It's well known that people with diabetes are at an increased risk for heart disease. In fact, the American Diabetes Association warns that diabetics are twice as likely to develop heart conditions than people without diabetes.
But what causes heart disease risk in the first place? And why does diabetes put people at a higher risk?
In this article, we'll take a look at the connection between heart disease and diabetes and how both of these conditions can be managed with appropriate lifestyle changes.
What's The Connection Between Diabetes and Heart Disease?
Diabetes and heart disease have several overlapping risk factors, which is one of the reasons that we see so many diabetics developing cardiovascular issues. However, there is also a direct link between these two metabolic conditions due to high blood sugar's impact on your vascular tissue.
When your cells become resistant to insulin, as is the case with type 2 diabetes, blood sugar has no way out of circulation. As a result, glucose can lodge into places it doesn't belong – like your vital organs and tissues.
In the case of cardiovascular disease, over time, high blood sugar can damage your blood vessels and the nerves that control your heart, disrupting normal blood flow and creating inflammation. Chronic inflammation in your arteries can eventually lead to the buildup of plaque, which sets the stage for atherosclerosis and cardiovascular dysfunction (heart failure, heart attack, and stroke).
Furthermore, research shows that high levels of insulin may also instigate issues such as hypertension, endothelial dysfunction, and athersclerotic plaque formation.
But the underlying issue with both heart disease and diabetes starts several steps before we get to high blood sugar – both of these conditions are lifestyle diseases that can be traced back to preventable risk factors such as poor diet, obesity, and lack of exercise.
Of all the modifiable risk factors that come with metabolic diseases, diet is the leading culprit. In fact, many of the factors that contribute to these conditions can be directly traced back to the food you put in your body.
For example, a diet full of processed and refined foods can directly lead to weight gain and inflammation, which is one of the leading risk factors for diabetes and heart disease. Research shows that carrying excess fat tissue increases insulin resistance and also creates inflammatory conditions in your body.
When your cells become resistant to insulin, glucose builds up in your blood, which drives your pancreas to secrete more insulin in an effort to stabilize blood sugar. Over time this can wear out your pancreas, and your ability to secrete insulin diminishes – further driving high blood glucose levels.
While overeating any type of food can certainly increase weight, studies suggest that diets high in sugar and refined foods are especially obesogenic. This is likely due to the fact that highly processed foods tend to be less satiating, leading to overconsumption of calories without the requisite feedback from your satiety hormones that tell you to stop eating.[4,5]
A diet that consists of highly processed foods is also associated with higher levels of LDL cholesterol, inflammation, and oxidative stress. All of these factors contribute to the pathology of heart disease by setting the stage for plaque formation[6,7].
Couple this with foods that spike blood sugar and cells that are insulin resistant, and you have a recipe for metabolic disaster.
Lack of Exercise
No one would be surprised to learn that exercise is good for you, but when it comes to metabolic health, exercise isn't just a "nice to have" – it's crucial.
In fact, research shows that sitting for long periods can change your body's metabolism, increasing blood sugar levels and producing cells that are resistant to insulin[8,9].
One of the ways that exercise supports insulin sensitivity is by increasing the number of insulin receptors on the outside of your cells. By enhancing the number of "doors" glucose has to enter, insulin becomes more effective at its job.
If you think about it from an energy-needs perspective, this makes sense. Highly active people will need more energy to keep up with their activities. Therefore, increasing their ability to take in glucose from the blood would enhance their physical performance.
When we sit for hours at a time, on the other hand, the need for quick fuel diminishes, which reduces our cells' call for glucose.
When it comes to heart health, physical activity improves several factors for cardiorespiratory fitness. For instance, physical activity increases circulation and can directly lower blood pressure. Furthermore, when you're active, it improves your muscle's ability to pull oxygen out of the blood – reducing the amount of work your heart has to do to pump blood around your body.
Exercise also positively impacts blood lipids, increasing HDL (good cholesterol) and lowering triglycerides.
Lack of physical activity, on the other hand, can result in higher levels of LDL cholesterol and triglycerides, which may contribute to the thickening of your arterial walls. Furthermore, research shows that sitting for prolonged periods may result in high blood pressure – another contributor to heart disease[12,13,14].
Therapeutic And Preventative Lifestyle Factors
The good news about the pathology of heart disease and diabetes is that if lifestyle sets the stage for these conditions, then lifestyle can also help you prevent and possibly reverse them.
Focus on Whole Foods and Reduce Processed Foods
Refined foods are not only less satiating than whole foods, but most of them contain ingredients that are detrimental to your health. When you eat refined or processed foods like pizza, cookies, ice cream, and so on, your body gets confused as it recognizes food is coming in, but the lack of nutrients leaves it wanting for more.
Furthermore, these foods contain higher levels of sugar, particularly fructose, which is indicated in fatty liver disease and insulin resistance.
Processed foods also contain unhealthy fats, like omega-6 and trans fat. These types of fats can contribute to inflammation in your body and may increase your risk of heart disease[16,17].
Instead, focusing on whole foods will supply your body with the nutrients it needs for optimal health while also keeping you full and satisfied. This is the most straightforward diet change you can make to improve heart health and increase insulin sensitivity.
Try a Low-Carb Diet
If you want to take your diet a step further, try reducing your carbohydrate intake with a low-carb diet. Research shows that following a low-carb or keto diet can help to resensitize your cells to insulin, improve blood lipids, and promote weight loss – all factors that can enhance your metabolic health and reduce the risk for diabetes and heart disease.
Since everyone's body is unique, what constitutes low-carb for one person may not be the same for another. If you want to learn more about low-carb dieting, you can seek the advice of a nutritionist or dietician or check out the BioCoach App, where you can access everything you need to get started with a low-carb lifestyle.
Physical activity not only improves cardiorespiratory health, but it enhances your body's ability to utilize glucose. On the other hand, sitting around all day can negatively impact your heart and blood sugar homeostasis.
In the beginning, you may want to start slow with gentle yoga routines or moderate-paced walks to enhance your physical fitness levels. After some time, you can move on to more rigorous training, like running, weight lifting, or even high-intensity workouts.
With that being said, you don't need to train like an athlete to receive a metabolic payoff. In fact, walking for just 30 minutes a day can produce a range of health benefits related to metabolic health, including weight loss, reduced blood pressure, and improved blood lipids.
The American Heart Association recommends that adults move for at least 150 minutes per week, and for maximum benefit, try to hit 300 minutes (5 hours per week). Again, this doesn't have to be high-intensity exercise; anything that increases your heart rate will do.
Focus on Weight Loss
As you've learned, the risk for heart disease and diabetes greatly increases with obesity. Therefore, losing weight is one of the most powerful steps you can take to regain your health and mitigate the onset or progression of these metabolic diseases.
Focusing on weight loss does not mean crash dieting and exercising like crazy. In fact, when it comes to sustainable weight loss, slow and steady is key.
The good news is that weight loss usually follows once you find a diet and exercise regimen that works for you. Therefore, shifting those lifestyle factors is really all you need to do to find your way back to a healthy weight.
Ultimately, the goal isn't to reach a certain number on the scale but rather to have your metabolic markers, such as cholesterol levels and blood glucose, reach a healthy range.
With proper diabetes management, you can reduce your risk for heart disease and other metabolic conditions. Since the root of metabolic dysfunction often comes down to poor diet and lack of movement, transitioning to a healthy lifestyle can significantly affect the progression of both of these conditions.
Start with your diet by including more whole foods and less processed food, and try cutting your carbs to see how your blood markers respond. Many people find that with these changes, they start to see lower blood glucose and shifts in their blood lipids.
In addition to healthy eating, adding in physical activity will sensitize your cells to insulin while also increasing your vascular health.
To learn more about diet and exercise routines for optimal metabolic health, check out the BioCoach App, where you'll be supplied with expert advice to help get your metabolic health on track.
- Hardy, Olga T., Michael P. Czech, and Silvia Corvera. "What causes the insulin resistance underlying obesity?." Current opinion in endocrinology, diabetes, and obesity 19.2 (2012): 81.
- MacDonald, Ian A. "A review of recent evidence relating to sugars, insulin resistance and diabetes." European journal of nutrition 55.2 (2016): 17-23.
- Rauber, Fernanda, et al. "Consumption of ultra-processed food products and its effects on children's lipid profiles: a longitudinal study." Nutrition, Metabolism and Cardiovascular Diseases 25.1 (2015): 116-122.
- Bhardwaj, Bhaskar, Evan L. O’Keefe, and James H. O’Keefe. "Death by carbs: added sugars and refined carbohydrates cause diabetes and cardiovascular disease in Asian Indians." Missouri medicine 113.5 (2016): 395.
- Fritschi, Cynthia, et al. "Association between daily time spent in sedentary behavior and duration of hyperglycemia in type 2 diabetes." Biological research for nursing 18.2 (2016): 160-166.
- Richter, Erik A., and Mark Hargreaves. "Exercise, GLUT4, and skeletal muscle glucose uptake." Physiological reviews (2013).
- Sohn, M-W., et al. "Sedentary behavior and blood pressure control among osteoarthritis initiative participants." Osteoarthritis and cartilage 22.9 (2014): 1234-1240.
- Crichton, Georgina E., and Ala Alkerwi. "Physical activity, sedentary behavior time and lipid levels in the Observation of Cardiovascular Risk Factors in Luxembourg study." Lipids in health and disease 14.1 (2015): 1-9.
- Marchesini, Giulio, et al. "Association of nonalcoholic fatty liver disease with insulin resistance." The American journal of medicine 107.5 (1999): 450-455.
- DiNicolantonio, James J., and James H. O’Keefe. "Omega-6 vegetable oils as a driver of coronary heart disease: the oxidized linoleic acid hypothesis." Open Heart 5.2 (2018): e000898.
- Iqbal, Mohammad Perwaiz. "Trans fatty acids–A risk factor for cardiovascular disease." Pakistan Journal of Medical Sciences 30.1 (2014): 194.
- Foley, Peter J. "Effect of low carbohydrate diets on insulin resistance and the metabolic syndrome." Current Opinion in Endocrinology, Diabetes, and Obesity 28.5 (2021): 463.
- Bond Brill, J., et al. "Dose–response effect of walking exercise on weight loss. How much is enough?." International journal of obesity 26.11 (2002): 1484-1493.
- Wang, Xukai, et al. "The injurious effects of hyperinsulinism on blood vessels." Cell biochemistry and biophysics 69.2 (2014): 213-218.