DEAR DR. DONOHUE: What should I eat with type 2 diabetes, high blood pressure and high cholesterol? All the advice I get tells me what I cannot eat — no potatoes, no bread, no crackers, no cereal, no fruit. Since breakfast is the most important meal of the day, I don’t know what to eat. — C.L.
ANSWER: The diet for type 1 and type 2 diabetes is not as restrictive as it once was. You can eat all the foods you mentioned. Sugar also can be eaten, something that was strictly prohibited in the past. You have to use it in moderation, and it’s best to save sugar calories for other carbohydrates by using artificial sweeteners.
Weight reduction, if applicable to you, is the best way for you to control blood sugar. A 5- to 10- percent weight loss is a sure way to keep blood sugar where it should be. For high blood pressure, limit salt. You ought not to eat more than 1,500 milligrams a day of sodium. Read the sodium content of foods on their nutrition labels. For cholesterol control, cut back on fatty meats and whole-fat dairy products. You can use low-fat dairy.
Carbohydrates are an issue with diabetes. Carbohydrates are sugars and starches. They should constitute 50- to 55- percent of your total daily calories. Fruits (yes, you can eat them), vegetables, cereals, breads, crackers, pastas and similar foods are carbohydrates. You have to get a book that lists the calorie content of foods and their protein, fat and carbohydrate makeup. These guides are in all bookstores, and they’re cheap.
Breakfast shouldn’t be a problem. You can drink orange juice if you like it, have cereal, have toast and drink coffee or whatever.
You need a coach in the form of a dietitian. The dietitian can help you navigate through the difficulties of understanding a diabetic diet. Your doctor or the local hospital can put you in touch with one.
You can also contact the American Diabetes Association, whose website is diabetes.org. Or call 1-800-342-2383. The association will provide you with tons of information on diet and on diabetes in general. The booklet on diabetes presents this illness and its treatments in detail. Readers can obtain a copy by writing: Dr. Donohue — No. 402W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am a 59-year-old man. About five years ago, I had my spleen removed due to a traumatic injury. I was vaccinated with the pneumococcus vaccine. I was told that it would last a lifetime. Does that apply to a person without a spleen? — J.K.
ANSWER: The spleen is an integral part of the immune system. People who don’t have one are more susceptible to infections and, in particular, to pneumococcal infections. The pneumococcus (NEW-moe-KOK-us) causes pneumonia and potentially lethal blood infections. People without a spleen need a second dose of the vaccine five years after the first dose. The pneumococcal vaccine is popularly called the pneumonia vaccine.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.