Tai Ibitoye (@taitalksnutrition) is a UK Registered Dietitian with postgraduate degrees in Dietetics and Nutrition and Human Nutrition. She is currently a doctoral researcher in Food and Nutritional Sciences. Here, she explains how to eat to reduce your risk of type 2 diabetes and heart disease, which both appear to be risk factors for contracting a severe form of of the illness, when it comes to COVID-19.
*For individualised medical and dietary advice, please make sure you speak to your GP and Registered Dietitian, respectively.*
You’re currently living through a health pandemic. That truth alone is likely hard on your wellbeing levels. Even for those of us who are fortunate enough to not fall sick ourselves, or to watch someone we love suffer, there’s still the physical reality of less time spent moving your body, thanks to extra hours inside; or the mental load of seeing death tolls rise.
One potentially scary piece of data that has emerged from the coronavirus crisis, so far, is that those who deal with diabetes and heart disease are more susceptible to developing severe illness if they do catch the virus.
This reality is backed up by heavy data. A recent study published in the British Medical Journal (BMJ), which involved 20,133 UK patients admitted to hospital with COVID-19, showed that their most common comorbidities were chronic heart disease (31%), uncomplicated diabetes (21%), non-asthmatic pulmonary disease (18%) and chronic kidney disease (16%). The Office for National Statistics (ONS) reported that ischaemic heart diseases, also known as coronary heart disease, was the second most common main pre-existing condition across all ages and sexes in England and Wales, with 3,647 deaths (10.8% of all deaths involving COVID-19 in March and April 2020).
Plus, the OpenSAFELY collaborative discovered that having uncontrolled diabetes was associated with increased risk of death from COVID-19. Another study, which is currently undergoing peer review for journal publication, showed that mortality rates in people with Type 2 diabetes increased in line with the level of hyperglycemia (high blood sugar). Deaths in people with diabetes in England have more than doubled during the COVID-19 pandemic and researchers implied that risk factor control could diminish the impact of COVID-19 in diabetes.
Of course, the severity of COVID-19 can vary from person to person – no matter the details of your personal health situation. Similarly, having one of the illnesses mentioned above does not mean that you will definitely contract the virus.
It’s also true that correlation does not necessarily mean causation. However, knowing ways to reduce your risk of chronic conditions like heart disease and diabetes is vital for your overall health, perhaps now, more than ever.
Scroll on for my 11 nutritional tips to reduce the risks – plus, some extra lifestyle advice, to keep you well.
1/ Eat your veg
Evidence shows that regular fruit and vegetable consumption has a protective effect against cardiovascular disease and type 2 diabetes. Fresh, frozen, dried and tinned fruit and vegetables all count towards your five-a-day. One portion is about 80g, which is roughly the amount you can fit into the palm of your hand. Need some inspo? Try the below, for a few ideas.
- Two small fruits such as plums or satsumas or one larger fruit like an apple, an orange, peach or medium banana
- Three heaped tablespoons of vegetables
- A dessert bowl of salad
- A handful of grapes, cherries or berries
100% fruit or vegetable juice, pure fruit juice and smoothies can be used. But, they only make up a maximum of one of your five a day, however much you drink. Know that these drinks often do contain added sugar, so it is better to eat the whole fruit and vegetable instead.
2/ Consume at least 2 servings of fish per week
Your mum was onto something with those tuna sandwiches. One of these servings should be an oily fish. Think: salmon, mackerel, herrings or sardines. Why? Oily fish contains polyunsaturated fat (omega 3 fatty acid). These appear to have benefits for your heart health.
If you’re not a fish eater, all good. Opt for alternative sources of omega 3 fatty acids such as walnuts, pecan, hazelnuts, flaxseeds, pumpkin seeds, hemp seeds, green leafy vegetables, soya beans and soya products such as tofu.
3/ Keep your salt consumption low
You should have no more than 6g of salt a day, which is equivalent to a teaspoon (yes, really.) Regularly eating too much salt can increase your risk of developing high blood pressure – and this increases your chance of developing heart disease and type 2 diabetes. It’s hard when it’s a habit, but try to avoid adding salt when you are cooking and use fresh herbs and spices instead like coriander, basil, rosemary, ginger, garlic and parsley to make your meals sing.
Outside of the cooking realm, know that some foods which you buy pre-made are heavy on the sodium – cheese, bacon, salami, olives, gravy granules, stock cubes, salted and dry-roasted nuts are in this bracket.
Also, look out for the salt content in the everyday foods you buy, and opt for lower-salt options. Nutrition labels on food packaging now make this a lot easier. Most pre-packed foods have a nutrition label on the front, back or side of the packaging. Some may show colour-coded nutrition information to show whether the salt content is green (low), amber (medium) or red (high).
4/ Fill up on fibre
Fibre is a type of carbohydrate found in plant-based foods which has been shown to improve blood glucose control and lower risk of heart disease. In the UK, the average fibre intake for adults is 60% (18g) of what it should be (30g.) Here is a list of the some of the best food choices for fibre and total fibre per 100g:
- Two slices of wholemeal bread (5g of fibre)
- Bran cereals (13-24.5g of fibre)
- Boiled wholemeal pasta (3.5g of fibre)
- Baked potato (5g of fibre)
- Carrots (2.3g of fibre)
- Apple (1.8g of fibre)
- Almonds (7.4g of fibre)
- Peas (4.5g of fibre)
- Chickpeas (4.3g of fibre)
- Baked beans (3.7g of fibre)
5/ Cut down on processed meat
Regular consumption of processed meat has been associated with increased risk of type 2 diabetes and cardiovascular disease. If you include meat in your diet, opt for leaner cuts of meat that are lower in fat or trim visible fat and remove the skin of meat before cooking. You can also consider having meat-free days during the week where you consume fish or have a plant-based meal including beans, pulses and other vegetable sources of protein like tofu.
6/ Limit your booze intake
Drinking too much alcohol is linked with type 2 diabetes and heart disease. If you are partial to the sauce, it is best to spread your units evenly over three days or more: don’t save up your units for a particular day. One top tip? Aim for at least two alcohol free days a week.
7/ Choose unsaturated oils
Use monoand polyunsaturated fats instead of saturated to help protect your heart. Minimise intake butter, palm oil and coconut oils, which are high in saturated fat while focusing on unsaturated oils like olive, sunflower and rapeseed oils. These types of oils are still high in calories and so should still be consumed sparingly.
8/ Snack mindfully
You know this one, but it’s worth reiterating. Cut down on snacks that are high in fat, salt and free sugars such as crisps, chocolate, biscuits, doughnuts and opt for healthier snack alternatives like fresh or frozen fruits, vegetable sticks dipped in salsa or hummus, plain popcorn, a small handful of unsalted nuts, fruit loaf, low-fat yoghurt or soya yoghurt, oatcakes and rice cakes.
9/ Don’t fry everything
Where possible, use cooking methods that reduce the amount of fat in your dishes. Try different cooking methods such as grilling, baking, oven cooking, microwaving or steaming food instead of frying or roasting.
10/ Choose low-fat dairy and dairy alternatives
If you are something of a dairy fiend, try to go on for lower-fat or reduced-fat dairy products such as semi-skimmed or skimmed milk, low-fat yoghurt and lower-fat cheese like mozzarella, feta and cottage cheese. Vegan? Go for lower-fat dairy alternatives such as lower-fat soya milk and soya yoghurt.
11/ Nix your fizzy drink habit
Be mindful of how much sugary drinks you are having during the lockdown and beyond. There is a link between sugar sweetened beverages and increased risk of type 2 diabetes and heart disease. Cutting down on fizzy and energy drinks can help reduce your risk and help maintain a healthier weight. Try to opt for plain water or infuse your water with fruits for taste, sugar-free drinks, semi-skimmed or skimmed milk, tea or coffee without added sugar. Where possible, opt for decaffeinated tea or coffee as regularly drinking caffeinated beverages can increase risk of high blood pressure, which is a risk factor for type 2 diabetes and cardiovascular disease.
You might have heard that there are certain supplements that can lower your risk of type 2 diabetes and heart disease. Currently, there is no robust scientific evidence to support this. So, unless you’ve been told to take a supplement by your GP or Registered Dietitian, you don’t need to take supplements apart from vitamin D as per current government advice. It’s better to get all your vitamins and minerals by eating a variety of foods.
Other tips to keep type 2 and heart disease at bay
Apart from making sure that you are having a healthy and varied diet to lower risk of type 2 diabetes and cardiovascular disease. There are some lifestyle factors that should also be taken into consideration to lower your risk even more.
1/ Keep moving
Regular physical activity is associated with reduced risk of a range of diseases including type 2 diabetes and cardiovascular disease. Adults should aim to do strengthening activities that work all the major muscles (legs, hips, back, abdomen, chest, shoulders and arms) at least two days a week. As well as this, do at least 150 minutes of moderate intensity activity a week. This can be in the form of brisk walking, riding a bike, pushing a lawn mower, dancing or playing tennis. Check out the Women’s Health YouTube channel for videos on HIIT, yoga and bodyweight strength training.
2/ Manage stress
Not being able to manage stress levels properly can have a negative effect on our overall health. Constant stress has been shown to keep blood glucose levels elevated. Thus, it is important to practice self-care and find ways to help alleviate stress levels. Consider scheduling time to unwind, partake in healthy activities that can make you feel relaxed or speak to a family, friend or health professional to let off some steam.
3/ Quit smoking
Smoking can increase risk of developing heart and circulatory disease. If you smoke, quitting is the single most important step you can take to protect the health of your heart. Find your local stop smoking services. These services staffed by expert advisers provide a range of proven methods to help you quit.
Of course, continue to follow government guidance on social distancing as well as speaking to your healthcare professional for advice.
08/06/20 An earlier version of this article included a headline which used the phrase ‘type 2 diabetes diet’ which was misleading. This has been updated.
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