Winter walks page 10 Winter walks page 10

Transcription

“winter comes,
can spring be far behind...”
Winter walks page 10
Festive fare pages 16 & 17
ADVICE · LETTERS · NEWS · FOOD & DRINK · GENETICS · LATEST RESEARCH
RS
MEMBEIZES
R
WIN P
e6
See pag
Please note that our helpline
01628 628 638 is available from
Monday to Friday 9.30am to 4pm.
Our experienced team of nurses and
dietitians will be pleased to answer
your call. Out of hours please leave
a message and telephone number on
our answer machine.
H·E·A·R·T UK
Courtesy of Chambers ‘Book of Days’
helpline
4 December 1997: The European
& enquiries
8 December 1980: English
director’s cut:
“Plus ca change...”
Michael Livingston
On this day
Oh, but they have changed actually – and they will continue to change most assuredly for the better. As we approach this time of rest, recuperation,
thought for others and a time of being with our families, we should reflect
that not all in the world is so dreadful. Indeed we must all look to having
surely done some good during the past year. I am sure all those associated
with H·E·A·R·T UK can genuinely feel pride for the support, action, and
awareness achieved in 2006.
Change can sometimes be painful, even when its intent is to mark that change for the better and
changes we are making at the Charity will be for the good of those that we support. There is no
laurel resting in the offing and come the year change, we shall all continue working as hard as
ever to achieve the goals of the future.
You will see change as we start to drive forward, from pilot stage to reality, our Family Support
Centres – some ten of these in major cities around the UK over the next three years. We hope
that you, the patient, will be enthusiastic to learn more of this work as we progress and indeed
be keen to take part in this change for good. We shall be looking at a much broader front to
provide support for the work we do – this will mean that our presence on the High Street will
be considerably raised over the next year and we expect to gain that extra interest - and indeed
sponsorship - for our work, from the public at large. This will allow us to direct our support with
greater strength toward you, the patient, and your family. We shall be raising our voice more
strongly on the political front too. We have some very exciting fundraising events planned for
next ‘season’, and we shall be telling you about these in upcoming Digests and on the web.
We shall be seeking your thoughts next year and asking you how YOU think we are doing and
what you think we could do better and what more we can do. You will spot changes in the Digest
and in our other literature as we try to harmonise and maximise our efforts. We really do want to
be addressing our thoughts and skilled support towards those that we see as our main reason for
our being here in Maidenhead – that main reason is YOU, the patient and your families.
So stand by – it’s going to be a great Year – with you on our side we really can do an even better job!
Michael Livingston, Director H·E·A·R·T UK
No. 105 Volume 20
Hyperlipidaemia Education & Atherosclerosis Research Trust
7 North Road, Maidenhead, Berkshire SL6 1PE
Tel: 01628 628 638 Fax: 01628 628 698
e-mail: [email protected]
website: www.heartuk.org.uk
© 2005 H·E·A·R·T UK ISSN 1741-7864
Charity Registration No: 1003904
Company limited by guarantee No: 2631049
H·E·A·R·T UK DIGEST
Editor: Gill Stokes
Associate Editorial Team: Baldeesh Rai, Maria Whitehouse, Marianne Wightman
email: [email protected] · website: www.heartuk.org.uk · advertising: 01628 628 638
fax: 01628 628 698 · main office: 01628 628 638
Union voted to ban tobacco advertising.
songwriter, vocalist and rhythm guitarist
with the Beatles John Lennon was shot
dead outside his New York apartment.
actress Dame Judi Dench was born.
23 December 1888: Dutch
Post-Impressionist painter Vincent Van
Gogh (1853-1890), in remorse for having
threatened Paul Gauguin (1848-1903),
cut off part of his own ear with a razor.
scientist and mathematician Sir Issac
Newton was born.
26 December 1898: Pierre and
Marie Curie announced their discovery of
Radium.
24 January 1908: English solider
Robert Baden-Powell (1857-1941)
organised England’s first Boy Scout
Troop.
27 January 1823: English
physician and pioneer of vaccination
Edward Jenner died.
29 January 1896: Walter Arnold
of Kent became the first British motorist
to be fined for speeding at eight miles an
hour in a two-mile-an-hour area.
Improved body scanning research
A four-year project, begun in October 2006, could lead to improved understanding of
serious illnesses including heart disease, stroke and diabetes.
A team of scientists, engineers and mathematicians from the Universities of Bath, West of
England and Bristol and Cardiff Medical Schools will be undertaking a fundamental revision
of a body scanning technique called electron spin resonance imaging. They hope that, by
improving its sensitivity and speed, this imaging instrument will be able to take a threedimensional snapshot image of the chemical state of an organ such as the heart, and this
could lead to new treatments.
Electron spin resonance imaging works in a similar way to magnetic resonance imaging
(MRI) body scanners, but electron spin resonance is more suited to imaging chemical
processes in the body than MRI.
In this
issue…
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Winter walks
Cholesterol concern
Nutritional nuggets
Festive recipes
Book review & reader offer
10
11
15
16/17
20
Increase in diabetes in England
There were 100,000 new cases of diabetes in England in the year up
to September 2006, when figures showed the number of cases to
be more than 1,890,000, with a further 750,000 people estimated as
having undiagnosed diabetes.
Diabetes UK’s ‘measure up’ campaign urges people to take a quick
waist measurement to check if they are at risk of Type 2 diabetes.
Early diagnosis is crucial to try to avoid serious complications
of diabetes such as blindness, kidney failure,
For more information,
heart disease, stroke and nerve damage.
visit: www.diabetes.org.uk
‘From the Heart’ study
The ‘From the Heart’ study investigated
both the current practice of physicians
in the diagnosis and treatment of high
cholesterol; and physician and patient
attitudes towards management of the
condition. Of the 1,547 patients who took
part in the study, 50% feared cancer
compared with just 29% who feared a
heart attack or stroke. Although some
60% of the patients questioned had heard
of bad (LDL) and good (HDL) cholesterol,
74% couldn’t state ‘heart attack’ as a
consequence of high cholesterol. The
study concluded that a lack of patient
understanding of high cholesterol and its
associated cardiovascular disease (CVD)
risk presents a major challenge for health
professionals and may contribute to
poor compliance with treatment and
lifestyle changes.
10
20
15
Positive effect of eating oily fish outweighs risk
The benefits of moderate fish consumption outweigh the potential
hazards from pollutants that they may contain. This applies to adults,
and with the exception of certain fish species, women of child
bearing age.
There have been several studies that have shown that the dietary
intake of oily fish is associated with a reduced risk of heart disease.
However, there has been concern over potentially harmful levels of
substances such as mercury, dioxins and PCBs, found in some fish.
This has resulted in confusion regarding the role of oily fish in a heart
healthy diet.
Researchers from Harvard Medical School in Boston have shown that the negative health
effects of exposure to these pollutants appear to be offset by the cardiovascular benefits. It is
advised that pregnant women should avoid shark, swordfish, fresh tuna and king mackerel to
minimise any neurodevelopmental effects on the unborn child, due to mercury exposure. For
the rest of the adult population, low levels of pollutants and their effects are outweighed by
the potential benefits of eating oily fish as part of a heart healthy diet. The researchers state
that any concerns should have little impact on choices or consumption of oily fish.
Walnuts can protect arteries from effects of saturated fat
Research recently published in the Journal of the American College of Cardiology
has shown that eating a handful of walnuts can reverse the changes in the inner lining
(endothelium) of arteries, associated with the development of atherosclerosis, that can
be caused by eating a high fat diet. Researchers at the University of Barcelona have
demonstrated that eating walnuts regularly for one month improves endothelial dysfunction
and that even one serving could be beneficial. However, the scientists have warned that this
does not mean that people could follow an unhealthy diet just because they were regularly
eating walnuts. People should continue to follow a diet that is low in saturated fat and use
walnuts to replace unhealthy alternatives. The research team concluded that, while eating
walnut oil could be beneficial, eating the nuts themselves, particularly if they are raw, is a
better option.
digest
December / January 2007 heartuk.org.uk
03
regular: more news
news
more
High blood sugar and cardiovascular disease
Scientific Sessions
The association between blood glucose concentrations and risk of heart disease and stroke
starts below the thresholds used to define diabetes. Latest estimates show that worldwide at
least three million people a year die from cardiovascular disease because of higher than ideal
blood sugar levels. Of these, about one million have diabetes. If these estimates are accurate,
high blood sugar concentrations account for an even greater proportion of cardiovascular
deaths worldwide than smoking. Lancet 2006;368:1651-9
NOVEMBER 2006
‘National Salt Awareness Week’
29 January – 4 February 2007
The main theme for Consensus Action on Salt and Health’s
(CASH) 7th National Salt Awareness Week will be the progress
made in salt reduction and labelling over the last ten years,
including what consumers can do to lower their salt intake.
Health professionals throughout the UK will be participating.
To order resources see website: www.actiononsalt.org.uk
Expert pharmacists
American Heart Association
Congress, Chicago
Genomics to play a key role
in prevention and therapy
Genetic factors are poised to take a leading
role in the prevention and treatment of
cardiovascular disease. “There will be a genetic
test panel available to tell us which families
and which individuals within those families are
candidates for myocardial infarct (heart attack)
at a very young age”, predicted Eric Topal,
Chair of cardiovascular medicine and Professor
of medicine and genetics, Cleveland.
Waltzing beats exercise for patients
with chronic heart failure (CHF)
Experienced pharmacists are now able, after undergoing extra training, to become ‘experts’
in the management of long-term conditions such as diabetes and heart disease, enabling
them to deliver more services to patients.
Competency-based training demonstrating appropriate knowledge and skills, beyond the core
professional role, will lead to accreditation as a ‘Pharmacist with a Special Interest’ (PhwSI).
Health Minister Andy Burnham said, “All pharmacists play a valuable role in helping patients
manage their medicines, as well as contributing to public health. Pharmacists with Special
Interests will give patients more choice about where, when and from who they seek
healthcare advice and treatment.”
Working closely with other health professionals, PhwSIs will, for example, be able to hold
specialist diabetes clinics with patients to help them manage their condition and medicines.
Better alcohol treatment
services needed
In the wake of increasing levels of drink-related
death and disease in the UK, Alcohol Concern
is launching a national campaign to persuade
the government to inject more cash into alcohol
treatment services.
The number of people requiring hospital treatment
for alcohol-related illnesses in this country has
risen by 50% in the last five years, according to
the Department of Health, with mortality rates
nearly doubling between 1991 and 2005.
BMJ;Vol 333: 18 Nov 06:1037
A study from Italy reported that the clinical
difference is small, but the evidence is in
- waltzing does more than aerobic exercise
for the health of a patient with CHF. Waltzing
improves heart rate and peak oxygen uptake,
but, perhaps more important, many patients
find this form of exercise intrinsically enjoyable
and so they are more likely to do it.
Influenza vaccination urged for
cardiovascular disease patients.
Preventing flu is one of the best ways to
prevent morbidity and mortality in patients
with heart disease and perhaps the least
appreciated! It is estimated that worldwide
annual flu epidemics result in 3 to 5 million
cases of severe illness and between 250,000
and 500,000 deaths every year.
Women’s antioxidant and folic acid
cardiovascular study (WAFACS)
Results of a randomised trial of folic acid and
B vitamins in the secondary prevention of
cardiovascular events in women did not support
their preventive actions against cardiovascular
disease in women with established vascular
disease or those at high risk.
Baldeesh Rai, Dietitian, HEART UK
04
heartuk.org.uk December / January 2007
digest
regular: fundraising
inspirationalfundraising
Last minute Christmas shopping!
H·E·A·R·T UK’s Christmas Shop will be open for orders of
cards and gifts until Monday 18 December. Why not visit
our website: www.heartuk.org.uk or call 01628 628 638
straightaway to guarantee delivery by Christmas. Buying
H·E·A·R·T UK Christmas cards and gift helps us to raise vital
awareness about high cholesterol.
1/2
Price hot air balloon flights
The perfect Christmas gift...
Looking for a truly amazing gift for that special someone this
Christmas? Or perhaps a once-in-a-lifetime experience for yourself?
Look no further – a Virgin Balloon Flights Adventure Pack
experience will be the Christmas present to remember as you soar
over the famous and familiar sights far below.
And, for a limited time only, we’re giving all our readers the
chance to get their hands on Adventure Packs (rrp £285) for half
the normal price, just £142.50!
What’s more, Virgin will pay H·E·A·R·T UK £5 for every
booking made as a result of this promotion.
Here’s what you
can look forward to:
• An unforgettable three to four
hour ballooning experience, with
approximately one hour flying time.
• A traditional champagne toast.
• A commemorative certificate signed
by Sir Richard Branson and your pilot.
• A choice of 100+ UK launch
sites (Full list available at www.virginballoonflights.co.uk) and
transport back to your original launch site.
• PLUS – A limited edition Virgin Flight Shoulder Bag
containing compact binoculars, heavy-weight branded pen,
baseball cap, DVD and re-designed marquee key ring and
P&P worth almost £100!
It’s the experience of a lifetime...
But you need to be quick – this fantastic
offer ends January 1. Call 0870 444 2768 today
quoting ‘H·E·A·R·T UK’.
www.virginballoonflights.co.uk
Terms and Conditions
1. Offer valid until 1 January 2007 and relates to a Virgin Balloon Flights
Adventure Pack (RRP £285) which is valid for one year from start date which
you can specify at the time of purchase. 2. Voucher price includes VAT, postage
and packing and is £142.50 for one person. 3. The offer cannot be used in
conjunction with any other offer or promotion. 4. This promotion is open to
readers and staff only. 5. Choice of launch sites excludes London. 6. Full copies
of Virgin Balloon Flights Terms and Conditions and product RRPs are available
on request. 7. Full postal address for the Head Office of Virgin Balloon Flights is
Jesson House, Stafford Court, Telford, Shropshire TF3 3BD. 8. Children aged
7 to 16 must be accompanied by a responsible adult. 9. Passengers must be
at least 4’6’ tall. 10. Offer not valid in Republic of Ireland or Northern Ireland for
flying, but vouchers may be purchased and used for launch sites in England,
Scotland and Wales. 11. We are unable to fly passengers who are pregnant or
anyone who has recently undergone major surgery.
Anniversary Ball
Next year the Charity celebrates
25 years of cholesterol care,
marking the occasion with an
Anniversary Ball on Thursday
17 May 2007 at Blenheim
Palace, home of our Patron,
His Grace The Duke
of Marlborough!
This event will combine celebration with fundraising in a
most beautiful and exclusive setting, and presents many
corporate sponsorship opportunities. The evening begins
with a Champagne Reception in the Great Hall, followed by a
Gala Dinner in The Orangery and dancing to The Arrhythmics.
Tickets are £150 each and may be reserved now with a 20%
deposit. For more information about the event, please contact
Carole Gryglaszewska.
Running for Peter
On 15 October, Martyn Blud and
a team of friends ran the Cardiff
Half-Marathon in memory of
Peter Collier who died, suddenly
and unexpectedly, in April 2006
whilst playing football.
Peter’s widow Victoria, together
with family and friends, has already raised in excess of £3,000
through a fundraising evening held earlier this year.
Our very sincere thanks go to everyone who has raised funds
for our work in 2006. If you would like help with organising
your own event for H·E·A·R·T UK, please call Carole on
01628 628 638 or email: [email protected]
Cycle London to Paris 29 June - 2 July 2007
This long weekend challenge links two great European cities,
London and Paris, covering around 300km in just 3 days.
Encounter historic towns, sleepy villages and rolling countryside
en-route. Cycle along wide Parisian boulevards to the finishing
line at the city’s most famous landmark, the Eiffel Tower. Then
enjoy a free day exploring the sights of Paris before boarding
the Eurostar train back to London.
For more information about H·E·A·R·T UK challenges, please
email Carole at: [email protected] or call 01628 628 638.
digest
05
regular: cardiovascular matters
homocysteine
heart disease
and
high levels of homocysteine are linked with heart disease
“Some people make too
much homocysteine;
the amount you produce
is influenced by your
diet and your genes.
Plasma homocysteine
concentration is also
raised with age, male
gender, impaired renal
function and smoking as
well as with the use of
various drugs.”
A fact sheet about
homocysteine and
many other topics are
available to down
load as PDFs from
www.heartuk.org.uk
What is homocysteine?
What are the dietary sources of folic acid?
Homocysteine is a breakdown product of a
substance called methionine; methionine is an
amino acid – a building block of protein.
Foods rich in folic acid include: green leafy
vegetables such as spinach, broccoli, Savoy
cabbage, curly kale, Brussels sprouts and
asparagus: citrus fruits such as oranges and
grapefruits, pulses such as black-eyed beans
and chickpeas, dairy products and wholegrain
cereals. An increasing number of foods
- particularly breakfast cereals and bread - are
fortified with folic acid. Some researchers are
calling for folate to be put into biscuits and
cakes, too.
High blood levels of homocysteine occur for
a short time after eating large amounts of
animal protein, but persistently high levels
have been found in many people with coronary
heart disease. Excess homocysteine is
converted into a compound which combines
with LDLcholesterol to form fatty streaks and
atherosclerosis. In addition, homocysteine
triggers changes in the artery lining that can
lead to thrombosis.
What influences blood
homocysteine levels?
Some people make too much homocysteine;
the amount you produce is influenced by your
diet and your genes. Plasma homocysteine
concentration is also raised with age, male
gender, impaired renal function and smoking
as well as with the use of various drugs.
Folic acid is easily destroyed during prolonged
storage and up to 50% can be lost during
cooking, so a spinach salad or a broccoli stirfry is better for you than the boiled vegetable.
A number of drugs including antacid,
anti-bacterial agents, anticonvulsants and
antihistamines interfere with folate metabolism
and can therefore lead to reduced folic acid
status. Alcohol also interferes with the storage
of folic acid.
The metabolism of homocysteine is controlled
by a number of vitamins, including folic acid,
vitamin B6 and B12. Low levels of these
vitamins, of which folic acid has so far had
the most publicity, appear to be linked to high
levels of homocysteine.
What dose of folic acid is needed
to bring homocysteine levels down
to normal?
Can homocysteine levels be reduced?
Are there any adverse effects?
Persistently raised homocysteine levels can be
reduced to normal by dietary supplements of
folic acid.
Folic acid is generally considered safe,
even in high doses, except in patients with
pernicious anaemia. For this reason, doses
of folic acid exceeding 0.4 mg daily should
not be taken if there is any reason to suspect
pernicious anaemia.
news
Although a dose has not been clarified, it is
becoming clear that 0.4 mg daily (400 mcg) of
folic acid is normally very effective.
more
December 2006 H·E·A·R·T UK prizewinners
H·E·A·R·T UK’s latest prize-winning members are:
Roger Calver (Hinckley)
Wins: “Eating for a Healthy Heart” book
Dr Lance Sandle (Cheadle Hume)
Wins: “Best Medicine – Lipid Disorders” book
Dr Ralph Abraham (London)
Wins: Three free admission vouchers to any
exhibition at the Royal Academy of Arts
Valerie Kaye (Rotherham)
Wins: “Understanding Cholesterol” book
Angela Neal (Horsham)
Wins: Free admission for a family of four to Fishers
Farm Park, Wisborough Green, West Sussex
06
digest
Christopher Mackay (Edinburgh)
Wins: A Voucher for a family of four to
The Hampden Experience at the
Scottish Football Museum, Glasgow
efficient planning
estate
Frank Fermor
regular: financial matters
for your
It is said that only two things in life are
inevitable, death and taxes, and yet IHT is
largely avoidable, if you plan your financial
affairs wisely. In April 2007 the personal
exemption from IHT increases by £15,000
to £300,000. However, for a couple owning
a freehold, detached property, particularly
in Southeast England, there is a significant
potential liability to IHT. Although no IHT
initially arises on assets transferring to the
surviving partner, the great day of reckoning
arrives upon the second death.
Not only the value of the property less any
outstanding mortgage loan, but the savings,
personal possessions, life assurance and even
large gifts given away in the last 7 years will all
have to be taken into account. After deducting
the personal Nil Rate band, the whole
remaining estate will be taxed at 40% - unless
there has been careful financial planning.
Let’s deal first in broad terms with matters
of general interest and, then separately, I
shall offer thoughts to those who feel that
with prudent tax planning they can ‘buck the
system’ and at least minimise any liability of
their estate to IHT.
General matters
• Always make a Will and, if you are a married
couple or parties to a civil partnership
agreement, make your planning a joint
exercise. Never attempt a DIY job but
employ a solicitor, they are not expensive
for such purposes and a pair of basic
“mirrored” Wills should only cost around
£200-250 while a later Codicil (an
amendment or update) far less.
• Not everyone knows that a witness to a Will
cannot be a beneficiary nor that the two
witnesses must both be present and sign
together when the Will is executed.
• Without a Will the latest version of the laws
of intestacy apply. While very precise in their
wording, with priority to the surviving spouse
and then to children, they do not necessarily
distribute your estate in the manner you
would have intended and actual distribution
can take far longer than when a valid Will
has been completed.
Tax planning
• A married couple or civil partners should
always structure their affairs with the aim
of maximising the use of their individual Nil
Rate bands. Where practical, and after due
consideration of future cash requirements,
each person should plan to distribute
outside that partnership a sum equivalent
to at least their exemption, otherwise the
exemption on the first death is lost. Through
the use of an appropriate trust, it is possible
to use your Nil Rate band while still enabling
your partner access to the funds.
• If your home is owned with your partner, then
far greater flexibility is available if the property
is registered as “tenancy in common” instead
of the customary “joint ownership”. Assets
owned “jointly”, including bank and building
society accounts, automatically become the
property of the survivor.
• All gifts given more than 7 years before
death are exempt.
• Gifts to a combined value of £3,000 per year
are exempt, as are larger gifts clearly given out
of normal income and of a size not detrimental
to the living standards of the donor.
• Gifts upon marriage of up to £5,000 are
exempt, depending upon family relationship
with the happy couple.
• Other gifts donated within 7 years of death
will be liable to IHT. That liability may be
reduced through “taper relief”, but only to the
extent that the gifts exceed the Nil Rate band.
• A Trust fund with provision for distribution
upon death is exempt from both income and
capital gains taxes. Such trusts are complex
and it’s essential that a financial advisor
and/or a solicitor are used.
• Certain other assets including woodlands
and AIM (alternative investment market)
investments held for more than two years
are also exempt. Provisions regarding these
and overseas assets can be complicated
and expert advice should be sought.
• Life assurance should be exempt if “written
in trust”, with the trustees granted ultimate
discretion on the distribution following death.
• All payments and bequests to registered
charities are exempt from IHT. Your solicitor
will help with appropriate wording, which
should address the possibility of your
favourite charity changing its name or
merging with another.
In recent years the Chancellor
of the Exchequer has regularly
increased the personal
exemption (“Nil Rate” band)
before the commencement of
liability to inheritance tax (“IHT”)
broadly in line with inflation.
However, property prices have
been rising far more rapidly for
decades – between 2002 and
2006 the price of the average
private house in England
doubled to £202,660 – and
increasingly more estates
are becoming liable.
Do plan in consultation with your partner, to
ensure that your loved ones do receive what
you both intend and that the distribution on
each of your deaths is maximised by the
legitimate avoidance of tax. Executors can
be beneficiaries and although Wills do not
require a solicitor to act as an Executor, they
are advisable in complex cases. Wills are
normally invalidated by marriage and should
be reconsidered upon other major milestones
in your life such as a new birth in the family.
Most people fail to foresee when ‘their time
is up’ – so don’t leave it too late, or your
intended beneficiaries will not thank you. Once
you have ‘put your affairs in order’, you should
be able to sleep more comfortably, at least as
far as the law is currently concerned – and
hopefully for many years to come.
Frank Fermor
digest
07
regular: genetics
Steve Humphries
niceguidelines
for the management and treatment of FH
NICE and FH
You have probably all heard of NICE (The
National Institute for Health and Clinical
Excellence). This is an organisation, set up
by the Government, whose job is to produce
guidance on the use of new and existing
medicines, treatments and procedures within
the NHS. They also develop guidance on the
appropriate treatment and care of people with
specific diseases and conditions within the
NHS. One of the important things they do
is to look at new treatments and drugs, and
to see if they are a significant improvement
on old treatments and drugs. New advances
are (almost) always more expensive, and for
something to get NICE “approval” it has to
not only work better (for example, for a new
statin to be able to get LDL-cholesterol levels
even lower than the old ones), but also it has
to save the NHS money in the long term!
This could be, for example, by preventing
more people getting a disease that requires
hospitalisation (such as reducing the number
of heart attacks), reducing the length of the
time the patients need to stay in hospital
(after a heart attack), and of course ultimately
reducing the number of people dying! To
calculate the relative cost and benefit of a new
treatment, Health Economists use different
measures like “cost-per-life-year-gained” which
sounds a bit cold-hearted when you are talking
about someone’s life or health, but it is the
only sensible way the NHS can prioritise how
best to use its scarce resources.
Earlier this year, NICE announced it would be
preparing a guideline on the management and
treatment of familial hypercholesterolaemia
(FH), and I’m pleased to say that I’ve been
appointed the lead advisor for this. The
guideline is commissioned by NICE to the
National Collaborating Centre for Primary Care
(which is hosted within the Royal College of
General Practitioners) and we are supported
by an excellent team of more than five of their
staff. The first public meeting was held in
July to discuss the Scope of the guideline (to
discuss what the guideline will include and
what it won’t), and this is available at
www.nice.org.uk/page.aspx?o=340235,
on the NICE website. In brief the scope
covers issues such as what drugs are most
cost effective for treating FH patients, what
information and advice should be given to
parents about having their children tested,
and what should be done with the very rare
children who are homozygous for FH. The
second stage has been to set up a panel of
experts to form a Guideline Development
Group (GDG) many of whom will be familiar
to you and whose names are shown in the
box. They include the chair (who as well as
being a GP is also a member of the post-MI
guideline and lipids-modification guidelines
being currently drawn up by NICE), several
lipidologists, a paediatrician, a nurse, a
dietitian, a health economist, a GP and, most
importantly, two patient representatives who
have FH. These are Dawn Davies (who writes
for the Digest) and Phil Rowlands, who lives
in Cardiff.
Our job, over the next eighteen months, is
to look at all the evidence we can find about
managing and treating FH patients and to
draw up recommendations. To do this we
have decided on a number of Key Clinical
Questions based on the boundaries defined
in the scope, and we will now look at two or
three of these at each of ten meetings (once
every six weeks) over the next 18 months.
When will it be completed?
Once we have looked at all the evidence we
then draw up a report which goes for a wide
range in consultation, when, for example,
H·E·A·R·T UK, BHF, The Royal Colleges,
and even drug companies can comment
and suggest changes. Finally, the report is
published, with the target date for August
2008. Although the NICE process often
seems very slow, I am sure you agree that it
is better to do a thorough job and get it right
than rush it and miss some important facts.
If you have any questions or things you think
should be brought up please feel free to
contact myself, Dawn or Phil by writing to The
H·E·A·R·T UK office.
Prof Steve Humphries, CEO of the London
IDEAS Genetic Knowledge Park, and Director
of the DH, UK FH audit and cascade project
The NICE Guideline Development Group (GDG) Team of Experts
GP Chair: Dr Rubin Minhas (Kent)
Lipidologists: Professor Andrew Neil (Oxford), Dr Mary Seed (London), Dr Ian McDowell (Cardiff)
Cardiology Nurse Specialist/Genetic Counsellor: Ms Melanie Watson (Bangor)
Dietitian: Ms Helen Stacey (Charing Cross, London)
Screening Specialist: Professor Margaret Thorogood (Warwick)
Paediatrician: Dr Philip Lee (Great Ormond Street Hospital, London)
GP: Dr Nadeem Qureshi (Nottingham)
Patient representatives: Dawn Davies, Phil Rowlands
Other experts such as Dr Rossi Naoumova (London) and Dr Tony Weirzbicki London)
are being co-opted on to help with specific issues.
08
digest
feature: study report/safer medicines
studyreport safer
medicines
Study report: Experiences of
familial hypercholesterolaemia
New prescription delivery service
promises safer medicines
Familial hypercholesterolaemia (FH) is an hereditary high cholesterol
condition which is as common as type 1 diabetes, although it
commands considerably less public awareness. This study set out to
look at people’s experiences of living with FH, asking things like how
they found out they had the condition, what sort of impact it has had on
them and their families, and whether it has caused them any difficulties
in their day-to-day lives. The study is based on interviews with 31
people with FH who attend a large lipid clinic in the north of England.
Against a backdrop of increasing global risk from fake medicines,
a new UK-based service, Prescription Delivery Services (PDS),
has launched the world’s first home delivery service of prescription
medicines scientifically batch-tested to prove their authenticity.
People came to be diagnosed with FH through a variety of routes,
some because of family events or their own heart disease, some
because of a chance cholesterol test, and others because of problems
with ‘lumps’ round their joints or eyes. It was their good fortune
that these ‘lumps’ were recognised as possible indicators of raised
cholesterol. Overall, many people had not been aware of a family
history of heart disease or high cholesterol before their own diagnosis
was established.
In the main, having FH had led to few problems once people had
got used to the required dietary changes and to taking medication.
Occasional difficulties in getting travel and health insurance were
mentioned and one man talked of the particular constraints he had
faced trying to find appropriate, but satisfying healthy meals in his work
in the manual trades. However, no one reported finding the condition
stigmatising in any way. As one young man said: “Other families have
different illnesses and complaints, so it’s just another one on the list.”
People were generally positive about their futures. They thought that
one could avoid illness, or at least postpone it, through following
lifestyle advice, taking medication and being monitored regularly.
One issue that people were concerned about was the diagnosis and
support of children and young adults. People sometimes talked of
their own lack of engagement in earlier years or the resistance of their
adult offspring to cholesterol testing because “when you’re young you
think you’ll live for ever”. In other words, ill-health is not something
that young people want to or are used to thinking about. Indeed, one
woman told me that, at first, she had “completely ignored it, but at the
same time had real psychological problems thinking I was going to die
early”. This points to the importance of providing support, particularly
for young people, around the time of diagnosis. H·E·A·R·T UK
children’s lipid clinics project provides one example in this area.
The effects of counterfeit medicines have been well documented of late,
from cancer patients receiving fake epogen and deaths due to fake antimalarials, to people with epilepsy experiencing seemingly inexplicable
breakthrough seizures. Counterfeit statins and anti-hypertensive
medicines have been found in the UK and the USA in the past few
months. The new service acknowledges the patient’s basic right to safe
medicines and consistent supply of those medicines. PDS has been
developed by a group of leading global campaigners for safe medicines.
One of the people behind PDS, Jim Thomson (Chief Executive of the
Centre for Mental Health and EU Liaison for the Partnership for Safe
Medicines) identifies the problem by saying “For some time now,
we have been campaigning against counterfeits and, despite some
successes, fake drugs keep turning up in the supply chain. In July this
year, for example, counterfeit Lipitor was again found – a full year after
the same rogue batch had been recalled. The conventional supply
chain just isn’t doing its job in protecting patients.”
PDS insists that the only way to be sure about the authenticity of a
medicine is to conduct a battery of scientific tests, comparing a sample
of each batch of the medicine against a pre-tested control sample.
They say that this also guarantees consistency of supply – a critical
factor in an open market like Europe where patients routinely receive
poorly repackaged foreign medicines with patient information leaflets
that may be poorly translated, if indeed they are translated at all.
Thomson goes on “We know how clever the counterfeiter is and we
know that effective technology to combat counterfeiting – the so-called
‘silver bullet’ – is a long way off. It was time to do something concrete for
patients and the sensible, practical thing to do was provide batch-tested
medicines, direct to the patient, at no extra cost. That’s what we’ve done.”
To find out more about this free service and how to register for safer
medicines, visit: www.prescriptiondeliveryservices.com or
telephone: 0845 094 2339
Many thanks to everyone who participated in this study. For further
information please email: [email protected]
Kate Weiner is a research fellow at the Institute for the Study of
Genetics Biorisks and Society, University of Nottingham.
digest
09
regular: exercise
keep onwalking
a breath of fresh air
Walk off the Christmas pudding with winter festival
There’s a chance to walk off the Christmas pudding with the
Ramblers’ Association’s Festival of Winter Walks, starting on Boxing
Day (26 December 2006 – 2 January 2007).
“Britain’s biggest
walking festival is
a breath of fresh air
after the excesses of the
party season and the
perfect opportunity to
kick-start your New Year
fitness resolutions.”
Britain’s biggest walking festival is a
breath of fresh air after the excesses
of the party season and the perfect
opportunity to kick-start your New
Year fitness resolutions.
Hundreds of varied walks led by
Ramblers members, all free and open
to everyone, are planned throughout
England, Scotland and Wales. Many
are relatively short and, at an easygoing pace, suitable for all the family.
The nationwide festival is designed to take full advantage of the delights of
winter walking. The appeal of clear, crisp winter air; energy-boosting walks
and the chance to socialise with friends and family has lured thousands
away from the sofa, telly and leftover turkey since the event began 18
years ago, and now attracts more than 15,000 people every year.
All who take part in a Festival walk and want to join the Ramblers’
Association will receive a 20% discount off membership. For full
walks details please log onto our website at
www.ramblers.org.uk/winterwalks or call 020 7339 8500.
If exercise is on your list of New
Year’s resolutions, walking is the
perfect way to get started. It’s
free, you don’t need expensive
equipment and just 30 minutes’
walking a day will benefit your
health. Regular walking can
halve the chance of coronary
heart disease, reduce blood
pressure and cholesterol levels;
it can help reduce weight
and maintain weight loss,
increase bone density and help
fight osteoporosis as well as
enhancing mental well-being.
Ramblers’Association Festival Co-ordinator Mariusz Wilczynski said:
“There’s nothing nicer than wrapping up warm and heading out into
beautiful crisp winter air with friends for an energising walk. The festival
is a great launch pad for those who have decided to improve their
health and fitness in 2007 and just need a little bit of encouragement.”
And if you want an extra challenge for the New Year, there’s a chance
to contribute to the upkeep of Britain’s footpaths with the RA’s Use Your
Paths Challenge. During the 18-month challenge the public is asked
to walk footpaths which they can then register on a specially created
website at www.useyourpaths.info
News of a special fundraising walk:
Great Wall of China
...and some news of a rather special fundraising walk from Natasha Dougall of
Wheldon Events and organiser of H·E·A·R·T UK’s summer conferences.
“Flying into Beijing, we traversed the wall in four parts and in the main were privileged to
walk along sections where tourists are unable to go. This only added to the magnificence
of the scenery and sites that awaited us and gave us an appreciation of the enormity of the
task in constructing this 600 year-old ‘dragon’ which snakes its way across China’s lands.
This I think only added to the poignancy of the task for many of us taking part.
10
FACT: You cannot see the Great Wall
of China from space!
Walking anywhere between two and nine hours in a day, we started our trek at Hyangyaguan,
onwards then to Jinshalin, Gubeiko, Simatei, Mutianyu and finishing up in Juyongguan.
“How I became privy to this tit-bit of information
was whilst undertaking a 100km trek of the Great
Wall to raise funds for the Alzheimer’s Society. Why
– because my mother suffered from it and I wanted to
help raise awareness of this terrible disease.
Dementia affects over 750,000 people in the UK with
55% having Alzheimer’s Disease; 20% with a form
caused by vascular disease; 15% with Lewy bodies
and 5% with Pick’s Disease.
It is frightening to think that dementia is now the 4th
most common cause of death amongst women and
the 9th most common cause amongst men in the UK!”
Natasha Dougall
Accommodated in traditional Chinese hotels and villages located amidst the rolling hills,
we were made to feel extremely welcome. With a multitude of freshly prepared dishes
presented simply to us each evening we went to bed tired but satisfied.
digest
Truly an amazing country with amazing people.
Xie-xie to everyone to supported me. I’m delighted to say that the overall total raised
is £59,000.”
Natasha Dougall
H·E·A·R·T UK is promoting a Great Wall of China Trek in 2007 from 13 – 22
October. If you would like more information about this event please contact our
fundraising department.
feature: cholesterol concern
cholesterol
concern
Nation’s heart health in jeopardy
due to lack of cholesterol concern
Women lagging behind men in taking action
to care for their cholesterol
The recent ‘Caring about Cholesterol’ report1,
released by Flora pro.activ and BUPA, reveals
that four in ten women have never had a
cholesterol test, compared to three in ten men.
It also shows that men are significantly more
likely than women to currently be taking steps
to address high cholesterol.
The report highlights women are just as
likely to be concerned about the physical
appearance of ageing skin as they are about
high cholesterol. The findings go on to show
that although people with cholesterol above
the recommended level make some dietary
and lifestyle changes, they don’t make all the
changes they could. For example, less than half
try to reduce their waist measurement or eat
more good fats or cholesterol-lowering foods
- all important steps to help lower cholesterol.
The ‘Caring about Cholesterol’ report has
been released by Flora pro.activ and BUPA,
who are working together to highlight the
importance of lowering cholesterol. People
who choose Flora pro.activ to lower their
cholesterol can now choose to get two
months’ free health insurance from BUPA,
marking the first time the UK’s leading
private healthcare company has identified a
cholesterol-lowering food as playing a key
role in preventative healthcare. BUPA is also
offering 15 per cent off selected BUPA health
assessments to people who buy one Flora
pro.activ product before 31 December 2006.
The current Joint British Guidelines state that
everybody’s total blood cholesterol should be
5mmol/l or below. If however you are at higher
risk of developing a heart health problem, it
should be 4mmol/l or below2.
Michael Livingston, the Director of the
cholesterol charity H·E·A·R·T UK welcomes
the initiative, “The average cholesterol level
in the UK is between 5.5 and 5.6mmol/l3, but
new national guidelines for healthy cholesterol
levels, recently revised to be more stringent,
mean millions of us need to bring our levels
down. It is encouraging to see two leading
companies working together to help drive
down cholesterol levels and try to achieve an
improvement in the nation’s heart health.”
“...four in ten women have
never had a cholesterol
test, compared to three in
ten men...”
References:
1. Caring about Cholesterol report
released by Flora pro.activ and BUPA
incorporating research carried out by
Lightspeed Research, one of the world’s
leading online research providers.
2. British Hypertension Society, Diabetes
UK, H·E·A·R·T UK, Primary Care
Cardiovascular Society, The Stroke
Association, JBS2 (2005): Joint British
Societies’ guidelines on prevention
of cardiovascular disease in clinical
practice. Heart; 91 (supplement V).
3. British Heart Foundation (2005). Health
Promotion Research Group, Department
of Public Health, University of Oxford.
Coronary Heart Disease Statistics.
Flora pro.activ:
• Flora pro.activ cholesterol lowering range contains plant sterols which are
proven to significantly lower LDL-cholesterol. Reductions of 10-15% can be
achieved, when moving to a healthy diet.
• The cholesterol-lowering effect of plant sterols has been known since the
1950s, with over 140 studies published which support their efficacy and safety.
• For more information please visit www.floraproactiv.co.uk
digest
11
regular: young people
healthychildren
New ideas for health
During September a gathering of over 100 health experts and parents discussed the issues
and barriers to healthy eating in children. Whilst the meeting overwhelmingly concluded that
parents play the single most important role in helping their children lead a healthy lifestyle, all
agreed that parents desperately need help, advice and support.
The meeting, which was organised by Sainsbury’s, was attended by Caroline Flint, Public
Health Minister, and was set up to contribute to the Government’s “Small Change, Big
Difference” campaign.
Top of the list of conclusions reached was the need for everyone involved in the healthy
lifestyle debate to work together to provide consistent and improved education on how
this can be achieved by parents. Many initiatives are already in operation but better
communication and delivery through local community activities will provide the most practical
steps to assist parents.
Caroline Flint said: “It’s about all of us, government, the NHS, retailers and manufacturers
working better together nationally and in local communities to give people the advice,
information and support that will help them improve their health. And it’s about people using
their power as consumers to demand that support.”
Joining Caroline Flint on the expert panel were Dr David Haslam (National Obesity Forum),
Julia Unwin (Deputy Chair, Food Standards Agency), Amanda Ursell (nutritionist) and Justin
King (Chief Executive Officer of Sainsbury’s).
Cult TV show gets kids fit
BBC2’s hit kids’ TV show, Lazy Town, looks set to do
what politicians and experts have failed to do – keep our
children’s weight under control! The concept of the show
is simple. When eight-year old Stephanie arrives in Lazy
Town she can’t get anybody to play with her because
they are all too busy watching TV or playing computer
games and eating too much sugar. She finds and ally in
a super-fit super-hero called Sportacus, who collapses if
he eats sugar, so only eats ‘Sport Candy’ (fruit)! Together
they bring Lazy Town to life, defeating Robbie Rotten’s
attempts at sabotaging their fun.
The show was first aired in Iceland where school kids
sent the sales of fruit and veg up by 22%. The creator
of Lazy Town, Magnus Scheving, also plays the part of
Sportacus and believes the show has been a success
because it hides the healthy eating message with a lot of
fun and games. He is now being dubbed Iceland’s version
of Jamie Oliver as he wants to launch a chain of Lazy
Town restaurants!
For now, Britain will have to wait to see if Lazy Town can
help revolutionise our children’s diet and exercise habits.
f.h.UK
kids’ workshop
Hi guys,
Time for an update on
the f.h.UK DVD – we
started filming at the end
of November. I know it
seems a crawl but we
had a way to trawl... to raise
the cash to go into production
mode. We finally got the Green Light after
the DoH (not a Homerism but the Department
of Health) - agreed we could use the final
year funding of a three-year Education grant
awarded to H·E·A·R·T UK for the f.h.UK project
- originally for a series of UK-wide workshops.
The thinking was changed due to the demand present and future. The best way for us to reach
everybody - 15,000 - in the UK alone would be
to re-think and do it as a DVD - which would
mean everybody would get a shot at it, not just
those living in big towns or cities.
So... that’s what we did, and we then developed
it. Thank you to Michael Livingston and all the
H·E·A·R·T UK team for letting that happen.
Hopefully we’ll be able to get the DVD out
to some of you guys to review before we
release the final version. It’s for you - so it has
to work. It’ll be a multi-media gig with drama,
animation, music, documentary and talking
heads. You can take in the whole thing or
choose a chapter and do it a bit at a time.
Pre-production is a blast. It’s not Hollywood, so
everything’s tight. Every pound has to count,
so creative, clever and collaboration are the
collective key. We’ve got a great team - from
the boss, Dr Stephanie Matthews, through
cast and crew down to the lowest of the low
- the scriptwriter... me. So please, for me, just
a little sympathy... a kind word for the bird
that writes the absurd... and remember what
occurred or was overheard and then feared...
when we didn’t know fh could be deterred.
I’ll do a diary of the ‘shoot’... it’ll be a hoot.... a
golden boot... a rooty-toot... a high salute.
Remember... we’re not just a notch on a
whitecoat’s suit... don’t have to be mute. We
have a collective voice... let’s use it.
You’ll be able to link in through H·E·A·R·T UK
website or direct to www.fhunkymedics.com.
In the New Year I want to start some chit-chat
with you so if there’s anything you want to say,
you’ll have your chance.
Hope your Yule Is cool
Billy
12
digest
regular: ask dawn
reasons
ask
dawn
cheerful
to be
expert patient
Dawn Davies
American peanuts
New innovative unsalted flavours and mixes - so you can
enjoy all the goodness without the salt!
Why are American peanuts a good value superfood
for daily snacking?
1. Good health
A daily handful of peanuts can help protect against heart disease,
type 2 diabetes, gallbladder disease and obesity and they are now
recognised as a good source of the ‘right kind of fat’, the heart-healthy
monounsaturated fats.
2. Weight loss
Four independent research groups have now reported that moderate fat
diets including peanuts can help with weight loss. With a Glycaemic Index
(GI) of just 14, American peanuts can be a daily part of weight loss and
healthy diet programmes.
Recent studies at Oxford Brookes University indicate that peanuts have
one of the lowest GIs of all nuts. For weight loss diets, swap in a daily
snack of a handful of peanuts to replace other less nutritious foods.
There’s a 14 day diet plan, now available free to download from
www.peanutsusa.org.uk/2gu6
3. Wellbeing
Peanuts are a good source of the essential amino acid tryptophan
and micronutrients folic acid and zinc, low levels of which have been
associated with increasing levels of depression.
Research shows that regular peanut consumers have higher intakes of
vitamin E, folate, magnesium, zinc, iron, heart-healthy monounsaturated
fat and dietary fibre than people who rarely eat peanuts, so improving
diet quality.
Want to sample the new ranges of unsalted varieties of
American peanuts? - See the flyer in this issue of Digest.
Dear Dawn
In a past issue of the Digest an article on peanuts suggested
that they are good for you, and another issue recommended
reducing your salt intake. I like roasted peanuts but can’t find
any that are unsalted apart from ones in their shells. Do you
know where I can obtain shelled unsalted roasted peanuts?
Mr D Withams
Dawn replies...
Dear Mr Withams
You are quite right – peanuts are good for you and too much salt
is bad! We should all try and keep our salt intake below 6g per
day. Peanuts are a good source of monounsaturated fats, protein
and fibre but they are energy-dense with 50% coming from fat.
This means that they need to be consumed instead of another
protein source or limited to small amounts to avoid the risk of
weight gain. (See below).
Unsalted peanut and raisin mix is available at Sainsbury’s and at
certain times of the year you can get them on their own. Julian
Graves sell redskin peanuts at £1.49 for 500g and I’m sure
you’ll also find unsalted roasted peanuts in health food shops or
specialist food stores.
Two UK peanut manufacturers are in the process of launching
ranges of unsalted, flavoured American peanuts and dried fruit
and peanut mixes, initially for the schools market. Whilst they are
not yet widely available in the shops, H·E·A·R·T UK readers have
the opportunity to sample these new unsalted peanuts (see left).
Dawn Davies
H·E·A·R·T UK Dietitian Linda Main adds: “Peanuts appear to
have a satiating effect and in studies eating up to 2 – 3 small
handfuls per day are not associated with an increased body mass
index (BMI). This seems to be because peanuts can suppress
hunger for up to 21/2 hours (longer than other snacks do),
therefore leading to a reduced intake of other foods.”
Ask Dawn
Look for the words ‘American
Peanuts’ or the Quality USA
logo on packaging to be
assured that you are buying
great tasting, high quality
peanuts and peanut butter.
Please post, fax or email your questions for Dawn to the
H·E·A·R·T UK office and we will pass them on to her. If you
don’t wish your letter to be published in the Digest please let
us know.
H·E·A·R·T UK,
7 North Rd, Maidenhead, Berkshire, SL6 1PE
Email: [email protected]
Fax: 01628 628 698
digest
13
feature: taking care of your heart
taking care
heart
of your
Public urged to be ‘heart heroes’
Public urged to be ‘heart heroes’
A campaign has been launched in East
Berkshire to help people respond more quickly
when faced with a possible heart attack.
The ‘Heart Hero’ initiative is using a number of
creative ways to get across the importance of
acting promptly.
Hundreds of thousands of tickets being issued
by pay-and-display machines in Windsor,
Ascot and Maidenhead point out that chest
pain could be a heart attack needing an
immediate 999 call.
Beer mats carrying similar messages plus
important information on how to reduce the
risk of a heart attack – giving up smoking or
exercising more, for example – are planned for
the next phase of the campaign early in 2007.
Lesley Richards, a specialist cardiac nurse
based at King Edward VII Hospital Windsor,
said: “We are trying to reach as many people
as possible with the simple message that they
must act quickly in response to chest pain.
Every year thousands of people in the UK die
or suffer long term ill-health following a heart
attack. The outcome could have been much
better for many if those around them had
acted as soon as the first signs appeared.
“By doing the right thing in the ‘golden hour’
immediately after a heart attack, we can
save lives, minimise damage to the heart and
increase the chances of a full recovery.”
Simon Brown, Medical Director of the South
Central Ambulance Service and a GP in
Sandhurst, said: “The public should not worry
about wasting ambulance resources for
any patient suffering chest pains. It is vitally
important for these patients to receive medical
assistance as soon after onset of symptoms as
possible. If in doubt ring 999 and the emergency
control operator will be able to take the relevant
details, despatch an ambulance resource to
scene and also offer advice to treat the patient
prior to the arrival of the paramedics.”
Other key messages include encouraging
people to:
• realise that not all heart attacks are dramatic
• understand that heart attack symptoms can
be different for men and women
The campaign is backed up by a website
which provides further useful information.
www.bhps.org.uk/hearthero
The ‘Heart Heroes’ project is a joint
initiative bringing together a number of
organisations including South Central
Ambulance Service NHS Trust, Berkshire
East Primary Care Trust, the Royal
Borough of Windsor and Maidenhead and
a local support group – THROB (The Heart
Rehabilitation Organisation for Berkshire).
The parking tickets have been funded by the
pharmaceutical company Sanofi Aventis.
1
2
3
4
Suspect Heart Attack?
Don’t Hesitate!
Dial 999!
Early Treatment = Successful Outcome
The British Heart Foundation’s ‘Doubt Kills’ campaign
A staggering 40% of people would not make
999 their first call if they suspected they were
having a heart attack, a survey for the British
Heart Foundation (BHF) has revealed. And an
even greater number, 64%, say they would
call someone other than 999 first if they were
experiencing chest pain – the main symptom
of a heart attack.
Professor Peter Weissberg, BHF Medical
Director, said: “These statistics portray a very
worrying, and perhaps very British, reluctance
to call 999 even in the most serious of
emergencies. Maybe it is our natural reserve
and stoicism, but it is costing lives.
“Every second counts when you are having
a heart attack, and the quicker you call
999 the greater your chances of survival.
Unfortunately too many people waste vital
minutes questioning their symptoms – our
message is if you’re suffering chest pain, call
999 immediately, because doubt kills.”
Evidence shows that people experiencing
heart attack symptoms delay an average of
90 minutes before an ambulance is called.
By the time treatment to restore blood flow
to the heart is given, an average of 2 hours
and 40 minutes has passed – but in many
cases this delay is even longer. Those who
receive treatment 1-2 hours after the onset
of symptoms are twice as likely to survive as
those who get treatment within 4-6 hours.
The ‘Doubt Kills’ campaign aims to help
reduce death and disability from coronary heart
disease, which remains the UK’s single biggest
killer with almost 106,000 deaths in 2004.
Professor Weissberg added: “Someone
suffers a heart attack every two minutes in
the UK, and about one in three dies before
reaching hospital. Many more suffer life-long
debilitation because their heart muscle has
been permanently damaged. Sadly many
of these deaths and heart muscle damage
could have been avoided if people had sought
help immediately. Successful treatments
for heart attacks are available in the form of
clot-busting drugs and procedures to open
blocked arteries.
“Central chest pain is the most common
warning sign of a heart attack, but it does
not have to be excruciating to be a serious
problem. The most common mistake people
make is to assume it is indigestion, so anyone
experiencing bad indigestion-like symptoms
should call for help, particularly if they are not
prone to indigestion normally.”
There are also other symptoms to be aware
of such as a dull chest pain that radiates
to the left arm or jaw, breathlessness and
sweating – a combination of which can
indicate urgent danger.
For more information visit: www.bhf.org.uk/doubtkills
14
digest
regular: nutrition
Nigel Denby
nutritional
nuggets
Nigel Denby, nutrition consultant and food
writer concludes his series of Digest articles
with some healthy tips for the festive season.
Superfood
Satsumas are traditionally associated with
Christmas time in the UK and are at their
best in December and January. Because they
come in a variety of sizes and require almost
no preparation they are an ideal ‘on the go’
snack for children and adults alike. A bowl of
satsumas will fill a room with delicious citrus
aromas and make a welcome change from
some of the more indulgent winter treats. One
medium satsuma has 25 calories and is a
great source of immunity boosting vitamin C
and folic acid.
Golden rules for safe turkeys
Diet myth
Party drinks
Can you binge eat and then starve for a
few days to make up for it? Well of course
the answer is yes you can, but your body
won’t thank you for it. It’s estimated that on
Christmas day alone most of will pile through
a whacking 6,000 calories and can easily gain
around 1.5kg. Starving after over-indulgence is
basically treating the symptom rather than the
cause. The best way to handle over-indulgence
is to plan exactly how far you want to go before
it starts, accept that you will eat and drink a little
more than usual over the holiday and then when
it’s all over start afresh with a sensible eating
and activity plan - no fads, no detox gimmicks,
just good old common sense.
The party season means we are all likely to
have a drink or two - but is it all worth it the
next day when the pounding head and dodgy
stomach reminds us about the night before?
Folk medicine has a wide variety of hangover
cures. A good hangover cure should replace
essential nutrients lost by the body while
counteracting the influence of residual poisons
of alcohol; very few cures do both at once.
Who ate all the pies
Your average mince pie contains around 250
calories and about 10g of fat - that’s 10% of a
man’s daily calorie and fat allowance in just one
bite! The main problem isn’t the mincemeat but
the pastry; add cream or brandy butter and the
figures just keep going up. This year try making
topless mince pies or use Filo pastry and make
mince parcels which will cut those calories and
fat by around a third.
Christmas cake and Christmas pudding (on its
own!) actually has fewer calories and fat than
mince pies. Go for un-iced Christmas cake
and serve Christmas pud in bite-size pieces
with a dollop of low fat crème fraiche.
These may sound familiar or make you laugh:
• Drinking pickle juice, the pickle juice of
cucumbers in the morning is a staple
hangover remedy in Poland;
• The Ulster Fry, an all day breakfast
• Drinking Coca Cola, also known as the
Black Doctor or Black Aspirin
• Cabbage leaves or tomato juice is said to
work in the Mediterranean
• ‘Hair of the dog’. This really will add to the
problem and any relief will be short lived
- the later stages of consumption of alcohol
cause more of a negative effect than the
first; by consuming more alcohol the body
begins processing the newer alcohol bringing
temporary relief from the effects of your initial
hangover - your body is conning you!
• And of course there’s common sense, if you
feel drunk, STOP drinking!
Chestnuts
Per 50g shelled, chestnuts only contain
85 calories and 1.4 g of fat. Try a different
stuffing for your Christmas turkey roast
and add blanched and coarsely chopped
chestnuts to the stuffing.
If you are using a frozen turkey make
sure it’s completely defrosted before
cooking. Use these timings as a guide:
In a fridge at 4oC (39oF), allow about 10
to 12 hours per kg, but remember not all
fridges will be this temperature.
In a cool room (below 17.5oC, 60oF) allow
approximately 3 to 4 hours per kg, longer if
the room is particularly cold.
At room temperature (about 20oC, 68oF)
allow approximately 2 hours per kg.
• Always keep raw poultry away from food
which is ready to eat
• Store your raw turkey in the bottom of
the fridge so no juices can drip onto
cooked food.
• Thoroughly clean worktops, dishes,
utensils and chopping boards after they
have touched raw poultry
• Do not wash your turkey - bacteria will
splash onto the draining board and
surrounding surfaces - proper cooking will
kill any bacteria.
• As a general guide, for a turkey under
4.5kg allow 45 minutes per kg plus 20
minutes; for one weighing between 4.5kg
and 6.5kg 40 minutes per kg; and for
those over 6.5kg 35 minutes per kg at
180oC, 350oF, Gas Mark 4 (after the
oven has preheated).
• Keep any leftover turkey in the fridge and
only take out as much as you want to use
each time.
• If you’re reheating leftover turkey, or other
food, always make sure it’s piping hot all
the way through before you eat it. And
don’t reheat more than once. Ideally, try to
use leftovers within 48 hours.
digest
15
regular: food & drink
mmmmm
This edition’s recipes...
take a more festive theme and would
grace the table for any family celebration.
Many contain nuts which are not only
popular at Christmas but are also low
in saturated fat and have a cholesterol
lowering effect.
More festive recipes (as featured in
previous December editions of Digest)
can be downloaded from our website.
Nutritional analysis
Guideline Daily Amounts
Calories
Fat (g)
Saturates (g)
Salt* (g)
GDA Men
2500
95
30
6
GDA Women
2000
70
20
6
*Based on sodium
Christmas Ice Cream Pudding
Ingredients:
• 300g (11oz) of dried mixed fruit
• 110g (4oz) of toasted almonds
• 11⁄ 2 tsp of mixed spice
• 2 litres (4 pints) of low-fat
soft scoop ice cream
• 60 ml (2 fld oz) of apple juice or brandy
Method
1 Place fruit in a large mixing bowl, pour
over the apple juice or the brandy and
leave covered for a few hours for the
fruit to soak this up.
2 Add the almonds and mixed spice to the
fruit mixture.
3 Fold in the ice cream (you may need to
bring this out of the freezer for a little
while for it to soften sufficiently).
4 Meanwhile line a large pudding basin
(2-3 litre) with cling film.
5 Once mixed, spoon the mixture into the
pudding basin and firm it down.
6 Cover with cling film and return to the
freezer overnight.
6
7
Cover with cling film and return to the
freezer overnight.
The cling film allows you to turn the
pudding out onto a plate to serve.
Each 4oz scoop provides
• 139 kcal (calories)
• 1.5g saturated fat
• 5.5g fat
• 33mg salt
Festive Fruit Cake
Serves 12
Ingredients:
• 500g (1 lb) of a good quality
dried mixed fruit
• 60g (2oz) dried apricots, chopped
• 2 tsp of honey or golden syrup
• 150 ml (6 fld ozs) fruit juice
e.g. orange, apple, or pineapple
• 225g (8oz) mashed potato
• 225g (8oz) self raising flour
• 1 tsp of bicarbonate of soda
• 1 tsp of mixed spice
• 75g (3oz) chopped nuts or stem ginger
Method
1 Grease a 20cm square cake tin with a
little oil and line with grease proof paper.
2 Place the dried mixed fruit, chopped
apricots and honey/golden syrup in a
saucepan with the fruit juice.
3 Bring to the boil and simmer for about
5 minutes.
4 Add the mashed potato and mix well.
5 Sift flour, bicarbonate of soda and mixed
spice together and add to the fruit.
6 Add chopped nuts or ginger and mix
well to combine.
7 Bake at 160°C / 320°F/ Gas Mark 3 for
11⁄4 hours.
Each portion provides
• 4.5g fat
• 250mg salt
Best before...
This cake will not keep as long as a
traditional fruit cake so be sure to keep
it covered in the fridge. The birds will be
pleased to finish off any crumbs after the
festive season.
Winter Fruit Salad
Ingredients:
• 150 ml (6 fl oz) fresh orange juice
• 50g (2oz) raisins
• 1 tbsp (15ml) brandy
• 1 tbsp (15ml) honey
• Segments from one orange
• Segments from 6 mandarins
• 3 tbsp flaked almonds
Method
1 Combine the orange juice, honey
and brandy together. Pour over the
segmented orange, mandarins and
raisins and refrigerate until required.
2 Lightly toast the almonds in a metal
dish under a grill watching carefully to
endure they don’t burn.
3 Sprinkle the fruit salad with the almonds
just before serving.
• 1g saturated fat
digest
• 6.3g fat
• 46mg salt
Walnut Spiced Puffs
Makes 15
Ingredients:
• 2 egg whites
• 125g (5oz) of sugar
• 2 tsp of cinnamon
• 1⁄4 tsp nutmeg
• 1⁄4 tsp crushed cloves
• 90g (31⁄ 2oz) chopped walnuts
• Walnut halves for decoration
Method
1 Beat the egg whites until stiff, mix in the
sugar and spices, a little at a time.
2 Gently fold in the chopped walnuts.
3 Place small quantities onto a well
greased baking sheet and top with
walnut halves.
4 Bake at 120°C/ 250°F/ Gas Mark 1
for 30-40 minutes.
4 Serve with plain yogurt or stewed apple.
Each puff provides
16
Serves 4
• 6.2g fat
• 23mg salt
regular: food & drink
mtasty recipes
Seasonal Dip
Serves 6 as a starter
Ingredients:
• 2 slices of whole grain bread
• 1⁄ 2 tsp ground cumin
• 1⁄4 tsp of cayenne
• 4 medium red peppers
• 1 tbsp (15ml) of olive oil
• 2 tbsp (30ml) of red wine vinegar
• 45g of walnuts
• Toasted bread, pitta pieces, crudités
Method
1 Place the peppers under a hot grill, turn
occasionally until charred and blistered
all over. This takes about 10 minutes.
Leave to cool.
2 Spread walnuts in a metal baking pan
and bake for 8-10 minutes at 180°C/
350°F / Gas Mark 4 until toasted.
3 In a saucepan toast cumin over a low heat
for 1 to 2 minutes, until very fragrant.
4 Remove skin from peppers and discard
along with the seeds. Cut peppers into
large pieces. Place toasted walnuts in a
blender and whiz until well ground, add
roasted peppers, cumin, bread, vinegar,
olive oil and cayenne. Blend until smooth.
5 Transfer to a bowl and refrigerate. Remove
from fridge 30 minutes before serving.
6 Serve with pitta slices, toast triangles
and crudités.
The whole dip provides
• 50g fat
• 1g salt
1 serving provides
• 8.2g fat
• 0.2g salt
Banana and
Walnut Loaf
Makes 12 slices
Ingredients:
• 4 medium sized bananas
• 160g (6oz) walnut pieces
• 30g (1oz) plain flour
• 110g (4oz) wholemeal plain flour
• 110g (4oz) olive oil based spread
• 140g (5oz) soft dark brown sugar
• 2 large eggs
• 1 tsp baking powder
• 1 tsp ground cinnamon
• Zest of one orange and one lemon
Method
1 Pre heat oven to 180°C /350°F /Gas
mark 4.
2 Toast walnuts on baking sheet in the oven
for 7-9 minutes. Cool and roughly chop.
3 Peel and mash bananas to a puree in a
blender or by hand. Add baking powder,
cinnamon and both flours and mix.
4 Add remaining ingredients except nuts
and beat until well mixed.
5 Fold in walnut pieces. If neccessary
add a little skimmed milk to achieve a
consistency that drops off a spoon.
6 Put mixture in a 1 kg (2lb) loaf tin which
has been lined with greaseproof paper.
7 Bake in the centre of the oven for 11⁄4
- 11⁄ 2 hours or until loaf feels springy
in the centre. Leave to cool in the tin
before removing.
Each puff provides
• 16g fat
• 30mg salt
Fruit Tarts
Serves 8
with Walnut Oat Crust
Ingredients:
• 75g (3oz) old fashioned rolled oats
• 1 tsp toasted chopped walnuts
• 75g (3oz) of flour
• 1⁄4 tsp ground cinnamon
• 2 tsp (10g) cold olive oil spread
• 2 tsp (10ml) apple juice
• 1-2 tsp (5-10g) maple syrup
• 250ml apple juice
• 1 tbsp unflavoured gelatine
• 225g (8oz) of frozen red fruit
• 1 tsp (5ml) lemon juice
• 1⁄ 2 tsp vanilla essence
• 2 tsp (10g) arrowroot powder
• 2 tbsp (30ml) cold water
Method
1 Place walnuts and oats in a food
processor and whiz for a few seconds
to a course consistency.
2 Add flour and cinnamon and pulse once
or twice to combine.
3 Add spread, maple syrup and a little apple
juice. Pulse briefly to form a soft dough.
4 Press dough evenly into the bottom and
side of a 7 inch flan tin.
5 Pierce dough several times with a fork
to prevent bubbling when baking.
6 Blind bake at 200°C/ 400°F/Gas Mark
6 for 15-20 minutes or until golden.
Allow to cool.
7 To prepare the filling combine the
remaining apple juice and gelatine
in a small pan. Allow to stand for 10
minutes. Warm, stirring gently for 10
minutes allowing the gelatine to fully
dissolve. Add frozen fruit and lemon
juice. Reduce heat to low.
8 Combine arrowroot and cold water in
a small bowl and stir until arrowroot is
completely dissolved. Add to saucepan
and continue to simmer for three
minutes, stirring constantly. Remove from
heat and transfer filling to medium bowl.
9 Cover and allow to thicken for about
20 minutes.
10 Pour filling into baked crust, smoothing
the top. Allow to set.
digest
• 2.2g fat
• 53mg salt
17
regular: your letters
mailbox
Dear Editor,
I am forty five years old, have
two teenage children, work
full time and have raised
cholesterol. I tend to get very
stressed during the run-up
to Christmas. Do you have
any advice to help keep my
stress levels down?
A recent survey of 1500 people
has suggested Christmas
comes second on everyone’s
worry and stress list, just
behind financial problems! Does
the Yuletide season really need
to get everyone so uptight?
Here are a few tips to help you
through the holiday season.
“Spread the
handing out of
the presents
throughout the day
- that way the kids
won’t get overexcited or bored by
the end of the day.”
• Plan your budget, work out
what you can afford and try
hard to stick to it!
• Plan the main events and
allow plenty of time for writing
down shopping and cooking
requirements.
• Consider a complete break from
the usual Christmas routine.
Does this year really have to
be bigger and better than last
year? Could you consider going
away for a change?
• Be assertive – if you do not
want to give presents to people
then tell them in advance rather
than apparently “forgetting.”
• Take a break from all the
preparations and allow some
time to pamper yourself.
For example, going to the
hairdresser or beauty salon or
even just putting your feet up
and listening to music, the radio
or reading a book for a chosen
period each day. You will feel
completely refreshed!
• Get plenty of exercise and fresh
air – it is a great stress buster.
Remember that shopping is
exercise, particularly if you park
the car further away from the
shops than usual and use the
stairs instead of the lift.
• If family rows tend to occur at
Christmas and you can’t face it,
don’t let it trouble you or make
you feel guilty – take some
time away from the maddening
crowd to restore your
equilibrium! You are entitled to
an argument-free Christmas.
• Spread the handing out of the
presents throughout the day
- that way the kids won’t get
over-excited or bored by the
end of the day.
• Make time for relaxing and
quiet activities – the computer
and the television both have an
off button!
Dear Editor,
I try to choose packaged food carefully but I get quite confused
when looking at the nutritional composition of products. I would
really like some help with how to identify foods that fit within the
nutritional guidelines and which help with cholesterol lowering.
No more than one third of the energy in our diets should be derived
from fats and the majority of this fat should be unsaturated. For
many people it can be difficult to convert this advice into real food.
Guideline Daily Amounts have been developed to help and are often
used on packaging as a way of enabling us to understand how the fat
in a product can contribute to overall intake. Use the table below to
help you to determine the maximum fat and saturated fat intake for your
age and gender.
Age (years)
Energy Intake (kcals)
Male
Female
Fat (g)
Male
Female
Saturated Fat (g)
Male
Female
11-14
2200
1850
85
70
25
25
15-18
2750
2100
105
80
35
25
Adults
2500
2000
95
70
30
20
If you divide this allowance roughly into 4 portions this should give
you an idea of the amount to set as a maximum for each meal. For
example, an adult male has a maximum fat intake of 95g of which no
more than 30g should be saturated. This could be divided as follows:
maximum amounts of fat – 10g for breakfast, 30g for lunch, 30g for
dinner and 30g for milk and snacks.
Below gives an example of how this might work out over a day
Food
Quantity
Calories (kcals) Fat (g)
Saturated Fat (g)
DAILY ALLOWANCE
Semi skimmed milk
2/3 pint
Tea and coffee
Milk from
allowance no sugar
170
6.3
3.7
-
-
-
0.36
BREAKFAST
Wholegrain cereal
9 tablespoons
315
1.71
Milk
from allowance
-
-
-
Toast
1 slice
87
1
0.2
Low fat spread*
1 teaspoon
26
2.9
0.6
1 large
114
0.4
0.1
Sandwich
2 slices of bread
191
2.55
0.44
Sliced chicken
2 -3 ozs
118
1.9
0.5
Watercress
Few sprigs
Neg
-
-
Low fat spread*
2 teaspoons
53
5.9
1.2
Low fat yoghurt
1 carton
145
2.8
1.8
Pure fruit juice
1 small carton
74
-
-
2ozs/50g
303
27
4.2
4ozs lean beef
247
10.7
4.5
MID MORNING SNACK
Banana
LUNCH
MID AFTERNOON SNACK
Unsalted nuts
EVENING MEAL
Beef casserole each
portion containing:
Vegetables – 160g 81
0.2
of onion, carrot, celery, butter beans combined
Cooking oil*
1 tablespoon
135
15
Mashed potatoes
2 large (8ozs)
180
0.25
Strawberries
4ozs
30
-
Low fat ice cream
1 scoop
37
1.6
Red wine
1 standard glass
85
-
Neg
EVENING SNACK
18
digest
Milk
From allowance
Malted drink
2 teaspoons
36
0.2
Digestive biscuit
1
70
3.2
TOTALS
2497
84
22
RECOMMENDATIONS
2500
95
30
*High in mono or polyunsaturated fats
Marianne Wightman
Maria Whitehouse
Cathy Ratcliffe
regular: about H·E·A·R·T UK
aboutus
Cholesterol UK: political profile
H·E·A·R·T UK website
For someone who has recently been found
to have inherited high cholesterol (FH) the
news can have a profound effect on the
individual and their family. Most people have
never heard of FH and may feel isolated
following the diagnosis. For this reason we
have asked several people with experience
of FH to tell their own story, and these are
now on the website. You may be shocked
but we also hope that you will be inspired
and informed by these compelling stories.
Please let us know if you feel that you have
an FH story to tell as we would like to form
a collection of stories.
October 2006 has been another successful
month for the website and we hope that it
continues to be easy to use and informative.
Any feedback is most welcome!
Maria Whitehouse
Standing order payment
Dear Member,
Next time you renew your membership with
H·E·A·R·T UK, why not consider paying by
standing order? Standing order payment
has many advantages:
• There is no need for us to send you a
reminder letter regarding the renewal
of your membership which in turn will
reduce administration costs for us and, of
course, for yourself.
• The standing order remains in place until
you decide to cancel your membership
with us and/or the standing order.
• You are in total control about
membership fees.
All of us can only benefit by setting up a
standing order. Please take this option into
consideration next time your renewal is due.
Thank you.
Marianne Wightman, Membership Manager
H·E·A·R·T UK played a significant lobbying role at the Labour, Liberal Democrat and
Conservative Party Conferences this year. Cholesterol UK, the political wing of H·E·A·R·T UK
and a joint initiative with the British Cardiac Patients Association (BCPA), joined forces with
the Primary Care Cardiovascular Society (PCCS), Primary Care Diabetes Society (PCDS)
and the National Obesity Forum (NOF) to offer cardiovascular health checks to MPs and
Ministers. More than 600 individuals took the opportunity to have their waist circumference,
blood pressure, blood glucose and cholesterol checked at the conferences!
This partnership, supported by an educational grant from sanofi aventis, provided an excellent
opportunity to engage with politicians from all parties and to raise awareness of cholesterol
as a significant cardiovascular disease risk factor. Colleagues from the PCCS, NOF, PCDS
and I (on behalf of Cholesterol UK) briefed over twenty influential politicians about the need
for comprehensive cardiovascular risk factor screening and assessment for all adults aged
40 years onwards, as recommended by the Joint British Societies’ Guidelines on Prevention
of Cardiovascular Disease in Clinical Practice (2005). We secured political support for our
call for implementation of cardiovascular risk factor testing and its inclusion in the Quality
Outcomes Framework (QOF) to ensure an effective national approach. We also presented
messages on the importance of tackling unhealthy lifestyles and obesity to avoid the resulting
legacy of diabetes, heart disease, stroke and other related diseases.
Among the politicians who participated in risk-testing were Health Minister Rosie Winterton
MP, Conservative Health Spokesman Dr Andrew Murrison MP and Liberal Democrat Shadow
Health Secretary Steve Webb MP. The Rt Hon Kevin Barron MP, Chair of the Health Select
Committee, spent considerable time discussing the cardiovascular health of the nation and
also endorsed our call for cardiovascular risk testing to be included in the QOF. In addition,
Shadow Health Secretary Andrew Lansley MP visited the stand in the Health Zone and
Baroness Barker, Liberal Democrat Health Spokesperson in the House of Lords joined us for
a dinner debate. The Chancellor of the Exchequer, Rt Hon Gordon Brown MP also visited the
stand and spent time with the nurses who briefed him on the tests they were undertaking.
Building on the contacts made during the party political conference season, Cholesterol UK
is continuing to lobby Government for implementation of a national cardiovascular risk factor
testing programme which will save lives as well as time and money for the NHS.
Cathy Ratcliffe, Communications Manager, Cholesterol UK
Editor’s note
As we approach another year’s end, I’d like to take this opportunity to thank both our new
members and all our loyal longer-standing supporters. Your annual subscription provides
important funds towards the charity’s work, most importantly in helping us continue to offer
information, advice and support to the thousands of people affected by heart disease that
contact us via our helpline, email or by letter each year. In the new year we shall have a
new local rate call line number, which will mean we can offer counselling support for
even more people in coming years. Look out in the next Digest for the new number.
I sincerely hope that you have found your Digests helpful; please keep your comments and
suggestions coming; and we all look forward to keeping you up-to-date on heart-health matters
throughout 2007.
With best wishes for a peaceful holiday. Gill Stokes, Editor
digest
19
book review
& important dates for your diary
*For health professionals only
*29 January – 4 February 2007
*27 – 29 June 2007
National Salt Awareness Week 2007
See page 4 for details
H·E·A·R·T UK
21st Annual Medical & Scientific Meeting:
contact: Consensus Action on Salt and Health
web: www.actiononsalt.org.uk
‘Back to the Future: Familial Hypercholesterolaemia
Revisited’ AND ‘Clinical Lipidology Live!’
*19 – 20 March 2007
Heriot-Watt University, Edinburgh
The first announcement and booking form can be
downloaded from the H·E·A·R·T UK website.
web: www.heartuk.org.uk
3rd National Conference on Obesity and Health
Manchester Conference Centre
contact: Index Communications Meetings Services
tel: 01794 511331/2
fax: 01794 511455
email: [email protected]
web: www.obesityandhealth.co.uk
Free online access to
Simple Guides Health Books at H·E·A·R·T UK
H·E·A·R·T UK has recently
boosted its range of
patient information with
the Simple Guides Health
Books – Cholesterol,
Blood pressure and
Type 2 Diabetes all
available FREE online
at www.heartuk.org.uk
Written by leading medical experts Simple
Guides will empower you with the information
you need to take an active part in your
healthcare. Founding Trustee of H·E·A·R·T
UK and practicing GP Dr Jonathan Morrell
said, “Simple Guides online provide quick and
easy access to reliable and trustworthy health
information. This initiative puts diet, lifestyle,
medication and disease management at the
fingertips of patients.”
Patients’ response to the Simple Guides has
been universally positive too.
“Excellent information. A great read!”
With two thirds of the UK population having
high cholesterol and with high blood pressure
affecting over 16 million people in the UK,
recent studies have shown that knowledgeable
patients are better able to prevent and have
better control over their condition. Simple
Guides provide a step-by-step guide through six
beautifully illustrated chapters allowing you to
gain the knowledge you need for FREE online!
Simple Guides – Cholesterol, Blood Pressure
and Type 2 Diabetes are available to view free
online at www.heartuk.org.uk or the books
themselves can be purchased through ASDA
pharmacies at the special price of just £3
(RRP £5.99).
Digest readers can also order the books for just £3.50 per title
(including p&p) by calling the H·E·A·R·T UK office on: 01628 628638.
Alternatively please send your name and address with cheque made
payable to: H·E·A·R·T UK Trading Company Ltd
to: H·E·A·R·T UK, 7 North Road, Maidenhead, Berkshire, SL6 1PE
20
digest
H·E·A·R·T UK DIGEST
Although H·E·A·R·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.

Winter walks page 10 Winter walks page 10

Transcription

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