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Berwick Area Heart Support Group
December 2004 Newsletter
Next meeting 1st December at the Day Hospital Berwick Infirmary 7pm – 9pm Guest Speaker Diane Edgar from the Borders Healthcare Trust followed by our Christmas Buffet suggested donation £1.
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Janet Punton gave the November 04 talk to the Heart Group.
Janet is the ‘prescription’ nurse at the practice in Belford. She has trained at Lancaster University Department of Nursing Studies, and has the job at Belford keeping track of patients, particularly those with diabetes but also the much smaller number who need looking after in the 6 weeks after a heart attack. The changes she encourages them to make are pretty well the same for both groups! Some patients are diagnosed for the first time as diabetics when they are in hospital following a heart attack, but this may be a temporary condition, which reverts to normal after recovery from the attack. These patients need watching though. As a general rule heart patients like our group should have a blood test for sugar once a year.
Diabetics and heart patients get high-dose statin. Then there are changes in ‘lifestyle’. For diabetics (usually Type II or ‘late-onset’ diabetes) or those with impaired sugar tolerance, the first thing is to get over the fear that comes with the diagnosis. Nobody these days needs to develop the serious symptoms that we used to associate with diabetes. No need for kidney failure or loss of eyesight or circulation in toes. No need either to increase the risk of heart attack. Treatment will prevent the symptoms from developing. Untreated diabetes however will seriously increase artery problems and the risk of heart attack.
(Janet explained that Types I & II diabetes are really very different diseases. Type I is where glands fail to produce the insulin needed to control sugar levels in the blood. This condition is fairly well understood and needs careful insulin replacement. Type II is diagnosed when the body produces what should be sufficient natural insulin but the insulin cannot properly control the sugar in the blood. Either the blood sugar is permanently too high or fails to come down fast enough after a meal. Why these problems develop is not understood. Even a few skinny people who exercise a lot can develop the condition but people who develop belly fat (the ‘apples’ as distinct from the ‘pears’) are much more at risk. It seems to be mostly down to lifestyle, to types of food and to not enough exercise.
1. Exercise is the first step in treatment.
2. Then comes food. This is not just the old advice of cutting out sugar. Get the fat / oil levels down; fibre, fibre, fibre, substitute for the higher fat foods. (Janet left us some wonderfully helpful work sheets).
3. If the above are not sufficient (and they usually are) there is oral medication.
4. In reserve is insulin injection.
Numbers 1 & 2 apply also to heart patients, whether they have a blood sugar problem or not.
Janet has 200 patients now on her diabetic list. The idea is to not miss anybody. Janet and colleagues are ‘pro-active’. They go after the patients! Patients carry their own medical records. (Consultant, GP, nurse, chiropodist, physio, whoever, will update the record as they go along.) People can follow their own progress. And there is progress. None of them have high blood pressure now. Need for medication can be reduced (except the statin of course). The scheme, particularly the involvement of the patient, and each having his or her own record card, has won a Northumberland NHS award. Janet has deliberately gone for training as an ‘educator’. Education means starting from where the patients are starting from. The patients get active. They mostly use group work and have a lot of fun.
Our Heart Group hopes to have more contact with the Belford scheme. It may be possible to get some of the people who have made lifestyle change to come and help us get going some active working groups? Apparently there have been some cooks who have cracked the problems. We could maybe make a start with them! In the meanwhile, good walking!
Phil. Harris
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Old-Fashioned Chicken Noodle Soup with Winter Vegetables
Preparation time : 20 minutes
Cooking time : 40 minutes
Serves 4
Ingredients
3 chicken breasts with the bone, about 1 ½ pounds total
6 cups chicken stock
1 medium onion, diced
2carrots, peeled and thinly sliced
2 parsnips, peeled and thinly sliced
1 medium leek finely chopped
4 ounces egg noodles
¼ cup chopped parsley
salt to taste
freshly ground black pepper
Cooking Instructions
1. Remove the skin from the chicken breasts and place them in a large soup pot. Add the chicken broth, bring it to a boil and reduce the heat so that the broth just simmers. Simmer until the chicken is thoroughly cooked, about 15 minutes. Remove the chicken and transfer to a plate to cool.
2. Skim the fat from the broth and bring it back to a boil. Add the onion, carrots, parsnips and leek. Simmer until the vegetables are soft, about 5 minutes. Add the noodles and cook for 5 more minutes.
3. Meanwhile, discard the bones from the chicken and chop the meat into small pieces.
4. Add the chicken and parsley to the soup pot and simmer for another minute or two. Season to taste with salt and pepper. Serve in warm soup bowls with a thick slice of bread.
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Donation
On behalf of the British Heart Foundation we would like to thank Mr &Mrs Mee and Mr & Mrs Walsh for the donation received in memory of their dear friend who passed away recently
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Food thought
Prevention or therapy?
We need all the help we can get. Just taking our medicine is important but not enough. The food we eat matters, and as a rough rule of thumb we are advised to use a lower fat diet, particularly cutting out ‘saturated fat’ and go for higher fibre (plant) foods. That is a precautionary or preventive approach. I distinguish between prevention and therapy. If we have proved we have arterial heart disease, angina or heart attack, then we need therapy.
We come in all shapes and sizes.
Even ‘skinnies’ can have arterial disease, or insulin resistance or late-onset diabetes. (Untreated blood sugar problems more than double the risk of a heart fatality. First line of treatment is exercise and diet). But, arterial disease does not mean you will definitely have a heart attack. There are a lot of people with arterial disease walking around who have no symptoms and might have a heart attack only when they are very old, or never. Those of us who are much more prone to the actual heart attack need a two-prong approach.
First, reduce the risk of heart attack. Stop smoking, get or keep weight down, avoid the ‘fat hit’ or ‘sugar hit’ type meals. (You know the feelings.) Take the statin (which cuts inflammation as well as cholesterol) and aspirin (which helps prevent a blood clot). Start walking if possible. I would add, personally, get any gum disease or chronic tooth infection treated.
Long term, increase exercise and make it daily and change what you eat. It is very difficult to keep weight down without exercise and/or if we eat much fat and oil. Saturated fats will increase your ‘bad’ LDL cholesterol. Trans-fat is a no-no. Animal fats, and vegetable palm oil or coconut oil (or oil just labelled ‘vegetable’) should be minimal. Substitute with olive oil – a ‘virgin’ olive oil contains ingredients other than just oil and these ingredients probably do you good. Change to whole meal bread. (Cut out white bread and pastries. A very recent Australian study suggests the single most effective step in preventing the progression of late-onset diabetes is leaving out white bread. Getting sugar from fruit, with no added sugar, seems OK, and fruit contains protective ingredients).
We are very variable in our internal make-up. What suits one does not suit another. Even a very low fat diet does not suit everybody. (Your doctor can check that your HDL, the ‘good cholesterol’, does not decrease seriously and that your triglycerides do not suddenly increase.) The change in eating suited me. It seems that the large majority of people who cut out fat and go over to porridge for breakfast and vegetable main meals with beans or lentils (and really plenty vegetables but not too much starchy potato), and get walking, start to lose weight and begin to feel much better. I did. I was astonished. At the age of 49 (after MI) I started to feel 30 again. Well, it does not last quite like that forever; I’m nearly 64 now! Some things do last, however. My painful ‘‘arthritic’ ankle that had been damaged in a climbing accident when I was young, also improved amazingly and I could run again. I still can.
Have a look at the following, which have been found to be useful in medical studies and cannot do any harm! No guarantees for claims for cholesterol lowering or other health effects, but all of these continue to get a ‘good press’!
A handful of raw almonds daily can lower cholesterol, and also lower the genetic risk factor for coronary disease, lipoprotein(a). Almonds also reputedly blunt abnormal spikes in blood sugar after eating and help prevent diabetes. “They are tremendously filling and are great for sugar addicts who need to snack, since almonds take the edge off your sweet tooth” (so they say). Almonds, as well as useful protein and calcium contain mostly monounsaturated oil and also a useful amount of protective pro-anthocyanidins. The latter are found also in most berries and grapes and plums
Soy products are a source of many beneficial substances, such as isoflavones. “Eating soy protein powder, three tablespoons a day in fruit smoothies, protein shakes, or blended with yoghurt or other foods will lower LDL by around 12%” is a quote from one medic. (Whole meal Soy is more easily and cheaply available. Try making ‘fruit smoothies’ – we will provide a demonstration).
Pectin is found in apples, particularly in the skin, and in the rinds of citrus fruits. Pectin is a natural fibre that lowers cholesterol; the same foods also provide flavonoids that yield broad health-promoting effects. (I make a ‘fruit smoothie’ that contains, in addition to berries also rich in flavonoids, apple with its skin, and also oranges and lemons with only the coloured bitter outer-layer removed.)
Similarly other protective substances are in Brassicas. With salads etc. you can use broccoli mini-seedlings from sprouted broccoli seed. (Terry obtained the broccoli sprouting information from the national food research laboratory, Norwich and other science centres. We have a supply of organic broccoli seed and can give a demonstration*.)
Of soluble fibres, among the best is oat bran. Containing twice as much beta-glucan as oatmeal, oat bran is a source of soluble fibre that can lower cholesterol by around 10-15% while also reducing blood sugar and providing roughage for bowel health.
Starchy beans such as black, pinto, Spanish, red, and kidney beans provide significant soluble fibre that can lower LDL. “Consuming one-half cup of these beans each day in one or more meals is an easy way to lower cholesterol. Note that fibres like the wheat fibre found in whole wheat bread and raisin bran cereals do nothing for your cholesterol”.
Phytosterols are soybean derivatives that can lower cholesterol by 12-15%.
Fish oilcan raise HDL (‘good’ cholesterol) and lower small LDL (bad stuff) when taken in the form of a concentrated omega-3 preparation. “One or two high dose capsules a day of fish oil has tremendous benefits beyond its lipid effects, including reduced mortality from heart attack, anti-inflammatory and mood-improving effects, and reduced cancer risk”.
Personally, I watch my vitamins and make sure I have the recommended daily amount (RDA) of these and the minerals, including magnesium. I do not take supplemental iron. My blood count is fine and iron in older men gets a ‘bad press’.
Phil Harris
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Wally’s Yarns
Read the Instructions
My wife always says, "When all else fails, read the instructions," but these ones don't sound like they'd get you very far!
·On a hairdryer:
"Do not use while sleeping,"
·On a box of cornflakes:
"You could be winner! No purchase necessary. Details inside."
·On a bar of soap:
"Directions: Use like regular soap."
· On some frozen dinners:
"Serving suggestion: Defrost."
·On Tesco's Tiramisu dessert (printed on bottom of box):
"Do not turn upside down."
·On Marks & Spencer Bread Pudding:
"Product will be hot after heating."
·On packaging for a Rowenta iron:
"Do not iron clothes on body."
·On Boot's Children's Cough Medicine:
"Do not drive a car or operate machinery after taking this medication."
·On Nytol Sleep Aid:
"Warning: May cause drowsiness."
·On some brands of Christmas lights:
"For indoor or outdoor use only."
·On a Japanese food processor:
"Not to be used for the other use."
·On Sainsbury's peanuts:
"Warning: contains nuts."
·On an American Airlines packet of nuts:
"Instructions: Open packet, eat nuts."
·On a child's superman costume:
"Wearing of this garment does not enable you to fly."
Click for Wally’s Yarns
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January Newsletter
The newsletter/website team are going to have a break over Christmas and hopefully come back refreshed and full of energy and inspiration for next year .
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