By our mid-forties, we’re all at AN INCREASED RISK of a “heart event”. Fix your diet
and you diminish the risk, say KATE O’BRIEN and PAULA MEE in their new book, Your Middle Years
Heart disease is now the leading cause of death in women over 50. The risk of high blood pressure and high blood cholesterol increases after the menopause; as oestrogen levels decline, harmful LDL increases and the good HDL cholesterol decreases. Fatty cholesterol deposits develop and harden within the blood vessel and blood flows under increased pressure through narrowed vessels. When there is a complete blockage, oxygenated blood is prevented from reaching the brain and a stroke occurs. If the heart muscle is deprived of oxygenated blood, a heart attack ensues. Keeping cholesterol and blood pressure levels as near normal as possible is vital, particularly post menopause, and an annual cholesterol and blood pressure test is important, especially where there is a history of cardiovascular disease in the family.
Cholesterol is a waxy, fat-like substance. Nearly two-thirds of the body’s cholesterol is made by the liver and what we eat contributes to the remaining third. Your risk of having a heart event is increased by having a high level of Low-Density Lipoprotein. A High-Density Lipoprotein is protective because HDL carries cholesterol away from the arteries and back to the liver, protecting against its accumulation on artery walls. A low HDL can put you at risk of heart disease.
CHOLESTEROL IN FOOD
Cholesterol is found in some foods (eggs, liver, prawns, crab and lobster) but this type of dietary cholesterol has little effect on your blood cholesterol. Most women can continue to enjoy moderate amounts of these foods (between four and six eggs per week). The more damaging sources of cholesterol are trans and saturated fats, found in cakes, biscuits, pastries, processed meats, butter and cream. Eating too much may increase your risk of heart disease and stroke. The evidence overall suggests that we should limit saturates to less than a third of all the fat we eat. Trans fats increase LDL levels and lower HDL levels, cause inflammation and increase the tendency for blood clots to form inside blood vessels. The recommended intake is no more than two grammes of trans fats a day.
Better for your heart than trans or certain saturated fats, unsaturated fats are divided into monounsaturated and polyunsaturated fats. Olive oil, rapeseed and other seed oils, walnuts, Brazil nuts, almonds, hazelnuts, avocados, sunflower seeds, sesame seeds, pumpkin seeds and chia seeds are all sources of unsaturated fats. The protective omega-3 fats in certain fish keep the heartbeat regular, reduce triglycerides and prevent blood clots forming in the arteries by making the cells less sticky and assist in protecting the heart and joints. Oily fish – trout, mackerel, salmon – is the best natural source of omega-3 fatty acids. Eat two portions every week.
Blood pressure is the force of blood against the artery walls, which rises and falls during the day. It is recorded as two numbers: systolic pressure (as the heart beats) over diastolic pressure (as the heart relaxes between beats). A healthy blood pressure is 120/80 millimetres of mercury (mmHg) or lower. If your blood pressure remains elevated over time, the condition is dangerous because it makes the heart work too hard, and the force of the blood flow can harm arteries. If uncontrolled over time, it can lead to heart disease, kidney disease and stroke. Your doctor may prescribe medication.
Many women combine dietary and lifestyle interventions in conjunction with blood pressure medication. The Dietary Approaches to Stop Hypertension eating plan contains very little saturated fat, red and processed meat, desserts and sugary drinks. Eating less salt is a vital part of reducing your blood pressure. The DASH approach replaces foods that are high in salt with foods that contain potassium, calcium and fibre. The diet includes whole grains; small servings of lean fresh meats, lots of fish and poultry; nuts and beans; low-fat dairy; and large quantities of fruit and vegetables. For more details of the DASH diet, see www.dashdiet.org.
Your Middle Years (Gill Books, €16.99) is published March 11.
5 Dietary Changes To Fix Your Heart …
Porridge, muesli, home-made granola, oatcakes. Add barley, which contains beta-glucan which can also lower cholesterol, to soups, and fibre-rich kidney beans, lentils and chickpeas to stews. Eating 30g of nuts a day may lower LDL. Apples, grapes, strawberries and citrus fruits are rich in pectin, a soluble fibre that lowers LDL.
The active ingredients in functional foods (spreads and little shot bottles) are usually plant stanol or sterol esters, naturally occurring substances found in many grains such as wheat, rye and maize. They have a similar structure to cholesterol and so
they compete with it in the gut and
inhibit its absorption.
If your triglycerides are high, reduce sugar and sugary foods, sugar-sweetened drinks, soft drinks and fruit juice, cakes, biscuits and chocolate. Reduce alcohol: have just one drink on any one occasion and try to have three alcohol-free days a week; eat a dinner serving of oily fish such as salmon, trout, or mackerel, twice a week.
SHAKE THE SALT
Add little or no salt when cooking porridge, rice, pasta or potatoes. Adapt recipes with herbs, spices or lemon juice. Avoid highly salted foods such as crisps, popcorn, salted nuts, processed meats and ready meals. Buy lower-salt versions of stock cubes, soy sauce and Worcestershire sauce.
Being overweight increases the risk of
high blood pressure. That risk rises as your weight increases (obese BMI>30). Systolic and diastolic blood pressures drop an average of 1mmHg for roughly every 0.5kg of weight lost, although the actual amount varies from person to person.
Total cholesterol (TC):
5.0 mmol/L or less.
Low-density lipoprotein (LDL) cholesterol after an overnight fast: 3.0mmol/L or less.
High-density lipoprotein (HDL) cholesterol: 1.2 mmol/L or more.
TC/HDL ratio: 4.5 or less, that is your total cholesterol divided by your HDL cholesterol. This reflects the
fact that for any given TC level, the more HDL the better.
Triglycerides: 1.8 or less.
Kate O’Brien and Paula Mee
This article appeared in a previous issue, for more features like this, don’t miss our March issue, out Thursday April 7.
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