Hi Becky Shires,

You question is actually pretty common and can be confusing for many people.  There are a couple of things to think about here. 

First, your Dad is 83 years old.  This is not generally an age where we start to be very strict with a person's diet. Watching salt intake can help prevent fluid retention around the heart and lungs making it easier to breath and easier for the heart to pump. But, often after heart problems and surgery, a person's appetite is poor.  And at 83 years old, taste is not as acute as it once was, so eating is done more for necessity rather than for flavor.  If you are too strict on your father's diet and salt intake, he may end up losing his desire to eat and become malnourished and underweight. In nursing homes and rehab facilities, the real push is to liberalize a person's diet as much as possible.  Someone like your father in a rehab facility would be on a regular, no added salt diet with diabetic condiments. The goal is to keep people well nourished and strong, not to try to prevent further long term damage to their clogged arteries. It's great to encourage healthy choices, but not so great if it means your dad will refuse to eat. Of course, in addition to steak, he should also eat fruits, vegetables, low fat dairy and whole grains.

Second, realize that many physicians prescribe things based on their expertise.  So, if the cardiologist told him to watch his salt, but did not mention the diabetes and carbs, it was likely just an oversight or there was an assumption that the primary care physician or endocrinologist was going to address that part of the diet. I do encourage your Dad to watch his portion sizes, especially with carbohydrates. I also encourage him to visit his primary care physician every 4 to 6 months to monitor his diabetes and determine if he needs medication.  Many hospitals give insulin if blood sugar is >120 because well controlled blood sugar helps people heal faster.  This does not mean he will require insulin or even oral medication now, but he may require it in the future. 

It also depends on what your father's diet currently is like.  A vegetarian diet is not always healthy (many vegetarians eat loads of carbohydrates and high fat dairy which will not benefit your father). He can still eat meat, even red meat, and be healthy. Finally, he should continue to try to lose weight if he is overweight. 

Best of luck to you and your Dad,

Monica M. Skidmore, MS, RD

Becky Shires

8/13/10 10:02am

Thanks Monica, Yes, even though I'm a veggan,I too have diabetes type 2.My

blood sugars were elavated recently with the stress of caring for elderly father &

mother,but after attending a diabetic carb counting class,I'm now on a correct

diet of healthy fat,protein,carb ratio which is better for me since I don't eat

meat only as special treats.Since I've been on it for a few days and I still enjoy

eating more vegetables,I need to watch how much fruit and starchy vegetables

I'm only required to have on a 1400 calorie a day meal plan.Surprisingly,my blood

sugar is going down since I'm also on Niaspan due to very low HDL.My cardiologist wants the healthy ratio of HDL to offset the bad LDL since I too have one major blocked artery but he didn't insert a stent due to the many

collaterials that my arteries had formed.I will undergo a stress test in 2 weeks

with a radioactive dye to see if there is any change to the heart function since

my last stress test 5 years ago when I began to have angina pain as well.

I exercise daily between 30-60mins on a treadmill as well as alternating using

a stationary bike. Your advise was very much appreciated concerning my father.

Thank you so much & God Bless.                 Becky