Well, you have heart disease! NOW is the time to take action.

Whether you have blocked heart arteries and had a heart attack or open heart bypass surgery or a stent, or have heart failure, the lifestyle principles are the same.               

A healthy lifestyle can reduce the risk of further problems.

At HCP we believe that lifestyle changes are just as important as medication. They go hand in hand. One without the other is far less effective at preventing new problems from occurring. After all, what we want and what you want are the same – a healthy, enjoyable life with as few trips to hospital as possible. While we can prescribe medications to help manage your heart disease, in the end, it’s up to you to change the negative lifestyle factors which make your disease worse. So what are the basic lifestyle aims?

Lets start with some basic guidelines:

• Consume an overall healthy diet.
• Aim for a healthy body weight
• Aim for recommended levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides.
• Aim for a normal blood pressure.
• Aim for a normal blood glucose level.
• Be physically active.
• Avoid use of and exposure to tobacco products.

Healthy Eating

The general principles are easy – Eat less, Low animal fat, high dietary fibre and low salt (sodium).   That's it!

Four simple things which are easy to say but seem hard to do. You just have to remember that what you eat is YOUR choice. Sure you may not do the cooking or shopping but I’m sure your spouse/partner will help out. Here are some very basic guidelines.

• Use canola or olive oil based margarine, or better still – nothing.
• Cook with canola, olive or peanut oil – not lard or fat – better still use a griller.
• Low fat diary – milk or yogurt. Minimize ice-cream and cheese.
• Eat fish twice a week. Fresh or as canned tuna or salmon. Never deep fried!
• Red meat three times a week. Low fat cuts. Only low fat mince. No sausages. No salami. No bacon. Chicken without the skin – dry roasted or grilled, not fried.
• Whole grain or multigrain or high fibre bread.
• Choose low salt (sodium) foods – read the can or packet’s table or contents.
• Reduce simple sugars – jam, soft drink, lollies, chocolate, biscuits, cake.
• Plenty of fresh fruit and vegetables. Steam or wok fry the veges. if you need.
• Snack with nuts, raisins, whole grain bread, and low fat yogurt.
• Drink plenty of water. At most five cups of tea or coffee a day.
• Choose smaller size, NEVER up-size when having takeaway – best avoided.
• At a restaurant - have a side salad with the main course. Skip the bread. Skip desert. Water alternating with wine, beer or soft drink.
• Portion size is very important. It's OK not to ‘clean your plate’ – forget what your mother said.
• 3 alcohol portions per day is enough. A bottle of wine is 8 portions!
• Look for the National Heart foundation ‘tick’ of approval.
• Buy a Heart Foundation cook book or use the internet.
• Ask for a referral to a dietician. Especially if you have special requirements.

Exercise

The more the better and anything is better than nothing – seems simple. Although being ‘active’ at home or work is helpful it isn't a substitute for proper exercise.
Start slowly and build up. Remember “from an acorn the might oak tree grows”. It may not be much at first but you WILL feel so much better in a few months. After a heart attack or open heart surgery or a stent it’s important to ask your cardiologist what you can and can’t do. Here’s some guidelines –

• Take it easy for the first 3 days – walking around the house or yard only.
• No mowing the lawn, digging the garden or lifting more that 10kgs (=2 heavy shopping bags) for 3 weeks. No sex for 3 weeks.
• From day 3 onwards start with a 10-15minute gentle walk on flat ground.
• As each week goes by add on 5 minutes and quicken the pace.
• The target is 30-40 minutes at least 5 days per week.
• The target is to exercise at a level of intensity which makes you mildly breathless and makes you sweat. You should never be uncomfortable or distressed.
• STOP if you get chest pain or light headed – see your GP as soon as possible.
• Even the most elderly can gradually build up a walking programme.

The Wesley and Greenslopes hospitals both have cardiac rehabilitation programmes – attend them. You will learn a lot about your heart and healthy living.

Some more exercise tips

• Wear comfortable, loose clothing. Take a water bottle and stay hydrated.
• Buy proper sports shoes that fit properly – they help minimize injury.
• Walk, swim or cycle – don’t jog, it’s usually not necessary and can cause injury.
• Exercise when its coolest – early morning is best.
• Make exercise part of your work day routine – just set the alarm clock earlier.
• Find a partner to exercise with and motivate you to keep going. It’s also safer.
• You don’t have to join a gym – but they do offer variety and motivation.
• Set your self a goal – eg. walk the ‘Bridge to Brisbane’. Hike Mt. Coot-tha.
• Weigh yourself at the same time each day – keep a diary.
• Learn how to check your heart rate or pulse – then we can set targets.

It really is up to you. The goal is to develop a lifestyle of healthy eating and sustainable exercise – FOR LIFE!

Dr. Stephen Cox
Heart Care Partners. April 2007.