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Dairy Products. A high intake of dairy products may lower risk factors related to type 2 diabetes and heart disease (insulin resistance, high blood pressure, obesity, and unhealthy cholesterol). Some researchers suggest the calcium in dairy products may be partially responsible for these benefits. Vitamin D contained in dairy may also play a role in improving insulin sensitivity, particularly for children and adolescents. However, because many dairy products are high in saturated fats and calories, it’s best to choose low-fat and nonfat dairy items.
Fats and Oils
Some fat is essential for normal body function. Fats can have good or bad effects on health, depending on their chemistry. The type of fat is more important than the total amount of fat when it comes to reducing heart disease. Monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) are “good” fats that help promote heart health, and should be the main type of fats consumed. Saturated fats and trans fats (trans fatty acids) are “bad” fats that can contribute to heart disease, and should be avoided or limited.
Current dietary guidelines for diabetes and heart health recommend that:
- Total fat from all fat sources should be 25 - 35% of total daily calories.
- Monounsaturated fatty acids (found in olive oil, canola oil, peanut oil, nuts, and avocados) and omega-3 polyunsaturated fatty acids (found in fish, shellfish, flaxseed, and walnuts) should be the first choice for fats.
- Omega-6 polyunsaturated fatty acids (corn, safflower, sunflower, and soybean oils and nuts and seeds) are the second choice and should account for 5 - 10% of total calories as part of total fat intake. Linoleic acid, the main omega-6 fatty acid found in food, has anti-inflammatory properties. Higher intakes of omega-6 fatty acids may help improve insulin resistance, reduce diabetes risk, and lower blood pressure.
- Limit saturated fat (found predominantly in animal products, including meat and full fat dairy products, as well as coconut and palm oils) to less than 7% of total daily calories.
- Limit trans fats (found in margarine, commercial baked goods, snack and fried foods) to less than 1% of total calories.
All fats, good or bad, are high in calories compared to proteins and carbohydrates. In order to calculate daily fat intake, multiply the number of fat grams eaten by nine (1 fat gram provides 9 calories, whether it's oil or fat) and divide by the number of total daily calories desired. One teaspoon of oil, butter, or other fats contains about 5 grams of fat. All fats, no matter what the source, add the same calories. The American Heart Association recommends that fats and oils have fewer than 2 grams of saturated fat per tablespoon.
Try to replace saturated fats and trans fatty acids with unsaturated fats from plant and fish oils. Omega-3 fatty acids, which are found in fish and a few plant sources, are a good source of unsaturated fats. Generally, two servings of fish per week provide a healthful amount of omega-3 fatty acids. Fish oil dietary supplements are another option. Fish and fish oil supplements contain docosahexaenoic (DHA) and eicosapentaenoic (EPA) acids, which have significant benefits for the heart. Discuss with your doctor whether you should consider taking fish oil supplements.
Low-Fat Diets. The American Diabetes Association states that low-fat diets can help reduce weight in the short term (up to 1 year). Low-fat diets that are high in fiber, whole grains, legumes, and fresh produce can offer health advantages for blood sugar and cholesterol control.
Dietary Cholesterol
Animal-based food products contain cholesterol. High amounts occur in meat, dairy products, egg yolks, and shellfish. (Plant foods, such as fruits, vegetables, nuts, and grains, do not contain cholesterol.) The American Heart Association recommends no more than 300 mg of dietary cholesterol per day for the general population and no more than 200 mg daily for those with high cholesterol or heart disease.
Vitamins and Supplements
Research has shown that vitamin supplements have no benefit for heart disease and diabetes. Because of the lack of scientific evidence for benefit, the American Diabetes Association does not recommend regular use of vitamin supplements, except for people who have vitamin deficiencies.
Patients with type 2 diabetes who take metformin (Glucophage) should be aware that this drug can interfere with vitamin B12 absorption. Calcium supplements may help counteract metformin-associated vitamin B12 deficiency.
Sodium (Salt)
It is important for everyone to restrict their sodium (salt) intake. People with diabetes should reduce sodium intake to less than 1,500 mg daily. Limiting or avoiding consumption of processed foods can go a long way to reducing salt intake. Simply eliminating table and cooking salt is also beneficial.
Salt substitutes, such as Nusalt and Mrs. Dash (which contain mixtures of potassium, sodium, and magnesium) are available, but they can be risky for people with kidney disease or those who take blood pressure medication that causes potassium retention. Similarly, while eating more potassium-rich foods is helpful for achieving healthy blood pressure, patients with diabetes should check with their doctors before increasing the amount of potassium in their diets. [For more information on potassium, see “Other Minerals,” below.]
Other Minerals
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Review Date: 05/05/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
