Heart disease

Heart disease is an umbrella term that consists of a number of conditions affecting the heart. The term is used interchangeably with cardiac disease, but is not to be confused with cardiovascular disease that includes disorders of both the heart and blood vessels.

Coronary heart disease is referred to as ‘heart disease’. As well as being the most common, it is the most deadly. According to the World Health Organisation (WHO), coronary heart disease is the leading cause of death in the UK and worldwide.

Other conditions that sit under the heart disease umbrella include, but are not limited to; angina, arrhythmia, congenital heart disease and heart failure.

On this page we will explore coronary heart disease in more detail, its symptoms and how a heart healthy diet can aid in preventing it. We will also explore how a nutrition professional can help.

Coronary heart disease

Coronary heart disease (CHD) describes the process where your coronary arteries narrow due to an accumulation of fatty deposits in their walls. Over time, these deposits may break away, causing a blockage in the arteries and stopping the flow of oxygenated blood to the heart. This process is called atherosclerosis. The pain atherosclerosis causes is known as angina, one of the main symptoms of CHD.

Symptoms

The two most common symptoms of CHD are heart attack and angina.

Angina

Angina, a type of chest pain, is caused when your coronary arteries become narrowed.

You may have felt a similar sensation if you have had indigestion before, as it can be mild and uncomfortable. However, if you experience a severe angina attack, it can feel painful. There is typically a tightness around the centre of the chest, which can spread to the stomach, neck, arms, back or jaw.

Angina is usually triggered when taking part in physical activity or in stressful situations. Symptoms tend to pass in 10 minutes or less and they can be relieved by a nitrate tablet or spray, or simply by resting.

Heart attacks

A heart attack is caused by a complete blockage of your arteries. It can cause considerable damage if it is not treated straight away and can be fatal.

The symptoms of a heart attack often correlate with angina, but they are more severe.

Symptoms of a heart attack include:

  • bouts of breathlessness
  • nausea
  • sweating
  • lightheadedness
  • pain in other parts of the body.

Similar to angina, the symptoms can feel like indigestion. For example, they may include heartburn, a heaviness in your chest or a stomach ache.

Heart attacks can happen at any moment in time, even when you are relaxing. If you suffer from heart pains for more than 15 minutes, this could indicate the start of a heart attack.

Causes

Many causes of coronary heart disease can be reduced by making a number of lifestyle changes. Causes include:

  • diabetes
  • high blood pressure
  • high cholesterol
  • smoking
  • being overweight or obese
  • lack of physical activity
  • excessive alcohol consumption.

Some risk factors are predetermined and cannot be changed. These include:

  • age
  • sex
  • ethnic background
  • family history.

Preventing coronary heart disease

You can reduce the risk of developing coronary heart disease by making certain lifestyle changes. If you already have it, you can reduce the chance of having any further episodes by doing the same.

The lifestyle changes include:

  • healthy eating
  • becoming physically active
  • managing your weight
  • quitting smoking
  • drinking less alcohol.

Preventing heart disease with a healthy, balanced diet

Eating a healthy, balanced diet is key to preventing heart disease.

To reduce the risk of developing coronary heart disease, you should aim to eat:

  • some eggs, meat, beans, fish and other sources of protein that are non-dairy
  • a minimum of five portions of fruit and vegetables a day
  • some dairy foods including milk
  • starchy whole grain foods, including brown rice and pasta, whole grain (wholemeal, wholewheat and rye) bread and oats, pulses (beans and lentils)
  • only a small amount of drinks and food that are high in sugar, fat or both.

Tips for a heart healthy diet

Cut down on your total fat intake

Reducing the amount of total fat you consume is beneficial when trying to prevent heart disease. Foods that contain fat (especially saturated fat) are bad for your heart because they increase cholesterol.

Foods that contain high levels of saturated fat include:

  • sausages
  • meat pies
  • fatty cuts of meat
  • cream
  • butter
  • lard
  • hard cheese
  • biscuits
  • cakes.

Try to replace foods that are high in saturated fat with a lower fat version, or you can start off by eating them in smaller portions. Your diet should, however, contain unsaturated fats that you can swap with saturated fats. This is because they increase the amount of good cholesterol in our bodies that help reduce blockages in our arteries.

Foods that are high in unsaturated fats that should be added to your heart healthy diet include:

  • oily fish (e.g. sardines, mackerel and salmon)
  • nuts (e.g. walnuts, pecans and almonds)
  • vegetable oils (e.g. olive and rapeseed)
  • seeds (e.g. pumpkin, sunflower and linseeds/flaxseeds).

Boiling, microwaving, steaming, grilling or poaching your food instead of frying or roasting limits the amount of extra fat you need to add when cooking.

Reduce your sugar intake

Aim to cut down on the amount of sugary food and drinks in your diet. ‘Free sugars’ typically reside in biscuits, cakes, sweets, chocolate and some soft drinks. Free sugars are types of sugar that are added to drink or food, as well as the sugars that are naturally found in syrups, unsweetened fruit juices and honey.

Food and drink with added sugars tend to be calorific, so consuming too much of them can lead to you putting on weight. Weight gain, especially around the abdomen, is a risk factor for type 2 diabetes, which in itself is a risk factor of coronary heart disease.

Cut down on salt in your diet

Try to limit the amount of salt that is in your diet. While your body does need salt, too much of it can cause high blood pressure, which is heavily linked to heart disease.

You shouldn’t eat more than six grams a day - this is around one teaspoonful. Avoid adding extra salt when cooking and keep salt away from the dinner table. Also, when you are out shopping, check food labels to evaluate the salt content in your food. Food is considered to be high in salt if it contains more than 0.6g of sodium or 1.5g of salt per 100g.

Add fish to your weekly shop

For a rough guideline, try to eat two portions of fish every week. This includes a portion of oily fish such as mackerel or salmon. Pregnant women, however, should avoid eating more than two portions of oily fish a week.

To cut down on added salt content, switch from fish that are canned in brine for fish in tomato juice or water instead. If you don’t like eating fish or are a vegetarian, try to include some flaxseed oil or flaxseeds/linseeds in your diet.

Introduce nuts and seeds as a snack

Snacking on a mixture of seeds and unsalted nuts are also beneficial for heart health. Have a small handful every day.

Eat your 5 a day

Aim to eat at least five portions of fruit and vegetables each day. These foods can be a great source of vitamins, minerals and fibre. For more information, visit our 5 a day fact-sheet.

Eat more fibre

Fibre helps to lower cholesterol and blood pressure. Eat a mix of high fibre foods, including fruit and vegetables, oats, pulses (beans and lentils) and whole grain products (pasta, bread and rice).

Try soya

Try to include some soya (25g) in your diet every day. This could be soya mince, tofu, milk (make sure it is fortified with calcium if you swap with dairy milk) and yoghurts. Check the labelling for the amount that they offer.

Eat some plant stanols and sterols

You could also add some plant stanols and sterols to your diet. These need to be eaten every day to have the effect of lowering cholesterol. You need between 2-3g per day. They can be found in special vegetable spreads, milks or yoghurt drinks. Check the labelling for the amount that they offer. These products are expensive, so if they are not affordable then it is best to focus on other dietary changes.

Lifestyle changes for a healthy heart

Exercise regularly

The benefits of exercise are boundless. Cardiovascular exercise will help burn calories and get rid of excess fat, reducing the risk of cholesterol blockages in the arteries and preventing heart disease. Just 150 minutes of moderate to intensive exercise a week will help improve your cholesterol levels. This could include:

  • cycling - puts very little strain on joints
  • brisk walking - can burn a lot of calories without exerting the heart too much
  • swimming - like cycling, impact on joints is minimal due to the uplift of the water
  • yoga - helps build core muscles without adding extra resistance (weight training), which could potentially put strain on the heart.

Manage your weight

Your practice nurse or GP will be able to tell you if you are a healthy weight. You can also visit our weight management page and use the BMI calculator to find out your body mass index (BMI) and find out how a nutritionist can help you maintain a healthy weight.

In the case of managing your weight, a nutrition professional will be able to develop a healthy eating plan to help you achieve a healthier body. This plan will be tailored to you, taking your metabolism, build/frame, lifestyle, dietary requirements and level of exercise you do, all into consideration.

The three main areas of weight management that a nutrition professional can help you with include:

Quit smoking

To improve your heart health as a smoker, the best thing you can do is quit, as smoking is one of the major causes of coronary heart disease. If you stop smoking your risk of having a heart attack drops by half of that of a smoker.

‘Second hand smoking’ is dangerous too. Non-smokers that live with smokers are at a greater risk of developing heart disease than those who do not. The chemicals in cigarettes (tar, carbon monoxide, nicotine etc.) can:

  • increase the likelihood of your blood clotting
  • inhibit the amount of oxygen that your blood can transport to your body and heart
  • increase your heart rate and blood pressure, which will make your heart work harder
  • cause damage to the lining of your arteries, which can lead to an accumulation of fatty deposits.

Drink less alcohol

It is best not to drink alcohol as it increases your risk of getting cancer, but if you do then limit to 14 units per week for men and women. Try to have at least three to four days per week when you do not drink alcohol. Alcohol contains calories and it is easy to put on weight if you regularly drink.

How can a nutrition professional help you with preventing heart disease?

A nutrition professional can offer you expert guidance without the confusion of conflicting theories or commercial dieting fads. Although we have covered the basics on this fact-sheet, a nutrition professional will tailor a food plan to your personal needs and requirements.

A nutrition professional can provide you with help and support to discover where you may be going wrong with your current eating habits. They can also help find out what food groups you are eating too much of, or are lacking.

Finding a nutrition professional that you personally get along with is the perfect first step to take to adopt a suitable heart healthy diet plan that will fit around your life. A balanced diet can help you lose weight, lower your cholesterol, reduce your risk of heart disease and experiencing a stroke or heart attack, and improve the quality of your life.

If you are concerned that you may be lacking in the motivation and diet knowledge, are suffering a deficiency or may have an intolerance to a food, speaking to a nutrition professional can really help.

Content reviewed by dietitian, Elizabeth Campling. All content displayed on Nutritionist Resource is provided for general information purposes only, and should not be treated as a substitute for advice given by your GP or any other healthcare professional.

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