If you have type 2 diabetes, you've already had a heart attack-whether you've had one or not!

"The guideline for physicians from the American Heart Association are to treat a person with diabetes as if that individual has already had a heart attack," says cardiologist Seth Baum, MD, medical director of Integrative Heart Care in Boca Raton, Florida, and author of The Total Guide to a Healthy Heart.

How does diabetes hurt your heart?

As excess sugar careens through the blood stream, it roughs up the linings of the arteries.

Insulin resistance (the subpar performance of the hormone that moves glucose out of the bloodstream and into muscle and fat cells) raises blood pressure, damaging arteries.

Diabetes also injures tiny blood vessels called capillaries, which hurts your kidneys and nerves-damage that in tum stresses the heart.

The end result-an up to seven-fold increase in the risk of heart disease and stroke, the cardiovascular diseases (CVD) that kill four out of five people with diabetes.

But recent studies show there are several natural ways for people with diabetes to reverse the risk factors that cause heart disease...

Recent Research

It's never too late to exercise-and a little goes a long way. Researchers at the University of British Columbia in Vancouver, Canada, studied 36 older people (average age 71) with . type 2 diabetes, high blood pressure, and high cholesterol, dividing them into two groups.

One group walked on a treadmill or cycled on a stationary bicycle for 40 minutes, three days a week. The other group didn't.

To find out if the exercise was helping with CVD, the researchers measured the elasticity of the arteries-a fundamental indicator of arterial youth and health, with arterial stiffness increasing the risk of dying from CVD.

Results: After three months, the exercisers had a decrease in arterial stiffness of 15% to 20%.

"Aerobic exercise should be the first-line treatment to reduce arterial stiffness in older adults with type 2 diabetes, even if the patient has advanced cardiovascular risk factors" such as high blood pressure and high cholesterol, conclude the researchers, in Diabetes Care.

What to do

Kenneth Madden, MD, the study leader, and associate professor of geriatric medicine at the University of British Columbia, says, "You can improve every risk factor for diabetes and heart disease-and you can do it in a very short period of time."

Dr. Madden recommends that older people with diabetes and cardiovascular disease see a doctor for a checkup before starting an exercise program.

Once you get the okay from your physician, he says to purchase and use a heart monitor during exercise, so you're sure that you're exercising at the level used by the participants in his study-6o% to 75% of maximum heart rate.

Example: An estimate of your maximum heart rate is 220, minus your age. If you're 60, that would be 220 - 60 = 160. Exercising at between 60% to 75% of your maximum heart rate means maintaining a heart rate of between 96 and 120 beats per minute.

Finally, Dr. Madden advises you exercise the amount proven to improve arterial elasticity-a minimum of three sessions of aerobic exercise a week, of 40 minutes each.

Maximize magnesium. Researchers in Mexico studied 79 people with diabetes and high blood pressure, dividing them into two groups. One group received a daily 450 milligrams (mg) magnesium supplement; one didn't.

Results: After four months, those on magnesium had an average drop of 20 points systolic (the higher number in the blood pressure reading) and 9 points diastolic (the lower number). Those on the placebo had corresponding drops of 5 points and 1 point.

"Magnesium supplementation should be considered as an additional or alternative treatment for high blood pressure in people with diabetes," says Fernando Guerrero-Romero, MD, the study leader.

What to do: "Magnesium acts as a natural vasodilator, relaxing arteries and lowering blood pressure," says Dr. Baum. "People with diabetes should incorporate a magnesium supplement into their regimen."

He suggests a daily supplement of 400 mg, about the level used in the study.

"People with diabetes and high blood pressure should also be encouraged to increase their dietary intake of magnesium, through eating more whole grains, leafy green vegetables, legumes, nuts and fish," says Dr. Guerrero-Romero.

Eat like a Neanderthal. Researchers in Sweden tested two diets in 13 people with type 2 diabetes-the diet recommended by the American Diabetes Association (ADA), a generally healthful diet limiting calories, fat and refined carbohydrates; and a "Paleolithic" diet, consisting of lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts-and no dairy products, refined carbohydrates or highly processed foods, whatsoever.

In terms of lowering risk factors for heart disease, the Paleolithic diet clubbed the ADA diet.

Results: After three months, it had done a better job of decreasing...

• High LDL "bad" cholesterol,

• High blood pressure,

• High triglycerides (a blood fat linked to heart disease) and

• Too-big waist size (excess stomach fat is linked to heart disease).

The diet was also more effective at increasing HDL "good" cholesterol.

And it was superior in decreasing glycated hemoglobin (A1C), a measure of long-term blood sugar control.

"Foods that were regularly eaten during the Paleolithic, or Old Stone Age, may be optimal for prevention and treatment of type 2 diabetes, cardiovascular disease and insulin resistance," concludes Tommy Jonsson, MD, in Cardiovascular Diabetology.

What to do: "Eating a Paleolithic diet is far easier than most people think," says Robb Wolf, owner of NorCal Strength & Conditioning in Chico, California, and author of The Paleo Solution.

The Basic Diet

Eat more-lean meat, fish, shellfish, fruits, vegetables, eggs and nuts.

Eat less (or eliminate)-grains, dairy products, salt, refined fats and refined sugar.

Resource: You can order pre-packaged Paleolithic snacks and meals at www.onestop paleosbop.com.

• Have a cup of hibiscus tea. Researchers in Iran studied 53 people with type 2 diabetes, dividing them into two groups. One group drank a cup of hibiscus tea twice a day; the other drank two cups a day of black tea. (The hibiscus tea was made from Hibiscus sabdariffa, which is also known as red sorrel, Jamaican sorrel, Indian sorrel, roselle and Florida cranberry.)

Results: After one month, those drinking hibiscus had...

• Higher HDL "good" cholesterol,

• Lower LDL "bad" cholesterol,

• Lower total cholesterol and

• Lower blood pressure.

The black tea group didn't have any significant changes in blood fats or blood pressure.

The findings were in The journal of Alternative and Complementary Medicine and the journal of Human Hypertension.

What to do: Consider drinking a cup or two of hibiscus tea a day, says Hassan Mozaffari Khosravi, PhD, an assistant professor of nutrition, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, and the study leader.

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