Therapeutic diet for diabetics and hypertensives

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Extract from the article: Diet can reduce the risk of overall cardiovascular events. The diet for cardiovascular disease aims to control weight, regulate blood sugar, reduce blood pressure to avoid recurrence and preserve the heart. The diet should be healthy, varied and bala

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Diet can reduce the risk of overall cardiovascular events. The diet for cardiovascular disease aims to control weight, regulate blood sugar, reduce blood pressure to avoid recurrence and preserve the heart. The diet should be healthy, varied and balanced.

The main points of the diet for cardiovascular disease are: choosing foods that are sources of good fats, avoiding fats that are harmful to the heart, consuming fibre and fruit and vegetables, ensuring a low glycaemic index diet, encouraging physical activity and a healthier lifestyle.

Are saturated fats also bad?

Recent studies have shown that only some of them, in excess, can be harmful to the cardiovascular system, in particular palmitic acid. There is therefore no question of excluding saturated fatty acids from the diet, as long as they do not represent more than 8 to 12% of the daily calorie intake (i.e. approximately 20g of saturated fatty acids per 2000 kcalories), with little palmitic acid.

In practice: significantly limit to once a week or even avoid consumption of industrial products, where refined, rich oils are often incorporated (ready-made meals, pastries, biscuits, crisps, quiches, cold meats, confectionery, ice cream, etc.).

You can allow yourself 10g of butter and 40g of cheese, as long as you do not eat any other foods very rich in saturated fatty acids on the same day: fatty meats, dessert creams, pastries, cold meats. The daily amount of meat should not exceed 150 to 200g per person. Beef is rich in iron, but you should avoid fatty cuts (ribs, rib steak) and prefer leaner cuts (fillet, scoter, chuck, cheek). The same goes for lean pork. Game, poultry and fish are to be preferred, as they are low in saturated fats, better assimilated by the body, and studies have shown that they do not increase the risk of cardiovascular disease.

Foods to be favoured

Oats (bran, flour) contain beta-Glucan, a very viscous soluble fibre which, at a rate of 3g per day, lowers total and LDL cholesterol. It should be introduced gradually, however, as it is highly laxative.

Flax seeds are very rich in omega-3. They can be found in some breads, or bought in a health food shop and added to a salad or soup with 2 teaspoons. Soya derivatives contain special proteins, and several studies have shown that an intake of 25 g per day reduces LDL levels by 4 to 6%. Eating them regularly (e.g. twice a week) also allows you to eat less meat, which is more fatty.

Fatty acids are beneficial

They have proven their benefit in terms of preventing cardiovascular accidents. In detail:

Monounsaturated fats: to be favoured. Otherwise known as omega-9, they reduce LDL-c. They are found in large quantities in certain oils: soya, olive, peanut and walnut oils, which are important to consume on a daily basis. Oleaginous fruits (almonds, cashew nuts, hazelnuts, etc.) also contain them, and should be consumed 5 to 10 times a day.

Polyunsaturates: a good balance. While omega-3s are very protective, omega-6s have a rather pro-inflammatory effect in excess. The ratio between the two should be 1:5, i.e. 5 times more omega-6 than omega-3. To restore the balance, it is therefore necessary to reduce the consumption of fats that are very rich in omega-6 (sunflower oil, corn oil) and at the same time increase the intake of omega-3: oily fish (twice a week), soya oil (2 tablespoons per day out of the 3 daily), possibly margarines made from these oils.

Should I stop eating eggs?

Not at all. A person with no risk factors can allow themselves up to 7 eggs a week, or up to 4 if they have high cholesterol, but no more than 2 if they have diabetes, as two studies have shown that eggs in this case can increase the risk of a cardiovascular accident. The mechanism has not been clearly identified, but according to researchers, diabetics, especially type 1, absorb more cholesterol from eggs than others. In any case, eggs from seed-fed hens are preferable, as they are richer in omega-3.

Why eat fruit and vegetables?

The fibre and antioxidants they contain partly neutralise the adverse effects of deleterious saturated fatty acids, including palmitic acid and pro-inflammatory omega-6. In addition, soluble fibre (found in apples, pears, bananas, grapes, oranges, onions, garlic, leeks and garlic) has the ability to bind to cholesterol in the intestine, facilitating its elimination through the stool. It is therefore important to eat 2 to 3 fruits a day and 2 portions of vegetables, including one raw vegetable (100 to 150g) and one portion of cooked vegetables (200 to 250g). Wholegrain cereals and pulses are also good sources of fibre.

Physical exercise, a cardioprotective effect

Compared to sedentary people, more active people have a lower mortality rate from all causes, including those linked to cardiovascular accidents. This message, conveyed by the WHO, is accompanied by several recommendations: Favour endurance activities: walking, running, swimming, cycling, dancing.

Be regular in your exercise: at least 150 minutes per week at moderate intensity (you are slightly out of breath) or at least 75 minutes at sustained intensity (you are definitely out of breath), bearing in mind that the two can be combined.

Split the sessions: as long as each period lasts at least 10 minutes. For example, you could do 10 minutes of brisk walking in the morning, and 10 minutes at lunchtime or in the evening) on all 5 days of the week (i.e. 100 minutes), and complete with 50 minutes of another activity at the weekend.

William O.

Article validated by Kponou Matthieu Tobossi, Specialist in Diet Therapy & Specialist in Food Hygiene and Quality (Lomé)