This is a bit of a reverse post, because today rather than sharing information, I’m seeking some.
I’m hoping the Real Food Wednesday readers, along with my own, can rally to help me out with a situation in our family this week. My mother-in-law had a sudden double bypass last week, and we’re all trying to figure out how to help her nail down a diet in the aftermath of heart surgery. She’s only 57, which will help the recovery, but she also has diabetes, which complicates everything dramatically.
Her surgery was for a 95% blocked left main artery. I guess there are different types of blockages, and hers was an “osteo-lesion”, if that makes a difference as to what she should eat to avoid a heart attack or further surgery. Yes, this absolutely runs in her family. Her father had his first heart attack at 47, she lost a sister to heart disease in her early 30s, and all three of her brothers have had heart attacks and/or surgery.
“What to eat” would be a hard enough question if we just tried to follow the diet recommendations given at the hospital, because the “Heart Healthy Diet” and the “Diabetes Healthy Diet” have some contradictions. Me being the food lady, however, further complicates the matter. I know some of the recommendations are a load of crap bad research and misguided good intentions, but I need some hard facts to back me up.
For example:
The hospital diet says “NO butter” and “YES margarine”. They’d rather my mother-in-law eat plastic and trans fat (doesn’t everyone know those are bad yet???) than healthy butterfats. Grrrr…
The diet also says “NO egg yolks” and “YES egg whites”, just as I’ve been trying to teach my in-laws that egg yolks have gotten a bad rap and are really, really good for you! (UPDATE: Hospital says only 2-4 egg yolks per week; use egg whites or egg substitutes instead.)
We’ll be going over to visit tomorrow (7/8) and I can get copies of the “diets” and will update this post in the evening, but for now, I’m looking for information:
- What are important foods to avoid because they cause heart disease?
- What are important foods to avoid because they are dangerous for diabetics’ blood sugar regulation?
- What are foods that a diabetic with heart disease CAN eat and feel good about?
- How do we balance “heart smart” vs. diabetes? (This question will have more specifics to work with once I get copies of those diets.)
- Low fat? Low carb?
- What grains will have the least impact on blood sugar?
- What kind of sweeteners can she use?
- What about salt?
- Best sources of protein? Calcium?
- Recipes to share?
I’d love to see the comments on this post go through the roof so we all can have a deep source of information about diabetes, heart disease and nutrition. I’ll even go through the comments and add bullet points to this post as people share good info. Feel free to leave links to resources and research so we can back up our knowledge with sources, the more legitimate-looking, the better! Book references are right up my alley, too, and I can summarize them in future posts and link back to this one.
If you’re interested in this topic, you can leave a short comment like, “I’m interested” and then click “subscribe to comments”. The good advice other readers share will come to your inbox in the form of an email.
So what should a diabetic recovering from heart surgery eat? Bring on the comments!!!
Welcome and thank you, Real Food Wednesday Readers from Kelly the Kitchen Kop!
UPDATE: The lists from the hospital
My comments and queries are in italics:
from a pamphlet called “Taking Control of Coronary Artery Disease”:
Risk factors you can control:
- Smoking
- Stress
- Exercise (can reduce LDL and increase HDL)
- Blood cholesterol levels:
Too much cholesterol in the blood increases risk for CAD. Cholesterik and other substances in the blood form plaque that narrows the pathways of the arteries. Choose foods that are low in saturated fat, and try to eat more fruits and vegetables, nuts and whole grains. - Blood pressure (reduce salt in diet)
- Weight
- Diabetes and blood sugar levels
Risk factor lowering program:
- Blood pressure -
- reduce sodium intake to less than 2,300 mg per day Does “real” sea salt make a difference?
- eat more fruits, vegs, unsalted nuts and whole grains (4-5 servings daily of both fruits and begs, and 4-5 servings of nuts per week)
- eat foods high in soluble fiber (oats, vegs, barley, peas and beans) Great but tricky with the diabetes, because all these have carbs which need to be limited.
- 2-3 servings of low-fat dairy products per day Same as above with carbs…
- Controlling cholesterol -
- lower intake of saturated fats to less than 16 g per day NT would say sat fats are not the enemy…but why not?
- avoid foods containing trans fatty acids Yes! Avoid! This item I am behind 100%!
- lower intake of cholesterol to less than 200 mg/day Isn’t there research that eating dietary cholesterol doesn’t raise blood cholesterol?
- eat food high in soluble fiber
- use food containing plant stanols/sterols (butter/margarine substitutes such as Benecol, Take Control) But Benecol, much to my dismay, lists “hydrogenated soybean oil” as the 4th ingredient!!! Of course the nutrition facts still list “0g trans fat” under the FDA loophole…
- increase omega-3 fatty acids by eating more fish or taking a capsule Sounds great!
HEART-HEALTHY EATING
Reduce foods high in saturated fat:
- Choose low-fat dairy products such as ½% or skim milk, and cheese with less than 3 g of fat per oz. What about the oxidized cholesterol in low fat milk? How do I demonstrate the health benefits (and non-artery-clogging traits) of full-fat dairy?
- Choose lean meats
- Try reduced-fat salad dressings and mayo A conundrum, because reduced-fat condiments usually have to add sugars and salt to make up for the fat!
- Use a “light” tub margarine instead of butter or stick margarine Hello, trans fats!!!
Use low-fat cooking methods:
- Remove skin and fat from meat and poultry prior to cooking
- Bake or broil instead of fry Yes…
- Use egg subs or egg whites in baked goods As long as its not powdered egg (oxidized cholesterol)
- Skim the fat off broth and gravy And lose the immune-boosting properties?
- Use low-fat cooking sprays instead of oil
Sub healthier fats for sat fats:
- Use canola or olive oil instead of shortening or butter in cooking Some would say canola is bad and butter is good…how do I deal with this conflicting info?
- Try nuts like almonds, hazelnuts or pecans as a snack instead of cheese or chips Great!
- Try soy foods as a lower-fat meat alternative Sketchy…
- Increase your consumption of fish, such as salmon and mackerel
Limit alcohol
Decrease salt
- Take the shaker off the table
- Try salt-free seasonings
- Limit canned soups and entrees
- Reduce processed foods in your diet
- Buy fresh or frozen instead of canned vegs
- All these sound doable and make sense – less processed food is good!
Increase fiber:
- Select 3-6 servings of whole grain cereals, breads and pastas per day
- Add fiber gradually to let your body get used to the changes
- Increase fluids as you increase fiber
- Try legumes (beans) as a meat sub But that raises carbs…
Decrease simple sugars:
- Limit candy, soda and sweets
- Try fruit instead of sugar to sweeten cereals, pancakes and other foods
- Cut back on sugar in coffee and tea
- Buy unsweetened fruits, or canned fruits in their own juice
- Try cal-free sugar subs to sweeten foods
Increase fruits and vegs
- Set a goal of 5-9 servings of each per day
- Choose whole fruit more often than juices Yes…
- Add fruits and vegs to snacks, meals and low-fat desserts
Choose wisely when eating out
- Limit fast foods
- Skip the sauce – ask for light or no mayo on sandwiches
- Don’t order super-sized meals
- Watch out for hidden fats in salads and other “light” items And hidden sugars!!!
- Avoid fried foods
- Order smaller portions
COMMON QUESTIONS ON HEART-HEALTHY EATING
What kind of fat raises cholesterol?
- cholesterol = animal products – meat and dairy
- Eggs and organ meats very high
- When you eat cholesterol your blood cholesterol level can go up But does it?
- Saturated fat
- Trans fats
Is butter better than margarine? No! Butter is high in saturated fat and cholesterol. Benecol is better. I simply disagree, but I need documentation!
Can I eat eggs? 2-4 egg yolks per week. Egg whites or sub is better.
Nuts? Yes, but watch portion size.
DIABETES HEALTHY EATING: BASICS
Foods that affect your blood sugar the most are called carbs:
- Starchy foods (breads, cereals, pasta, rice, tortillas, dried beans, potatoes, peas, corn)
- Milk and yogurt
- Fruits and juices
- Sweet foods and drinks
DO
- Eat 3 meals a day
- Eat meals at about the same time every day
- Include some carbs at each meal
- Eat lean meats or low-fat cheese and vegs each day
- Try using sugar subs instead of table sugar
- Drink water, diet soda, etc
- When hungry fill up on salads and vegs
DO NOT
- Skip meals
- Eat large portions of carbs
- Eat a lot of desserts and sweets such as cookies, cakes, pie, candy, honey, jam, jelly and syrup Is honey metabolized any differently than sugar? Is it a better alternative for diabetics or not?
- Drink sweet drinks
- Drink alcohol
Any ideas on these hospital guidelines? They are not out-of-date, but from fall 2008.
Kitchen Stewardship is dedicated to balancing God’s gifts of time, health, earth and money. If you feel called to such a mission, read more at Mission, Method, and Mary and Martha Moments.
Health Benefits of some select Super Foods:
- Chicken Stock/Broth
- Beans/Legumes
- Yogurt
- Monounsaturated Fats: Avocado, Peanut Butter and Olive Oil
- Omega-3s: Salmon and Flax
Hungry for more? Related posts:
Both my father and my sister in law are insulin dependent diabetics and I have to say right off that every diabetic is different. Some can’t eat brown rice because it sends their sugar soaring and some can’t eat white rice for the same reason but can eat brown. You will have to see over time what works and what doesn’t. Look into the glycemic index for foods that typically don’t raise blood sugar and try those first. Instead of margarine, though, I have found that if you take 1/2 olive oil and 1/2 butter and mix them, you get a spreadable mixture that is more heart healthy than margarine. For sugar replacements, try stevia, crystaline fructose, and other natural, but not blood sugar raising things. Hope that helps.
Kristen’s last blog post..English Muffins: Take Two ~ Success!!
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I’m so sorry to hear of your mother-in-law’s illness. Praying for a full and speedy recovery for her.
My father-in-law (quintuple bypass and diabetes) is able to stay healthy by limiting his carbs intake (that is, bread, pasta, rice, and potatoes), limiting his sugars (ice cream and soda) and walking each day.
Jendeis’s last blog post..WFMW – Scrolling Blogroll Boxes
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I’m so sorry your mother-in-law has gone through this, and I pray her recovery is quick.
For someone with this many complications to her health, I would recommend finding a GREAT nutritionist who can meet with her one-on-one and give her specialized advice.
The BEST decision I ever made was to find a nutritionist and get solid nutritional information for my own self and family.
(And I’m also groaning over the whole margarine and egg thing…my guess is that the hospital’s materials are grossly out of date!)
Take care, and keep us posted!!
Llama Momma’s last blog post..baked ice cream
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Watching these comments with interest. The book The Schwarzbein Principle is really good at explaining why the typical diet prescribed to diabetics and heart patients can usually make things worse. It’s an informative read and written in laymans terms.
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Katie Reply:
July 8th, 2009 at 9:38 pm
Thank you – I’ve requested it from the library!
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I am very interested in this topic. I am 51, type II diabetes, high cholesterol/triglycerides and on meds for all. My dh has the same cholesterol/trigly problems plus high-blood pressure. I feel he’s on his way to type II diabetes. Have been doing NT 75% for over a year, but numbers haven’t gotten better–in fact they’ve gotten worse
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Katie Reply:
July 8th, 2009 at 9:40 pm
Ouch. That’s not what I was hoping to hear! What parts of NT have you focused on the most, out of curiosity? How is your carb intake? Thanks so much for sharing…
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Hey, Kristen. Sorry to hear about the illness in your family, but your in-laws are lucky to have such a dedicated and devoted daughter-in-law to do all this research.
As for the egg vs yolk issue, I have to agree with the doctors. Egg yolks may be healthy for your immediate family, for people who aren’t struggling with cholesterol and plaque problems, but those who are need to be careful. I agree with you that margarine is terrible because the plasticky substances build up in your arteries just like animal fat, but I don’t think butter fat is any better. Again, butterfat in moderation may be okay for those in good health, but perhaps your inlaws should stick with olive and other mono-unsaturated fats.
Here http://www.glycemicindex.com/ is a link to the glycemic index. It may help you in meal planning. Serving something with a low glycemic index (chicken breast) with a food that has a higher index (carrots or peas) can help balance it out.
As for sweeteners, while Splenda and other sweeteners market themselves as “safe for diabetics,” I think it’s just best to use them in moderation, and avoid white sugar as much as possible.
Here’s one more link, from the National Insitute of Health, that might be helpful http://www.nlm.nih.gov/medlineplus/diabeticdiet.html
Good luck, and thanks for your blog– I love it!
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Katie Reply:
July 8th, 2009 at 9:41 pm
Lizzie, I totally agree with you about the artificial sweeteners. They may not raise blood sugar, but if they raise your risk of cancer or other diseases, the sweets just ain’t worth it. Thanks for the links, I’m checking them out tonight! Katie
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I’m in the same boat. My 61 yr old husband had a quadruple heart bypass surgery 6 wks ago. He has type 2 diabetes and a family history of hardening of the arteries. I thought that I was feeding him correctly–lowfat and low carb. His bloodwork done a month before showed nothing wrong. I’m really considering a “plant based diet” (Rave Diet. com). Looking forward to your suggestions.
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Katie Reply:
July 8th, 2009 at 11:10 pm
There’s a lot of info in the “real food/WAP” world about low-fat foods, particularly dairy, causing heart disease. Go figure. I think everyone agrees that low carb is important for diabetics, and making sure the carbs you do eat are whole grains or fiber-rich legumes, stuff like that. Beyond that little tidbit, I have a lot to learn myself! I’ll certainly be doing some more research…
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Of course one important thing you left out is whether she has type 1 or type 2 diabetes which is very important information. Type 1 diabetes means that the pancreas is shot and will no longer produce insulin…Type 2 diabetes means the pancreas produces most likely too much insulin and the body has become desensitized to it.
That said:
One thing I would suggest is a high quality fish oil supplement…good for heart health and lowering inflammation all around. Of course nothing beats a little walking for exercise too. Another thing to keep in mind is tricks like cinnamon helps balance blood sugar (and also can help ’sweeten’ foods (such as oatmeal) with less sugar as well as supplements like chromium (http://www.naturalnews.com/001532.html) can help to stabilize blood sugar too. As far as salt goes I think the important thing is to be using a high-quality (and non-iodized) sea or kosher salt with sea salt really being the best. At the very very least a non-iodized version though because the iodine that is in our table salt is not the form of iodine that our bodies have processed for thousands of years and they don’t know what to do with it (which causes lots of thyroid problems in the US). Another thing is Vitamin D…making sure to get some sun with no sunscreen daily, maybe for the walk, especially during the summer. It’s definitely important to not cut out all the fats because not only do they help with blood sugar stabilization and hunger management they also help with vitamin and mineral absorption.
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Katie Reply:
July 8th, 2009 at 11:09 pm
Awesome advice, thank you! I love the stuff about cinnamon – that I can definitely share with MIL without sounding crazy.
She has type 2 diabetes, and hasn’t been on insulin but is temporarily (hopefully) following surgery.
I use the “Real Salt” brand that is similar to celtic sea salt and hope to talk them into using it. I’ll make some homemade whole grain products with it for her, for whenever she has bread products anyway – I figure at least if I make them, we know that they’re 100% whole grain and with no trans fats.
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I try and tell my family the same things you are with little luck (my dad has diabietes) – cinnamon and garlic are good for diabetics as it helps regulate blood sugars. As well, additional fibre added to carbs seems to help, don’t remove all carbs, just pick ones that are also high in fibre.
From everything I have noticed, eating smaller meals, more often, and having regular daily exercise is the biggest help in maintenance.
Christine’s last blog post..Simplifying Your Life
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I have heard wonderful things about fish oil reducing cholesterol and plaque buildup in arteries. And I’ve also heard of the raw food diet reversing diabetes in 30 days…have you heard of this movie? http://www.youtube.com/watch?v=YSUw9SaPLmA
Michelle @ Find Your Balance’s last blog post..Pasta for strong bones, say what?
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Katie Reply:
July 8th, 2009 at 9:45 pm
Michelle, Thank you for the link – watching the video now. I read on the WAP website that diabetics should have more vit A and D and should take cod liver oil, so that matches right up with the fish oil thing. ???
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May your Mother-in-law have an easy recovery from her surgery.
Has the registered dieticion at the hospital talked to your mother-in-law and her family?
You could consult the American Diabetes Association and the American Heart Association. Your local library could be a source of many cookbooks; librarians can help, just ask them.
Health insurance should cover Diabetes Education especially if referred by a doctor for Diabetes Education Classes. These are helpful for the patient and another person can accompany the patient if the classes are not full.
Diabetes testing meters are useful at home and supplies are covered by insurance.
Good luck and don’t get discouraged. It gets easier to choose foods as time goes by and exercise helps in combinatin with diet and doctor’s visits. You will learn about A1C tests and blood sugar testing.
My broter-in-law is diabetic and had heat bypass several years ago and my sister-in-law and husband are both diabetics.
Nita
Nita’s last blog post..Can you spot the differences?
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Katie Reply:
July 8th, 2009 at 11:06 pm
My in-laws are meeting with the dietician tomorrow, again, but she already had a short conversation with her. She told me today that she specifically asked: margarine or butter? and was told that there’s a lot of conflict there, so don’t do either. Benecol was recommended, which is very expensive, and the 4th ingredient or so was hydrogenated soybean oil. I could have spit! I can’t wait to hear what this gal tells them tomorrow – there is just SO much conflicting research and information out there! What I’m most worried about is that the information they’ll get from the “experts” won’t be correct. They think I’m crazy to distrust the hospital…the same hospital that served her a white roll with every meal before and after heart surgery, even though she is diabetic. Duh.
Thanks for your input – hopefully we can wade through all the info and come out on the healthy side!
Katie
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I’m definitely interested in the comments too. My FIL is basically in the same situation: heart disease and diabetes. It seems like he can’t eat ANYTHING!
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I just updated the post with the hospital guidelines. Come back to see what they recommend and help me navigate the waters!
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Something interesting I’ve learned about cholesterol and how it is tied to family heritage is that if your ancestors came from parts of the world where they would have typically been outside for large portions of the day you will probably have higher cholesterol. This is because cholesterol on the skin is changed to Vitamin D (which protects bones, heart health, from cancers) and with more sun exposure they would have needed more vitamin D. My husband’s family for instance is from Lebanese descent and they have high cholesterol (but not necessarily heart problems). Yet another good reason to get out in the sun. Triglicerides are strongly linked to fructose consumption. Fructose unlike other sugars are metabolized by the liver into triglicerides.
An article on Cholesterol http://drbenkim.com/articles-cholesterol.html
http://www.amazon.com/gp/product/0967089700?ie=UTF8&tag=lifeessential-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0967089700
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Katie Reply:
July 9th, 2009 at 10:34 pm
I have read before that high cholesterol is not always linked to heart disease. Very interesting. My husband is fighting high triglycerides…needs to cut back on the pop! Thanks so much for the link.
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