A Healthy Heart

Heart attacks affect one in four deaths in men and one in six deaths in women in the UK. The risk factors for heart disease include high cholesterol, high blood pressure, bad diet, obesity, lack of exercise, excess alcohol intake and high levels of stress.

Apart from a genetic predisposition, nearly all these risk factors can be avoided with diet and lifestyle changes. There are three basic scenarios that can produce a heart attack. 1) Partial or complete blockage of one of the arteries that supply the heart with oxygen, most often a blood clot. 2) An arrhythmia may set in so that the heart is no longer pumping enough blood to ensure its own supply. 3) A weak spot in a blood vessel called an aneurysm may rupture and cause internal bleeding.

No one knows exactly why some people develop heart disease and others do not but a number of significant factors and clues have been identified.

1. Homocysteine,  an amino acid formed as a result of the metabolism of another amino acid, methione which is essential for normal growth. Too much homocysteine is toxic to the vascular system and is strongly associated with atherosclerosis. High homocysteine levels can be detected in over 20% of people with heart disease. (This test is still not readily available on the NHS so sometimes needs to be done privately - please call me for more details on 01323 71784).

2. High levels of blood fats specifically certain lipoproteins and triglycerides are also associated with the increase in heart disease. Lipoproteins are molecules that transport cholesterol in the bloodstream, there are two principal types; LDL and HDL. High levels of LDL can lead to the formation of fatty plaques. High levels of HDL however appear to carry cholesterol away form the arteries and back to the liver. Triglycerides are lipids that bind to protein to form the high and low density lipoproteins. As with LDL triglycerides levels are associated with atherosclerosis. Eating too many fatty foods, drinking too much alcohol or having high insulin levels can results in elevated triglycerides levels.

Another possible factor could be 3. Insufficient amount  of antioxidants - antioxidants render free radicals harmless and help the body dispose of toxic substances that may cause cellar damage. 4. High levels of fibrinogen a blood clotting protein may also be involved. If these levels are high the blood is more likely to clot.

With all this is mind can we do anything to prevent heart disease - below I've set out some basic tips on:

How to avoid heart disease

• Get your cholesterol, hdl/ldl, triglycerides and homocysteine tested by the time you are 40 yrs of age, particarly if you have a genetic history of heart disease.
• Get your blood pressure checked yearly over the age of 40 yrs.
• Do not smoke or exceed the recommended weekly units of alcohol (3-4 units for men and 2-3 units for women).
• Your health is more at risk if you have a large waist size (for men - over 40 inches and women over 35 inches).
• Get regular exercise three times a week.
• Avoid stress and anger - use yoga/meditation/ exercise to help reduce stress levels.
• Eat oily fish, high in omega 3 three times a week. (tinned tuna does not count!).
• Cut out saturated fat, trans fat and hydrogenated fat in your diet.
• Avoid all refined sugar and processed foods.
• Avoid animal products, pork and pork products, fried and fatty food.
• Good fat is needed so avoid faddy low fat diets - do include oily fish, nuts, seeds, avocadoes, olive oil and margarine (include one with plant sterols). You can eat a few eggs a week - (they do not increase cholesterol as much as originally thought!).
• For high cholesterol, eat garlic liberally in your diet, and include apples, carrots, oily fish, pulses and plenty of fibre in the forms of fruit and vegetables and whole grains -  (fibre can reduce serum cholesterol) - this can be found in barley, beans, brown rice, oats and psyllium husks.
• For high blood pressure, follow a strict salt free diet i.e. eliminate ALL salt from your diet. Read labels carefully, this will include MSG, baking soda, canned foods, and over the counter medications e.g. ibuprofen, sugar substitutes and soy sauce. Eat a high fibre diet and take supplemental fibre i.e. psyllium. Eat plenty of fruits and vegetables e.g. apples, bananas, broccoli, cabbage, garlic, grapefruit, green leafy vegetables, peas, squash and sweet potatoes.
• Avoid ALL animal fats and aged cheeses.

Many of my patients over the age of forty have no idea what their cholesterol or blood pressure is, and bearing in mind I have seen people as young as nineteen with high cholesterol, I say its never to early to know what they are!!  Last year a male patient of mine whose cholesterol was 9.4, with very high triglycerides and high LDL levels with a rigorous diet and supplement programme managed to get his cholesterol down to 5.2 within eight weeks - his consultant was delighted!

If you have been diagnosed with high cholesterol/high blood pressure and your GP is in agreement for you to try diet and exercise strategies first, before medication, do see a qualified nutritionist who will be able to help. It is possible to bring down cholesterol levels within about two months but you will need advice on how to go about this. If you would like your homocysteine tested it is still not widely available on the NHS and is very easy to bring down to normal levels if raised (please call me on 01323 737814 or email at katenut@aol.com if you would like your levels tested privately).