So my father in law is coming to visit and he’s 89, diabetic, and in congestive heart failure . I asked him what type of food I should have for him and he insisted that I should just make what we always make for breakfast, lunch, dinner, etc.
However, he always likes to be low maintenance and never complains, and I know he has dietary restrictions…but he won’t tell me what they are. A google search tells me that diabetics should “limit” sugar and starch (which seems to rule out a lot of what we normally eat, but I’m not exactly sure how they define “limit”)…but he has the added issue of being in heart failure, so I ask you dopers: what should I prepare for meals?
I’m thinking that lean protein and vegetables are ok, but I’m hoping someone in the know can give me some guidance. Anyone?
I don’t know anything about congestive heart failure, but I got the diabetes thing handled.
Of course, it’s hard to generalize, without knowing what type of diabetes your F-i-L has, what kind of treatment he’s on, and what he likes to eat, but in general:
think low carb. It’s not just sugar and starch, it’s all carbs. Blood-sugar-wise, an apple is just as tricky as a cookie.
Breakfast is the most difficult meal to make low-carb. Eggs & meat & veggies are good (crustless quiches are great if he’ll eat 'em). Full-fat yogurt is also good (the lowfat tends to make up for it by being higher in carbs). If he wants to have toast, get whole grain/hi fiber bread. Steel-cut oats are also good. Breakfast cereal/muffins/etc are to be avoided.
For lunches and dinners: Soups/stews, as long as they’re light on noodles & potatoes. Watch the carbs on store-bought soups, they can get high. Once again, think “meat with a side of veggies”: steak with broccoli, chicken with roasted veggies, etc.
Snacks: cheese, salami, sausage, hard boiled eggs, nuts. All yummy and harmless to the blood sugar.
That’s the basics. It’s pretty much just a healthy diet for anyone, regardless of diabetes. But I want to stress - overall, go with what he wants. He’s probably got his own likes/dislikes, and even if he’s doing something unhealthy, you probably don’t want to try to fix him. Heck, he’s 89 years old and visiting you, that speaks to doing something right!
He may be fluid restricted.
Many people in heart failure are advised not to take in more than 1500mls of fluid a day. You may not want to make a lot of soup (also, hard to make a tasty low salt soup) and juices or to keep topping up his glass or offering drinks.
Low fat, low salt, low sugar, unrefined carbs, lean protein, lots of oily fish, lots of green veg and salad would be the ideal, medically, but probably not that fun for him. Allow yourself some room to manoeuvre.
Watch the bread, prepared snacks and cold cuts- BIG sources of salt.
Depending on his medications, he may need to watch his potassium intake as well (tomatoes, bananas, orange juice, avocados and low-sodium salt alternatives are all sources of potassium).
In a pinch, if you have an HMO and access to calling the nurse help line, you could give them a call and ask for suggestions.
I know what I like to eat, diabetic with high blood pressure.
I normally have oatmeal with cinnamon and a couple tbsp of raisins as sweetening [or sometimes a couple tbsp unsweetened applesauce] and on weekends I splurge on a 2 egg omelet made with a a couple tbsp salsa and shredded cheddar cheese as sort of a low rent huevos rancheros. I have 1 slice of pepperidge farms ancient grains bread as toast with smart balance and my weekly cup of real coffee [i detest decaf and much more than 1 cup of coffee gives me palpitations. Isn’t that a great victorian word?]
My nutritionist signed off on my salad that I always have for lunch, it has cabbage as the base instead of lettuce, but romaine is great as is spinach as part of a chopped salad. I use canned garbanzo beans as the protein, which might be a bit high in salt. I also shred in a carrot, celery and chop up about 6 black olives, also they may be a bit high in salt. I make my own olive oil and balsamic vinaigrette. Total volume of the salad is 2 cups.
I might emphasize portion control also - I would suggest you bring everybody’s dinners out already plated instead of a grab for your own food family style. That way he won’t be tempted to eat too large an amount of something he shouldn’t. A classic three plop is indicated [1 portion of meat, 2 half cup portions of vegetables. Go easy on sauces and condiments. Season with herbs and spices, not glopy sauces that can hide carbs, salt and sugars. ]
Just to clarify, FIL has type 2 diabetes, is non-insulin dependent, takes lasix (diuretic) and a whole host of other meds for his heart disease/chf.
So I’m thinking, if I do a low fat/low sodium version of Athena’s diet, that should be good. Lean meats and vegetables (kind of like the Dukan diet). The only thing I’ll have to modify is to add some ‘good’ fats, because he definitely does not need to lose any weight. I’ll also get some Smart Balance.
And irishgirl, if you check back in…let me know if fluids have to be controlled if he is taking lasix. Just to be on the safe side though, I won’t serve soup or top off his drinks.
Also, upon re-reading my op, it sounds like FIL is at death’s door. Not the case at all …or at least he doesn’t act like it. He is totally lucid and funny, gets around no problem (though he gets a little out of breath if he walks up a hill). So we want to keep him around as long as possible, hence the question. Thanks again, all!
Lasix gets rid of excess salt from the body. Most, maybe all people (at some point) with heart failure, retain excess salt in their bodies. As a rule, anyone using Lasix for heart failure should probably also be restricting their intake of dietary salt.
On the other hand, water (fluid) restriction is only needed for people with heart failure whose body is holding onto water above and beyond its tendency to hold onto salt. This can only be determined by measuring the concentration of sodium in the blood looking for hyponatremia* (low blood sodium concentration). If the sodium concentration is low it means that is has been diluted down by excess water.
Most people with heart failure do not require fluid restriction since most people with heart failure do not hold onto much extra water (this is very different than holding onto salt/sodium).
As an (arrogant) aside, IMO most docs do not understand the difference in pathophysiology and rationale for water (fluid) versus sodium (salt) restriction.
*much of (its various versions) written by yours truly
Thank you, KarlGauss. I actually do not know if he is holding on to salt or water and he likely will not tell me, but I do know he had fluid in his lungs which is why they gave him the lasix. He is very knowledgeable about his medical issues, but VERY private and does not want any special treatment (e.g. special meals prepared on his behalf). That is why I am trying to plan meals (for a week!) that the whole family can eat.
Also do you think shellfish is too high in sodium for him…given the very limited information I’ve given you? I’m not clear whether it tastes salty (at least to me) because of added salt or because it comes from the sea. Any idea?
Just don’t be too dogmatic. It’s really extremely hard to go both low-fat and low-carb. I’d try to think healthy fat/healthy carb, meaning veggies, whole grains, moderate portion of fruit. And I’m sure someone else can chime in on healthy fats. I’m afraid I consider just about all fat healthy, so I’m not the best resource there.
Maybe eggs scrambled in a non-stick pan with peppers and onions for breakfast. Grapefruit sections and avocado slices as a luncheon salad with a little vineagrette. Baked apples or pears. Baked or roasted chicken with sweet potatoes or wild rice. Roast beef with a lot of herbs and garlic.