We've already taken a pretty detailed look at heart disease this month ? covering risk factors, cholesterol, blood pressure and an absolute multitude of dietary and lifestyle tips! However, if I'm to give you the most comprehensive perspective on how you can potentially say a big fat NO to heart disease, then there's one more area we need to cover.

High homocysteine is a crucial factor to understand if we are going to tackle heart disease comprehensively. Whilst in some ways it is yet another thing to worry about, there are two extremely positive things to bear in mind.

Firstly, many of the steps that lower cholesterol and blood pressure also lower homocysteine (so it's not too complicated to address) and secondly, lowering homocysteine also helps to reduce your risks of other diseases such as diabetes and Alzheimer's. So what is it? Well, dietary protein contains several amino acids, one of which is called methionine. Methionine is metabolised into two important substances in the body ? glutathione (a powerful antioxidant) and s-aenosyl methionine (or SAMe), which facilitates more than 40 essential biochemical reactions in the body.

All sounds good so far, but the problem is that if you don't have enough B vitamins, folic acid and zinc in your diet, then methionine doesn't get all the way to being glutathione or SAMe ? instead, it gets stuck in the middle of the pathway as homocysteine.

Homocysteine acts as a temporary intermediate substance, but when it gets stuck and accumulates, it can become a serious problem. Not only does it limit the quantities of glutathione and SAMe in the body, but it can also damage the arteries, brain and DNA. What's the proof? Here's an example. In 2002, Dr David Wald, a cardiac registrar from Southampton General Hospital in the UK, published the results of his work on homocysteine and heart disease in the British Medical Journal. Wald and his colleagues had examined the association between high homocysteine and cardiovascular risk in 20,000 people. They found that with every 5 unit increase in homocysteine in the blood, the risk for heart disease increased between 32 and 42 percent.

The solution of course isn't to stop eating dietary protein. You need to remember that glutathione and SAMe are powerfully protective. But you do need to make sure that you get enough B vitamins, folic acid and zinc in your diet. There are also several other steps you can take, outlined in the advice below. In addition to this, more research has shown that approximately one in ten people have an inherited genetic mutation that makes them more likely to have higher homocysteine levels. These individuals may well benefit from supplement higher levels of the nutrients that metabolise homocysteine.

I am of course going to show you how to lower your homocysteine levels via your diet and lifestyle. However I'm aware that I've given you three healthy heart protocols already this month ? one general, one for managing cholesterol and one for lowering blood pressure.

This time, instead of just giving you tips for managing homocysteine, I thought I'd collate all the information into one easy to read guide. Whilst specific protocols can be useful, in reality most of us need to take a holistic approach.

Your comprehensive guide to a healthy heart! H = lowers Homocysteine C = lowers Cholesterol BP = lowers Blood Pressure

1. Know your cholesterol and blood pressure measurements (C, BP) It's critical that you go for your annual physical. For those of you that are in between physicals, or simply want an update, go and get your blood pressure, blood sugar and cholesterol measured for free at the health fair on April 7th, 11am-4pm, at Number One shed.

2. Eat less meat (H, C, BP) Diets high in animal protein are linked to a higher homocysteine level and tend to be higher in saturated fat. Reduce meat to four lean servings a week and replace some with fish and vegetarian sources of protein (mixed beans, hummus, soy beans, tofu, nuts.)

3. Increase fish oils (C, BP) Oily fish, such as mackerel, salmon, tuna and sardines have a very high Omega 3 "good fat" content. Omega 3 has been shown to lower bad LDL cholesterol, raise good HDL cholesterol and help thin the blood to reduce blood pressure. Aim to eat oily fish at least 3 times a week (baked or grilled, not fried) or consider supplementing Omega 3. However, please consult your GP before supplementing your diet with Omega 3 oils as some medical conditions (e.g. epilepsy) and drugs (e.g. blood thinners such as Warfarin) are contraindicated.

4. Reduce sodium, increase potassium (BP) A layer of muscle surrounds your heart and arteries. Too much sodium and too little potassium can increase the pressure from these muscles, which in turn increases blood pressure. Nobody needs to add salt to their food, there is enough sodium present naturally. Check food labels for sodium content and aim for less than 1,500 mg daily (approximately half a teaspoon.) Ready meals, sauces, deli meats and snack foods often contain high sodium.

5. Increase whole grains, beans and green leafy vegetables (H, C, BP) These foods are rich in calcium, magnesium and potassium ? all important for controlling blood pressure. They are also rich in the B vitamins which help to metabolise homocysteine and fibre, which actively removes bad LDL cholesterol from the body.

6. Increase vitamin C rich foods (C, BP) Vitamin C has been shown to maintain elasticity of blood vessels. It also inhibits excessive cholesterol production. Yellow peppers, blueberries, strawberries, broccoli, oranges and papaya are all rich in vitamin C. You may also choose to supplement vitamin C (1,000 mg daily), but if you have any health conditions or are on any medications, do check with your doctor first.

7. Increase celery, garlic and onions (BP, H) Celery contains something called 3-n-butyl phthalide, which has been shown to lower blood pressure. Aim to eat 4 stalks of celery every day, organic if possible. Celery is good in salads, stir-fry or with hummus/salsa. Garlic and onions have sulphur-containing compounds that also help to lower blood pressure and homocysteine, so use them liberally in your cooking!

8. Reduce your intake of "bad" saturated fats (C, BP) Saturated, trans and hydrogenated fats should be avoided as these directly raise bad LDL cholesterol. Saturated fats cause the blood to become thick and sticky, raising blood pressure. Avoid saturated, hydrogenated and trans fats - such as those found in fried foods (e.g. KFC, chips), margarines, cookies, full fat dairy produce, red meat, cakes, pastries, creamy sauces and other processed foods.

9. Keep your bad LDL cholesterol low (C, BP) Go easy on foods that are naturally high in cholesterol ? including shrimp, meat, eggs and dairy products.

However, if ? and only if! ? you are following the other steps religiously, it's ok to have these foods occasionally.

Remember, it's more important to protect the cholesterol that's in your body (by eating fruit and veg), raise HDL (e.g. via fish oils) and lower LDL (e.g. via fibre), than to focus on banning cholesterol altogether.

10.Avoid caffeine (H, C, BP) Caffeine depletes the body of B vitamins and can therefore raise homocysteine levels, especially if you have several caffeinated drinks a day. It is also a stimulant that promotes the "fight or flight" response, releasing the stress hormones that elevate blood pressure.

Avoid caffeinated drinks (including Red Bull and cola) and replace with decaf, or preferably herbal/fruit teas. For those of you haven't yet tried a herbal/fruit/decaf tea you liked, try the Traditional Medicinal brand at Down to Earth or the decaf Revolution teas available at Miles ? quality makes all the difference!

11. Give up smoking (H, C, BP) Easier said than done I know, but nicotine is also a stimulant that promotes the fight or flight response. This will of course include the nicotine patch and gum, but both are better alternatives to smoking ? especially if you manage to give up. Bear in mind that smoking can also deplete the body of B vitamins, raising homocysteine levels.

12. Avoid alcohol (H, BP) Be careful here. The American Heart Foundation recommends no more than two drinks daily for men and one for women. This doesn't mean that you can save them all up and drink 7-14 in one sitting! Again, alcohol depletes B vitamins and also bear in mind that alcohol raises blood sugar and increases the production of free radicals ? both of which damage arteries.

12. CoQ10, Sytrinol and Noni Juice (C) Whilst statins block the enzymes that make cholesterol, they also prevent the manufacture of CoQ10. This antioxidant is vital for maintaining a healthy heart so if you are taking statins, consider supplementing CoQ10. The American Heart Association has also recently reported that Noni Juice has been shown to lower LDL cholesterol. In addition, research shows that Sytrinol (available at Rock On) can lower LDL and improve HDL levels. However, always consult your GP prior to taking any supplement in conjunction with medication.

13. Take a good quality multivitamin and mineral ? every day! (H, C, BP) Supplements help to cover your bases when your diet and lifestyle steps fall short. Optimum levels of nutrients can also actively help to lower high homocysteine levels. Be careful of cheap supplements bought from pharmacies or grocery stores. Whilst they often cover the RDA (Recommended Daily Allowance) for most nutrients, they often fall short on optimum nutrition. Down to Earth and Rock On both sell top quality supplements. Look for one that provides at least 25mg B1, B2, B3, B5 and B6, 10ug of B12, 200ug folic acid and also A, D, E, magnesium, selenium, chromium and zinc.

14. Keep fit! (C, BP) Exercise actively helps to lower LDL and raise HDL cholesterol. Being overweight is another risk factor for heart disease as the excess weight puts too much pressure on your heart. However, even if you are on target, exercise is still crucial for controlling blood pressure.

15. Manage your stress levels (H, C, BP) I can't emphasise enough how important this is. Stress always exacerbates any health condition, but is especially harmful to those with heart disease as it raises both blood pressure and ? as it depletes B vitamins ? homocysteine too.

The advice given in this article is not intended to replace medical advice, but to complement it. Always consult your GP if you have any health concerns.