What is the relationship between diabetes and heart disease?

As a Lark DPP user, you learned that diabetes raises your risk for heart disease. You also may have learned about some ways to lower your risk for having a heart attack or developing heart failure. The mission about heart health touched on a few strategies, such as choosing healthy fats, getting more fiber, and improving fitness, but there is way more to learn about preventing type 2 diabetes and supporting a healthy heart when you have prediabetes.

Lark Diabetes Prevention Program (DPP) provides coaching on behaviors that lower diabetes risk, and these same lifestyle choices can also improve heart health. That may increase your motivation even more! Here is a bit about diabetes, your heart health, and how Lark DPP can help.

Blood Sugar and Your Heart

Diabetes is a risk factor for stroke and heart disease, including heart attacks and heart failure. Heart disease is the leading cause of death among older adults with type 2 diabetes, and people with diabetes are up to four times as likely to develop heart disease as those without diabetes.

There are a few reasons why high blood sugar can harm your heart and blood vessels. High blood sugar for a long period of time can cause damage to your blood vessels, similarly to how high blood sugar can lead to damage to your kidneys to cause kidney disease. Damage to the blood vessels in your eyes can impair vision, damage to the blood vessels in your feet or hands can cause peripheral neuropathy, and damage to other blood vessels can lead to a heart attack or reduced circulation.

There are other links between diabetes and heart health. Most people with diabetes also have hypertension, or high blood pressure, which is another major risk factor for heart disease and stroke. Diabetes and insulin resistance also put you at risk for high cholesterol, which is you guessed it! more bad news for your heart.

With all these links between diabetes and heart trouble, it is worth doing what you can to prevent or delay type 2 diabetes and to support a heart-healthy lifestyle. Luckily, most of the healthy choices you make can do double duty in lowering diabetes risk and improving heart health.

Weight Control as a Priority 

 Losing weight is a major focus in the Diabetes Prevention Program (DPP). You may have already set a goal weight and be working towards it. Lark DPP can coach you along the path to a healthier weight.

Why should you lose weight? If you are overweight and have prediabetes, losing weight can:

• Lower diabetes risk by over 50%.
• Lower total and bad LDL cholesterol levels.
• Lower blood pressure.

We are not talking about massive amounts of weight to get these benefits. Losing even 5 to 7% of your body weight (10 to 14 lb. if you weigh 200 lb.) can give you these effects.

Lark DPP already coaches towards a healthy weight loss diet. You are taking steps to lose weight every time you:

• Take smaller portions or take home half of your restaurant meal.
• Choose fruit instead of dessert.
• Steam or bake instead of fry.
• Drink water instead of soda.
• Trim fat off of meat before cooking.
• Take the stairs instead of the elevator.

Remember, weight loss may be a priority, but it should not take over your life. You are more likely to lose weight and keep it off when you approach weight loss with a healthy attitude. Aim for gradual weight loss and small changes in habits as you keep checking and tracking your weight when you use Lark.

Physical Activity as Daily Medicine

Physical activity is part of the DPP because it lowers risk for type 2 diabetes, but it also has a host of heart-healthy effects. People with prediabetes who achieve at least 150 minutes per week of moderate-intensity physical activity lower their type 2 diabetes risk by about half compared to not exercising.

When it comes to heart health, exercise is as powerful as medicine and it carries no harmful side effects. According to the 2018 Physical Activity Guidelines from the Department of Health and Human Services, increased physical activity can:

• Lower risk for cardiovascular mortality, cardiovascular disease, and heart failure.
• Increase good HDL cholesterol.
• Lower total and bad LDL cholesterol.
• Reduce blood pressure.
• Reduce chronic inflammation (a heart disease risk factor).

Moderate-intensity exercises can include activities such as brisk walking, hiking, swimming, water aerobics, cycling, gardening, playing tennis, and rowing. While the ultimate goal is to get at least 150 minutes per week, with more being better, the immediate goal is to do what you can. Start at your level and work up gradually. Lark can help you track your activity and see how it changes over time.

These are a few strategies that may help if you are having trouble getting started with an exercise program or if you still find it hard to get out the door each day to work out.

• Focus on the immediate benefits. The long-term promise of lowering diabetes and heart disease risk is nice, but you can exercise making you feel better right now! It increases energy, improves focus, and improves mood.
  
  
• Work towards a reward. Go ahead, bribe yourself. Promise yourself a new shirt, a massage, or tickets to a concert if you stick to your workout program for a couple of weeks.
  
  
• Find something you love. If you are having trouble getting active, it may be because you are trying the wrong activity. Keep trying new things until you find something you like. Or, experiment with your entertainment you may do best when you watch TV, listen to music, workout in silence, or chat with one or more workout buddies.
  
  
• Mix it up. You may simply need to get out of a rut. If you are getting bored, try changing up the intensity and length, and also do a variety of activities. You might try two or three different activities in a single week.

Keep logging your activity in Lark DPP to stay motivated and improve heart health.

Eating Right for Heart Health and Blood Sugar

Diet quality is the top risk factor for mortality and disability in the United States[2], affecting risk for everything from certain cancers and to arthritis and Alzheimer's disease. Needless to say, your diet affects blood sugar levels as well as heart health.

Early in the program, you may have learned about certain dietary factors and their effects on blood sugar. The Eat Well Mission talked about why vegetables, whole grains, healthy proteins, and healthy fats can lower diabetes risk. The more recent Lark DPP Mission, Heart Health, dug into health fats and fiber.

The following chart shows a range of healthy and unhealthy dietary factors. Increasing the healthy ones and lowering the unhealthy ones in your diet can

• Lower blood sugar
• Lower risk for type 2 diabetes
• Reduce insulin resistance
• Lower bad “LDL” cholesterol
• Lower blood pressure
• Lower triglycerides
• Lower risk for heart disease
• Raise HDL cholesterol
• Increase chronic inflammation, a risk factor for heart disease and diabetes

Eat More Non-starchy vegetables like Lettuce, tomatoes, bell peppers, mushrooms, eggplant, zucchini, broccoli, cabbage, green beans, spinach, kale, celery, artichoke, asparagus, cauliflower, carrots

Eat More Whole grains like Whole-wheat bread and pasta, brown rice, quinoa, teff, amaranth, barley, oatmeal, whole-grain breakfast cereals

Eat More Legumes like Beans, lentils, split peas, soybeans

Eat More Healthy fats like Nuts, peanuts, avocado, olive oil, flaxseed

Eat More Dietary fiber like Fruit, vegetables, whole grains, nuts, seeds, peanuts, legumes

Eat More Seafood like Salmon, tuna, trout, herring, shrimp, oysters, tilapia, halibut

Eat More Reduced-fat dairy products like Non-fat milk and yogurt, low-fat cheese

Eat More Potassium like Fruits, vegetables, yogurt, beans, winter squash, nuts

Have Less Saturated fat like Fatty red meat, poultry skin, butter

Have Less Sodium like Pickles, soup, canned goods, olives, cheese, fast food, many dressings and sauces

Have Less Fried foods like French fries, fried chicken, onion rings, doughnuts, mozzarella sticks, hash browns, fish sticks, fried shrimp

Have Less Trans fat Processed snack and other foods with partially hydrogenated oils

Have Less Sugar-sweetened beverages like Soft drinks, sports drinks, flavored coffee, sweet tea, fruit drinks

Have Less Refined carbohydrates like White bread, pasta, and rice, refined breakfast cereal

Have Less Processed meat like Ham, sausage, hot dogs, pastrami, pepperoni, bologna

It is certainly not easy to hit the dietary goals. In fact, fewer than 2% of American adults hit recommendations[3], so you certainly do not need to feel bad if your diet is not perfect. It may just mean that you have plenty of room for improvement – and every improvement that you make may lower diabetes risk and improve heart health!

Lark's nutrition coaching is designed to help you make small changes to improve your nutrition bit by bit. Healthy behaviors can become habit when you practice them over time. Once you establish one healthy behavior, you can move onto the next without much trouble. There is no need to pressure yourself to make all the changes at once. Instead,

• Log your meals and snacks in Lark so you can stay aware and get feedback.
  
  
• Think about making one or two small changes a day, such as choosing a whole grain instead of refined, or having a tuna or peanut butter sandwich instead of one with processed meat.
  
  
• Log in often and read all the lessons so you can learn more about diabetes and heart health.

More Healthy Habits

You can attack diabetes and heart health from almost any direction, and Lark is there for you whenever you want. Chat with your coach about stress and ways to manage it whenever you are feeling anxious. As you learned in the Mission, Heart Health, keeping alcohol consumption to moderation, if you choose to drink at all, can have benefits.

Sleep deprivation can increase insulin resistance and diabetes risk, as well as raise levels of chronic inflammation in your body. Log your sleep in Lark and go through the sleep coaching conversations to see how you can increase it if necessary to get optimal amounts. Adding more sleep may be a way to lower diabetes and heart disease risk while it gives you more energy every day.

Tobacco use is a major risk factor for both diabetes and heart disease. Those who smoke have a one-third higher risk for diabetes, and quitting smoking can lower heart disease risk by about half. If you are a smoker or you use other forms of tobacco and you want to quit, contact your healthcare provider for options. If you are given the choice, you can also opt in to Lark's Tobacco Cessation program to get ready to quit.