaded breakfast to supercharge your energy during the day and setting it up so that your insulin levels overnight are lower. This is a great way to lower your total daily insulin dose. You should also try to limit insulin prior to activity and time it post-activity when you are more sensitive and need less insulin overall.

5. Create Insulin Sensitivity

Being active is a great way to introduce a higher level of insulin sensitivity. This sensitivity will lower your total daily dose overall, aiding in total reductions in body fat. When timed with an appropriate meal plan and diet it can be a recipe for success!

Keep in mind, anything worth doing takes work! What is one of the biggest obstacles to T1D management success? It certainly isn’t a lack of desire. No, it’s just one thing…

Follow-through.

All the tools in the world don’t matter if you aren’t implementing what you learn. Practicing your nutrition timing and activity can help you to create greater insulin sensitivity which lowers your total daily dose. Ultimately, when you track the total daily insulin dose, this can help lead to longer-term weight loss and happiness with enhanced blood sugars.

Source: diabetesdaily.com

The Keto Diet Isn’t for Everyone: A Type 1 Diabetes Perspective

This content originally appeared on Beyond Type 1. Republished with permission.

By Christel Oerum

I’m a firm believer that there is no such thing as a “Diabetic Diet,” but that we each need to find the best diet for our bodies and mental happiness.

In the search for the diet that’s right for me, I tried the keto diet, and this is what happened.

Why I Decided to Try the Keto Diet

I’ve been living with type 1 diabetes since 1997 and didn’t pay much attention to my diet or followed any specific nutrition regime for the first 17 years. I just ate and adjusted my insulin to my food. And you know what, that worked pretty well for me.

Then in 2014, I started preparing for my first bodybuilding competition and I really had to focus on my diet in a way I never had before. Back then, my coach had me on a high protein, medium/low-carb, and very low-fat diet.

After that experience, I became fascinated with different nutrition approaches and I’ve tried out quite a few diets in the name of research and just plain curiosity.

What is so fascinating about nutrition is that every approach has its die-hard followers and I’m always curious to see if I’ll love it as much as they do.

So, in the name of research, I set out to try the keto diet on my own body.

How I Implemented the Keto Diet

The keto diet restricts the amount of carbohydrates and protein consumed, which means that you primarily rely on fats for your daily energy. The goal is to consume very few carbohydrates (~5% of your daily calorie consumption, or 20-50 grams max), thereby forcing your body to burn fat for fuel.

Fans of the keto diet usually like the approach because it supposedly helps with blood sugar management as well as weight management. And let’s face it, if you’re into bacon and cheese, it sounds very alluring.

Many say that they’ve seen weight loss even though they don’t pay attention to calories, simply because a diet high in fat is very satiating, making them feel full quickly so they eat less.

Based on all of this, I decided to eat less than 50 grams of carbs a day (including veggie carbs/fibers), about 80 grams of protein, and as much fat I needed to feel full without keeping a track of my calorie intake.

My Experience Following the Keto Diet

Christel

Image source: Beyond Type 1

At first, my experience was great. I enjoyed the cheese, nuts, seeds, and avocado that my diet predominantly consisted of.

When it came to my diabetes management, I saw a flatter blood sugar profile with fewer spikes on my Continuous Glucose Monitor (CGM) that I often see when I eat a more carb-heavy diet (which is not surprising since carb are what gets converted into glucose the fastest in the bloodstream).

But my experiment quickly went south. I started to become increasingly insulin resistant after only about a week, which meant that I needed more and more insulin to manage my blood sugars, even though I was eating very few carbs.

I still wasn’t seeing any major spikes in my blood sugars, but since fat slows down the release of glucose into the bloodstream, my blood sugar would continue to slowly creep up. To keep my blood sugars in-range, I had to increase my long-acting insulin significantly while micro-dosing my rapid-acting insulin more often.

The reason for the micro-doses rather than doing larger doses was to adjust my blood sugar without ending up with low blood sugar.

Not only did I become more insulin resistant and had a harder time managing my blood sugars, I also started to have a lot of digestive issues and was gaining weight at an alarming rate.

None of the last two issues are really a surprise.

  1. My digestive issue was most likely related to my diet being low in fibers and volume
  2. And when it comes to my weight gain, fats are very calorie-dense compared to protein and carbs and since I wasn’t monitoring my calorie intake, I was eating too many calories for my needs. I have a healthy appetite and fats alone were just not satiating enough to make me feel full quickly.

After about a month of sticking to the keto diet, I switched back to my moderate/low-carb way of eating. At that point I didn’t feel good, I was constantly bloated, couldn’t fit in my clothes, and my endo was not impressed with how negatively it was impacting my diabetes management.

If you only take one thing away from this post, I hope that it will be this: that you can (and should) try things out, and if they don’t work for you, then “cut your losses.”

It’s Not a Failure, It’s Just an Approach That Doesn’t Work for You

So maybe the keto diet intrigues you, or the Paleo or Vegan diet sounds more appealing. My recommendation would be to research the diet, talk to others who have tried it, assess if it might trigger any unwanted eating patterns, and then try it out if you like.

There are thousands of people with diabetes who follow any of the three diets I mention above with great results so they clearly work for a lot of people – they just don’t work for all people. It may take some experimentation to find the diet that works for you.

If you’re interested in trying the keto diet, you can find a keto meal plan with recipes on Diabetes Strong.

Source: diabetesdaily.com

What to Eat for Better Heart Health

As the famous saying goes, “You are what you eat,” and it is in fact true that our diet is intimately connected to health outcomes. When it comes to something that we have a lot of control over – our diet – why not take the next steps to make it healthier!

This article focuses on research-backed tips for achieving a more “heart-healthy” diet, which is especially important for people with diabetes, since the condition can increase the risk for heart disease.

Choose Unprocessed Foods

Many researchers will agree that population-based nutritional studies can be prone to many limitations. It can be very difficult to draw accurate and consistent conclusions about the specific effects of a single food or food group; instead, it is generally accepted that the overall dietary patterns and combination of specific foods consumed paint a more complete picture. However, most studies do agree on the importance of choosing whole foods over highly processed items.

For instance, ample evidence points to the harmful effects of highly-refined, high-glycemic load carbohydrates (e.g., corn syrup, white bread, most pre-packaged desserts), when it comes to cardiovascular health. The Cleveland Clinic recommends eschewing such carbohydrate sources and instead choosing less processed sources, like whole-grain bread and quinoa, for example.

Similarly, there has been some evidence to suggest that eating processed meats may increase heart disease risk. When possible, choosing unprocessed or minimally processed protein sources is the better choice.

Eating “clean” in this regard can also help you minimize your intake of trans fat, which has been consistently shown to increase heart disease risk.

Incorporate More Plants

Numerous studies point to the heart health benefits of a plant-based diet. Did you know that the vast majority of our pharmaceuticals are derived from plants? It’s no wonder that eating more plants can mitigate disease risk – they are packed with antioxidants, vitamins, fiber, and numerous other beneficial substances.

Have you ever heard of “eat the rainbow”? Choosing a variety of fiber-rich and colorful vegetables and fruits will help you incorporate a diverse array of heart-healthy nutrients.

Of course, for people with diabetes, the carbohydrate (sugar) content matters, so be mindful and opt for lower-glycemic-impact choices, like leafy green vegetables, zucchini, brussels sprouts, broccoli, and peppers. Consider choosing berries, and high-in-fiber, lower-in-sugar fruits to get the nutrients you need while also keeping the blood sugar level steady.

Photo credit: Foundry (Pixabay)

Don’t Shy Away from Fats

For many decades, it had seemed that dietary fat was public enemy #1 when it came to heart health. In particular, saturated fats and cholesterol (and thus many nutritious foods, like eggs and meat) earned a bad rep.

However, the picture turned out to be much more complicated. Experts explain that there has been a lack of consistency in the available data regarding the effects of saturated fat and cholesterol intake on cardiovascular disease (CVD) risk. Importantly, while some studies showed an association between red meat consumption and CVD, most of these studies were focused on processed meat products (see above).

Photo credit: GerDukes (Pixabay)

What is well-established is that incorporating “healthy-fats” (in particular, omega-3 fatty acids) from sources like fish, avocados, and nuts, appears to have favorable effects on CVD risk. This is a large component of the famous Mediterranean diet, which has been consistently associated with improved cardiovascular health. In contrast, keep trans fat intake at bay (which should be easy enough when mainly eating whole, unprocessed foods).

Choose Water

Besides choosing whole foods (read: no sugar added!), it is equally important to stay smart about beverages. We live in a society that makes it easy and normal to choose sugar-laden drinks (from the orange juice or Macchiato in the morning to the soda at lunch, to the sweetened iced tea with dinner). Choosing to forgo sugar-sweetened beverages is highly recommended for better heart health.

Summary

While many nutrition studies can be inherently messy in their design and interpretations, a few well-accepted notions regarding a heart-healthy diet have consistently emerged. Overall, whole-foods-based, unprocessed meals that are low in sugar and high in omega-3 fatty acids, incorporating a variety of plants, and drinking water or unsweetened beverages, can help reduce CVD risk.

References

Anand SS, Hawkes C, de Souza RJ, et al. (2015) “Food Consumption and its impact on Cardiovascular  Disease: Importance of Solutions focused on the globalized food system.” Journal of the American College of Cardiology. 66(14): 1590-1614. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4597475/

Cleveland Clinic (2018) “Heart Healthy Diet.” https://my.clevelandclinic.org/health/articles/17079-heart-healthy-diet

Harvard T.H. Chan School of Public Health (2020) “Preventing Heart Disease.” https://www.hsph.harvard.edu/nutritionsource/disease-prevention/cardiovascular-disease/preventing-cvd/

Kim H, Caulfield LE, Garcia-Larsen V, et al. (2019) “Plant-Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All-Cause Mortality in a General Population of Middle-Aged Adults.” Journal of the American Heart Association 8(16). https://www.ahajournals.org/doi/full/10.1161/JAHA.119.012865

Source: diabetesdaily.com

Six Tips: How to Cut Sugar and Processed Foods from Your Diet

This content originally appeared on diaTribe. Republished with permission.

By Frida Velcani

UCSF’s Dr. Robert Lustig explains how we all can reduce our consumption of sugar and processed foods and why it’s important for promoting health

As people spend more time at home during the COVID-19 pandemic, attitudes and behaviors around food are shifting. While some people may be making healthier and more conscious food choices, others may find themselves responding to stress (prompted by work, health, unemployment, family, or communication challenges) by snacking more often and gravitating toward processed and ultra-processed foods (more on ultra-processed food from the American Heart Association here). Experts are calling what we’re in a “syndemic” – a word coined in the 1990s to mean multiple interrelated epidemics happening at the same time – in this case, COVID-19, under-nutrition, and obesity. The word was popularized most recently in an article in The Lancet. In this article, we focus on the dangers of processed foods and how to cut down on them.

One of the main ingredients in processed foods is sugar – which is shown to cause chronic diseases and inflammation in the body. As background, inflammation occurs when something damages your body’s cells and your immune system releases chemicals that increase blood flow and support to that area. While this response is essential to fighting infections, too much inflammation for a long time (chronic inflammation) can be harmful to our health.

In a compelling recent webinar hosted by the New York Times, University of California San Francisco’s Dr. Robert Lustig discussed the negative health effects of consuming too much processed food and sugar. He cut through the nutritional clutter and described helpful steps that people can take to improve their eating habits and cut unhealthy foods from their diet. While this is easier said than done, there are many benefits to eating less sugar for people with diabetes – you can increase blood glucose stability and improve your time in range.

What makes most processed food unhealthy?

Processed foods often include substances that are not found in typical home-cooked meals – substances such as dyes, artificial flavors, non-sugar sweeteners, and preservatives. Processed foods also lack many of the key nutrients that your body needs, including fiber, omega-3 fatty acids, and various vitamins and minerals. For examples of processed foods and a deeper dive into how they can affect the body, read our article.

As Dr. Lustig emphasized, about 90% of the sugar we consume comes from processed foods, and 75% of packaged items in grocery stores are spiked with sugar.

Sugar can be found in many sweeteners: table sugar, high-fructose corn syrup, maple syrup, and agave. Consuming excessive amounts of any of these sweeteners can increase your risk of weight gain and chronic diseases, such as type 2 diabetes and heart disease. While obesity can significantly increase a person’s risk of developing these diseases, Dr. Lustig said that people who do not have overweight or obesity can still be at risk for chronic conditions, particularly if they are eating more processed foods. As if the heightened risk for complications is not bad enough, sugar consumption has also been shown to speed up aging.

Simple (but not necessarily easy) ways to cut down on sugar and processed foods

A fiber-rich diet (consisting of fruits, vegetables, beans, whole grains, and nuts) can help reduce inflammation in the body by feeding helpful bacteria in your gut and keeping sugar from being absorbed into your liver. You should aim to eat at least 25 grams of fruits and vegetables per day. If you are looking for some ways to incorporate more fiber-rich foods (and fewer processed foods) into your diet, you can:

  • Shop in the fresh produce section of the grocery store and avoid shelved items if you can – we know this is not always easy with a limited budget for groceries.
    Stat

    Image source: diaTribe

    Read the nutrition facts label with an eye for added sugars, and try to avoid them.

    • There is an “added sugar” line on most labels that will show how much sugar has been added to the food during preparation.
    • If sugar (or one of sugar’s more scientific names such as “fructose,” “glucose,” or any word ending in “-ose”) is listed as one of the first three ingredients, try hard to avoid that food.
  • Include a vegetable with every meal. If you choose fruit, aim for low-carb fruits, like berries.
  • If you choose to try to quit eating sugar and cut out certain foods with sugar completely, it may help to start with eliminating it from a single meal, such as breakfast.
    • Eliminate foods high in sugar, such as cereal and pastries.
    • Try a protein-based breakfast instead of a breakfast high in carbohydrates and sugar.
  • If you’re able, purchase fresh bread from the bakery instead of from the bread aisle – and if you can, aim to limit bread as much as possible..
  • Limit yourself to one alcoholic drink (or fewer) during social events and try to avoid any alcoholic drinks with sugar.

If this article inspires you to ditch the processed foods and to start cooking more at home without sugar at all, check out our 19 low-cost, low-carb recipes from Catherine Newman!

Source: diabetesdaily.com

Kitchen Makeover: What to Purge and What to Stock Up On

This content originally appeared on TCOYD: Taking Control of Your Diabetes. Republished with permission.By Dana Palermo If you had to choose the healthiest food option between a product labeled “natural” and another one labeled “healthy”, which would you pick? They both sound good, right? Well you might have to dig a little deeper because there’s actually no […]
Source: diabetesdaily.com

How a Vitamin D Deficiency Affects Diabetes

This content originally appeared on Integrated Diabetes Services. Republished with permission. More studies are being done on the implications of vitamin D deficiency in persons with diabetes. As much as pharmacology and medical science are unlocking the impacts of different chemicals on our bodies, the basic vitamins on the side of our Flintstones bottles still […]
Source: diabetesdaily.com

How to Get More Brightly Colored Food into Your Diet

This content originally appeared on TCOYD: Taking Control of Your Diabetes. Republished with permission.By Susan Thomas Recently I’ve become known to my clients as the “Vegetable Pitchman Dietitian.” I’ve gotten this name because I advise them to fill half their plates at lunch and supper with non-starchy vegetables. Unfortunately, this advice is not often popular […]
Source: diabetesdaily.com

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