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Posted: January 4, 2024

Heart-Healthy Lifestyle Changes

An image shows a heart-shaped bowl full of vegetables and fruits and a prescription on the table.

Wondering what lifestyle changes can protect your heart from diabetes complications? We have answers. (Pssst … you can enjoy a simply delicious diet!)

  • Wondering what heart-healthy lifestyle changes to make after a diabetes diagnosis? Relax! You just need to put the same health advice you’ve already heard into action.
  • The top tips for better health are those you’ve always heard - quitting smoking, lowering your stress levels, exercising regularly and eating a heart-healthy diet.
  • Research shows that when it comes to protecting heart health, the simple and delicious Mediterranean Diet is even better than a low-fat diet.

Nearly 11.7 million Canadians live with diabetes or prediabetes. If you’re one of them, you already know how this condition could affect your health. Over time, uncontrolled blood glucose levels can damage various organs, blood vessels and nerves. Diabetes also puts you at a higher risk of developing heart disease and stroke. Fortunately, you can take action to protect your body and your heart.

How does diabetes affect my health?

Having diabetes means that your body is not able to balance blood glucose levels. Depending on the type of diabetes, the body is unable to make insulin, use insulin, or both. Insulin deficiency means that your pancreas has lowered the amount of insulin it makes. If your body cannot use insulin as well as it should, this is called insulin resistance.

A diabetes diagnosis can be startling. You may feel that you should be making sweeping changes. If you’re overwhelmed, relax. You can can actively prevent complications by following the same health advice you’ve always heard.

  • Quit smoking.
  • Lower your stress levels.
  • Exercise regularly.
  • Follow a heart-healthy diet.

When you understand what is most important, you can make better decisions from moment to moment. Choices that you can stick with confidently are best.

Recommendations from the heart and stroke foundation of canada

  • Healthier choices help reduce many of the risk factors for heart disease and stroke.
  • Eat well. Focus on vegetables and fruit, whole grain foods, and variety in your protein choices. Limit ultra-processed foods, sugar, salt and fats.
  • Get moving and stay active.
  • Maintain a healthy weight. Where you carry your weight is also important. Aim for a healthy waist size.
  • Stop smoking. (Your pharmacy may have a program for helping people quit.) Avoid second-hand smoke as well.
  • Manage your stress. Understand what makes you feel stressed, and learn effective ways to respond to it.
  • Speak with your diabetes care team, and check out the Foundation’s Healthy Living webpage to learn more:

Diabetes health targets

Your diabetes care team can advise you on assessing and managing your diabetes to keep:

  • blood glucose levels within target range
  • A1c at 7.0% or less
  • blood pressure below 130/80 mmHg
  • LDL (harmful) cholesterol below 2.0 mmol/L.

What are some heart-healthy food choices?

One of the most well-known heart healthy diets is called the Mediterranean Diet. Research shows that compared to a low-fat diet, it can help lower the rate of heart attack, stroke, and even death from heart-related causes.

A Mediterranean-style diet focuses on eating plant-based foods. It gives you fibre, phytochemicals, vitamins, minerals, lean protein and mono-unsaturated fat. It is also lower in saturated fat, sodium and added sugar. Basically, this diet gives you more of the good stuff your body needs. Even better, it suggests eating super-tasty and colourful foods that are sure to keep your taste buds happy.

After just a few changes, you can begin to benefit from the Mediterranean Diet. Once those habits feel comfortable, stick with and slowly build on them. Remember, your current eating habits did not develop overnight. You shouldn’t expect to change them overnight either.

One advantage of the Mediterranean diet is that it helps to raise “good” (HDL) levels of fat while countering the “lousy” (LDL) types. Triglycerides - a lipid or fat that provides energy – are a stickier form of cholesterol that can cause issues with the heart, even when levels are in normal range. Higher triglyceride levels are common among people who have diabetes. Along with better fats, the fibre-rich foods and whole grains in the Mediterranean diet can lower LDL cholesterol levels. For those who find it difficult to keep LDL consistently below 2.0 mmol/L, statin medications may be a good option.

What are the top tips from the mediterranean diet?

  • Eat fruits and vegetables, beans and legumes, nuts and seeds, cereals and whole grains every day.
  • Use olive oil as your main source of added fat in your cooking.
  • Eat fish and poultry a few times a week.
  • Limit how often you eat sweets, desserts and dairy products, as well as red and processed meats.
  • Wine with meals is often associated with the Mediterranean diet. If wine is appealing, consume it in moderation. For wine, one standard drink is 142 mL (5 ounces). Alcohol may be associated with other health risks, so if you do not drink wine already, it is not recommended that you do so now. Speak with your doctor to find out if alcohol is safe for you. Also, remember that water is important for hydration.

Snack and meal inspiration

  • Start your day on the right foot. Make a bowl of oatmeal porridge cooked with unsweetened non-dairy milk, berries and crushed walnuts.
  • Not a fan of oatmeal? No problem! Instead, opt for a mixed-vegetable omelette with a side of whole grain toast and sliced avocado for breakfast.
  • If you feel tuckered out by mid-morning, grab some plain Greek yogurt with a handful of blueberries to re-energize you before lunch.
  • Make your lunch count! Enjoy a mixed green salad with olive oil and balsamic vinaigrette, roasted pumpkin seeds and a salmon salad sandwich for an extra heart-healthy kick.
  • Let’s not forget the mighty bean. Prepare a mixed bean salad with an array of your favourite vegetables as a fibre-packed, meatless lunch choice.
  • Curb that hunger. Snack on a handful of almonds before dinner to prevent your hunger from taking charge.
  • Feast your eyes (and belly!). Enjoy a marinated baked chicken breast along with a side of roasted sweet potato, and plenty of bell peppers and zucchini to fill the rest of your plate.
  • Craving something sweet? Apple slices with all-natural peanut butter make a refreshing nighttime snack when you feel hungry. Read labels carefully to avoid added sugar and sodium in some peanut butters.

Exercise is essential

It will come as no surprise to hear that physical activity is also crucial to safeguarding your health.

  • Studies show people who exercise have improvements in A1c, triglyceride and cholesterol levels. They also have better cardiac and overall health compared to people who are less active.
  • Check with your health care provider before starting any high intensity or competitive exercise. This is especially important if you are an older adult with current or previous vision, mobility, or heart issues.
  • Try to do around 20 minutes of moderate to vigorous (sweat-inducing) activity each day. Remember that it’s most important to add some activity, even if it’s not for very long when you first begin. Ideally, you would be active for 150 minutes over the course of a week, with no more than two days off in a row.
  • Resistance (weight) training is recommended along with aerobic exercise. Most studies done on this type of training suggest progressing to three sets of eight repetitions, at moderate to high intensity, three times a week or more.
  • Remember that long periods of aerobic exercise may increase insulin sensitivity for up to two days. Monitor your blood glucose after aerobic exercise. If you use insulin, you may need to talk to your health care team about adjusting the amount.
  • Avoid sitting for long periods of time. If you must sit when you work, make a habit of getting up and moving around from time to time. Being a couch potato is not good for your health.

Make the most of your team

Health care professionals can help you to manage your diabetes. If you haven’t seen your family doctor for a diabetes check-up recently, making an appointment is a good place to start. You will likely want to be seen every three to six months to check your HbA1c. (Some pharmacies now do HbA1c testing too.)

A registered dietitian specializes in food and nutrition. This health care professional can help you make sense of nutrition information and advise you about your diet. Ask your doctor for a referral to a local dietitian who specializes in diabetes care. Your community pharmacist, another key member of your health care team, can explain how certain medications can help manage your diabetes and protect your heart.

Although a diabetes diagnosis can feel overwhelming, you can take action to care for your health. Talk to your health care team about ways to protect your heart.

For cooking and nutrition inspiration:

Cookspiration, Dietitians of Canada:

Diabetes Canada:

Heart and Stroke Foundation:

WRITTEN BY: Sanja Petrovic, RD, CDE, MSc.
REVIEWED AND UPDATED BY: Eric Hsu, RPh, CDE, a pharmacist in Vancouver, B.C.