If you’re living with diabetes, you already know how important it is to manage your blood sugar. But did you know it’s just as crucial to keep an eye on your cholesterol? According to Kelly King, a registered dietitian and certified diabetes care and education specialist with the Texas Health Virtual Care Delivery team, people with diabetes are at double the risk of developing heart disease. Keeping both your blood sugar and cholesterol levels in targe range can help reduce your risk of heart attacks and strokes, ensuring a healthier future.

However, King notes she regularly hears many misconceptions about what you can and can't eat when managing both diabetes and cholesterol, something she hopes to help clear up.

"You don’t have to give up your favorite meals entirely," she says. "Small adjustments, like choosing a leaner protein or adding more vegetables, can make all the difference."

So, let’s get into it!

Why Cholesterol Management Matters for People Living with Diabetes

While blood sugar management is essential for preventing the complications of diabetes, your cholesterol plays a major role in your overall health — especially your heart health. According to the American Heart Association (AHA), people with diabetes are more likely to develop cardiovascular issues due to high blood sugar levels damaging blood vessels and nerves controlling the heart. 

"Managing both your blood pressure and cholesterol, alongside your blood sugar, is key to lowering the risk of heart disease and other serious health issues," King explains.

Foods That Help Manage Both Conditions

Thankfully, there are plenty of delicious and nutritious foods that can help manage both your blood sugar and cholesterol levels. King recommends focusing on fiber-rich foods like:

• Oats and oatmeal
• Lentils and beans
• Fruits and vegetables
• Chia seeds and flax seeds
• Psyllium fiber

Fiber is a hero when it comes to managing both conditions. The AHA recommends consuming at least 25 to 30 grams of fiber per day to help reduce LDL cholesterol and promote healthy blood sugar levels. 

"For blood sugar, high-fiber foods take longer to break down into sugar," King explains. "For cholesterol, soluble fiber binds to LDL, helping to clear it from your system." 

Fruit and vegetables are also a great way to boost fiber and nutrition. The AHA recommends at least 4-5 servings of fruit and vegetables daily. Incorporating more fruits and vegetables can seem like a challenge, but King has some tips:

• Keep them visible and ready at home.
• Add them to meals and snacks.
• Throw them into smoothies or sauces for an easy boost.

Just remember to avoid canned fruits with added sugar!

Lean Proteins

Protein can be a powerful ally for both blood sugar and cholesterol management. King suggests lean proteins like chicken, turkey, fish, and plant-based options such as tofu and lentils (just remember that lentils are a carbohydrate and will affect blood sugar levels). These choices help keep blood sugar stable and cholesterol within target levels. The ADA also emphasizes the importance of limiting high-fat proteins like sausage and fried foods, which can raise cholesterol and increase your risk of heart disease.

Whole Grains

Whole grains are high in fiber and can aid in both blood sugar management and heart health. The ADA recommends incorporating whole grain options like whole grain bread or pasta, brown rice, and quinoa into your meals. These grains help decrease risk of blood sugar spikes when paired with lean protein and unsaturated fats, as well as support healthy cholesterol levels.

Healthy Fats

While King notes that fats don’t play a major role in spiking your blood sugar levels, it’s still important to keep an eye on your fat intake, especially if you also have high cholesterol or you are trying to manage your weight. 

However, not all fats are created equal, especially when managing cholesterol. Healthy fats, like unsaturated fats (found in olive oil, avocado, nuts, and seeds), are heart-healthy and won’t raise your LDL levels. However, saturated fats (found in butter, bacon, and cream) and trans fats (often hiding in processed foods) can spike LDL cholesterol and harm your heart.

The AHA strongly recommends limiting saturated fats to no more than 5-6% of your total daily calories and avoiding trans fats altogether.

The Power of Eating Patterns

You’ll find many of these food items in diets like the Mediterranean Diet and the DASH Diet, which is why they’re both endorsed by the ADA and AHA. Additionally, these diets provide the framework to help guide you on what to eat, how much and when. 

DASH stands for Dietary Approaches to Stop Hypertension. We’ve talked about the DASH diet before because it is the diet that patients learn about and must adhere to when going through Cardiac Rehab after a heart procedure, being diagnosed with heart disease or having a traumatic heart event.

The DASH diet follows heart-healthy guidelines to limit saturated fat and trans fat, and includes eating fruits, vegetables, and low-fat or nonfat dairy foods. It also includes eating whole grains, fish, and poultry.

The Mediterranean diet has been long hailed as the heart-healthy diet and a key to longevity. However, because it recommends a small glass of red wine each day and doesn’t limit salt, two factors that the AHA feels contributes negatively to heart health, it does not fully align with the AHA’s goals. But with the elimination of the suggested glass of wine and a careful eye on your salt intake, this can still be an amazing diet to follow.

Another effective method King recommends is the Plate Method. Imagine your plate has four quadrants. Start off with a 9-inch plate and fill half your plate with non-starchy vegetables, one-quarter of the plate with lean protein, and the last quarter of the plate with complex carbohydrates, such as whole grains, beans, and sweet potatoes.

Carbohydrates play a major role in blood sugar management, but the type and amount you eat matter. King advises choosing high-fiber, low-sugar carbohydrates like whole grains, fruits, and low-fat dairy. 

"It helps to pair carbs with lean proteins, non-starchy vegetables, and heart-healthy fats," she says. This combo can stabilize blood sugar while protecting your heart.

The ADA emphasizes that choosing complex carbs — like those found in whole grains, legumes, and vegetables — can help prevent blood sugar spikes and support heart health.

Reading Food Labels Like a Pro

Finally, King emphasizes the importance of reading food labels. Focus on serving size and prioritize nutrients like fiber while limiting added sugars and saturated fats. The easiest way King has found to easily identify foods that should be limited or increased in your diet is to look at the Daily Value (DV) percentage on food labels.

“Something with a DV of 5% or less means that item is low in that particular nutrient, which is good for things you’re trying to limit, like sodium, saturated fat or sugar, for instance,” King explains. “10% is a good or decent source of a nutrient which would be good for fiber and vitamins/minerals. 20% or more for the DV is even better for items that you’re being encouraged to consume more of.”

Cooking Techniques for Heart and Blood Sugar Health

Cooking plays a major role in managing both blood sugar and cholesterol levels, and the way you prepare your food can make a big difference. By using healthier cooking techniques, you can reduce unhealthy fats, lower sodium, and avoid spikes in blood sugar, all while maintaining the flavor and enjoyment of your meals. King suggests a few simple yet effective ways to cook smarter:

• Baking, grilling, broiling, roasting or steaming
• Using fat-free liquids or low-sodium broths
• Trim off visible fat from proteins
• Spicing things up with herbs and spices instead of salt

“If using a sauce or seasoning blend, look at the label for low- or no-sodium and low- or no-added sugar,” King suggests. “You can even look online for a recipe you can follow that is more in line with your diet.”

Remember, everyone's nutritional needs are different. For personalized advice, consider consulting with a registered dietitian who can create an individualized meal plan tailored to your specific needs and preferences.

“I recommend checking with your insurance to see if medical nutrition therapy is covered,” King adds.

For more information about diabetes visit TexasHealth.org/Diabetes.