digest THE MAGAZINE FROM H·E·A·R·T UK SPRING 2007 For everyone seeking a healthy heart a spring in your step FLORA LONDON MARATHON: page 5 My story Personal account: PAGE 11 UK A ·T ’ D ·R S ·A R 7 ·E BE AGE H EM M Heart-healthy Two heart-healthy lunch menus: PAGE 8 P ADVICE · LETTERS · NEWS · FOOD & DRINK · EXERCISE · LATEST RESEARCH Y 2 director’s cut... “The Rules of Cricket and lifestyle change” You have two teams, one in the ﬁeld and one IN W Michael Livingston Director H·E·A·R·T UK ell, right now, unless you are up late or very early, you won’t be watching leather being smashed to the ON and OFF side by Aussie willow. But if we were all to live longer, there is just the chance that we shall be able to watch UK cricket under lights through much of our warmer winters. Global warming, yes, but if it means that we all take to better diets from the middle sea, is that such a bad thing? I am all for more cricket - if, we (poms) could only improve - but let us go one better and embrace the Mediterranean Diet. Each man that’s in the team that’s IN, goes out and when he’s out, he comes in, and the next man goes in until he’s out. We are rightly bemoaning a generation (or two) who are far from keen to stand, let alone exercise, and who are far more interested in teasing their pleasure from a home computer. But help is at hand - a new series of computer games has arrived under the name of Wii (pronounced wee) that rely on animated standing exercise of participants holding a zut (Aussie) or zapper in their hand in order to play golf, ping pong or tennis. This really is quite exhausting, so unless Health and Safety get their desk-bound banning frenzied ﬁngers in, there is a good chance that exercise will take on a new but seriously positive change for the better. When they are all out, the team that’s out, comes IN, and the side that’s been IN, goes out. Banishing the weed is going to get a whole lot easier, because in the warm spring this year in the UK, there will be very few places left where smoking will be permitted; one of those will hopefully be outside buildings and conferences. Only Ray Mears will be left to remind us how lighting up safely can still be achieved in Outer Mongolia, the Polar Icecaps and in the middle of the Nullarbor Plain! Those that have gone out, now try to get those coming in, out. Sometimes one gets men still in and not out, but when both teams have ﬁnally been IN and OUT, including the not-outs, then it’s the end of the game! If trying to understand the Rules has caused you stress, then move on, play with a wee or warm your days with a Mediterranean diet and drop the weed. news update... keeping you up-to-date with the latest news Wednesday 14 March 2007 Make a fresh start with... a healthier body You don’t have to wait long for the beneﬁts to start once you stop, after... Statin users risk heart attacks by not complying with treatment • 20 minutes: your blood pressure and pulse return to normal • 24 hours: carbon monoxide will be eliminated from your body and your lungs will have started to clear out the tar that’s been clogging them up • 48 hours: your senses of taste and smell are greatly improved After a few weeks your breathing and circulation can improve making exercise and any coughs and wheezing better. Many people taking statins are having preventable heart attacks because they are not complying with their treatment or taking too low a dose. This is the conclusion of new research published on-line in European Heart Journal, having followed the prescription records of nearly 60,000 patients in the Netherlands for up to 14 years. And the saving could soon add up, after... Patients were divided into two groups – those at high risk of heart attack and those at low risk. Half of all patients stopped taking statins within two years and only a third were persistent users, on a high or intermediate dose. Among persistent users, hospital admissions for heart attacks fell by nearly a third, compared to non – persistent users. Among patients using the high or intermediate doses, the risk reduction was as high as 40%, while a low dose reduced the risk by only 20%. • 1 week: £35 = a cheap ﬂight abroad or a few CDs • 1 month: £152 = a shopping spree or the monthly food bill • 6 months: £912 = a family holiday or some new furniture Helplines... See www.nosmokingday.org.uk for helplines in many other languages, and for lots more information about stopping smoking. • England & Wales . . . . 0800 169 0 169 • Scotland . . . . . . . . . . . . . . 0800 84 84 84 • N. Ireland . . . . . . . . . . . . . 0800 85 85 85 • Pregnancy . . . . . . . . . . . . 0800 169 9 169 • Quitline . . . . . . . . . . . . . . . 0800 00 22 00 or email: [email protected] Most lines also have an out-of-hours information service. DIGEST SPRING 2007 The researchers calculated that, every year, around 300 to 400 statin users in the Netherlands have an avoidable heart attack because of sub-optimal doses or discontinuing treatment. It was felt that these ﬁgures were likely to be typical of Europe as a whole CONTENTS 03 welcome... this issue... �� Welcome to the ﬁrst edition of 2007’s Digest. Inﬂuenced by all those TV ‘makeovers’ so in vogue in 2006, it was decided that your magazine should undergo one too (though rather more subtle changes for us!) We hope you like your latest edition – we value your opinions and aim to produce a useful magazine in an appealing format – so please let us know how we’re doing! �� Although you will see changes - by necessity, it will also (for the time being at least), become a quarterly rather than bi-monthly publication, it will nonetheless be packed full of up-to-date information and interesting features. A further change is that the Digest will be focused more towards patients, their families and junior health professionals, while our senior medical members will now receive updates via regular e-newsletters. Keep your letters, personal stories, requests and views coming – all correspondence will be answered and, if so desired, wherever possible be included in the Digest. Please check our website for any information you can no longer ﬁnd in the Digest, such as diary dates, updates from our colleagues in Europe, scientiﬁc reports or the latest news for kids with FH from the fh-UK team... www.heartuk.org.uk When another change was suggested – this time, your new-style magazine’s name, I thought our readers may wish to offer their thoughts, and if you feel inspired to do so please call the H·E·A·R·T UK ofﬁce (details above) or email me with your suggestions... if yours is chosen, you will receive a year’s free membership! This just leaves me to thank all our past and present contributors, the editorial team – and most importantly, you, our subscribers and valued H·E·A·R·T UK members, for helping us to continue providing support and information to people with FH and those at risk of cardiovascular disease. Gill Stokes, Editor [email protected] 02 News 06 Exercise 08 Recipes 11 Personal account 13 Ask Dawn 14 Mailbox 15 Meet the team 16 Book review �� & research How to get active Mmmm, more tasty recipes Tom Tracey Expert patient advice Your letters at H·E·A·R·T UK & reader offer Dangers of online pharmacies More and more people are buying prescription-only drugs from sites on the internet. While reputable sites are regulated and registered with the Royal Pharmaceutical Society, there are many more that do not play by the rules. Many of these sites are run by people who have no medical or pharmaceutical qualiﬁcations and are based outside the UK, so that the UK Medicines and Healthcare Products Regulatory Agency (MHRA) is effectively impotent. Among the concerns of the MHRA are that the drugs may not have been prescribed by a healthcare professional and that they may not have been checked for quality and effectiveness. The World Health Organisation is particularly concerned about the substandard drugs that are available over the net and they also state that internet-based sales are a major source of counterfeit medicines in industrialised countries. To ﬁnd out whether an online pharmacy is legitimate, patients should be aware of the Royal Pharmaceutical Society’s code of ethics on the information that registered online pharmacies should provide. Websites must display the name of the owner of the business, the business address, the name of the pharmacist and details of how to conﬁrm the registration status of the pharmacy and pharmacists. A few things to remember.... • Do not buy prescription-only drugs from sites that do not ask for a prescription from a doctor or other suitably qualiﬁed health professional. • Be wary of online pharmacies that do not give a physical address. • Avoid websites that promise or advertise a miracle cure. • Ensure that both the pharmacy and pharmacist are both properly registered. • Before starting any new medication, do speak to your GP. helpline & enquiries... New telephone helpline number operational! We are pleased to announce that you can now contact H·E·A·R·T UK’s telephone helpline for medical or dietary information or advice on the following local call rate number: 0845 450 5988 The helpline is open from Monday to Friday between 9.30am & 4pm, and is manned by nurses and dietitians. (Please leave a message on the answerphone out of hours). Please contact us on: 01628 777046 for all business, membership enquiries and non health-related calls, including membership queries. No. 106 Volume 21 Hyperlipidaemia Education & Atherosclerosis Research Trust 7 North Road, Maidenhead, Berkshire SL6 1PE Tel: 01628 777046 • Fax: 01628 628 698 • Email: [email protected] • Website: www.heartuk.org.uk © 2005 H·E·A·R·T UK ISSN 1741-7864 Charity Registration No: 1003904 • Company limited by guarantee No: 2631049 H·E·A·R·T UK DIGEST Editor: Gill Stokes Associate Editorial Team: Linda Main, Baldeesh Rai, Maria Whitehouse, Marianne Wightman Advertising: 01628 777046 • Email: [email protected] • Website: www.heartuk.org.uk Main ofﬁce: 01628 777046 • Helpline: 0845 450 5988 • Fax: 01628 628 698 Designed & produced: Fusion Design • www.fusionweb.co.uk SPRING 2007 DIGEST 4 REGULAR more news... keeping you up-to-date with the latest news H·E·A·R·T UK position statement on statin treatment H·E·A·R·T UK, as one of the signatories to the Joint British Societies’ guidelines (JBS2)1, advocates statin treatment for the secondary prevention of cardiovascular disease (CVD) and for primary prevention in individuals with an estimated 10-year CVD risk of 20% or more. Recent evidence, in the Heart Protection Study2, strongly suggests that statin treatment is costsaving down to a risk threshold below 20%. Accumulating evidence indicates that the National Service Framework for Coronary Heart Disease (NSF)3 cholesterol targets of 5 and 3 mmol/l, for total and LDL-cholesterol respectively, should be superseded by the recent JBS2 targets of 4 and 2 mmol/l, especially in high risk cases – e.g. patients with established cardiovascular disease or diabetes. We would strongly urge the National Institute for Health and Clinical Excellence (NICE) to endorse the 20% risk threshold and the revised targets in its forthcoming recommendations, and for the Department of Health (DH) to incorporate them in any future change in the Quality Outcomes Framework for general practices (QOF), given the Genetics information in translation The London IDEAS Genetics Knowledge Park (GKP) has recently published a series of factsheets on familial hypercholesterolaemia (FH) in English and the following languages: Turkish, Gujerati, Urdu and Punjabi; and translations into Arabic and Farsi are pending, together with audio versions in Somali and Sylheti. The factsheets, together with glossaries of terms and an evaluation form, can be downloaded from the GKP website: www.londonideas.org For further information, please contact Dr Amy Hunter, GKP Manager at: [email protected] or call: 020 7242 9789 Ext 0757 DIGEST SPRING 2007 lifetime cost effectiveness of such a strategy. We also reiterate, from the NSF, the importance of achieving at least a 25% reduction in cholesterol or a 30% reduction in LDL cholesterol even if this gives results lower than 5 and 3 mmol/l. References 1. JBS 2: Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice. HEART, Volume 91, Supplement V December 2005 2. Lifetime cost effectiveness of simvastatin in a range of risk groups and age groups derived from a randomised trial of 20,536 people, Heart Protection Study Collaborative Group. BMJ, doi:10.1136/bmj.38993.731725.BE (published 10 November 2006) 3. The Department of Health. National Service Framework (NSF) for Coronary Heart Disease. Modern standards and service models. London: Department of Health, March 2000. For further information please contact: Cathy Ratcliffe, Operations Manager, H·E·A·R·T UK on tel: 01628 777046 or email: [email protected] Shellﬁsh and cholesterol Statins and Parkinson’s disease The following statement has been made on behalf of H·E·A·R·T UK by Dr Bruce Grifﬁn, Reader in Nutritional Medicine at the University of Surrey, to clarify the concerns regarding the effect of shellﬁsh and eggs on blood cholesterol levels. In response to news from a small research study in the USA that claims to have found a link between statins and Parkinson’s Disease, Dr Tony Wierzbicki, Chairman of H·E·A·R·T UK’s Medical, Scientiﬁc & Research Committee, said: “I fully support the recent decision by NHS Direct to amend their warning that shellﬁsh could raise blood cholesterol. The important fact for the public to remember is that there is no solid scientiﬁc evidence to link dietary cholesterol in such foods as eggs and shellﬁsh with increased risk of coronary heart disease (CHD) (see: Lee & Grifﬁn 2006). Foods that contain cholesterol can produce a small increase in blood cholesterol in some people but this is clinically insigniﬁcant and will not increase your risk of developing CHD. In other words, the sensible consumption of shellﬁsh (2-3 times a week), will produce no adverse effects on cardiovascular health. “High cholesterol and its LDL (‘bad cholesterol’) fraction are associated with an increased risk of heart disease, stroke and leg artery narrowing. This dietary advice applies to the general population, including individuals with moderately raised blood cholesterol (5 - 6.5mmol/l). However, patients with rare forms of genetically determined high cholesterol such as familial hypercholesterolaemia are a notable exception and will require their own speciﬁc guidelines” Lee A & Grifﬁn b. (2006) Dietary Cholesterol, eggs and coronary heart disease in perspective. British Nutrition Foundation, Nutrition Bulletin, 31; 21-27 Numerous trials over the last 10 years with statins have shown convincing beneﬁts in terms of reducing these events if patients take these drugs at adequate doses. This small population study links low LDL cholesterol levels with Parkinson’s disease. Other studies of statins given to the dopamine-producing cells in culture, which are the cells affected by Parkinson’s disease, have shown different results and implied beneﬁcial effects of statins through their anti-inﬂammatory actions. This study is thus a preliminary ﬁnding that requires conﬁrmation in larger scale longer-term studies and reports an association which may not be causal. The results of observational studies of statins in neurological disease, including dementia, have been conﬂicting, as is often the case in the early stages of research. It will require long-term, large scale, properly designed randomised controlled trials to come to deﬁnitive answers on the beneﬁts or risks of statin therapy in neurological disease.” REGULAR 5 inspirational fundraising... All the latest fundraising news and activities We are pleased to announce that Weight Loss Resources (WLR) has adopted H·E·A·R·T UK as its Charity of the Year for 2007. Through its website: www.weightlossresources.co.uk WLR offers tools and resources for healthy and sustainable weight loss, for those wishing to improve their ﬁtness levels and those concentrating on improving their diet and nutrition. The site works on a calorie counting basis providing real calorie and nutritional information. WLR does not endorse any fad diets, pills (unless prescribed by a medical professional) or potions and includes information and features, written by dietitians and doctors, on weight loss, healthy eating, ﬁtness and nutrition. 24/7 help and support is provided to members with their weight loss and healthy eating goals. Readers are invited to take a free, no obligation three-day trial. Contact us... For further information about H·E·A·R·T UK Fundraising, please contact Carole G on 01628 777046 or by email at: [email protected] or view our “How you can help” pages at: www.heartuk.org.uk Stop press... This year’s Flora London Marathon is especially important for H·E·A·R·T UK. If you watch the BBC Television coverage of the race, you should hear the Charity mentioned numerous times, and it’s all “tied in” with a great new fundraising scheme which takes off at the end of April! Watch this space! WLR is offering H·E·A·R·T UK readers a special membership price of: £7 per month (normal price £9.50) £18 per quarter (normal price £25.50) £30 per 6 months (normal price £45) To take advantage of the free trial offer/sign up to options, go to:www.weightlossresources.co.uk/heartuk/ Anniversary Ball For those who would like to join with us to celebrate 25 years of cholesterol care, it’s not too late to order your tickets for the Anniversary Ball at Blenheim Palace on Thursday 17 May. Enjoy a Champagne Reception in the Great Hall, followed by a Gala Dinner in The Orangery, and dance the night away to a lively ﬁve-piece band, The Arrhythmics. BBC Radio 2 newsreader Patrick Lunt will be our Auctioneer and other celebrities are expected to join in the celebrations. The Anniversary Ball combines celebration with fundraising and offers everyone a chance to support H·E·A·R·T UK by attending, donating a prize, or making a donation. Just make that call and pledge your support. Robin Stokes from Cumbria is combining his own personal challenge to climb Kilimanjaro with fundraising for H·E·A·R·T UK. Kilimanjaro is the highest mountain on the African continent, standing at 5,900m above sea level and is the world’s highest freestanding volcano. It is one of the seven highest mountains in the world and the only one you can climb without having to use climbing equipment! Some of Robin’s own family members have inherited high cholesterol and he is very keen that other families like his should have the beneﬁt of H·E·A·R·T UK support. If you would like to sponsor Robin’s Challenge, you can do so by contacting the Maidenhead ofﬁce (see above). �� H·E·A·R·T UK’s very own Operations and Communications Manager, Cathy Ratcliffe, is now in training for the Flora London Marathon 2007. Cathy joined H·E·A·R·T UK in May last year and soon decided to throw herself in at the deep end by offering to run the Flora London Marathon. The Charity is very lucky to have 10 guaranteed places donated by Unilever Flora, but we always ask our runners to apply for their own place in the ballot too. That way we maximise the fundraising potential. Cathy registered for a H·E·A·R·T UK guaranteed place with CRunCH, the clearing house for runners, which handles all our marathon administration. Then she collected a copy of Marathon News from her local sports shop and applied for a ballot place. Sadly she wasn’t lucky in the ballot but had a Charity place to fall back on. Sponsored Challenges... Cycle London to Paris, The British 10K London Run, and Trek the Great Wall of China are all fundraising events featured in a new H·E·A·R·T UK leaﬂet, “Are You Ready for a Challenge?” – only a phone call away. Flora London Marathon 2007 �� Part of Cathy’s training will include regular jogging around the streets of Maidenhead but she has also joined her local gym and started circuit training there, ending her sessions with a swim in the pool. She assures us that it’s all enjoyable but we have a feeling that that could all change as the 22nd April looms closer! Your sponsorship for Cathy or the H.E.A.R.T UK team would be most welcome! SPRING 2007 DIGEST 6 FEATURE get active... We talk to lots of people about how they get active In the Digest we have talked about how being more active can have a positive effect on your health and wellbeing (not to mention longevity!). For this issue *Nigel Denby’s team talked to lots of people about how they have found time to become more active. Being more active is about enjoying yourself, doing things you feel comfortable with and ﬁtting it in with your lifestyle. People who have never exercised before have found that being more active in their everyday life was the best and easiest way to start. *More from Nigel on next page! “I always used to work though my lunch time so I could get home earlier – but then I would end up sat in front of the TV eating junk. So now, after I have eaten my lunch I take a 20-minute walk to the local park and back. I have persuaded some of my colleagues to join me. It’s a good chance to catch up on the gossip” Lorraine, 32, from Barnstaple. “A friend came up with the idea of making life around the house a bit more, well... inconvenient - it sounds awful but really it’s not that bad. When I dry the pots I put each item away separately. If I’m doing the ironing I put the ironing board in the upstairs bedroom and the creased clothes downstairs in the kitchen, I fetch each item separately and put them away separately and when I do any cleaning or vacuuming I really put my back into it. Things take a little bit longer to do but I’ve really noticed the difference – the stairs don’t seem such a struggle any more” Eileen, 62, from Skegness. “I split my journey to and from work into a 30 minute train journey followed by a 15 minute walk. I arrive at work feeling relaxed and ready to face the day” Terry, 53, from Solihull. For some people, having a little more structure to their physical activity works better for them: “I need to know that I have a speciﬁc time slot when I am doing exercise; that way I can prepare for it in advance. So, for me, a circuit class a couple of evenings a week is perfect” Martin, 42, Humberside “I have three kids and no time or energy for exercise. But when my local leisure centre started up a crèche it meant I could have a swim once a week whilst my eldest two were having their swimming lessons and the youngest was being looked after. It took a lot of courage at ﬁrst, but you soon realise there are so many other people with the same fears as you” Tina, 43, Brighton. Remember whatever you do, enjoy yourself and do it for you! DIGEST SPRING 2007 FEATURE 7 members’ day... Nigel Denby 11 December 2006 • The Institute of Child Health, London W In his GL Diet books, Nigel translates the science of the glycaemic eating plan into a user-friendly and practical guide. As part of the GL diet, ‘slow-release’ carbohydrate foods to eat more of include the following: What is the ultimate diet? • Cereals: oats (with no added sugar), muesli, barley, couscous, bulgar wheat. • Breads with bits in: granary, soya & linseed, barley & sunﬂower, rye & pumpernickel. • Potatoes & roots: sweet & baby new potatoes, swede, celeriac, carrots. • Rice & pasta: basmati, wild, red, wholemeal. Don’t overcook. e were delighted to introduce Mr Nigel Denby to our audience at this year’s Members’ Day meeting. Nigel is a trained chef and dietitian and author of several books on weight management and the Glycaemic diet. Our readers have also gained lots of useful nutritional information from Nigel’s series in the Digest throughout 2006. Indeed, Nigel’s presentation on the Glycaemic Index and Glycaemic Load proved to be equally ‘digestible’! Nigel’s philosophy is based on the concept of diet freedom and the lifetime enjoyment of one’s food - without any associated guilt or humiliation. To work, it has to be easy to follow... after all, he said, picking dew-laden mushrooms at the crack of dawn isn’t an option for most of us! It also has to be safe and suit men and women alike. Nigel ﬁrmly believes that calorie-counting, food weighing, ‘points’ and quick-ﬁx solutions are not the way to go - even during the post-Christmas period and an average 5lbs weight gain! There has been much research into the glycaemic diet over many years, with greater focus more recently on its value as a successor to ‘low carbohydrate’ – instead of ‘nocarbs’ or ‘low-carbs’, the glycaemic diet is ‘slow-carbs’! The glycaemic index (GI) allocates a number to the amount of each food providing 50g of carbohydrates, rather than on actual portion sizes and the meal as a whole, and this can give false results. For example, you’d need to get through 11/2 lbs of carrots to consume 50g carbohydrates, and this would give an undesirably high GI score of 75. Since we are highly unlikely to have this amount on our dinner plates, carrots actually have a desirably low GL score. The GI method can therefore be complicated and confusing, whereas GL gives the ‘whole picture’. The harmful effects of hydrogenated (‘trans’) fats are also discussed in ‘The GL Diet’. A diet trial involving 15,000 adults in Europe with type 2 diabetes showed that those following a low glycaemic diet had signiﬁcantly lower waist circumferences, Nigel said, and the lipid proﬁle in post-menopausal women improved as the dietary GL ‘score’ decreased. A diet high in reﬁned, low quality carbohydrates is also linked with increased levels of C-reactive protein (CRP), a promoter of inﬂammation that is linked to coronary heart disease and other degenerative diseases. A 2002 review of research concluded that low glycaemic foods have a role in both the prevention and treatment of the metabolic syndrome, obesity, diabetes and coronary heart disease. Keeping to a low GL diet is simple and the results start from day 1... and there are no rigid rules to adhere to – you can have three bigger daily meals or six smaller ones if you prefer! GL = (GI x CHO (carbohydrate) per serving) ÷ 100 Is it just a fad? Low glycaemic eating is here to stay, said Nigel, and GL provides the necessary tool to simplify the science and aid its longevity. Food retailers are now taking on board the low glycaemic message with food labelling and advice to customers. Foods with a low GL are rated below 10, moderate GL rated between 11 and 19; and high GL above 20. For further information, log on to Nigel’s website: www.dietfreedom.co.uk Our other guest speakers at this year’s meeting were Professor Andrew Neil, H·E·A·R·T UK Chairman; and Professor Steve Humphries and his team from London IDEAS Genetics Knowledge Park, and we will be reporting on their enlightening presentations on familial hypercholesterolaemia (FH) in the next Digest. Gill Stokes SPRING 2007 DIGEST 8 REGULAR tasty recipes... A selection of tasty recipes for you to try... This edition of Digest brings us recipes from Alpro (manufacturer of soya-based products) and from MiniCol. Both these foods appear to play a role in improving heart health. Soya is naturally low in saturated fat and high in antioxidants and ﬁbre. Not only that but a daily intake of 25g of soya protein, taken as part of a healthy diet and lifestyle can actually reduce cholesterol levels. Minicol is a healthier cheese alternative. The dairy fat has been removed from milk and replaced with a healthier blend found in wheatgerm oil. Not only that but it’s rich in natural plant sterols as well, 2-3g of which have been shown to reduce cholesterol levels. Minicol Cauliﬂower Serves: 4 Ingredients • 1 large cauliﬂower • 300ml (1⁄2 pint) semi skimmed or skimmed milk • 130g (41⁄2 ozs) of miniCol, grated • 3 tbsp (45g /11⁄2 ozs) plain ﬂour • 50g (2 oz) polyunsaturated margarine • 1⁄2 tsp French wholegrain mustard • nutmeg • fresh herbs • back pepper to taste Method 1 2 3 4 5 6 Trim the cauliﬂower and then steam for around 15 minutes or until tender. Drain and place in a large oven-proof baking dish. Add the milk, ﬂour and margarine to a saucepan. Heat, stirring continuously until the sauce thickens, comes to the boil and is smooth. Simmer for a further 2 minutes. Add threequarters of the grated miniCol, mustard, a pinch of nutmeg and seasoning. Cook for a further minute stirring well. Pour the sauce over the cauliﬂower and sprinkle with the remaining miniCol. Place under a hot grill until golden brown and serve immediately. Garnish with fresh herbs DIGEST SPRING 2007 Minicol Stuffed Peppers Who said vegetables had to be boring? miniCol can help you make up ﬁve portions a day with this delicious recipe. Use a mixture of red, yellow and green peppers for added variety. Serves: 4 Cooking time: 20-30 minutes Ingredients • • • • • • • • • • 6 bell peppers 2 courgettes 1 aubergine 200g (71⁄2 oz) of mushrooms 100g (31⁄2 oz) of grated carrots 100g (31⁄2 oz) of onion 4 slices of wholemeal bread 200g (71⁄2 oz) of brown rice, cooked 130g (41⁄2 oz) of miniCol, grated black pepper to taste Method 1 2 3 4 Halve and de-seed the peppers. Reserve 8 pepper halves for stufﬁng. Place the remaining 4 pepper halves along with the courgettes, aubergine, mushrooms, grated carrots, onions and wholemeal bread into the food processor and whizz until ﬁnely chopped. Add the cooked rice and mix through; season with black pepper. Fill each pepper half with the mixture and place on a baking sheet, sprinkle the grated miniCol on top. Bake in the oven at 180°C for 20-30 minutes and serve. REGULAR 9 Homemade Tomato Soup With minicol croutons Serves: 4 Ingredients (Homemade Soup) • • • • • 1 tbsp olive oil 1 onion, ﬁnely chopped 3 stalks of celery, ﬁnely chopped 1 carrot, grated 4 tomatoes, chopped or 1 (14 oz.) can diced tomatoes • 1 tsp dried basil leaves • 750 mls of vegetable or chicken stock • Black pepper to taste Ingredients (miniCol Croutons) • • • • • 7 slices of French bread, cubed 65g (21⁄2 oz) of miniCol cheese, grated 1 tsp of Dijon mustard 1 tbsp of polyunsaturated margarine Pepper to taste Method (Homemade Soup) 1 2 3 4 5 6 Heat the olive oil in a large saucepan and sauté the onion, celery, and carrots until vegetables are tender. Add the tomatoes and basil. Simmer over a low heat, stirring occasionally, until the tomatoes are softened. Transfer the ingredients into a blender or food processor and blend until smooth. Return pureed mixture to a large saucepan and combine with the stock. Simmer, uncovered, until the soup is reduced to the desired consistency. Season with salt and pepper to taste. Method (miniCol Croutons) 1 2 3 Place the cubed pieces of French bread on a baking tray and toast until lightly browned. Meanwhile, mix together the remaining ingredients and then sprinkle them over the lightly toasted bread cubes until the miniCol cheese melts and begins to brown. Serve the cheese croutons warm over the tomato soup. Garnish with some fresh basil. Banana and Honey Ice Cream Serves: 6-8 Preparation time: 10 minutes Cooling time: 4-6 hours Ingredients • 550ml Alpro soya Banana Flavoured Dairy Free Shake • 1 tablespoon cornﬂour • 4 large egg yolks • 1 tablespoon caster sugar • 3 tbsps honey Method 1 2 3 4 5 Pour the milk into a pan, reserving 1 tbsp. Mix the reserved tbsp of milk with the cornﬂour. Bring to the milk to the boil and whisk in the cornﬂour mix. Beat the eggs and sugar together in a bowl and pour the Dairy Free Shake onto this. Whisk well and return to the pan. Cook over a low heat, stirring continuously. When it is thickly coating the back of the spoon, remove from the heat. If there are a few lumps in the custard sieve the custard. Allow to cool. Pour the custard into an ice cream machine and churn until frozen. When beginning to harden add the honey. If you do not have an ice cream machine, pour the custard into a ridged container. Place in the freezer and freeze for 3-4 hours, whisking every 45 minutes for the ﬁrst 3 hours. This will keep the ice cream smooth. When the ice cream is beginning to harden stir in the honey and continue to freeze. Rhubarb & Ginger Fool This divine dessert is so easy to make you may want to double the quantity – since one dish will never be enough! Preparation time: 20 minutes Ingredients • • • • • 350g (121⁄2 oz) rhubarb 55g (2 oz) caster sugar juice of 1 orange 1 stem ginger, ﬁnely chopped 4 x 125g pot Alpro soya Raspberry and Vanilla Alternative to Yogurt • 4 x 125g pot Alpro soya Dairy Free Vanilla Dessert or 125 g Alpro soya Dairy Free Alternative to Custard. Method 1 2 Place the rhubarb, sugar, orange juice and ginger and enough water to cover the rhubarb in a medium saucepan. Bring to the boil and simmer until rhubarb is soft. Empty the Alpro soya Raspberry and Vanilla Dairy Free Alternative to Yogurt and the Alpro soya Dairy Free Vanilla Dessert (or Alpro soya Dairy Free Alternative to Custard) into a large bowl and fold until mixed. Add the rhubarb and fold, leaving the mixture marbled. Chill until ready to serve garnished with orange peel. Serve in a cone or with fresh fruit. SPRING 2007 DIGEST 10 FEATURE educational meeting American Heart Association (AHA) Scientiﬁc Sessions, Chicago November 2006 G “I would like to thank Equazen and RJA foods for their support in making it possible for me to attend this educational meeting.” Baldeesh Rai “A study found that those who regularly eat dark chocolate or drink cocoa have a lower risk of blood clotting problems which can trigger heart seizures” DIGEST SPRING 2007 enomics is poised to take a leading role in the prevention and treatment of cardiovascular disease. “There will be a genetic test available to tell us which families and which individuals within those families are candidates for myocardial infarction (MI or heart attack) at a very young age”, predicted Eric Topol, Professor of medicine and genetics. Population studies reinforce the notion that heritable factors play a signiﬁcant role in cardiovascular disease (CVD). A report on more than 400 German families with a multigenerational history of MI found that not only does the occurrence of MI run in families but so does the location of the stenoses (coronary artery narrowings). Professor Topol also predicted that genomics will turn the dream of personalised medicine into reality. Researchers have recently found, for example, speciﬁc single nucleotide polymorphisms (SNPs) common to the 30 percent of Asians who exhibit no biological response to nitrates (anti-anginal drugs). The AHA’s 2006 Diet and Lifestyle Statement included recommendations to balance calorie intake and physical activity to achieve and maintain a healthy body weight; consume a diet rich in fruits and vegetables; choose wholegrain, high-ﬁbre foods; consume ﬁsh, especially oily ﬁsh, at least twice a week; limit intake of saturated fat to less than 7% of energy, trans-fat to less than 1% of energy, and cholesterol below 300mg/day. Professor W Willett reinforced the importance of diet. Smoking accounts for about one third of MIs in western countries, he said, and overweight and obesity contribute similarly. Reducing intake of total fat as a percent of calories is not an effective means of prevention, but evidence indicates that the type of dietary fat has a major impact on risk of coronary heart disease (CHD). Intake of transfat from partially hydrogenated vegetable oils strongly increases the risk (US manufacturers are required to show the trans-fat content of foods. But in British foods it is still lumped under the term ‘hydrogenated vegetable fat or oil’). Both omega 3 and omega 6 (n3 & n6) polyunsaturated fatty acids contribute to lower risk. The form of dietary carbohydrate also appears to importantly inﬂuence the risk of CHD; reﬁned starches are related to increased risk, but consumption of wholegrain, high ﬁbre cereal products have consistently been associated with lower risks. Higher consumption of fruits and vegetables contributes to lower risk, probably by multiple mechanisms. Many issues remain to be settled, including the optimal mix of mono and polyunsaturated fatty acids, the optimal amounts of n3 and n6 fatty acids, the amount and source of protein, and the effects of antioxidants, other phytochemicals and minerals. From their long-term studies, the professor said, they have calculated that modest dietary changes, together with the avoidance of smoking, regular physical activity and maintenance of a healthy body weight, can reduce rates of CHD by over 80%. Failure to take advantage of dietary and lifestyle means of preventing these diseases represents a tremendous lost opportunity for improved health and wellbeing. The role of n3 fatty acids from ﬁsh and ﬁsh oil in preventing cardiovascular risk is well established already, and increasing fatty ﬁsh consumption and/or supplementing with the n3 fatty acids EPA and DHA, should be considered for anyone with risk for CVD. Good news for chocolate lovers - a few squares of dark chocolate a day may cut your risk of heart attack. A study found that those who regularly eat chocolate or drink cocoa have a lower risk of blood clotting problems which can trigger heart seizures. This message will be welcomed by Britons, the biggest chocolate eaters in Europe! We consume on average 22lb of chocolate each per year. Dr Becker, who conducted the trial, told the conference that she wouldn’t advise people to eat lots of chocolate since it often contains high levels of sugar, butter and cream. But the equivalent of two tablespoons a day may be just what the doctor FEATURE 11 my story... Tom Tracey ordered. Another study from Switzerland suggested that dark chocolate increases coronary artery diameter in patients after heart transplantation. David Becker’s and his team from Philadelphia study examined an alternative treatment for hyperlipidaemia in a primary prevention population by comparing it to established therapy with simvastatin. Patients were randomised to either simvastatin 40 mg daily for 12 weeks, with traditional dietary and exercise counselling; or to a 12-week intensive lifestyle change programme with a Mediterranean Diet, aerobic exercise and supplements (pharmaceutical grade ﬁsh oil, 3g twice a day and red yeast rice, 1.2-1.8 g twice a day).The study concluded that simvastatin and the alternative treatment were both equally effective in lowering LDLcholesterol, with a mean decrease in LDL-c of 41% and 44% respectively. The alternative group had signiﬁcantly more triglyceride lowering effects. “As we age - is it about Weight or Waist?” highlighted the role that cardio-respiratory ﬁtness plays in attenuating the effects of being overweight. Follow-up studies suggest that unﬁt normal weight, overweight, and obese individuals are 3 to 4.5 times more likely to die than their ﬁt counterparts. Even for those who remain overweight or obese, an active lifestyle conveys important health beneﬁts. Stands in the Exhibition Hall included exhibits of omega-3 supplements, pomegranate juice, walnuts, ready to drink vegetable juices, low-salt soups, the Almond Board of California and canola oil, all offering clinical papers to support the beneﬁcial role of these products in heart health. A Change for the Better There’s stuff that happens and then there is Bad News Doctor Northcote had completed his diagnosis. Until that point the most frightening thing I had heard was: “Thatcher has won again”: “Rangers are odds on for nine in a row”: “Bush has been elected for a second term”. There had been other major events in my 54 years. The deaths of my father and most recently my brother Des saddened me but did not frighten me. Why? Because I was protected, nothing manifest, just a subliminal belief that is the prerogative of the apparently healthy. This belief is arrogance and I had it in spades. I had it right up until that nice Dr Northcote said; “Not what I expected Tom - looks like you will need a triple bypass”. “Not what I expected Tom - looks like you will need a triple bypass ” Dr Northcote A change of perspective “What does not kill you makes you stronger” observed the eminent German Philosopher and all round nutter, Nietzsche. Before I was aware of Nietzsche’s snappy summary, my mother, a less eminent but more practical philosopher had observed: “It’s character-building son”. (Adversity being the “What” and “It’s”). I believe then and now that there is merit in this philosophy. However, up to that point, adversity had meant obstacles to achieving what I wanted; qualiﬁcations, job, money, house, life abroad and all the practical problems of 30 years of marriage and two kids. This was different. For the ﬁrst time adversity was not something I could work harder to overcome and... it just might kill me. Despite the build-up to Dr Northcote`s diagnosis this was not something the invincible arrogant “me” was ready for. I offer this experience as testimony to the other “me’s” out there. How did we “Me’s” get like this? As with most things, women are more aware of the human condition than men. (The exceptions being football and peeing highest up a wall). They have regular reminders of pain and discomfort and a potential life-threatening experience with each child. Also in bringing up children there is regular contact with the medical profession. All of this and most importantly their innate common sense sees them taking more real care of themselves. Men, on the other hand drop off the medical radar after their BCG injections and come back into it when they break a bone or have some serious organ malfunction or life-threatening illness. This lack of attention to physical health is a combination of arrogance and fear. Arrogance in knowing that “I don’t get sick” and the fear of ﬁnding out that “I might be sick”. Women are smarter and braver than that. Like most men I had limited ﬁrst-hand experience of blood, doctors or hospitals. My one invasive procedure had been the removal of a tooth when I was 23. Hardly preparation for the good Doctor’s diagnosis. I was one of those self righteous people who seldom needed and never took a sickie. I looked down on those that did as weak and indulgent and by deﬁnition lacking in character. This may have been OK if I had stopped at the work-shy but I took it too far. I had a deep and unspoken belief that sickness itself was some kind of personal weakness. Sad, ah, but there you are. I tell you this as an insight into my prejudices and stupidity in case you recognised the symptoms - of course, I mean in someone else? In the autumn of 2005 all this foolishness was stirred, shaken and ﬂushed down the loo. Thankfully, at the time of writing, I did not follow it. SPRING 2007 DIGEST 12 FEATURE Strange the things you notice A wee touch of indigestion If you have been lucky enough to avoid a lifethreatening illness you will almost certainly have had a life-threatening event - a near-miss in a car, in-ﬂight plane troubles or even a particularly hairy passage on a boat. The event may have been life-threatening but the fear only lasts a short time and in some cases the experience can be exhilarating. These events quickly become stories that can be discussed with mates and even laughed at. A life-threatening illness is different. It is hard to talk about and even harder to laugh at... but you have got to try. It is important to remember people (men mostly... ok, me) are uncomfortable talking about illness. It reminds us of our mortality. So keep it light and upbeat. Each morning after breakfast I pulled the dinghy down to the water’s edge in preparation for the day’s boat trip. One morning I noticed a slight discomfort in my upper abdomen which I put down to indigestion so I changed the routine to have breakfast after I moved the dinghy and the indigestion reduced ... for a while. However, I started to notice that any signiﬁcant exertion through the day brought back the indigestion and it was becoming more severe. Also, if I stopped the exertion, the discomfort would reduce. Another thing; once diagnosed you start noticing things you had not noticed before like the preponderance of funeral cars on the drive to Ayr. Has there been a major epidemic that is being kept under wraps or have they always been there. No matter how hard you try to push your newfound illness and its associated fear to the back of your head it ﬁghts its way to the front. There was also the inevitable feeling of “Why me?” Thankfully, I did not dwell long on the question as the answer is simple: “Why not?” We are very lucky to have good health and wealth in one of the richest countries in the world. We have been dealt a very good hand. The calm before the storm In 2004 Sheila and I took over The Shorehouse on the Island of Arran. It had been a 26-bedroom hotel which had been converted to 10 selfcatering apartments. So, more time to ourselves and a bit of sailing on the quiet days. We sold the house in Ayr and set the kids up in ﬂats. It was a positive change after 30 years in the computer industry and something we had been planning for some time. In 2005 we added a little powerboating business to the stables and I was on the water most days and life was good. I had climbed Goat Fell in April and I walked and did some rowing every day. I had lost weight that I needed to lose and I felt as ﬁt as I had ever done. DIGEST SPRING 2007 Arran’s medical service is excellent. They get you when you arrive and put you down for annual MOTs thereafter. I had one of these coming up and I thought I would wait and mention it then. After going through the normal stuff I informed the nurse of my indigestion. My blood pressure, heart rate and ECG were ﬁne. My indigestion theory was holding up. The doc told me that an ECG stress test would deliver a more complete diagnosis. The test on the NHS would take 6 to 8 weeks. Deep down I knew I was kidding myself with the indigestion theory. So as a life-long Labour supporter, I went private. I saw Dr Northcote, Consultant Cardiologist, the same week. A wee touch of angina Dr Northcote was great. I gave him my symptoms and my indigestion theory. He dismissed the latter out of hand and told me I had angina. My only previous reference to this condition had been a sick joke from 20 years back. So he explained that the discomfort was caused by a lack of blood and oxygen to the heart normally caused by a blockage of an artery or arteries supplying the heart. The condition is normally progressive and can end with a complete blockage followed by heart failure. I knew what normally happened after that. The symptoms are treatable with heart surgery or angioplasty. I had no idea what angioplasty was but given the alternative, I liked the sound of it. Angioplasty is a procedure which ends with a metal tube (stent) expanding the artery at the point of constriction, restoring a normal blood ﬂow to the heart. It is done under local anaesthetic by inserting a lead wire through an artery in your arm or leg. Not great but better than the alternative. I clung to this as the cure of choice. Please forgive any inaccuracies in my description of the symptoms or the cure. They are my interpretation. Seek your own medical advice. Bad News, Good News I was sick but I was ﬁxable. The process of getting ﬁxed The next stage was a stress test which consisted of running on a treadmill while wired up to an ECG machine. I lasted 8 minutes. I asked the good doctor if the results conﬁrmed his diagnosis. He told me they didn’t but not to worry as I still had angina. Not sure why, but I was strangely comforted by his certainty. The stress test is followed by an angiogram; I know, more big words. Basically, dye is injected into your arteries to show the ﬂow of blood into the heart. This was the deﬁnitive test. It would show the doc where the stents would need to be placed. Up to this point the assumption had been stents. On completion of the tests and while I was still in theatre Dr Northcote gave me his scary diagnosis “Not what I expected Tom. Looks like you will need a triple bypass”. I have never been a good poker player and cannot be described as inscrutable. I felt shocked and frightened and I am sure that’s how I looked. I still looked like that when I was wheeled back into my room to give Sheila the news. She is a better poker player than me but she was still upset. After about 10 minutes of mutual reassurance Dr Northcote reappeared and said he had gone over the pics with the Heart Surgeon (Mr Craig) and they both concluded that surgery was the best option ... however, on further review Dr Northcote thought that he would have a reasonable chance of placing stents in the offending blockages but he still thought the REGULAR 13 “For the ﬁrst time adversity was not something I could work harder to overcome and... it just might kill me.” most certain course of action was surgery... I never heard the last bit. I clung to the stent option like a Ranger supporter clinging to the chance of winning the league. After further discussion with Mr Craig and Dr Northcote, Dr Northcote agreed to try the stent option. Anyhow, I had ﬁve stents implanted over two procedures. The one artery that was giving me the problem was 98% blocked and the others were precautionary/preventative implants. I felt immediately better. It’s good to be back In summary, I am “ﬁxed”. I was physically “ﬁxed” the day after the ﬁrst procedure. Not “ﬁxed” by my old illusion of “full health”. I have seen a moving picture of my heart’s arterial blood ﬂow and, although massively improved, it is not in the ﬁrst ﬂush of youth and I may need to go back for more work at some point, assuming I am given the chance. So, I take pills to lower cholesterol and thin the blood. I watch my diet and I exercise regularly. I just walked up Goat Fell at the weekend. Before the procedure I could not walk for the paper without a rest. So, I am ﬁxed, I am ﬁt. Nietzsche’s maxim would suggest that I am stronger. I am not sure about that but I think I am a little wiser. Lessons learned • Enduring pain is nature’s way of saying you need to be ﬁxed. Endurance is not a test of character but a test of common sense. • Get a regular health service check. You do it for your car and your lawnmower. • If you cannot get a fast diagnosis on the NHS go private for the price of a package holiday. If your condition is life-threatening the NHS will click in. Failing that, spend the money. • James Taylor is right: “Shower all the people you love with love, show them the way that you feel.......” • Cholesterol is essential to your health. Too much of the wrong type is a killer. I have heard of people being told that 5.2 is OK because it is the UK average. The UK - and Scotland in particular - has one of the highest rates of heart disease in the Western World. Pick a country with a lower death rate as your benchmark. • Diet can only reduce your cholesterol levels by 15-20%. If your levels are very high, diet will not get you there. If your diet is good, you’re over 50, have a family history of heart disease and your cholesterol is above 5, insist your doctor gives you drugs to reduce cholesterol levels. • There is no shortage of time to do all the things you want to do until someone tells you there is: Don’t wait for that discussion. Time is your main asset. How you spend it is your main decision. • After much deep reﬂection I agree with Linda Smith: The Hokey Cokey IS what it’s all about.” Tom Tracey ask dawn... Dawn Davies expert patient “...I still don’t meet the current guidelines of having a total cholesterol reading below 4mmol/l by a long way... ” Dear Dawn I recently received a letter from my PCT telling me that my statin prescription was being changed from rosuvastatin to simvastatin and I understand this switch is due to cost. I am worried about this change because, having been on statins for the past 22 years and more recently prescribed both rosuvastatin and ezetimibe*, I still don’t meet the current guidelines of having a total cholesterol reading below 4mmol/l by a long way. I do, however, have a good reduction, considering my levels were at one time 19mmol/l! I have suffered a heart attack and subsequently had a heart bypass operation and am 64 years old. Mrs C Phillips Dawn replies... There are few options available to severely affected patients with familial hypercholesterolaemia, and I am in a similar position at the moment, having to justify the cost of my LDL-apheresis≠ treatment. Many patients are also receiving letters from their Primary Care Trust advising that they are being switched from atorvastatin to simvastatin and this is, as you say, because simvastatin is cheaper than the other statins, being the only ‘off-patent’ statin currently available. However, for most people, simvastatin should prove as effective in keeping their cholesterol levels in check. But for others, such as someone with FH like you, whose cholesterol level remains in double ﬁgures, a more potent statin or combination treatment is needed. In some cases, LDL-apheresis treatment is required, and of course, this is far more expensive than drug therapy. My advice is to discuss further with your GP or lipid specialist about treatment options. It may also be worth contacting PALS, the Patient Advisory Liaison Service: www.pals.nhs.uk Alternatively please talk to H·E·A·R·T UK who will be able to offer advice and support. Try not to worry - your condition is treatable! I hope this has helped. Dawn Davies Since writing, Mrs Phillips has contacted Dawn to say that, having spoken to her specialist with her concerns, she is now back on rosuvastatin and ezetimibe.” * Ezetimibe (Ezetrol) is a cholesterol-absorption inhibitor that can be taken singly or alongside statin treatment. ≠ LDL-apheresis removes LDL-cholesterol from the blood and is used to treat severely-affected individuals. The treatment is usually carried out every two weeks. SPRING 2007 DIGEST 14 REGULAR mailbox... A selection of your letters received at H·E·A·R·T UK “Drinking a moderate amount of alcohol every day is considered to be good for heart health... ” Dear Editor, Dear Editor, Dear Editor, A family friend has recently returned from India with a Guggul supplement which he claims helps to reduce cholesterol levels. What is Guggul and just how effective is it in lowering cholesterol? I have recently been subscribed the latest statin for inherited high cholesterol and, while it’s reassuring to know that rigorous studies are carried out into new drug treatments, do the results of clinical trials always reﬂect the ‘real world’? Could you tell me exactly how much alcohol can be taken safely and whether there is a particular type of drink that is best? Guggulipids come from the resin of the mukul myrrh tree. Used in India for centuries, guggulipids have been researched signiﬁcantly since the 1960s for obesity and lipid disorders. The active ingredients are the guggulsterones. Clinical trials using various preparations of guggal have been carried out with moderate success in reducing total cholesterol and LDL-cholesterol measurements, although most studies did not look at other lipid or lipoprotein markers. However, a widely known clinical trial (published in the JAMA 2003) failed to show any beneﬁts with either using 1000mg or 2000mg/ day of a guggul extract and even showed raised LDL-C levels compared to placebo in hypercholesterolaemic subjects. While the study was only eight weeks’ duration, these data have placed caution for the use of guggul extracts as a supplement for lowering cholesterol. Cholesterol-lowering trials are among the largest and longest of the studies of medical conditions carried out. There are, however, rules that determine who is eligible to participate in drug trials, so the particular study will be applicable to a limited section of the general population. These rules are called ‘inclusion and exclusion criteria’. There have been large numbers of statin trials that have used different inclusion criteria, and similar results have been seen across all patient sub-groups from these various trials, so the results are likely to be applicable to the general population. Of course, some patients do drop out of trials, and others that have been assigned a placebo (‘dummy pill’) in the trial may be given a statin in the ‘real world’ (‘drop-in’). The power of research trials is reduced by drop-outs and drop-ins. In the ‘real world’ many people stop taking their medication, or just take it occasionally, and, in order to see the same beneﬁts as the clinical trials, the medication does, of course, need to be taken regularly. Drinking a moderate amount of alcohol every day is considered to be good for heart health. However, increasing the daily amount beyond one or two drinks a day does increase the risk of liver disease, high blood pressure, heart disease and stroke and various cancers. The current guidelines state that men should drink no more than 21 units per week and for women, this level drops to 14 units per week. You can work out the exact number of units in a drink by multiplying the volume (in mls) by the percentage ABV (alcohol by volume – found on the label) and dividing it by 1000. For example, the number of units each in a 330ml bottle of lager or alcopop, with a 5% ABV is: 330 x 5 = 1650 ÷ 1000 = 1.7 units Most wines are 11% or 12% ABV, and remember that pub measures are usually larger than the old 125ml glasses. A typical 175ml glass of wine usually works out as two units. A 25ml pub measure of spirits (40% ABV) is one unit, and half a pint of ordinary strength beer (3.5% ABV) is one unit too. Looking at many studies that have investigated these heart health beneﬁts, it appears that all alcoholic drinks seem to provide this beneﬁt, pointing to alcohol as the ingredient that counts. There is, however, evidence that the antioxidants (called polyphenols) in red wine help to reduce the stickiness of the blood and help reduce the tendency for it to clot, which in turn can also protect against heart disease. But remember that the health beneﬁts of moderate alcohol intake are only gained when consumed in small quantities, so don’t ‘save up’ all your units for a big night out! DIGEST SPRING 2007 REGULAR 15 about us... More information about and from H·E·A·R·T UK �� Meet the team at H·E·A·R·T UK... �� Director �� Michael �� Livingston � �� Marianne Wightman, Membership Manager �� Cholesterol crisis report �� H·E·A·R·T UK is launching a report about ‘Cholesterol and the ageing population; avoiding the crisis in health and pension costs’ at the King’s Fund on 19 February 2007. The report is commended by Kevin Barron MP (Chair of the Health Select Committee) and examines the far-reaching implications for the UK of failing to take action on raised cholesterol. In particular, it highlights the cost to our health, social care and pension systems as a result of a population who will be living and could be working longer than ever before. It also considers the treatment options for raised cholesterol and the efﬁcacy of recent public health measures in dealing with the problem. The report, supported by an educational grant from Merck Sharp & Dohme Ltd and Schering-Plough Ltd, will be available to download from the H·E·A·R·T UK website after the launch. Mike Foxton H.E.A.R.T UK’s new scheme for recycling cartridges and mobile phones is now well underway and we are pleased to enclose a recycling bag in this edition of Digest. If you are unable to use this yourself, please consider passing it on to someone else who might like to support our work. Don’t forget that Cartridges4Causes offer ink and toner cartridges at discount prices and make a donation of up to £1 for every item ordered. Visit their website at: www.cartridges4causes.co.uk or call 0800 881 8150 with any queries. All the latest news from the genetics team. Cathy Baldeesh Ratcliffe Rai Joanna Gill White Stokes Until then, remember you can check our website: www.heartuk.org.uk for news and information! Gill Stokes, Editor Main Hall As her children are still quite young, Sally’s hobbies are walking to and fro from school and nursery, lego, barbies and sleeping. In your next edition of the Digest ... Gryglaszewska Nurse Advisor/Digest Editor Sally has worked as a PA and secretary ever since leaving college, where she obtained two RSA diplomas, one in Ofﬁce Studies and the other in Medical Secretarial Studies. Carole Linda Sally H·E·A·R·T UK welcomes Sally Hall Sally started working for H·E·A·R·T UK in November 2006 as PA to Michael Livingston, The Director. She has spent the last ﬁve years looking after her two children and was eager to return to doing something she felt good at! Head of Fundraising �� State Registered Dietitian �� Maria Whitehouse Operations & Comms Manager �� Accountant �� Membership Manager �� Administrative & Financial Controller �� Assistant to the Director In the last Digest we included a new membership application form to replace the existing one which was stapled inside our magazine. The new form is double-sided with Patients’ and Health Professionals’ details on either side. Unfortunately, in some cases this has led to slight confusion amongst members. Please rest assured that we always inform you by writing some weeks prior to the renewal of your subscription. If you are unsure or have any questions regarding your membership, please telephone me on: 01628 777046 or email me at: [email protected] I do apologise for any inconvenience and/or confusion caused. �� State Registered Dietitian Dear Member, �� Nurse Advisor/Website Manager Membership application form Marianne Wightman SPRING 2007 DIGEST 16 REGULAR diary dates... book review... The Heart Recovery Book a rehabilitation guide Author: Irene Tubbs Only a third of patients discharged after a heart attack or coronary surgery currently receive rehabilitation, yet, in the UK, there are 270,000 heart attacks and 300,000 heart operations every year, while more than one million are on waiting lists for hospital treatment. The HEART REC OVERY Book This book provides valuable information on how to recover after heart attack, stroke or treatment for heart disease. Supportive and practical, it covers rehabilitation from the smallest details, such as postsurgical symptoms and how to breathe IRENE TUBB S without hurting your wound; to the wider aspects of lifestyle management, such as overcoming stress and conquering habits that may have contributed to heart disease. Topics covered include: • • • • • • • • • Taking medication and seeing your doctor again Practical issues such as work, driving, holidays Coping with emotions and stress Detailed exercises and safety tips Diaphragmatic breathing techniques and relaxation exercises How to give up smoking and drinking Healthy eating habits Step-by-step one year rehabilitation programme Learning to use positive thoughts to assist the healing process Following rehabilitation, many people ﬁnd that they feel healthier than they felt before their cardiac event. The message is simple: it’s never too late, so start today and learn to become your own health coach. Irene Tubbs has worked in coronary rehabilitation for more than 25 years. Wednesday 27 – Friday 29 June H·E·A·R·T UK 21ST Annual Medical & Scientiﬁc Meeting 2007 Heriot-Watt University, Edinburgh SCIENCE PROGRAMME: ‘Back to the Future: Familial Hypercholesterolaemia Revisited’ and ‘Clinical Lipidology Live!’ This meeting is: •Accredited by the RCN Accreditation Unit - 11 study hours •CPD approved - 18 credits Deadline for abstracts and conference grants: Friday 16 March Early Bird discount registration deadline: Sunday 29 April Full meeting details can be downloaded from: www.heartuk.org.uk contact: Natasha Dougall, Wheldon Events & Conferences tel: +44(0) 1922 457 984 fax: +44(0) 1922 455 238 email: [email protected] web: www.heartuk.org.uk Thursday 28 June 2007 H·E·A·R·T UK Patient & Members’ Workshop & Annual General Meeting Heriot-Watt University, Edinburgh Come and join us at this lively and interactive workshop, which is FREE for all H·E·A·R·T UK members! The morning programme includes a presentation from an FH patient with news of H·E·A·R·T UK’s Family Support Centres and advice on how to make your mark in raising cholesterol awareness, followed by small group discussions facilitated by members of the H·E·A·R·T UK team. Over lunch, there will be an opportunity to chat with our medical and scientiﬁc experts who will also be at Heriot-Watt University for the Charity’s Annual Conference. In the afternoon you will hear all about ‘superfoods’ from the Charity’s expert dietitians, and the ﬁnal session will have us all on our feet for a nottoo-strenuous workout from an exercise specialist! You are welcome to bring a guest too (A small donation in one of our collecting tins at the meeting much appreciated!) He or she may even be inspired to join up as a H·E·A·R·T UK member to gain year-round membership beneﬁts, including, of course, subscription to the Digest magazine. So don’t delay – reserve your place today Special Digest reader offer... Digest readers can order The Heart Recovery Book for just £7.50, including p&p (RRP £8.99), by calling: 01235 465500 and quoting order code: 978 085 969 9556 SHELHRB DIGEST SPRING 2007 H·E·A·R·T UK DIGEST Although H·E·A·R·T UK has endeavoured to ensure the accuracy of the entire publication, no liability will be accepted by the Trust, Ofﬁcers or members of staff, for information and opinions herein given. contact: tel: fax: email: web: Natasha Dougall, Wheldon Events & Conferences 01922 457 984 01922 455 238 [email protected] www.heartuk.org.uk Further details in May’s Digest. NURSES & DIETITIANS Did you know... if you wish to attend the two-day conference (including Patient & Members’ Workshop), by becoming a member of H·E·A·R·T UK you will save £30 on the registration fee? See: www.heartuk.org.uk or contact Natasha Dougall (see above) for further information or to download a registration form.