Health officials are concerned that patients on prescribed diets are putting their controlled diets on hold temporarily during this festive season.
The Sunday Observer sought the help of Consultant Cardiologist, Kuliyapitiya Hospital, Dr. Wasantha Abeywickrama to find out how our readers young and old alike can enjoy family get togethers this time around, while protecting their heart as well.
Q: During the festive season many persons on prescribed medications tend to put these on hold to enjoy the high sugar, high cholesterol foods served during this time. Is this a good practise? Why?
Dr. Wasantha Abeywickrama
A: No. Medications are prescribed for specific reasons, such as managing blood pressure, diabetes, cholesterol levels, heart disease or other chronic health conditions. Stopping them without consulting your doctor can lead to uncontrolled health risks. Not taking medications for diabetes can result in a spike in blood sugar levels, leading to complications such as nerve damage, kidney issues or even a diabetic coma. Similarly, stopping blood pressure tablets can lead to increased blood pressure levels suddenly causing a heart attack or a stroke.
Q: Many of us also eat out during the season at parties and restaurants. What advice would you give to those who do, especially if they are persons with compromised immune systems?
A: Raw or under-cooked foods: Foods such as raw meat, seafood or under-cooked eggs can harbour harmful bacteria or viruses. For people with compromised immunity, it is best to avoid dishes such as raw sushi, steak tartare or salads with raw eggs.
Street food- While tempting, street food can pose a higher risk of contamination due to possible poor food handling and hygiene conditions. If you are unsure, it is best to avoid it.
Limit high-sugar and high-fat food- Eating too much sugar and fat, common in festive treats, can weaken the immune system. High sugar intake can suppress the effectiveness of your immune cells making you more vulnerable to infections.
Pace yourself- It’s easy to overeat at parties and dinners, but moderation is the key. Eating large quantities of food in a short time can lead to digestive discomfort, dehydration and fatigue, which can further stress the immune system.
Q: If family members are present how can they help them choose the right food?
A: Offer healthier alternatives- When attending parties or family gatherings, family members can help ensure that the meal options include healthier, immune-supporting choices, such as vegetables, lean proteins (such as chicken or fish), and whole grains. They can suggest modifications to traditional recipes to make them lighter and more nutritious.
Avoid risky foods- Help avoid food that may pose high risks, such as raw or under-cooked meats, seafood or dishes that might have been sitting out too long in buffets. Choosing freshly prepared dishes is always safer.
Serve smaller portions- If there is a risk of overindulgence, family members can help control portion size. Serving smaller portions of rich or high-sugar foods ensures the person doesn’t consume too much, while still allowing them to enjoy a variety.
Balanced plate- Family members can assist in creating a balanced plate that includes plenty of vegetables, a moderate amount of lean protein, and smaller servings of carbohydrates (eg: wholegrains or starchy vegetables). This balance helps maintain energy levels and keeps blood sugar and cholesterol in check.
Q: Since Sri Lanka abounds in fresh local fruit and vegetables the year round, are there any specific heart healthy fruit you can suggest?
A: Sri Lanka is abundant with a variety of fresh local fruit and vegetables that offer plenty of heart-healthy options, making it easier to create a diet that supports cardiovascular health. Here are some specific foods that are heart-healthy and readily available in Sri Lanka:
1. Leafy Greens and Vegetables
Gotukola (Centella Asiatica): Known for its rich content of antioxidants, gotukola has anti-inflammatory properties and can help reduce cholesterol levels, contributing to heart health.
Spinach- A rich source of folate, potassium, and fiber, spinach helps lower blood pressure and supports healthy blood vessels.
Moringa leaves- Moringa, often called the ‘drumstick tree’ is packed with vitamins, minerals and antioxidants that help reduce cholesterol and lower the risk of heart disease.
Amaranth (Thampala)- High in fibre and potassium, amaranth leaves help maintain blood pressure and overall heart health. It can be cooked as a curry or added to salads.
2. Fruits
Papaya- Papaya is rich in fibre, vitamin C and antioxidants that help reduce inflammation and improve heart health. The fruit also contains beta-carotene, which is linked to improved cholesterol levels.
Pineapple- A great source of vitamin C and fibre, pineapple contains bromelain which may help reduce the formation of blood clots, improving circulation and heart function.
Bananas- Rich in potassium, bananas help maintain blood pressure and promote heart health. They are also a great source of fibre which helps lower cholesterol.
Avocados- Though not native to Sri Lanka, avocados are widely available and are heart-healthy due to their high content of monounsaturated fats, which help lower bad cholesterol (LDL) and raise good cholesterol (HDL).
Guava- High in fibre, vitamin C and potassium, guava can help lower blood pressure and cholesterol levels, reducing the risk of heart disease.
Pomegranate- This fruit is rich in antioxidants and polyphenols which help reduce inflammation, lower blood pressure and improve blood flow to the heart.
However, one needs to remember that high potassium-containing fruits are not good for people with renal disease and high calorie foods are not good for diabetic patients.
Q: With regard to cooking methods used during this time, give us some guidelines on what you consider as the best methods to use to reduce heart diseases at this time? Steaming. Boiling or grilling?
A: Moist heat cooking methods, such as boiling and steaming are the healthiest ways to prepare meats because they are done at lower temperatures.
For vegetable preparations, steaming trumps boiling for keeping nutrients such as carotenoids and phytochemicals.
Q: This is also the time when affluent families pull out their best wines to enjoy with their festive meals. How safe is it for a person with a heart condition or a diabetic to indulge in this habit?
A. There is some evidence that red wine might provide benefits to people with heart conditions but stick to a small glass of red wine.
Moderate red wine consumption is associated with increased HDL levels, the good cholesterol which helps to remove unhealthy cholesterol from blood vessels. However, recent studies show that there is no safe limit for alcohol consumption.
Q: What about beer and stout? Are they less harmful?
A: When it comes to those with heart conditions or diabetes, the consumption of beer and stout should be approached with caution, just like wine. While some might consider these beverages to be less harmful than wine, they still pose significant risks, especially when consumed in excess.
Potential risks
High calorie content: Beer is typically higher in calories compared to wine and spirits, which can contribute to weight gain. Excess weight is a significant risk factor for both heart disease and diabetes.
Increased blood pressure: Excessive consumption of beer, like any form of alcohol, can raise blood pressure, which is dangerous for those with heart conditions. High blood pressure can lead to complications like heart attack, stroke, and heart failure.
Heart arrhythmias: Heavy drinking of beer can increase the risk of cardiac arrhythmia (irregular heartbeats), especially for people with underlying heart conditions.
Q: So you agree with the current opinion of cardiologists that boiled cooled water is the best and safest drink of all?
A: Yes, I agree.
Q: Many individuals relax with a cigarette or a pipe. What are the adverse impacts of this habit especially if done in a crowded room in close proximity to non-smokers?
A: Breathing second hand smoke can cause coronary artery disease and stroke. The CDC (Center for Disease Control) says about 34,000 non smokers die from heart disease in the US from exposure to second hand tobacco smoke. It shows the damage caused by secondhand smoke. Also, it poses health hazards to pregnant women, infants and young children as well.
Q: How does smoking affect the heart?
A: Smoking has a large impact on heart disease and stroke. Smoking causes these effects through several mechanisms such as causing long-term increase in blood pressure. Increasing the heart rate, increasing the process of atherosclerosis and damaging the blood vessels and also by reducing the amount of oxygen that reaches the tissues are ways that the heart is affected.
Q: Is obesity also a cause for concern with regard to heart diseases? Today, we see an increasing number of women carrying excessive weight on their bodies, your comments?
A: Overweight and obesity are defined by the World Health Organization as abnormal or excessive fat that accumulate and present a risk to health. Obesity is measured in body mass index (BMI), which is a person’s weight (in kilograms) divided by the square of his or her height (in meters). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight.
Cardiovascular disease (CVD) mortality and morbidity has been shown to be elevated in individuals who are overweight, particularly with central deposition of adipose tissues. Obesity may be associated with hypertension, dyslipidemia, diabetes or insulin resistance and elevated levels of fibrinogen and C-reactive protein, all of which increase the risk of CVD events.
Here are three ways that obesity contributes to heart disease
It changes our cholesterol levels while it increases bad cholesterol (LDL) , decreases the good high density lipoproteins and it leads to high blood pressure and diabetes.
Q: What about obese children? According to the latest data this is due to the fact that children now spend much more time in front of a computer watching videos and games than on outside active games. What is the role of parents in helping them lead healthier lifestyles?
A. Certainly! Here are some suggestions for parents to motivate their children to engage in more outdoor activities:
Lead by example- Children often mimic parental behaviour. If parents are active and enjoy outdoor activities themselves, children are more likely to follow. Spend time outdoors as a family, whether it is going for walks, bike rides or engaging in sports together.
Make it fun- Find activities that your child enjoys and make them enjoyable experiences. Whether it is playing soccer, riding bikes, hiking, or simply exploring nature, make outdoor activities fun and engaging.
Limit screen time- Set limits on screen time, including TV, video games, and smart-phones, to encourage children to spend more time outdoors. Consider implementing a rule where outdoor playtime needs to happen before screen time.
Provide opportunities- Make it easy for children to engage in outdoor activities by providing them with the necessary equipment and resources. This could include bicycles, sports gear or even just a ball to play with in the backyard.
Offer rewards- Create incentives for outdoor play, such as earning rewards for reaching certain activity goals or completing outdoor challenges. Rewards could be anything from extra playtime to small treats or privileges.
Encourage socialisation- Organise outdoor activities with other children or families to encourage socialisation and make outdoor play more enjoyable. Children are often motivated to participate in activities when they have friends to play with.
Explore new activities- Introduce children to a variety of outdoor activities to help them discover what they enjoy. Consider enrolling them in sports leagues, nature clubs or outdoor adventure programmes to expose them to new experiences.
Emphasise the benefits- Educate children about the benefits of outdoor play, such as improved physical health, mental well-being, and creativity. Help them understand why spending time outdoors is important for their overall development.
Create a routine- Establish a daily or weekly routine that includes dedicated time for outdoor play. Consistency can help in the habit of being active outdoors.
Be supportive and encouraging- Offer praise and encouragement when children engage in outdoor activities, regardless of their skill level or performance. Positive reinforcement can motivate them to continue being active outdoors.
Q: Any Do’s and Don’ts on reducing risks of heart disease during this festive season
A: Certainly! The New Year season often involves celebrations and gatherings where there is an abundance of food, drinks and social activities. Here are some Do’s and Don’ts to help prevent or reduce the risk of heart disease during the Festive season.
Do’s:
Choose heart-healthy food- Opt for dishes that are lower in saturated fats, cholesterol and sodium.
Include plenty of fruit, vegetables, whole grains, lean proteins and healthy fats such as those found in nuts, seeds and fish.
Practise portion control- Enjoy festive foods in moderation and be mindful of portion sizes. Avoid overeating, especially high-calorie and high-fat dishes.
Stay active- Incorporate physical activity into your holiday festivities. Take walks with family or friends, dance at gatherings, or participate in outdoor games to stay active and burn off extra calories.
Stay hydrated- Drink plenty of water throughout the day, especially with the consumption of alcohol or salty foods. Proper hydration supports overall heart health and helps regulate blood pressure.
Manage stress- Festival seasons can be stressful with increased social obligations and responsibilities. Practise stress-reducing activities such as deep breathing, meditation, yoga, or spending time with nature to promote relaxation and lower stress levels.
Get adequate sleep- Aim for seven to nine hours of quality sleep per night. Prioritise restful sleep to support heart health and overall well-being.
Don’ts
Overindulge in unhealthy food- Limit consumption of foods high in unhealthy fats, sugars, and processed carbohydrates. Avoid excessive intake of fried foods, sugary treats and rich desserts.
Excessive alcohol consumption- Limit alcohol intake, as excessive drinking can raise blood pressure, contribute to weight gain and increase the risk of heart disease. Stick to moderate drinking guidelines, which recommend up to one drink per day for women and up to two drinks per day for men.
Ignore symptoms- Pay attention to any warning signs or symptoms of heart problems, such as chestpain, shortness of breath, dizziness or palpitation. Seek medical attention promptly if you experience any such symptoms.
Neglect physical activity- Avoid being sedentary for extended periods during the festive season. Make an effort to stay physically active and incorporate movement into your daily routine.
Skipping routine health check-ups- Don’t neglect regular check-ups with your healthcare provider, especially, if you have pre-existing risk factors for heart disease. Routine screening and check-ups can help monitor your heart health and detect any potential issues early on.
Q: Your message to our readers on enjoying a heart healthy festival season?
A: By following the above Do’s and Don’ts, you can enjoy the festive season while prioritising your heart health and reducing the risk of heart disease.
