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THE MAGAZINE FROM HВ·EВ·AВ·RВ·T UK
SPRING 2007
For everyone seeking a healthy heart
a spring in
your step
FLORA LONDON MARATHON: page 5
My story
Personal account: PAGE 11
UK A
·T ’ D
В·R S
В·A R 7
В·E BE AGE
H
EM
M
Heart-healthy
Two heart-healthy lunch menus: PAGE 8
P
ADVICE В· LETTERS В· NEWS В· FOOD & DRINK В· EXERCISE В· LATEST RESEARCH
Y
2
director’s cut...
“The Rules of Cricket and lifestyle change”
You have two teams, one in the п¬Ѓeld and one IN
W
Michael Livingston
Director HВ·EВ·AВ·RВ·T UK
ell, right now, unless you are up late or very
early, you won’t be watching leather being
smashed to the ON and OFF side by Aussie
willow. But if we were all to live longer, there is just the
chance that we shall be able to watch UK cricket under
lights through much of our warmer winters. Global
warming, yes, but if it means that we all take to better
diets from the middle sea, is that such a bad thing? I am
all for more cricket - if, we (poms) could only improve - but
let us go one better and embrace the Mediterranean Diet.
Each man that’s in the team that’s IN, goes out and
when he’s out, he comes in, and the next man goes
in until he’s out.
We are rightly bemoaning a generation (or two) who
are far from keen to stand, let alone exercise, and who
are far more interested in teasing their pleasure from
a home computer. But help is at hand - a new series
of computer games has arrived under the name of
Wii (pronounced wee) that rely on animated standing
exercise of participants holding a zut (Aussie) or zapper
in their hand in order to play golf, ping pong or tennis.
This really is quite exhausting, so unless Health and
Safety get their desk-bound banning frenzied п¬Ѓngers in,
there is a good chance that exercise will take on a new
but seriously positive change for the better.
When they are all out, the team that’s out, comes IN,
and the side that’s been IN, goes out.
Banishing the weed is going to get a whole lot easier,
because in the warm spring this year in the UK,
there will be very few places left where smoking will
be permitted; one of those will hopefully be outside
buildings and conferences. Only Ray Mears will be left
to remind us how lighting up safely can still be achieved
in Outer Mongolia, the Polar Icecaps and in the middle
of the Nullarbor Plain!
Those that have gone out, now try to get those
coming in, out. Sometimes one gets men still in
and not out, but when both teams have п¬Ѓnally been
IN and OUT, including the not-outs, then it’s the
end of the game!
If trying to understand the Rules has caused you stress,
then move on, play with a wee or warm your days with a
Mediterranean diet and drop the weed.
news update...
keeping you up-to-date with the latest news
Wednesday 14 March 2007
Make a fresh start with... a healthier body
You don’t have to wait long for the benefits
to start once you stop, after...
Statin users risk heart
attacks by not complying
with treatment
• 20 minutes: your blood pressure and pulse return to normal
• 24 hours: carbon monoxide will be eliminated from your body and
your lungs will have started to clear out the tar that’s been clogging
them up
• 48 hours: your senses of taste and smell are greatly improved
After a few weeks your breathing and circulation can improve making exercise
and any coughs and wheezing better.
Many people taking statins are having preventable
heart attacks because they are not complying with
their treatment or taking too low a dose. This is
the conclusion of new research published on-line
in European Heart Journal, having followed the
prescription records of nearly 60,000 patients in the
Netherlands for up to 14 years.
And the saving could soon add up, after...
Patients were divided into two groups – those at
high risk of heart attack and those at low risk. Half
of all patients stopped taking statins within two
years and only a third were persistent users, on a
high or intermediate dose. Among persistent users,
hospital admissions for heart attacks fell by nearly
a third, compared to non – persistent users. Among
patients using the high or intermediate doses, the
risk reduction was as high as 40%, while a low dose
reduced the risk by only 20%.
• 1 week: £35 = a cheap flight abroad or a few CDs
• 1 month: £152 = a shopping spree or the monthly food bill
• 6 months: £912 = a family holiday or some new furniture
Helplines...
See www.nosmokingday.org.uk for helplines in many other languages,
and for lots more information about stopping smoking.
• England & Wales . . . . 0800 169 0 169
• Scotland . . . . . . . . . . . . . . 0800 84 84 84
• N. Ireland . . . . . . . . . . . . . 0800 85 85 85
• Pregnancy . . . . . . . . . . . . 0800 169 9 169
• Quitline . . . . . . . . . . . . . . . 0800 00 22 00
or email: [email protected]
Most lines also have an out-of-hours information service.
DIGEST
SPRING 2007
The researchers calculated that, every year, around
300 to 400 statin users in the Netherlands have an
avoidable heart attack because of sub-optimal doses
or discontinuing treatment. It was felt that these п¬Ѓgures
were likely to be typical of Europe as a whole
CONTENTS 03
welcome...
this
issue...
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Welcome to the first edition of 2007’s Digest. Influenced by all those TV �makeovers’ so in vogue in 2006, it was decided that your magazine should undergo
one too (though rather more subtle changes for us!) We hope you like your
latest edition – we value your opinions and aim to produce a useful magazine in
an appealing format – so please let us know how we’re doing!
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Although you will see changes - by necessity, it will also (for the time being at
least), become a quarterly rather than bi-monthly publication, it will nonetheless
be packed full of up-to-date information and interesting features.
A further change is that the Digest will be focused more towards patients, their
families and junior health professionals, while our senior medical members
will now receive updates via regular e-newsletters. Keep your letters, personal
stories, requests and views coming – all correspondence will be answered and,
if so desired, wherever possible be included in the Digest. Please check our
website for any information you can no longer п¬Ѓnd in the Digest, such as diary
dates, updates from our colleagues in Europe, scientific reports or the latest
news for kids with FH from the fh-UK team... www.heartuk.org.uk
When another change was suggested – this time, your new-style magazine’s name,
I thought our readers may wish to offer their thoughts, and if you feel inspired to
do so please call the H·E·A·R·T UK office (details above) or email me with your
suggestions... if yours is chosen, you will receive a year’s free membership!
This just leaves me to thank all our past and present contributors, the editorial
team – and most importantly, you, our subscribers and valued H·E·A·R·T UK
members, for helping us to continue providing support and information to
people with FH and those at risk of cardiovascular disease.
Gill Stokes, Editor
[email protected]
02 News
06 Exercise
08 Recipes
11 Personal account
13 Ask Dawn
14 Mailbox
15 Meet the team
16 Book review
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& research
How to get active
Mmmm, more tasty recipes
Tom Tracey
Expert patient advice
Your letters
at HВ·EВ·AВ·RВ·T UK
& reader offer
Dangers of online pharmacies
More and more people are buying prescription-only drugs from
sites on the internet. While reputable sites are regulated and
registered with the Royal Pharmaceutical Society, there are
many more that do not play by the rules. Many of these sites
are run by people who have no medical or pharmaceutical
qualifications and are based outside the UK, so that the UK
Medicines and Healthcare Products Regulatory Agency (MHRA)
is effectively impotent. Among the concerns of the MHRA are
that the drugs may not have been prescribed by a healthcare
professional and that they may not have been checked for quality
and effectiveness. The World Health Organisation is particularly
concerned about the substandard drugs that are available over
the net and they also state that internet-based sales are a major
source of counterfeit medicines in industrialised countries.
To п¬Ѓnd out whether an online pharmacy is legitimate, patients
should be aware of the Royal Pharmaceutical Society’s code
of ethics on the information that registered online pharmacies
should provide. Websites must display the name of the owner of
the business, the business address, the name of the pharmacist
and details of how to confirm the registration status of the
pharmacy and pharmacists.
A few things to remember....
• Do not buy prescription-only drugs from sites that do not ask
for a prescription from a doctor or other suitably qualified
health professional.
• Be wary of online pharmacies that do not give a physical
address.
• Avoid websites that promise or advertise a miracle cure.
• Ensure that both the pharmacy and pharmacist are both
properly registered.
• Before starting any new medication, do speak to your GP.
helpline & enquiries...
New telephone helpline number operational!
We are pleased to announce that you can now contact H·E·A·R·T UK’s
telephone helpline for medical or dietary information or advice on the
following local call rate number:
0845 450 5988
The helpline is open from Monday to Friday between 9.30am & 4pm,
and is manned by nurses and dietitians. (Please leave a message on the
answerphone out of hours).
Please contact us on: 01628 777046 for all business, membership
enquiries and non health-related calls, including membership queries.
No. 106 Volume 21
Hyperlipidaemia Education & Atherosclerosis Research Trust
7 North Road, Maidenhead, Berkshire SL6 1PE
Tel: 01628 777046 • Fax: 01628 628 698 • Email: [email protected] • Website: www.heartuk.org.uk
В© 2005 HВ·EВ·AВ·RВ·T UK ISSN 1741-7864
Charity Registration No: 1003904 • Company limited by guarantee No: 2631049
HВ·EВ·AВ·RВ·T UK DIGEST
Editor: Gill Stokes
Associate Editorial Team: Linda Main, Baldeesh Rai, Maria Whitehouse, Marianne Wightman
Advertising: 01628 777046 • Email: [email protected] • Website: www.heartuk.org.uk
Main office: 01628 777046 • Helpline: 0845 450 5988 • Fax: 01628 628 698
Designed & produced: Fusion Design • www.fusionweb.co.uk
SPRING 2007
DIGEST
4 REGULAR
more news...
keeping you up-to-date with the latest news
HВ·EВ·AВ·RВ·T UK position statement on statin treatment
HВ·EВ·AВ·RВ·T UK, as one of the signatories to the
Joint British Societies’ guidelines (JBS2)1,
advocates statin treatment for the secondary
prevention of cardiovascular disease (CVD)
and for primary prevention in individuals with
an estimated 10-year CVD risk of 20% or more.
Recent evidence, in the Heart Protection Study2,
strongly suggests that statin treatment is costsaving down to a risk threshold below 20%.
Accumulating evidence indicates that the
National Service Framework for Coronary
Heart Disease (NSF)3 cholesterol targets of
5 and 3 mmol/l, for total and LDL-cholesterol
respectively, should be superseded by the recent
JBS2 targets of 4 and 2 mmol/l, especially in
high risk cases – e.g. patients with established
cardiovascular disease or diabetes. We would
strongly urge the National Institute for Health
and Clinical Excellence (NICE) to endorse the
20% risk threshold and the revised targets in
its forthcoming recommendations, and for the
Department of Health (DH) to incorporate them
in any future change in the Quality Outcomes
Framework for general practices (QOF), given the
Genetics information
in translation
The London IDEAS Genetics
Knowledge Park (GKP) has recently
published a series of factsheets on
familial hypercholesterolaemia (FH) in
English and the following languages:
Turkish, Gujerati, Urdu and Punjabi;
and translations into Arabic and Farsi
are pending, together with audio
versions in Somali and Sylheti.
The factsheets, together with
glossaries of terms and an evaluation
form, can be downloaded from the
GKP website:
www.londonideas.org
For further information, please
contact Dr Amy Hunter, GKP
Manager at:
[email protected]
or call: 020 7242 9789 Ext 0757
DIGEST
SPRING 2007
lifetime cost effectiveness of such a strategy. We
also reiterate, from the NSF, the importance of
achieving at least a 25% reduction in cholesterol
or a 30% reduction in LDL cholesterol even if this
gives results lower than 5 and 3 mmol/l.
References
1. JBS 2: Joint British Societies’ guidelines on
prevention of cardiovascular disease in clinical
practice. HEART, Volume 91, Supplement V
December 2005
2. Lifetime cost effectiveness of simvastatin in a
range of risk groups and age groups derived
from a randomised trial of 20,536 people,
Heart Protection Study Collaborative Group.
BMJ, doi:10.1136/bmj.38993.731725.BE
(published 10 November 2006)
3. The Department of Health. National Service
Framework (NSF) for Coronary Heart Disease.
Modern standards and service models.
London: Department of Health, March 2000.
For further information please contact:
Cathy Ratcliffe, Operations Manager, HВ·EВ·AВ·RВ·T UK
on tel: 01628 777046
or email: [email protected]
Shellfish and cholesterol
Statins and Parkinson’s disease
The following statement has been made on behalf
of H·E·A·R·T UK by Dr Bruce Griffin, Reader in
Nutritional Medicine at the University of Surrey,
to clarify the concerns regarding the effect of
shellfish and eggs on blood cholesterol levels.
In response to news from a small research
study in the USA that claims to have found a link
between statins and Parkinson’s Disease, Dr
Tony Wierzbicki, Chairman of H·E·A·R·T UK’s
Medical, Scientific & Research Committee, said:
“I fully support the recent decision by NHS Direct to
amend their warning that shellfish could raise blood
cholesterol. The important fact for the public to
remember is that there is no solid scientific evidence
to link dietary cholesterol in such foods as eggs
and shellfish with increased risk of coronary heart
disease (CHD) (see: Lee & Griffin 2006). Foods that
contain cholesterol can produce a small increase
in blood cholesterol in some people but this is
clinically insignificant and will not increase your risk
of developing CHD. In other words, the sensible
consumption of shellfish (2-3 times a week), will
produce no adverse effects on cardiovascular health.
“High cholesterol and its LDL (�bad cholesterol’)
fraction are associated with an increased risk of
heart disease, stroke and leg artery narrowing.
This dietary advice applies to the general
population, including individuals with moderately
raised blood cholesterol (5 - 6.5mmol/l).
However, patients with rare forms of genetically
determined high cholesterol such as familial
hypercholesterolaemia are a notable exception
and will require their own specific guidelines”
Lee A & Griffin b. (2006) Dietary Cholesterol, eggs and coronary
heart disease in perspective. British Nutrition Foundation,
Nutrition Bulletin, 31; 21-27
Numerous trials over the last 10 years with statins have
shown convincing benefits in terms of reducing these
events if patients take these drugs at adequate doses.
This small population study links low LDL cholesterol
levels with Parkinson’s disease. Other studies of statins
given to the dopamine-producing cells in culture, which
are the cells affected by Parkinson’s disease, have
shown different results and implied beneficial effects of
statins through their anti-inflammatory actions.
This study is thus a preliminary п¬Ѓnding that requires
confirmation in larger scale longer-term studies and
reports an association which may not be causal.
The results of observational studies of statins in
neurological disease, including dementia, have been
conflicting, as is often the case in the early stages
of research. It will require long-term, large scale,
properly designed randomised controlled trials to
come to definitive answers on the benefits or risks of
statin therapy in neurological disease.”
REGULAR 5
inspirational
fundraising...
All the latest fundraising news and activities
We are pleased to announce that Weight Loss
Resources (WLR) has adopted HВ·EВ·AВ·RВ·T UK
as its Charity of the Year for 2007.
Through its website:
www.weightlossresources.co.uk
WLR offers tools and resources for healthy
and sustainable weight loss, for those
wishing to improve their п¬Ѓtness levels and
those concentrating on improving their diet
and nutrition.
The site works on a calorie counting
basis providing real calorie and nutritional
information. WLR does not endorse any fad
diets, pills (unless prescribed by a medical
professional) or potions and includes
information and features, written by dietitians
and doctors, on weight loss, healthy eating,
п¬Ѓtness and nutrition. 24/7 help and support
is provided to members with their weight loss
and healthy eating goals. Readers are invited
to take a free, no obligation three-day trial.
Contact us...
For further information about HВ·EВ·AВ·RВ·T UK
Fundraising, please contact Carole G
on 01628 777046 or by email at:
[email protected] or view our “How you can
help” pages at: www.heartuk.org.uk
Stop press...
This year’s Flora London Marathon is
especially important for HВ·EВ·AВ·RВ·T UK. If
you watch the BBC Television coverage
of the race, you should hear the Charity
mentioned numerous times, and it’s all
“tied in” with a great new fundraising
scheme which takes off at the end of April!
Watch this space!
WLR is offering HВ·EВ·AВ·RВ·T UK readers a
special membership price of:
ВЈ7 per month (normal price ВЈ9.50)
ВЈ18 per quarter (normal price ВЈ25.50)
ВЈ30 per 6 months (normal price ВЈ45)
To take advantage of the free trial offer/sign up to options, go to:www.weightlossresources.co.uk/heartuk/
Anniversary Ball
For those who would like to join with us to celebrate 25
years of cholesterol care, it’s not too late to order your
tickets for the Anniversary Ball at Blenheim Palace on
Thursday 17 May.
Enjoy a Champagne Reception in the Great Hall, followed
by a Gala Dinner in The Orangery, and dance the night
away to a lively п¬Ѓve-piece band, The Arrhythmics. BBC
Radio 2 newsreader Patrick Lunt will be our Auctioneer and
other celebrities are expected to join in the celebrations.
The Anniversary Ball combines celebration with fundraising
and offers everyone a chance to support HВ·EВ·AВ·RВ·T UK by
attending, donating a prize, or making a donation. Just
make that call and pledge your support.
Robin Stokes from Cumbria is combining his own personal challenge
to climb Kilimanjaro with fundraising for HВ·EВ·AВ·RВ·T UK. Kilimanjaro is
the highest mountain on the African continent, standing at 5,900m
above sea level and is the world’s highest freestanding volcano. It is
one of the seven highest mountains in the world and the only one you
can climb without having to use climbing equipment!
Some of Robin’s own family members have inherited high cholesterol
and he is very keen that other families like his should have the benefit of
H·E·A·R·T UK support. If you would like to sponsor Robin’s Challenge,
you can do so by contacting the Maidenhead office (see above).
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H·E·A·R·T UK’s very own Operations and
Communications Manager, Cathy Ratcliffe,
is now in training for the Flora London
Marathon 2007.
Cathy joined HВ·EВ·AВ·RВ·T UK in May last year
and soon decided to throw herself in at the
deep end by offering to run the Flora London
Marathon. The Charity is very lucky to have 10
guaranteed places donated by Unilever Flora,
but we always ask our runners to apply for
their own place in the ballot too. That way we
maximise the fundraising potential.
Cathy registered for a HВ·EВ·AВ·RВ·T UK
guaranteed place with CRunCH, the clearing
house for runners, which handles all our
marathon administration. Then she collected a
copy of Marathon News from her local sports
shop and applied for a ballot place. Sadly she
wasn’t lucky in the ballot but had a Charity
place to fall back on.
Sponsored Challenges...
Cycle London to Paris, The British 10K London Run, and Trek the
Great Wall of China are all fundraising events featured in a new
H·E·A·R·T UK leaflet, “Are You Ready for a Challenge?” – only a
phone call away.
Flora London
Marathon 2007
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Part of Cathy’s training will include regular
jogging around the streets of Maidenhead but
she has also joined her local gym and started
circuit training there, ending her sessions with
a swim in the pool. She assures us that it’s all
enjoyable but we have a feeling that that could
all change as the 22nd April looms closer!
Your sponsorship for Cathy or the
H.E.A.R.T UK team would be most welcome!
SPRING 2007
DIGEST
6 FEATURE
get active...
We talk to lots of people about how they get active
In the Digest we have talked
about how being more active
can have a positive effect on
your health and wellbeing
(not to mention longevity!).
For this issue *Nigel Denby’s
team talked to lots of people
about how they have found
time to become more active.
Being more active is about
enjoying yourself, doing things
you feel comfortable with and
п¬Ѓtting it in with your lifestyle.
People who have never
exercised before have found
that being more active in
their everyday life was the
best and easiest way to start.
*More from Nigel on next page!
“I always used to work though my lunch time
so I could get home earlier – but then I would
end up sat in front of the TV eating junk.
So now, after I have eaten my lunch I take a
20-minute walk to the local park and back.
I have persuaded some of my colleagues to
join me. It’s a good chance to catch up on
the gossip” Lorraine, 32, from Barnstaple.
“A friend came up with the idea of making
life around the house a bit more, well...
inconvenient - it sounds awful but really
it’s not that bad. When I dry the pots I put
each item away separately. If I’m doing
the ironing I put the ironing board in the
upstairs bedroom and the creased clothes
downstairs in the kitchen, I fetch each item
separately and put them away separately
and when I do any cleaning or vacuuming I
really put my back into it. Things take a little
bit longer to do but I’ve really noticed the
difference – the stairs don’t seem such a
struggle any more” Eileen, 62, from Skegness.
“I split my journey to and from work into a 30
minute train journey followed by a 15 minute
walk. I arrive at work feeling relaxed and
ready to face the day” Terry, 53, from Solihull.
For some people, having a little more
structure to their physical activity works
better for them:
“I need to know that I have a specific time
slot when I am doing exercise; that way I
can prepare for it in advance. So, for me,
a circuit class a couple of evenings a week
is perfect” Martin, 42, Humberside
“I have three kids and no time or energy for
exercise. But when my local leisure centre
started up a crГЁche it meant I could have
a swim once a week whilst my eldest two
were having their swimming lessons and
the youngest was being looked after. It took
a lot of courage at п¬Ѓrst, but you soon realise
there are so many other people with the
same fears as you” Tina, 43, Brighton.
Remember whatever you do, enjoy yourself and do it for you!
DIGEST
SPRING 2007
FEATURE 7
members’ day...
Nigel Denby
11 December 2006 • The Institute of Child Health, London
W
In his GL Diet books, Nigel translates the science of the
glycaemic eating plan into a user-friendly and practical
guide. As part of the GL diet, �slow-release’ carbohydrate
foods to eat more of include the following:
What is the ultimate diet?
• Cereals: oats (with no added sugar), muesli, barley,
couscous, bulgar wheat.
• Breads with bits in: granary, soya & linseed, barley &
sunflower, rye & pumpernickel.
• Potatoes & roots: sweet & baby new potatoes, swede,
celeriac, carrots.
• Rice & pasta: basmati, wild, red, wholemeal.
Don’t overcook.
e were delighted to introduce Mr Nigel
Denby to our audience at this year’s
Members’ Day meeting. Nigel is a trained
chef and dietitian and author of several books on
weight management and the Glycaemic diet. Our
readers have also gained lots of useful nutritional
information from Nigel’s series in the Digest
throughout 2006. Indeed, Nigel’s presentation on
the Glycaemic Index and Glycaemic Load proved
to be equally �digestible’!
Nigel’s philosophy is based on the concept of diet freedom
and the lifetime enjoyment of one’s food - without any
associated guilt or humiliation. To work, it has to be easy
to follow... after all, he said, picking dew-laden mushrooms
at the crack of dawn isn’t an option for most of us! It also
has to be safe and suit men and women alike. Nigel п¬Ѓrmly
believes that calorie-counting, food weighing, �points’ and
quick-п¬Ѓx solutions are not the way to go - even during the
post-Christmas period and an average 5lbs weight gain!
There has been much research into the glycaemic diet
over many years, with greater focus more recently on its
value as a successor to �low carbohydrate’ – instead of �nocarbs’ or �low-carbs’, the glycaemic diet is �slow-carbs’! The
glycaemic index (GI) allocates a number to the amount of
each food providing 50g of carbohydrates, rather than on
actual portion sizes and the meal as a whole, and this can
give false results. For example, you’d need to get through
11/2 lbs of carrots to consume 50g carbohydrates, and
this would give an undesirably high GI score of 75. Since
we are highly unlikely to have this amount on our dinner
plates, carrots actually have a desirably low GL score. The
GI method can therefore be complicated and confusing,
whereas GL gives the �whole picture’.
The harmful effects of hydrogenated (�trans’) fats are also
discussed in �The GL Diet’.
A diet trial involving 15,000 adults in Europe with type 2
diabetes showed that those following a low glycaemic diet
had significantly lower waist circumferences, Nigel said,
and the lipid profile in post-menopausal women improved
as the dietary GL �score’ decreased.
A diet high in refined, low quality carbohydrates is also
linked with increased levels of C-reactive protein (CRP), a
promoter of inflammation that is linked to coronary heart
disease and other degenerative diseases.
A 2002 review of research concluded that low glycaemic
foods have a role in both the prevention and treatment of
the metabolic syndrome, obesity, diabetes and coronary
heart disease.
Keeping to a low GL diet is simple and the results start from
day 1... and there are no rigid rules to adhere to – you can
have three bigger daily meals or six smaller ones if you prefer!
GL = (GI x CHO (carbohydrate) per serving) Г· 100
Is it just a fad? Low glycaemic eating is here to stay, said
Nigel, and GL provides the necessary tool to simplify the
science and aid its longevity. Food retailers are now taking
on board the low glycaemic message with food labelling
and advice to customers.
Foods with a low GL are rated below 10, moderate GL rated
between 11 and 19; and high GL above 20.
For further information, log on to Nigel’s website:
www.dietfreedom.co.uk
Our other guest speakers at this year’s meeting were Professor Andrew Neil, H·E·A·R·T UK Chairman; and Professor
Steve Humphries and his team from London IDEAS Genetics Knowledge Park, and we will be reporting on their
enlightening presentations on familial hypercholesterolaemia (FH) in the next Digest. Gill Stokes
SPRING 2007
DIGEST
8 REGULAR
tasty recipes...
A selection of tasty recipes for you to try...
This edition of Digest brings us
recipes from Alpro (manufacturer
of soya-based products) and from
MiniCol. Both these foods appear to
play a role in improving heart health.
Soya is naturally low in saturated fat
and high in antioxidants and п¬Ѓbre.
Not only that but a daily intake of 25g
of soya protein, taken as part of a
healthy diet and lifestyle can actually
reduce cholesterol levels. Minicol is a
healthier cheese alternative. The dairy
fat has been removed from milk and
replaced with a healthier blend found
in wheatgerm oil. Not only that but it’s
rich in natural plant sterols as well,
2-3g of which have been shown to
reduce cholesterol levels.
Minicol Cauliflower
Serves: 4
Ingredients
• 1 large cauliflower
• 300ml (1⁄2 pint) semi skimmed
or skimmed milk
• 130g (41⁄2 ozs) of miniCol, grated
• 3 tbsp (45g /11⁄2 ozs) plain flour
• 50g (2 oz) polyunsaturated margarine
• 1⁄2 tsp French wholegrain mustard
• nutmeg
• fresh herbs
• back pepper to taste
Method
1
2
3
4
5
6
Trim the cauliflower and then steam for
around 15 minutes or until tender.
Drain and place in a large oven-proof
baking dish.
Add the milk, flour and margarine to a
saucepan. Heat, stirring continuously until
the sauce thickens, comes to the boil and
is smooth.
Simmer for a further 2 minutes. Add threequarters of the grated miniCol, mustard, a
pinch of nutmeg and seasoning.
Cook for a further minute stirring well.
Pour the sauce over the cauliflower and
sprinkle with the remaining miniCol.
Place under a hot grill until golden brown
and serve immediately.
Garnish with fresh herbs
DIGEST
SPRING 2007
Minicol Stuffed Peppers
Who said vegetables had to be boring? miniCol
can help you make up п¬Ѓve portions a day with
this delicious recipe. Use a mixture of red,
yellow and green peppers for added variety.
Serves: 4
Cooking time: 20-30 minutes
Ingredients
•
•
•
•
•
•
•
•
•
•
6 bell peppers
2 courgettes
1 aubergine
200g (71вЃ„2 oz) of mushrooms
100g (31вЃ„2 oz) of grated carrots
100g (31вЃ„2 oz) of onion
4 slices of wholemeal bread
200g (71вЃ„2 oz) of brown rice, cooked
130g (41вЃ„2 oz) of miniCol, grated
black pepper to taste
Method
1
2
3
4
Halve and de-seed the peppers. Reserve
8 pepper halves for stuffing. Place the
remaining 4 pepper halves along with
the courgettes, aubergine, mushrooms,
grated carrots, onions and wholemeal
bread into the food processor and whizz
until п¬Ѓnely chopped.
Add the cooked rice and mix through;
season with black pepper.
Fill each pepper half with the mixture
and place on a baking sheet, sprinkle the
grated miniCol on top.
Bake in the oven at 180В°C for 20-30
minutes and serve.
REGULAR 9
Homemade Tomato Soup
With minicol croutons
Serves: 4
Ingredients (Homemade Soup)
•
•
•
•
•
1 tbsp olive oil
1 onion, п¬Ѓnely chopped
3 stalks of celery, п¬Ѓnely chopped
1 carrot, grated
4 tomatoes, chopped
or 1 (14 oz.) can diced tomatoes
• 1 tsp dried basil leaves
• 750 mls of vegetable or chicken stock
• Black pepper to taste
Ingredients (miniCol Croutons)
•
•
•
•
•
7 slices of French bread, cubed
65g (21вЃ„2 oz) of miniCol cheese, grated
1 tsp of Dijon mustard
1 tbsp of polyunsaturated margarine
Pepper to taste
Method (Homemade Soup)
1
2
3
4
5
6
Heat the olive oil in a large saucepan and
sautГ© the onion, celery, and carrots until
vegetables are tender.
Add the tomatoes and basil. Simmer over
a low heat, stirring occasionally, until the
tomatoes are softened.
Transfer the ingredients into a blender or
food processor and blend until smooth.
Return pureed mixture to a large
saucepan and combine with the stock.
Simmer, uncovered, until the soup is
reduced to the desired consistency.
Season with salt and pepper to taste.
Method (miniCol Croutons)
1
2
3
Place the cubed pieces of French bread
on a baking tray and toast until lightly
browned.
Meanwhile, mix together the remaining
ingredients and then sprinkle them over
the lightly toasted bread cubes until the
miniCol cheese melts and begins to brown.
Serve the cheese croutons warm over the
tomato soup. Garnish with some fresh basil.
Banana and Honey
Ice Cream
Serves: 6-8
Preparation time: 10 minutes
Cooling time: 4-6 hours
Ingredients
• 550ml Alpro soya Banana Flavoured Dairy
Free Shake
• 1 tablespoon cornflour
• 4 large egg yolks
• 1 tablespoon caster sugar
• 3 tbsps honey
Method
1
2
3
4
5
Pour the milk into a pan, reserving 1 tbsp.
Mix the reserved tbsp of milk with the
cornflour. Bring to the milk to the boil and
whisk in the cornflour mix.
Beat the eggs and sugar together in a
bowl and pour the Dairy Free Shake onto
this. Whisk well and return to the pan.
Cook over a low heat,
stirring continuously.
When it is thickly coating the back of the
spoon, remove from the heat. If there are a
few lumps in the custard sieve the custard.
Allow to cool.
Pour the custard into an ice cream
machine and churn until frozen. When
beginning to harden add the honey.
If you do not have an ice cream machine, pour
the custard into a ridged container. Place in
the freezer and freeze for 3-4 hours, whisking
every 45 minutes for the п¬Ѓrst 3 hours. This
will keep the ice cream smooth. When the ice
cream is beginning to harden stir in the honey
and continue to freeze.
Rhubarb & Ginger Fool
This divine dessert is so easy to make you may
want to double the quantity – since one dish
will never be enough!
Preparation time: 20 minutes
Ingredients
•
•
•
•
•
350g (121вЃ„2 oz) rhubarb
55g (2 oz) caster sugar
juice of 1 orange
1 stem ginger, п¬Ѓnely chopped
4 x 125g pot Alpro soya Raspberry
and Vanilla Alternative to Yogurt
• 4 x 125g pot Alpro soya Dairy Free Vanilla
Dessert or 125 g Alpro soya Dairy Free
Alternative to Custard.
Method
1
2
Place the rhubarb, sugar, orange juice
and ginger and enough water to cover the
rhubarb in a medium saucepan. Bring to
the boil and simmer until rhubarb is soft.
Empty the Alpro soya Raspberry and
Vanilla Dairy Free Alternative to Yogurt and
the Alpro soya Dairy Free Vanilla Dessert
(or Alpro soya Dairy Free Alternative to
Custard) into a large bowl and fold until
mixed. Add the rhubarb and fold, leaving
the mixture marbled.
Chill until ready to serve garnished with
orange peel.
Serve in a cone or with fresh fruit.
SPRING 2007
DIGEST
10 FEATURE
educational meeting
American Heart Association (AHA) Scientific Sessions, Chicago November 2006
G
“I would like to thank
Equazen and RJA
foods for their support
in making it possible
for me to attend this
educational meeting.”
Baldeesh Rai
“A study found
that those who
regularly eat
dark chocolate
or drink cocoa
have a lower risk
of blood clotting
problems which
can trigger
heart seizures”
DIGEST
SPRING 2007
enomics is poised to take a leading
role in the prevention and treatment of
cardiovascular disease. “There will be a
genetic test available to tell us which families and
which individuals within those families are candidates
for myocardial infarction (MI or heart attack) at a
very young age”, predicted Eric Topol, Professor of
medicine and genetics. Population studies reinforce
the notion that heritable factors play a significant role
in cardiovascular disease (CVD). A report on more
than 400 German families with a multigenerational
history of MI found that not only does the occurrence
of MI run in families but so does the location of the
stenoses (coronary artery narrowings). Professor
Topol also predicted that genomics will turn the
dream of personalised medicine into reality.
Researchers have recently found, for example,
specific single nucleotide polymorphisms (SNPs)
common to the 30 percent of Asians who exhibit no
biological response to nitrates (anti-anginal drugs).
The AHA’s 2006 Diet and Lifestyle Statement
included recommendations to balance calorie
intake and physical activity to achieve and maintain
a healthy body weight; consume a diet rich in fruits
and vegetables; choose wholegrain, high-п¬Ѓbre
foods; consume п¬Ѓsh, especially oily п¬Ѓsh, at least
twice a week; limit intake of saturated fat to less
than 7% of energy, trans-fat to less than 1% of
energy, and cholesterol below 300mg/day.
Professor W Willett reinforced the importance of
diet. Smoking accounts for about one third of MIs
in western countries, he said, and overweight and
obesity contribute similarly. Reducing intake of
total fat as a percent of calories is not an effective
means of prevention, but evidence indicates that
the type of dietary fat has a major impact on risk
of coronary heart disease (CHD). Intake of transfat from partially hydrogenated vegetable oils
strongly increases the risk (US manufacturers are
required to show the trans-fat content of foods.
But in British foods it is still lumped under the term
�hydrogenated vegetable fat or oil’). Both omega
3 and omega 6 (n3 & n6) polyunsaturated fatty
acids contribute to lower risk. The form of dietary
carbohydrate also appears to importantly influence
the risk of CHD; refined starches are related to
increased risk, but consumption of wholegrain,
high п¬Ѓbre cereal products have consistently been
associated with lower risks. Higher consumption
of fruits and vegetables contributes to lower risk,
probably by multiple mechanisms. Many issues
remain to be settled, including the optimal mix of
mono and polyunsaturated fatty acids, the optimal
amounts of n3 and n6 fatty acids, the amount and
source of protein, and the effects of antioxidants,
other phytochemicals and minerals. From their
long-term studies, the professor said, they have
calculated that modest dietary changes, together
with the avoidance of smoking, regular physical
activity and maintenance of a healthy body
weight, can reduce rates of CHD by over 80%.
Failure to take advantage of dietary and lifestyle
means of preventing these diseases represents a
tremendous lost opportunity for improved health
and wellbeing.
The role of n3 fatty acids from п¬Ѓsh and п¬Ѓsh oil in
preventing cardiovascular risk is well established
already, and increasing fatty п¬Ѓsh consumption
and/or supplementing with the n3 fatty acids EPA
and DHA, should be considered for anyone with
risk for CVD.
Good news for chocolate lovers - a few squares
of dark chocolate a day may cut your risk of heart
attack. A study found that those who regularly eat
chocolate or drink cocoa have a lower risk of blood
clotting problems which can trigger heart seizures.
This message will be welcomed by Britons, the
biggest chocolate eaters in Europe! We consume
on average 22lb of chocolate each per year.
Dr Becker, who conducted the trial, told the
conference that she wouldn’t advise people to eat
lots of chocolate since it often contains high levels
of sugar, butter and cream. But the equivalent of
two tablespoons a day may be just what the doctor
FEATURE 11
my
story...
Tom Tracey
ordered. Another study from
Switzerland suggested that dark
chocolate increases coronary
artery diameter in patients after
heart transplantation.
David Becker’s and his team from
Philadelphia study examined
an alternative treatment for
hyperlipidaemia in a primary
prevention population by
comparing it to established
therapy with simvastatin. Patients
were randomised to either
simvastatin 40 mg daily for 12
weeks, with traditional dietary
and exercise counselling; or to a
12-week intensive lifestyle change
programme with a Mediterranean
Diet, aerobic exercise and
supplements (pharmaceutical
grade п¬Ѓsh oil, 3g twice a day and
red yeast rice, 1.2-1.8 g twice a
day).The study concluded that
simvastatin and the alternative
treatment were both equally
effective in lowering LDLcholesterol, with a mean decrease
in LDL-c of 41% and 44%
respectively. The alternative group
had significantly more triglyceride
lowering effects.
“As we age - is it about Weight
or Waist?” highlighted the role
that cardio-respiratory п¬Ѓtness
plays in attenuating the effects
of being overweight. Follow-up
studies suggest that unfit normal
weight, overweight, and obese
individuals are 3 to 4.5 times
more likely to die than their п¬Ѓt
counterparts. Even for those who
remain overweight or obese, an
active lifestyle conveys important
health benefits.
Stands in the Exhibition Hall
included exhibits of omega-3
supplements, pomegranate juice,
walnuts, ready to drink vegetable
juices, low-salt soups, the Almond
Board of California and canola
oil, all offering clinical papers to
support the beneficial role of these
products in heart health.
A Change for the Better
There’s stuff that happens and then there is Bad News
Doctor Northcote had completed his diagnosis.
Until that point the most frightening thing I had heard was:
“Thatcher has won again”: “Rangers are odds on for nine in a
row”: “Bush has been elected for a second term”. There had been
other major events in my 54 years. The deaths of my father and
most recently my brother Des saddened me but did not frighten
me. Why? Because I was protected, nothing manifest, just a
subliminal belief that is the prerogative of the apparently healthy.
This belief is arrogance and I had it in spades.
I had it right up until that nice Dr Northcote said; “Not what I
expected Tom - looks like you will need a triple bypass”.
“Not what
I expected
Tom - looks
like you will
need a triple
bypass ”
Dr Northcote
A change of perspective
“What does not kill you makes you stronger” observed the eminent
German Philosopher and all round nutter, Nietzsche. Before I was
aware of Nietzsche’s snappy summary, my mother, a less eminent but
more practical philosopher had observed: “It’s character-building son”.
(Adversity being the “What” and “It’s”). I believe then and now that
there is merit in this philosophy. However, up to that point, adversity had
meant obstacles to achieving what I wanted; qualifications, job, money,
house, life abroad and all the practical problems of 30 years of marriage
and two kids. This was different. For the п¬Ѓrst time adversity was not
something I could work harder to overcome and... it just might kill me.
Despite the build-up to Dr Northcote`s diagnosis this was not something the invincible arrogant “me” was
ready for. I offer this experience as testimony to the other “me’s” out there.
How did we “Me’s” get like this?
As with most things, women are more aware of the human condition than men. (The exceptions being football
and peeing highest up a wall). They have regular reminders of pain and discomfort and a potential life-threatening
experience with each child. Also in bringing up children there is regular contact with the medical profession. All of
this and most importantly their innate common sense sees them taking more real care of themselves.
Men, on the other hand drop off the medical radar after their BCG injections and come back into it when
they break a bone or have some serious organ malfunction or life-threatening illness. This lack of attention to
physical health is a combination of arrogance and fear. Arrogance in knowing that “I don’t get sick” and the
fear of finding out that “I might be sick”. Women are smarter and braver than that.
Like most men I had limited п¬Ѓrst-hand experience of blood, doctors or hospitals. My one invasive procedure
had been the removal of a tooth when I was 23. Hardly preparation for the good Doctor’s diagnosis.
I was one of those self righteous people who seldom needed and never took a sickie. I looked down on those
that did as weak and indulgent and by definition lacking in character. This may have been OK if I had stopped
at the work-shy but I took it too far. I had a deep and unspoken belief that sickness itself was some kind of
personal weakness.
Sad, ah, but there you are. I tell you this as an insight into my prejudices and stupidity in case you recognised
the symptoms - of course, I mean in someone else?
In the autumn of 2005 all this foolishness was stirred, shaken and flushed down the loo. Thankfully, at the time
of writing, I did not follow it.
SPRING 2007
DIGEST
12 FEATURE
Strange the things you notice
A wee touch of indigestion
If you have been lucky enough to avoid a lifethreatening illness you will almost certainly have
had a life-threatening event - a near-miss in a car,
in-flight plane troubles or even a particularly hairy
passage on a boat. The event may have been
life-threatening but the fear only lasts a short
time and in some cases the experience can be
exhilarating. These events quickly become stories
that can be discussed with mates and even
laughed at. A life-threatening illness is different.
It is hard to talk about and even harder to laugh
at... but you have got to try. It is important to
remember people (men mostly... ok, me) are
uncomfortable talking about illness. It reminds us
of our mortality. So keep it light and upbeat.
Each morning after breakfast I pulled the dinghy
down to the water’s edge in preparation for the
day’s boat trip. One morning I noticed a slight
discomfort in my upper abdomen which I put
down to indigestion so I changed the routine
to have breakfast after I moved the dinghy and
the indigestion reduced ... for a while. However,
I started to notice that any significant exertion
through the day brought back the indigestion and
it was becoming more severe. Also, if I stopped
the exertion, the discomfort would reduce.
Another thing; once diagnosed you start noticing
things you had not noticed before like the
preponderance of funeral cars on the drive to Ayr.
Has there been a major epidemic that is being
kept under wraps or have they always been there.
No matter how hard you try to push your newfound illness and its associated fear to the back
of your head it п¬Ѓghts its way to the front.
There was also the inevitable feeling of “Why
me?” Thankfully, I did not dwell long on the
question as the answer is simple: “Why not?”
We are very lucky to have good health and
wealth in one of the richest countries in the
world. We have been dealt a very good hand.
The calm before the storm
In 2004 Sheila and I took over The Shorehouse
on the Island of Arran. It had been a 26-bedroom
hotel which had been converted to 10 selfcatering apartments. So, more time to ourselves
and a bit of sailing on the quiet days. We sold the
house in Ayr and set the kids up in flats. It was a
positive change after 30 years in the computer
industry and something we had been planning
for some time. In 2005 we added a little powerboating business to the stables and I was on the
water most days and life was good. I had climbed
Goat Fell in April and I walked and did some
rowing every day. I had lost weight that I needed
to lose and I felt as п¬Ѓt as I had ever done.
DIGEST
SPRING 2007
Arran’s medical service is excellent. They get
you when you arrive and put you down for
annual MOTs thereafter. I had one of these
coming up and I thought I would wait and
mention it then.
After going through the normal stuff I informed
the nurse of my indigestion.
My blood pressure, heart rate and ECG were
п¬Ѓne. My indigestion theory was holding up.
The doc told me that an ECG stress test would
deliver a more complete diagnosis. The test on
the NHS would take 6 to 8 weeks. Deep down I
knew I was kidding myself with the indigestion
theory. So as a life-long Labour supporter, I
went private. I saw Dr Northcote, Consultant
Cardiologist, the same week.
A wee touch of angina
Dr Northcote was great. I gave him my symptoms
and my indigestion theory. He dismissed the
latter out of hand and told me I had angina.
My only previous reference to this condition
had been a sick joke from 20 years back. So he
explained that the discomfort was caused by a
lack of blood and oxygen to the heart normally
caused by a blockage of an artery or arteries
supplying the heart. The condition is normally
progressive and can end with a complete
blockage followed by heart failure.
I knew what normally happened after that.
The symptoms are treatable with heart surgery or
angioplasty. I had no idea what angioplasty was
but given the alternative, I liked the sound of it.
Angioplasty is a procedure which ends with a
metal tube (stent) expanding the artery at the point
of constriction, restoring a normal blood flow to
the heart. It is done under local anaesthetic by
inserting a lead wire through an artery in your arm
or leg. Not great but better than the alternative. I
clung to this as the cure of choice.
Please forgive any inaccuracies in my description
of the symptoms or the cure. They are my
interpretation. Seek your own medical advice.
Bad News, Good News
I was sick but I was п¬Ѓxable.
The process of getting п¬Ѓxed
The next stage was a stress test which
consisted of running on a treadmill while wired
up to an ECG machine. I lasted 8 minutes. I
asked the good doctor if the results confirmed
his diagnosis. He told me they didn’t but not to
worry as I still had angina. Not sure why, but I
was strangely comforted by his certainty.
The stress test is followed by an angiogram; I
know, more big words. Basically, dye is injected
into your arteries to show the flow of blood into the
heart. This was the definitive test. It would show
the doc where the stents would need to be placed.
Up to this point the assumption had been stents.
On completion of the tests and while I was
still in theatre Dr Northcote gave me his scary
diagnosis “Not what I expected Tom. Looks like
you will need a triple bypass”. I have never been
a good poker player and cannot be described
as inscrutable. I felt shocked and frightened and
I am sure that’s how I looked. I still looked like
that when I was wheeled back into my room
to give Sheila the news. She is a better poker
player than me but she was still upset. After
about 10 minutes of mutual reassurance Dr
Northcote reappeared and said he had gone
over the pics with the Heart Surgeon (Mr Craig)
and they both concluded that surgery was
the best option ... however, on further review
Dr Northcote thought that he would have a
reasonable chance of placing stents in the
offending blockages but he still thought the
REGULAR 13
“For the first time adversity
was not something I could
work harder to overcome and...
it just might kill me.”
most certain course of action was surgery... I never heard the last bit. I
clung to the stent option like a Ranger supporter clinging to the chance of
winning the league.
After further discussion with Mr Craig and Dr Northcote, Dr Northcote
agreed to try the stent option.
Anyhow, I had п¬Ѓve stents implanted over two procedures. The one artery
that was giving me the problem was 98% blocked and the others were
precautionary/preventative implants. I felt immediately better.
It’s good to be back
In summary, I am “fixed”. I was physically “fixed” the day after the first
procedure. Not “fixed” by my old illusion of “full health”. I have seen a
moving picture of my heart’s arterial blood flow and, although massively
improved, it is not in the first flush of youth and I may need to go back
for more work at some point, assuming I am given the chance. So, I take
pills to lower cholesterol and thin the blood. I watch my diet and I exercise
regularly. I just walked up Goat Fell at the weekend. Before the procedure
I could not walk for the paper without a rest. So, I am п¬Ѓxed, I am п¬Ѓt.
Nietzsche’s maxim would suggest that I am stronger. I am not sure about
that but I think I am a little wiser.
Lessons learned
• Enduring pain is nature’s way of saying you need to be fixed. Endurance
is not a test of character but a test of common sense.
• Get a regular health service check. You do it for your car and your
lawnmower.
• If you cannot get a fast diagnosis on the NHS go private for the price of
a package holiday. If your condition is life-threatening the NHS will click
in. Failing that, spend the money.
• James Taylor is right: “Shower all the people you love with love, show
them the way that you feel.......”
• Cholesterol is essential to your health. Too much of the wrong type is a
killer. I have heard of people being told that 5.2 is OK because it is the
UK average. The UK - and Scotland in particular - has one of the highest
rates of heart disease in the Western World. Pick a country with a lower
death rate as your benchmark.
• Diet can only reduce your cholesterol levels by 15-20%. If your levels are
very high, diet will not get you there. If your diet is good, you’re over 50,
have a family history of heart disease and your cholesterol is above 5,
insist your doctor gives you drugs to reduce cholesterol levels.
• There is no shortage of time to do all the things you want to do until
someone tells you there is: Don’t wait for that discussion.
Time is your main asset. How you spend it is your main decision.
• After much deep reflection I agree with Linda Smith: The Hokey Cokey
IS what it’s all about.”
Tom Tracey
ask
dawn...
Dawn Davies
expert patient
“...I still don’t meet the current
guidelines of having a total
cholesterol reading below
4mmol/l by a long way... ”
Dear Dawn
I recently received a letter from my PCT telling me that my statin
prescription was being changed from rosuvastatin to simvastatin
and I understand this switch is due to cost. I am worried about
this change because, having been on statins for the past 22 years
and more recently prescribed both rosuvastatin and ezetimibe*, I
still don’t meet the current guidelines of having a total cholesterol
reading below 4mmol/l by a long way. I do, however, have a good
reduction, considering my levels were at one time 19mmol/l! I
have suffered a heart attack and subsequently had a heart bypass
operation and am 64 years old.
Mrs C Phillips
Dawn replies...
There are few options available to severely affected patients with familial
hypercholesterolaemia, and I am in a similar position at the moment,
having to justify the cost of my LDL-apheresis≠treatment. Many patients
are also receiving letters from their Primary Care Trust advising that
they are being switched from atorvastatin to simvastatin and this is, as
you say, because simvastatin is cheaper than the other statins, being
the only �off-patent’ statin currently available. However, for most people,
simvastatin should prove as effective in keeping their cholesterol levels
in check. But for others, such as someone with FH like you, whose
cholesterol level remains in double п¬Ѓgures, a more potent statin or
combination treatment is needed. In some cases, LDL-apheresis
treatment is required, and of course, this is far more expensive than
drug therapy. My advice is to discuss further with your GP or lipid
specialist about treatment options. It may also be worth contacting
PALS, the Patient Advisory Liaison Service: www.pals.nhs.uk
Alternatively please talk to HВ·EВ·AВ·RВ·T UK who will be able to offer advice
and support. Try not to worry - your condition is treatable!
I hope this has helped.
Dawn Davies
Since writing, Mrs Phillips has contacted Dawn to say that, having
spoken to her specialist with her concerns, she is now back on
rosuvastatin and ezetimibe.”
* Ezetimibe (Ezetrol) is a cholesterol-absorption inhibitor that can be
taken singly or alongside statin treatment.
в‰ LDL-apheresis removes LDL-cholesterol from the blood and is used to treat
severely-affected individuals. The treatment is usually carried out every two weeks.
SPRING 2007
DIGEST
14 REGULAR
mailbox...
A selection of your letters received at HВ·EВ·AВ·RВ·T UK
“Drinking a moderate amount of
alcohol every day is considered
to be good for heart health... ”
Dear Editor,
Dear Editor,
Dear Editor,
A family friend has recently returned from
India with a Guggul supplement which he
claims helps to reduce cholesterol levels.
What is Guggul and just how effective is it
in lowering cholesterol?
I have recently been subscribed the latest
statin for inherited high cholesterol and,
while it’s reassuring to know that rigorous
studies are carried out into new drug
treatments, do the results of clinical trials
always reflect the �real world’?
Could you tell me exactly how much alcohol
can be taken safely and whether there is a
particular type of drink that is best?
Guggulipids come from the resin of the
mukul myrrh tree. Used in India for centuries,
guggulipids have been researched significantly
since the 1960s for obesity and lipid disorders.
The active ingredients are the guggulsterones.
Clinical trials using various preparations of
guggal have been carried out with moderate
success in reducing total cholesterol and
LDL-cholesterol measurements, although most
studies did not look at other lipid or lipoprotein
markers. However, a widely known clinical trial
(published in the JAMA 2003) failed to show any
benefits with either using 1000mg or 2000mg/
day of a guggul extract and even showed
raised LDL-C levels compared to placebo in
hypercholesterolaemic subjects. While the study
was only eight weeks’ duration, these data have
placed caution for the use of guggul extracts as
a supplement for lowering cholesterol.
Cholesterol-lowering trials are among the
largest and longest of the studies of medical
conditions carried out. There are, however,
rules that determine who is eligible to
participate in drug trials, so the particular
study will be applicable to a limited section of
the general population. These rules are called
�inclusion and exclusion criteria’.
There have been large numbers of statin trials
that have used different inclusion criteria,
and similar results have been seen across all
patient sub-groups from these various trials,
so the results are likely to be applicable to the
general population.
Of course, some patients do drop out of trials,
and others that have been assigned a placebo
(�dummy pill’) in the trial may be given a statin in
the �real world’ (�drop-in’). The power of research
trials is reduced by drop-outs and drop-ins.
In the �real world’ many people stop taking
their medication, or just take it occasionally,
and, in order to see the same benefits as the
clinical trials, the medication does, of course,
need to be taken regularly.
Drinking a moderate amount of alcohol every
day is considered to be good for heart health.
However, increasing the daily amount beyond
one or two drinks a day does increase the risk
of liver disease, high blood pressure, heart
disease and stroke and various cancers.
The current guidelines state that men should
drink no more than 21 units per week and for
women, this level drops to 14 units per week.
You can work out the exact number of units in
a drink by multiplying the volume (in mls) by the
percentage ABV (alcohol by volume – found on
the label) and dividing it by 1000. For example,
the number of units each in a 330ml bottle of
lager or alcopop, with a 5% ABV is:
330 x 5 = 1650 Г· 1000 = 1.7 units
Most wines are 11% or 12% ABV, and
remember that pub measures are usually
larger than the old 125ml glasses. A typical
175ml glass of wine usually works out as two
units. A 25ml pub measure of spirits (40%
ABV) is one unit, and half a pint of ordinary
strength beer (3.5% ABV) is one unit too.
Looking at many studies that have investigated
these heart health benefits, it appears that all
alcoholic drinks seem to provide this benefit,
pointing to alcohol as the ingredient that
counts. There is, however, evidence that the
antioxidants (called polyphenols) in red wine
help to reduce the stickiness of the blood and
help reduce the tendency for it to clot, which in
turn can also protect against heart disease.
But remember that the health benefits of
moderate alcohol intake are only gained
when consumed in small quantities, so don’t
�save up’ all your units for a big night out!
DIGEST
SPRING 2007
REGULAR 15
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пїЅпїЅпїЅпїЅпїЅпїЅ
Marianne Wightman, Membership Manager
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пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
Cholesterol crisis report
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅ
H·E·A·R·T UK is launching a report about �Cholesterol and the ageing population; avoiding the crisis in
health and pension costs’ at the King’s Fund on 19 February 2007. The report is commended by Kevin
Barron MP (Chair of the Health Select Committee) and examines the far-reaching implications for
the UK of failing to take action on raised cholesterol. In particular, it highlights the cost to our health,
social care and pension systems as a result of a population who will be living and could be working
longer than ever before. It also considers the treatment options for raised cholesterol and the efficacy
of recent public health measures in dealing with the problem. The report, supported by an educational
grant from Merck Sharp & Dohme Ltd and Schering-Plough Ltd, will be available to download from the
HВ·EВ·AВ·RВ·T UK website after the launch.
Mike
Foxton
H.E.A.R.T UK’s new scheme for recycling cartridges and mobile
phones is now well underway and we are pleased to enclose a
recycling bag in this edition of Digest. If you are unable to use this
yourself, please consider passing it on to someone else who might
like to support our work.
Don’t forget that Cartridges4Causes offer ink and toner cartridges
at discount prices and make a donation of up to ВЈ1 for every item
ordered. Visit their website at: www.cartridges4causes.co.uk or
call 0800 881 8150 with any queries.
All the latest
news from the
genetics team.
Cathy
Baldeesh
Ratcliffe
Rai
Joanna
Gill
White
Stokes
Until then, remember you can
check our website:
www.heartuk.org.uk
for news and information!
Gill Stokes,
Editor
Main
Hall
As her children are still quite young, Sally’s hobbies are walking to and fro from school and nursery,
lego, barbies and sleeping.
In your next edition
of the Digest ...
Gryglaszewska
Nurse Advisor/Digest Editor
Sally has worked as a PA and secretary ever since leaving college, where she obtained two RSA
diplomas, one in Office Studies and the other in Medical Secretarial Studies.
Carole
Linda
Sally
HВ·EВ·AВ·RВ·T UK welcomes Sally Hall
Sally started working for HВ·EВ·AВ·RВ·T UK in November 2006 as PA to Michael Livingston, The Director.
She has spent the last п¬Ѓve years looking after her two children and was eager to return to doing
something she felt good at!
Head of Fundraising
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
State Registered Dietitian
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
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Maria
Whitehouse
Operations & Comms Manager
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пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
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Accountant
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Membership Manager
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
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Administrative & Financial Controller
пїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
Assistant to the Director
In the last Digest we included a new membership application form
to replace the existing one which was stapled inside our magazine.
The new form is double-sided with Patients’ and Health Professionals’
details on either side. Unfortunately, in some cases this has led to
slight confusion amongst members. Please rest assured that we
always inform you by writing some weeks prior to the renewal of your
subscription. If you are unsure or have any questions regarding your
membership, please telephone me on: 01628 777046 or email me
at: [email protected] I do apologise for any inconvenience and/or
confusion caused.
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
пїЅпїЅпїЅпїЅпїЅ пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
State Registered Dietitian
Dear Member,
пїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅпїЅ
Nurse Advisor/Website Manager
Membership application form
Marianne
Wightman
SPRING 2007
DIGEST
16 REGULAR
diary dates...
book
review...
The Heart Recovery Book
a rehabilitation guide
Author: Irene Tubbs
Only a third of patients discharged after a
heart attack or coronary surgery currently
receive rehabilitation, yet, in the UK, there
are 270,000 heart attacks and 300,000
heart operations every year, while more
than one million are on waiting lists for
hospital treatment.
The
HEART REC
OVERY
Book
This book provides valuable information on
how to recover after heart attack, stroke
or treatment for heart disease. Supportive
and practical, it covers rehabilitation
from the smallest details, such as postsurgical symptoms and how to breathe
IRENE TUBB
S
without hurting your wound; to the wider
aspects of lifestyle management, such as
overcoming stress and conquering habits that may
have contributed to heart disease. Topics covered include:
•
•
•
•
•
•
•
•
•
Taking medication and seeing your doctor again
Practical issues such as work, driving, holidays
Coping with emotions and stress
Detailed exercises and safety tips
Diaphragmatic breathing techniques and relaxation exercises
How to give up smoking and drinking
Healthy eating habits
Step-by-step one year rehabilitation programme
Learning to use positive thoughts to assist the healing process
Following rehabilitation, many people п¬Ѓnd that they feel healthier than they
felt before their cardiac event. The message is simple: it’s never too late, so
start today and learn to become your own health coach.
Irene Tubbs has worked in coronary rehabilitation for more than 25 years.
Wednesday 27 – Friday 29 June
H·E·A·R·T UK 21ST Annual Medical & Scientific Meeting 2007
Heriot-Watt University, Edinburgh
SCIENCE PROGRAMME: �Back to the Future: Familial
Hypercholesterolaemia Revisited’ and �Clinical Lipidology Live!’
This meeting is:
•Accredited by the RCN Accreditation Unit - 11 study hours
•CPD approved - 18 credits
Deadline for abstracts and conference grants: Friday 16 March
Early Bird discount registration deadline: Sunday 29 April
Full meeting details can be downloaded from: www.heartuk.org.uk
contact: Natasha Dougall,
Wheldon Events & Conferences
tel: +44(0) 1922 457 984
fax: +44(0) 1922 455 238
email: [email protected]
web: www.heartuk.org.uk
Thursday 28 June 2007
H·E·A·R·T UK Patient & Members’
Workshop & Annual General Meeting
Heriot-Watt University, Edinburgh
Come and join us at this lively and interactive workshop, which is
FREE for all HВ·EВ·AВ·RВ·T UK members! The morning programme
includes a presentation from an FH patient with news of
H·E·A·R·T UK’s Family Support Centres and advice on how to
make your mark in raising cholesterol awareness, followed by
small group discussions facilitated by members of the HВ·EВ·AВ·RВ·T
UK team. Over lunch, there will be an opportunity to chat with
our medical and scientific experts who will also be at Heriot-Watt
University for the Charity’s Annual Conference. In the afternoon
you will hear all about �superfoods’ from the Charity’s expert
dietitians, and the п¬Ѓnal session will have us all on our feet for a nottoo-strenuous workout from an exercise specialist!
You are welcome to bring a guest too (A small donation in one
of our collecting tins at the meeting much appreciated!) He or
she may even be inspired to join up as a HВ·EВ·AВ·RВ·T UK member
to gain year-round membership benefits, including, of course,
subscription to the Digest magazine.
So don’t delay – reserve your place today
Special Digest reader offer...
Digest readers can order The Heart Recovery
Book for just ВЈ7.50, including p&p (RRP ВЈ8.99),
by calling: 01235 465500 and quoting order
code: 978 085 969 9556 SHELHRB
DIGEST
SPRING 2007
HВ·EВ·AВ·RВ·T UK DIGEST Although HВ·EВ·AВ·RВ·T UK has endeavoured to ensure
the accuracy of the entire publication, no liability will be accepted by the
Trust, Officers or members of staff, for information and opinions herein given.
contact:
tel:
fax:
email:
web:
Natasha Dougall, Wheldon Events & Conferences
01922 457 984
01922 455 238
[email protected]
www.heartuk.org.uk
Further details in May’s Digest.
NURSES & DIETITIANS
Did you know... if you wish to attend the two-day
conference (including Patient & Members’ Workshop),
by becoming a member of HВ·EВ·AВ·RВ·T UK you will save ВЈ30
on the registration fee? See: www.heartuk.org.uk
or contact Natasha Dougall (see above) for further
information or to download a registration form.
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