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Heart - small changes, big difference: Jul'13

Tags: diet , heart

Our dedicated nurse, Beverley discussed the changes you can you make to your lifestyle or diet, that will help make a postitive change for you heart health. Read the answers below:

AXA PPP healthcare: Good morning and welcome to our live chat. Please get all your 'heart' questions over to our dedicated nurse Beverley Barnes.

polo79poz asked: Hi, i have question. can you help me. my parents going to leave in uk. they are from Poland. what they need to have free help from doctors in uk. how that's look with specialist like for example cardiologist?

Beverley Barnes, our Dedicated Nurse answered: Dear Polo79poz, your Parents will need to register with a gp at this point they will be advised about their NHS entitlement. If they require any medical intervention the gp will refer them on to the appropriate specialist and hospital.

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Ruth asked: How important is genetics when it comes to heart problems? My family has a history of heart disease, does that put me at risk?

Beverley Barnes, our Dedicated Nurse answered: Dear Ruth,  Genes can pass on the risk of cardiovascular disease, and they can also be responsible for passing on other conditions such as high blood pressure or high cholesterol levels.
Lifestyle habits, such as smoking or poor diet passed on from one generation to the next can increase the risk of cardiovascular disease.
There's no single gene that increases your risk of getting heart disease. It's likely that several genes are responsible.
Regarding your family history
Family habits can affect you too - what you learn about eating whilst growing up, or whether anyone in your family smokes. However, whilst you can’t change your family's background, you can choose your lifestyle.
Unfortunately there is nothing you can do about your family history. Having a family history of cardiovascular disease is a 'non-modifiable' risk factor - this means it's a risk factor that you can't change.
Even if you have a family history, you can reduce your risk of getting cardiovascular disease by controlling other risk factors such as:
• not smoking
• managing high blood pressure
• managing high blood cholesterol
• being physically active
• keeping to a healthy weight and body shape, and
• controlling diabetes, if you have it.
I hope this answers your question. Bev

fiona asked: Hi - how can I ensure my salt intake is not to high without having to look at packets all the time?

Beverley Barnes, our Dedicated Nurse: Dear Fiona, I know it can be time consuming, but it is so important to get a healthy balance as a high salt intake  can play a significant part in high blood pressure and heart conditions. When cooking from fresh it is best not to add any additional salt. However if you do like the taste, there are low salt products on the market. With regards to ready meals and guidelines on packaging it is always best to check. Use nutrition labels to help you cut down on salt:
high is more than 1.5g salt per 100g (or 0.6g sodium)
low is 0.3g salt or less per 100g (or 0.1g sodium) 
When shopping for food, you can take steps to cut your salt intake:
Compare nutrition labels on food packaging when buying everyday items. You can really cut your salt intake by checking the label and choosing the pizza, ketchup or breakfast cereal that's lower in salt. Try choosing one food a week to check and swap when you're food shopping.
•Go for reduced-salt, unsmoked back bacon. Cured meats and fish can be high in salt, so try to eat these less often.
•Buy tinned vegetables without added salt. Do the same with tinned pulses.
•Watch out for the salt content in ready-made pasta sauces. Tomato-based sauces are often lower in salt than cheesy sauces or those containing olives, bacon or ham.
•For healthier snacks, choose fruit or vegetables such as carrot or celery sticks. If you are going to have crisps or crackers, check the label and choose the ones lower in salt.
•Go easy on soy sauce, mustard, pickles, mayonnaise and other table sauces, as these can all be high in salt.
Once you have checked out your favourite products, why not make a note of the salt levels for future reference. Bev

fiona commented: Thanks!

Sarahh asked: Why is salt bad for your heart?

Beverley Barnes, our Dedicated Nurse answered: Dear Sarah, Too much salt can raise your blood pressure, which puts you at increased risk of health problems such as heart disease and stroke. But a few simple steps can help you to cut your salt intake.
You don't have to add salt to food to be eating too much – 75% of the salt we eat is already in everyday foods such as bread, breakfast cereal and ready meals.
A diet that is high in salt can cause raised blood pressure, which currently affects around one third of adults in the UK.
High blood pressure often has no symptoms. But if you have it, you are more likely to develop heart disease or have a stroke.
Cutting down on salt lowers blood pressure, which means that your risk of having a stroke or developing heart disease is reduced.
Bev

ianto asked: Is salt bad for everyone or just for some people?

Beverley Barnes, our Dedicated Nurse answered: Dear Ianto,  Yes too much salt has a risk facter for everyone, salt can raise your blood pressure, which puts you at increased risk of health problems such as heart disease and stroke. But afew simple steps can help you to cut your salt intake.
You don't have to add salt to food to be eating too much – 75% of the salt we eat is already in everyday foods such as bread, breakfast cereal and ready meals.
A diet that is high in salt can cause raised blood pressure, which currently affects around one third of adults in the UK.
High blood pressure often has no symptoms. But if you have it, you are more likely to develop heart disease or have a stroke.
Cutting down on salt lowers blood pressure, which means that your risk of having a stroke or developing heart disease is reduced.
Bev

Heather asked: My Gran had heart disease which sadly in the end lead to her death, however I'm concerned that this will effect my Dad in his later years too, he has high cholesterol already - do you think he is a risk of getting heart disease also?

Beverley Barnes, our Dedicated Nurse answered: Dear Heather, sorry to hear about your Gran and I appreciate your concerns about your dad and his high cholesterol.I would anticipate that he is under his gp and being monitored for his cholesterol levels. Unfortunately he is at risk of getting heart diease and should be making life style changes now to reduce hischolesterol levels, this is very important to reduce his long term risk.
Here is some straight forward advice about fats that can help reduce cholesterol levels
To help look after your heart health it is important to keep an eye on how much fat you are eating as well as making sure you choose the right type of fats.
So to help keep your heart healthy:
• Cut right down on saturated fats
• Replace saturated fats with small amounts of mono and polyunsaturated fats
• Reduce the overall amount of fat you eat
• Cut down on foods containing trans fats.
It's also important to remember that all fats and oils are high in calories, so even the unsaturated fats should only be used in small amounts.
Saturated fat
Too much saturated fat can increase the amount of cholesterol in the blood, which can increase the risk of developing coronary heart disease.
Unsaturated fats
Unsaturated fats, which can be monounsaturated fats (for example olive oil, rapeseed oil, almonds, unsalted cashews and avocado) or polyunsaturated fats (including sunflower oil and vegetable oil, walnuts and sunflower seeds), are a healthier choice.
Omega-3 fats are a particular type of polyunsaturated fat, usually found in oily fish, that can help protect heart health. Try to have at least one portion of oily fish a week eg. fresh tuna, fresh or tinned salmon, sardines, pilchards and mackeral. If you have had a heart attack, aim for two to three portions a week.
Trans fats
Another type of fat, known as trans fat, can also raise the amount of cholesterol in the blood. 
I hope this information is of use and its never to late to make life style changes
Bev

Heather commented: Thanks Bev, that's really helpful information - I will talk this over with my Dad!

Anonymous146 asked: How much does being overweight impact your heart?

Beverley Barnes, our Dedicated Nurse answered: Dear anon, yes unfortunately being overweight can have a significantimpact on your heart. The following information can assist in finding out if you are at risk of heart disease
There are two main ways to tell whether you need to lose weight: your waist measurement and your Body Mass Index (BMI).
To find out your waist measurement, you will need a tape measure on hand, and to know your height and weight.
The following information below is a guideline to help you.
Increased risk Severe risk
Men Over 94cm (37") over 102cm (40")
South asian men - over 90cm (35.5")
Women Over 80cm (32") over 88cm (35")
South asian women - over 80cm (32")
Finding your BMI
Knowing your BMI can help you figure out whether you are overweight, the ideal weight, or underweight for your height. To calculate your BMI
there are many useful online tools. Once you have all the informtion you will be able to determine if you need to make some life style changes.
Bev

Ken asked: Can too much exercise be as harmful as none at all?

Beverley Barnes, our Dedicated Nurse answered: Dear Ken, too much exercise can be harmful if you havent built up a level of fitness appropriate to the exercise you are undertaking. It is always best to to increase your level of exercise gradually. If you have a heart condition it is better to be guided by your G.P or Cardiologist as to what level of exercise you should be undertaking and what exercises to avoid.  Generally speaking no exercise can be harmful, keeping as active as possible within individual limitations is very important for your health. Bev

AXA PPP healthcare: We've just had a question come through from Christopher on Facebook:

"I am quite fit and healthy in my 50's but I don't monitor my diet at all and eat as I please. Does my additional exercise support this and mean I can keep my diet the same?"

Beverley Barnes, our Dedicated Nurse answered: Dear Christopher, great to hear that your fit and healthy and exercise regularly. However as I do not know exactly what your diet consists of I am unsure if this would have an impact on your heart. Here are some guidelines to help assist you in working out if your diet could be improved
A balanced diet
The best way to understand it is to think of foods in food groups.
Everyone should aim for a well balanced diet. Faddy crash diets may not provide the balance of nutrients you need.
Try to eat:
•plenty of fruit and vegetables
•plenty of starchy foods such as bread, rice, potatoes and pasta. Choose wholegrain varieties wherever possible
•some milk and dairy products
•some meat, fish, eggs, beans and other non-dairy sources of protein
•only a small amount of foods and drinks high in fats and/or sugar.
Choose options that are lower in fat, salt and sugar whenever you can.Fruit and vegetables
A well-balanced diet should include at least 5 portions of fruit and veg a day. Try to vary the types of fruit and veg you eat. They can be fresh, frozen, dried or tinned. Pure unsweetened fruit juice, pulses and beans count as a portion, but they onlymake up a maximum of one of your five a day, however much you eat in one day.
A portion is about a handful (80g or 3oz), for example:
•4 broccoli florets
•1 pear
•3 heaped tablespoons of carrots
•7-8 strawberries

Fats
To help look after your heart health it is important to keep an eye on how much fat you are eating as well as making sure you choose the right type of fats.
So to help keep your heart healthy:
•Cut right down on saturated fats
•Replace saturated fats with small amounts of mono and polyunsaturated fats
•Reduce the overall amount of fat you eat
•Cut down on foods containing trans fats.
It's also important to remember that all fats and oils are high in calories, so even the unsaturated fats should only be used in small amounts.
Saturated fat
Too much saturated fat can increase the amount of cholesterol in the blood, which can increase the risk of developing coronary heart disease.

Unsaturated fats
Unsaturated fats, which can be monounsaturated fats (for example olive oil, rapeseed oil, almonds, unsalted cashews and avocado) or polyunsaturated fats (including sunflower oil and vegetable oil, walnuts and sunflower seeds), are a healthier choice.

Omega-3 fats are a particular type of polyunsaturated fat, usually found in oily fish, that can help protect heart health. Try to have at least one portion of oily fish a week eg. fresh tuna, fresh or tinned salmon, sardines, pilchards and mackerel.
Trans fats
Another type of fat, known as trans fat, can also raise the amount of cholesterol in the blood. 

Salt
Eating too much salt can increase the risk of developing high blood pressure. Having high blood pressure increases the risk of developing coronary heart disease.

Alcohol
If you drink alcohol, it's important to keep within the recommended guidelines - whether you drink every day, once or twice a week or just occasionally.

I hope this helps, but if you have a more specific question, please come back to me. Bev

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If you missed our live chat and have any further questions relating to heart health, then why not ask our panel of experts a question?

 

Ronnie asked: Is a daily aspirin still a good way to prevent heart attacks?

Beverley Barnes, our Dedicated Nurse answered: Dear Ronnie, aspirin can be used as part of heart disease management.
Aspirin in this setting should taken under gp direction. It is a gentle blood thinning agent and is prescribed for people with heart disease. although many peope take it as a preventative measure as they get older. Whilst taking aspirin can reduce your risk due to its properties, on its own it won't prevent a heart attack.
Bev

Ronnie asked: Also, does taking birth control raise the risk of developing heart disease?

Beverley Barnes, our Dedicated Nurse answered: Dear Ronnie. The contraceptive pill can slightly increase your risk of blood clotting problems, and can increase your risk of a deep vein thrombosis (DVT). The risk of this happening is small, but it increases if you smoke, are overweight, or remain immobile for a long time – for example, while travelling on a plane, car, bus or train.
A DVT can go on to cause a pulmonary embolism (PE) – where the blood clot moves up to your lungs. A PE is life-threatening and needs emergency treatment. So, if you notice signs of a DVT, contact your GP immediately.
The contraceptive pill can sometimes increase blood pressure, so you should have your blood pressure checked regularly while you’re taking it.
If you want to start or stop your contraception, we recommend you talk to your doctor as depending on your circumstances and heart condition they will want to monitor you.
Bev

Andy_M asked: Can you explain the effects smoking has on the heart?

Beverley Barnes, our Dedicated Nurse answered: Dear Andy. How does smoking damage your heart?
Smoking increases the risk of developing cardiovascular diseases, which includes coronary heart disease and stroke.
• Smoking damages the lining of your arteries, leading to a build up of fatty material (atheroma) which narrows the artery. This can cause angina, a heart attack or a stroke.
• The carbon monoxide in tobacco smoke reduces the amount of oxygen in your blood. This means your heart has to pump harder to supply the body with the oxygen it needs.
• The nicotine in cigarettes stimulates your body to produce adrenaline, which makes your heart beat faster and raises your blood pressure, making your heart work harder.
• Your blood is more likely to clot, which increases your risk of having a heart attack  or stroke.  Take a look at our cardiovascular disease page to find out more about blood clots and the damage they can do to your body.
Second-hand smoke
When non-smokers breathe in second-hand smoke - also known as passive smoking - it can be harmful. Research shows that exposure to second hand tobacco smoke is a cause of heart disease in non-smokers. Bev

Heather asked: I have quite an irregular sounding heartbeat according to my partner (although I'm not sure what a regular heartbeat is supposed to sound like). He said that it beats quite fast then stops... should this be a concern?

Beverley Barnes, our Dedicated Nurse answered: Dear Heather, In a average healthy adult the heart beats approximately 70 - 72 beats per minute. The sound of the heart beat is actually the valves inside the heart opening and closing as it pumps blood through the chambers and out through the body. Any changes such as a faster heart beat  that are not associated with an obvious cause e.g recent exercise, should be investigated by a health care professional such as your G.P. Bev

AXA PPP healthcare: Another question via Facebook, this time from Jenny:

"What is the ideal lifestyle to ensure good heart health?"

Beverley Barnes, our Dedicated Nurse answered: Dear Jenny, there are many facters to assist you in  undertaking a healthy life style to keep your heart healthy. These include the following;
• not smoking
• managing high blood pressure
• managing high blood cholesterol
• being physically active
• keeping to a healthy weight and body shape, and
• controlling diabetes, if you have it.
Your risk of developing cardiovascular disease also depends on other factors, such as your age, ethnic group and family history.
It is never too late to start making some changes that will keep your heart healthy. A good website to look at for specific information is the 'British Heart Foundation.' Bev

Anonymous116 asked: Do you have any tips on how to deal with someone who is suffering from a heart attack if there is no medical aid around?

Beverley Barnes, our Dedicated Nurse answered: Dear Anon, Cardiac arrest is totally different from a heart attack. A cardiac arrest happens when your heart stops pumping blood around the body. As a result you will be unconscious and won’t be breathing normally. Immediate cardiopulmonary resuscitation (CPR) and defibrillation is needed to have any chance of survival.
Having a heart attack is one of the causes for cardiac arrest. Other causes include electrocution or choking.
If you witness a cardiac arrest, you can increase the person's chances of survival by phoning 999 and giving immediate CPR.
You could also enrol on a local first aid course that teaches you CPR
Bev

Laurie D asked: Is it safe to drink alcohol if I am suffering from a heart condition?

Beverley Barnes, our Dedicated Nurse answered: Dear Laurie. Drinking more than the recommended limits can have a harmful effect on the heart. It can cause abnormal heart rhythms, high blood pressure, damage to the heart muscle and other diseases such as stroke, liver problems and some cancers.
Alcohol is also high in calories so it can lead to weight gain.  It also lowers inhibitions which might mean you find it harder to stick to your healthy eating plans when you have been drinking. If you are trying to lose weight, cut down on alcohol.

If you drink alcohol, it is important to keep within the guidelines:
• Men should not regularly drink more than 3 - 4 units of alcohol a day.
• Women should not regularly drink more than 2 - 3 units of alcohol a day.
These guidelines apply whether you drink every day, once a week or occasionally.
Most people don’t drink alcohol every day - but if you do, try having some days off – aim for at least two alcohol free days a week. Just make sure you don’t increase the amount you drink on the other days.
Drinking large amounts of alcohol in one go can cause additional damage to your body, so avoid heavy or ‘binge’ drinking – you can’t save up your units!  If you drink too much, avoid alcohol for 48 hours to allow your body time to recover.
How much is one unit of alcohol?
A unit is a measure of alcohol.  The number of units is based on the size of the drink and its alcohol strength.  The ABV (alcohol by volume) figure is the percentage of alcohol in the drink.
• One small glass (100mls) of wine (10% ABV) - be aware that many wines have a higher alcohol content than this and the size of glasses may be bigger. For example, a standard 175ml glass of wine (13% ABV) would be 2.3 units.
• Half a pint (about 300mls) of normal strength lager, cider or beer.
For example 3.5% ABV - be aware that many beers and ciders have a higher volume than this.
• A single pub measure (25mls) of spirits (40% ABV).
• A glass (50 ml) of liqueur, sherry or other fortified wine (20% ABV).
 
There may be some benefits to your heart health from moderate drinking (1 or 2 units a day). However, we would not advise you to start drinking if you don't already. There are safer and healthier ways to protect your heart. It is more important to start taking more physical activity, eat a healthy, balanced diet and to stop smoking.
 If you’ve recently been unwell or in hospital with a heart condition, or have undergone heart surgery, you should ask your doctor for advice on when you can resume drinking alcohol. 
If you are taking sleeping tablets or painkillers, remember that alcohol will have a more powerful effect.
Everyone should avoid drinking too much alcohol but this is particularly important if you are taking anticoagulant medication like warfarin.
Too much alcohol can interfere with the blood clotting process, so if you do drink alcohol it is better to have just a small amount regularly. Your anticoagulant clinic will be able to advise you on this.
Once you have recovered, it's OK for most people with a heart condition to drink a moderate amount of alcohol.
However if you have been diagnosed with certain conditions, such as some types of cardiomyopathy, it may be advisable to avoid drinking alcohol altogether. Check with your doctor for advice on whether it is safe for you to drink alcohol and how much. 
If you are taking medication, check with your doctor or pharmacist about how much alcohol you can drink. Bev

Allan asked: Which is more important to avoid, cholesterol or saturated fats?

Beverley Barnes, our Dedicated Nurse answered: Dear Allan, Unhealthy fats raise your cholesterol which is part of your blood picture and affects your heart when the levels are consistantly raised above normal levels. You need to have some fat in your diet to aid digestion. Fat becomes a problem and raises your cholesterol when there is an imbalance in your diet. Please see the following guide;
So to help keep your heart healthy:
• Cut right down on saturated fats
• Replace saturated fats with small amounts of mono and polyunsaturated fats
• Reduce the overall amount of fat you eat
• Cut down on foods containing trans fats.
It's also important to remember that all fats and oils are high in calories, so even the unsaturated fats should only be used in small amounts.
Saturated fat
Too much saturated fat can increase the amount of cholesterol in the blood, which can increase the risk of developing coronary heart disease.
Unsaturated fats
Unsaturated fats, which can be monounsaturated fats (for example olive oil, rapeseed oil, almonds, unsalted cashews and avocado) or polyunsaturated fats (including sunflower oil and vegetable oil, walnuts and sunflower seeds), are a healthier choice.
Omega-3 fats are a particular type of polyunsaturated fat, usually found in oily fish, that can help protect heart health. Try to have at least one portion of oily fish a week eg. fresh tuna, fresh or tinned salmon, sardines, pilchards and mackeral.
Trans fats
Another type of fat, known as trans fat, can also raise the amount of cholesterol in the blood. 
Bev

AXA PPP healthcare: This morning's live chat is now closed. Thank you all for joining and your great questions. And thankyou to our dedicated nurses Beverley and Caroline for their brilliant answers.


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