The Interplay of Cholesterol and Diabetes: A Guide to Heart Health

Cholesterol, often referred to as lipids, is a fatty substance coursing through our bloodstream. While it's notorious for its role in contributing to long-term health issues when levels are excessive, cholesterol is not entirely the villain it's often depicted as. In reality, cholesterol plays a crucial role in our cellular function, vitamin D production, and hormone synthesis.

Cholesterol comes in two primary forms: high-density lipoprotein (HDL), often deemed "good cholesterol," and low-density lipoprotein (LDL), colloquially known as "bad cholesterol." It's the balance between these two that matters most. If LDL levels soar while HDL levels plummet, the risk of cardiovascular complications, also known as heart disease or cardiovascular disease (CVD), significantly rises.

Another player in this intricate game is triglycerides, a blend of three fatty acids and glycerol. High triglyceride levels can spell trouble for your health.

For many, maintaining a balanced diet and an active lifestyle is sufficient to keep cholesterol levels in check. However, when bad cholesterol levels remain high, medications are often necessary. This holds particularly true for individuals with diabetes, who must have their cholesterol levels monitored annually. Managing your cholesterol is an integral part of comprehensive diabetes care.

Understanding the Risk of High Cholesterol Individuals with type 1 diabetes may not have elevated cholesterol levels, yet they could benefit from statin treatment as a preventative measure against heart disease. This proactive approach helps maintain cholesterol within a healthy range and reduces the risk of heart disease. Those with type 1 diabetes who should consider statin treatment include:

1. Individuals Older Than 40: Age plays a significant role in assessing heart disease risk.

2. Diabetics With a Decade or More of Diabetes: The duration of diabetes is a vital factor.

3. Those With Established Kidney Damage or Other CVD Risk Factors: Complications such as kidney damage heighten the risk.

For individuals with type 2 diabetes, CVD risk is often assessed using a tool called a QRISK calculator. Your healthcare team should elucidate your risk and advise you on managing blood fat levels. For primary CVD prevention, individuals with type 2 diabetes who carry a 10% or greater 10-year risk of developing CVD should consider statins. If you're grappling with high cholesterol, a blood test measuring total cholesterol, HDL cholesterol, and non-HDL cholesterol is advisable three months after initiating statin treatment. Individual cholesterol level targets should be discussed with your healthcare provider.

Taking Control of Your Blood Fat Levels Routine blood fat level checks are generally conducted once a year, although the current pandemic situation might necessitate adjustments. Here are steps you can take to manage your blood fats effectively:

1. Seek Support for Weight Loss: If you are overweight or living with obesity, professional guidance can make a significant difference.

2. Adopt a Healthy Diet: Prioritize fruits, vegetables, nuts, oily fish, and whole grains in your diet. These foods promote heart health.

3. Moderate Alcohol Consumption: While moderate alcohol consumption might offer some heart protection, excessive drinking can increase the risk of heart disease. Striking a balance is key.

4. Quit Smoking: Smoking poses a serious threat to heart health. Seek support to quit this habit.

5. Stay Active and Limit Sedentary Time: Regular physical activity benefits your cardiovascular system. Reducing prolonged periods of sitting is also essential.

6. Dietitian Consultation: Your GP can refer you to a dietitian who can offer guidance on reducing saturated fat intake while increasing fiber consumption.

Heart-Protective Foods Certain natural foods and functional foods can safeguard your heart. Here's a glimpse:

Oily Fish: Varieties like herring, salmon, sardines, and mackerel are rich in omega-3 fats, which benefit the prevention and management of CVD. People with diabetes are recommended to consume two portions a week. Vegetarian and vegan sources include walnuts, linseeds, chia seeds, and certain plant oils.

Fruits and Vegetables: These nutrient-packed foods lower the risk of CVD due to their low saturated fat content, high fiber content, and low-calorie profile. Phytochemicals, vitamins, minerals, and antioxidants present in fruits and vegetables contribute to overall health.

Nuts: Walnuts, almonds, and cashews are known to lower cholesterol levels and reduce the overall risk of CVD. Their unsaturated fats, plant sterols, stanols, and high fiber content make them heart-healthy options.

Soluble Fiber: Foods like peas, beans, lentils, broccoli, apples, berries, prunes, and sweet potatoes, as well as whole grains, contain soluble fiber that helps regulate cholesterol levels.

Oats and Barley: Rich in beta-glucan, a type of soluble fiber, oats and barley form a gel that binds cholesterol in the body, preventing its absorption into the bloodstream.

Functional Foods for Cholesterol Management Functional foods, those with components offering specific health benefits beyond basic nutrition, can be pivotal in managing cholesterol:

1. Probiotics: These promote the growth of healthy gut bacteria, aiding digestion and overall well-being.

2. Plant Sterols and Stanols: Naturally found in small amounts in fruits, vegetables, nuts, and seeds, these substances are proven to lower cholesterol levels. Consuming 1.5–2.4g daily can result in noticeable reductions in cholesterol in a matter of weeks. Fortified foods with added sterols and stanols can be effective, although they should be eaten regularly during meals.

3. Sterols and Stanols Safety: They are safe to use alongside medications like statins or fibrates. However, they may not directly reduce heart disease or stroke risk.

Before incorporating functional foods into your diet, especially if you're on cholesterol-lowering medications, consult your doctor. Some fortified foods might not be suitable for certain groups, such as pregnant and breastfeeding women or young children.

Supermarkets offer a variety of products containing plant sterols or stanols, which can be costly. Check the required daily servings for effectiveness and explore affordable options, such as supermarket own-brands. Examples of such products include Benecol and Betavivo.

In conclusion, the interplay between cholesterol and diabetes is a critical aspect of health management for individuals with diabetes. While cholesterol has both beneficial and harmful effects, maintaining a balance is essential. Empower yourself by adopting heart-healthy dietary and lifestyle practices and exploring functional foods that align with your health goals. Remember, managing your cholesterol is not just about avoiding the bad; it's also about embracing the good for a healthier, happier life with diabetes. Learn more about how you can get started with fitness & diabetes journey, talk to our experts today and GET A FREE CONSULTATION!

Source: Association of Diabetes UK