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Few of us actively think about how healthy our hearts are; not least because we can't see them, so assume they are ticking along nicely. And yet – although death rates from coronary heart disease (CHD) are falling – statistics from the British Heart Foundation show seven million of us are living with CHD, and it remains the UK's biggest killer.
The good news is that simple lifestyle tweaks are all it takes to keep heart disease at bay. Here's how to take the first steps to a healthy heart.
Being overweight increases your risk of high blood pressure, high cholesterol and type 2 diabetes (all markers for potential heart disease). And the more extra cladding you are carrying around your belly, the bigger your risk (the danger zone for a woman is a waist measuring 32in or over and for a man 37in or more).
If you can shave just two inches off your waist through diet and exercise, you reduce your risk of CHD by around 10-15 per cent.
Becoming more active will not only help to burn off calories, but will also help balance blood glucose, lower high blood pressure and lower LDL 'bad' cholesterol, while boosting levels of HDL: the 'good' variety.
The good news is that even moderate exercise, such as half an hour's worth of gardening or walking a day, something easily manageable, has been linked to a lower risk of heart attack and stroke.
If you don't currently do any regular exercise, brisk walking is one of the easiest ways to work it into your life – walk to the shops or to work, or join a walking group. The NHS recommends 30 minutes a day, but you can break this up into three manageable 10-minute slots.
OMEGA 3 These heart-healthy fats contribute to normal cholesterol levels and heart function
VITAMIN K2 Contributes to normal blood clotting
PLANT STEROLS Help to lower cholesterol levels
The Mediterranean diet trumps every single diet in the heart-healthy stakes. A study presented at 2017's European Society of Cardiology conference revealed that those with a history of heart disease who ate the Med way – plenty of fruit and veg, wholegrains, pulses, nuts, seeds, fish, olive oil, garlic and herbs plus moderate amounts of poultry, red meat and alcohol – had a 37 per cent lower risk of dying than those who did not.
The DASH (Dietary Approaches to Stop Hypertension) diet, which is low in saturated fat and sugar and salt, but high in vegetables, fruits, wholegrains, low-fat dairy, fish, poultry, nuts and vegetable oil, has been shown to lower not only blood pressure but also LDL cholesterol – the 'bad' type – in a matter of weeks.
The ketogenic (keto) diet is very low in carbs such as pasta, with moderate protein and high fat. It has been shown to help reduce some risk factors such as obesity, but its long-term effects are as yet unknown.
You don't have to suddenly live off spiralized lettuce or run marathons to improve this life-sustaining organ. Small changes can be gradually incorporated into your daily life, and have a big payoff.
Substitute one red meat-based meal a week for a plant-based one or one containing oily fish.
Fill up on low-calorie, high-fibre fruit and vegetables; include at least one extra portion of fruit or veg daily; cook with unsaturated fats like olive, sunflower or rapeseed; snack on fruit or heart-healthy nuts and seeds; use herbs and spices in place of salt.
A large 2017 study found moderate drinkers (classed as one or two drinks a day) were less likely to die from heart disease than those who didn't touch a drop. It is regularly drinking to excess that poses a problem.
The sooner the better. Figures from NHS England show smoking doubles your risk of having a heart attack.