September is annually dedicated to “healthy hearts” in honour of World Heart Day, which is celebrated on 29 September.
The purpose of these efforts is to raise awareness of heart disease and what can be done to prevent or treat it. In a country like South Africa where “heart disease and strokes are the second biggest killer”, thinking about and doing something about your heart health and lifestyle is vital for good health and a long life.
But are we as members of the public aware of where we can get help? And do trained health professionals know how to utilise the skills and training of their colleagues to achieve maximum benefits for their patients? I think not.
Working in little boxes
I am often frustrated by our tendency to live and work in in “little boxes” without ever seeing the bigger picture. If you are a medical doctor you probably only think in terms of treating the symptoms of heart disease with medication – and prescribe statins and antihypertensives for your heart and stroke patients.
A recent article published on the Medscape Website entitled “Imagine our World if We Taught it How to Eat”, by Dr Walton-Shirley, underlined the tendency of each health discipline only to search for and provide solutions in terms of their own training.
Walton-Shirley was discussing what she had learned at the European Society of Cardiology (ESC) 2015 Congress, at a session on “What should you eat to live a heart-healthy life?”. This life-changing session, according to Walton-Shirley, set out to teach ESC members how to save the world with the help of nutrition.
As a dietician, my colleagues and I have been trying to do just that for a very long time!
The Danish Miracle
One of the speakers at this important session of the ESC meeting was Dr Steen Stender who helped to get trans-fats banned at levels exceeding 2% in any food sold in Denmark, and the results are close to miraculous. Between 1985 and 2009, the mortality rate due to cardiovascular disease fell by 70% among the Danish population. It seems that the ban on trans-fats achieved its desired outcome.
The Mediterranean Diet
Walton-Shirley, who is a proponent of the Mediterranean diet, and teaches her cardiovascular, metabolic syndrome and obesity patients how to use this diet, also reported on the courageous statements made by Dr Simon Poole who emphasised that providing coronary artery disease patients with dietary advice is just as, if not more important, than putting stents into their blocked blood vessels.
Dr Poole is a GP practising in Cambridge, an author and broadcaster who is dedicated to making the Mediterranean Diet known in the UK. He was backed up by Dr Aseem Malhotra of the Frimley Health NHS Foundation, Camberley, UK, who said that after an MI (myocardial infarction), a high-fat Mediterranean Diet “is more effective than aspirin, statins, and coronary stents”.
a) Challenging Doctors
Inspired by the session on “What should you eat to live a heart-healthy life?” at the ESC Congress, Dr Walton-Shirley challenges her medical colleagues as follows:
- to take the importance of nutrition in relation to heart disease into their examination rooms and to provide each one of their cardiovascular (and stroke) patients with information on the Mediterranean Diet (or the DASH Diet for hypertension/strokes)
- to tackle their political representative to propose, champion and enact legislation that produces safe and health food (e.g. the trans-fat legislation that changed the Danish health statistics so drastically)
In South Africa legislation to limit exposure to trans-fats and salt is already enacted, but I doubt that our harassed medical doctors spend much time explaining the advantages of either the Mediterranean or the DASH Diets to their cardiovascular and/or stroke or hypertension patients.
An alternative is of course to refer such patients to the nearest registered dietician in their area. While it is encouraging how many cardiologists are already working together with registered dieticians in South Africa, the inclusion of dieticians in cardiovascular teams is an aspect of heart and blood pressure care that deserves to be utilised more widely by medical doctors and clinics.
b) Challenging Patients
ADSA (Association for Dietetics in SA) in cooperation with the Heart and Stroke Foundation SA (HSFSA) really care about the heart health of the South African population.
They invite you to contact them if you need help with a heart healthy diet. So please visit their Websites (ADSA: and HSFSA: ) or phone ADSA Head Office at: (011) 061-5000 to find a dietician who will help you apply the Mediterranean or the DASH Diet so that we can all say: We have taught South Africa what to eat!
- (ADSA (2015). Heart Awareness Month. Internal Communication. 25 Aug 2015; HSFSA (2015). Join us this Heart Awareness Month ... , show you care!
- Walton-Shirley, M (2015). Imagine Our World if We Taught it how to Eat. Medscape. Sept 01, 2015.