The Sussex Heart Charity

If you are a cigarette smoker you have about twice the risk of having a heart attack than a non smoker. If you also suffer with high blood pressure and high cholesterol, the 3 factors together multiply the chances of you suffering a heart attack by more than 8 times. If you smoke you should give up and try to maintain a healthy weight. Would you like help or information on how to quit smoking go to: http://smokefree.nhs.uk/

High cholesterol is a major factor of heart disease, but it can be treated through diet and exercise. The first step in lowering cholesterol levels is to change your diet.

What is cholesterol?

Cholesterol is a soft waxy substance and is an essential body fat (lipid), that is carried around the body in the blood, it can be found in all the body's cells. Only a small amount of the cholesterol in the body comes from your diet, it is mostly made in the body by the liver. The dietary cholesterol is found in food that comes from animals such as meat, poultry, fish, seafood and dairy products, especially egg yolks.

Cholesterol is required by the body to keep itself healthy, but too much cholesterol circulating in the blood is a health risk.

As cholesterol is not water-soluble it must bind to special proteins before it can be carried in the bloodstream, known as apoproteins. Once coated they form a package called lipoproteins, there are 2 main types of lipoproteins:

1. Low density lipoproteins (LDL), commonly known as bad cholesterol. LDL is the major cholesterol carrier in the blood. If there is too much LDL in the blood it can build up on artery walls. A high level of LDL cholesterol may give you an increased risk of coronary heart disease.
2. High density lipoproteins (HDL) commonly known as good cholesterol. HDL is actually good for maintaining the health of the heart and preventing the narrowing of the arteries (atherosclerosis) because it appears to carry cholesterol away from the arteries and back to the liver for disposal.

This is why the ratio between LDL and HDL cholesterol is important. Usually the body maintains a balance of cholesterol, making more if it needs it and getting rid of any excess. But sometimes this balance goes wrong. LDL levels can be lowered by eating a low fat diet and HDL levels can be raised by exercising.

The only way to try to prevent high cholesterol is to stick to a healthy balanced diet, low in saturated fats, get regular exercise, quit smoking and maintain a healthy weight. Most individuals can reduce their cholesterol level 15-20% by reducing the intake of foods high in cholesterol and fat, especially saturated fat.

Food to avoid or limit:

• Fatty meats but if you do eat them cut off all the visible fat.
• Sausages, goose and duck.
• Pies and pastries.
• Fat or oil in cooking.
• Prawns, shrimp and fish roe.
• Fried foods
• Dairy products such as full milk, cream, cheese, butter and ice cream.
• Egg yolks, limit to 2 a week.
• Cakes, crisps, biscuits, sweets and chocolate.

Try to grill or steam meats instead of frying or roasting but if you do roast, place meat on a rack to allow the fat to drain off. When frying choose a vegetable oil, such as sunflower.

Healthier foods which you could try eating are as follows:

• Fish, especially oil rich fish such as sardines, salmon, mackerel, pilchards and trout. This type of fish contains Omega-3 fatty acids and they are thought to lower LDL cholesterol.
• Poultry (chicken, veal or turkey) but remove the skin.
• Low-Fat dairy products, use semi skimmed or skimmed milk, low fat yoghurts and mono or poly-unsaturated spreads.
• Foods high in polyunsaturated (found in nuts, seeds and vegetable oils) and monounsaturated (found in olive, rapeseed, walnut oil and avocado) fats.
• Fruit and vegetables, you should eat at least 5 portions every day.
• Garlic
• Wholegrain breads
• Cereals
• Baked beans and red kidney beans
• Pasta and rice

If buying low fat foods ensure they are labelled "low in saturated fat" increase your intake of healthy monounsaturated and polyunsaturated fats (canola oil, avocado oil, or olive oil, for example) and add at least two daily servings of fibre (oats, fruits, vegetables).

Regular exercise may also help lower fat levels; try brisk walking, swimming or cycling. However, if you’ve not taken exercise in some time, are over 40 or have been ill, you should check with your doctor before doing anything too strenuous.

If these methods fail to lower your cholesterol levels, your doctor may prescribe a drug which will help to lower your cholesterol.

High blood pressure is one of several 'risk factors' that can increase your chance of developing heart disease, a stroke, and other serious conditions. As a rule, the higher the blood pressure, the greater the risk.

Treatment includes a change in lifestyle risk factors where these can be improved - losing weight if you are overweight, regular physical activity, a healthy diet, cutting back if you drink a lot of alcohol, stopping smoking, and a low salt and caffeine intake. If needed, medication can lower blood pressure.

There are two types of diabetes. The first occurs in childhood and is called insulin-dependent diabetes. People with this form of diabetes take daily insulin injections to compensate. The more common form of the disease is called adult-onset, non-insulin dependent diabetes. In this case the body makes insulin but is unable to use it. It frequently affects people who are obese, who come from families with diabetes, or who have high blood pressure.

Uncontrolled diabetes of either type damages the bodies very small arteries. Diabetes doubles the risk of coronary heart disease.

Diabetes with obesity, high blood pressure, high cholesterol and high triglycerides can increase the risk of heart disease by a factor of four times.

you are obese if you are more than 20% over the target weight for your height. If you are over your target weight, you should seriously look at a diet and exercise programme to address the issue.

Check your ideal weight: http://www.nhs.uk/Tools/Pages/healthyweightcalculator.aspx