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A nutritious start to a healthy life

I've spent the past few weeks talking about children, so now let's jump to the other end of the spectrum. What can we do as adults to ensure that we meander into old age with a healthy body and mind? I'll spend the next four weeks looking at this ? but let's start by getting to the of the matter?.

So, yes, this week I'm going to take a look at the heart and how we can keep it healthy from a nutritional point of view. To assist me in this exercise I have just opened a bottle of red wine. I do love red wine but I generally only have one glass ? however as these articles sometime take me a few hours to write, I'm hoping I'll still be sober by the end. If I become incoherent, you'll know what happened!

First, let's consider the bad news. As citizens of a westernised culture, we have a 50 percent chance of dying from heart or artery disease. But "chance" is probably a bad choice of words, as ? and this is where the good news comes in ? heart disease is largely completely preventable. Now, for the average person there is nothing natural or inevitable about dying from heart disease. In the 1930s, heart attacks were so rare that they could only be diagnosed by specialists. You could argue that this was due to a lack of knowledge or technology, but consider this ? autopsies performed on the mummified remains of Egyptians showed no signs of the blockages in the arteries that would have resulted in heart attacks or strokes. Also, the Japanese have historically had a much lower incidence of heart disease than either the American or British populations. However as Japanese diets and lifestyle come into line with the westernised norm (high sugar, fat, stress and alcohol) their incidence of heart or artery disease has also increased.

Now although we are familiar with the term "heart disease", our biggest area of concern is really "artery disease". Three main problems occur in the arteries, all of which contribute to high blood pressure. Firstly, we can develop arterial plaque on the artery walls called atherosclerosis. This plaque reduces the blood flow to the heart. Secondly we can develop blood that is thicker and stickier than normal, containing clots, and thirdly, our arteries can actually harden (a process known as arteriosclerosis.) Individually these are a cause for concern, but together they are especially dangerous ? as they can lead to a blockage of the artery that ultimately stops the flow of blood into the heart. Angina (chest pain upon exertion or stress) usually occurs where there is a partial blockage, and a heart attack occurs where there is a total blockage. Although many people understand stokes to be an aspect of heart disease, they are in fact caused by a blockage or artery rupture that obstructs oxygen supply to the brain. However the causes of strokes and artery diseases overlap, so by targeting one, you will in fact help to prevent both.

So I've mentioned plaque, hardening arteries, high blood pressure and thicker blood as contributory causes of heart and artery disease ? but what about cholesterol? Many people are obsessed with their cholesterol levels and we all know individuals who avoid eggs or seafood due to their high cholesterol level. However, is cholesterol in food really as bad as it's made out to be? The fact is that we all do need cholesterol in the body as it's crucial for healthy hormone production and for good mental health. That high blood cholesterol is a risk factor for heart disease is not under debate here, but what is under debate is the idea that a diet containing cholesterol rich foods actually contributes to high blood cholesterol. Recent research has actually failed to demonstrate a link for example between the number of eggs a person eats and their cholesterol level. But the most interesting fact is this - the Inuit Eskimos have one of the highest cholesterol diets in the world, yet they have one of the lowest incidences of heart disease.

The case of the Inuit has highlighted the difference between good cholesterol and bad cholesterol. A "good" lipoprotein called HDL takes cholesterol out of the arteries and back to the liver where it can be recycled. In contrast, a "bad" lipoprotein called LDL carries cholesterol to the artery walls where it may be deposited. So rather than focusing on avoiding cholesterol rich foods altogether, we may be better off aiming to reduce our LDL cholesterol and increase our HDL cholesterol instead. But how do you actually do this? Well for tips on this and other nutritional aspects of heart disease, try out the 12 steps below!

Saturated fats cause the blood to become thick and sticky, encouraging the formation of clots. 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 and creamy sauces.

Oily fish, such as mackerel, salmon, tuna and sardines have a very high Omega 3 "good fat" content. Omega 3 (rich in the Inuit diet) has been shown to help thin the blood (reducing blood pressure), increase good HDL cholesterol and lower bad LDL cholesterol. Aim to eat oily fish at least three 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 with the use of Omega 3.

To be safe, go easy on foods that are naturally high in cholesterol ? including shrimp, eggs and full fat dairy produce. LDL cholesterol deposited on artery walls is bad enough, but oxidised cholesterol is even worse as it is more difficult for the body to remove. Cigarette smoke, fried foods and pollution all oxidise cholesterol. If you do smoke, it is vital that you give up. However antioxidants found in fruits and vegetables do help to protect cholesterol from oxidation.

Vitamin C has been shown to inhibit excessive cholesterol production and to maintain elasticity of blood vessels. Yellow peppers, blueberries, strawberries, broccoli, oranges and papaya are all rich in vitamin C. You may also choose to supplement vitamin C ? try starting with 500mg daily, but if you have any health conditions or are on any medications, do check with your doctor first.

Your heart and arteries are surrounded by a layer of muscle. Too much sodium can increase the pressure from these muscles, which in turn increases blood pressure. Whilst we all do need some sodium, nobody needs to add salt to their food, there is enough sodium present naturally in our foods.

These foods are all rich in calcium, magnesium and potassium ? all important for controlling blood pressure, but magnesium is most important. A severe magnesium deficiency can actually cause a heart attack in the absence of any arterial blockage, as it can result in cramping of a coronary artery. These foods are also rich in B6, B12 and Folic Acid and are vital for the safe conversion of a substance called homocysteine in the blood. Excess homocysteine can create lesions on artery walls which attract the deposit of atherosclerotic plaque. More on homocysteine later on this month!

Fiber reduces LDL (bad) cholesterol as it binds with bile salts and causes them to be excreted from the digestive tract. Bile salts are vital for digestion and are made using LDL cholesterol, so the body will divert LDL cholesterol away from the artery walls and into the digestive system in order to make more bile salts. Whole grain oats and apples are particularly good at helping to remove excess cholesterol from the body.

Some studies do suggest that a moderate alcohol intake actually helps to prevent heart disease, but this is currently under debate.

However, there is certainly some evidence to suggest that the bioflavonoid content of red wine has beneficial antioxidant properties. Men are generally advised to restrict their intake to two glasses of red wine daily and women are advised to restrict their intake to one glass daily. However if you currently have any health concerns, please consult your doctor or dietician for a personal recommendation.

While statins block the enzymes that make cholesterol, they also prevent the manufacture of CoQ10 ? an antioxidant nutrient that is vital for a healthy heart. However, always consult your GP prior to taking any supplement in conjunction with medication.

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 a healthy heart ? for example, it helps to improve circulation and reduces both cholesterol and blood pressure.

Stress always exacerbates any health condition, but is especially harmful to those with heart disease as it causes an increase in blood pressure. Try relaxing forms of exercise (Yoga, Tai Chi, Qigong, Pilates, walking), massage and meditation.

If you are over 30, make sure you go for your annual physical. Don't fall into the trap of thinking that "ignorance is bliss" ? it's much easier to deal with a minor problem early on, than to deal with a major problem at a later stage.