Healthy Eating for your Heart

Amy Vong, a dietitian at Ang Mo Kio Hospital, stresses the importance of dietary management for diabetes related health disease.

Diabetes Mellitus (DM) is a chronic and debilitating disease that may lead to severe complications such as blindness. kidney failure and heart disease. Several factors including obesity and physical inactivity have been associated with an increased risk of the complications. In Singapore, DM was the 6th leading cause of death in 1997 and the prevalence of DM among Singaporeans adults between the ages of 18 and 69 was 9.0% in 1998. The survey showed that more than half of those with diabetes in Singapore had poor blood sugar control with a mean HbA1c of 8.5%.

Heart disease is one of the most serious diabetes complications, accounting for the majority of diabetes-related deaths. The risk of heart disease is two to four times greater in diabetes, occurs at a younger age, is more fatal and is much higher in women with diabetes. The risk of coronary heart disease is increased in patients with high blood cholesterol, high blood pressure, smoking, and high blood sugar.

Dietary treatment is an essential component of successful diabetes management. The aim of dietary treatment is to modify food intake and lifestyle to attain and maintain good blood sugar, blood cholesterol and blood pressure. This will help to prevent and treat the chronic complications of diabetes like high blood pressure, kidney disease and heart disease. Those with diabetes can improve their health through healthy food choices, physical activity, and individualised diet planning.
 

The dietary approach for people with diabetes should result in a significant decrease in the chances of getting heart and blood vessel disease by lowering cholesterol levels. If your LDL cholesterol (Bad Cholesterol) level— is 2.6 mmol/l or higher, making lifestyle changes and improving your diet with the help of a dietitian are recommended as the first steps of management. However, if your cholesterol remains high, your doctor may recommend that you continue with lifestyle and dietary changes as well as the addition of lipid lowering medication. Following a healthy diet is one of the best things you can do for your heart. Your dietitian can help devise a meal plan to improve your cholesterol levels. Such a plan should include the following:

I. Cut down on saturated fats. Foods rich in saturated fats include meat and poultry fat, dairy products (butter, full cream milk, cheese, ice cream), palm oil, coconut oil/milk, palm kernel oil, and cocoa butter.
 

2. Limit cholesterol intake to less than 200 mg per day. Cholesterol is found mainly in egg yolks and organ meats.
 

3. Limit trans fats. Foods that have high content of trans fats include stick margarine, shortenings and partially hydrogenated oils used in pre-packaged foods like cakes, cookies, crackers, fried snacks, and instant noodles, etc.
 

4. Reduce total fat intake by choosing lower fat foods and using healthier cooking methods such as steaming, stir-frying, baking and grilling.
 

5. Cut down on sugars and refined carbohydrates (such as white bread and polished rice) and emphasise low glycaemic index carbohydrates (such as oats, wholegrains, cereals) (Brown rice is medium GI, not low GI).
 

6. Take one to two servings of fish (such as salmon, mackerel, Atlantic herring, trout and swordfish) per week to obtain the health benefits of omega 3 fatty acids.
 

7. Increase your fibre intake. There is an overall benefit of higher fibre intake along with lower fat intakes in improving blood cholesterol levels. Fibres are present in vegetable, fruits, oats, legumes, etc.
 

8. Eat smaller, more frequent meals throughout the day.
 

9. Limit your alcohol intake to one to two servings each time.
 

10.Keep your lifestyle active by enjoying regular physical activities (at least three times per week).

Treat yourself to healthy and delicious foods that will protect your heart. It is never too late to modify your lifestyle habits. Give yourself a chance to make the most out of your life even if you have diabetes or heart disease!
 

Author's Note: The facts and guidelines outlined in this article are based on literature from the Ministry of Health, Singapore, and the American Dietetics Association.