“We improve the diet to improve the gut microbiome, and we improve the gut microbiome to change our immune, inflammatory, and metabolic function.” -- Dr. Alex Vasquez, DO, DC, ND
When you talk about the health of your heart, you can’t separate out the sugar component! Here's why and what to do...
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Ask 10 random people on the street what nutrients to watch for heart health, and you’ll get 10 variations on “saturated fat and cholesterol.”
In fact, there’s no real evidence saturated fat and/or cholesterol from whole foods causes heart disease. But did you know about the connection between some types of carbohydrates and heart disease? It’s not as simple as “carbs cause heart disease,” but there is a connection for certain types of carbohydrates, especially highly refined carbs. Basically, the problem is that sugar and refined carbs damage the lining of your blood vessels, technically called the vascular endothelium.
Meet Your Endothelium
The endothelium is a layer of cells on the inner surface of your blood vessels. A healthy endothelium prevents blood clotting, keeps inflammation under control, regulates the formation of new blood vessels, and controls blood pressure by constricting or dilating your blood vessels. Basically, if you want a healthy cardiovascular system, you need a healthy endothelium.
Poor endothelial function is one of the first signs of heart disease. It can cause high blood pressure (aka: hypertension) by constricting blood vessels too much. If the anti-clotting function of the endothelium fails, then you’ll be more prone to developing clots.
Blood Sugar Levels and Endothelial Function
This review goes over the relationship between carb quantity, carb quality, and endothelial function.
High blood sugar (hyperglycemia) changes the behavior of the endothelium and damages the endothelial lining of the blood vessels. This is called endothelial dysfunction. In endothelial dysfunction, the endothelium doesn’t dilate easily, even when it’s supposed to. When the endothelium stays constricted all the time, it causes high blood pressure because the same volume of blood is being forced through the constricted blood vessel.
The technical term for this is flow-mediated dilation (abbreviated FMD). If someone has normal FMD, they don’t have any endothelial dysfunction and their blood vessels can dilate as normal to prevent high blood pressure. If someone has reduced FMD, they’re in trouble – endothelial dysfunction, high blood pressure, the whole shebang.
High blood sugar also increases inflammation in the endothelium. If you really want to get technical and nerdy about it, high blood sugar increases the formation of advanced glycation end products (AGEs) in the blood vessels and impairs anti-inflammatory action in the endothelium.
But keep in mind, endothelial dysfunction is a problem caused by high blood sugar, not necessarily just eating carbs. Different amounts and types of carbs affect different people’s blood sugar in different ways. Some people can eat quite a high-carb diet and have 0 blood sugar problems. Other people start having blood sugar swings if they look sideways at a potato.
Luckily, there have been quite a few studies on what kind of carbs are linked to endothelial dysfunction.
Carb Quantity and Carb Quality and Endothelial Function
According to the review, researchers first noticed the carb-endothelium connection during oral glucose tolerance tests (OGTTs). Glucose is a type of simple sugar and the fastest type of carbohydrate to digest. In an OGTT, the doctor gives you a pure glucose drink and measures how well your body can cope with the glucose load. The whole point is to make your blood sugar spike and then see how fast your body can bring blood sugar levels back down.
Researchers started noticing that OGTTs caused relatively significant endothelial damage. That was the first sign that blood sugar spikes could cause endothelial problems. On the other hand, they could prevent problems by giving patients vitamin C (an antioxidant) or a statin (statins are anti-inflammatory). This makes sense, since endothelial damage is an inflammatory type of oxidative stress.
An OGTT is an artificial situation that doesn’t really imitate the effect of a normal meal on blood sugar. But on the other hand, an OGTT is basically a super-concentrated sugar dump, and it’s not that much different from, say, eating a huge amount of candy or drinking a big glass of Coke. And lots of people eat a lot of highly refined sugar in the form of candy and Coke. So the review went on to examine carb quantity and carb quality as they affect endothelial function.
When the researchers looked at carb quantity, they actually found that low-carbohydrate diets were associated with poorer vascular health and more endothelial damage, but noted that the effects of increasing fat and protein to compensate naturally obscured any relationship between carb quantity and endothelial health. So they moved on to carb quality.
Carb quality was easier to study. In a couple different human intervention studies, low-GI (read: low-junk) diet were pretty effective for improving endothelial health. This is backed up by various different association studies, which the authors also cited. Carb quantity may or may not be important, but the ability of those carbs to cause blood sugar issues (which will obviously vary from person to person) definitely seems to be. Here's how to break your sugar habit.
The Long Term: Insulin Resistance and Endothelial Health
Insulin resistance is a measure of long-term blood sugar problems. Looking at people with insulin resistance can give you an idea of how blood sugar problems affect endothelial health in the long term.
This study looked at subjects who started out as either insulin sensitive or insulin resistant. In people with insulin resistance, their endothelial health (measured by flow-mediated dilation) was worse all the time, when they were just walking around. Then it got even worse after a meal, especially a high-carb meal. Unfortunately, the researchers in this study didn’t test carb quality at all, only the total number of carbs in the meal.
Also, remember the OGTT results from above? People with diabetes got even worse endothelial problems from an OGTT than healthy people. That’s another sign that baseline insulin issues exacerbate the damage of blood sugar spikes.
Insulin resistance, which is a sign of long-term issues with blood sugar regulation, is pretty clearly linked to chronic endothelial damage.
Summing It Up: Carb Quality Counts for Heart Health
Even healthy people will have a transient decrease in endothelial function after a sugar overload like an oral glucose tolerance test. But the real problem here is the long term because diets full of refined carbs (high GI) tend to cause chronic endothelial dysfunction. Unsurprisingly, people with insulin resistance have higher levels of endothelial dysfunction. Blood sugar spikes and other blood sugar regulation problems damage the endothelial lining and if that keeps going on, it causes long-term problems.
Endothelial dysfunction is the very first step towards heart disease. It makes people more vulnerable to blood clots and raises blood pressure.
Carb quality and blood sugar management matters for heart health. If you want to keep your ticker going strong, maybe forget about the saturated fat and cholesterol and start focusing on sugar!
Article courtesy of Paleo Leap
Adopting and implementing these simple dietary strategies will really help tame that “inflammation tiger.”
Ever see the top 10 superfoods lists? November is Diabetes Month and November 14th is World Diabetes Day, so today’s superfoods list is for those with diabetes! These foods are packed with nutrition, and many of them help control blood sugar levels and reduce the risk of heart disease. As with all foods, you need to work the diabetes superfoods into your individualized meal plan in appropriate portions.
Ginger
Ginger may improve long-term blood sugar control in people with type 2 diabetes. Research shows ginger works by increasing uptake of glucose into muscle cells without using insulin, which is great for managing high blood sugar levels. It’s also worth noting ginger has a very low glycemic index.
Salmon or any Fish High in Omega-3 Fatty Acids
Salmon is an excellent choice for people with diabetes. This high protein food is low in saturated fat, which you want to avoid for heart reasons, and doesn’t contain carbohydrates so it won’t affect blood sugar levels. Those omega-3 fats are important for your heart and overall health. Your goal is 6-9 ounces of fish per week.
Hemp Seeds
Hemp is definitely on the hot list these days. Like seeds in general, hemp seeds have many health advantages including heart healthy fats (they have a good amount of omega-3), protein, fiber, minerals and antioxidants. They’re also rich in Vitamin E, and are mild and tasty, too. Hemp reduces inflammation and benefit those with arthritis, cardiovascular disease, and psoriasis. By improving circulation and reducing inflammation, hemp products may be particularly beneficial for diabetics. But for those who are wondering, although they come from the same plant as marijuana, no, they do not get you high.
I love cinnamon, and like chia seeds, I seem to add it to many things I make, such as plain Greek yogurt, smoothies, oatmeal, fruit, and chili. Cinnamon is not only flavorful but has also been shown to decrease levels of fasting glucose, total and “bad” cholesterol, and triglyceride levels. I can also increase “good” cholesterol levels.
Almonds will help diabetics in two ways: slower digestion and prevent heart disease. Almonds are one of the most nutrient-dense nuts, and are especially high in vitamin E which slows plaque development that leads to atherosclerosis. But don’t feel like you need to limit yourself to just almonds—diabetics can eat any kind of nuts. When nuts are combined with high-glycemic index foods, such as pasta, they can potentially slow their absorption, stabilizing blood glucose levels. The fiber and plant sterols found naturally in nuts helps lower “bad” cholesterol and increases “good” cholesterol.
Eat an ounce a day to provide key healthy fats and decrease your hunger: 22 almonds, 49 pistachios, or 18 cashews.
Goji berries are extremely high in antioxidants and important phytonutrients like beta-carotene and zeaxanthin, both which are critical for eye health. It’s thought goji berries could protect the eyes from diabetic retinopathy. They’re also a great source of iron and vitamins C and A.
One ounce of goji berries provides 20 grams of carb, 3g protein, and 1g fiber. Add them to your diet by sprinkling them on salad, plain Greek yogurt, cooked vegetables, and in soup. Goji berries interact with certain blood pressure and diabetes drugs, so check with your physician.
Chia seeds are a total protein, which many plants are not. They’re also high in fiber, rich in healthy omega-3s, and high in calcium and antioxidants. These little chia’s benefit diabetics by helping control blood glucose, reducing blood pressure, and lowering C-reactive protein, a major marker of heart disease risk. This study was published in Diabetes Care.
You can add chia seeds to almost anything. I love them in Greek yogurt, smoothies, oatmeal and stew.
Vinegar
Having two Tablespoons of vinegar before a meal can reduce the spike in blood concentrations of both insulin and glucose after the meal. This is particularly beneficial to those with pre-diabetic symptoms when blood sugar control is crucial. Start your meal with a salad in a vinegar-based dressing to get the benefits, and also consider other ways to use vinegar in recipes, such as a zesty marinade for chicken or pork. If you’re hardcore, some people swear by drinking vinegar solo!
Give us your feedback!
What do you think of our diabetes superfoods list? Do you regularly eat many of these? Do you avoid any? Are we missing any on our list?
In Health and Happiness,
Kelly Harrington, MS, RDN
Registered Dietitian Nutritionist for Healthy Goods
Almonds are not only delicious, they’re also effective for managing blood sugar levels for Type 2 diabetics.
Almonds Benefit Type 2 Diabetics
A meta-review of 12 similar studies showed a daily intake of about ½ cup (2 ounces) of tree nuts over an eight week time period significantly reduces HemoglobinA1c and fasting glucose in individuals with type 2 diabetes. Tree nuts include almonds, Brazil nuts, walnuts, hazelnuts, macadamia nuts, pistachios, pecans, and cashews. This is not only great news for diabetics, but also non-diabetics since blood sugar spikes aren’t healthy for anyone.
A Few Reasons Tree Nuts Benefit Type 2 Diabetics
Tree nuts may be effective at helping diabetics for a few reasons.
First, the nuts replace simple carbohydrate choices which are known to spike your blood sugar.
Second, tree nuts are digested and absorbed more slowly due to their fat, fiber, and protein content. This slower absorption in turn slows down the conversion to blood glucose. This is a good thing! Go here to learn more about the disadvantage of the blood sugar rollercoaster.
Third, the fiber, protein and fat content in almonds means it only takes a handful to keep you feeling full and satisfied so you won't have the urge to overeat. Maintaining a healthy weight or losing weight is critical for diabetics. When someone has Type 2 diabetes, even a little weight loss can lead to huge improvements in blood sugar control.
Nutritional Benefits of Almonds
Almonds pack a big punch nutritionally speaking as well. They’re rich in vitamin E, calcium, magnesium and potassium. Additionally, almonds are a significant source of protein and fiber, while being naturally low in sugar. They’re packed with healthy unsaturated fat without any cholesterol. Of all tree nuts, almonds rank highest in protein, fiber, calcium, vitamin E, riboflavin and niacin content by weight. There are 160 calories in 23 almonds, with the majority of these calories coming from healthy fat.
The Union Square Cafe’s Bar Nuts
There are numerous ways to include almonds on a daily basis. You can simply eat raw almonds or try this mixed nut variety mix. This mix sounds very addicting so enjoy and don’t forget to monitor your portion sizes.
Ingredients
2 ¼ cups (18 ounces) assorted unsalted raw tree nuts, including cashews, almonds, Brazil nuts, hazelnuts, walnuts, and pecans
2 Tablespoons coarsely chopped fresh rosemary leaves
½ teaspoon cayenne pepper
2 teaspoons dark brown sugar
2 teaspoons sea salt
1 Tablespoon unsalted butter, melted
Directions
1. Preheat the oven to 350 degrees F.
2. Toss the nuts in a large bowl to combine and spread them out on a baking sheet. Toast in the oven until light golden brown, about 10 minutes.
3. In a large bowl, combine the rosemary, cayenne, sugar, salt and melted butter.
4. Thoroughly toss the toasted nuts in the spiced butter and serve warm.
Enjoy your almonds and nut mix!
In Health and Happiness,
Kelly Harrington, MS, RDN
Registered Dietitian Nutritionist for Healthy Goods
Reference:
1. Viguiliouk E, Kendall CW, Blanco Mejia S. Cozma AI, Ha V, Mirrahimi A, Jayalath VH, Augustin LS, Chiavaroli L, Leiter LA, de Souza RJ, Jenkinds DJ, Sievenpiper JL. Effect of Tree Nuts on Glycemic Control in Diabetes: A Systematic Review adn Meta-Analysis of Randomized Controlled Dietary Trials. PLoS One. 2014 Jul 30;9(7).
2. Recipe courtesy of Nigella Lawson.
Almonds are not only delicious, they’re also effective for managing blood sugar levels for Type 2 diabetics.
Almonds Benefit Type 2 Diabetics
A meta-review of 12 similar studies showed a daily intake of about ½ cup (2 ounces) of tree nuts over an eight week time period significantly reduces HemoglobinA1c and fasting glucose in individuals with type 2 diabetes. Tree nuts include almonds, Brazil nuts, walnuts, hazelnuts, macadamia nuts, pistachios, pecans, and cashews. This is not only great news for diabetics, but also non-diabetics since blood sugar spikes aren’t healthy for anyone.
A Few Reasons Tree Nuts Benefit Type 2 Diabetics
Tree nuts may be effective at helping diabetics for a few reasons.
First, the nuts replace simple carbohydrate choices which are known to spike your blood sugar.
Second, tree nuts are digested and absorbed more slowly due to their fat, fiber, and protein content. This slower absorption in turn slows down the conversion to blood glucose. This is a good thing! Go here to learn more about the disadvantage of the blood sugar rollercoaster.
Third, the fiber, protein and fat content in almonds means it only takes a handful to keep you feeling full and satisfied so you won't have the urge to overeat. Maintaining a healthy weight or losing weight is critical for diabetics. When someone has Type 2 diabetes, even a little weight loss can lead to huge improvements in blood sugar control.
Nutritional Benefits of Almonds
Almonds pack a big punch nutritionally speaking as well. They’re rich in vitamin E, calcium, magnesium and potassium. Additionally, almonds are a significant source of protein and fiber, while being naturally low in sugar. They’re packed with healthy unsaturated fat without any cholesterol. Of all tree nuts, almonds rank highest in protein, fiber, calcium, vitamin E, riboflavin and niacin content by weight. There are 160 calories in 23 almonds, with the majority of these calories coming from healthy fat.
A fun, vegan option for almonds is to make almond milk. Don’t let the length of this recipe fool you because making almond milk is actually fairly easy.
How to Make Your Own Almond Milk
Ingredients
1½ cups whole, raw almonds
4 cups filtered water
1 whole vanilla bean, chopped (or 1 teaspoon vanilla extract)
2-4 pitted dates, to taste (or 1½ Tablespoon maple syrup or honey)
¼ teaspoon cinnamon
Small pinch of sea salt, to enhance the flavor
Instructions
1. Soak 1 cup of raw almonds at least 4 hours or overnight. Make sure all the almonds are covered with water. Take a look at this blog about Soaking Nuts to get a better idea of how to soak nuts. Soaking softens them and makes them much easier to blend. Many claim soaked almost taste and digest better too.
2. Once the almonds are soft, rinse and strain the almonds and pop them into your blender. Add 1½ cups of filtered water. This will create a really smooth paste.
3. Blend for 1-2 minutes. You may need to stop the blender a couple times to stir the mixture with a spatula.
4. Once you have a beautiful, smooth puree, add your flavors—vanilla (beans or extract), dates, and cinnamon. You might find a pinch of sea salt brings out the other flavors in the milk.
5. Add the remaining 2½ cups of filtered water. Blend for several minutes on the highest speed until it’s completely smooth and frothy. Blend Taste the milk and adjust the vanilla, cinnamon, and other additions to taste.
6. Now it’s time to strain the almond solids out of the liquid for a smoother, creamier product. This can be done using cheesecloth or a nut milk bag.
7. If using cheesecloth, place 3 or 4 layers over a metal strainer set over a bowl. Pour the almond milk through the strainer into the bowl. You might have to do this part in batches, depending on the size of your strainer and bowl. Use a spoon or spatula to press down on the strainer and move the solids around, to help the almond milk through the cheesecloth.
8. Once most of the milk has passed through the strainer, gather up the cheesecloth and gently squeeze it to remove excess liquid. You’ll be left with really fine almond meal inside the cheesecloth.
9. You can discard the leftover almond meal, or dry it out in a dehydrator and use it in place of almond flour in baking recipes.
Enjoy your almonds and your almond milk!
In Health and Happiness,
Kelly Harrington, MS, RDN
Registered Dietitian Nutritionist for Live Superfoods
Reference:
1. Viguiliouk E, Kendall CW, Blanco Mejia S. Cozma AI, Ha V, Mirrahimi A, Jayalath VH, Augustin LS, Chiavaroli L, Leiter LA, de Souza RJ, Jenkinds DJ, Sievenpiper JL. Effect of Tree Nuts on Glycemic Control in Diabetes: A Systematic Review adn Meta-Analysis of Randomized Controlled Dietary Trials. PLoS One. 2014 Jul 30;9(7).
