Diabetes and Heart Disease: 5 Lifestyle Fixes for Head-to-Toe Health

with Christos S. Mantzoros, MD 

Diabetes and heart disease worsen with obesity, affecting nearly every organ in the body. Here's what you can do to avoid these diseases and improve your overall health.

Nearly 8 in 10 people will reach the age of 50 years with obesity, or as cigarette smokers, or both.1 The impact that lifestyle behaviors can have on both the length and quality of your life can be worsened or improved simply by the choices you make.

Even making adjustments to be in better control of your blood sugar can go a long way in reducing your risk of developing diabetes and assuring you good heart health for years to come.

Here are 5 lifestyle tips that can extend your lifespan by 16 years.Learn valuable way you can improve your heart health and reduce your risks of diabetes, obesity, and cancer. Photo: marilyna @ iStock

Diabetes,Obesity, and Heart Disease: A Matter of Living

When facing this trifecta of chronic systemic conditions, there is a disconcerting array of medical problems that typically develop over—some you may know about and others may be news to you:

  • high blood pressure (hypertension)
  • high cholesterol (dyslipidemia)
  • heart attack (congestive heart failure)
  • stroke
  • peripheral artery disease including foot ulcers and amputation
  • kidney disease and renal failure
  • vision loss (retinopathy)
  • nerve damage (neuropathy)

“Since genetics plays only a minor role in obesity, the way we live is the root cause of obesity for the vast majority of us. This typically leads to hormone changes, and ultimately to diabetes, hypertension, and elevated lipids (cholesterol), and yet is overlooked,” says Christos S. Mantzoros, MD, professor of medicine and chief of endocrinology, diabetes and metabolism at Harvard Medical School in Boston, Massachusetts, during his presentation at the 2nd annual Heart in Diabetes Medical Conference in Philadelphia, Pennsylvania.2

While we may not know the precise underlying mechanisms of obesity that lead to the myriad of complications encompassing diabetes and heart disease, what we can say is that in more than 96% of the population, these conditions are driven by lifestyle and environmental factors," says Dr. Mantzoros. 

As such, you can improve your health and reduce your disease risks just by adopting a vegetable-based heart-healthy diet and committing to daily physical activity.

5 Lifestyle Actions to Side-Step Common Chronic Diseases

“As worrisome as having heart disease, diabetes, and obesity may be, there is a sure way to avoid or lessen the risks from these co-existing conditions: Consider your lifestyle,” Dr. Mantzoros tells EndocrineWeb. “The answer may not be glamorous or exciting, but it is achievable IF you are willing to revisit five critical lifestyle factors: your diet, level of exercise, alcohol use, cigarette smoking, and body weight.”

What will you gain by making better food choices, moving more, reconsidering your relationship to drinking and smoking, and above all, finding your way to a healthy weight?

“A middle-aged person, say a 50-year-old man, has the potential to live to 93 years of age if all recommended lifestyle changes are adopted otherwise his life expectancy may be reduced by as much as 43 years.” says Dr. Mantzoros, “so there is potential 16-year net gain in life expectancy by adopting a healthy lifestyle that aims to:

  1. Have good blood sugar control;
  2. Achieve good blood cholesterol (lipids) levels;
  3. Be sure your blood pressure is not too high;
  4. Strive for a waist circumferance and body mass index (BMI) in the healthy range;
  5. Take the medications your doctor prescribes."

Aim for Mediterranean--Style Lifstyle
By adopting food choices that fit a Mediterranean approach to eating and living, you will be able to achieve the first 4 lifestyle goals. We have solid evidence that people who embrace a a mostly plant-based diet that delivers the following on a daily basis lessen the risks of diabetes, obesity, and heart disease:1-4

  • Have a handful of nuts (such as walnuts but any kind will do) as a snack, with yogurt, in your salad or stir-fry.
  • Choose monounsaturated fats such as extra virgin olive oil.
  • Rely on beans, lentils, chick peas for good fiber and protein
  • Plan your meals with the focus on vegetables, vegetables, vegetables, and fruit.

And fitting in some physical activity most every day, even just walking (with the aim of 10,000 steps to maintain your current weight or 12,000 to 15,000 to lose weight, if that's your goal, throughout the day), enjoy one drink when having alcohol if you are a woman, and 2 drinks if you are a man, and commit to giving up cigarettes—once and for all—if you haven't already done so. 

How Do You Go About Making Needed Behavior Changes?

Admittedly, changing any longheld behaviors is hard; on that, we can all agree. If you (or a loved one) haven’t been successful in sticking to a goal, may you can approach it another way so you don't have to deal with the consequences of having a heart attack, losing kidney function, or requiring an amputation, says Dr. Mantzoros.

This time, choose just one or two of lifestyle factors to focus on. This can mean the difference between improving your long-term quality of life. After all, your choices are a matter of life or death, he says.

Sure, you've heard this before and can't resist the temptation to roll your eyes.

“These messages are so important that it can't hurt to keep hearing them until you heed them,” Dr. Mantzoros says.

Here are a few more lifestyle consideration that may assist anyone who would welcome a bit of extra help with overweight or obesity:

  • Do a daly weigh-in (preferably at the same time each day)  
  • Work with a dietitian to design a personalized diet and exercise plan 
  • Seek peer support (someone who will join you for walk, and cheer you on).
  • Take your medications as prescribed every day

When Facing Both Diabetes and Heart Disease 

If you already have a diagnosis of type 2 diabetes (T2D), then you are no doubt already learning ways to of making adjustments to your diet and considering what works to be more active.

"Maybe you’ve been told that you have high blood cholesterol and/or high blood pressure but you don't have any symptoms; you should still be concerned. The answer to lessening all the risks associated with diabetes and heart disease are summarized in one word—lifestyle," says Dr. Mantzoros.

In fact, tweaking your food choices and adding some steps is the surest way to both prevent further weight gain, and manage all the factors that may reveal possible trouble in your blood (ie, glucose, lipids, bood pressure) that will impact your long-term health, he says.

Going it alone is so much harder 
Hopefully, you have the support of a friend or two who is striving to make these changes too. Being in good company, and have (and giving) steady, positive support, makes all your efforts easier to achieve and increases the likelihood that you'll be motivated to stick with it.

You should also have the support and guidance of a medical team led by your primary doctor. If you are at risk for (prediabetes), or have type 2 diabetes, maybe you can consult with a certified diabetes educator, or dietitian, and other health care team members who can help you to identify ways you might address obstacles to your success. For example, showing you how to reduce your salt if you have high blood pressure or findings satisfying eating out  when you too busy to cook. If not, let your doctor know you could use some help.

Sure, you know that you should take the medications but make sure that you understand why you are taking them, and can afford them, says Dr. Mantzoros. Otherwise, discuss your concerns with your doctor so you medication can be tailored to fit your circumstances best.

No Matter What You've Tried, You Can't Lose the Weight 

By adopting these key strategies, you may notice that your weight will begin trending down too. 

A diet that is built around vegetables, heart healthy (monounsaturated) fats, and a little lean protein, and making sure you are moving more than sitting, sets up the basics of a healthier weight. However, most people who have tried and failed may need more than reminders of what to eat.2,3

"The truth is, diet and exercise are a necessary first step, but for many, this is simply not enough to prompt you to achieve sufficient weight loss. There are a variety of medications that may help to control your blood sugar and lessen your heart disease risk, while promoting desirable weight loss," says Dr. Mantozoros.

There are also medications specifically designed to address the reasons for your past weight struggles, which can help reduce your appetite, address your carb craving, and help you to feel full when you are eating the requisite heart-healthy meal.

Also, there are medical nutrition therapy programs, such as liquid meal replacements and protein-rich meal plans that may be worth considering in order to kick-start needed but elusive weight loss.

For others, this may miss the mark, or just not be enough. Research supports the value of bariatric surgery to reverse diabetes, reduce weight, and lessen the risks for heart disease.5

"Don’t feel shy or hesitate about discussing these options with your doctor, or a weith management specialist," he says. It’s time to embrace every possible means to manage your health, including the elusiveness of weight loss.

Lifestyle Choices and Medications Reduce Diabetes and Heart Disease Risks      

At least 68% of people who reach age 65 and have type 2 diabetes will likely die from heart disease.6 And if that isn’t reason enough for you to want to adopt a more heart-healthy lifestyle, having diabetes can increase your risk for certain cancers, too.7

"So, as much as you might wish to attribute your predicament to genetics, the simple and honest reality is that improving your quality of life—by reducing the systemic expanse of diseases commonly arising with diabetes—is achievable with a Mediterranean-style diet and attention to other major lifestyle factors (ie, body weight, exercise, smoking, and alcohol)," Dr. Mantzoros says. That, and taking your medications consistently and without fail. 

Here's to a long and healthy life!

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