The Heart Health Special

The Heart Health Special

Source: Men's Fitness UK

Diseases of the heart and circulatory system (CVD, or cardiovascular disease) were the second most common cause of death in the UK in 2014 with about 155,000 deaths, or 27% of deaths overall – only just behind the infinitely more sinister cancer with 29% of deaths.

Coronary heart disease alone is the single biggest cause of premature death in UK men, causing 15% of premature male deaths. “Heart and circulatory disease still kills around one in four people in the UK, stealing them away from their families and loved ones,” says the British Heart Foundation.

And that’s before you start counting the financial cost – in England alone the NHS spent £4.3bn treating CVD in 2013-14. The good news, however, is that 80% of all heart disease is caused by modifiable lifestyle factors including diet, physical activity and smoking, and it’s not too late to undo damage caused by poor habits.

Read on to find out how you can help your heart in its pulsatory responsibilities and thus improve and extend your own stay on earth. But first, five things you (probably) never knew about your love pump.

Hearty Facts

1. Your heart isn’t on the left-hand side of your chest

It’s actually centrally located under the breastbone. The heart itself is asymmetrical and the left ventricle has muscular walls that are much thicker and larger than the right because it is responsible for pumping blood all the way around the body.

2. Your heart is the size of two fists

It’s often said that your heart is the size of your fist, but this is only true for children – once you grow to adulthood it’s actually the size of both of them.

3. Your heart beats with the force of you squeezing a tennis ball


Squash a tennis ball in your hand and you’re using about the same amount of force that your heart uses to pump blood around your body.
4. Your heart will pump three supertankers of blood before you die

If you live an average lifetime then your heart will pump a million barrels worth of blood around your body. Your 5.6 litres of blood circulates through your body three times in every minute and travels 12,000 miles in a day.

5. You can die from a broken heart

Stress cardiomyopathy is where heart muscles are temporarily weakened by a shock or stressful event

10 Risks and What to Do About Them

1. High Blood Pressure

Your blood pressure is the pressure at which blood is squirted around your body, and hypertension, or high blood pressure, means too much stress is being placed on the plumbing. Blood pressure readings feature two numbers. The upper (systolic) number shows the highest pressure caused by the heart beating, while the lower (diastolic) number is the lowest pressure, when your heart is resting between beats. A reading of more than 120/80 indicates you need to take steps to bring it down.

According to the British Heart Foundation an unhealthy diet accounts for half of all hypertension (including eating too much salt), while being inactive or obese account for about 20% each. So lifestyle changes are vital to get the pressure down.

Drugs can also do the job and a two-decade long study published in December 2014 showed that treatment should be applied earlier. “Treating blood pressure to a lower level than currently recommended could greatly reduce the incidence of cardiovascular disease and potentially save millions of lives,” said study lead author Kazem Rahimi of the University of Oxford. So get your blood pressure checked, pronto, either at your local chemist or the doctor’s, or buy a gadget and do it at home.

2. Your Age

There’s not much you can do about this one – lying doesn’t work – but being aware of the risks means you can get checked out by your GP and take steps to get a healthier heart. After about 45 years, the risk of cardiovascular disease rises with one out of 100 men developing signs of heart disease. By 55, the risk has doubled to 2.1% out of 100, and by the age of 85, 7.4% of men have developed cardiovascular disease.

3. “Bad” Cholesterol

High LDL or “bad” cholesterol levels in the blood contribute to coronary heart disease, while high HDL (“good”) cholesterol levels actually protect the heart (and low levels of it increase disease risk). But don’t go thinking cutting eggs from your diet alone will help – over 80% of cholesterol in the body is manufactured and managed there. Instead you need to focus on reducing saturated and trans fats (the usual delicious suspects – snacks, biscuits, fast foods, etc), while increasing your fibre intake.

RECOMMENDED: Beat Heart Disease by Improving Your Cholesterol

4. Genetic Profile

You can’t change the genes you were dealt, but knowing the increased risk if your family has a history of the disease helps take early preventative measures. If your father or brother suffered a heart attack before the age of 55, or if your sister or mother before 65, then you are at greater risk of developing heart disease. And if both parents suffered heart disease before 55, then you have a 50% higher chance of developing CHD than the general population. The genes responsible are linked to high blood pressure and abnormal blood lipids (fancy medical jargon for fat). So focus on combating these two threats if your family is on first name terms with the staff of the cardio ward.

5. Physical Inactivity

A chronic lack of exercise is catastrophic for heart health. Modern life, from transport, to work, to entertainment is geared around sitting on your arse, and it can kill you by raising blood pressure, elevating triglycerides (more fat) and lowering “good” cholesterol. The British Heart Foundation recommends that adults should aim to be active every day: “At least 2.5 hours of moderate intensity activity (a week) in bouts of 10 minutes or more”, they reckon. “One way to approach this is to do 30 minutes on at least five days a week.” You can also condense this into 75 minutes of “vigorous intensity” exercise spread throughout the week. But don’t think hammering the cardio is enough. “Adults should also undertake physical activity to improve muscle strength on at least two days per week,” says the BHF.

RECOMMENDED: Joe Wicks’ 15-minute HIIT workout

6. Being Overweight

Got a beer gut? Then here’s the bad news: “Fat concentrated in the abdomen is a predisposing factor for cardiovascular disease,” says the ever-cheerful British Heart Foundation. In addition, the World Health Organisation’s waistline cut-off point – above which you are at risk – is 37 inches. And if you have a body mass index of over 30? The same. Get active, and take some fish oil supplements while you’re at it – a University of South Australia study found that overweight people who took fish oils while following an exercise programme lowered their blood fats and increased “good” cholesterol levels.

RECOMMENDED: How to Lose Belly Fat with Simple Lifestyle Changes

7. Smoking

Still on the fags? Seriously? Despite everyone knowing that smoking virtually guarantees an earlier appointment with death, 78,200 people were still felled by smoking in 2013. Smoking has absolutely nothing good to offer your heart.

8. Diabetes

Type 2 diabetes is directly linked to an unhealthy, high-sugar diet and it in turn raises your risk of heart disease. Having either type of diabetes means you’re at three times the risk of having a heart attack. And the effect of diabetes on CHD death rates is getting worse, not better. New research, published in September 2014 in the Journal of the American College of Cardiology says sugary drinks are partly to blame and that drinking one or two servings of sugar-sweetened drinks per day raises your risk of heart attack or fatal heart disease by 35%. Glucose can cause insulin spikes, which can lead to type 2 diabetes while fructose (in fruit juice) can trigger the release of triglycerides and “bad” LDL cholesterol into the bloodstream from the liver.

9. Poor Diet

Eating badly contributes to the furring up of your arteries – the classic preparation for a massive heart attack. Lots of vegetables and fruit, on the other hand, actively improve the health of your heart. If you eat them.

In September 2014, three leading heart docs claimed that lifestyle and diet changes, such as adopting a Mediterranean diet, can be even more effective than drugs, and that 80% of heart disease is caused by “modifiable lifestyle factors”, including diet. “A healthy diet offers a far more powerful, sustainable and enjoyable plan than lifelong statin tablets,” says Professor Simon Capewell, vice-president of the UK Faculty of Public Health.

10. Stress

Being in a constantly adrenalised state isn’t good for your heart. “When we were cavemen, that adrenaline helped us be ready if a tiger was going to attack,” says Dr Richard Stein, professor at New York University’s Center For The Prevention Of Heart Disease. “Today, all the tigers are in our heads.” One way to combat daily stress is to use meditation. In a 2012 study in the journalCirculation: Cardiovascular Quality and Outcomes, subjects who used transcendental meditation were 48% less likely to have a heart attack. “Think of it as a 20-30 minute vacation from the stress in your life,” says Dr Stein. But you don’t have to go all new age – even taking uninterrupted time out to walk while listening to your favourite music counts as a de-stress.
Healthy Heart Foods

Nutritionist Taru Towers (thrivelondon.com) reveals the best and worst foods for your heart.

Five of the Best Foods for your Heart

1. Non-starchy vegetables: A source of fibre, vitamins, minerals, antioxidants and other phytonutrients, veg is at the centrepiece of a heart-healthy diet. Aim to include a portion the size of your fist in every meal with a minimum of two different colours.

2. Fatty fish and flaxseed: Sardines, herring and anchovies or flaxseeds are all a source of anti-inflammatory omega-3 oils. Fresh, non-rancid oil directly from these foods helps the body to modulate inflammation, often an underlying cause of heart disease.

3. Avocado: Pear-shaped perfection for cardiovascular health, the avocado packs considerable fibre, healthy monounsaturated fat and potassium.

4. Colourful berries: Rich in antioxidants and vitamins, and lower in sugars compared to most fruits. Defrosted frozen berries are a great option and sometimes more nutritious than fresh because storage and transport can reduce the nutrient values of fresh foods.

5. High quality lean protein: The quality of your protein is imperative – don’t forget to use plant protein sources such as lentils, beans and tofu, and enjoy lean animal protein in moderate quantities, leaving a day or a two a week for purely vegetarian meals.

Five of the Worst Foods for your Heart

1. Processed foods and takeaways: These foods are the clubhouse of the trans fats, which love to negatively alter your cholesterol composition. They are the healthy heart’s dietary enemy number one.

2. Soft drinks: Sugars and sweeteners induce a hormonal cascade, which is harmful systemically, let alone for your heart. Soft drinks can also leach potassium out of the body, possibly even leading to hypokalemia (potassium deficiency).

3. Alcohol: The experts are currently bickering over whether modest quantities of red wine are part of a heart-healthy Mediterranean diet, but alcohol in itself is nothing but liquid full of nutrient-void calories.

4. White bread, cakes and biscuits: Nutrient-void, the negative effects of refined grains are comparable to white sugar – bad for your waistline as well as your heart.

5. Cigarettes: Not strictly speaking a “food”, but the almost immediate positive effects for the heart from quitting the gaspers are so considerable that smoking has been highlighted in all of the research looking at cardiovascular disease risk factors.

More Healthy Heart Foods

Jamie Lloyd, a fitness writer, speaker and coach is co-author ofTotal Bodybreakthroughs, adds his recommendations for nutritious foods that give your heart an extra helping hand.


Almonds

Almonds and other nuts contain healthy oils, vitamin E and other substances that help keep your cholesterol levels in check. They're also a good natural source of protein and fibre. Eat as a snack by themselves or sprinkle slivered almonds on green beans with lemon juice to make a delicious side dish.

Tomatoes

Packed with vitamins and lycopene, tomatoes have long been associated with a reduced risk of heart disease. Add thick slices of tomatoes to sandwiches and salads or enjoy tomato sauce on pasta. In fact, cooked tomato sauce and canned tomato sauce both contain more lycopene than the equivalent weight in raw tomatoes.

Olive Oil

Full of monounsaturated fats, olive oil lowers LDL, reducing your risk of developing heart disease. Look for extra-virgin olive oil because it's made using a natural process that involves no chemicals or any other additives.

Spinach

Popeye knew firsthand the value of eating spinach. Hands down, spinach is the powerhouse of the vegetable kingdom. Its rich, dark colour comes from the multiple phytochemicals, vitamins, and minerals (especially folic acid and iron) that also fight disease, protect against heart disease, and preserve your eyesight.

Oatmeal

Your grandma called it roughage and we need plenty of it each day. Oatmeal is one way to pack it in. Oats are wholesome whole grains and a great source of vitamins, minerals, and cholesterol-lowering fibre. Research shows oats lower cholesterol levels, keep you regular and may help prevent certain cancers.

Brussels Sprouts

Forget any childhood aversion you may have had to this green veggie, your heart is a fan. Brussels sprouts contain a high amount of soluble fibre compared to other vegetables. Soluble fibre binds cholesterol in the digestive tract where it's then excreted by the body. 200g of cooked sprouts contain 4g of soluble fibre.

Salmon

Omega-3s make this fish a darling of heart health, as it lowers triglycerides and slows the rate of hardening of the arteries. Other heart-healthy fatty fish such as sardines, mackerel, and lake trout, also contain high amounts of omega-3s.

A Cardiologist’s Advice

The King of Hearts

Still not got it? Let UK cardiologist Dr Usman Sheikh drive the point home.

What are the biggest threats to heart health in Britain?

You can break it down into four main ones. The first is a lack of physical activity. With advancements in modern technology we are becoming lazy, which in turn is adversely affecting our hearts. The second is snacking. As healthy snacks are expensive people keep on eating unhealthy ones that contain a lot of sugars and salt along with saturated fats. Then there’s smoking – this causes narrowing of the coronary arteries. Lastly there’s stress – it’s always underestimated but plays a key role in adverse heart problems.

If I only do one thing for my heart today, what should it be?

The one thing I’d like everyone to do is spend at least a few minutes being more active, everyday. That doesn’t have to be in a gym – even a brisk walk can help.

What about diet – do I need to cut out all saturated fat?

You don’t need to cut all saturated fats, but your intake should be restricted to less than 10 per cent of your daily energy intake [7 per cent if you are at high risk of heart disease]. Most people eat about 35 per cent more than the recommended amount. Healthy monosaturated and polyunsaturated fats provide essential fatty acids and soluble vitamins.

What’s the best start to my day for heart health?

Oatmeal is good as it helps to lower cholesterol. It prevents absorption of cholesterol, acting like a sponge. Blueberries, strawberries and other berries help to lower blood pressure.

Are there heart-healthy swaps I can make in my everyday diet?

There are foods that can help. If you like chocolate then eat dark chocolates as they have more cocoa, which helps to lower blood pressure. Soya milk is great source of protein without the bad fats, which can adversely affect your heart. Oily fish like mackerel and salmon are high in omega-3, and you should avoid red meat as much as you can. When using oil, rapeseed oil is the best [followed by olive oil] as it helps to lower cholesterol. Swap sweet, fatty snacks for nuts – they contain vitamin E, which is good for the heart in general.

With the heart there’s an unquestionable link between lifestyle and its health…

Yes, it’s true that heart health is directly related to environmental and lifestyle factors, but bad genes also play a part. A family history of hypercholestrolaemia can have a negative impact.

Given that is the case what can we do to check out heart health?

Men should get their cholesterol checked in their mid-thirties and if you have a family history of ischaemic heart disease. Regular blood pressure checks are worthwhile too. Anyone above the age of 40 can have a health check at their local GP practice.

What’s been the most important heart health discovery recently?

Coronary artery stents have revolutionised heart health. They’re basically metal scaffolds, which can stretch open the coronary arteries that are narrowed. Thousands of lives have been saved because of the development of stents.

Can you turn around the health of a long-neglected heart?

Yes, damage can be reversed by lifestyle changes and a healthy diet. An increase in physical activity and a reduction in sugary, high-fat foods is a great place to start. Exercise itself can help to increase the level of good cholesterol [HDL] and lower the bad cholesterol [LDL].

Is it possible to damage the heart through over-exertion?

In a healthy individual there is no risk of damage from excessive exercise. But in someone who already has a weak heart it can be problematic, so check with your GP before embarking on a new programme of exercise.

What’s the future for heart health – is there any research that could be revolutionary?

The future of heart health is bright. Loads of trials are being done all over the world to improve heart health, from making better medications, to improving investigations – better stents with less complications are the future. And people are more aware of their health thanks to the media and the British Heart Foundation, which helps to prevent heart disease in the first place.

Dr Usman Sheikh is a Cardiac MR/Interventional Fellow at the Royal Devon & Exeter Hospital