Upwards - British Heart Foundation

Page created by Jeanette Salazar
 
CONTINUE READING
Upwards - British Heart Foundation
Inspiration           Information     Support                  Summer 2021

Coping through tough times
Build resilience when your world
turns upside down

Carbs: good or bad?
Get the lowdown on carbohydrates

     Reaching
upwards
Meet the people celebrating
60 years, thanks to research

Breathing easy
How you can manage
your breathlessness

Covid’s impact
Readers share their
road to recovery

                                    British Heart Foundation
Upwards - British Heart Foundation
Contents
Summer 2021

News                                                                     Nutrition                                32
4      Your letters                                                      20 Recipes: pull out and keep
                                                                         	 Caesar salad, ratatouille
                                                                                                                                                                                                      Editor’s letter
5      Behind the headlines                                                 flatbreads and butter
	
 Does too much sleep raise your                                             bean salad
                                                                                                                                                                                                      Welcome to the Summer issue of Heart Matters.
       risk of a heart attack?
                                                                         23 Ask the expert                                                                                                                    This is a very special issue, as we celebrate
6News                                                                    	 Plant milks, and                                                                                                                  the BHF’s 60th birthday. So we met up with
	
 Heart attack risk identified by new                                        protein for breakfast                                                                                                             three inspirational people who are also 60
 technology, and new ways you
                                                                         24 Carbs: good or bad?                                                                                                       years young to help us celebrate. Wendy, Helen and
 can fundraise and volunteer
                                                                         	 Understand carbohydrate                                                                                                   Neil (page 16) show that whatever age you are, and
                                                                            types and whether you need                                                                                                whatever your heart condition, you can have new
Medical
                                                                            to cut down                                                                                                               hobbies, new experiences and new ambitions. For
8      Why I had the vaccine                                                                                                                                                                          them, as for the BHF, 60 is just the start.
 Three readers explain what they’d 26 Healthy eating, made simple
	                                                                                                               Coping in turbulent times
                                   	
 say to someone who isn’t sure yet
29 Breathe easier
                                      What you really need to know
                                                                                 about eating a balanced diet                                      16                                                 We’ve also taken the opportunity to look back on what
                                                                                                                                                                                                      our research has achieved over the last 60 years, as
	                                                                                                                                                                                                    well as what we’re still working on (page 12).
                                                                                                                                             24
   Breathlessness can be difficult to                                    Living well
   live with: learn how to manage it                                                                                                              60 years young
                                                                         11
                                                                          Fear of needles                                                                                                             Coronavirus continues to have an impact on many of
34 Ask the expert                                                        	
                                                                          How to cope if you struggle                                                                                                 our lives, including for Suki and David (page 36). On
	Understanding your echo report;
                                                                                                                                                   12
                                                                          with injections                                                                                                             page 32, Heart Matters readers share tips on coping
   calcified arteries; and weight
                                                                         32 Coping in turbulent times                                                                                                 with turbulent times. And on page 8, three people with
   gain when you have heart failure
                                                                         	 Ways to cope when life gets                                                                                               heart conditions share with us why getting the vaccine
                                                                            unpredictable or difficult                                                                                                is important to them. Don’t miss this if someone in your
Celebrating 60 years
                                                                                                                                                                                                      life isn’t sure about getting the vaccine yet.
12 Pioneering research                                                   Research
	 How we’ve saved and improved                                                                                                                                                                       As you may have spotted, the pandemic meant that
   lives over six decades                                                40 Taking part
                                                                                                                                                                                                      we couldn’t bring you your Spring issue, so we’re
                                                                         	 What it’s like to be in clinical
                                                                                                                                                                                                      pleased to be back. Our income has been badly hit
16 Sixty years young                                                        trials and how they’re making
	 Meet the people also celebrating                                         a difference
                                                                                                                                                                                                      by the pandemic, but we’re working hard to keep
   their 60th this year, thanks to                                                                                                                                                                    bringing you Heart Matters for free. To help us do this,
   research                                                              43 The latest research                                                                                                       you may see that future issues include information
                                                                         	 New projects we’re funding           Carbs: good or bad?
                                                                                                                                                                                                      about products or services from the BHF as well as our
Real life                                                                                                                                                                                             partners. And if you’d like to support us, every donation
                                                                                                                                                                                                      is welcome. Visit bhf.org.uk/HMdonate, or donate by
36 Covid’s impact
                                                                                                                                                                                                      phone at 0300 330 3322, or send a cheque payable to
	 Suki and David share their
                                                                                                                                                                                                      ‘British Heart Foundation’ to British Heart Foundation,
   journeys to recovery                                                                                                                           60 years of pioneering research                     2300 The Crescent, Birmingham B37 7YE (if possible,
                                                                                                                                                                                                      please include a covering note that mentions Heart
                                                                                                                                                                                                      Matters). And a huge thank you to those of you who
                            Have your say on Heart Matters                                                                                                 Online exclusives                          have already donated.
                            Go to bhf.org.uk/heartsurvey                                                                                                   Visit bhf.org.uk/HMmag
                            to tell us what you thought of this issue. You could win a £50 John                                                                                                       We’d love to hear from you about whether this issue
                            Lewis or Amazon voucher! Or post comments to Editor Sarah                                                                10 tasty low-salt recipes
                                                                                                                                                   •	                                                has helped you, or any feedback you have. Email
                            Brealey at the address on page 4.                                                                                                                                         HMeditor@bhf.org.uk, write to us at the address on
                                                                                                                                                     5 lessons we’ve learned from lockdown
                                                                                                                                                   •	                                                page 4, or take our survey at bhf.org.uk/heartsurvey.
                                                                                                                                                     Quiz: How much do you know about carbs?
                                                                                                                                                   •	
Heart Matters is published by the British Heart Foundation, Greater London House, 180 Hampstead Road,
London NW1 7AW. ISSN17459753 The British Heart Foundation is a registered charity in England and Wales
(225971) and in Scotland (SC039426). Views expressed in this magazine are not necessarily those of the British                                     • Get Covid-19 updates at bhf.org.uk/coronavirus
Heart Foundation. The BHF does not endorse third-party products and services featured in Heart Matters.
Information is correct at time of going to press. © BHF 2021. G204/0621                                          Covid’s impact                                                                       Sarah Brealey, Editor

2 I Heart Matters                                                                                                                                                                                                                                  bhf.org.uk I 3
Upwards - British Heart Foundation
News                                                                                                                                                                                                                                                         News
                                                                                                  We love to read your emails,
                                                                                                  letters and tips, so keep writing:

Your
                                                                                                  HMeditor@bhf.org.uk or                                                                                                        The Daily Mail, 17 May 2021
                                                                                                  Heart Matters,                                                                                                                "Chilly spells can give you a heart
                                                                                                  British Heart Foundation,                                                                                                     attack"
                                                                                                  180 Hampstead Road,                                                                                                           According to research published in

  letters
                                                                                                  London NW1 7AW                                                                                                                the journal Heart, lower temperatures
                                                                                                                                                                                                                                are linked to more cases of people
                                                                                                                                                                                                                                having cardiac arrests.
                                                                                                                                                                                                                                   The Daily Mail covered this study
                                                                                                                                                                                                                                with the unfortunately misleading
                                                                                                                                                                                                                                headline, “Chilly spells can give you
                                                                                                                                                                                                                                a heart attack.” The study focused on
Appreciating scars                         watching a football match. The heart           to help (Winter 2020) and by the                                                                                                      cardiac arrests, which is when your
I had a heart valve replaced at the        attack caused a cardiac arrest - the           people who use CPR to try to save a                                                                                                   heart suddenly stops pumping blood
end of October 2020, so much of the        club had a defibrillator, and the physio       life, sometimes successfully but sadly                                                                                                around your body and your brain is
magazine’s content is so relevant to       used that and CPR to try to help my            sometimes not.                                                                                                                        starved of oxygen, causing you to fall
me. I was particularly interested in the   husband until the ambulance                    Andrew Low                                                                                                                            unconscious. While heart attacks are
article on scars, ‘Marks of change’,       arrived 15 minutes later.                      Kenton, Middlesex                                                                                                                     one of the main causes of cardiac
(Winter 2020). I am very proud of          Although he did not survive,                                                                                                                                                         arrests, they are not the same thing.
mine. For me it says: ‘Look what I         it was a huge                                  Positive way                                                                                                                             The study found that lower
have survived.’ In fact, I was quite       comfort to know                                I would like to compliment you on                                                                                                     temperatures and big drops in
disappointed that there are no stitch      that everything                                the excellent job you all do, not only                                                                                                temperature within one day were
marks to make it show up more! Thank       had been done to                               keeping us informed of new treatments,                                                                                                linked with more cases of cardiac
you so much BHF and Royal Brompton         save him. Another                              trials, and research but in making us                                                                                                 arrests.
Hospital for continuing to research and    reason to start                                feel someone is interested in us and our                                                                                                 It also found that cardiac arrests
improve the treatment of heart patients    CPR as soon as possible.                       conditions. It can be very isolating and       The Sun, 5 May 2021                                                                    were more likely to happen on
- you are much appreciated.                Lesley Barnes                                  difficult dealing with heart issues.           "The ‘sleep formula’ that can slash risk    research has not been published, the       Sundays, Mondays and public
Murray Simmons                             Greenford, Greater London                          You don’t want to worry family and         of heart attack and stroke"                 authors said that people who slept six     holidays than other days of the week.
Oakley, Hampshire                                                                         friends, so having your magazine lay           It’s long been known that there is a link   to seven hours had the lowest risk of a       The study analysed data for over
                                           Deeply moved                                   out all the facts in its lovely positive way   between lack of sleep and your risk of      heart or circulatory problem (such as      half a million people in Japan who
The importance of CPR                      Thank you for the magazine. I was              is so important. l look forward to the         heart disease or stroke. But according      a heart attack or stroke).                 had cardiac arrests out of hospitals
Thank you for your article on CPR          deeply moved by the stories of the             next edition.                                  to recent research from the United             Much of the press coverage of           between 2005 and 2013. It’s important
(Winter 2020). My husband died of          nurse who has been struck down by              Janet Price,                                   States, too much sleep can affect your      this story was based on a press            to note that it simply showed an
a heart attack five years ago whilst       a heart condition and dearly wants             Cwmbran, South Wales                           risk too.                                   release, issued before the study was       association between cold weather
                                                                                                                                             The study followed 14,000 Americans     presented to the American College          and cardiac arrests. It didn’t prove
                                                                                                                                         over several years. Participants were       of Cardiology. Before a full study         cause and effect, i.e. that cold
                                                                                                                                         divided into three groups: those who        has been published, it’s hard to           weather in itself is responsible for
   Shared experience                       I felt. To my surprise he totally understood                                                  slept less than six hours a night, those    understand the details of the findings,    causing cardiac arrests.
   I was interested to read Megan          how I was feeling. He promised me, if it                                                      who slept six to seven and those who        and how significant and accurate
   MacKintosh’s story about scarring       was possible, he would cut from the side                                                      slept more than seven. Although the full    they are.                                     THE BHF VIEW
   (Winter 2020, pictured). Back in 1970   of my chest, so any scarring could not                                                                                                                                                  Chloe MacArthur, Senior Cardiac
   I was in the same position as her.      be seen. After surgery I will never forget                                                       THE BHF VIEW                                                                           Nurse at the British Heart
   I was just 22 years old and facing      my surgeon telling me that I got my wish,                                                        Getting a good night’s sleep is important for good health. When it comes to            Foundation (BHF) said: “This study
   open heart surgery for a hole in the    and that all went well with the op.                                                              our heart and circulatory health, this study suggests there might be a sweet           is interesting as we know that the
   heart (atrial septal defect). I was         I’m so glad that I talked to my                                                              spot between getting too much and getting too little sleep. But it’s difficult to      weather has the potential to affect
   horrified by the thought of what sort   surgeon. Although it might not be                                                                say this for sure based on one study, which hasn’t even been published in full,        the heart...But the most important
   of scarring I might be left with but    possible for a scar to be hidden in every                                                        so may not yet have been peer reviewed by other scientists. What’s more, this          thing for any of us to focus on is
   did not want to seem vain, as it was    case, do talk to the doctors involved,                                                           type of research can’t prove cause and effect, and we wouldn’t suggest you             managing our underlying risk
   a life-saving operation. I was given    they do listen.                                                                                  change your habits based on this research.                                             of heart and circulatory disease
   some advice to tell the surgeon that    Maureen Bettison                                                                                    The research shouldn’t trigger alarm bells for those of us who might have           by having a healthy, balanced
   was going to do the operation how       Halstead, Essex                                                                                  the occasional bad night’s sleep or long lie-in. However, if you are really            diet and getting enough physical
                                                                                                                                            struggling with your sleep, it’s important to talk to your GP.                         activity.”

4 I Heart Matters
                                                                                                                                                                                                                                                               bhf.org.uk I 5
Upwards - British Heart Foundation
News

                                                                                                   New technology
                                                                                                   CaRi-Heart can perform                Join Team 60                                                                                  Dates for
                                                                                                                                                                                                                                       your diary
                                                                                                   a deep-dive into heart
                                                                                                   scans, using artificial
                                                                                                   intelligence
                                                                                                                                         To celebrate our 60th year,
                                                                                                                                         we’ve come up with some fun
                                                                                                                                         fundraising ideas. Why not host                                                               July & August
                                                                                                                                         a 60s-themed dress up day                                                                     Live & Ticking: online events.
                                                                                                                                         or a quiz night, walk or run 60                                                               We’ll be celebrating our
                                                                                                   intelligence. It identifies areas     miles in a month, or take up                                                                  60th anniversary, covering
                                                                                                   of inflammation in the heart’s        something new for 60 days?                                                                    some exciting research topics
                                                                                                   blood vessels, which can be a         If you’re celebrating your 60th                                                               including heart surgery and
                                                                                                   potential early warning sign for      too, you could ask for donations                                                              statins. Book your place at
                                                                                                   a future heart attack.                for your birthday. Set up your                                                                bhf.org.uk/publicevents.
                                                                                                      The scientific work behind         virtual collecting tin and get
                                                                                                   CaRi-Heart was initially carried      ideas at bhf.org.uk/team60.                                                                   22 August
                                                                                                   out by BHF researchers at                                                                                                           The Vitality Big Half. Join our
                                                                                                   the University of Oxford. The                                                                                                       team on the closed roads of

‘Invisible’ heart attack risk                                                                      technology was tested in a
                                                                                                   BHF-funded study involving
                                                                                                                                         Win this necklace
                                                                                                                                                                              BHF shops need you
                                                                                                                                                                                                                                       London, passing the iconic
                                                                                                                                                                                                                                       Tower Bridge and Cutty Sark,
                                                                                                   around 4,000 patients who             F.Hinds and Chappelle are                                                                     for this exciting half-marathon.
identified by new technology                                                                       were followed for nine years
                                                                                                   after their original scan. At least
                                                                                                                                         donating five per cent of sales
                                                                                                                                         of all heart-themed jewellery
                                                                                                                                                                              After months of closing during lockdown, we’ve
                                                                                                                                                                              reopened our shops, recording more than £1 million
                                                                                                                                                                                                                                       Find out more at bhf.org.uk/
                                                                                                                                                                                                                                       thebighalf or call 0300 222 5719.
                                                                                                   one in three patients who had         until 23 July to support our life-   in sales on the first day of reopening in England and
Research we’ve funded has led       to check the blood vessels                                     a CT coronary angiogram and           saving research. See in stores or    Wales in April this year. We need your quality items     12 September
to a new technology that can        that supply their heart for                                    were initially considered low         visit fhinds.co.uk and chapelle.     more than ever. Every sale supports our vital work as    Brighton Marathon and 10K.
help identify people at high        any narrowed or blocked                                        risk were shown to have a much        co.uk. To mark our partnership,      we seek to recover from the devastating impact of        Choose to run the full marathon
risk of a heart attack, whose       areas. About three quarters                                    higher risk after CaRi-Heart          they are giving away this            the pandemic, which has seen our net income cut in       or 10K, join our team and enjoy
risk was previously undetected      of the time, the scans find                                    was applied to their scan. So         9ct Gold Open Heart Ruby             half over the last year.                                 the coastal views along this
by routine scans. Those             no significant narrowing of                                    this technology could mean that       necklace worth £325. To be in           There are also new ways to volunteer with             scenic course. Find out more at
identified with these ‘invisible’   these coronary arteries, so                                    thousands more people every           with a chance of winning, visit      our shops. Those who enjoy a bit of DIY can help         bhf.org.uk/brightonmarathon or
early warning signs can be          people are sent home without                                   year get offered the treatment        bhf.org.uk/fhindsprize before        with our furniture assembly service, which allows        call 0300 222 5719.
monitored more closely and          treatment. But some of them will                               they need.                            midnight on 23 July.                 customers to buy prebuilt items from us. We are
given the right preventative        go on to have heart attacks at                                    CaRi-Heart has now                                                      also looking for volunteers to test donated electrical   29 September
medication, potentially saving      some point in the future.                                      received European safety                                                   items and online sales volunteers to help grow our       Heart Hero Awards 2021: online
their lives.                           Now a new technology,                                       accreditation, meaning it can                                              presence on online selling platforms.                    event. Tune into our virtual
   CT coronary angiogram            CaRi-Heart, can perform a                                      be used by doctors across the                                                 Find out more about donating items or                 awards ceremony at 7pm to
scans are a fairly common test      deeper dive into the scans                                     UK and Europe and rolled out                                               volunteering at bhf.org.uk/how-you-can-help or pop       hear the incredible stories and
for people with chest pain,         using a type of artificial                                     across the NHS.                                                            into your local store.                                   the innovative fundraising
                                                                                                                                                                                                                                       activities that have taken place
                                                                                                                                                                                                                                       over the past year from our
                                                                                                                                                                                                                                       shortlisted finalists. Register at
News bites                                                 scientists at the University of
                                                           Cambridge have identified 12
                                                                                                   Drug could prevent Covid
                                                                                                   lung damage
                                                                                                                                         to treat tapeworm – helps
                                                                                                                                         block the process of the virus
                                                                                                                                                                              health.
                                                                                                                                                                              your  health.
                                                                                                                                                                                        Mindful
                                                                                                                                                                                              Mindful
                                                                                                                                                                                                   Chef Chef
                                                                                                                                                                                                        havehave
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Causes of ‘silent’ strokes                                 changes to
                                                           locations  on12our
                                                                           genetic
                                                                               DNA which
                                                                                     regionsare    A tapeworm drug could                 damaging lung cells. They            BHF
                                                                                                                                                                              by  BHF
                                                                                                                                                                                    dietitians.
                                                                                                                                                                                        dietitians.
                                                                                                                                                                                                  To To
                                                                                                                                                                                                     mark our                          3 October
Lacunar strokes, caused by                                 of DNAtolinked
                                                           linked    theseto types
                                                                               these
                                                                                   oftypes
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                                                                                                                                                                              mark   our partnership,
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6 I Heart Matters                                                                                                                                                                                                                                          bhf.org.uk I 7
Upwards - British Heart Foundation
Medical

                            Why I got                                                                 compared to a proven vaccine? Having
                                                                                                      the vaccine is not just a lifesaver in

the vaccine
                                                                                                      terms of preventing the illness, but is
                                                                                                      also vital to help prevent those potential
                                                                                                      lasting or long-term effects.
                                                                                                         I have been self-isolating through
                                                                                                      the pandemic. It’s been difficult, and I
                                                                                                      know I’m not the only one. We need to
                                                                                                      suppress the virus through vaccination
                                                                                                      so we can all start to get back to some
                                                                                                      kind of ‘normal’.
 – and what I’d say to someone who isn’t sure yet                                                        If I was speaking to someone unsure
                                                                                                      about getting the vaccine, I’d want
                                                                                                      to understand why they feel that way.
 Three people with heart conditions tell us why getting the Covid-19 vaccine                          So if it’s because people are unsure
                                                                                                      about the vaccines being developed
 mattered to them, and what they would say to anyone who feels hesitant                               so quickly, it’s about explaining how no
                                                                                                      steps were skipped and it’s been done          Kelvin Pitman, 71, from Newbury, is a retired director in
                                                                                                      properly. I think UK research and our          research and development. He had a heart attack in 2008,
                                                                                                      scientists and regulatory bodies are           has atrial fibrillation and has a pacemaker.
                                                                                                      among the best in the world. I have
                                                         Zena Forster, 65, from                       total faith that everything has been           For me, getting the vaccine was important to protect myself, my wife, and my
                                                                                                      examined carefully and that there is the       daughter who lives on her own and is in our ‘bubble’, as well as to protect anyone
                                                         Newcastle, is a retired
                                                                                                      ongoing monitoring.                            else I might come into contact with.
                                                         NHS patient manager.                            If it’s because people are worried              I also want to be able to see my other daughter, her husband and our three
                                                         She has familial                             about side effects, I think it’s just really   grandchildren. They live in Dubai and we haven’t seen them for 18 months. We
                                                         hypercholesterolaemia (an                    important to be clear that the risks if        want to do anything that will make it safer and more possible to see family and
                                                         inherited condition which                    they are there are very low, compared          friends, as soon as we can.
                                                         leads to very high cholesterol)              to the benefits of not getting Covid-19.           I also wanted to help build up herd immunity, which I think is very important.
                                                         and has had a stroke and a                      Whether or not you trust the                We want to get to a point where society can open up without worrying about
                                                                                                      government, there should be trust in           more waves of the virus. So it’s important that as many people as possible are
                                                         heart attack.
                                                                                                      what the scientists and the people who         vaccinated.
                                                                                                      have actually done the work on the
                                                         Getting the vaccine was important            vaccines are saying.
                                                         to me to protect myself, those around           Vaccines have achieved so many              We want to do anything that will make it safer and
                                                         me and my community. It’s not just           good things. When I was growing up in
                                                         about yourself but protecting all the        the 50s, you would hear about people           more possible to see family and friends, as soon as
                                                         people you might be in contact with in       with polio needing an iron lung to             we can.
                                                         daily life. I would feel terrible if I was   breathe or being fitted with callipers to
                                                         responsible for passing on Covid-19 to       walk. The availability of a vaccine has            Another important point is to try to limit the spread of new coronavirus variants.
                                                         someone else.                                eradicated that in the UK.                     Every time someone gets infected, there is potential for a variation to occur. So
                                                             I had the virus in early 2020, and          Getting the vaccine is about                the less transmission you have, the less chance there is for mutations, and the less
                                                         have had ongoing symptoms since              protecting ourselves and each other.           chance for new strains to spread.
                                                         then, including some issues with my                                                             I think for some people, there’s a religious element – they think that if they have
                                                         heart. So, for me personally, getting the                                                   faith they will be protected, so they don’t have to worry. I do have a fairly strong
                                                         vaccine is also about being protected                                                       faith, but I see it in a different way. God has given us this vaccine to protect us.
                                                         from getting it again – I’ve been through    It’s not just about                                The chances of catching Covid, and the chances of life-threatening
                                                         it already and definitely don’t want to      yourself but protecting                        complications from the virus, far outweigh what seems to be an incredibly small
                                                         get it again.                                                                               risk of any serious side effects if you have the vaccine. Overall the risk of something
                                                             We know it can have lasting effects,
                                                                                                      all the people you might                       happening to you after a vaccine, compared to usual life or getting Covid-19 itself,
                                                         so why would you want to take the risk       be in contact with.                            is very small.

8 I Heart Matters                                                                                                                                                                                                              bhf.org.uk I 9
Upwards - British Heart Foundation
Medical                                                                                                                                                                                                                                                                              Living well

Joy Akinsanmi, 27, from London, works in communications. She was born with Marfan syndrome,                                                                           Overcoming your
                                                                                                                                                                                    fear of needles
an inherited condition that can cause heart defects.

                                                                                     in the news are probably linked to an
                                                                                     immune reaction, and aren’t the kind of
                                           I did read a lot about                    clots I take warfarin to prevent. Overall,
                                           the different vaccines                    I understood that the benefits of having
                                                                                                                                                                      Having an injection can be difficult, but there are some simple
                                           and how they’ve been                      the vaccine still outweighed the risks.
                                                                                        I talked a lot about it with my                                               ways you can make it easier. Rachelle Beaven offers some tips
                                           developed. I wanted                       grandma, who really didn’t want
                                           to feel as informed as                    the vaccine. She was apprehensive:
                                                                                     because she’s older she remembers lots
                                                                                                                                                                      If the thought of having an injection
                                                                                                                                                                      or blood test makes you anxious,
                                                                                                                                                                                                                                                               or an object in the room may help.
                                                                                                                                                                                                                                                               You could also try listening to music
                                           possible about having                     of things that have happened to the                                              you’re not alone. Up to one in 10                                                        through headphones, or answering
                                           the vaccine.                              Black community and she felt scared. I                                           people have a fear of needles.                                                           maths questions in your mind –
                                                                                     think it helped that I was honest about                                              We know that this fear can make                                                      whatever works to distract you.
                                                                                     my own apprehensions and reasons                                                 it hard to face injections, blood
                                           informed as possible about having         for choosing the vaccine. I said “I’m                                            tests or vaccines, even though they                                                      Positive thinking: It can help to focus
                                           the vaccine.                              human, I’m nervous, it’s new, but this                                           may benefit your health. The good                                                        on the positive reason why this is
                                               Having had heart surgery to           is what we know and I’m willing to try                                           news is that there are some simple                                                       happening – whether it’s to protect
                                           correct complications of my Marfan        this. And if you get to the point that you                                       techniques which can help to                                                             you from a virus, or to look after your
                                           syndrome, I have experience of my         are in a hospital bed really unwell with                                         overcome it.                                                                             health. Remember that it will be a very
                                           life being saved because of medical       Covid, you’d look back and wish you                                                                                                                                       quick, temporary discomfort – which is
                                           interventions that wouldn’t have          had the vaccine.” So putting it into that                                        Preparing for your appointment                                                           well worth it for good health.
                                           existed without research. So that gives   perspective, she agreed to have it.                                              If you are worried or anxious you
                                           me faith in research and the way             Everything has risks, but it’s about                                          may feel sweaty, sick, dizzy or light-                                                   After the appointment
                                           things are tested.                        whether the benefit outweighs the risks.                                         headed. Practising deep breathing                                                        Most people are relieved to find that
                                               I’m on warfarin, which means          I was really scared before my heart                                              can help in the days before your                                                         the experience was quicker and much
                                           there is more risk of bleeding from the   surgery when I was told that there is                                            appointment. Try this exercise:             Talk it through: Let the person who          easier than they thought it would be.
                                           vaccination, but you can have it as       a five per cent risk of dying from that                                          •	Take a long, deep breath in              is treating you know if you are feeling      It can help to reflect on or write down
                                           long as your INR levels are controlled.   particular procedure. But when I looked                                              through your nose.                      nervous. They will make sure you are as      how it went, so you can remember
                                           Because I’m on warfarin, the first        into all the options, I thought OK, the                                          •	Let it flow into your belly, as far as   comfortable as possible, answer any          what worked for next time.
I was apprehensive about getting the       vaccination centre I went to refused      benefit of me going ahead with the                                                   you comfortably can.                    questions you have and distract you              If despite trying these techniques,
vaccine, but for me, it seemed like        to give me the vaccine, so I went to a    surgery outweighs the risks. I think the                                         •	Slowly exhale through your nose.         from the process by chatting to you. If      your fear of needles is causing
the better choice to have it instead of    different centre to have both my first    same sort of thing applies to deciding                                           •	Repeat the exercise for three to         you’re feeling faint, they can help you to   ongoing anxiety or you are avoiding
continuing to live in fear of the virus,   and second dose. The staff there were     on the vaccine.                                                                      five minutes each day.                  lie down if you’d prefer to.                 healthcare because of it, speak to
which I’ve been told I’m extremely         lovely and made me feel safe, and            If people are not comfortable, I’d                                                                                                                                     your GP. They may be able to refer
vulnerable to. Before getting the          being on warfarin didn’t cause any        suggest they research the different                                              If you are worried about pain from          Distract yourself: Try not to focus on the   you for treatment such as behavioural
vaccine, I felt super apprehensive         problems with the vaccine itself.         options, and speak to people they trust                                          the needle, you can apply a numbing         needle. Focusing on a positive memory        therapy.
about leaving home at all. Once I              I was more apprehensive about the     about their concerns, whether it’s a GP                                          cream before the appointment, to
had the first dose, I felt a bit more      second dose because by then there         or care team, or someone they trust                                              dull the feeling. You can get it from a
comfortable. I went out to eat –           were concerns about blood clots. I’ve     generally in life.                                                               pharmacy or on prescription. (Don’t         What can I do if I start to feel faint?
outdoors, but it was the first time I’d    had a blood clot before, and also                                                                                          forget to tell the person who’s treating    If you begin to feel lightheaded and are worried you might faint, practising applied
felt able to even do that for more than    a blood clot would be a particular                                                     Illustration: Kotryna Zukauskaite   you where you have applied it.)             tension could help to regulate your blood pressure to avoid fainting.
a year.                                    problem for me because I have a                                                                                                                                        How to practise ‘applied tension’:
   I think it’s important for people to    mechanical heart valve. But luckily        Find out more                                                                   At the appointment                          •	Sit comfortably.
get vaccinated to protect themselves       because I’m on blood thinners, I could     Get answers to your Covid-19                                                    Relax: As you sit down, relax your          •	Tense the muscles in your arms, upper body and legs for 10 to 15 seconds until
and allow themselves to live as            speak to my great anti-coagulation         questions, from the second dose                                                 shoulders and arms - the more                   you feel warmth rising to your face.
normal a life as possible again.           team at St Barts Hospital, who know        to side effects, at bhf.org.uk/                                                 relaxed you are, the less you will          • Relax your muscles for 30 seconds.
   I did read a lot about the different    me and my risk factors, and I also         coronavirus.                                                                    notice the needle. Remember your            •	After 30 seconds, repeat the tensing exercise until you feel the warmth in your
vaccines and how they’ve been              did my own research. I realised that                                                                                       slow breathing exercises. Counting              face again.
developed. I wanted to feel as             the rare type of clots that have been                                                                                      your breaths can also be helpful.           •	Repeat the exercise five times.

10 I Heart Matters                                                                                                                                                                                                                                                                        bhf.org.uk I 11
Upwards - British Heart Foundation
Celebrating 60 years

    60 years of
pioneering
                     research
                     How we’ve saved and improved lives over
                     six decades – and the challenges we’re
                     now taking on

This year we celebrate 60 years of our       Since the 1960s, the
life-saving research – from heart attack
care to treatments for stroke, and from
                                             annual number of heart
understanding the causes of vascular         attack deaths in the UK
dementia to the best care for people
with congenital heart disease.
                                             has more than halved.

Transforming heart attack
treatment with specialist care
In the 1960s, the treatment for people
who had suffered a heart attack was
bed rest and pain relief. Most of them           At the time, the lack of treatments
died within a year and many others           meant that after a heart attack many
went on to suffer long-term health           people developed a life-threatening
problems, such as abnormal heart             heart rhythm, leading to cardiac arrest
rhythms and heart failure.                   (in which the heart stops pumping
   It was Desmond Julian, who became         blood around the body). In the early
a BHF Professor and later our first          1960s, few heart attack patients - even
Medical Director, who radically              those in hospital - survived a
changed how heart attack patients            cardiac arrest.
were cared for. When a visiting junior           The BHF funded equipment for Dr
                                                                                       Illustration: Matt Herring

doctor in Australia in the early 1960s, he   Julian to set up a coronary care unit
was one of the first people in the world     in Edinburgh in 1967, working with Dr
to propose specialised units for cardiac     (later BHF Professor) Michael Oliver.
care, which have since transformed           Dr Julian showed that having heart
care for heart attack patients across        patients on one ward, monitoring them
the globe.                                   continuously, and having the right

12 I Heart Matters                                                                                                  bhf.org.uk I 13
Upwards - British Heart Foundation
Celebrating 60 years

equipment and staff on standby for          for vascular dementia that work by          drug called tenecteplase might help          congenital heart disease by carefully      one of the first people to recognise the   Dr Babu-Narayan and colleagues
emergencies, would increase survival        draining waste fluid from the brain.        treat strokes. Professor Keith Muir at the   mapping the anatomy of different           importance of caring for the growing       worked out how heart scarring seen
rates. His measures included training                                                   University of Glasgow is running a trial     heart defects and showing how these        number of adult survivors of congenital    on imaging scans can be used to
staff in cardiopulmonary resuscitation      Stopping the damage caused                  to compare tenecteplase with alteplase       affected the heart’s electrical system     heart disease, pioneering ‘GUCH’ –         predict which adults with repaired
(CPR), and having defibrillators at         by stroke                                   in thousands of people, to see which         that coordinates the heartbeat. This       Grown up Congenital Heart Disease          tetralogy of Fallot need an implantable
hand, so that if a cardiac arrest did       Strokes cause around 34,000 deaths          is best at helping them recover from         has enabled surgeons to avoid putting      – care in the UK and Europe. The BHF       cardioverter defibrillator (ICD), which
happen, the patient had the best            a year in the UK, and are the single        ischaemic stroke. Professor Muir and         a stitch where it could disrupt an         funded Professor Somerville to create      could save their life if they experience a
chance of being revived.                    biggest cause of severe disability.         his team are also being funded by us         electrical circuit in the heart, making    a follow-up system for survivors of        life-threatening heart rhythm.
   In its first year the unit reduced          A stroke happens when the blood          to take part in an international clinical    surgery safer.                             congenital heart disease, to identify
deaths by more than 30 per cent.            supply to part of the brain is cut          trial testing whether tenecteplase              BHF-funded advances have helped         which factors make a difference to their   Pioneering pacemakers
Soon hospitals around the world were        off, causing brain cells to become          improves recovery in people with mild        more children with congenital heart        long-term survival.                        People with a very slow or irregular
following their example.                    damaged or die. This is usually             strokes, who are not usually offered         disease to grow up and grow older.            Since then, we have funded more         heartbeat may need a pacemaker.
   Since the 1960s the annual number        because of a blockage in one of the         clot-busting drugs. Even mild strokes        But this has come with new challenges.     research to find out how best to care      Pacemakers work by sending electrical
of heart attack deaths in the UK has        brain’s blood vessels (an ischaemic         and mini-strokes can lead to lasting         Many survivors require lifelong care,      for adults living with congenital heart    impulses that stimulate your heart to
more than halved, thanks in part to         stroke), or when a blood vessel bursts,     disability, so this study could lead to a    as some are at risk of heart failure and   disease. In 2011, we funded Dr Sonya       beat with the correct speed or rhythm.
Professor Julian’s vision and the work of   causing a bleed in the brain (a             new way to treat this kind of stroke.        sudden death from unexpected heart         Babu-Narayan at Imperial College           Around 50,000 people are fitted with a
the coronary care units now established     haemorrhagic stroke).                                                                    rhythm disturbances.                       London, to refine ways of identifying      pacemaker in the UK each year.
throughout the country.                        The very first research funded by the    Improving care for people with                  In the 1970s and 1980s we funded        which adults born with tetralogy of            In the 1950s, cardiologist Aubrey
                                            BHF in the 1960s was to support BHF         congenital heart disease, from               work by Professor Jane Somerville at       Fallot (a complex heart defect) could      Leatham and his technician Geoffrey
Understanding the causes of                 Fellow Dr Enid Joan Acheson at North        birth to adulthood                           the Royal Brompton Hospital. She was       be at increased risk of sudden death.      Davies worked to develop a prototype
vascular dementia                           Staffordshire Royal Infirmary to identify   Each day in the UK, around 13 babies                                                                                               pacemaker. In 1960 they implanted
Vascular dementia is the second most        the causes of strokes, which were little    are diagnosed with a congenital                                                                                                    the UK’s first internal pacemaker.
common type of dementia, affecting          understood back then. Since then we’ve      heart condition, which means a heart                                                                                               There were many challenges with
around 150,000 people in the UK.            funded millions of pounds of research       problem they are born with. Before the                                                                                             the early versions of pacemakers. The
It’s caused by reduced blood flow to        to better prevent and treat these life-     BHF was founded in 1961, the majority                                                                                              first prototypes needed relatively high
parts of the brain, which damages                                                                                                                                                                                          voltages to pace the heart, which were
and eventually kills brain cells in the                                                                                                                                                                                    painful. Leatham and Davies overcame
affected area. The reduced blood flow       Before the BHF was founded in 1961, the majority                                                                                                                               this problem by creating devices that
can be caused by a stroke or mini-                                                                                                                                                                                         had better contact with the heart
stroke or by narrowing and blockage of      of babies born with severe congenital heart disease                                                                                                                            muscle, so that lower voltages could be
the smallest blood vessels in the brain.    died before their first birthday. Today, more than                                                                                                                             used. Even so, early pacemakers were
    People with vascular dementia have                                                                                                                                                                                     still bulky and required a traumatic
few treatment options and there isn’t       eight out of 10 survive to adulthood.                                                                                                                                          operation to open the chest, in order to
much evidence to say which treatments                                                                                                                                                                                      sew electrodes directly onto the heart.
are best. The BHF is working with                                                                                                                                                                                              Almost as soon as the BHF
other funders, including Alzheimer’s        threatening conditions.                     of babies born with severe congenital                                                                                              was formed, we began funding
Society and the Stroke Association, to          This has included a large clinical      heart disease in the UK died before                                                                                                Aubrey Leatham’s research into the
understand more about the disease           trial which showed that statins can help    their first birthday. Today, more than                                                                                             development of pacemaker technology
and find new ways to treat or prevent it.   to prevent strokes, both in people with     eight out of 10 survive to adulthood.                                                                                              at St George’s Hospital in south
    For example, we’re funding Professor    high cholesterol and also in those with         BHF Professor Sir Magdi Yacoub                                                                                                 London. Within five years, Dr Leatham’s
Roxana Carare at the University of          ‘normal’ cholesterol levels.                developed a surgical technique in                                                                                                  team had successfully treated several
Southampton to explore whether the              We’re now looking at how to improve     the 1970s to repair transposition of the                                                                                           hundred patients.
brain’s methods of removing waste           treatments for stroke. Giving a “clot-      great arteries (which means the heart’s                                                                                                Their pioneering work has helped
substances are linked to vascular           busting” drug to break down the clot        major blood vessels are swapped or                                                                                                 pave the way for today’s miniature,
dementia. Tiny pathways in the walls        and restore blood flow through the          reversed). This life-saving operation,                                                                                             sophisticated pacemaker devices that
of the small blood vessels in the           brain in the first few hours after an       called the arterial switch, is now used                                                                                            can transform people’s quality of life.
brain are used to carry away toxic          ischaemic stroke can greatly improve        by surgeons across the world and is
waste products. Dr Carare is studying       the chances of recovery. Right now,         successful in over 95 per cent of cases.                                                                                           Find out more
how this system goes wrong in mice          doctors use a drug called alteplase,           Throughout the 1970s and 1980s,                                                                                                 Read more stories on incredible
and whether it causes dementia.             but we are funding clinical trials          BHF Professor Robert Anderson helped                                                                                               research and how you can join in our
This research could lead to drugs           looking at how a newer clot-busting         to improve surgery for children with                                                                                               60th birthday at bhf.org.uk/birthday.

14 I Heart Matters                                                                                                                                                                                                                                     bhf.org.uk I 15
Upwards - British Heart Foundation
Celebrating 60 years

                                                  60 years young
                                                  This year we celebrate 60 years of the BHF. Wendy Cook, Helen Cawthorne and
                                                  Neil Davidson are also 60 this year – a milestone they might not have reached
                                                  without research. They tell their stories of survival to Charlotte Rastan

                                                  Helen Cawthorne
                                                  Helen, from Derbyshire, found out she had an inherited heart condition after
                                                  she had a cardiac arrest in the swimming pool on Valentine’s Day in 2011.

                                                  “I first found out I had a disease          the condition and managing it.                  Foundation, sharing my story to raise
                                                  of the heart muscle called ARVC                 When I was recovering, I got a dog,         awareness. And I’m on the Patient
                                                  (arrhythmogenic right ventricular           Spike, and we go for walks every day.           Information Panel - we’re a group of
                                                  cardiomyopathy), when I woke up in          Because of my heart condition, I do             people who use our experience of heart
                                                  hospital after a cardiac arrest.            find walking uphill difficult. It still hurts   and circulatory disease to shape the
                                                      The quick actions of the lifeguards     when someone jogs past me, because              work of the BHF. I want to help in any
                                                  giving me CPR and using a defibrillator     triathlons were such a big part of my           way I can, so that others benefit.
                                                  on me saved my life. Valentine’s Day is     life. ARVC is something that can’t be              In 1965 my father’s mum died
                                                  now my second birthday. My partner          cured, but I’ve shown you can still have        suddenly on a bus when she was in her
                                                  Mick and I say it’s the day that I lived,   a life. I see life in a lot more detail now.    60s. We think it was probably the same
                                                  not the day I nearly died.                  I’m not whizzing past like I used to.           condition I have, but it was not really
                                                      I was told I would need an                  I’m such an outdoor person. Mick            known about then. Things have moved
                                                  implantable cardioverter defibrillator      and I love to go walking in Yorkshire,          on hugely, thanks to research.
                                                  (ICD) as I was at risk of another cardiac   on the very edge of Wharfedale, a                  When you get an unexpected
                                                  arrest. I used to compete in triathlons     huge limestone valley. You look over            diagnosis you can crumble, but
                                                  and duathlons at an international           there and the world just melts away. It’s       sometimes you’ve got to have a Plan
                                                  level for Great Britain from 1993-2001.     stunningly beautiful.                           B. You’ve got to be thankful for what
                                                  I had to give it up and I wondered if           I am retired now, as I want quality         you’ve got and for the beauty of the
                                                  my life would ever be normal again.         years. I volunteer for the British Heart        world.”
                                                  Would I be able to go back to work as
                                                  a teacher? Would I have to be escorted
                                                  everywhere?
                                                      I took things really slowly and built   I see life in a lot more detail now. I’m not whizzing
                                                  back up. Mick and I would go for            past like I used to.
                                                  walks and at first I could just reach the
                                                  metal gate in the local park and back.       Some people with ARVC get few symptoms, but others are more severely
                                                  Gradually my confidence grew, and I          affected. We are funding research to try to find out why it can vary. At Keele
                                                  returned to work.                            University, researchers are creating 3D heart tissue models that can be used to
                                                      My heart condition is genetic, so my     investigate the underlying biology of ARVC. This could help us identify people
                                                  two brothers are screened regularly.         at high risk of developing severe ARVC and eventually lead to new ways to
Helen’s heart condition means she can’t run any
                                                  One good thing is that my two nieces         treat the disease.
more but she loves walking in the countryside
with her partner, Mick, and dog, Spike            and nephew are seeing me living with

16 I Heart Matters                                                                                                                                                      bhf.org.uk I 17
Upwards - British Heart Foundation
Celebrating 60 years

Wendy Cook                                                                                                                         Neil Davidson                                                                            home, but by December I was well
After the sudden deaths of three                                                                                                   Neil, from Halifax, had a cardiac arrest and would have died without CPR.                enough to travel to Australia to
brothers, Wendy Cook was diagnosed                                                                                                 Now he’s driven to spread CPR training and to fundraise for defibrillators so            see Oliver.
with familial hypercholesterolaemia                                                                                                more lives are saved.                                                                       I call Oliver my life saver. It’s very
(FH), a genetic condition that causes                                                                                                                                                                                       emotional. He had learnt CPR when
high cholesterol from birth and can                                                                                                “I started feeling unwell in March 2017.         Oliver told Janice to ring 999. They    he was 15, as part of a PE lesson, and
lead to a heart attack at an early                                                                                                 I was getting night sweats and had no        manhandled me to the floor and Oliver       now I’m dedicated to spreading CPR
age. She now takes statins and is                                                                                                  energy, just feeling rotten. I went to the   started CPR on me straightaway. He          skills as far and wide as I can. I work
celebrating a birthday that she                                                                                                    GP who sent me straight to hospital for      carried on for 21 minutes until the         with the Resuscitation Council UK and
thought she might not reach.                                                                                                       lots of tests. They told me I had to go on   first responder turned up and used a        Yorkshire Ambulance Service to spread
                                                                                                                                   antibiotics for endocarditis, an infection   defibrillator on me to shock my heart       awareness and I do voluntary training
“Philip was the first of my brothers to                                                                                            of the inner lining of the heart, and that   back to a normal rhythm.                    in the community. The CPR training kit
pass away, and the inquest said he                                                                                                 it had affected one of my heart valves.          I was several weeks in hospital, and    from the BHF is always in my car.
had died of ischaemic heart disease.                                                                                                   While waiting for surgery to replace     in that time I had the surgery to replace      I’ve set up a community fund to raise
He was 45. Then three years later                                                                                                  my mitral valve, I had a cardiac             my mitral valve. I couldn’t even walk       money so we can get a trainer to teach
we lost my brother Paul to the same                                                                                                arrest. It was 3am on 31 July 2017 and       at first and was in a wheelchair on the     community groups CPR. My birthday
condition, and then another brother,                                                                                               apparently I was gasping for air. My         wards, but I walked out of hospital on 7    party in November is going to be a
Michael, two years after that. That                                                                                                wife Janice shouted out for Oliver, one      September and started my life again. It     comedy night to raise money for it. It
left me, my brother Tony and sister                                                                                                of my two sons. He lives in Australia but    was a second chance for me.                 seemed like the best thing I could do to
Christine. It all happened so fast I didn’t                                                                                        just happened to be home on holiday.             I took things very slowly when back     mark my 60th.”
have time to come to terms with it all.
    After Paul died, I contacted my GP
and that’s when she first mentioned FH.
I was 52 and had never heard of it, but
it was clear that heart disease was in
the family and my cholesterol was high.
    I went on statins and my cholesterol
came right down. I just take my tablet
before I go to bed. The fact that statins
can give you a future is amazing. It
means my family don’t have to go
through all that again.
    After Michael died, my GP sent me
for genetic testing and the results came
                                              The fact that statins can give you a future is
back saying I have an altered gene.           amazing. It means my family don’t have to go
It’s not one of the main genes already
known to be linked to FH but they said
                                              through all that again.
in future, with more research, they may
be able to link the gene to FH.               The BHF has been a major funder of FH research, particularly through our
    It’s my 60th birthday in July. I’m not    support over 30 years for the leading UK expert in FH, former BHF Professor
a party kind of person - I would like         Steve Humphries.
to celebrate in a quieter way with my         Professor Humphries and his team discovered many of the genetic defects which
husband Paul and family. I am just            cause FH, leading to a blood test for the faulty genes, so doctors could diagnose
glad to get to this age. It’s such an         or rule out FH. They also showed that genetic testing for family members of a
achievement in our family to reach 60.        person with FH (a process called cascade testing) helped to spot more people          In the UK thousands of people die every year following a cardiac arrest in
    My nephews and nieces all have            with the condition. Identifying people who have FH and cascade testing of             their home. We’ve been supporting CPR training for decades, and in 2014
their cholesterol tested. I am looking        family members is now an NHS priority.                                                we started a campaign to save more lives each year by creating a ‘Nation of
after myself, but I would like the next       We’ve also helped to fund clinical trials that have demonstrated the ability of       Lifesavers’ through CPR training. We’ve also been pushing for CPR training to
generation to be really aware and             statins to reduce the risk of heart attack, heart disease and stroke. Statins have    be added to the secondary school curriculum, which has now been achieved
the generation after that. I am               saved the lives of many people, both with and without FH.                             in most of the UK.
definitely hopeful.”

18 I Heart Matters                                                                                                                                                                                                                                     bhf.org.uk I 19
Pull out and keep

                                                                                                                                                                                                                                                                        Pull out and keep
                                                                                    Ratatouille flatbreads                                                                                        Watermelon,
                                                                                    with harissa                                                                                                  butter bean and
                                                                                           Preparation time: 15 mins Cooking time: 10 mins
                                                                                           Serves: 2 Not suitable for home freezing
                                                                                                                                                                                                  orange salad
                                                                                                                                                                                                         Preparation time: 15 mins Cooking time: none
                                                                                    Energy Carbo-          Fibre      Sugars    Fat   Saturates    Salt                                                  Serves: 2 Not suitable for home freezing
                                                                                    1007kj hydrate         6.9g        8.2g    6.0g     1.5g      0.55g
                                                                                    240kcal 34.1g                      Low     Low      Low        Low
                                                                                     12%                    23%        9%      9%        8%        9%                                             Energy Carbo-          Fibre      Sugars    Fat   Saturates    Salt
                                                                                    % = an adult’s reference intake                                                                               1116kj hydrate         10.5g       20.0g   6.5g     3.7g      0.66g
                                                How we made it healthier                                                                                                                          266kcal 33.5g                       Low    Low      Low        Low
                                              Griddling the vegetables rather       Ingredients                                                                                                    13%                   35%         22%     9%       19%       11%
                                                                                                                                                                                                  % = an adult’s reference intake
                                             than frying keeps the fat content      1 small aubergine, trimmed and thinly sliced
                                            down. Using harissa gives a great                                                                                                                     Ingredients
                                         flavour to the soft cheese, reducing the   1 medium sized courgette, trimmed and
                                                                                                                                                                                                  300g (10oz) wedge of fresh watermelon
                                          need for salty seasonings and sauces      sliced (or a red pepper cut into thick strips).
                                            – but check the labels and choose                                                                                                                     400g tinned butter beans, 235g drained
                                              the harissa with least salt. Fresh    1 small red onion, peeled and sliced into
                                                                                                                                                                                                  weight
                                                  herbs such as coriander           thin rings
                                                     also add flavour.                                                                                                                            ½ head fennel, very thinly sliced
                                                                                    2 tsp olive oil
                                                                                                                                                                                                  80g (3oz) piece cucumber, diced
                                                                                    50g (2oz) low-fat soft cheese
                                                                                                                                                                                                  1 orange, peeled and segmented
                                                                                    ½ tsp harissa paste (choose the lowest-salt
                                                                                    version)                                                                                                      50g (2oz) feta cheese, crumbled
                                                                                    2 small flour tortillas (wholegrain if possible)                                                              1 tbsp fresh mint, roughly torn
                                                                                    1 medium tomato                                                                                               Dressing:
                                                                                    1 tbsp fresh coriander, chopped                                                                               Juice of ½ orange
                                                                                                                                                                                                  1 tsp honey
                                                                                    Method                                                                                                        1 tbsp fresh mint finely chopped
                                                                                    1 Toss the aubergine, onion and courgette or pepper
                                                                                      slices with the olive oil. Heat a griddle pan until
                                                                                    piping hot, reduce the heat to medium then cook the                                                           Method
                                                                                                                                                                                                  1
                                                                                    vegetables for 10 minutes until tender, turning them                                                             Remove the rind from the watermelon and slice
                                                                                    over after 5 minutes.                                                                                            thinly. Arrange around the edge of a serving platter.

                                                                                    2  Meanwhile, mix together the soft cheese and
                                                                                       harissa. Spread each flour tortilla with half the soft
                                                                                    cheese mixture, top with the griddled veg.
                                                                                                                                                                                                  2   Toss together the butter beans, fennel, cucumber
                                                                                                                                                                                                      and orange segments and pile into the centre of
                                                                                                                                                               How we made it healthier             the watermelon.
                                                                                                                                                            Beans are a good source of fibre

                                                                                    3    Finely dice the tomato and scatter over the
                                                                                         vegetables with the coriander.
                                                                                                                                                             and protein, and low in fat, so
                                                                                                                                                          they are a great ingredient to turn a        3    Scatter with feta cheese and torn mint.

                                                                                    4   Either eat like a pizza or roll up as tightly as you can
                                                                                        to form a wrap. Eat straight away or, for a picnic
                                                                                                                                                          salad into a more substantial meal.
                                                                                                                                                           Feta cheese is high in fat and salt,        4    Mix together the orange juice, honey and mint
                                                                                                                                                                                                            and drizzle over the salad. For the perfect
                                                                                                                                                                                                      packed lunch or picnic,cut the watermelon smaller
                                                                                                                                                               so we use just a little in this
                                                                                    or packed lunch, wrap in baking parchment, twisting                                                              and mix with all the other ingredients before piling
                                                                                                                                                                         salad.
                                                                                    each end tightly.                                                                                              into suitable containers or jars to transport.

                    20 I Heart Matters                                                                                                                                                                                                                bhf.org.uk I 21
Pull out and keep
                                                                                                                                                                                                                                                                     Nutrition

                                                                           Healthier Caesar salad
                                                                                  Preparation time: 15 mins Cooking time: 25 mins
                                                                                  Serves: 2 Not suitable for home freezing                           Ask the                                                                    Send in your nutrition questions

                                                                                                                                                                                                                                    Email: HMeditor@bhf.org.uk

                                                                                                                                                       expert
                                                                                                                                                                                                                                    Write to: Heart Matters, British Heart
                                          How we made it healthier
                                                                                                                                                                                                                                    Foundation, 180 Hampstead Road, London
                                         We made a tasty yet creamy
                                                                           Energy     Carbo-       Fibre     Sugars    Fat    Saturates    Salt                                                                                     NW1 7AW
                                         dressing out of roasting garlic
                                                                           1770kj     hydrate      5.6g       9.2g    19.4g     3.6g      0.49g
                                          and blending with fat-free       425kcal     22.5g                  Low     Med       Low        Low                                                                                      Call our Heart Helpline: 0300 330 3300
                                          yogurt – it has a fraction of     21%                    19%        10%     28%       18%        8%
                                            the fat of a traditional       % = an adult’s reference intake
                                                Caesar dressing.
                                                                           Ingredients
                                                                           2 chicken breasts
                                                                           ½ tsp cumin seeds                                                                                  Are plant milks just as good for you, or better, than dairy?
                                                                           ½ tsp smoked paprika                                                                                Plant milks such as almond, oat and soya             Dairy milk contains more protein
                                                                                                                                                                               are becoming an everyday addition to many        than some other plant milks, although
                                                                           200g tomatoes, halved
                                                                                                                                                                        people’s diets - either instead of or alongside dairy   most of us get more protein than we
                                                                           4 cloves garlic, peeled                                                                      products.                                               need so this isn’t necessarily a big
                                                                                                                                                                           Non-dairy milks vary in the nutrients that they      consideration. Soya and pea milks have
                                                                           3 sprigs fresh thyme                                                                         provide, and don’t have the same combination of         more protein than most other plant milks,
                                                                                                                                                     Victoria Taylor    nutrients as dairy. However, there are other food       and a similar amount to cow’s milk.
                                                                           50g (2oz) slice ciabatta bread or any other rustic loaf                   is the BHF’s       sources of all the nutrients that are found in dairy        Try to avoid plant milks that have added sugar
                                                                           1 tsp rapeseed oil                                                        Senior Dietitian   products, so any differences aren’t necessarily a       and/or salt. (While dairy milk does contain natural
                                                                                                                                                     with 20 years’     problem as long as you plan your diet so that it        sugars, these are milk sugars which are not the kind
                                                                           1 small head cos lettuce, thickly shredded                                experience         includes other sources.                                 that we’re recommended to cut down on.)
                                                                                                                                                                           There are differences between brands as well             There may be no harm in switching to plant milks,
                                                                           3 tbsp fat-free Greek style natural yogurt                                                   as between different types of plant milk, so it’s a     but there is no nutritional reason to stop drinking
                                                                           Freshly ground black pepper                                                                  good idea to check the nutrition label. Try to choose   cow’s milk either. Dairy milk is nutritious and while
                                                                                                                                                                        one that has been fortified with calcium, B vitamins    protein and calcium content is well known, we are
                                                                                                                                                                        (riboflavin and B12), vitamin D and iodine. That’s      still developing our understanding of how its unique
                                                                           Method                                                                                       because for most of us, dairy products are a source     package of nutrients can affect our health.

                                                                           1 Preheat the oven to 200C/180 fan/Gas 6. Line a baking tray with
                                                                             non-stick baking parchment. Mix together the cumin and paprika
                                                                           and rub over both sides of the chicken breasts. Place onto one side of
                                                                                                                                                                        of these nutrients. If you choose unfortified plant
                                                                                                                                                                        milk (organic plant milks for example) these will not
                                                                                                                                                                        generally contribute as many nutrients to your diet
                                                                                                                                                                                                                                    So, in short, from a nutrition point of view there
                                                                                                                                                                                                                                isn’t a strong reason why any specific milk is “best”.
                                                                                                                                                                                                                                It’s about the nutrients in each and whether you will
                                                                           the baking tray.                                                                             as dairy milk.                                          have other sources of them in your diet.

                                                                           2   Add the tomato halves to the other side of the tray cut side up,
                                                                               add the garlic cloves between the tomatoes and lay the thyme
                                                                           sprigs on top. Cook for 25 minutes.
                                                                                                                                                                              What’s a good source of protein to have for breakfast?
                                                                                                                                                                              The good thing about           Most of us are getting the               Making your porridge with

                                                                           3   Brush both sides of the bread with the oil, then cut into cubes.
                                                                               Add to the oven for the last 10 minutes of cooking time.
                                                                                                                                                                              including protein in your
                                                                                                                                                                        breakfast is that it can help you
                                                                                                                                                                        to feel more satisfied, so could
                                                                                                                                                                                                             recommended amounts of
                                                                                                                                                                                                             protein, partly because there
                                                                                                                                                                                                             is protein in more foods than
                                                                                                                                                                                                                                                   milk instead of water or having a
                                                                                                                                                                                                                                                   poached or boiled egg instead of
                                                                                                                                                                                                                                                   jam on your toast will increase the

                                                                           4    Carefully lift the chicken onto a board and slice on the diagonal.
                                                                                Pile into a serving bowl. Add the tomatoes to the chicken.
                                                                                                                                                                        help you to be less tempted to
                                                                                                                                                                        snack mid-morning. Being aware
                                                                                                                                                                        of the protein in all your meals
                                                                                                                                                                                                             you might think, including in
                                                                                                                                                                                                             breakfast foods like wholemeal
                                                                                                                                                                                                             bread and bran flakes. But if
                                                                                                                                                                                                                                                   amount of protein you’re eating.
                                                                                                                                                                                                                                                      Try not to regularly eat
                                                                                                                                                                                                                                                   processed protein foods such

                                                                           5   Place the cooked garlic into a small blender, add the yoghurt
                                                                               and any cooking juices from the tomatoes and blitz to a smooth
                                                                           dressing. Season with black pepper.
                                                                                                                                                                        can be helpful if you’re trying to
                                                                                                                                                                        lose weight or maintain a healthy
                                                                                                                                                                        weight, but this doesn’t need
                                                                                                                                                                                                             you do want more protein, there
                                                                                                                                                                                                                   are better sources, such as
                                                                                                                                                                                                                      eggs, baked beans and
                                                                                                                                                                                                                                                   as bacon and sausages (and
                                                                                                                                                                                                                                                   vegetarian alternatives), smoked
                                                                                                                                                                                                                                                   salmon and other smoked fish,
                                                                                                                                                                        to mean a high-protein diet,                    low-fat (unsweetened)      as these may be high in salt and

                                                                           6    Add the lettuce to the chicken and tomatoes and toss well. Drizzle
                                                                                with the dressing and scatter with croutons.
                                                                                                                                                                        unless this is what works for you.              yoghurt.                   sometimes saturated fat too.

                    22 I Heart Matters                                                                                                                                                                                                                                  bhf.org.uk I 23
Nutrition

         Carbs:
good or bad?
Carbs can be controversial, but do you need to avoid them?
Senior Dietitian Victoria Taylor explains

What are carbohydrates?                     which the body uses for energy, but         What’s the problem with carbs?
Carbohydrates or ‘carbs’ are often          starchy carbs provide a slower release      Although carbohydrate foods can be
given a bad press. Aside from the           of energy than sugars because they are      good for us, surveys show that we’re not
fact that there are no “bad” foods in       larger molecules which take longer to       making the healthiest choices when it
moderation, it’s not really fair to treat   break down. So that’s better for keeping    comes to the type we’re eating. Most of
all carbs as the same. The reality          us well fuelled for our daily activities.   us are eating too much sugar – which
is that there are different types of           The fibre in wholegrain and high-        can contribute to a high calorie diet
carbohydrates – sugars, starch and          fibre starchy foods can help prevent        and therefore weight gain. So instead
fibre – and these have different effects    constipation and maintain a healthy         of cakes, biscuits, sugary drinks and
on our health.                              gut – and gut health is increasingly        sweets, choose healthier snacks like
    There are carbohydrates in most         understood to be important to our           fruit and veg or low-fat plain yoghurt.
of the foods we eat. But when we talk       overall health. Research has also           Fruit and dairy products do contain
about carbohydrates, we usually mean        shown a link between diets high in          sugars, but these foods offer other
                                                                                        benefits such as fibre or protein as well
                                                                                        as a range of vitamins and minerals.
                                                                                                                                    •	A medium slice of wholemeal bread
Most people in the UK don’t eat as much fibre as is                                     Are low-carb diets healthier?                  or a medium apple both contain.
recommended to benefit our health.                                                      Low-carbohydrate diets have grown              around 15g (½ oz) of carbohydrate
                                                                                        in popularity for losing weight. They       • Half a pint of milk contains 13g (½ oz)
                                                                                                                                     	
                                                                                        are also used by people with type              of carbohydrate.
starchy foods and sugary foods. Starchy     fibre and a lower risk of heart and         2 diabetes to help manage blood             • A 50g bar of chocolate contains
                                                                                                                                     	                                         What’s the bottom line?
foods, like pasta, rice, potatoes and       circulatory disease, type 2 diabetes        sugar levels. A low-carbohydrate               around 30g (1oz) of carbohydrate.        Carbohydrates provide us with
bread, should make up just over a           and bowel cancer.                           diet with 130g (4 ½ oz) or less of total                                                important nutrients, and don’t need
third of our diet. Sugary foods, such as       Most people in the UK don’t eat          carbohydrate per day has been                  Because carbohydrates are in so          to be cut out of our diets. Reducing
sugary drinks, biscuits and cakes, don’t    as much fibre as is recommended to          shown to be safe and effective in           many foods, you’ll need to plan your        carbohydrates can be a useful strategy
need to be included in a healthy diet -     benefit our health, so swapping to          the short term for weight loss and          diet carefully to make sure you get all     for some people trying to lose weight or
but many of us eat them regularly, and      wholegrain versions of bread, rice,         diabetes control.                           the food groups you need for a healthy      manage type 2 diabetes.
it’s ok to enjoy them in small amounts.     cereals and pasta is an easy step              However, it doesn’t suit everyone        balance of nutrients and enough fibre.         Choosing wholegrain, high-fibre
                                            towards better health. The type of          and hasn’t been shown to be better             If you do have diabetes, you should      starchy carbohydrates and cutting
Why do we need carbs?                       soluble fibre in oats has also been         long-term than other approaches, such       discuss any changes to your eating          down on sugary foods will help you to
Carbs give us energy. In a healthy          found to help reduce cholesterol            as a Mediterranean-style diet, so think     habits with the health professionals        have a healthy digestive system as well
balanced diet, most of our energy           levels, so porridge or no-added-sugar       about what will suit you best.              who are helping you to manage it. If        as looking after your heart health.
comes from wholegrain and high-fibre        muesli are a great way to start                If you are keen to try a low-            you’re taking any medication which
starchy carbohydrates, like oats, whole-    the day.                                    carbohydrate diet you’ll need to look       could increase the chances of you
grain bread or pasta, brown rice,              Wholegrain and high-fibre                at all the foods you eat that provide       having low blood glucose, this might         Test your knowledge
and new potatoes (with skins on). All       starchy carbohydrates also provide B        carbohydrates, not just sugary and          need to be monitored more carefully or       Try our carbs quiz at bhf.org.uk/carbs
carbohydrates break down to glucose,        vitamins, folate, zinc and magnesium.       starchy foods. To give you an idea:         be adjusted.

24 I Heart Matters                                                                                                                                                                                                         bhf.org.uk I 25
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