Prevent Heart Disease

M Most importantly- more so than any other factor you can change- DON’T SMOKE. Sister at the surgery can give you a leaflet with a few tips that can double your chances of stopping smoking in the long-term. It’s not going to be easy- but stopping smoking is the single most important step to stop you having heart problems.

M get regular exercise- at least three times a week, sufficient to work up a least a sweat for more than 20 minutes. As you get fitter, increase the amount you take. Brisk walking, heavier gardening, running, biking, swimming, going to the gym, it doesn’t matter. Forget the lift, use the car less.

M have your blood pressure checked once every five years or so- not necessary more than once every 3 - 5 years, unless you have a problem identified.

Ì If you do have a problem, consider buying your own simple to use BP monitor from the chemists for about £40- should be VAT free. The readings you take relaxed at home are of far more value than the odd one in the adrenaline -provoking surgery.

Ì Target level is about 140 / 85, though somewhat higher levels may have to be accepted if reduction causes you problems- you’ll be discussing this with the surgery.

Ì Reducing the amount of salt you eat can help everybody keep their blood pressure down. Don’t add salt at the table, use LoSel if you must, avoid salty foods, crisps, nuts etc.

M Alcohol- yes, in moderation it can help, particularly red wine- but no more than 14 units a week for a woman, 21 units for a man. A unit is one pub wine glass of wine, a pub measure of spirits, or half a pint of beer

M If you have a family history of diabetes, have your urine checked for sugar every 3 years, or if you develop symptoms of thirst, weight loss and passing a lot of urine

M try to keep your weight down. Being a stone or two overweight is no big deal- and far far better than smoking- so work at it slowly

M Eat a healthy diet. Mediterranean style diets prevent heart disease.

Ì Eat five portions- each as big as your fist- of fruit and vegetables every day

Ì cut down on meat and fats. Cut off visible fat from meat

Ì eat lots of fibre.

Ì Eat lots of brown rice, pasta, potatoes- not chips!

Ì use a low-fat spread, sparingly

Ì throw away your frying pan. Bake, grill, poach instead

Ì remember the Healthy Eating Plate- lots of filling whole foods at the right, just a few fats and sugars on the left.

M don’t get too fixated on cholesterol. It’s not the main thing in preventing heart disease- smoking is-, though it is more important if you do have established hardening of the arteries or heart disease, or perhaps several of the other risk factors mentioned above. Just concentrate on changing to a healthy diet for all the rest of your life.

Drugs

Aspirin in low dose should be taken if at all possible by all those with established heart disease. It can cause indigestion. It shouldn’t be taken by everybody though, as it can increase the risk of stroke- if you’re at low risk of heart attack, that increased risk of stroke can outweigh aspirin’s heart benefits.

Anti-coagulants such as warfarin in low dose may help those at high risk of heart disease.

Beta-blocker drugs should be taken if at all possible by all those who have had a heart attack. They can’t be used if you have asthma.

Unproven But Interesting Stuff in the Research Pipe-line

Anti-oxidant vitamins- vitamins A, C (500 mg a day?) and E (400 units a day?) - may help prevent the damage to the blood vessels, but can be dangerous in excess. See Mediterranean Diet comments- keep munching the 5 portions of fruit and veggies!

Homocysteine- an amino-acid in our diet- may be even more of a problem than cholesterol. Folic acid, Vitamin B6 (pyridoxine, 10mg a day?) and B12 (1 mg. a day?) in the diet may help lower it. Those fruit and veggies will help!

Streptococcus toxins from dental plaque on our teeth may help trigger off the final clot that causes a heart attack. Good dental hygiene may help reduce this. It won’t do any harm!

Fibrinogen is the stuff clot is made of- smoking raises the level of this in the blood.

Lecithin may have a role in breaking down cholesterol to be transported away

HEALTHY EATING HINTS .

*CHOOSE THESE-* *starchy, high fibre foods, fruit & veggies*	*IN MODERATION-* *a little of what you fancy*	*AVOID-* *fats, sugars to excess- but enjoy your food!*
*CEREAL FOOD*
Wholemeal bread & flour, oatmeal, wholegrain cereals, porridge oats, crispbreads, wholegrain rice and pasta, sweetcorn.	White flour, white bread, sugar coated breakfast cereals, white rice, pasta	Fancy breads e.g. croissants, savoury cheese biscuits, cream crackers
*FRUIT & VEGETABLES*
All fresh and frozen vegetables - peas, broad beans, sweetcorn. Dried beans and lentils are particularly high in fibre. Baked potato - eat skins wherever possible. Fresh fruit. Dried fruit	Chips- once a week, if you really must, if cooked in suitable oil-see below avocado pears, olives.	Potato crisps, chips cooked in unsuitable oil or fat
*NUTS.*
Walnuts	Almonds, brazil nuts, chestnuts, hazelnuts, peanuts.	Coconut.
*FISH*
All white fish, oily fish, (not fried) e.g. herrings, tuna	Shellfish occasionally.	Fish roe.
*MEAT (LEAN)*
Chicken, turkey, veal, rabbit, game.- 2-4 oz. portions	Ham, beef, pork, Iamb, bacon, lean mince, liver and kidney occasionally.	Visible fat on meat (including crackling). sausages, pate, duck, goose. streaky bacon, meat pies, meat pasties.
*EGGS & DAIRY FOODS*
Skimmed milk, skimmed milk cheese e.g. cottage and curd cheese, egg white (3- 5 egg yolks per week only) Low fat yoghurt	Edam cheese, Camembert. Parmesan.	Whole milk, cream, hard cheese, stilton, cream cheese, excess egg yolks.
*FATS*
All fats should be limited	Margarine labelled 'high in polyunsaturates', olive oil, corn oil, sunflower oil, soya oil, safflower oil. “Benecol” spread can actually lower cholesterol	Butter, dripping, suet lard, margarine not 'high in polyunsaturates” cooking/vegetable oil of unknown origin.
*MADE - UP DISHES*
Skimmed milk puddings, low fat puddings, e.g. jelly, sorbet, skimmed milk sauces Pastry, puddings, cakes and biscuits made with suitable margarine or oil and wholemeal flour	Pastry puddings, cakes and biscuits made with suitable margarine or oil and white flour. Ice-cream,	Tinned or whole milk puddings, dairy ice-cream, pastry, puddings, cakes, biscuits and sauces made with whole milk, eggs or unsuitable fat or oil. All proprietary puddings and sauces. Mayonnaise
*SWEETS, PRESERVES AND SPREADS*
Bovril, Oxo, Marmite. aspartame sweetener- (Canderel) Non-sugar gum. Non-sugar sweets, eg no sugar Polos	Meat and fish pastes, boiled sweets, fruit pastilles, peppermints, etc., Jam, marmalade, honey, sugar.	Peanut butter, chocolate, toffees, fudge, butterscotch, lemon curd, mincemeat
*DRINKS*
Tea, coffee, mineral water, unsweetened fruit juices, clear soups, homemade soups e.g. vegetable, lentil,	Packet soups, Alcohol- red wine especially, but no more than 21 units a week	Cream soup