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Berwick Area Heart Support Group
July 2004 Newsletter
NEXT MEETING JULY 7th At the DAY HOSPITAL BERWICK INFIRMARY
From 7.00pm – 9.00pmGuest Speakers Mandy,Michelle and Elaine from Cardiac Rehab at the Swan Centre are coming along to answer all the questions you have about cardiac rehab such as, What is cardiac rehab? What happens in a cardiac rehab program? How else can cardiac rehab benefit me? How can I learn more? Come along and get the answers to your questions and try some of the exercises
******
On 2nd June, at our last meeting, our speaker was Marie McWilliams of Age Concern.
If we were specifically asked, “What does Age Concern do?” I would imagine that our individual, answers would vary greatly, either because of personal knowledge, or the fact that we were guessing, and say something like, they help the old, but it’s all a bit more involved than that Marie did come to explain projects that are currently on offer from Age Concern, and commenced by explaining that Age Concern Northumberland, like all other Age Concern groups are all independent of each other, but are all affiliated to Age Concern England.
But firstly I have to take exception to the fact that she has put me and many of you as well, into a group, and called us older people. Apparently the classification of an older person is 50+, and an older older person is 70+.
Now me, I’m only 35 + VAT and about 40% inflation, gradually noticing that my hair has gone from dark brown with some executive highlights of grey to nearly all grey with lots of white thrown in. But old! I don’t think so, it must have been that paper round I had as a kid. So Marie lass, just to let you know, that is not one of your better chat up lines, and I’ll wait until I’m 70 before admitting I’m getting older.
Joking apart, one of the main stays of the organisation is its information line. Open to all, dare I say it? older people, their helpers or families.This is a general information line, manned by volunteers, all trained by Age Concern, and is open Monday to Friday 10am to 1pm. Although it is based in Alnwick, calls are charged at the local rate, and the number is: - 0845950150.They can only give information of a general nature, and certainly not legal advice. Marie gave examples of “Yes” we can give information on Residential Homes, Stair lifts or Home Helps, but “No” to a legal matter like, If I sell my house, does the Tax Man need to know. But like all good people, whilst they cannot give this sort of advise themselves, they usually know a man that can, and will usually be able to tell you who to contact, or pass you onto an Organisation that deals with these matters.
The queries that are received are varied and diverse. Marie says it’s always nice to get a new query. If it cannot be answered at the time, someone will ring back later with an answer.
Also, and part of the same service, Age Concern have many leaflets covering the most common questions asked concerning us older persons, and some that are not so common. Hopefully Terry managed to rescue a list of the subjects covered, and will be reproduced it with this news letter, and you can see for yourselves how varied the subjects are. These can give legal advice and are kept up to date with current legislation. These leaflets also cover some leisure activities, and gives advice to people who might be a bit wary of going out on their own, or meeting new people for the first time, or just thinking of trying something new. Again this service is open to all.
Smoke alarms
One snippet if information, on smoke alarms. If you do not have one, contact either Age Concern or the Fire Service (Please don’t ring 999 for this), and the Fire Service will come and fit you one for free, with a 10 year battery.
Other Activities
Some other activities run by Age Concern in the Berwick area; -
- Aging Well classes.
- Social Day Care
- Lunch Club, This is at St. James Court, open to all, but you have to arrange this, you cannot just turn up without booking.
- Dementure Day Care, 3 days a week at Norham.
- Meals on Wheels
On all these subjects, please contact Age Concern for the full facts, also on the availability of Day Care, Home Care, and other home related matters, as, whilst not in Berwick yet, it is hoped to set these up in the near future.
Message in a Bottle
Something else Marie spoke about was message in a bottle. This is a scheme recognised by all the emergency services and can help save lives. What it consists of is, a smallish plastic jar, with a sheet of paper inside, and two sticky backgreen crosses. On the sheet of paper you would fill in you personal details, i.e.:-
- Name, age and date of birth and address
- Any illness you are currently being treated for
- Current Medication
- Any allergies
- Next of kin
- Your Doctors surgery
You don’t have to remember all this, its all on the form. The form goes back into the bottle which you place in the fridge, and then almost forget about unless some part of you details change. On the outside of the fridge door you put one of your green crosses, and on the back door, or the door most often used, you place the second green cross.Then if the worst happens and you are taken to hospital, and you are unable to tell the emergency staff anything, you may be unconscious, all they need to do is go to your fridge and get all your details, so that treatment can start quicker. The whole idea is that the bottle is kept in the fridge, so please don’t hide it in the wardrobe and expect it to be found.These bottles are available from Age Concern, or in Berwick, from Social Services, below the Library, or Citizens Advice, Tweed Street. A very good idea, especially if you live alone, or your medication or treatment is a bit complicated.
Marie did answer some personal questions, but it was an interesting insight into the work of Age Concern, and maybe, just maybe, I might soon have to a admit that I may be beginning to sneak into that older group.
Thank you Marie
******
Wally’s Yarns
The spell of warm weather reminded me of one of my little stories.
John, a middle aged married man, was stood in the pub one Sunday lunch time, waiting for David his widowed friend to join him, for a quick pint, before going home for lunch.
David had been to church. He fancied one of the spinsters in the choir, and so had been going for the last couple of weeks, hoping to catch her eye.When he arrived at the pub after church, John noticed that one side of David’s face was bright red, and it looked as though he might have the start of a black eye.
John said “I thought you were at church, what happened to you?”
David said,” I was, that’s where it happened”.
John said, “What happened?”
David started to tell him how he got his red face. He said” I was sat there, in church, minding my own business. I was sat behind Molly Green that was,You know who I mean; she married the butcher on the High Street Anyway she was wearing this silky summer dress that was all light and flowing, with big flowers on.
John nodded, in acknowledgement.
David continued, “Well we had all been kneeling down to pray, and when we got up again, and began the next hymn, I noticed that her dress had got caught up between the cheeks of her bottom. (That’s not in the original story; I’ve changed it for the sake of decorum) Well I know what that’s like, it’s not very comfortable, and so I lent forward and pulled it out for her. As I did she jumped, gave a bit of a stifled scream, and then turned round and gave me such a smack across my face, before going off to an empty seat, muttering something.
John said, “That serves you right, that’s nothing to do with you, you shouldn’t have done that, it serves you right. If the woman’s decided to take in a bit of washing, it nothing to do with you, and it serves you right.
They had their pint and went home. David feeling sorry for himself.
The next week John was waiting in the pub, just as before. When David joined him, again he had a red face, and his eye, which had only just better from last week, was starting to swell again. John said “Not again. what happened this time?”
David said “It’s not my fault this time, well not really. What happened was, again I was sat behind Molly Green, and she had another of those silky, flowery dresses on, and just like last time, after we got up from praying I noticed that it was caught up her bottom again”.
John interrupted, “Don’t tell me, didn’t you learn last week?
David continued, “No I didn’t do the same this week, I didn’t touch it, but the fella next to me did, he lent forward and pulled it out, but, after last week I know she doesn’t like it out, so I lent forward and poked it back in.”
Wally
******
Secrets of Romany
Long Life And Health
‘ Their secrets are not so much a mystery but simply a way of life based on common sense
Avoid stress and strain, Do not rush things but take your time and make perfection your goal, not the clock.
Let tomorrow take care of tomorrow.
Get plenty of fresh air whenever you can, as it has a magical effect on the body.
Walk instead of riding around; use your body or it will get old and fat.
As far as you can, rise with the sun and go to sleep with it; all nature does and so should you.
Eat healthily by eating only fresh, simple, wholesome, life-giving foods and avoid like the plague all stodgy, sickly, artificial, poor quality foods.
Eat sparingly of rice, pasta, and sweets but eat your fill of all manner of herbs, vegetables, fruit, buttermik, malted milk, wholesome bread and oats. Never cook in aluminium pots and pans but instead use ironware; aluminium impairs the quality of food and can cause symptoms in sensitive people.
Never peel vegetables such as potatoes because the skin contains much goodness that keeps your skin and hair healthy. Never use onions that have been cut and left for a while as they draw germs into them (as with leaving cut onions in a newly painted room). Never discard outer leaves of vegetables, even if they are full of holes, for they contain more vitamins and nutrients than the paler inner leaves. Eat plenty of lettuce. It is a wonderful food, full of goodness
(extract taken from The Complete Country Bizarre published in 1970/74 and edited by Andy Pittaway and Bernard Scofield.)
When I read this I though, these are all the things we should be doing .
******
Recipe of the month
Pasta salad on lettuce(serves 4)
Preparation time: 5 minutes
Cooking time: 10 minutes
Ingredients
200g pasta (twists or shells if available)
2 tomatoes, washed and cut into chunks
Quarter of a cucumber, washed and cut into chunks
1 tablespoon raisins
225g tin of tuna
3 tablespoons natural yoghurt
2 tablespoons low calorie mayonnaise
4 large lettuce leaves, rinsed and shaken dry
3 spring onions, washed and sliced
Method Cook the pasta in boiling water for the time stated on the packet. Drain and place in a large bowl. Add the tomato, cucumber, raisins and tuna to the bowl and stir together. Add the yoghurt and mayonnaise and blend in. Divide into 4. Serve each portion on a lettuce leaf and scatter with sliced spring onions and sprouting broccoli. Alternatives Use cherry tomatoes instead of chopped tomatoes. Add 25g toasted cashew nuts. If low calorie mayonnaise is unavailable, use standard mayonnaise but add half the amount and top up with more yoghurt
Berwick area Heart Support Group
August 2004 Newsletter
NEXT MEETING August 4 At the DAY HOSPITAL BERWICK INFIRMARY From 7.00pm – 9.00pm
I know Terry will be saying something about the August’s meeting, but the plans are, (weather permitting,) to again join up with the Walking for Health Group and go for a walk. There will be a longer and a shorter walk, both will be on firm ground, but may involve all or a portion of the Walls. The longer walk will last about an hour, and both will return to the Day Hospital, for a cup of tea and something to eat. Or as my Grandson calls it a ’Worzel Gummage party’, ‘a cup of tea and a slice of cake’ which was one of Worzel’s favourite sayings
Please decide which walk you want to do but don’t over do it, but if you decide to do either please wear sensible shoes, and bring a coat just in case it rains. No one is being forced to do either walk. There will no doubt be some staying at the Day Hospital. If you do decide to do a walk and have not already filled in a health questionnaire, please turn up a few minutes early on the day and it can be done. It is necessary for Insurance reasons.
On Wed. 7th. July, at our last meeting, we were lucky to have not one, but three guests. Only one spoke though, the other two made us work. Our guests were, Mandy Thompson, Practice nurse and Cardiac Rehab nurse at Well Close Surgery, and Michelle and Elaine from the Swan Centre.
All three were there with a common purpose, which was to advise us on the benefits of regular exercise, with useful advice on how to achieve it. All three are fully committed to Cardiac Rehab.
Mandy, who first came and spoke to us back in January about the Cardiac Rehab 3 programme which had commenced at the Swan Centre, again explained the benefits of regular exercise, and how it can lower both blood pressure, and cholesterol levels, reduce weight, and improve stamina, strength and all round general fitness and well being.
She reminded us of the basics of the Rehab 3 exercise programme, which is still ongoing at the Swan Centre, with an explanation of the routine and exercises covered, which includes warm up, work out, cool down and relaxation sessions.
She also mentioned the fact that she was always in attendance, as were at least two Swan Centre Staff, and on Thursdays there was also a physiotherapist. Mandy also said that if members were interested in exercise, but were uncertain as to how much they should or could do, or they did not want to exercise alone, or were wary of exercising at all in case they overdid it, they would be welcome to come along on either a Tuesday or Thursday at 1.15pm. to the Swan Centre and either watch what happens, or even join in provided their own Doctor has authorised exercise.
This may not make sense, but whilst I was writing the next paragraph I remembered something that Mandy said, so I’ve come back to add it here:- If when you read Swan Centre you think gym, or lifting heavy weights, with grunts and groans, or walking or pedalling endlessly on machines getting nowhere, then forget it, this is not the sort of exercise that is being done. What are being done are low impact rhythmic movements. No special clothing is required, just loose clothing and soft shoes.
I rather suspect that this is the first time the next bit of information has been made public as well, but because the Cardiac Rehab 3 programme is at the Swan Centre, there is also a difibulator kept at the centre, and staff have been trained to use it.
Whilst no one attending the exercise programme has had need of this equipment, a few weeks ago a gentleman who is a regular visitor/user of the gym suddenly collapsed. The usual checks were made and it was decided the difibulator was required. It was used, and thankfully the man is now up and about, following a stay in hospital.
As two of the staff involved were in the room, a well deserved round of applause were given.
This takes us on to Michelle and Elaine. This is when the work started. Michelle, who usually leads the warm up session, ran through a typical warm up routine which included all the movements that would be required to do the work out. Elaine showed how the same exercises could be done sitting down. I think everyone present got involved, being at the front, you don’t see what’s going on behind. I can only hope that you enjoyed it. So if anyone who was present wants to know what Cardiac Rehab 3 is all about, that’s as hard as it gets. Even in the work out section you only do what you feel you are able to do.
So, again, if you are interested in supervised sensible exercise, call along and see Mandy at the Swan Centre, times are given earlier in this article.
Michelle and Elaine had to leave as they were still working and had classes to take, but Mandy stayed and answered personal questions whilst the rest of us drank tea.
Thank you Mandy, Michelle and Elainefor your time, and advice.
Click to return to index
Wally’s Yarns
Light hearted comments on two recent sporting failures
Firstly tennis,
After Tim Henman lost his match at Wimbledon, he still had a ball in his hand, so as he left the court, thinking of where he had gone wrong, he absently mindedly put the ball in his pocket.
As he was walking down the corridor to the locker room, he passed a couple of the cleaners walking in the opposite direction. He noticed that one of them was looking quizingly at his bulging pocket, so he pointed to it and said “Tennis Ball” One cleaner looked at the other and said, “No wonder he’s just lost, the poor lad must be in agony. I had tennis elbow once and I know howpainful that was”.
Still on tennis
Two women sat in their club discussing tennis. One said to the other “Which side do you watch when you are watching tennis on TV”? The other said,” I always watch BBC1” The first one said, “We don’t, have you never noticed, the grass is always greener on the other side.”
And so to football,
Two men had watched the England V Portugal in the pub, and discussed their views on the match as it took place, each having an opinion on every kick, pass and referee’s decision. After the match, they continue to discuss where England had gone wrong, and it got late. When they realised the time the first one said, “I’m glad I’m not married, I would get a right telling off going in at this time.”
The other said “Me too”
The first one said, “So you’re not married either. I used to be, but we got divorced a couple of years ago, we used to argue a lot”
The second one said,” Us too, we just got divorced a few months ago. But let me guess, I bet the arguments were about money or sex, ours were”.
The first one said, “You’re right; we did try to work things out, we talked about it, discussed it, promised to make changes, but it never worked, and, I still think she was charging me too much”.
Oily fish and nuts
I don’t know what Terry has got about food this month, but here are two things I’ve read in the last few days.
The first is about oily fish. I first heard about this on GMTV, but only got part of the story. A couple of days later in was in the paper, and I got the whole story. Apparently although we are advised to eat several portions of oily fish a week for its Omega 3 oils, too much of the fish can be harmful as it contains pollutants. I will put in a fuller explanation next month, but the GMTV Doctor makes the following recommendations: If you are a woman of child bearing years, or a young girl only have a maximum of 2 portions per week. Boys, Men and older women can have 4 portions.
Nuts.
If you avoid nuts because you think they are fattening, its time to look at them again. Apparently twenty almonds contain 165 calories and 14g fat, but if eaten in place of sugary snakes, they can aid weight loss because their outer coating blocks some of the fat from being absorbed.(I think they mean the brown skin, not the coating on sugared almonds)
45Pistachios contain 158 calories and 13g fat and are rich in potassium, which helps lower blood pressure.Brazils are bursting with cancer fighting selenium, and 7 contain 186 calories and 19g fat. Last but not least, the Peanuts 30 unsalted ones contain 196 calories, and 20g fat, but plenty of folate, which can help fight heart disease
Wally
****
Recipe of the month
Smoked Haddock with crushed new potatoes
450 g new potatos
170g frozen peas
4x170g fillets smoked haddock
425 ml milk scalded
2 slices onion
45g butter
salt & pepper to taste
for the sauce
1 small pot crème fraiche
4tbsp lemon juice
salt and pepper to taste
for the garnish
chopped chives or parsley or sprouted broccoli
Method
1 preheat oven to 175c/350f/gas mark 4
2 Cook the potatoes until tender. Add peas at last minute
3 While the potatoes are cooking, place the haddock, skin side up, in a roasting tin, in a single layer, pour over the warm milkadd the sliced onion and bake for 15 min.
4 Make the sauce by mixing the ingredients together, Season to taste
5 Drain the potatoes well, crush with a fork adding the butter and season to taste
6 When haddock is cooked, take from roasting tin and remove skin
7 Divide potatoes onto four plates, cover with haddock, add sauce and garnish
Berwick area Heart Support Group
September 2004 Newsletter
NEXT MEETING September 1st At theDAY HOSPITAL BERWICK INFIRMARY From 7.00pm – 9.00pm Guest Speaker Dr Chris. Plummer Cardiologist at Wansbeck General Hospital will give a talk on Pacemakers and related devices. Where are we in 2004?
From their invention in the 1960s, pacemakers have come a long way in treating heart rhythm disturbances and are now being used to treat some forms of heart failure. A development of the pacemaker, the implantable cardioverter defibrillator, invented in 1980, is now being used not only to control slow heart rates but also treat dangerously fast heart rhythms. I will show how these devices work and how we can use them to improve quality and increase quantity of life in our patients.If you’re reading this newsletter and you think you would be interested in this particular subject, please come along, you’ll be made very welcome.
Allerdean Country Fair
Andy and Phil attended a presentation evening at The Plough Inn, Allerdean where they were presented with a cheque for £50 towards the costs of the monthly newsletter.
**
Wally and myself have attended a six week course on ‘Self-management of Long–term Health Conditions, I think the most rewarding thing about the course was the fact that our own group has covered more than 75% of the subject matter we discussed. More on this next month.
Process Mapping Event Cardiac Rehabilitation across Northumbria Healthcare Trust and the North Locality of Northumberland
Phil and Terry attended a meeting at Lee Moor Alnwick on 19th July. 2004. There were representatives from all interested parties. The aim of the meeting was to follow the path of a cardiac patient from arriving in A&E through their time in hospital, recuperation time, cardiac rehab ect. And highlight all the problems areas in the system, And then find solutions to the problems
Terry
**
Last month we didn’t have a speaker, we joined up with the ‘Walking for Health’ group, and 35 of us went for a walk. There were two groups, one group did a shorter walk with Lesley and Bea, I don’t know exactly where they went, but the longer walk went down Marygate, into Woolmarket and up onto the Walls by the Lion House. We then did part of the Walls, coming off at the Nessgate, and then to the end of the pier. Retracing our steps we then went up across the Fields past the Golf Course, and back to the Hospital.There we had a seat, and a cup of tea and some light refreshments. I hope everyone enjoyed themselves, it makes a nice change to get out, and the weather was kind to us.
Thanks to, Kathy, Irene and Ann for the refreshments, also Lesley, Bea, Tom and Arthur, the walk leaders.
Whilst still thinking refreshments, if you tried the quiche, and thought that it was tasty but different, here is the recipe. Its Kathy’s, I take no credit for it, but I have halved the ingredients otherwise you will be feeding the 5,000.
1 ptk. Precooked rice. (flavoured if preferred)
Mixed vegetables
250 grm Cottage Cheese
3 eggs.
Method.
Partially cook mixed veg. Empty rice into ovenproof dish and spread across base, not too thick. Add mix veg. Mix cottage cheese and eggs together, and pour mixture over vegetables. Bake at about 180 degrees until firm to touch and a nice golden colour as all the good books say.
This is the basic recipe; there are all sorts of variations. I’m sure you will have your own favourite fillings; the good bit about this one is nopastry .So if you watch what you do put in, it could be a healthy meal.
Some other things I’ve read in the papers over the last few weeks. These are not must do’s, they are just for interest, and are suggestions for lowering blood pressure. Potassium seems to be mentioned a lot, it lowers the blood pressure because it helps the body get rid of the sodium.(Salt)
Bananas
Eat more potassium-rich fruit and veg. Bananas, potatoes; celery and wholegrain cereals are all good sources. The article I read suggested two bananas a day would make an impact, and that the riper fruits were better than the not so ripe ones.
Tomato Juice
By drinking just one glass of tomato juice for breakfast each morning you can lower blood pressure, but make sure it’s the low salt version.
Tomato juice contains gamma-amino-butyric acid, a deficiency of which can lead to hypertension (high blood pressure).
Mediterranean Style Meals
Studies have shown that Garlic can reduce blood pressure. Meals such as Spaghetti Bolognaise contain a combination of blood pressure-busting ingredients, such as tomatoes, garlic and olive oil. Black pepper, oregano and basil all used in Italian cooking, are good too.
Not to forget the Spanish, who, as a nation, have the lowest death rates in the world from cardiovascular disease. Scientists suspect meals like paella are responsible. It is made with Saffron, which contains crocetin, which is another chemical which lowers blood pressure. Paella is also made with red peppers, full of potassium and useful antioxidants, and paella rice is full of fibre.
Milk
People who drink Low-fat, or skimmed milk, and who eat low-fat dairy products, are less likely to get high blood pressure. Calcium is one factor, but milk contains potassium and magnesium, which also helps.
Fish
The old favourite, oily fish. Mackerel, salmon,sardines etc. Omega-3 oils have been shown to lower blood pressure. But to minimise the risk of contaminants, women should eat no more than two portions per week, men and boys, four.
Salt
THIS IS WHERE WE CHANGE; WE HAVE TO EAT LESS OF THIS.
Eating less salt is the single most important thing we can do. Apparently we eat about 50 times more than our ancestors, and it causes the body to retain fluid, increasing our blood pressure. On average we eat 9.5 grm. of salt a day (That’s two teaspoons). When you consider we should eat no more than 6 grm. even down to 3 grm. if you already have high blood pressure, or heart problems..
As much as 80% of our intake comes from prepacked food such as tinned soups, savoury snacks and ready meals. Read the labels, if it gives a sodium level instead of salt, you have to multiply the figure given by 2.5. So a sodium level shown as 0.6 grm. becomes 1.5grm. of salt, for some of us that’s half our daily allowance. No wonder the manufacturers use sodium levels instead of salt….
But not all high salt foods taste salty. One of the biggest sources of salt in our diet is bread. I’ve had look at the most popular sliced loaves in the supermarket, most of them average 0.5grms. of salt per slice. So again, all I can suggest is, read the labels.
Wally’s Yarns
Change of subject now.
My grandson Jack, who’s 8, has grown up, believing that you have to have grey hair to be old enough to drink beer. This is because it was the first thing I thought of when he wanted to try my beer when he was a toddler, and was not hard for him to believe as all the adults in our family have one or two grey ones, and I’ve got enough for all of us.
We were both at the hairdressers a couple of weeks ago, and as it was hot I asked for my hair to be cut a little shorter than usual. Mr Burgeon did cut a little deeper and in doing so found a patch of darker hair on the back of my head. Jack who was sitting, waiting, notice this patch of darker hair, and informed me, and all the shop that I would soon have to stop drinking beer, as I was losing my grey hair, it was turning black. The age of innocence, long may it continue.
A teenage lad was revising for his exams and was trying to do his homework. He asked his Dad for some help as he was having difficulty starting a crossword which contained many of the words he needed to know. His Dad helped him with the first word and then suggested he went to his room to finish it. Half an hour later he went back to his Dad and said that he had finished, but needed a hand with the last word. He Dad said, “If it’s the last word you need you better go and see your mother, she always gets the last word in this house”.
Later he asked his Dad, “What is the difference between theory and reality?”
His Dad thought about it and said, “Go and ask your sister if she would sleep with the window cleaner for one million pounds”
When he got back the lad said, “Yes Dad, my sister said she would sleep with the window cleaner for one million pounds”
“Right then, go and ask your Mother if she would sleep with the coalman for one million pounds”
Again when the lad got back he said, “Mother said, yes, she would sleep with the coalman for one million pounds”
His Dad said, “There’s your answer son, in theory, you and I are living with two millionaires, but in reality, we are living with two women with loose morals.”
Wally Selby.
*****
Recipe of the month
Prawn and Rice Salad
225g cooked peeled prawns, fresh or frozen
90g cooked long grained rice, chilled
1 x 225g tin pineapple pieces, in natural juice, drained
½ cucumber, diced
25g mixed nuts, roughly chopped (optitional)
1 x 15ml (1 tablespoon) Low fat mayonnaise
a few whole prawns to garnish
method
1 In a large bowl, mix together the prawns, rice, pineapple, cucumber and nuts.
2 Stir in the dressing.
3 Garnish with prawns and serve with crusty wholemeal bread and salad
Healthy Eating
Are all calories alike?
Not all calories are the same, a calorie from fat is not the same as a calorie from protein or carbohydrate, either in the number of calories it contains or in the way it is metabolised in the body.
Fat has over twice as many calories as either protein or carbohydrates. (Fat has nine calories per gram, whereas protein and carbohydrate have only four calories per gram.).
Your body easily converts dietary fat calories into body fat. One hundred fat calories can be stored as body fat by expending only 2.5 calories, whereas your body has to spend 23 calories, almost 10 times as much to convert one hundred calories of dietary protein or carbohydrates into body fat. Only about 1% of dietary protein or carbohydrates end up as body fat because your body would rather use them up right away than waste energy to store them. So by keeping fat consumption low, not only do you tend to consume fewer calories, but also those calories are less likely to be converted into body fat.
Dairy products, which contain no fibre or complex carbohydrates at all, are about as high in fat as they come:. However, whole milk contains a large percentage of fat, skimmed or semi-skimmed milk is a more healthy option. Skimmed milk also contains more calcium than full-fat milk, because the mineral is found in the watery part of the milk and so is effectively concentrated by the skimming process.
Full cream milk is 3.3% fat by total weight, which doesn’t sound bad, but 50% of the calories in full cream milk are derived from fat 38% of the calories in semi skimmed milk come from fat, skimmed milk derives 10% of it’s calories from fat
The average daily consumption of fat in the U.K. is 102g for men = to 918 calories and 74g for women = to 686 calories which is approx. 37% of the recommended daily calories, your body only needs less than 20% calories as fat to provide the essential fatty acids
Carbohydrates provide the most easily accessible energy source for your body. The other main sources of energy are protein and fats.
Complex carbohydrates are low in calories, high in fibre, and are bulky, so they fill you up. Besides filling you up, they biochemically signal your brain that you have had enough to eat, whereas fat doesn’t.
Simple carbohydrates,do not fill you up. They have no fibre and are not at all bulky. When sugar is refined the fibre is removed and the warning signals that tell your brain you’ve had enough to eat are also removed, because of this, it becomes very easy to consume virtually unlimited amounts of it and thus a large number of calories without feeling full.
The sugar in complex carbohydrates is unrefined and absorbed into your blood stream slowly, so your blood sugar levels and energy levels remain more constant, in contrast, simple carbohydrates, means simple sugars are absorbed quickly, your blood sugar rises fast, in response your pancreas pumps out more insulin to lower your sugar level, so it then quickly falls, often lower than it was to start with, when this happens you feel tired and hungry, your body says “Hey, I need something to eat so I can raise my blood sugar back to normal” and when your body produces more insulin, you are more likely to convert dietary calories into body fat
Besides regulating your blood sugar level, insulin plays an important role in fat metabolism. Because insulin increases the secretion of lipoprotein lipase, (an enzyme that increases the uptake of fat from your bloodstream into fat in your body’s cells) when your body produces more insulin, you are more likely to convert dietary calories into body fat.
The daily recommendation of protein for adults (over the age of 19) is 55 g protein per day. But it’s the balance of foods we eat over a few days that’s important, rather than what we eat every day. So if you don’t manage to eat much protein on one day, you should aim to eat a bit more over the next few days. This is because the body contains a small reserve of protein so it can cope with day-to-day variations. However, eating large amounts of protein is bad for the kidneys, so it’s important not to eat too much protein, and it’s especially important to keep within twice the recommended amount.
Also, if you eat far more protein than you need, you will be taking in excess calories, and this means you will put on weight
Protein is formed from building blocks called amino acids. There are approximately 22 different kinds of amino acids that combine to form literally billions of varieties of proteins. Your body can make 13 of these amino acids. The other nine are called “essential amino acids,” since they must be supplied in the diet. Of these, only three lysine, tryptophan, and methionine are critical, since the others are plentiful in most foods.
The amino acids that come from plant foods are exactly the same as the amino acids that come from animal foods. When you eat protein from, whether from a steak or from a meal of rice and beans, that protein is digested into the individual amino acid building blocks. Your body then takes these amino acids and converts them into whatever proteins you need. Unlike animal products, though, no single plant source contains all of the essential amino acids. Fortunately, though, plant based foods contain the three critical amino acids in different proportions, so by eating a variety of foods, you will obtain all the necessary amino acids.
Recommended daily calorie intake varies from person to person, UK Department of Health Estimated Average Requirements (EAR) are a daily calorie intake of 1940 calories per day for women and 2550 for men. Since most adults in the UK lead a sedentary lifestyle, these figures apply to adults with low activity levels
The type of calories you eat is more important than the amount of calories. On average we consume fewer calories than our ancestors did one hundred years ago. Yet even though we eat less than our ancestors, we weigh more.The difference today is where the calories come from. In 1910, 60% of our calories came from carbohydrates and about 20% from fat, by 1999 about 40% of our calories come from carbohydrates, and about 40% come from fat, almost double.
Alcohol suppresses your body’s ability to burn fat. When you drink alcohol, your body burns fat much more slowly than usual. In one study, for example, researchers found that three ounces of alcohol reduced the body’s ability to burn fat by about one-third. The unburned fat may go to your waist, creating a beer belly. So it is not just the calories and the fact that alcohol is converted into simple sugars that make it fattening, but also the way that alcohol throws off your body’s normal disposal of fat in your diet
Pre-packaged foods usually contain a lot of extra salt, sugar and fat. Companies say that's what the British taste demands - but is it because that's what we get? If you only eat the odd packaged meal when you're short of time, then you're OK. If you live on packaged food then your salt, sugar and fat intake will be unhealthily high. Have a look at the nutritional information on the packaging and choose ones with less fat, sodium (salt), and sugar.
Four tastes are inherent to our tongue: sweet, sour, salty and bitter. Even so, these tastes can be modified. For example, you may have had the experience of reducing your salt consumption (after all the adverse press salt has received in the last week or so ) When you first reduce the salt in your diet, the food may taste to bland, but after about two weeks, your palate has readjusted. The taste for fat is an acquired one, so it is even easier to modify than one of the inherent tastes like salt.
A new system for classifying carbohydrates calls into question many of the old assumptions about how carbohydrates affect health. This new system, known as the glycemic index, measures how fast and how far blood sugar rises after you eat a food that contains carbohydrates. The new system (glycemic index) does not change the calories in carbohydrates, in the article I still refer to them as complex and simple carbohydrates, and probably the simplest way to remember the new system is complex carbs are Low in sugar Low-glycemic simple carbs are High in sugar High-glycemic
From the newspapers
Diet Boost for Heart Patients
This was in the newspapers a month or so ago, and I though it was relevant to the above.
Doctors are hailing a ‘slow burn ‘ diet that helps heart patients recover faster from bypass surgery. A study has shown those patients who ate ‘ heart healthy’ foods for four weeks before their operation left hospital two days earlier than those eating normally.
The study showed that simple changes to everyday meals could help patients cope better with surgery, and the ‘heart health diet’ rapidly improved levels of cholesterol and other components in the blood.
The London Imperial School of Medicine compared the progress of 35 patients awaiting a bypass. For four weeks before hand half were asked to eat a diet containing foods with a low Glycaemic Index (GI ). The body breaks down these foods more slowly into glucose, resulting in a slower rise in blood sugar levels. Low GI foods pasta, muesli, brown rice, whole fruit, beans, pulse vegetables
The remaining patients ate their usual diets; including high Gi foods These release large amounts of glucose quickly, causing a rapid rise in blood sugars.
When I was researching for this article it made me ask myself “how much fat am I actually eating?” so I’ve been looking at nutritional information on packaging. And working out my fat intake. You get a shock when you find out how much fat you eat daily. Try it.
Terry
Berwick Area Heart Support Group
October 2004 Newsletter
At our last meeting on September 1st. 2004 Dr. Chris. Plummer, gave us a very interesting talk on Pacemakers. You don’t need to have had a pacemaker fitted to have been interested in what he had to say. I only hope I took enough notes, I forgot to write some of the time, because I was listening.
Dr. Plummer is a Cardiologist with Northumberland Care Trust, working at both Wansbeck and Hexham Hospitals, and whilst there are various Departments working together to keep our hearts healthier, i.e. ECG, Medicines, Stents and Surgery, Dr Plummer concentrates mainly on the electrical monitoring, and “plumbing” that is available.
Monitoring
There are 2 external and 1 internal monitors currently in use.
External first,
One is worn across the chest and monitors the heart for 24 hours at a time. Another is worn on the wrist, similar to a watch, and only records when it detects that the heart is misbehaving. Either beating too fast or too slow or some of the other things misbehaving hearts get up to. The data collected can then be passed to the hospital by phone.
The internal one, is inserted under the skin near the collar bone, and is used to monitor the heart for up to 2 years.
Dr. Plummer then moved onto Pacemakers.
With the use of a comprehensive Power Point display, (By the way, if it’s true that a picture paints a thousand words, no wonder I couldn’t keep up), but also whilst he showed pictures he passed around actual examples of pacemakers, together with some of the pipes and electrodes, which helped to put things into perspective, and make it more easily understood.
But to put it very simply a Pacemaker consists of a power pack, a sensor, a counter and a pulse generator. Different models can be used to work on either single or double chambers of the heart, but all are designed to either ease pain, or make someone live longer.
With the help of his display Dr. Plummer was able to show exactly how pacemakers worked, and what bits went where. He was also able to show the effect of different heart problems.
Pacemakers are usually implanted under the skin near the collar bone. Wires lead into the heart along the veins. One wire monitors the heart beat, the counter counts the seconds, and if necessary another electrode stimulates either one or two chambers. Antibiotics are given before during, and for two days after the operation, to avoid the risk of infection. After release from hospital its no driving for at least a week, and then a follow up check at four weeks.
Pacemaker for treating Heart Failure.
This is for when one side of the heart gets out of step with the other. This is inefficient and causes tiredness and fatigue.
A pace maker and three wires is fitted, and gets both sides beating in harmony again. This used to be a major operation, but now is relatively easier, with a much smaller operation, with wires fed along veins and arteries.
Another type of pacemaker monitors CardiacArrest. It is an internal difibulator. These used to be big pieces of equipment, with a working life of about 18 months, but now they are much smaller, smaller than a box of matches, and have a working life of about 8 to 10 years. If a cardiac arrest is registered it administers a shock, which hopefully gets everything working again.
Costs of pacemakers vary. It costs between 3 and 4 Thousand pounds for a smaller one, up to between 12 and 13 thousand pounds for the difibulator type. In Dr. Plummer’s view all cost effective.
Dr. Plummer did stop for a cup of tea, and answered many questions on a one to one basis. Thank you Dr. Plummer
****
Wally’s Yarn
I’ve been struggling for a funny story this month; I must have stayed in more. One story that did spring to mind was about a young couple that had just got married.
He was a strapping; big built lad that had worked on building sites most of his working life, whilst she was a petite lass who worked in an office.
Following the usual advice from his older work mates, on his wedding night as they undressed for bed, he passed his trousers to his wife and said,
“Here put these on”
She couldn’t understand why, but she did as he asked. He then asked for them back, and when she gave them to him, he said with a degree of sternness in his voice, “That is the first and last time you wear the trousers in this marriage”.
She didn’t say anything, and passed her pants to him and said, “You put these on”
He looked at her and said, “You must be joking, there’s no way I can get into these”
She said, “You’re right, and neither will you all the time you have that attitude”.
A PRAYER FOR STRESSED PEOPLE
Grant me the serenity to accept the things I cannot change, The courage to accept the things I particularly don’t like, and the wisdom to hide the bodies of those I had to kill today because they got on my nerves.
And also help me to be careful of the toes I may stand on today, as they may be attached to the feet I may have to kiss tomorrow.
Help me always to give 100% at work:-
12% on Mondays,
23% on Tuesdays
40% on Wednesdays,
20% on Thursdays,
and 5% on Fridays
And help me remember that when I’m having a really bad day, and it seems that people are trying to wind me up, it takes 42 muscles to frown, 28 to smile, but only 4 to extend my arm and smack someone in the mouth.
Wally
****
Recipe of the month
LIGHTNING BRITISH TURKEY FILLETS
Ingredients
4 turkey fillets or escalopes
40gr margarine or butter
1 tbsp oil
1 onion, peeled and sliced
1 red pepper, de-seeded and thinly sliced
1 tbsp flour
200ml lager or pale ale
150ml chicken stock
½ tsp dried thyme
1tbsp sugar
salt and freshly ground black pepper
4tbsp single cream
chopped parsley to garnish
method
Split the fillets or escalopes in half through the centre with a sharp knife to give 8 thin slices. Season the turkey with salt and pepper. Heat the butter or margarine and oil in a pan until melted, then fry the turkey for 3-4 minutes each side until golden brown. Remove from the pan. Fry the onion and pepper in the same oil until soft and lightly coloured. Stir in the flour and cook for 1 minute, then gradually add the lager and stock and bring to the boil. Add the thyme sugar and seasonings. Replace the turkey and simmer for about 8-10 minutes until tender. Stir in the cream, adjust the seasonings and reheat gently. Serve sprinkled with chopped parsley.
Berwick Area Heart Support Group
November 2004 Newsletter
NEXT MEETING November 3rd At the DAY HOSPITAL BERWICK INFIRMARY From 7.00pm – 9.00pm Guest Speaker. Sister Janet Punton Prevention of Type 2 Diabetes
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At our last meeting on Oct 6th the advertised speaker Diane Edgar from the Borders Healthcare Trust was unable to come to the meeting, {Diane Edgar will now be the guest speaker for the Dec 1st meeting} Micheal Redican at very short notice stepped in and gave a talk and demonstration on Aromatherapy
Micheal’s emphasis was really about self-treatment, and restricted to arm and hand massage. He demonstrated the technique on himself.
In aromatherapy, the aroma therapist would prepare oil especially for this treatment, but you can now purchase, many “ready made-up” oils which are prepared for various aches and pains
Micheal demonstrated the procedure, oil up the right hand for the left arm and hand {obvious really} Proceed to oil-up the left hand and arm, with sufficient oil to allow smooth running of the massage hand.
Open handed Effleurage- stroking up the hand and arm, with the open hand. Then begin Kneading from the upper arm to the hand including gentle but firm kneading around the elbow with your right thumb. Then whole hand circling the elbow. Continue thumb kneading down the forearm muscle, and circle round the wrist. Drain between the tendons on the back of the hand- particularly the soft tissue at the base of the fingers and thumb. Then knuckle crunch, followed by effleurage up the arm hand and arm. Finally just hold the hand to finish off. Then repeat procedure on the right arm and hand.
Thanks to Micheal for stepping in at such short notice and giving such well prepared talk and demonstration.
****
Wally’s yarn
Wally is unavailable to do his report this week and I know you all look forward to “Wally’s Yarn”, I found this little story in the “The Weekly Small Shopkeeper” a daily newspaper published monthly once a year on the 29th Feb.
A guy walked into a little corner shop with a shotgun and demanded all of the cash from the till. After the shopkeeper put the cash in bag, the robber saw a bottle of Scotch that he wanted behind the counter on the shelf. He told the shopkeeper to put it in the bag as well, but the shopkeeper refused and said, "No because I don't believe you are over 18." The robber said he was, but the shopkeeper still refused to give it to him because he didn't believe him. At this point, the robber took his driver's license out of his wallet and gave it to the shopkeeper. The shopkeeper looked it over and agreed that the man was in fact over 18 and he put the Scotch in the bag. The robber then ran from the store with his loot. The shopkeeper promptly called the police and gave the name and address of the robber that he got off the license. They arrested the robber two hours later.
Wally reminded me to tell you that the “Charities Cup” committee had presented a cheque for £400 to Mandy and Michelle at Cardiac Rehab, this money was to go towards equipment that would help cardiac rehab patients. This donation will benefit many of our readers and we would like to join Mandy and Michelle in thanking the Charities Cup Committee for their donation.
****
Notes of interest from the newspapers
We know that tinned tuna contains no omega 3s but now researchers at Harvard Medical School in Boston have discovered grilled, canned or baked fish such as Tuna can reduce the risk of arterial fibrillation, a deadly heart condition that affects more than half a million people in the UK. Arterial fibrillation is also a leading cause of strokes among the elderly. Those who ate fish two to four times a week were 28% less likely to develop the condition. But eating fried fish can actually increase the risk
Arterial fibrillation occurs when the two upper chambers of the heart, the atria, beat irregularly. Some blood does not get pumped out and can form a clot. It is estimated that up to 20% of all strokes are triggered by the condition
****
Japanese scientists have discovered a gene that causes heart attacks. In what could be a significant step forward in the battle against Britain’s biggest killer, a study found that victims of heart attacks are more likely to have a mutation in the key gene. The discovery could help identify people at greater risk of suffering heart disease from an early age. Because the gene is hereditary, doctors could also spot whole families who may be vulnerable to heart attacks. Professor Jeremy Pearson, associate medical director of the BHF, said the findings were “important scientifically”
****
Recipe of the month
Apple and Marmalade Mackerel
Ingredients
2 x 225g (8oz) whole mackerel or herring, fresh or defrosted, cleaned, heads and tails removed
1 large dessert apple, cored and diced
4 x 15ml spoon (4 tablespoons) water
3 x 15ml spoon (3 tablespoons) thick cut marmalade
1 x 15ml spoon (1 tablespoon) whisky
Method
Preheat the grill
Place the apple and water into a saucepan. Bring to the boil and simmer for 3-4 minutes. Stir through the marmalade and whisky.
Grill the mackerel for 6-8 minutes each side, brushing with the apple-marmalade sauce.
Pour over the remaining sauce and serve with seasonal vegetables.
Serves 2
Terry
What makes the difference?
A little while ago, Terry and Phil met Pat Crowe from the NHS Care Trust, Morpeth, who is Clinical Network Manager (CHD, Diabetes & Stroke). Her job is to make sure that health professionals connect with one another. She came to us because the Trust is keen that the professionals connect with the public as well as with one another. Pat wanted also to tap into Terry’s experience in creating a successful computer website.
Prevention is better than disease and is even more important for those of us with a problem. What has made the difference in lowering the number of people dying of heart disease in the last 20 years? How many of us die from these conditions? How many die young compared with those who have a MI when they are old? We asked her whether we could find out how many people lived with heart problems in our area and whether we could tell how we compared with other places. She has written to us to say that Dr Mike Lavender, who is the Director of Public Health, is willing to be one of our ‘speakers’. We will fix that. Dr Lavender will be the man to explain some of the statistics.
In the meanwhile, Pat sent us some interesting information. Here is a brief digest. Generally, deaths from CHD are decreasing, although for men, CHD and stroke account for more than 40% of all deaths. Men die earlier from these diseases than women. Women are at much lower risk of heart attack when younger but will often die from heart disease in old age. For men, the number of years lost because of CHD / stroke is about the same as those lost because of cancer. In recent years Northumberland has done better than the national average for deaths from CHD and stroke. Berwick’s decrease is in line with the reduction in Northumberland. Alnwick has not seen a reduction. We will ask Dr Lavender, but is it because Alnwick has an increasingly elderly population? It looks like it. Last year, clinics at Infirmary Drive and Rothbury had about double the number of MI per 1000 of the patients on their list, compared with both the Berwick clinics and the Glendale clinic (Wooler). Belford was in between.
Control of blood pressure in CHD and related patients seems patchy across the area.Take up of flu jabs was high (above 78%), but Berwick town did less well than Belford or Glendale.There are more than a thousand heart patients in the Berwick area.
Table. CORONARY HEART DISEASE IN THE BERWICK AREA 2003 / 2004
(Figures were adapted from a printout showing uptake of flu jabs)
|
CLINIC
|
CHD PATIENTS (approx.)
|
PATIENTS having MI during the year
|
|
Well Close
|
775
|
13
|
|
Union Brae
|
352
|
8
|
|
Belford
|
257
|
8
|
|
Glendale
|
103
|
2
|
We can see that our Newsletter is only reaching a small fraction, even though we have doubled the numbers.
The national numbers are worth thinking about. Details have just been published for the 20 years up to 2000. CHD mortality decreased 50% from 1981 to 2000. The biggest single reduction in death from CHD was from people giving up smoking. At least half (50%) of the improvement was down to that. Improvement due to a small drop in cholesterol (on average nationally) reduced deaths from CHD by 5% (accounting for 10% of the 50% reduction) but this was just about wiped out by increases in obesity and diabetes. Overall, improving risk factors accounted for 60% of this large reduction in deaths over the 20 years. All medical treatments put together accounted for only 40% of the reduction. Individual medical treatments were way down the list. Bypasses and angioplasty (‘revascularisation) accounted for about 4% of total reduction and even clot busters (‘thrombolysis’) saved fewer people during MI than emergency aspirin. Treating angina patients with aspirin in the community saved nearly twice as many lives as treating unstable angina patients in hospital. (These details are from B.Unal et al., Circulation. 2004;109:1101-1107 "Explaining the Decline in Coronary Heart Disease Mortality in England and Wales Between 1981 and 2000".)
We know that ‘statins’ are becoming more widely prescribed, so we will expect to see a difference for the 3 years 2001 to 2004.But health out here in the community is what matters. We know that the majority of people have some arterial disease by the time they are 50 - 60, even if they do not show it. Keep taking your aspirin and your statin. Bear in mind, though, that we need all the help we can get in reducing risk factors.
Phil Harris
****
Depression and Heart Disease
A fact sheet that summarizes what heart disease patients need to know about depression.
· Persistent sad, anxious, or "empty" mood
· Feelings of hopelessness, pessimism
· Feelings of guilt, worthlessness, helplessness
· Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
· Decreased energy, fatigue, being "slowed down"
· Difficulty concentrating, remembering, making decisions
· Insomnia, early-morning awakening, or oversleeping
· Appetite and/or weight changes
· Thoughts of death or suicide, or suicide attempts
· Restlessness, irritability
If five or more of these symptoms are present every day for at least two weeks and interfere with routine daily activities such as work, self-care, and childcare or social life, seek an evaluation for depression.
Introduction
Depression can strike anyone. However, research over the past two decades has shown that people with heart disease are more likely to suffer from depression than otherwise healthy people, and conversely, that people with depression are at greater risk for developing heart disease. Depression may make it harder to take the medications needed and to carry out the treatment for heart disease. Treatment for depression helps people manage both diseases, thus enhancing survival and quality of life.
Depression and anxiety disorders may affect heart rhythms, increase blood pressure, and alter blood clotting. They can also lead to elevated insulin and cholesterol levels. These risk factors, with obesity, form a group of signs and symptoms that often serve as both a predictor of and a response to heart disease. Furthermore, depression or anxiety may result in chronically elevated levels of stress hormones, such as cortisol and adrenaline. As high levels of stress hormones are signaling a "fight or flight" reaction, the body's metabolism is diverted away from the type of tissue repair needed in heart disease.
Despite the enormous advances in brain research in the past 20 years, depression often goes undiagnosed and untreated. Persons with heart disease, their families and friends, and even their physicians and cardiologists (physicians specializing in heart disease treatment) may misinterpret depression's warning signs, mistaking them for inevitable accompaniments to heart disease. Symptoms of depression may overlap with those of heart disease and other physical illnesses. However, skilled health professionals will recognize the symptoms of depression and inquire about their duration and severity, diagnose the disorder, and suggest appropriate treatment.
Depression Facts
Depression is a serious medical condition that affects thoughts, feelings, and the ability to function in everyday life.
Depression results from abnormal functioning of the brain. The causes of depression are currently a matter of intense research. An interaction between genetic predisposition and life history appear to determine a person's level of risk. Episodes of depression may then be triggered by stress, difficult life events, side effects of medications, or other environmental factors. Whatever its origins, depression can limit the energy needed to keep focused on treatment for other disorders, such as heart disease.
Get Treatment for Depression
Effective treatment for depression is extremely important, as the combination of depression and heart disease is associated with increased sickness. Prescription antidepressant medications, particularly the selective serotonin reuptake inhibitors, are generally well-tolerated and safe for people with heart disease. There are, however, possible interactions among certain medications and side effects that require careful monitoring. Therefore, people being treated for heart disease who develop depression, as well as people in treatment for depression who subsequently develop heart disease, should make sure to tell any physician they visit about the full range of medications they are taking.
Exercise is another potential pathway to reducing both depression and risk of heart disease. A recent study found that participation in an exercise training program was comparable to treatment with an antidepressant medication (a selective serotonin reuptake inhibitor) for improving depressive symptoms in older adults diagnosed with major depression. Exercise, of course, is a major protective factor against heart disease as well.
Use of herbal supplements of any kind should be discussed with a physician before they are tried. Recently, for example, scientists have discovered that St. John's Wort, an herbal remedy sold over-the-counter and promoted as a treatment for mild depression, can have harmful interactions with some other medications.
Treatment for depression in the context of heart disease should be managed by a mental health professional-for example, a psychiatrist, psychologist, or clinical social worker-who is in close communication with the physician providing the heart disease treatment. This is especially important when antidepressant medication is needed or prescribed, so that potentially harmful drug interactions can be avoided. In some cases, a mental health professional that specializes in treating individuals with depression and co-occurring physical illnesses such as heart disease may be available.
While there are many different treatments for depression, they must be carefully chosen by a trained professional based on the circumstances of the person and family. Recovery from depression takes time. Medications for depression can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted. No matter how advanced the heart disease, however, the person does not have to suffer from depression. Treatment can be effective.
Remember, depression is a treatable disorder of the brain. Depression can be treated in addition to whatever other illnesses a person might have, including heart disease. If you think you may be depressed or know someone who is, don't lose hope. Seek help for depression.
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.
*****
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
*****
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.
*****
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
*****
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."
*****
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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