Diet and Nutrition

Fat Intake and Diabetes

January 11, 2017   /

My doctor is really focused on my blood cholesterol levels. I have diabetes, not heart disease. Why is my doctor so concerned about this?
You may not know that diabetes and heart disease are closely linked. People with diabetes are at an increased risk for heart disease. In fact, your doctor knows that achieving and maintaining normal blood lipid profiles are very important to diabetes management. Just as watching your carbohydrate intake can affect your blood sugar, watching your fat intake can affect your blood lipid profile.

What blood lipid levels are considered normal?
To prevent heart disease, your goals are:

  • Low total cholesterol
  • Low low-density lipoprotein (LDL) cholesterol
  • High high-density lipoprotein (HDL) cholesterol

The National Cholesterol Education Program guidelines are:

  • LDL cholesterol of <100 milligram (mg)/deciliter (dL)
  • Total cholesterol <200 mg/dL
  • HDL cholesterol level at ³40 mg/dL and preferably >60 mg/dL

Talk to your doctor about how your blood lipid values compare to these normal ranges.

How can changing my diet help keep my blood lipids normal? Can my doctor just give me medicine?
Maintaining a healthy diet and lifestyle offers the best potential for decreasing your risk for heart disease, especially if you already are diagnosed with diabetes. It is well recognized that many dietary factors influence the risk for developing heart disease and its risk factors. Saturated fats and trans fats in the diet are found to increase LDL cholesterol levels, therefore increasing the risk for heart disease. That is why changing your diet is important.

I am already careful about what I eat because of my diabetes. Will watching dietary fat intake make my diet more complicated?
Not necessarily. An overall healthful diet will help control your diabetes and prevent heart disease. You probably are already aware of how much and what type of carbohydrates you eat. Now you can apply the same skills to avoiding excess dietary fat. Many of the same foods that are high in sugar also are high in fat, such as sweets and desserts.

What are the dietary fat guidelines for people with diabetes?
Experts recommend that you:

  • Limit saturated fats to <7% of total calories
  • Limit intake of trans fats as much as you can
  • Limit dietary cholesterol to <200 mg/day
  • Include two or more servings of fish containing omega-3 fatty acids/week

What is a trans fat?
Trans fats are the by-product of a process called hydrogenation, which takes liquid oils and turns them into solid fats. These fats often are used in margarines, commercial baked goods, crackers, and cookies. Because they can result in an increased LDL cholesterol level and an increased risk of cardiovascular disease, trans fats are listed on the Nutrition Facts label found on most foods. To limit your intake of trans fats, limit your intake of commercial baked goods, including pastries, crackers, and cookies, as well as fried fast-foods.

What is saturated fat?
Saturated fat is a type of fat that is known to raise your LDL cholesterol level, thus increasing your risk for heart disease.

It is found mainly in animal products:

  • Whole milk
  • Cheeses made with whole milk
  • Fatty cuts of beef and pork
  • Fat on poultry, including the skin
  • Dark-meat poultry

Two vegetable oils, coconut oil and palm oil, also are highly saturated. Using lean cuts of meat, low-fat dairy foods, and vegetable sources of protein, such as dried beans, can help reduce your intake of saturated fats to <7% of total calories, as is recommended.

What are omega-3 fatty acids, and why are they important?
Omega-3 fatty acids from fish, especially oily or fatty fish, are shown to improve cardiovascular disease outcomes. For that reason, two or more servings of fish/week are recommended, excluding commercially fried fish fillets. In addition to its benefits, fish may replace higher saturated-fat foods in the diet.

The fish with the highest content of omega-3 fatty acids are:

  • Salmon
  • Herring
  • Mackerel
  • Anchovies
  • Sardines

What type of cooking oils are the best to use when you have diabetes?
It is best to use a mixture of polyunsaturated (corn, soybean, sunflower, and safflower oils) and monounsaturated oils (canola, olive, and peanut oils) to keep your heart healthy. As a rule, you want to use as little fat as possible in your cooking and baking, but when you do use fats, these liquid forms are healthier for your heart than solid fats, such as margarine, butter, and shortening. Choose soft margarines, such as tub or squeeze, over other types. Select canola or olive oil for cooking most often, but learn to use different types of oils, such as peanut oil, to enhance the flavor of your cooking.

 

References and recommended readings
American Diabetes Association®, Bantle JP, Wylie-Rosett J, et al. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care [serial online]. 2008;31(suppl 1):S61-S78.

American Heart Association Nutrition Committee, Lichtenstein AH, Appel LJ, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation [serial online].2006;114:82-96. Available at: http://www.circ.ahajournals.org/cgi/content/full/114/1/82. Accessed May 16, 2012.

National Institutes of Health, National Heart, Lung, and Blood Institute. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Executive Summary. Available at: http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3xsum.pdf. May 16, 2012.