Spotlight on… heart disease

Coronary heart disease is the single biggest killer in the UK today. While some risk factors are non-modifiable, there are many lifestyle choices you can make that can help to keep your heart healthy. Nutritionist Jo Lewin explores the effect different foods have on heart health and suggests recipes to help you on your way…

A red heart-shaped bowl with a knife and fork

We are repeatedly told that eating a balanced diet can improve our health, both now and in the future. Diet plays an important role in the prevention of coronary heart disease. Maintaining a healthy weight can also help keep blood pressure within the normal range.

What is heart disease?

Heart disease or cardiovascular disease (CVD) includes all diseases of the heart and circulation including coronary heart disease (angina and heart attack) heart failure and stroke. CHD and stroke may be caused by the process of atherosclerosis, which happens when the arteries (that supply the heart and brain with oxygen-rich blood) become narrowed by a gradual build up of fatty material within their walls. In time, the arteries may become so narrow that they cannot deliver enough oxygenated blood to the heart muscle when it needs it. The pain or discomfort that this can cause is called angina. A heart attack can cause permanent damage and happens when a narrowed coronary artery becomes blocked by a blood clot, so oxygenated blood cannot reach the heart. A stroke happens when a blood clot blocks an artery that carries blood to the brain or when a blood vessel bursts and bleeds into the brain – starving brain cells of oxygenated blood.

What causes heart disease?

There are certain things about you and your lifestyle that can increase your risk. Risk factors that you can do something about include:

Risk factors that you can’t control include:

  • Family history of cardiovascular disease
  • Your ethnic background
  • Your age – the older you are, the more at risk you are of developing cardiovascular disease
  • Your sex – research shows that men are more likely to develop CHD at an earlier age than women

Food for a healthy heart

Get your five-a-day

A brightly coloured rainbow tuna salad

Eating a diet rich in a range of fruits and vegetables can help to lower the risk of heart disease. Fruit and vegetables are full of vitaminsminerals, fibre and other nutrients, all of which may play a role in helping to reduce our risk of coronary heart disease in different ways. Fresh, frozen, chilled, canned or dried fruit and vegetables along with beans, pulses and 100%, unsweetened juice (not from concentrate) all count. Aim to eat at least five portions of a variety of fruit and vegetables a day.

Recipe suggestions – get on your way to five-a-day:
Tuna rainbow salad
Shredded green salad
Red lentil & squash dahl

Fruit and vegetables are rich in antioxidants and potassium, a mineral that may help to control blood pressure and regulate your heartbeat. Fruit, green leafy vegetables and root veg are also rich in folate, which is essential for the formation of blood cells and helps control the level of a compound called homocysteine in the blood. There is growing evidence that people with high levels of homocysteine may have a higher risk of CHD.

Fat

The message regarding this macronutrient is clear. Keep saturated fat within Reference Intakes (RI) or guideline daily amounts and focus on heart-friendly fats. Heart-friendly fats include the monounsaturated and polyunsaturated fats found in olive oil, avocado, nuts and seeds (and their oils) and oily fish. Cut down on pastries, crisps and biscuits and eat more fruit and vegetables.

Saturated fat is frequently vilified as it is linked to cardiovascular disease. Red meat, butter, cheese, burgers and sausages, are high in saturated fat, as are ghee, coconut and palm oils. A diet high in saturated fat can increase blood fats including triglycerides as well as increase your risk of obesity, heart disease, type 2 diabetes and stroke. However, recent studies are now suggesting that the saturated fats in certain foods such as those in dairy products including cheese, do not appear to be as harmful as once thought. This may be because other nutrients in dairy, like calcium, may modify the effects on blood fats such as triglycerides.

Recipe suggestions – fill up on healthy, unsaturated fats:
Avocado salad
Broccoli lemon chicken with cashews
The health benefits of nuts

Oily fish

A super healthy salmon salad dish with couscous

Aim to eat two portions of fish a week, at least one of which should be oily. Oily fish provides the richest source of omega-3 polyunsaturated fats that can help lower blood triglyceride levels. Eating oily fish regularly can help to reduce the risk of coronary heart disease.  Choose oily fish such as herring, mackerel, pilchards, sardines, salmon and trout.

Recipe suggestions – heart-healthy fish suppers:
Tangy trout
Super healthy salmon salad
Grilled mackerel with soy, lime & ginger

If you don’t like oily fish, there are some vegetarian sources of omega-3 fats that you can include in your diet. These include flaxseeds, flaxseed oil, rapeseed and walnuts. The type of omega-3 fats in these foods is a less potent form than you find in oily fish, so you will need to eat them regularly.

Fibre

Fibre can also help reduce the amount of cholesterol absorbed into your bloodstream. Try to include, porridge oats, beans, pulses, lentils, nuts, fruits and vegetables. They are all high in soluble fibre, which can help lower cholesterol. A high fibre diet also helps fill you up, making you less likely to snack on fattening foods.

Recipe suggestions – high-fibre favourites:
Vegetable & bean chilli
Courgette, pea & pesto soup
Apple & blueberry bircher

Salt

Asparagus soldiers with a soft boiled egg

Try to reduce the amount of salt you eat as regularly eating too much is linked to raised blood pressure. On average, people in the UK are eating more salt than they need. It is recommended that adults have no more than 6 grams of salt a day. That is about one teaspoonful.  Don’t add salt to your food at the table and try to use herbs, garlic, spices or lemon juice to add flavour.

Salt is hidden in foods such as packet/canned products, instant noodles, soups, ketchups, sauces and salty savoury snacks, as well as the everyday foods we eat like bread and breakfast cereals, so it’s important to use nutritional information on the front or back of packs to make low salt choices. Many everyday foods such as bread and cereals contain a lot of salt too.

Recipe suggestions – slash the salt in all your meals:
Low-salt breakfast recipes
Low-salt lunches
Low-salt dinner ideas
Processed foods

Often high in saturated fat, salt and sugar, processed foods can pose a quandry when trying to eat healthily. Try cooking from scratch, using basic, fresh and if possible, seasonal ingredients. Also check food labels.

Alcohol

It is important to stick to recommended limits for alcohol – 14 units a week. Avoid binge drinking and if you do over indulge, avoid alcohol for the following 48 hours.  Alcohol is also high in calories and even a small amount can increase your appetite and so can be linked to weight gain. For more information on healthy drinking habits, visit drinkaware.co.uk.

For more information visit…

The British Heart Foundation
The Stroke Association
Diabetes UK

More ways to keep your heart healthy…

The best heart-healthy recipes
What to eat for a healthy heart
Top 10 tips for a healthy heart
Heart-healthy portions
More health and nutrition tips


This article was last reviewed on 27th September 2017 by nutritional therapist Kerry Torrens.

A registered Nutritional Therapist, Kerry Torrens is a contributing author to a number of nutritional and cookery publications including BBC Good Food. Kerry is a member of the The Royal Society of Medicine, Complementary and Natural Healthcare Council (CNHC), British Association for Applied Nutrition and Nutritional Therapy (BANT).

Jo Lewin works as a Community Nutritionist and private consultant. She is a Registered Nutritionist (Public Health) registered with the UKVRN. Visit her website at www.nutrijo.co.uk or follow her on Twitter @nutri_jo.

All health content on bbcgoodfood.com is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. If you have any concerns about your general health, you should contact  your local health care provider. See our website terms and conditions for more information.

 

Spotlight on… diabetic diets

A healthy, balanced diet is key to keeping your blood sugar levels in check and your diabetes under control…

A woman taking a blood sugar reading

What is diabetes?

Diabetes is a lifelong condition caused by a failure of the blood sugar regulation mechanism in the body. This is controlled by a hormone called insulin. Diabetes results when the pancreas does not secrete enough insulin or cells of the body become resistant to insulin so blood sugar levels are not controlled as they should be. Without the proper function of insulin, sugar cannot enter muscle or fat cells, causing serious secondary complications such as heart disease, stroke, kidney disease, neuropathy and other complications.

How many types of diabetes are there?

Recent research has suggested that diabetes could be seen as five separate diseases, with the potential for treatment to be tailored to each of the different forms. The study was published in The Lancet Diabetes and Endocrinology and looked at 14,775 Scandinavian patients. However, while experts saw the results as promising, they cautioned that further research would be necessary before changes could be made to treatment.

The NHS still classifies diabetes in two types.

Type 1 diabetes

Insulin dependent, less common and usually develops before the age of 30.

Type 1 diabetes occurs when the pancreas stops producing insulin. The exact cause is unknown but some believe that it is an autoimmune response in which the body attacks its own pancreatic cells. People with Type 1 diabetes must take insulin for life.

Type 2 diabetes

Non-insulin dependent, used to be most common in later life but is becoming increasingly more prevalent in younger generation largely due to an increase in obesity.

In Type 2 diabetes, the pancreas still produces insulin, but either it is not producing enough or the body does not respond to it properly. The most common cause of type 2 diabetes is obesity. In many cases, Type 2 diabetes can be avoided through eating a healthy, balanced diet and taking regular exercise and often can be controlled in the same way if diagnosed. However, some cases will require medication and your doctor should be the one to determine whether this is necessary.

Recent research has reported interesting evidence to support the reversal of type 2 diabetes. Research funded by Diabetes UK and performed by a team at Newcastle University reported that type 2 diabetes can be reversed by an extremely low-calorie diet (600 kcals per day).

This diet is extreme and Diabetes UK strongly recommends that such a drastic diet is only undertaken under professional medical supervision. People with diabetes who want to lose weight should consult their GP before undertaking any new eating plan.

…a note on gestational diabetes

Gestational diabetes is a type of diabetes that affects women during pregnancy, when some women have slightly higher than normal levels of glucose in their blood and their body cannot produce enough insulin to transport it all into the cells.

Read more from the NHS on gestational diabetes.

A pregnant woman next to a bowl of salad

Symptoms

Symptoms of diabetes can include tiredness, thirst, frequent urination and skin infections. A full list of symptoms can be found at diabetes.co.uk Diabetes must always be controlled under the management of a doctor. For further advice and information see: diabetes.org.uk

Health implications

People with diabetes of either Type 1 or 2 have a higher chance of developing a range of health conditions including heart disease, stroke, high blood pressure, circulation problems, nerve damage and damage to the kidneys and eyes. If you are overweight then losing this excess weight healthily and steadily can have a very positive effect on blood sugar levels and can reduce the risk of developing Type 2 diabetes. It’s also particularly important to build up a good exercise routine as this will help the body maintain good blood sugar levels.

Food choices for diabetics

Dietary modification is fundamental to the successful management of both Type 1 and Type 2 diabetes, though making sensible choices will mean you can continue to enjoy a wide range of foods. It’s imperative that weight is kept within the normal range. The dietary guidelines are very similar to those recommended for a healthy lifestyle: eat less sugar and fat, include more fibre-rich starchy foods and more fruit and vegetables with moderate amounts of meat, fish, milk and dairy. Choosing the right foods can make a big difference and eating regularly helps to ensure blood sugar levels do not fluctuate too much.

A magnifying glass and a calculator next to food nutrition labels

Foods to eat

– Starchy carbohydrates provide energy and help maintain and control blood glucose levels so should factor in every meal, though portion sizes and carb intake should be discussed with a dietitian to ensure you are eating to your individual needs. Look for wholemeal or wholegrain breads, high fibre breakfast cereals, wholemeal pasta and brown rice.

– Fibre can slow the rate at which the starch and sugar in foods enter the bloodstream. It can also help manage cholesterol levels as part of a balanced diet. This kind of soluble fibre is found in oats, pulses, fruit and vegetables.

– Whether you are taking insulin or not, stick to low GI foods (see below for suggestions).

– Magnesium, chromium, zinc and vitamin B3 all help to stabilise blood sugar. Eat plenty of green vegetables, whole grains, dairy foods, brewer’s yeast, seafood and pulses to ensure adequate amounts of these micronutrients.

– Maintain your hydration levels with water, herbal teas etc. but avoid squash and sugary drinks.

Foods to avoid

– Diabetes is linked to a higher risk of cardiovascular disease so the same heart friendly healthy eating principles apply. See our Spotlight on heart disease article.

– If you decide to drink alcohol, avoid drinking more than the recommended amount, and never drink alcohol on an empty stomach. Men and women are advised not to reguarly drink more than 14 units a week. Depending on the amount you drink, alcohol can cause either high or low blood glucose levels (hyperglycaemia or hypoglycaemia). Drinking alcohol may also affect your ability to carry out insulin treatment or blood glucose monitoring, so always be careful not to drink too much.

– Minimise refined carbohydrates and enjoy low GI foods instead.

Moderate your intake of the following:

  • Over-ripe bananas
  • Fruit yogurts and desserts high in sugar
  • Fruit juices
  • Dried figs & dates
  • White bread, baguettes and bagels
  • Cream crackers & white rice cakes
  • Iced cakes & pastries
  • Scones, crumpets and waffles
  • Sweet pies
  • Fruit canned in syrup
  • Breakfast cereals containing sugar
  • Baked & mashed potatoes and chips
  • White rice
  • Corn & rice pasta
  • Pizza
  • Popcorn
  • High sugar jams & jellies
  • Crisps and other potato & corn snacks
  • Fruit drinks containing added sugar
  • Fizzy drinks containing sugar
  • Sweets & chocolate bars
  • Thickened soups
  • Table sugar
  • Ice cream containing glucose syrup or high levels of other sugars

Three cans of fizzy drinks next to lots of sugar cubes

Swap these higher GI foods… For these lower GI foods
Refined sugary cereal Oatmeal porridge, All bran or muesli
White bread sandwiches Whole grain/granary bread sandwiches
White rice Basmati rice, wholegrain rice
Biscuits/cookies Small handful of nuts
Sugary fizzy drinks Water
Sweets/sugar candy Raw vegetable sticks with cheese or low-GI fruit
Milk chocolate bar Plain dark chocolate (70% or more cocoa solids)
Jam or marmalade on toast Avocado or nut butter on toast
Curry with rice Curry with chickpeas or lentils
Rice cakes Oatcakes
Pretzels Walnuts

Recipe suggestions

Simple salads to keep those blood sugar levels in check:

Mexican bean salad
Chickpea & roasted pepper salad
Salmon & soya bean salad

Use beans and pulses in chillis and stews and serve with brown rice:

Spicy meatballs with chilli black beans
Lighter cassoulet

Managing your weight can help control Type 2 diabetes. Check out some of our favourite low-fat recipes which don’t compromise on taste:

Zesty haddock with crushed potatoes & peas
Superhealthy Singapore noodles

For further advice or information regarding the diagnosis or management of diabetes please consult your doctor.


This article was last reviewed on 27th September 2017 by nutritional therapist Kerry Torrens.

A registered Nutritional Therapist, Kerry Torrens is a contributing author to a number of nutritional and cookery publications including BBC Good Food magazine. Kerry is a member of the The Royal Society of Medicine, Complementary and Natural Healthcare Council (CNHC), British Association for Applied Nutrition and Nutritional Therapy (BANT).

Jo Lewin works as a Community Nutritionist and private consultant. She is a Registered Nutritionist (Public Health) registered with the UKVRN. Visit her website at www.nutrijo.co.uk or follow her on Twitter @nutri_jo.

All health content on bbcgoodfood.com is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. If you have any concerns about your general health, you should contact  your local health care provider. See our website terms and conditions for more information.

By Jo Lewin – Associate nutritionist

3 underrated soft skills that’ll get you ahead (no matter where you’re going)

3 underrated soft skills that’ll get you ahead (no matter where you’re going)

The Muse

Taylor Swift
Carrie Davenport | TAS | Getty Images Taylor Swift

Cultivating the right skills in your career will make the difference between getting a promotion and getting passed over for one, landing your dream job and settling for a role you don’t love, and being given that big new account or watching your not-so-favorite co-worker get the opportunity.

The question is, which so…

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3 underrated soft skills that’ll get you ahead (no matter where you’re going)

Taylor Swift

Carrie Davenport | TAS | Getty Images Taylor Swift

Cultivating the right skills in your career will make the difference between getting a promotion and getting passed over for one, landing your dream job and settling for a role you don’t love, and being given that big new account or watching your not-so-favorite co-worker get the opportunity.

The question is, which soft skills are the right ones?

More from The Muse:
Every question you’ve ever had about soft skills (but didn’t want to ask)
The underrated skills that will make you a better employee (and human being)
9 soft skills that’ll put you ahead of the competition, according to real hiring managers

Whether you’re a career veteran or just entering the workforce, here are three highly-underrated soft skills that’ll help you no matter where you go in your career:

Top Google execs say this one skill is what every young professional should know

Top Google execs say this one skill is what every young professional should know
1. Focus

In his book, “Deep Work: Rules for Focused Success in a Distracted World,” author Cal Newport outlines the benefits of the intense focus you have when you’re fully engulfed in a task (a.k.a., not checking Twitter or Facebook).

Newport lays out three reasons why it’s such a valuable skill. First, those periods of concentrated effort allow you to produce more than usual. Second, most people gravitate toward easier work (checking email) versus hard, satisfying tasks (that big project you’ve been delaying), so it’ll help you stand out. Third, it maximizes the use of your skills and talents in a way that gives your work more meaning and you more satisfaction.

Develop it: Block out time (and space)

It’s impossible to practice your focus if you’re constantly interrupted to go to meetings. Fix this by identifying one segment of your day and block it off from any meetings. Look for a two-hour time slot when you can just think and work — and then mark it as “busy” on your calendar.

Next, set up your environment so you can focus on difficult tasks without temptation. Consider browser apps like Self-Control — it’s free! — or Freedom. Put your phone on airplane mode. Turn off notifications on your computer. If your team is on Slack, set yourself to “Do not disturb.”

The more time you make to practice and engage with focused work, the more prepared you’ll be to tackle these kinds of projects when they arise.

The world's greatest leaders have these traits in common

The world’s greatest leaders have these traits in common

2. Openness to feedback

It doesn’t matter how well you deliver feedback: If you won’t listen to critiques about your own work, you’ll never grow (not to mention, you’ll make yourself pretty unapproachable). People will not only be less inclined to work with you, but they also may discount your advice in return.

In “Thanks for the Feedback: The Science and Art of Receiving Feedback Well,” authors Douglas Stone and Sheila Heen walk through the challenges of receiving feedback. For example, when you hearconstructive criticism, your initial gut response is often to say, “You’re wrong.” But being defensive won’t help you grow.

Develop it: Listen attentively

Instead of insisting the other person is wrong, Stone and Heen suggest a different tact: “That’s interesting. I would like to understand more about why we see this differently.” By asking for specifics, you can get to the root behaviors and observations leading to their judgment.

Now, often in feedback conversations, two or more topics pop up. Don’t try to tackle everything at once.

For example, let’s say you walk into your manager’s office and receive this onslaught:

I just wanted to chat with you about that project you’re working on. You’re behind schedule, and I’m concerned that it’s not headed in the right direction.

There are actually two issues here. First, there’s the pace of the project. Second, there’s the overall direction. Trying to tackle these at the same time means each could get short shrift. Instead, when you notice this happening in conversation, use this line from Stone and Heen’s book:

I see two related but separate topics for us to discuss. They are both important. Let’s discuss each topic fully but separately, giving each topic its own track.

When you say this — and then actually listen — you’ll impress your co-workers with your ability to both hear and incorporate their feedback.

How changing majors in college leads to professional success

MailChimp CEO Ben Chestnut on his nonlinear path to success

3. Accountability

It’s one thing to enthusiastically volunteer for a new project. But it’s another to see it though to completion.

Sometimes you may bite off more than you can chew, but you don’t want to make it a habit.

According to a study on over-commitment, it’s hard to know what future tasks will take up our time, so we underestimate and expect to have more available time in the future than we actually do. Additionally, people underestimate how long projects will actually take.

Develop it: Overestimate and plan for the worst

Use the Scotty Principle: Determine how long you think a task will take. Then, add 25 percent to 50 percent and promise it’ll be done by the end of the lengthier estimate.

Best-case scenario, you’ll finish with time to spare.

But best-case scenarios, while awesome, are not what you should be planning for. If you’re chronically struggling with deadlines, stop scheduling your day based on everything going right.

Assume at least one thing won’t swing your way. Better yet, plan for this by setting aside blocks of time strictly for unexpected items. For example, three or four days a week, I build in a 45-minute block just for catch up on random tasks that I didn’t anticipate. This way, you’re building in contingencies so you can start meeting deadlines and be seen as someone who’s 100 percent dependable.

This article originally appeared on The Muse.