STRIKE BACK AGAINST HEART ATTACK: HOW TO CUT YOUR RISKS

Watch those fats — and don’t overload on cholesterol. Two things in the foods you eat can affect your blood cholesterol; one is saturated fats, the other is cholesterol (from animal foods). Of the two, saturated fat is the more important. Over the last quarter of a decade, at least 230 studies done on around 24,000 people have confirmed that, in most healthy people, saturated fat influences blood cholesterol level more than dietary cholesterol does: more than twice as much, in fact?Saturated fats are those that are solid at room temperature: like the fats in meats, whole milk and whole-milk dairy products, and some vegetable oils such as coconut and palm oil.Saturated fats stimulate your body to produce more cholesterol, which clogs your arteries and raises your risk for a heart attack. A distinction is made between these “bad-for-your-heart” saturated fats, and the unsaturated fats which, studies show, rid your body of excess cholesterol and are therefore “good for your heart.” There are two types of unsaturated fats: Monounsaturated fats which are the main fats in groundnut, olive and canola oils; and polyunsaturated fats which are the main fats in corn, safflower, sunflower and soyabean oils, as well as in fish oils.In recent years, medical scientists have become concerned about a practice that’s become increasingly common among food manufacturers. In an effort to prevent the vegetable oils they use from turning rancid, manufacturers bubble hydrogen through them, making them “hydrogenated” and rich in what is called trans fats. The chemical change that ensues makes these fats more like animal fats. Vanaspati and margarine are two prime examples of hydrogenated vegetable oils. “Trans” fats are today found in all kinds of prepared foods, from potato chips to biscuits and “lite” butter. And, many researchers today believe that, gram for gram, trans fats are almost as bad for your cholesterol levels as saturated fat. Recent studies seem to back them up. One Harvard study, done on 90,000 women and reported in the Lancet, found that those who ate the most foods high in trans fats (especially margarine) had a more than 50% higher risk of heart disease than women who ate these fats rarely.Here are some ways to reduce your intake of both arterycloggers:Hold down your overall intake of fat and minimize yourintake of foods rich in saturated fat and trans fats in particular. Try to balance your fat intake in the proportions of one-third monounsaturated, one-third polyunsaturated, and one-third saturated. Research has found that those born with the high-risk apo E4 gene respond dramatically to very low-fat dietDon’t just add “heart-healthy” unsaturated fats to your diet — but do substitute them for saturated fats wherever possible.Remember that all oils are a combination of unsaturated and saturated fats: it is the predominance of one kind of fat that makes an oil ‘saturated’ or ‘monounsaturated’ or ‘polyunsaturated’.Find and minimize the trans fat that’s hidden in processed foods. Look for “hydrogenated fats,” “partially-hydrogenated vegetable oils” and similar indications on food labels. The labels however don’t tell you how much of trans fat the products contain.Not all vegetable oils are “heart-healthy” oils. Beware of those that are high in saturated fats, the so-called “tropical oils” — coconut oil, palm-oil and palm-kernel oil. And remember that all vegetable oils are high in fat calories — 126 calories per tablespoon — whether these come from saturated fats or unsaturated fats. And excess calories can cause weight gain.Reduce the use of all cooking oils by baking, boiling, steaming, poaching or microwaving foods instead of frying, deep-frying or saut?ing them.When you do saut?, use non-stick cookware which allows you to make do with less oil. Also, try saut?ing food in broth, fruit juices or wine, instead of oil.Say ‘Yes’ to Exercise. From being almost an afterthought, exercise is now among cardiac doctors’ top-of-the-list recommendations when they’re advising patients about lifestyle changes. With good reason, too. It is now beyond doubt that exercise lowers your risk of heart disease, and of a heart attack, if you do it regularly and in moderation. The extent of reduction in risk is estimated to be between 35 and 55″% — more than what you can expect from dietary changes!Fears were fuelled a few years ago by a Harvard study that suggested heart attack risk was over 100 times greater in sedentary people who abruptly took up strenuous exercise than among those who did light or no exercise. The crucial factor here is that persons who were out of shape and sedentary engaged in vigorous physical exertion. The triggering activity was seldom exercise, but rather daily activity such as housework or climbing stairs. On the other hand, staying in shape has been found to progressively reduce the risk of a heart attack. Most heart attacks do not occur during exercise; the small number (4 per cent) that do, are brought on by strenuous activity — people overdoing it. Nobody really knows why, but it is theorized that when sedentary people engage in vigorous exertion, the strain increases blood flow and blood pressure, causing plaque to dislodge from an artery wall and to obstruct blood flow to the heart. Exercising just once or twice a week lowers the risk posed by a sedentary lifestyle by over 80%.Indeed, a large number of studies show that regular exercise over the long term reduces the risk of a heart attack quite as much as quitting smoking does. Brisk walking — for about half an hourseveral times a week — ideally meets the criterion of a workout that’s moderate in intensity yet packing enough punch to lower your heart disease risk.There are at least five ways in which exercise protects your heart: by increasing levels of “good” cholesterol and lowering levels of “bad” cholesterol and triglycerides, both implicated in the formation of clogged arteries.by lowering blood pressure, especially if it is only mildly elevated.by improving the capability of your heart in terms of its ability to pump blood and its ability to create new coronary arteries if existing ones are partially clogged.by helping you burn excess fat, which is one of the risk factors in heart disease.by lowering blood sugar levels in non-insulin-dependent diabetes (yet another risk factor for heart disease). The best thing you can do for your heart is not to be scared info stopping exercise, but — if you’re still leading an inactive life — to start moving. If you have more than one of the risk factors for heart disease, it is recommended that you take a stress test before starting an exercise programme. This is an electrocardiogram done while you exercise, and it helps to detect signs of heart disease. While the results are not always error-free, taken in conjunction with other clinical findings it can help your doctor guide you on your exercise options.Lose Weight. Whether you do it through dietary changes, or through a combination of healthy eating and exercise, losing weight will help you to raise your HDL level.Stop Smoking. Tobacco suppresses HDL levels and raises blood pressure. If you quit, your HDL number will rise. And your blood pressure numbers will improve.Ask your doctor about a vitamin B prescription. Prescription doses of niacin (vitamin B3) have been found to raise levels of HDL, and lower levels of LDL and triglycerides. But in the high doses required, niacin becomes a drug and can harm the liver; it should only be taken under medical supervision.Learn to relax. Stress appears to raise cholesterol levels, possibly by stimulating the release of stored fat into the blood;. Stress also releases high levels of the hormone, epinephrine, which constricts blood vessels and raises blood pressure.We don’t yet have definite proof that stress directly brings on heart disease, but the real connection may be indirect: the unhealthy ways in which some of us cope with stress, including junk food on the run, smoking/drinking heavily, even ignoring chest pain till it is too late.If you’re a menopausal woman, consider HRT. Hormone replacement therapy (HRT), by bolstering a menopausal woman’s declining levels of heart-protective estrogen, can reduce her cardiac risks. Because estrogen therapy alone can increase the risk for uterine cancer, it is usually combined with a second hormone, progestin (which blunts the cancer risk). The combination therapy has been found to be as effective as estrogen alone in cutting heart disease risk. In an important ongoing study (the Nurses’ Health Study), nearly 60,000 menopausal women were followed up; in those who took the estrogen-progestin combination, heart disease risk was cut by 61 per cent — a little higher, in fact, than the 55 per cent reduction in those who used estrogen alone.Pop a painkiller. After a century of service as a fever and pain reliever, aspirin has won its spurs as a life-saver — an inexpensive and powerful defense against heart attacks, strokes and even some forms of cancer. In the case of heart attacks — and strokes — aspirin appears to work by inhibiting the clotting process by which an artery nourishing a portion of the heart muscle (or brain tissue) is blocked. It is thought to do this by preventing platelet cells in the blood from sticking togther. In a recent study, a 20 per cent reduction in heart attack recurrence was achieved by those who popped half an aspirin a day.*53\332\2*

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