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Don't overeat, don't get drunk, don't smoke!

The Grinch who stole Christmas... but for a good reason

Desmond Allen

Monday, December 16, 2013    

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WITH the onset of the Christmas season, when overeating and physical inactivity is the order of the day, has come a stern warning from one of the Caribbean's leading experts in medical biochemistry and diabetology: Watch out for heart disease!

Dr Dalip Ragoobirsingh, director of the Diabetes Education Programme at the University of the West Indies, (UWI) Mona, whose knowledge on diabetes and heart disease is sought after in many countries, recently facilitated a workshop on the topic 'Cholesterol and Cardiac Diseases' organised by UWI's Faculty of Medical Sciences mainly for health care professionals.

The workshop recognised that heart disease is one of the leading causes of death in Jamaica and the Caribbean and was held as part of the 22nd Annual Medical Conference and Workshop entitled 'Affairs of the Heart'.

If Dr Ragoobirsingh assumed the role of the Grinch who stole Christmas, it was for a good reason. He cautioned against overindulgence resulting in the after-Christmas excess weight gain and provided some suggestions for prevention as well as treatment of fat-related heart disorders.

People with high blood fats (hypercholesterolemia), as well as those desirous of preventing it, are best treated initially by lifestyle changes, including diet. He encouraged them to have smaller meals, with increased amounts (two servings daily) of fruits and vegetables regularly — rather than eating a large meal at each sitting.

"One of our other problems is also the quality of our foods. It is recommended that we reduce fried and fatty foods as well as fast foods. Use less thick gravy and sauces than usual. Reduce, if not remove high sodium seasoning salts which can be replaced with natural seasonings such as onion, escallion, garlic, and celery, among others," he advised.

"Have more chicken and fish and use lean meat cuts, if you must. These are best baked, steamed, grilled, and roasted. Having the other preparations such as curry, fricassee occasionally. We are encouraged to make a concerted effort to remove saturated fats from our meals," said Ragoobirsingh, noting that international clinical studies had shown that reduction in dietary fats improves heart health by removal of the plaque already deposited.

He stressed the need for low-impact exercises, such as walking, cycling, and swimming, for 20 to 30 minutes at least four times weekly, saying it was to help decrease body weight, blood sugar, blood cholesterol, blood pressure and, eventually, the amount of medication required, for thosee already being treated for any chronic disease.

Reduce consumption of alcohol, he suggested, recommending a daily glass of wine, preferably red, which had been shown to give a measure of protection to the heart and blood vessels. "But avoid drunkenness at all cost," the doctor urged.

For smokers, he strongly advised immediate cessation of cigarette smoking.

If the desired levels of cholesterol are still unattainable then the introduction of drug therapy is necessary on doctor's orders.

Turning to the professionals at the workshop, Dr Ragoobirsingh said that 75 per cent of the cholesterol (fats) used by the body was produced internally. The remaining 25 per cent was derived from the diet.

"These fats are better transported in the blood wrapped in a special protein (apoprotein) producing the different lipoproteins which include the low-density lipoproteins (LDL) that are the bad fats and the high density lipoproteins (HDL) or good fats. It would be very useful to do an annual blood check on these since it will inform us of our risk for heart attacks, strokes and high blood pressure, which are among the leading causes of death in Jamaica and the world over.

It was important to note, he said, that high blood pressure or hypertension was often referred to as the silent killer, "so it would suit each of us to find some way of detecting this villain early".

"Low plasma HDL or increased LDL could result in hardening of the arteries (atherosclerosis). It has been established that once the LDL level exceeds a critical concentration it damages the lining of the vessels with higher blood pressure, including the coronary arteries of the heart. This is made worse by other synergistic factors, such as hypertension and hormonal abnormalities including diabetes mellitus. The partial or total occlusion of the coronaries results in a reduced supply of nutrients and oxygen to the heart resulting in chest pains (angina) and eventually a heart attack (myocardial infarction)," he said.

"Similar changes can occur in the vessels feeding the kidneys, leading in time to increased blood pressure. Persistent, untreated hypertension has similar effects to a weightlifter bench-pressing a weight above his or her bodyweight. This leads to swelling of the heart muscles (cardiomegaly). This, too, can also result in a myocardial infarction.

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