You no doubt have heard that you can lower your blood glucose, blood lipids (cholesterol) and blood pressure if you eat healthy. Weight loss often helps, too. Do you know how much you can expect your numbers to improve from healthy eating and weight loss?
JUST THE FACTS ABOUT HEALTHY EATING
Health care providers make decisions and give advice based on research studies of different treatments. Over the last 10 years, many studies have been done looking at how healthy eating affects blood glucose, lipids and blood pressure. Here’s what these studies have shown:
BLOOD GLUCOSE
People with type 2 and pre-diabetes can lower both their A1C (the long-term measure of blood glucose control), as well as their fasting blood glucose levels, through healthy eating and weight loss. People who have had type 2 for less than one year can lower their A1C by almost 2 percent. People who have had type 2 diabetes for more than four years can lower their A1C by about 1 percent. Although that may not sound like much, for every 1 percent you lower your A1C, you lower your risk for long-term problems from diabetes by about one-third. Fasting blood glucose levels have been shown to drop by 50 to 100 mg/dL. These decreases are about the same or are slightly more than the decrease many diabetes medicines initially produce. People with type 1 diabetes can lower their A1C by about 1 percent when they receive nutrition counseling.
BLOOD FATS
An eating plan that limits the saturated fat to between 7 and 10 percent of calories and no more than 200 to 300 mg/dL of cholesterol each day can reduce total cholesterol by 10 to 13 percent. This means that if your total cholesterol was 250 mg/dL, it could come down to 218 to 225 mg/dL, LDL (bad cholesterol) can be reduced by 12 to 16 percent and triglycerides by 8 percent. Lowering your cholesterol reduces your risk for a heart attack.
BLOOD PRESSURE
Lowering the amount of sodium you eat to 2,400 mg per day can cause small, but significant, decreases in both the top and bottom blood pressure numbers. This can reduce your risk for a stroke, heart attack or other problems from diabetes. A large study, called the DASH Diet, showed that a low-fat diet (including fruits, vegetables and low-fat dairy foods) lowered blood pressure enough to make a difference. In general, research has shown that the less sodium you take in, the more your blood pressure goes down. Research also shows hat the benefit of a lower sodium intake may be even greater in people who are salt-sensitive, which includes many people with diabetes.
WEIGHT LOSS
Losing about 10 to 20 pounds has been shown to have several health benefits. In fact, studies show that losing 10 pounds may be as effective as some blood pressure medicines in lowering blood pressure.
TYPE 2 DIABETES PREVENTION STUDIES
Several diabetes prevention studies have shown that intensive initial lifestyle counseling (help with weight loss and becoming physically active), along with ongoing support, can slow down the movement from pre-diabetes to type 2 diabetes. This intensive counseling has been shown to be more effective for many people than usual nutrition counseling and the oral diabetes medicine, metformin. People who had this kind of intensive counseling also had lower blood pressure and triglycerides, as well as increased HDL, the good cholesterol. By the end of the study, they were taking fewer medicines for high blood pressure and blood lipids than the group that did not receive intensive lifestyle counseling.
WHEN TO CHECK YOUR PROGRESS
Studies show that you can observe if nutrition counseling and healthy eating are helping you reach your target goals in as little as six weeks to three months. If you hit your target goals, then you can stick with your healthy eating plan. If you do not, it is probably time to review your plan with your counselor and see if there are any more changes you are willing and able to make. It may be time to add a medicine to help you reach your blood glucose, blood pressure and/or blood lipid target goals but don’t forget to continue to eat healthy. Needing to take medicines is not a reflection on your efforts. It does not mean that you have failed. It simply means that your body needs more help than you are able to achieve with a healthy eating plan. Keep in mind that to stay healthy, it’s most important to reach and stay at your target goals.
Even if they do not ask, talk with your health care providers about your efforts and goals. Let them know that you are trying to keep the number of medicines you take to a minimum. At the same time, make sure that you get the medicines you need to get and keep your blood glucose, lipids and blood pressure in your target ranges. If you have not seen a dietitian for a while, ask for a referral.
KEEP HEALTHY EATING PART OF YOUR DIABETES PLAN
The impact of a healthy eating plan may be the greatest when you are diagnosed with pre-diabetes or type 2 diabetes. However, there is no doubt that you will be able to manage your blood glucose, blood lipids and blood pressure better over the years if you eat healthy along with taking the medicines you need.
IS NUTRITION COUNSELING COVERED BY HEALTH PLANS?
More health plans now cover nutrition counseling, often called Medical Nutrition Therapy (MNT). The detailed answer depends on your health coverage. Medicare now covers MNT for diabetes, and most states have laws mandating that some health plans cover this service. To find out if your health plan covers nutrition counseling, call the toll-free number on your insurance card, check your plan’s Web site or ask someone at the diabetes education program in your area. If you have questions about Medicare’s coverage, call your Medicare office or go to www.medicare.gov.
FIND A NUTRITION COUNSELOR
Look for a registered dietitian (RD) who also is a certified diabetes educator (CDE). An RD/CDE is likely to be a dietitian who is also an expert in diabetes care.
- Contact an American Diabetes Association (ADA)” Recognized” Diabetes Education Program. Most of these programs employ an RD who also is a CDE. They may provide education and counseling in a group class or individually. Call 1-800-DIABETES (1-800-342-2383) and ask for the program nearest you.
- Contact American Association of Diabetes Educators (AADE) to get the names of dietitians who are diabetes educators. Call AADE at 1-800-TEAMUP4 (1-800-832-6874) or go to www.diabeteseducator.org and click on” Find an Educator.”
