Eating for a Healthy Heart
Loving your heart doesn’t mean surviving on a diet that’s
completely fat free. In fact, it couldn’t be easier or tastier
to keep your heart healthy – and lose those excess
pounds at the same time. Weight Loss Resources dietitian
Juliette Kellow reveals all...
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Have a Healthy Heart Diet
By WLR Dietitian
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Gone are the days when a healthy heart diet meant
filling up on tasteless, boring meals. The latest advice to
help us lower the risk of heart disease actively encourages us
to create meals with delicious, fresh ingredients like salmon,
avocado, olive oil, oats, wholegrains and an array of fruit
and vegetables.
Fortunately there are plenty of things you can do to
help keep your heart healthy. And more often than not, looking
at your diet – and losing weight if necessary – are
the simplest changes you can make to help heart health.
What are the risk factors of heart
disease?
The four major risk factors for heart disease are smoking,
having high cholesterol, having high blood pressure and being
physically inactive.
However, being overweight,
diabetes, drinking too much alcohol, and
having too much salt in our diet also increases the risk.
A family history of heart disease is also a risk
factor.
Bear in mind, our risk of heart disease depends on how many
risk factors we have and how strong each individual risk
factor is.
Giving up smoking and taking more
aerobic exercise are
important first steps.
Many of the other risk
factors – such as high cholesterol, high blood pressure, being
overweight and having too much alcohol and salt – can all be
improved by eating a healthier diet.
What's the importance of lowering cholesterol?
Cholesterol is a fatty material that’s made mainly in the
liver. It’s an essential part of every cell and is the
building block of many important steroid hormones. However,
too much in the blood increases the risk of heart disease.
Cholesterol uses the body’s circulation as its transport
system and travels around on vehicles made up of proteins.
These combinations of cholesterol and protein are called
lipoproteins and there are two main types – low density
lipoproteins (LDL) and high density lipoproteins (HDL).
Bad Cholesterol
LDL transports cholesterol from the liver to the cells,
where certain amounts are needed. However, any remaining
cholesterol can be chemically changed (a process called
oxidation) and taken up by the cells in the artery walls where
it starts to build up – it’s this process that causes
narrowing of the arteries or atherosclerosis. Consequently,
high levels of LDL cholesterol increase the risk of heart
disease – that’s why it’s sometimes called ‘bad’ cholesterol.
Good Cholesterol
In contrast, HDL carries excess cholesterol away from the
arteries to the liver, where the body gets rid of it. As a
result, high levels of HDL cholesterol are thought to protect
against heart disease and so, are sometimes called ‘good’
cholesterol.
How do I find out my cholesterol levels?
Your blood cholesterol levels can be measured by a simple
blood test. Your doctor will look at figures for your overall
or total cholesterol level, plus figures for your LDL and HDL
cholesterol. All these values are measured in units called
millimols per litre of blood, usually shortened to mmol/l.
Healthy levels are as follows:
- Total cholesterol – less than 5 mmol/l
- LDL cholesterol – less than 3 mmol/l
- HDL cholesterol – more than 1 mmol/l
How do I go about lowering cholesterol?
Your doctor may prescribe medication. However, it’s also
important to look at your diet.
According to the
British Heart Foundation eating a heart healthy diet can help to lower
your cholesterol levels by between 5% and 10%. In most cases,
the aim is to reduce your total cholesterol, particularly by
lowering levels of LDL or ‘bad’ cholesterol. But it’s also
important to raise levels of HDL or ‘good’ cholesterol.
In particular, losing weight is one of the most important
things you can do to lower your cholesterol if you are
overweight or obese. Better still, losing those excess
pounds will also help to reduce other risk factors for heart
disease such as high blood pressure and diabetes.
Overall, you should cut down on the total amount of fat you
eat. For a healthy heart diet Weight Loss
Resources recommends that no more than 30 percent of your
daily calories come from fat.
This means if you have a
daily
calorie intake of 1,500 calories, you should have no more
than 50g of fat; if your daily calorie allowance is 2,000
calories, you should have no more than 66g of fat a day.
Fortunately, WLR does the maths for you – all you need to do
is look at your Nutrition Profile in Food Diary to find out the maximum
amount of fat you should have each day. (You can take a
free trial of WLR's tools
to see how it works.)
It’s important for heart health to make sure you’re eating the
right types of fat, too. There are three main types of fat in
food – saturates, monounsaturates and polyunsaturates. Most
foods contain a mixture of these, but they are generally
classified according to the type of fat found in the largest
amount.
Saturates
Foods high in saturates include fatty meats, full-fat dairy
products, butter, lard, cream, cheese and many processed and
takeaway foods. These types of fats increase LDL or ‘bad’
cholesterol so it’s important to eat fewer of them.
Polyunsaturates
Good sources of polyunsaturates include pure vegetable oils
and spreads such as sunflower, corn and soya oils and
margarines and some vegetables. These types of fat help to
lower LDL or ‘bad’ cholesterol. But they also lower HDL or
‘good’ cholesterol.
Monounsaturates
Good sources of monounsaturates include olive oil, rapeseed
oil, avocados, nuts and seeds. These types of fats lower LDL
or ‘bad’ cholesterol but they help to maintain levels of HDL
or ‘good’ cholesterol.
Ultimately, as well as eating fewer fatty foods in your
diet,
it’s important to swap foods high in saturates for foods rich
in unsaturates. It might sound complicated but in practice
it’s simple – for example, if you really must fry, use a small
amount of olive oil rather than butter!
What about foods that contain cholesterol?
A few foods such as liver, kidney, prawns and eggs do
contain more dietary cholesterol than many other foods.
However, thanks to research, we now know the cholesterol in
food has little effect on our blood cholesterol levels – it’s
saturated fat that has the biggest impact. Consequently, there’s
no need to limit the amount of these foods you eat, unless
your GP or a dietitian has specifically advised you to do
this.
Do I need to worry about trans fats?
Trans fats have increasingly been in the news in the past
few years. They tend to be found in foods that contain
hydrogenated fats or hydrogenated vegetable oils and are
thought to be as harmful to heart health as saturates. This
means it’s a good idea to eat fewer foods that contain them.
Ironically, it’s the processing of pure vegetable oils – a
good source of heart-friendly unsaturates – that creates
harmful trans fats! During manufacturing, these liquid oils
have hydrogen bubbled through them in a process called
hydrogenation to improve their texture, flavour and shelf
life. The resulting product is a more solid fat called
hydrogenated fat or hydrogenated vegetable oil, which goes on
to be used as an ingredient in many processed foods.
Currently, there are no legal requirements for food
manufacturers to label trans fats on their products and few
choose to do so. This means for now, you need to scour
ingredients’ lists for hydrogenated fats or hydrogenated
vegetable oils. If a product contains either, it will almost
certainly contain trans fats, too – and the higher up the list
the ingredient appears, the more trans fats the product will
contain.
The good news is, eating fewer foods that contain trans
fats not only helps to keep your heart healthy, but also helps
shift those pounds. The reason: trans fats tend to be found in
cakes, biscuits, margarines, takeaways, pastry, pies and fried
foods – all foods that are also loaded with calories!
Are omega 3 fats really good for you?
Despite recent reports to the contrary, most health experts
still believe omega 3 fats have an important part to play in a
healthy heart diet.
- Omega 3 fats are a particular type of polyunsaturated
fat that reduce the stickiness of blood, making it less likely
to clot.
- Omega 3s also help to keep the heart beating
regularly and protect the small arteries, which carry blood to
the heart, from damage.
- Omega 3 fats help to lower
levels of another type of fat found in the blood called
triglycerides, high levels of which are linked with heart
disease.
Our bodies can make omega 3 fats from foods like rapeseed
oil, walnut oil and soya. However,
oily fish such as salmon,
sardines, mackerel, trout, fresh tuna, pilchards, kippers and
herring are also packed with omega 3 fats. In fact, omega 3
fats are thought to be so important for our health that the
Food Standards Agency recommends we should all eat at least
one serving of oily fish each week.
What are triglycerides?
Triglycerides are another type of blood fat or blood lipid.
Like high cholesterol, raised triglyceride levels in the blood
can increase the risk of heart disease and stroke.
Being
overweight or obese, having a high fat diet, drinking too much
alcohol and not taking enough exercise can all contribute to
high triglyceride levels. Usually, blood tests to measure
cholesterol also measure triglyceride levels. Anything above
2mmol/l is considered high.
The good news is, a healthy heart diet that helps to reduce
cholesterol will also help to reduce triglycerides – and
should help you to lose weight at the same time.
How important is fibre?
Most fibre-rich foods are low in fat, which makes them a
great choice for a healthy heart. But they’re also packed with
vitamins, minerals and naturally occurring plant chemicals
called phytochemicals.
When it comes to heart disease prevention – and other
conditions such as cancer – it appears to be this whole
package of fibre and nutrients that’s important. Indeed,
there’s good evidence that eating a
high fibre diet with more wholegrain foods such
as wholemeal bread, brown rice and wholegrain breakfast
cereals can help to prevent heart disease – one large study
found that women who ate around three servings of wholegrain
foods a day were 30 percent less likely to suffer from heart
disease.
Furthermore, a particular type of fibre called soluble
fibre may also help to lower blood cholesterol levels.
This
type of fibre is found in some fruits, vegetables, oats,
barley and pulses such as beans, lentils and peas – all
low-fat foods that are also a great choice if you’re also
trying to lose weight.
In particular, soluble fibre is thought to bind with
cholesterol and prevent it from being reabsorbed into the
bloodstream. This lowers the amount of cholesterol in the
blood, therefore reducing the risk of heart disease.
Soluble fibre also forms a gel in the
intestine, which is thought to slow down the digestion and
absorption of carbohydrates. This helps to keep blood sugar
levels steady, preventing carb cravings that leave many of us
reaching for sugary snacks that are also often combined with
fat – we’re talking biscuits, chocolate, toast and jam,
muffins, doughnuts!
How do fruit and vegetables help?
Most fruit and vegetables are low in fat and high in fibre
– both of which are important for a healthy heart diet. But fruit
and veg are also packed with antioxidants, which help to
protect against heart disease.
Antioxidant vitamins such as
beta-carotene and vitamins C and E work their magic by
‘mopping up’ harmful free radicals, which can cause oxidation
of LDL cholesterol – a problem that potentially speed up the
process of the narrowing of arteries.
In addition, many fruit and vegetables are also good
sources of naturally occurring plant chemicals such as
flavonoids, which act as powerful antioxidants. No doubt
you’ve heard it before, but health experts recommend eating
five servings of different fruit and veg every day – and the
more colours you go for, the greater the variety of nutrients
you’ll get!
Is soya good for heart health?
Eating more soya – a good source of
both soluble fibre and isoflavones (from the flavonoid family)
– may help to protect against heart disease.
Studies show that
including 25g of soya protein each day as part of a diet low
in saturates can help lower both total cholesterol and LDL or
‘bad’ cholesterol. You can get this amount of soya protein by
drinking around three glasses of soya milk a day, but make
sure you choose unsweetened varieties. There are also many
soya desserts, yogurt alternatives and creams available but
always check the nutrition information first as they may be
higher in calories than you’d expect.
Do products like Flora ProActiv and Benecol
that claim to lower cholesterol really work?
There’s evidence that products containing plant sterols and
stanols reduce the absorption of cholesterol from the gut and
so lower blood cholesterol levels as a result. However, it’s
worth bearing in mind that these products are often expensive.
They’re also not a substitute for a healthy diet - even if
you choose to have margarines, milks, yogurts or drinks that
are enriched with plant sterols, you still need to eat a
healthy diet to reduce your risk of heart disease. And if
you’re trying to lose weight, it’s also worth checking out the
calories before filling your shopping trolley with them.
What's the problem with salt?
High blood pressure is a risk factor for heart disease so
it’s important to keep it under control. In fact, research
shows that people with high blood pressure are three times
more likely to develop heart disease or have a stroke than
people with normal blood pressure.
As well as losing weight, one of the most important things
you can do is eat fewer salty foods and avoid adding salt to
dishes when cooking or eating them. This is because salt
contains sodium – and it’s high intakes of this that raise
blood pressure.
Most people in the UK eat
too much salt. As a guideline, the Food Standards Agency recommends we
should each have less than 6g of salt a day.
To meet this
target most of us need to cut down on salty foods, which
include ketchup, pickles, crisps, ready meals, takeaways,
processed meats such as ham, bacon and burgers, pastry
products, pizza, canned soups, ready-made cooking sauces and
canned fish in brine. The good news is, these are often low in
essential nutrients but high in calories and so won’t help you
shift those pounds. Foods like bread, breakfast cereals and
cheese can also be packed with salt although they usually
contain good amounts of vitamins and minerals, too.
Unfortunately, not all foods are labelled with values for
salt and so you need to do the maths. As a guideline, simply
multiply the value for sodium by 2.5.
Is alcohol good or bad for a healthy heart?
According to the British Heart Foundation, drinking no more
than one or two units of alcohol a day is thought to help
protect against heart disease – but only in men over the age
of 40 and postmenopausal women! Meanwhile, alcohol also helps
to raise HDL or ‘good’ cholesterol and may reduce the
stickiness of the blood.
However, people who persistently exceed sensible drinking
limits – that’s a maximum of three units a day for women and
four units a day for men – are more likely to suffer from risk
factors associated with heart disease such as high blood
pressure. Binge drinking can also cause abnormal heart rhythms
and regular heavy drinking may lead to an enlargement of the
heart.
While some research has suggested red wine is the most
beneficial alcoholic tipple for heart health, this is still
not conclusive. Indeed, it’s now thought that small amounts of
any alcohol are associated with a lower risk of heart disease.
However, it’s worth bearing in mind that most experts agree
that eating a healthy diet, stopping smoking and being more
active are likely to have a far greater benefit to heart
health than drinking small amounts of alcohol.
Meanwhile, it’s worth remembering that
alcohol contains
calories but little else in the way of nutrients. Therefore,
drinking large amounts won’t help your waistline!
How do I get started on a healthy heart diet?
Read my practical tips on
Eating for a Healthy
Heart then start using the food diary in WLR to see how it
all fits together - you can
try it free for 24 hours.
Further Information The British Heart Foundation has
comprehensive info and advice, see
All Your Heart Health Questions Answered. The US
FDA have a colourful PDF showing the
elements of a healthy heart diet. The BBC website
has more information about
risk factors and prevention.
www.florahearts.co.uk Flora pro.activ is hosting roadshows
across the UK, offering free heart health checks.
H.E.A.R.T. - The Cholesterol Charity
HEART UK supports all those at risk of inherited high
cholesterol and cardiovascular disease.
www.heartuk.org.uk
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