I asked for tips that we can stick to in the long run to “guarantee” us a healthy heart! Let’s find out from Profs/Drs Miguel Sousa Uva, Steen Dalby Kristensen, Kenneth Dickstein, Thomas Lüscher, Lars Rydén, Marten Rosenqvist, Jean-Pierre Bassand, Joep Perk, Dan Atar and Heinz Drexel.
SMOKING
None of them smoke! Or on rare enough occasions for us to not mention any names.
RED RED WINE.....
Red wine is by far more popular than smoking, but have we not heard that in reasonable amounts, it can do wonders for the heart!
They admit to “red wine being one of their weaknesses” but stick to the recommended limits and always choose red wine over any other drink, given the choice, which seems the best compromise (pleasurable and reasonable!)
Some are lucky, they just prefer it anyway “I do so by preference of taste, a couple of glasses every evening except if I am on call" says Lüscher. Lars Rydén prefers to stay on water but allows himself red wine twice a week.
BLOOD TESTS
Our panel regularly take blood tests to detect bad cholesterol as often as twice a year (Uva), but mainly on an annual basis or every couple of years, at the most with five year intervals (Kristensen) so probably a good habit to adopt to ensure everything is ticking along nicely.
FAVOURITE RECIPE FOR A HEALTHY HEART
Their favourite recipe for a healthy meal ranges from fresh fish and seafood with crispy vegetables (Kristensen) to “something low fat, low carb, rich in fruit and veg, fish and red wine “ (Bassand) or the typical Mediterranean diet that Uva goes for, i.e. olive oil, fish, vegetables and fruit. Our Scandinavian panel recommend “fish several times a week“, but maybe they take fishing as a hobby too? Sometimes they prefer a “steak with a simple salad” (Rosenqvist) but then I question, how do you turn down the chips!
Vegetable ratatouille is Dickstein’s favourite. Perk has found the way to a healthy heart with seafood and "fresh vegetables from my own kitchen garden“. Some are lucky to know what is naturally good for their heart: “I primarily eat what I like. This happens to be rather Mediterranean.” And sorry, burgers, chips, ice-cream and soda simply aren’t on the menu, back to the same usual recommendation: “Avoid a too high calorie intake, eat fish often and fruit and vegetables every day.”
MANAGING TO STAY HEALTHY WHILE TRAVELLING EXTENSIVELY
When travelling and having to attend official dinners or dining at restaurants, Kristensen's trick to cut down on fat, sugar or salt is to "not use additional salt for a served meal (this is offensive to the cook) and try to avoid cakes and fatty desserts". You can also make the conscious effort to choose fish instead of meat. Leave out the dessert, is their best recommendation, but perhaps we could ask restaurants to devise dessert-free menus for me then? Most of them say there is a heart-healthy choice if you look carefully. Some don’t bother trying to avoid the baddies, safe in the knowledge that they’re wary the rest of the time. So they just enjoy their meal and go back to their good habits once back home. Rydén says “I often eat fish and search the menu for healthy choices and select from them when they exist.”
FIVE FRUIT AND VEG A DAY – DOES ANYONE MEET THIS FIGURE? IS IT THE SAME EVERYWHERE IN EUROPE?
"During a normal working day I would eat at least five pieces of fruit. For dinner some vegetables or salad will usually be on the table" is one way to meet this figure according to Kristensen.
Bassand points out that in France fruit and vegetables are simply not cheap, so it makes it harder for everyone to obey the five-a-day rule: “I do it, but it’s hard to get it implemented country-wide because people generally don’t like eating fruit and vegetables, and it’s very expensive anyway.”
In Portugal the message isn’t conveyed as yet. Atar reports that the same message is relayed in Norway, but unfortunately difficult to manage. In Sweden the message is similar but not as strong. Says Perk: We hear the same message in my country and I try to live up to it but do not always succeed. Sometimes one is easier to keep than the other, this is the case for Dickstein, a "vegetarian who loves vegetables and hates fruit”!
EXERCISE
Here is the exercise they manage to fit in their super-busy day: an easy way to do it (in
flat countries at least!) is to “bicycle to work”, if the journey allows it anyway (for me it would take about 3 days, not sure my management will agree to this). Regularity is key, but they all say the hardest thing is to do it regularly – after all we know they don’t work on a 9 to 5 basis. Drexel likes to moutain bike or bicycle three times a week. Uva manages an impressive four times a week jog, tennis game, swim or work-out. Jogging twice a week and weight-lifting is Lüscher's recipe.
Atar recommends to “exercise every second day at least 30 minutes achieving a substantial and sustained rise in HR” but reckons it’s a hard objective to keep. "Alternatively he is constantly running behind his two baby boys which is at least as strenous as the first recommendation." "Tennis twice a week. Never use the elevator" says Rosenqvist. Even in New York City?
Exercise needs to be both “relaxing and stress-relieving” according to Kristensen.
Dickstein is
big on running, and has been spotted at quite a few congress races so we believe him,but is concerned about his knees. He did some long runs on a competitive level but did not undergo ECGs, echos or stress tests as is now the rule. So did Rydén, as well as skiing "many years ago at a very low level mostly to have a goal for training regularly". He wasn't scanned either. The same for Perk who did rowing at competition level but no testing was done at the time.
EXERCISE BEST FOR THE HEART
Swimming, walking, hiking, garden work, mountain biking, gardening or simply go up and down the stairs rather than use the elevator!
HARDEST RISK FACTORS TO CONTROL (no, you are not alone!)
This is probably a very personal issue, hence the mixed answers. Bassand finds hypertension the hardest risk factor to control. Drexel thinks diet is the trickiest, followed by exercise and then smoking, which you should never start. Perk says from his patients' point of view, it is undoubtedly smoking. For most, its either diet, exercise, smoking or all three!
STRESS MANAGEMENT
We received very inspired answers. Clearly no-one but a happy few can spend their days reading a book while basking in the sun or getting spa treatments, but our panel gives us personal tricks to learn to relax!
"We should probably try to work less and avoid doing too many different things at the same time. For me, work in the catherisation laboratory is usually fairly relaxing – however, the night work is clearly not healthy" explains Kristensen. Uva is looking into meditation in an attempt to cut down stress.
Atar believes we should try to take a nap in the afternoon and slow down our pace. Dickstein recommends to "leave your work behind when entering the weekend". "Try to be engaged in one activity at the time. "I completely fail here", admits Perk.
Lüscher's philosophy is “If you like what you do and if you know how much you can do, there is no stress. Stress occurs once you have to do more than you can and are able to do.”
Lars Rydén’s view is to “enjoy what I call positive stress and this means work in my case. However I also try to relax by exercising, reading good books and listening to music, when I have a chance. To be with the family and to see friends is another way to relax between hectic work moments”.
THEIR BEST TIPS FOR A HEALTHY HEART
They’re not necessarily about eating fruit, they're more about getting life into perspective, learning to say no and to relax… and laugh about it all.
"Do not smoke. Try to be happy, relaxed and avoid over-weight" says Kristensen. Bassand advises to "enjoy life, and stick to the recommendations for preventing heart disease!" "Call the European Heart-healthy telephone number 035140530 as introduced by the 4th Joint CVD prevention task force" remind Perk and Atar. Uva recommends to "keep to a regular exercise program and avoid bad food". Choose the right parents, says Lüscher!
Rosenqvist has quite a list: "a four week vacation annually; sleep at least 7-8 hours per night; regular exercise; a supporting family; be selective in your choices, learn to say no in the nicest possible way, laugh at least 5 times a day!" Prof Rydén recommends “to live a happy life with a good family and a few very good friends, with a lot of interesting work and regular physical activity and to (try) not to eat too much but in any case good food”. For Dickstein, "you shouldn’t worry and developing a sense of humour is the best way to live a longer life".