Reviewed by Robert Ehrman, MD

Having diabetes means you are more likely to get or have heart disease-especially if you have type 2 diabetes. One way to reduce your risk of, or take care of heart disease, is to get and keep your blood lipids (fats) in control. Blood lipids include your LDL (bad cholesterol); HDL (good cholesterol); and triglycerides. It is common for people with type 2 diabetes who are overweight to have high triglycerides, low HDL and an unhealthy form of LDL: the dense type vs. the light and fluffy type.

RIGHT FATS VERSUS LOW FAT

For years, the nutrition message you heard was to keep the amount of fat you ate low: about 30 percent of your calories or less. This message has evolved because of newer research. Today’s nutrition message, as written in the Dietary Guidelines for Americans, is to enjoy a bit more fat (if you want), but make sure that the extra fat is the right type.  Eat anywhere from 20 to 35 percent of your calories as fat.  Make sure you eat more polyunsaturated and monounsaturated fats and get your saturated and trans fat intake as low as you can.

EASIER SAID THAN DONE

Generally, Americans eat too much saturated and trans fat and not enough polyunsaturated fat. It’s easy to understand why. Americans eat too much meat, whole milk, full-fat cheese, creamy salad dressings, sour cream, cream cheese, sweets and fried foods. American also eat too many processed and restaurant foods that contain partially hydrogenated fats, which is trans fat.

TIME TO REBALANCE THE FATS YOU EAT

Rebalance is the name of the game when it comes to fats today.  This is especially true for people with diabetes, who also are at risk for heart disease.  “It is important and also challenging for people with type 2 diabetes to eat the right types and balance of fat,” says Marion J. Franz, a registered dietitian formerly of the International Diabetes Center in Minneapolis. The Number 1 goal when it comes to rebalancing yours fats is to eat less saturated and trans fat. This will be the most help in getting and keeping your blood lipids in the healthy target zone.

CHOOSE MORE UNSATURATED FATS

Research shows that if you eat more unsaturated fats -that’s polyunsaturated and monounsaturated fats- you may raise your HDL and lower your LDL to get your blood lipids nearer to the target zones. Americans seem to eat enough monounsaturated fat, but not enough polyunsaturated fat. This means we need to work harder to get in those polyunsaturated fats.

One recent study suggests that people with type 2 diabetes can eat more polyunsaturated fats by eating only a handful (1 ounce) of walnuts each day. Walnuts are a good source of omega-3 polyunsaturated fats. Another good source of omega-3 is oily fish, such as salmon, mackerel and tuna. Lynda Gillen, one of the study’s researchers, notes that “eating 1 ounce of walnuts every day, along with about 12 ounces of oily fish a week, has been shown to help people with diabetes improve their HDL and LDL numbers.”

TWO TWEAKS TO EAT MORE POLYS

With this new research in mind, you may want to tweak your healthy eating plan in two ways:

1. Enjoy 1 ounce of walnuts a few times a week. Choose walnuts as a snack, a topper for hot or cold cereal, mixed into a fresh fruit cup or tossed on a salad.
2. Eat a 3-ounces serving (cooked) of oily fish at least two times per week.  Prepare it in a low-fat way: grilled, poached, steamed or broiled.  Make a few servings of grilled salmon or tuna at a time.  Have one serving for dinner, then top a salad with a serving the next day.

If you make these two tweaks, consider a few notes of caution from diabetes nutrition expert Franz: Moderation and variety are still important because the best eating plans are those that rely on a wide range of healthy foods, including fruits and vegetables. Make these tweaks while you also eat less saturated and trans fat. If you decide to add walnuts, omit another food to keep your calorie count where it should be. Franz adds, “Be careful to not overeat any food.  Clearly walnuts are good for you, but their calories can add up quickly.”

Today, experts suggest that there are 4 ways -in addition to medicines, if you need them- to get and keep your blood lipids in control:

1. Get to or stay at a healthy weight.
2. Eat healthy foods: more fruits and vegetables and whole grains.
3. Eat foods with more healthy fats (polyunsaturated and monounsaturated) and less unhealthy fats (saturated and trans fat).
4. Be physically active most days of the week.

4 TIPS TO EAT MORE POLYUNSATURATED AND MONOUNSATURATED FATS

1. Use liquid oil instead of butter, margarine or spreads to prepare food and bake.  Choose well-balanced oil such as canola, soy, corn or vegetable oil.
2. Make your own salad dressing with healthy liquid oil.
3. Enjoy a handful of any type of nuts, including walnuts, for a snack.
4. Use slices of avocado and a few olives as condiments.

5 TIPS FOT EAT LESS SATURATED AND TRANS FATS

1. Eat less cheese and choose part-skim or reduced-fat cheese when you eat it.
2. Eat no more than 3 ounces of cooked meat (red meat, poultry or fish) at a time.  Prepare them in low-fat ways.
3. Choose fat-free milk and yogurt.
4. Limit processed foods that contain partially hydrogenated fats by reading ingredient lists and the Nutrition Facts panel that now must list trans fat.
5. Limit fried foods in restaurants. If you fry at home once in a while, use a healthy liquid oil, such as canola or safflower oil.