Obesity

Weight management

Your heart has to work harder to carry the excess weight and therefore it is advisable to aim to be a healthy weight for your height. Being overweight is a risk factor for coronary heart disease. It is associated with high cholesterol, high blood pressure and diabetes. Being overweight increases the strain on your heart. Reducing your weight by a modest amount (5 – 10kg or 11-22 lb) and maintaining this will help reduce these risk factors.

Remember to make realistic changes you can maintain for life.To reduce your weight you need to balance the amount of food that you eat with what you are burning up through daily activity. Try smaller portions at meals, use low fat products and fill up on fruit and low calorie snacks instead of biscuits and crisps. During the cardiac rehabilitation programme further advice will be provided regarding activity/exercise.

Weigh yourself no more than once per week on the same scales and at the same time of day. You may find losing weight is easier if you join a club or if a friend also tries to lose weight with you. Get the support of your family and friends. You can also request a referral from a dietitian through your GP or the cardiac rehabilitation team.

Remember it is much more important to increase your level of physical fitness and to follow the guidelines for healthy eating than to lose weight.

There are scales on the ward for your use. If you are unsure about your ideal weight please ask a member of the cardiac rehabilitation team who will be able to advise you.

What you eat plays an important role in coronary heart disease. It can influence your cholesterol level, your blood pressure and your weight. All these are risk factors for coronary heart disease. Certain foods may actually help to protect against heart disease. Research shows that by following these guidelines you can reduce your risk of having another cardiac event.

Fat

Aim to reduce the total fat content in the diet, especially saturated fat. Try to replace saturated fat with monounsaturated fat where possible.

Saturated fat

Saturated fat is found in dairy products, meat and meat products such as burgers and sausages, pastries, cakes and biscuits, coconut and coconut oil and palm oil.

It is the saturated fat in your diet that is converted to cholesterol by your liver. It is
therefore particularly important to reduce this type of fat in your diet.

Dairy Products: Full fat dairy foods are high in saturated fats. However it is important to eat dairy products regularly as they provide an excellent source of calcium. Try reduced fat varieties e.g. skimmed or semi-skimmed milk and low fat yoghurt. All cheese contains a high amount of fat. Think about reducing your portion size or you could try the lower fat alternatives.

Unsaturated fat

Monounsaturated fats are found in olive oil, rapeseed oil and peanut oil. They are
also found in avocados, almonds, hazelnuts. This is the fat you need to have more of to protect your heart.

Polyunsaturated fats are found in sunflower oil, cornflour oil, grapeseed oil and safflower oil. They are also found in nut, seed and soya oils or spreads, and all oily fish.

Vegetable oil can be high in monounsaturated or polyunsaturated fats. Check the label if you wish to use this and look for those higher in monounsaturated fat.

What type of oil should I use?

Preferably use olive oil or rapeseed oil.

What type of spread should I use?

Preferably use an olive oil based margarine or one that is labelled ‘high in
monounsaturates.’

Oily Fish

Eating oily fish can help to protect your heart.
Oily fish include: Sardines, Mackerel, Herring, Pilchards, Kippers, Trout and Salmon.

Fresh, frozen, smoked or tinned varieties can be included with the exception of tinned tuna. Fresh tuna is a source of omega-3 but tinned tuna is not.

If you are unable to eat oily fish regularly, fish oil supplements can protect yourheart in the same way. These can be bought from chemists, health food shops andsupermarkets.

After a Heart attack we recommend:

•2-3 portions of oily fish per week (4-6oz per portion) or An omega-3 supplement labelled as having 500-1000mg of ‘EPA and DHA’ (two of
the key omega-3 fatty acids) per day.

After any other cardiac event we recommend:

• Portions of oily fish per week (4-6oz per portion) or An omega-3 supplement labelled as having 500mg of ‘EPA and DHA’ (two of the
key omega-3 fatty acids) per day.

If you eat oily fish regularly, you do not need to take fish oil supplements as well.
Studies have shown no additional benefit from consuming more oily fish than these recommended amounts.

Cod liver oil tablets do not contain omega-3 fatty acids unless it specifically says on the label that they have been added.

Eat More Fruit and Vegetables

Try to eat five portions of fruit / vegetables a day. These contain a large variety of
components that protect the heart.

A ‘portion’ is 80g which is roughly equivalent to a small handful e.g.