Dear Lynn:

I have lost weight and modified my diet to control arteriosclerosis but now have a diagnosis of diabetes. Can you recommend a diet to control diabetes, cholesterol and triglycerides? Thanks,
Alberta

Dear Alberta:

First, congratulations on taking a proactive approach to your diagnosis by modifying your diet. Many people with both diabetes and cardiovascular disease have found a diet lower in carbohydrates and moderate in fat to be helpful.

The American Heart Association recommends a low-fat diet to prevent and treat heart disease. Their Step 1 diet recommends no more than 30 percent calories from fat; the Step 2 diet (when Step 1 doesn't produce the desired results) limits fat to 20 percent of the calories. When most Americans reduce dietary fat intake, they increase carbohydrates. Unfortunately, a higher-carbohydrate diet often results in elevated blood glucose and triglyceride levels.

If you've tried the traditional low-fat plan but have elevated blood glucose and triglycerides, I often recommend the following moderate-fat, moderate-carb diet:

1. Use 1-2 teaspoons of olive or canola oil at most meals. Monounsaturated fats appear to lower cholesterol levels. This might mean an increase in overall fat in your diet, but remember it's the type of fat that's important. Saturated fats, primarily found in animal products and snack foods, should remain low.
2. Focus on whole grains for your primary carbohydrate sources. Look for the word "whole" in the first ingredient in most of the breads, crackers, cereals, pasta, rice, etc. that you eat on a regular basis. Whole grains contain more fiber and tend to have less effect on blood glucose levels.
3. Avoid fat-free foods that are high in simple carbohydrates such as refined flour or sugars. Those foods typically raise blood sugar levels rapidly. Examples are fat-free cereal bars, reduced-fat cookies and fat-free ice cream. Check labels to be sure.
4. Avoid drinking all fruit juices. Fruit juice, even if it is 100 percent juice, is mostly simple carbohydrates that will raise your blood sugar level. Instead of drinking juice, eat fresh fruit in moderation. Too much fruit, more than four servings a day, may raise blood glucose levels.
5. Use a paper plate divided into three sections as your serving-size guide. The largest section should contain vegetables, the second section whole grains, and the third section protein sources such as poultry, seafood, legumes or tofu. That usually means a decrease in grains and protein and an increase in vegetable servings for most people. The end result should be lower blood sugar and triglyceride levels.
6. Use legumes often. Legumes such as kidney beans, garbanzo beans and split peas are digested slowly. Their fiber content helps lower cholesterol levels, and their slow digestion helps keep blood sugar levels lower.

Make sure you test your blood sugar to best evaluate which of these suggestions gives you the most desirable results. Your physician can monitor your cholesterol and triglyceride levels. Check with a Registered Dietitian in your area if you have specific questions. This type of diet may give you the desired results, and at the worst it certainly won't hurt. Remember, though, that although many aspects of disease can be improved with a healthy diet and exercise, sometimes our bodies need medication to help them along. It doesn't mean you've failed, just that you need some assistance.

Sincerely,
Lynn Grieger, R.D., C.D., C.D.E.

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