Q: My husband is a diabetic on Coumadin. How can I help him eat healthy?

I cant seem to find a diet on your site for a diabetic/coumidin person. Husband had open heart surgery in Jan. and I cant seem to cook right... every time he goes to get his coumidin level checked it is different.... he is also a diabetic on oral medication for that....any help would be greatly appreciated.

Q: Dr. Gourmet Says...

The first step is for you and your husband to speak with your physician about the the number of calories he should be eating each day. Many physicians have a dieticians available to their patients. Such referrals are especially helpful and if possible, you should go to the appointment with your husband.

Diabetics need to follow a diet based on a strict number of calories each day. Sometimes the number is to help with weight loss. At the same time it's extremely important for diabetics to eat a balanced diet. One key to this is consuming three regularly scheduled meals each day. Often doctors will recommend that their diabetic patients have a small bedtime snack as part of their diet as well.

The plans found in the eatTHISdiet section on the Dr. Gourmet web site are based on recommendations of the American Diabetic Association and American Heart Association. Using the eatTHISdiet plan with the number of calories recommended by your husband's doctor or dietician is an option.

A lot of the foods that are good are also higher in Vitamin K. One approach to healthy eating for patients on Coumadin® (warfarin) is to eat foods that have a similar amount of Vitamin K each day. For example, one day you could serve your husband brussels sprouts, the next broccoli and the next a salad made with spinach or having cooked spinach as a side dish. By eating a consistent amount of such foods each day the intake of Vitamin K is likely to be more stable.

Another approach is to eliminate foods that are high in Vitamin K from the diet altogether This is an easier approach but you have to make sure to feed your husband other vegetables. There are a LOT of veggies that don't have very much Vitamin K in them.

You can find an eatTHISdiet plan - Coumadin Users Diet on the website. This plan is based on guidelines by the American Diabetic Association and the American Heart Association and should be appropriate for your husband to help him control his diabetes. Every recipe has information about whether the dish might be an issue for those taking warfarin.

There are also food lists on the site to help guide you. They range from very basic information about Vitamin K content to very detailed. Here are the links:

http://www.drgourmet.com/md/warfarinbrief.pdf

http://www.drgourmet.com/md/relativewarfarinlist.pdf

http://www.drgourmet.com/md/warfarincomprehensive.pdf

Thanks for writing,

Dr. Gourmet
Eat well, eat healthy, enjoy life!