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On the pulse

September is Irish Heart Month. Rude Health magazine looks at how to prevent heart issues as we age and the role of good and bad cholesterol

Cardiovascular disease (heart disease and stroke) remains one of the leading causes of death and disability in Ireland,” says Dr Angie Brown, medical director of the Irish Heart Foundation. “The risk of developing heart disease increases with age, but this process is accelerated if you smoke, have a high blood pressure, high cholesterol, if you are overweight, are physically inactive, have diabetes and drink excess alcohol. To reduce the risk of premature heart problems it is important for people to get their blood pressure checked, get their cholesterol and blood sugar checked and treated if necessary, eat a healthy diet, stop smoking and take regular exercise. Treating any of these risk factors reduces the chance of suffering from a heart attack or developing heart failure."

Prevention better than cure?

“The heart health epidemic continues to be a result of modern lifestyles and it's still commonplace for people diagnosed with ‘high cholesterol’ to be automatically put onto statin medications,” says Gerald Colfer of health store Only Natural in Wexford town. “This is a result of ignorance of a bigger picture, knowledge which would allow patients to take care of their heart health in a more holistic and supportive way. The first approach should be dietary. This should be based on the knowledge that not all fats are bad for the heart. One review of 72 studies (600,000 people) found no link between saturated fat and heart disease. What it did find was a link between heart health and consumption of trans fats. These are primarily consumed in processed foods like deep fried foods and highly processed foods like cakes and biscuits. On the other hand omega-3 fats found in oily fish, vegetable oils and nuts were found to be beneficial.”

What about cholesterol?

“The jury is still out on cholesterol levels,” says Jill Bell of health store Well and Good in Midleton, Co Cork. “Many experts believe that homocysteine levels are a more accurate indicator of heart disease than raised cholesterol levels, and that the magic figure of 5 mmd/L is more appropriate for a 25-year-old male than, say, a 60-year-old woman. That said, it’s still sensible to keep cholesterol in check, and we would often recommend plant sterols, red rice yeast extract or artichoke to help, as well as adding garlic to food.”

“High cholesterol may be partly due to dietary factors and partly genetic, so in some people a low cholesterol diet can improve your cholesterol to a satisfactory level,” says Dr Brown.

“My tips for lowering cholesterol include: fewer foods from the top shelf of the Food Pyramid such as chocolate, crisps, cakes, biscuits, sweets; get down to a healthy weight – being overweight means the heart has to work harder to pump blood around the body; eat oily fish twice a week; choose lean meats – trim fat off meat and skin off chicken; use healthy ways of cooking, such as grilling or oven baking instead of frying; eat more fruit and vegetables; eat more wholegrain varieties of cereals, breads, pasta and rice; be physically active every day; stop smoking as it raises your cholesterol and increases risk of heart attack and stroke.”

Can the Mediterranean diet help your heart?

“To maintain good heart health, prevention is key, and the starting off point is diet,” says Jill Bell. “The Mediterranean diet has long been suggested as being ideal, and it’s also lovely to eat. Replace butter and saturated fat with olive oil, less red meat and more fish than our traditional diet, lots of antioxidant fruit and vegetables, and flavour-enhancing herbs such as fennel and oregano which also have great immune boosting properties. In general Mediterranean people nibble less than we do between meals, and they eat fewer biscuits, sugary and salty snacks and processed foods. While we don’t live near the Med we have our own heart-healthy foods too, such as oily salmon, mackerel and sardines, oats, pot barley and any amount of wholegrains, sweet potatoes, chard and kale, linseeds, and plenty of (imported) beans, lentils, nuts and seeds.”

“A heart-healthy diet is a typical Mediterranean diet rich in healthy fats from fish, olive oil and avocados, nuts and seeds,” says Gerald Colfer. “It’s a low sugar, low glycaemic diet, high in fibre and largely plant-based with lots of non-starchy, beneficial vegetables like spinach, kale, broccoli, courgettes and red and yellow peppers. Also include beans and pulses instead of grains for variety and protein content.”

What about sugar?

“Excess sugar consumption converts into abnormal blood cholesterol and belly fat,” says Gerald Colfer. “It’s directly linked to unhealthy cholesterol and triglyceride levels and low levels of HDL or ‘good cholesterol’. Sugar in any form, including flour and other refined carbohydrates, and especially high fructose corn syrup commonly added to fizzy drinks and sweet processed foods has the effect of turning on your body’s own cholesterol production factory. This happens in your liver cells and is called lipogenesis. The result is more bad cholesterol, higher triglycerides and less good cholesterol.”

What about your lifestyle?

“Overweight is a significant factor in heart disease, and it’s alarming for the future to know that a third of Irish children are overweight,” says Jill Bell. “Encouraging healthy eating habits in our kids is vital. A firm ‘no’ to crisps and biscuits as regular rewards is a kindness for their future heart health, and there are plenty of healthy substitutes available as sugar- and salt-free snacks, fresh fruit and dried fruit such as apple crisps and chewy bananas. Exercise is also key at any age. It will keep our bodies in good shape, keep the heart muscle ticking over healthily and ward off raised blood pressure. For many people a brisk walk for half an hour three times a week is easily achievable. If you have a desk job it’s sensible to take a couple of minutes' break every hour or so to walk and stimulate circulation.”

Irish Heart Month

The World Health Organisation states that 80% of premature cardiovascular disease cases are caused by an unhealthy lifestyle, and making positive lifestyle changes can improve heart health. Throughout the heart month campaign the Irish Heart Foundation aims to raise awareness of these risks and support people to make small changes for their health.

This year, the campaign, Escape Your Chair, aims to raise awareness of the risks of physical inactivity or sitting down for a long period of time and motivate people to move more and sit less during their day. This September, visit www.irishheart.ie to calculate your sitting time and find out ideas and tips on how to move more and sit less.

Heart-friendly supplements

Amino acid L-Arginine – can help lower blood pressure and help protect against heart disease.

Artichoke - reduces levels of LDL cholesterol, and helps the liver to produce more bile which clears toxins including unwanted cholesterol.

Cayenne – opens up the cardiovascular system and makes it easier for blood to flow through the blood vessels, helping to lower blood pressure.

Co-enzyme Q10 – nourishes and strengthens the muscles of our body, particularly the hard working heart muscle.

Chromium – helps maintain normal blood sugar levels.

Fish oil supplements – impart an improvement in cardiovascular risk and help to thin the blood. A supplement of fish oil with omega-3 will cut down on unhealthy fats called triglycerides.

Green tea – a relaxing drink thought to be helpful in controlling cholesterol.

Hawthorne – as a tea or tincture, is an effective and gentle modulator if the heart is either over- or under-performing.

Magnesium – maintains the regularity of the heartbeat as well as keeping blood pressure within the normal range.

Omega-3 - from fish or plant sources. It is a natural blood thinner and anti-inflammatory, and some omega-3 products combine plant sterols with the oil, doubly useful for the circulatory system.

Potassium – as a food supplement can be very effective in reducing blood pressure.

Sterols and stanols – found in nuts and grains, these compounds help control cholesterol levels. Also available as supplements.

Vitamin C – strengthens artery walls, protects against plaque deposits, and increases the availability of nitric oxide, which helps to improve blood flow.

Other help may include a high strength garlic formulation, vitamin D3, niacin, red yeast rice or lecithin.

Ask your local health store staff for advice.

Can fibre help?

“Having adequate fibre in our diets reduces pressure on the liver which is the organ that produces ‘good’ HDL cholesterol,” says Jill Bell. “In particular oatbran and linseeds bind with excess cholesterol in the bowel and help elimination of toxins.”

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