Diet and coronary heart disease in diabetes

Persons with diabetes mellitus have an increased cardiovascular morbidity and mortality and therefore it is imperative to identify and treat aggressively all cardiovascular risk factors. The first line of intervention aiming to reduce the cardiovascular burden is dietary therapy along with other recommendations for lifestyle modification. Compliance with life-long dietary changes is a major issue and therefore emphasis should be placed on whole foods and dietary consumption habits. Also, dietary changes should be individualised according to patient's nutritional needs, lifestyle, cultural eating habits, taking into consideration all risk factors and existing comorbidities. Nevertheless, at least two main strategies have been proven to be effective in preventing coronary heart disease: 1) modification of fat quality through substitution of saturated fat, dietary cholesterol and trans- fatty acids with non-hydrogenated mono- and poly-unsaturated fats and increased consumption of omega-3 fatty acids; 2) modification of carbohydrate quality by choosing high-cereal fiber and low-glycaemic load intakes instead of refined grain products. Although the best diet for reducing cardiovascular risk remains uncertain, a combination of dietary interventions offers great benefits in preventing coronary events.