Top tips for good heart health

1. Cut down on saturated fat and replace with unsaturated fats – for example swap butter and coconut oil for rapeseed, olive and sunflower oils and spreads made from these.
2. Have fish twice a week – one should be an oily type (such as mackerel, salmon or sardines).
3. Watch your salt intake – aim for less than 6g a day. Check the nutrition label on foods, and do not add salt in cooking or at the table.
4. Include high-fibre and wholegrain foods in your diet like wholegrain breakfast cereals, wholewheat pasta and pulses (such as lentils and beans). Fruit and vegetables are good fibre providers too.
5. Give up smoking – this is one of the best things you can do to protect your heart.
6. Keep active – aim for at least 150 minutes a week (around 30 minutes a day, five days a week) of moderate physical activity.
7. Do not drink to excess – adults should drink no more than 14 units a week, with several alcohol-free days each week.
8. Aim for a healthy weight.

Heart disease and stroke

Heart disease and stroke are a major cause of death worldwide. In the UK, heart disease by itself is the biggest single cause of death; 15% of male and 10% of female deaths in 2014. 

The number of deaths from heart disease have been decreasing in recent years but it is still one of the major causes of premature death (before 75 years) in the UK and a leading cause of ill health. But the good news is - it is largely preventable! Eating a healthy diet can help reduce your risk of heart disease and stroke.

The condition that causes most heart attacks and strokes is known as atherosclerosis

• Atherosclerosis is the build-up of fatty material inside arteries (blood vessels) like the coronary arteries that supply blood to the heart.
• The build-up of fatty material causes a narrowing in the artery, and as these become more severe, they can restrict the flow of blood so enough blood cannot reach the heart. 
• This can cause the symptoms of angina (such as chest pain and shortness of breath).
• If the fatty material breaks down (or ruptures), a blood clot can form, which can completely block the artery and lead to a heart attack.
• Strokes occur if such ruptures happen in arteries in the brain, stopping the flow of blood.

Who is at risk?

There are several risk factors for atherosclerosis and heart disease. A risk factor is something that that increases your chance of getting a disease.

• High blood pressure (hypertension)
  Having high blood pressure puts strain on your heart that can lead to your blood vessels becoming damaged, making them more at risk of heart disease.
• Smoking
  Quitting smoking is the single best thing you can do for your heart health.
• High blood cholesterol
  High levels of cholesterol (a type of fatty substance) in the blood can build up in the walls of the coronary arteries, restricting blood flow to the heart and rest of the body.
• Diabetes
  The increased levels of blood glucose that can occur in type 1 and type 2 diabetes can damage the coronary arteries, increasing the chances of heart disease developing.
• Lack of exercise
  Not exercising regularly increases the chance of high blood pressure, higher cholesterol levels and overweight and obesity. These are all risk factors for developing heart disease.
• Being overweight or obese
  Research shows that being overweight or obese can raise your blood cholesterol levels, increase your blood pressure and increase your risk of developing type 2 diabetes.
• Family history of heart disease
  You are considered to have a family history of cardiovascular disease (CVD) if your father or brother was under age 55 years when they were diagnosed with CVD, or your mother or sister was under age 65 years when they were diagnosed with CVD.
• Ethnic background
  For the South Asian population (Bangladeshis, Indians and Pakistanis), and people with an African Caribbean background, CVD risk can be higher than for the rest of the UK population.
• Age
  Your risk of developing heart disease increases with age.
• Gender
  Men are more likely to develop heart disease earlier than women.

The more risk factors you have, the greater your personal risk. But there are many things you can do to reduce your overall risk and keep your heart healthy. It’s never too late to start!

Even though you cannot do anything to change some of these risk factors, there are several lifestyle behaviours that put you at increased risk that can be changed. The main ones are:

• smoking
• a poor diet
• excessive alcohol consumption
• lack of physical activity.

These factors contribute to the risk of obesity, type 2 diabetes, high blood pressure and high cholesterol levels, which are some of the strongest risk factors for heart disease.

Maintaining a healthy bodyweight

Maintaining a healthy bodyweight and shape can significantly protect your heart. People who are overweight or obese tend to have a higher risk of certain risk factors for heart disease, such as increased levels of blood cholesterol, high blood pressure and an increased risk of developing type 2 diabetes.

As well as bodyweight (measured as body mass index [BMI]), your shape can affect your health risk. If you are overweight and carry fat around the waist (apple–shaped), you are at greater risk than if you carry fat on the hips and thighs (pear-shaped).

• If you are a man, your chance of developing health problems is higher if your waist measurement is more than 94cm (37inch), and higher still if it is more than 102cm (40inch).
• If you are a woman, your chance of developing health problems is higher if your waist measurement is more than 80cm (31.5inch), and higher still if it is more than 88cm (34.5inch).
• Type 2 diabetes prevalence is strongly associated with ethnicity. The International Diabetes Federation and South Asian Health Foundation agree that men from South Asian and Chinese ethnic groups are at increased risk of type 2 diabetes if waist size is greater than 90cm.

Together with being physically active, eating a healthy, balanced diet will help you maintain a healthy bodyweight as well as providing your body with all the vitamins, minerals and other nutrients it needs to keep healthy. Read on for top tips for eating to keep your heart healthy!

Eating to keep your heart healthy

The Eatwell Guide is the UK's healthy eating model for the general population. It is a practical tool to help us to make healthy choices about the foods and drinks we choose to consume. Some of the healthy eating guidelines in the Eatwell Guide may be particularly relevant if you are looking to eat well to protect your heart. Good dietary patterns that include wholegrains, fruit and vegetables, nuts and seeds, oily fish and choosing unsaturated fats (such as the Mediterranean dietary pattern) are important for good heart health. Following the Eatwell Guide will help you to choose a better dietary pattern. Find out more about the Eatwell Guide on this government webpage.

Top tips for ethnic diets

It is known that some population groups such as South Asians (Bangladeshis, Indians and Pakistanis) and people with an African Caribbean background can have a higher risk of CVD than the rest of the UK population.

Here are some healthy eating tips for ethnic diets to help you look after your heart.

• Cut down on cooking with ghee, butter, palm oil or coconut oil/milk/cream, as these types of fat are high in saturated fat. Instead use oils that are high in unsaturated fat (monounsaturates and polyunsaturates), such as rapeseed, olive and sunflower oils and spreads.
• Avoid adding ghee or oil to foods such as chapattis or dhal.
• Use lean cuts of red meat such as lamb, beef, mutton and goat, as these varieties can be high in fat.
• Only eat foods high in calories and fats occasionally, for example cakes, biscuits, samosas, pakoras and fried plantain. Savoury Indian snacks and sweets should also be limited in the diet as they are high in calories, sugars and fat.
• Choose wholemeal or wholegrain varieties of starchy foods such as chapatti, wholemeal pitta bread, boiled brown rice or potatoes instead of paratha, puri or fried potatoes.
• Choose less salty foods such as salt fish, bacon and salty snack foods (such as crisps and salted nuts) and do not add salt when cooking.
• Help reach your 5 A DAY by adding vegetables and pulses like okra, kidney beans and black-eyed peas to curries and stews.

Healthy lifestyle

Healthy eating is just one part of a healthy lifestyle. It is also important to consider other risk factors that may contribute towards your risk of heart disease.

Here are some tips to help you look after your heart:

• Give up smoking

You are nearly twice as likely to have a heart attack if you smoke compared to people who have never smoked. Therefore, giving up smoking is one of the most important things you can do to protect your heart. The chemicals in smoke reduce the amount of oxygen your blood can carry to your heart and body; raise your heart rate and blood pressure so your heart must work harder; damage the lining of your arteries (blood vessels), causing a build-up of fatty deposits; and make the blood more likely to clot (thicken).

If you’re thinking about quitting smoking, find out more about what help and support is available from your local Stop Smoking Service on this NHS webpage. 

• Take part in physical activity

Being inactive is a major health risk and one of the main causes of death and ill health in the UK.

You should aim for 150 minutes of moderate intensity physical activity (when you feel warm and slightly out of breath) a week. You could do this by doing 30 minutes of activity on five days of the week, but it could also be broken up into smaller sessions of 10 minutes or more. If you can do more, then that is great but be careful not to overdo it to start with. If you need to lose weight then you should aim for 45-60 minutes of moderate exercise every day. Talk to your GP before starting on a new exercise programme, especially if you have a history of heart disease, stroke or other health problems.

When you take part in activity, your body needs more oxygen and so your heart and lungs must work harder. This helps to make your heart and blood vessels become more efficient over time. It also helps develop your stamina (how long you can be physically active for). Brisk walking, dancing, cycling and swimming are all great examples. So, start at a pace that suits you and gradually increase what you can do.

Being more active does not have to mean joining a gym!  Even pushing a lawnmower counts!

No matter how much physical activity you do, it’s important to avoid sitting down for long periods of time, for example whilst watching TV, using a computer, reading and travelling by car, bus or train. Being seated for long periods of time is bad for your health and has been linked to weight gain.

• Drink alcohol moderately

Regularly drinking more alcohol than we are recommended over a long period of time raises blood pressure, which is a risk factor for heart disease and stroke. It can also weaken the heart muscle so the heart cannot work as well. Binge drinking (drinking more than six units a day for women or eight units a day for men) is a risk factor for heart disease.

There has been some evidence that for heart disease, drinking alcohol at low levels may be good for our hearts (compared to not drinking). However, when looking at total mortality – risk of death from all causes - a recent government review found that the protective effect from drinking alcohol regularly at low levels appears to be important only for women aged 55 years and over, and that for most adults any benefit to heart conditions is outweighed by the increase in risk from other health conditions such as increased risk of some cancers.

So, although very low levels of alcohol may have some protective effects against heart disease, this is more than outweighed by the adverse effects of alcohol on other health conditions.

Alcohol is not advised as a way of achieving better heart health, this can be better done through exercise, diet, not smoking and managing risk factors such as high blood pressure and high cholesterol levels.

The new recommendations for alcohol to keep any health risks low are that:

• men should not drink more than 14 units of alcohol each week, the same level as for women.
• men and women should have several alcohol-free days each week.

A standard glass of 12% ABV wine (175ml) is equivalent to about two units, and a pint of ordinary beer is also the equivalent to two units.

Information reviewed October 2016.