Ask Dr. Gourmet

I am a diabetic on Coumadin. What should I eat?

I need to know about diets on Coumadin, Like what not to eat, but I also am a diabetic. Can you help me with what to do?

Dr. Gourmet Says...

The first step is for you to speak with your physician about the the number of calories you should be eating each day. Many physicians have dietitians available to their patients. Diabetics need to follow a diet based on a strict number of calories each day. Sometimes the amount of calories is to help with weight loss as well as controlling blood sugar.

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 created using The Dr. Gourmet Diet Plan software on the Dr. Gourmet website will have you following a Mediterranean-style diet, which our most recent evidence shows is the best diet for diabetics. Using the planner with the number of calories recommended by your doctor or dietitian is an option.

A lot of the foods that are good for you 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 eat spinach and the next day broccoli. Then you could have a salad made with lettuce or cabbage as a side dish. By eating a consistent amount of such foods each day, your 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 eat other vegetables. There are a LOT of veggies that don't have very much Vitamin K in them, however.

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,

Timothy S. Harlan, MD, FACP
Dr. Gourmet

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