Spotlight on… heart disease
Coronary heart disease is the single biggest killer in the UK today. While some risk factors are non-modifiable, there are many lifestyle choices you can make that can help to keep your heart healthy. Nutritionist Jo Lewin explores the effect different foods have on heart health and suggests recipes to help you on your way…
We are repeatedly told that eating a balanced diet can improve our health, both now and in the future. Diet plays an important role in the prevention of coronary heart disease. Maintaining a healthy weight can also help keep blood pressure within the normal range.
What is heart disease?
Heart disease or cardiovascular disease (CVD) includes all diseases of the heart and circulation including coronary heart disease (angina and heart attack) heart failure and stroke. CHD and stroke may be caused by the process of atherosclerosis, which happens when the arteries (that supply the heart and brain with oxygen-rich blood) become narrowed by a gradual build up of fatty material within their walls. In time, the arteries may become so narrow that they cannot deliver enough oxygenated blood to the heart muscle when it needs it. The pain or discomfort that this can cause is called angina. A heart attack can cause permanent damage and happens when a narrowed coronary artery becomes blocked by a blood clot, so oxygenated blood cannot reach the heart. A stroke happens when a blood clot blocks an artery that carries blood to the brain or when a blood vessel bursts and bleeds into the brain – starving brain cells of oxygenated blood.
What causes heart disease?
There are certain things about you and your lifestyle that can increase your risk. Risk factors that you can do something about include:
- Having high cholesterol
- High blood pressure
- Being overweight
- Having diabetes
- Being physically inactive
Risk factors that you can’t control include:
- Family history of cardiovascular disease
- Your ethnic background
- Your age – the older you are, the more at risk you are of developing cardiovascular disease
- Your sex - research shows that men are more likely to develop CHD at an earlier age than women
Food for a healthy heart
Get your five-a-day
Eating a diet rich in a range of fruits and vegetables can help to lower the risk of heart disease. Fruit and vegetables are full of vitamins, minerals, fibre and other nutrients, all of which may play a role in helping to reduce our risk of coronary heart disease in different ways. Fresh, frozen, chilled, canned or dried fruit and vegetables along with beans, pulses and 100%, unsweetened juice (not from concentrate) all count. Aim to eat at least five portions of a variety of fruit and vegetables a day.
Get all five of your 5-a-day in one dish with our 5-a-day recipe collection.
Fruit and vegetables are rich in antioxidants and potassium, a mineral that may help to control blood pressure and regulate your heartbeat. Fruit, green leafy vegetables and root veg are also rich in folate, which is essential for the formation of blood cells and helps control the level of a compound called homocysteine in the blood. There is growing evidence that people with high levels of homocysteine may have a higher risk of CHD.
The message regarding this macronutrient is clear. Keep saturated fat within Reference Intakes (RI) or guideline daily amounts and focus on heart-friendly fats. Heart-friendly fats include the monounsaturated and polyunsaturated fats found in olive oil, avocado, nuts and seeds (and their oils) and oily fish. Cut down on pastries, crisps and biscuits and eat more fruit and vegetables.
Saturated fat is frequently vilified as it is linked to cardiovascular disease. Red meat, butter, cheese, burgers and sausages, are high in saturated fat, as are ghee, coconut and palm oils. A diet high in saturated fat can increase blood fats including triglycerides as well as increase your risk of obesity, heart disease, type 2 diabetes and stroke. However, recent studies are now suggesting that the saturated fats in certain foods such as those in dairy products including cheese, do not appear to be as harmful as once thought. This may be because other nutrients in dairy, like calcium, may modify the effects on blood fats such as triglycerides.
Aim to eat two portions of fish a week, at least one of which should be oily. Oily fish provides the richest source of omega-3 polyunsaturated fats that can help lower blood triglyceride levels. Eating oily fish regularly can help to reduce the risk of coronary heart disease. Choose oily fish such as herring, mackerel, pilchards, sardines, salmon and trout.
If you don’t like oily fish, there are some vegetarian sources of omega-3 fats that you can include in your diet. These include flaxseeds, flaxseed oil, rapeseed and walnuts. The type of omega-3 fats in these foods is a less potent form than you find in oily fish, so you will need to eat them regularly.
Fibre can also help reduce the amount of cholesterol absorbed into your bloodstream. Try to include, porridge oats, beans, pulses, lentils, nuts, fruits and vegetables. They are all high in soluble fibre, which can help lower cholesterol. A high fibre diet also helps fill you up, making you less likely to snack on fattening foods.
Try to reduce the amount of salt you eat as regularly eating too much is linked to raised blood pressure. On average, people in the UK are eating more salt than they need. It is recommended that adults have no more than 6 grams of salt a day. That is about one teaspoonful. Don’t add salt to your food at the table and try to use herbs, garlic, spices or lemon juice to add flavour.
Salt is hidden in foods such as packet/canned products, instant noodles, soups, ketchups, sauces and salty savoury snacks, as well as the everyday foods we eat like bread and breakfast cereals, so it’s important to use nutritional information on the front or back of packs to make low salt choices. Many everyday foods such as bread and cereals contain a lot of salt too.
Often high in saturated fat, salt and sugar, processed foods can pose a quandry when trying to eat healthily. Cook from scratch more often, using whole, fresh and if possible, seasonal ingredients. Also always check food labels in order to make an informed decision before you buy.
It is important to stick to recommended limits for alcohol - 14 units a week. Avoid binge drinking and if you do over indulge, avoid alcohol for the following 48 hours. Alcohol is also high in calories and even a small amount can increase your appetite and so can be linked to weight gain. For more information on healthy drinking habits, visit drinkaware.co.uk.
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This article was last reviewed on 27 June 2019 by Kerry Torrens.
A qualified nutritionist (MBANT), Kerry Torrens is a contributing author to a number of nutritional and cookery publications including BBC Good Food magazine. Kerry is a member of the The Royal Society of Medicine, Complementary and Natural Healthcare Council (CNHC), British Association for Applied Nutrition and Nutritional Therapy (BANT).
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