Cardiovascular disease (CVD) includes ischaemic heart diseases such as angina and heart attack, stroke, heart failure, heart valve problems and arrhythmias. These are the leading causes of death and disability in the world, claiming 17.9 million lives a year. This is a third of all deaths globally.

Along with other non-communicable diseases, CVD contributes to poverty, particularly in low- and middle-income countries, due to massive health spending and high out-of-pocket expenditure.

World Heart Day, which is celebrated every year on September 29, plays a crucial role in changing the situation. It is a vital global platform to raise awareness and encourage individuals, families, communities and governments to act.

Several health conditions, including lifestyle, age and family history, can increase the risk of cardiovascular disease. Although age and family history cannot be changed, there is a lot that can be done to prevent it. In fact, 80 per cent of premature deaths from CVD could be avoided if the four main risk factors – tobacco use, unhealthy diet, physical inactivity and alcohol intake – are controlled. 

Small lifestyle changes can make a big difference to heart health: 30 minutes of activity a day, giving up smoking and eating a healthy diet can help prevent heart disease and stroke.

The results of adopting a healthy lifestyle are evident. Within two years of stopping smoking, the risk of coronary heart disease is substantially reduced. Within 15 years, the risk of CVD returns to that of a non-smoker.

Physical activity can help you maintain a healthy weight and lower your blood pressure, cholesterol and sugar levels. For adults, it is recommended to spend at least 30 minutes every day in moderate-intensity exercise, like brisk walking or cycling. Children and adolescents should undertake an hour of physical activity every day.

Being overweight or obese increases the risk for heart disease. Achieving and maintaining a healthy weight is essential.

Heart diseases such as angina, heart attack and stroke claim 17.9 million lives a year. This is a third of all deaths globally

Having an overall healthy dietary pattern can help avoid cardiovascular disease and its complications. A healthy diet includes a variety of fruits and vegetables; whole grains; low-fat dairy products; skinless poultry and fish; nuts and legumes; and non-tropical vegetable oils.

Many food products can pose high risk to health and it is recommended to limit saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages. One of the diets that fits this pattern is the Dash (dietary approaches to stop hypertension) eating plan.

Most healthy eating patterns can be adapted based on calorie requirements and personal and cultural food preferences. This diet approach controls hypertension, which is a risk factor and a condition that increases the risk of cardiovascular disease.

The Mediterranean diet blends the basics of healthy eating with the traditional flavours and cooking methods of the Mediterranean. This is recognised by the World Health Organisation as a healthy and sustainable dietary pattern. Various studies have found that the Mediterranean diet is associated with reduced risk factors for cardiovascular disease.

The main components of the Mediterranean diet include:

• Daily consumption of vegetables, fruits, whole grains and healthy fats;

• Weekly intake of fish, poultry, beans and eggs;

• Moderate portions of dairy products;

• Limited intake of red meat.

The foundation of the Mediterranean diet is vegetables, fruits, herbs, nuts, beans and whole grains. Meals are built around these plant-based foods. Moderate amounts of dairy, poultry, eggs and seafood are also central to the Mediterranean diet.  In contrast, red meat is eaten only occasionally.

Healthy fats are central to the Mediterranean diet, replacing saturated and trans fats, which contribute to heart disease. Olive oil is the primary source of added fat in the Mediterranean diet. Olive oil provides monounsaturated fat, which has been found to lower total cholesterol and low-density lipoprotein (LDL or ‘bad’) cholesterol levels. 

A large study (Predimed) has shown that olive oil consumption, specifically the extra-virgin variety, is associated with reduced risks of cardiovascular disease and morta­li­ty in individuals at high cardiovascular risk.

Fish is also important in the Mediterranean diet. Fatty fish, such as unsalted mackerel, herring, sardines, tuna and salmon are rich in omega-3 fatty acids, a type of polyunsaturated fat that helps decrease triglycerides, reduce blood clotting and decrease the risk of stroke and heart failure. One can help prevent cardiovascular disease by making healthy choices and mana­ging any health conditions under the supervision of a health professional.

Tips to go Mediterranean: 

•  Eat more fruits and vegetables. Aim for at least five portions a day.

•  Choose whole grains, including wholegrain bread, cereal and pasta.

•  Use healthy fats. Use olive oil as a replacement for butter when cooking or on bread. 

•  Eat more seafood. Eat fish twice a week. 

•  Reduce red meat. Substitute meat with fish, poultry or beans. 

•  Eat some dairy such low-fat Greek or plain yogurt and small amounts of a variety of low-fat cheeses.

•  Use herbs and spices, as these boost flavour, and reduce salt.

Prof. Charmaine Gauci is Superintendent for Public Health.

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