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

With Christos S. Mantzoros, MD 

Diabetes and heart disease worsens with obesity adversely impacting every organ in the body. Here's what you can do to avoid these diseases and lessen your overall risks.

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

Do you know that the higher your blood sugar the more likely you are to develop cardiovascular disease?

And that is just the tip of the iceberg. Diabetes and heart disease as well as fatty liver disease that may lead to cirrhosis usually coincide with obesity, too.

There are five key strategies to reduce your risks for diabetes and heart disease, and obesity.

Obesity, Diabetes, and Heart Disease: A Matter of Life or Death

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. Montzoros. 

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.

Try These 5 Lifestyle Actions to Side-Step Diabetes & Heart Disease

“As worrisome as having heart disease, diabetes, and obesity may be, there is a sure way to avoid or lessen the risks brought on by 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 potential16-year net gain in life expectancy by adopting a healthy lifestyle that aims to improve blood sugar, lipids, blood pressure, and a lower body mass index (BMI).”

We have solid evidence that people who embrace a Mediterranean-style diet that delivers on the following on a daily basis: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.
  • Plan your meals by starting with the vegetables, vegetables, vegetables, and fruit.

And fitting in some physically activity most every day, even if it’s as simple as walking a few miles (or 10,000 steps to maintain your current weight or 12,000 to 15,000 to lose weight, if you prefer this goal) that are accumulated throughout the day, limit your alcohol to one drink if you are a woman, and at most 2 drinks if you are a man, and yes its time to give up—once and for all—smoking if you've already started or do not start at all. And, seek to keep your weight within the defined healthy range.

How Do You Go About Making Needed Behavior Changes?

Changing behaviors is hard; on that, we can all agree. If you (or a loved one) haven’t been successful, It may be worth reconsidering when the alternative is lost years of life and the disabilities that come from having a heart attack, losing kidney function, or requiring an amputation, says Dr. Mantzoros.

To lessen the chances of having a heart attack or stroke, think about choosing just one or two of the critical lifestyle factors that you can focus on. This can mean the difference between achieving a reasonable quality of life or more directly—it is a matter of life or death, he says.

Sure, you’ve heard this before but resist the temptation to roll your eyes.

“These messages are so important that you need to keep hearing them until you heed them,” says Dr. Mantzoros, and when you’ve done your best, here are a few more critical messages to consider for those with overweight or obesity:

  • Weigh-in to check your body weight daily (preferably at the same time)  
  • Work with a dietitian to have a plan for your diet and exercise
  • Garner peer support (someone who will encourage you to succeed and/or even plan your meal, so the grocery shopping, or eat with you so you are getting at least one healthy meal a day).
  • Take the medications that your doctor prescribes.

When Facing Both Diabetes and Heart Disease 

Should you already have a diagnosis of type 2 diabetes (T2D), then you are no doubt already in the throws of dealing with the challenge of making adjustments to your diet and physical activity.

"Maybe you’ve been told that you have high blood lipids and/or high blood pressure but you aren’t aware of 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, lifestyle is the best and surest way to both prevent weight gain, rising blood sugar, elevated lipids, increasing blood pressure, and forestall or lessen the impact of these medical concerns on your long-term health, he says.

Presumably, you have the support and guidance of your doctor as well as a certified diabetes educator, likely a dietitian, and other health care team members who can help you to identify appropriate strategies for your particular challenges such as reducing salt if you have high blood pressure or avoiding fast food meals when you too hungry to cook.

While your doctor will continue to reinforce the need to make lifestyle changes to avoid progressing to diabetes and heart disease, once your health is compromised and your risks are elevated, the next best course of action is to be fastidious about taking your medicine.

Sur, you know the medications that can help you gain better control over your blood sugar;  just as important, are the many effective medications that can improve your other health risks such as lowering your blood pressure, reducing your blood cholesterol (ie, statins, omega-3 fatty acids), and achieving needed weight loss, says Dr. Mantzoros.

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

By adopting key strategies geared to reducing your blood sugar and your blood cholesterol, you may find that your weight will begin trending down too.

A diet that is built around lots of vegetables, unsaturated fats, and a little lean protein, and a day that means your moving more than sitting, offers the basis for a healthier weight. However, most people who have tried and failed may need more than a push to eat healthier.2,3

"The truth is, diet and exercise are a necessary first step, but for many, this is simply not enough to prompt sufficient weight loss. There are a variety of medications that may help better control your blood sugar and lessen your heart disease risk, and promote 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 an obesity specialist," he says. It’s time that you 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 who have diabetes will likely die from heart disease.6 And if that isn’t reason enough to finally heed to adopt a more heart-healthy lifestyle, having diabetes can increase your risk for certain types of cancer 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 disease complications brought about by disease and heart disease—is achievable with a Mediterranean-style diet and attention to the other major lifestyle factors (ie, body weight, exercise, smoking, and alcohol)," Dr. Mantzoros says.

That, and taking your medications consistently and without fail. 

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