Heart to heart

Heart disease kills one New Zealander every 90 minutes yet there are simple things we can do to prevent it. Men and women have different risk factors says nutritionist Lisa Yates, but small changes can improve your heart health and reduce your risk.

Many of us know someone who suffers from (or has suffered from) cardiovascular disease. Medication is recommended for around one in five New Zealanders over the age of 35 to prevent new or further heart attacks or stroke. The majority of us already have at least one risk factor for heart disease. What those risk factors are, and how we come to develop them, is different for men and women.

Risk factors

While the following heart disease risk factors affect both men and women, they may have a greater effect on one gender than the other. These risks fall into one of two categories: those that can be changed (or reversed) and those that are unchangeable.

What you can change

• Poor diet. A diet high in saturated fat, trans fat and salt, while low in fibre, fruit and vegetables, is top of this list. Only 56 per cent of men and 69 per cent of women get three or more serves of vegetables a day, and only half of men and two-thirds of women get two serves of fruit each day.
• Being overweight or obese. The number of people who are overweight or obese is on the rise. Men with waist measures of 100cm or more and women with measurements of 90cm or more are at increased risk.
• Physical inactivity. Generally speaking, women are less active than men.
• High blood pressure. One in seven adults takes medication for high blood pressure. More will be undiagnosed.
• Stress, depression and social isolation. While stress levels fluctuate, women are more likely to experience episodes of depression than men.
• Excessive alcohol intake. Men tend to drink more alcohol (and more often) than women.
• Impaired glucose tolerance. This is a stepping stone to type 2 diabetes (and heart disease) and is higher in men than women for most age groups.
• High blood cholesterol. One in 12 adults take medication for high cholesterol – eight per cent of men and six per cent of women. This increases with age: one in five New Zealanders over 65 years old takes medication for high cholesterol.
• Smoking. About 20 per cent of New Zealanders smoke, with no difference between men and women.

What you can't change

• Low birth weight. Baby girls are usually at higher risk of this than baby boys.
• Genetics. A family history of heart disease, stroke, high blood pressure, high cholesterol, diabetes or overweight/obesity can increase your risk.
• Menopause. Oestrogen levels, which are thought to protect the heart, drop after menopause, while abdominal weight gain, another risk factor, is likely.
• Having an ‘apple’ shaped figure if you’re female. Abdominal obesity is a risk factor for heart disease.

Women

Fact

Women are six times more likely to die from heart disease than breast cancer.

Heart attack warning signs for women

Unlike men, women may have pain in their shoulder or stomach – not in the chest. If you feel these pains anywhere in the upper body for 10 minutes or more, or if the pain is severe, get it checked immediately. These subtle symptoms may not be recognised as cardiovascular-related disease and the longer you delay, the more heart muscle damage could occur.

Common diet mistakes that influence women’s risk

• Living on diet products. The ‘low-fat’ weight-loss mantra of the ‘80s and ‘90s is outdated. Doctors, dietitians and other medical experts agree that it’s necessary to include healthy fats in your diet.
• Counting kilojoules, not nutrients. It’s important to make sure you are feeding your body vitamins and minerals, not just the right amount of energy.
• Putting your family’s health before your own. It’s not just the kids who need to eat well – you do, too.
• Emotional eating. Unresolved stress or anxiety, which research shows can contribute to heart disease, can lead to emotional eating as a coping mechanism. Aside from the unresolved anxiety, the stress on your heart from fluctuating weight can be deadly.
• Skipping breakfast. The first meal of the day is vital for your metabolism, weight and health.
• Takeaway coffee every day. Downing those large, kilojoule-dense coffees made with full-fat milk and added flavours can give you more than just an energy hit. Full-fat dairy is rich in saturated fat. Switch to a regular-sized coffee with trim milk.
• Drinking too much alcohol. That one glass with dinner may actually hold two to three standard serves of alcohol which means a lot of extra kilojoules on top of your meal.
• Eating off the kids’ dinner plate to avoid waste. Look for new ways to use leftovers (save it for next day lunches) or cook less food.
• Not enough sleep. When overly tired, women tend to compensate eating carbohydrate-rich foods and drinking high-fat coffee drinks for an energy rush. Lack of sleep also makes it far too easy to opt out of exercising!

Lifestyle tips for women

• Do you always have a biscuit with your cup of tea? Do you find yourself eating dinner after everyone else has finished? Know your ‘bad’ eating patterns and work to change them. Small dietary changes can become life-long healthy habits.
• Exercise for at least 30 minutes every day. This is vital for your physical and mental health. Exercise isn’t a chore, it can be valuable ‘alone’ time, or time to catch up with a friend (or your partner or kids) by working out together.
• Stress can be disastrous for our health, especially if we let it fester inside. If stressors are causing you to put your health on the back burner, it helps to talk about it – with a partner, friend, family member or professional counsellor. Weight gain and health problems can make stress even harder on your body, leading to more weight and health problems – a vicious cycle.
• If you are pregnant (or planning on getting pregnant), protect your baby’s health before s/he is born. Eating well and taking pre-natal vitamins is essential for your health and the life-long health of your baby.
• If you are a smoker, quit. Smokers are at a far greater risk of heart disease than non-smokers.

Men

Fact

Men are nine times more likely to die from heart disease than from prostate cancer.

Heart attack warning signs for men

Men may have central chest pain, pressure or pain radiating down one arm. If this occurs, get medical attention immediately.

Common diet mistakes that influence men’s risk

• Eating too much meat. All you need is a steak the size of a deck of cards, three to four times a week. If you’re still hungry, take it as a sign you need more vegetables. Avoid charring your meat, and start eating fish twice a week.
• Eating like the teenager you once were with giant portions and a habit of going back for seconds (or thirds). If you no longer maintain the training levels of years past, you can’t maintain the same food intake.
• Celebrating or commiserating with your sporting team each week with high-fat pies, chips and beer. Enjoy the camaraderie, not the kilojoules.
• Relying on takeaways and pre-packaged foods when you are too tired to cook (or the chef of the house is not home). Learn some basic, healthy recipes, double or triple the quantities, then stock the freezer with the results!
• Drinking too much alcohol. Whether it’s four beers a night or binge drinking once a week, it’s dangerous. When you do drink, stick to one to two standard drinks.
• Knocking back the energy drinks on a daily basis. New research has found energy drinks can increase risk of blood clotting and reduce blood vessel functioning – both significant risk factors for a heart attack – so limit your intake.
• Adding salt to meals or choosing salty foods. Add flavour to food with herbs and spices without adversely affecting your blood pressure.

Lifestyle tips for men

• Don’t try to get all your exercise in one session. If you are starting up your exercise regime, recognise that your body isn’t at peak performance anymore. Start slowly and build. No one will think less of you if you start out doing 10 push-ups instead of 100.
• Have a medical check up – knowing your blood pressure and cholesterol stats is an important step in getting a handle on your health.
• Develop your relationships. Spending quality time with mates, your children and your partner is as important to your health as eating more fruits and vegetables.
• When job stress starts getting the better of you, dedicate some time to learning time management skills. Sometimes, the simplest tactics can make the biggest difference: you would be surprised by how many people have slashed their stress by effectively managing their time.

Know your numbers

The Heart Foundation’s new website www.knowyournumbers.co.nz has a simple three-minute questionnaire where you can find out your real heart age and sign up for your personal heart health plan.