World Heart Day – 29th September 2012
Believe it or not, the disease that claims the most lives in the UK is not cancer, but Coronary Heart Disease. Cardiovascular disease (heart attack and stroke) kills around 82,000 people in the UK every year. Worldwide this figure is an estimated 17 million people. There are currently about 2.7 million people in the UK diagnosed with Coronary Heart Disease of which approximately 1.6 million are under 75. Why am I giving you these statistics? Well this Saturday (29th September) is World Heart Day, a day devoted to raising awareness of the dangers of heart disease and the steps we can take to help prevent it.
Heart disease and family history
As with many diseases, some people are more likely to develop cardiovascular disease than others. Studies have shown that ethnicity has a part to play – for example, South Asian people living in the UK are 1.5 times more likely to die from Coronary Heart Disease before the age of 75 than the rest of the population. Similarly, if you have a family history of heart disease in the family, you have a greater risk factor than somebody else following a healthy lifestyle with no family history. A family history is defined as a father or brother diagnosed with cardiovascular disease under the age of 55, or a mother or sister diagnosed under the age of 65. However, just because a member of your family has fallen victim to the disease it does not necessarily follow that you will too.
Smoking and high blood pressure
The likelihood of having a heart attack is determined by a number of other risk factors, the majority of which concern lifestyle and eating habits. If you smoke, for example, you are twice as likely to have a heart attack as someone who has never smoked. But even if you have smoked up to this point, stopping now will reduce your chances. Other risk factors include high blood pressure (hypertension), which can be checked using a blood pressure monitor. You should be looking to have a blood pressure reading in the region of 140/85mmHg. If it is higher, you can help to control it by losing weight, eating healthily and reducing alcohol and salt intake. Medication to control blood pressure is also available on prescription from your doctor.
Obesity and diet
Overweight and obese people are at a much increased risk of heart disease. This is because they generally consume a diet rich in fat, which increases the level of cholesterol in the blood. This clogs the arteries, causing the heart to work harder to pump blood around the body. Forcing blood through arteries which are too narrow leads to high blood pressure, which also increases the risk. Cholesterol is produced in the body and plays an essential role in how our cells work. There are two types of cholesterol: LDL (Low Density Lipoprotein) and HDL (High Density Lipoprotein) as well as fatty substances called Triglycerides. Without getting too technical, HDL has a protective function, whereas too much LDL in the system is not good for the heart.
Good fat vs. Bad fat
Some fat is essential for a healthy diet, so we should never cut it out completely, but we do need to be mindful that the type of fats we consume could have either a beneficial or detrimental effect on heart health. Conventional advice from the British Heart Foundation and others is that in order to reduce cholesterol we need to cut down on the saturated fats we eat (e.g. butter, lard, margarine) and instead use olive oil, sunflower oil, rapeseed, oils and polyunsaturated or monosaturated spreads . Oily fish is also good for the heart since it contains Omega 3 oil it is suggested that we eat at least two portions of this per week. Dieticians also recommend a high fibre diet derived from beans, pulses, fruit, vegetables, oats, nuts and lentils. Even cholesterol-containing foods like eggs and shellfish are more beneficial for the body than fatty foods –as long as they are part of a balanced diet.
Fat and Cholesterol – the alternative view
Conventional wisdom on diet and heart disease is not shared by everybody and there is now compelling evidence to suggest that high levels of blood cholesterol do not increase the risk of heart disease. The conventional wisdom on heart disease, which is currently promulgated by the health professionals, is based on the Diet-Heart Theory which concludes that the higher the level of blood cholesterol (TC) the greater the risk of heart disease. Hence it follows that if the TC is lowered there will be a corresponding reduction in the chances of developing heart disease. This is the justification for advising people to reduce their intake of saturated fat (SFA) because it claimed that SFA tends to push up the TC. A similar rationale is used to justify the prescription of cholesterol-lowering drugs such as statins.
Our Chairman, Dr Verner Wheelock, has been studying the relationship between fat, cholesterol levels, obesity and mortality rates and has reached the following conclusions, backed by several independent studies, which fly in the face of what we have come to accept as sound nutritional advice:
A detailed re-examination of the original scientific evidence coupled with the latest research demonstrates that the Diet-Heart Theory is flawed for the following reasons:
- An association does not demonstrate that there is cause and effect and there is definitely no reliable science to show that lowering cholesterol actually lowers the risk of heart disease. There may well be an association between the number of ambulances and the frequency of road accidents across the country but this does not mean that if the authorities cut down on the ambulance service that there will be a corresponding reduction in the road accident rate.
- Although there is an association between TC and heart disease rate in middle-aged men this does not apply to men or women over the age of 50 years.
- There has been a mistaken emphasis on heart disease to the exclusion of other causes of death. There is now good evidence that at low TC levels the all-cause death rate actually increases. There are also indications that low TC levels may reduce the effectiveness of the body’s immune system and contribute to the development of Alzheimer’s Disease. Furthermore repeated studies confirm that for people over 70 years old the higher the TC the greater the life expectancy.
Dr Wheelock concludes that there really is no case for reducing the consumption of SFA or any other fat for that matter with the exception of the trans fatty acids, which are being steadily eliminated by the food industry. During the last 25 years the amount of fat consumed in the typical British diet has fallen significantly…..at the same time the incidence of obesity has soared. Diabetes which is a critical risk factor for heart disease has more than doubled in the last 20 years.
Exercise – the heart is a muscle
The heart is a muscle, so regular exercise is a must for keeping it in shape. This doesn’t mean that you have to start training for the London Marathon, or spend 3 hours per day in the gym, but it does mean that you should perform some type of aerobic exercise. Swimming and walking are good examples, as are gardening, cleaning or climbing the stairs. The heart will also be strengthened by doing some resistance training using bands, weights, or even carrying heavy shopping.
To recap, then, to keep our hearts healthy we need to:
- Stop smoking
- Reduce salt and alcohol intake
- Eat a healthy diet, including 5 portions of fruit and veg per day
- Eat mostly polyunsaturated or monosaturated fats and spreads
- Eat oily fish
- Exercise
- Try and reduce the levels of stress in our lives
More information about heart disease and how to have a heart-healthy lifestyle can be found on the British Heart Foundation’s website www.bhf.org.uk
For more information about healthy eating, why not take a look at our nutrition courses – available online and face-to-face.