What else should people at risk for diabetes look for on the food label?
First, let me explain that risk for diabetes is linked to a complex of factors we call metabolic syndrome. They include high blood pressure, elevated triglycerides, abnormal cholesterol, elevated blood sugar levels, and abdominal obesity (waist circumference of more than 40 inches in men, more than 35 inches in women). Anything you can do to prevent any of these risk factors will lower your risk of diabetes. That means several items on food labels can be very useful.
Let’s start with high blood pressure. What’s important?
Calories, as I’ve mentioned. Being overweight increases the risk of hypertension, or high blood pressure. But looking at how much sodium in food is also important. There’s a strong link between too much salt and high blood pressure. Data from the Dietary Approaches to Stop Hypertension, or DASH, suggest that most people should consume no more than 2,300 milligrams of sodium a day. Cutting back even further, to no more than 1,500 milligrams, further reduces the risk of developing high blood pressure. People with diabetes who also have high blood pressure usually have an accelerated course toward kidney failure. That’s why we recommend a lower target blood pressure for people with diabetes than for those without diabetes.
You mentioned abnormal cholesterol levels. What information on a food label is relevant?
Labels can help you see what kinds of fat are contained in a food item. For a long time, people worried about total fat. We now know that the amount of fat doesn’t matter as much as the kind of fat. Saturated fat increases LDL, the so-called bad cholesterol. So does trans fat, which comes from partially hydrogenated oils. It’s wise to eliminate trans fat entirely. Saturated fat should be kept to less than 10% of total calories. Cholesterol should be limited to less than 300 milligrams per day. People with high LDL should even aim for lower consumption, typically less than 7% saturated fat and less than 200 milligrams of cholesterol.
What about healthy fats? What should people look for on the label?
Unsaturated fats are a healthy choice, since they don’t increase bad cholesterol levels. Having some fat in a meal slows digestion, which can blunt the glycemic effect, which is how high and how fast blood sugar levels climb after you eat something. Including protein in a meal also slows digestion and reduces the glycemic effect. Unsaturated fat comes in two types, monounsaturated and polyunsaturated, both indicated on food labels. Examples of monounsaturated fat include olive oil, hazelnuts, almonds, cashews, avocado, sesame seeds, and pumpkin seeds. Eating oily fish at least two times a week is also helpful. Oily fish are rich in omega-3 fatty acids, which help in lowering a type of dangerous fat in the circulation called triglycerides.