FRESH & HEALTHY 
Step-by-Step to Life
A fresh approach to the way we should think,
eat and a clear guide to matters of health. 

Shân Biesman-Simons of the Heart Foundation, Director for Nutrition and Education, tells us about health concerns such as cholesterol, diabetes and blood pressure, and what it takes to remain fit and healthy within the limits of chronic diseases. The benefits of regular exercise, how to deal with high blood pressure, also called the silent killer, and explains the types and risk factors of diabetes.

What is cholesterol?

Cholesterol is a waxy, fatty substance in the blood that plays an important role in our cells and hormones. The liver produces all the cholesterol that the body needs, but is encouraged to produce excess amounts by the fat that we eat, particularly saturated fats.

A high blood cholesterol level is seen as dangerous to our health, because excess amounts are deposited on the insides of arteries. If the blood cholesterol level continues to be high, more fatty material is deposited, narrowing the artery even more, resulting in restricted blood flow to the heart and other areas of the body. The restricted blood flow encourages formation of a blood clot, which may cause the final blockage. If the blood flow is blocked off completely, it can result in a heart attack or stroke.

 

Who should have their cholesterol tested?

Most people with high cholesterol levels feel perfectly healthy – there are usually no warning signs. The only way to find out is to test for it. All adults should know their cholesterol levels and have it tested at least once every five years. Those with a family history need to be tested for it more regularly.

 

Target cholesterol levels

When the blood cholesterol level is tested, the total cholesterol as well as the different types of cholesterol is determined. The following are normal levels:

Total cholesterol <5.0mmol/l
Low Density Lipoprotein (LDL) cholesterol <3.0mmol/l
High Density Cholesterol (HDL) cholesterol >1.2mmol/l

 

How can cholesterol levels be lowered?

The first step should always be dietary intervention, whereafter drug treatment can be considered. The main focus point should be on lowering intake of fat, especially saturated fat. The various classes of fat affect cholesterol levels differently:

 

Raise cholesterol levels:

*  Saturated fat: animal fat (fats solid at room temperature) especially from fatty meat and full cream dairy products, butter, coconut oil and palm kernel oil.

*  Trans fat: hydrogenated fats such as brick margarine, shortening and foods prepared with these fats, for example high fat baked goods.

 

May lower cholesterol levels:

*  Polyunsaturated fat: vegetable oils such as sunflower, soy and corn oil, soft margarines, oily fish and legumes.

*  Monounsaturated fat: olive oil and canola oils or margarines, avocado, nuts and olives.

Products carrying the Heart Mark are low in saturated fat, low in cholesterol, low in salt and high in fibre, where applicable.

Diabetes Mellitus is an abnormally high blood glucose (sugar) level caused by the inability of the body to either produce or respond properly to insulin. Insulin is a hormone necessary to carry glucose from the bloodstream into the body cells where it is used for energy. If there is too little insulin, blood glucose levels continue to rise, as glucose is not removed from the bloodstream. 

 

Type 1 diabetes (insulin dependant diabetes)

This generally occurs in children and young adults who do not produce enough insulin. Its onset is usually rapid and symptoms experienced are severe. Life-long treatment (injection) with insulin is necessary. 

 

Type 2 diabetes (non-insulin dependant diabetes)

This type generally occurs in adults, is the most common form of diabetes and is often associated with obesity. Sufferers still produce insulin, but it might not be enough, or the body is not using it efficiently. Symptoms are usually mild and will appear gradually. Some people may not have any symptoms at all. 

 

Risk factors for diabetes

Age, obesity, family history, physical inactivity, impaired glucose tolerance and certain ethnic and racial groups. 

 

What are the symptoms for diabetes?

* Constant thirst
* Increased hunger 
* Urinating more than usual
* Tiredness
* Unexplained weight loss
* Blurred vision or visual disturbances
* Skin infection due to slow healing wounds
* Those with uncontrolled diabetes can experience complications as the disease progresses
* In severe cases diabetes may cause coma

 

How is diabetes diagnosed?

A blood sample is taken to test for the glucose level. High blood glucose will usually indicate diabetes. If glucose is detected in a urine sample, it also indicates diabetes and this will be confirmed by a blood test. Normal blood glucose is between 4 to 6mmol/l.

 

How does diabetes affect the heart?

Heart disease is the leading cause of diabetes-related deaths because constant high blood sugar is associated with narrowing of the arteries, increased blood triglycerides (a type of fat), decreased levels of HDL (good) cholesterol, high blood pressure and heart attack. 

 

Can diabetes be cured?

Unfortunately, there is no cure for diabetes, but with careful monitoring and commitment, diabetics can avoid complications and enjoy a long, productive life.

 

How must a diabetic eat?

Diabetics need to follow a healthy, individualised eating plan, including regular meals, choosing foods low in fat and added sugars and going for the high fibre options where possible. It is important to keep active and stay at a healthy weight. 

Hypertension (high blood pressure) is also called the ‘silent killer’ as there are rarely any visible symptoms. It is estimated that one in four South Africans between the ages of 15 and 64 suffer from high blood pressure. It is one of the leading causes of heart attack, stroke, kidney failure and premature death. If not treated, the heart becomes too weak for this increased workload, resulting in heart problems. Tiredness, shortness of breathy and swollen ankles are often experienced. High blood pressure can nlead to a heart attack or stroke and affect other parts of the body.

 

What is blood pressure?

Blood pressure is the force exerted by the heart, against the resistance created by the arteries, to keep the blood flowing throughout the body. As blood flow increases and decreases, blood pressure does the same. 

 

Risk factors for high blood pressure

*  Being overweight
*  A family history of high blood pressure, strokes or heart attacks
*  An unhealthy diet, including excessive salt intake
*  Excessive alcohol consumption
*  Physical inactivity
*  Stress
*  Race: blacks develop high blood pressure more often than Caucasians
*  Age: in general, the older you get, the greater your chance of developing high blood pressure
*  Pregnancy
*  Certain drugs such as birth control pills, steroids and anti-inflammatory drugs
*  Some other diseases such as kidney disease

 

At what level is blood pressure high?

The following is a guide to acceptable blood pressure levels:
Normal: 130/85
High Normal: 130/85 to 140/90
Hypertension: mild 140/90; moderate 160/110; severe 180/110 to 210/110
Very high: over 210/110

 

Who should have their blood pressure tested?

People with high blood pressure should have it tested at least every three months to keep it under control. If you don’t have high blood pressure, regular blood pressure testing is still important for adults (once every two years at least).

 

Ten commandments for someone with high blood pressure

*  Know your blood pressure; have it checked regularly
*  Know what your weight should be; attain and maintain that weight
*  Don’t use excessive salt in cooking or at meals and avoid salty food
*  Eat a healthy, low-fat diet
*  If you drink alcohol, do so in moderation
*  Don’t smoke cigarettes or use tobacco products
*  Do regular exercise
*  Make certain your family members have their blood pressure checked regularly 
*  Take your medicine exactly as prescribed. Don’t run out of pills even for a single day
*  Keep appointments with the doctor

 

Most high blood pressure can’t be cured, 
but it usually can be controlled. 

 

 

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