g186 eating well

7/29/2019 G186 Eating Well

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Eating wellKeeping food fun andgood for your heart

50 YEARS Beating heart disease together


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The British Heart Foundationand healthy eating

There are lots of good reasons for you and your family

to eat healthily. A good diet, in combination with beingphysically active, is an important part of staying healthyand making sure that children grow well. It can helpyou to maintain a healthy body weight and also keepyour blood cholesterol levels and blood pressure down.So this means that, in the long term, it can also help toreduce the risk of coronary heart disease, strokes,

certain forms of cancer, and diabetes.Eating well

The British Heart Foundation (BHF) thinks that, as well as being goodfor you, eating healthily should be enjoyable too. If it s enjoyable, youremore likely to carry on eating healthily. Eating a wide variety of foodsmeans you wont get bored with your food, as youll be able to eat foodswith lots of dierent tastes and textures and maybe even try some new

foods too.

Eating healthily is great for all ages. Its a good idea to get younger familymembers in the habit early, but its never too late to start. Working oneating healthily as a family is a great challenge, and doing it togethermeans you can support each other to make changes that last, too.

The BHF wants to help you choose the best sorts of foods for you andyour family, and to be able to combine these into a balanced diet. This

booklet will give you all the information you need, as well as practicaltips and ideas for how you can put it all into practice.

Eating wellis for everyone who wants to look after their health, eatmore healthily and reduce their risk of heart disease. So whetheryoure eating at home or eating out, whether youre having a lazyday or youre on the run were here to help you make healthierfood choices and enjoy doing it!

This guide does not replace the advice your health professionals may give

you based on their knowledge of your condition.


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1Contents

ContentsWhat is heart disease? 2

What is healthy eating? 5

Feeding the family 29

How do I know what changesI need to make? 35

Making it happen! 39

Going shopping 45

Weight management overweight and underweight 53

What does a healthy diet look like? 59

Planning meals 65

Small changes add up! 75

Eating out 81

Keeping it going 84

Getting creative in the kitchen 86

How the British Heart Foundationcan help you 102

Index 107


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What is heart disease?

The most common form of heart diseaseamong adults is called coronary heartdisease. It happens when the coronaryarteries the arteries that bring oxygen-richblood to your heart muscle becomeblocked or narrowed because of a build-upof fatty deposits called atheroma.

Angina is the chest pain or discomfort thatcan occur when your heart does not getenough oxygen-rich blood because thecoronary arteries have become narrowed.

Angina can be brought on by physicalactivity or emotional stress, or it cansometimes happen when you are resting.

If a piece of atheroma breaks o, it maycause a blood clot to form. This blood clot

may block the coronary artery, causing partof the heart to be starved of oxygen-richblood and may become permanentlydamaged. This is a heart attack.


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3What is heart disease?

What increases the riskof heart disease?

Coronary heart disease is more likely to happen if youhave certain risk factors. (A risk factor is something thatincreases the likelihood of getting a disease.) The mainrisk factors for coronary heart disease are:

smoking

high blood pressure

high blood cholesterol

being physically inactive

age

ethnic background

being overweight/obese

diabetes, and having a family history of coronary heart disease.

Why is eating well important?

Healthy eating can help to reduce your risk ofdeveloping coronary heart disease. If you already have

heart disease it can help to protect your heart fromfurther problems.

Healthy eating has many other health benets too. Itcan help you to maintain a healthy weight and reduceyour risk of diabetes, high blood pressure, and highcholesterol. It can also help reduce the risk ofdeveloping some cancers.


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The Eatwell plate appears courtesy of the Food Standards Agency. Crown copyright material isreproduced with the permission of the Controller of HMSO and Queens Printer for Scotland.

The eatwell plate shows how much of what you eat should comefrom each food group. This includes everything you eat during the

day, including snacks.

So, try to eat:

plenty of fruit and vegetables

plenty of bread, rice, potatoes, pasta and other starchy foods choose wholegrain varieties whenever you can

some milk and dairy foods

some meat, sh, eggs, beans and other non-dairy sources of protein

just a small amount of foods and drinks high in fat and/or sugar

Look at the eatwell plate to see how much of your food should comefrom each food group. You dont need to get the balance right at everymeal. But try to get it right over time such as a whole day or week.

Try to choose options that are lower in fat, salt and sugar

when you can.

Fruit andvegetables

Bread, rice,potatoes, pastaand other starchy foods

Meat, sh,eggs, beansand other non-dairysources of protein

Milk anddairy foods

Food and drinks highin fat and/or sugar


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5What is healthy eating?

What is healthy eating?

There are no single foods or one size tsall menus that you need to follow to eathealthily. All foods can be included in ahealthy diet. You just need to make sureyou get the right balance.

The best way to understand it is tothink of foods in food groups. We needlots of foods from some food groups,and less foods from other groups. Theeatwell plate above shows how to balance

the dierent food groups to make upa healthy diet.


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Despite what many people think, healthyeating really isnt about excluding foods.

Its about eating a wide variety of foods, butjust eating them in the right proportions.

A lot of people say healthy eating is abouteating everything in moderation, but thisisnt strictly true. We need to eat more of

some things and less of others.

So how much should we be eating ofthe dierent food groups each dayand why?


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Fruit and vegetables

Its important to eat fruit and vegetables, because

there is evidence that people who eat more than veportions of fruit and vegetables a day have a lower riskof developing heart disease. The reasons why still needto be researched.

What we do know is that they contain bre and avariety of vitamins and minerals which make them an

important part of a healthy diet. Eating more of themalso means there is less room in your diet for otherfoods high in saturated fats, salt and sugar. The brethey contain also makes them lling to eat and helpskeep our digestive system healthy.

About a third of the food we eat should be made up offruit and vegetables. Aim to have at least ve portionsof fruit and vegetables each day. Also, try to eat a varietyof dierent types of fruit and vegetables, so that you canbenet from all the dierent nutrients they can oer.

There are ve ways to get your ve a day theycan be fresh, frozen, tinned (in juice or water),dried or juiced.

Juice only counts as one portion a day. Pulses like kidneybeans, chick peas and haricot beans can also be includedin your ve a day, but only as one portion a day, howevermuch you eat.

Taking dietary supplements doesnt seem to have thesame health benets as eating fruits and vegetables.


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How much is a portion?

An adult portion is 80g (about 3oz) of fresh, frozen ortinned fruit or vegetables, 30g if it is dried or 150ml ifyou are having juice. Some examples of one portionare given in the box below. Or, a good guide is thata portion is about a handful.

Children should also have ve portions of fruit andvegetables a day, but the portion size should beadjusted to the child. The handful measurement workswell for children too. Use your childs handful as a guide

for the right portion for them. This means that as theygrow, so will their portion size. Its good to get childrenin the habit of having fruit and vegetables ve timesa day from an early age.

How much is one portion?

Fresh fruit Small fruits: 2 or more forexample, 2 plums, 2 satsumas,2-3 apricots, 7-8 strawberriesor 14 cherriesMedium fruit: 1 medium fruit for example, 1 apple, banana, pear,orange or nectarineLarge fruits for example, half a

grapefruit, 1 slice of papaya, 1 sliceof melon (2-inch slice), 1 large sliceof pineapple, or 2 slices of mango(2-inch slices)

Dried fruit 1 tablespoon of raisins, currants,sultanas or mixed fruit2 dried gs3 dried prunes


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Tinned or frozen fruit andvegetables

Roughly the same quantity of fruitor vegetables that you would eatas a fresh portion for example:

2 pear or peach halves8 segments of tinned grapefruit3 heaped tablespoons of carrots,peas or sweetcorn

JuicesOnly counts as oneportion a day

A glass (150ml) of 100% juice (pure,unsweetened fruit juice, orvegetable juice, or smoothie*).

Green vegetables 2 broccoli spears4 heaped tablespoons of cabbage,spring greens or green beans

Cooked vegetables 3 heaped tablespoons of cookedvegetables for example, carrots,peas or sweetcorn3-8 cauliower orets

Salad vegetables 2-inch piece of cucumber1 medium tomato7 cherry tomatoes

Pulses and beansOnly counts as oneportion a day

3 heaped tablespoons of bakedbeans, haricot beans, kidney beans,cannellini beans, butter beans orchick peas

*Smoothies can also be counted as two portions a day provideda portion contains 80g whole fruit and 150mls juice.


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Bread, rice, potatoes, pastaand other starchy foods

These are the foods you should base your meals

around. As well as bread, rice, potatoes and pasta, thisfood group includes chapattis, naan, yam, plantain andcous cous. Choose wholegrain or higher-breversions of these starchy foods whenever you can.

High bre foodsare important to keep your digestive system healthy.These foods also provide energy that is released slowly, so they willkeep you going until your next mealtime and make you less temptedto snack in between meals.

Foods high in soluble bre can help to absorb cholesterol whichcould help to reduce cholesterol levels. Good examples are porridge,beans, pulses, lentils and nuts.

Foods such as bread, rice and pasta often get a bad reputation forbeing fattening, but thats only really true if you add lots of fat to themwhile youre cooking or preparing them to eat. Bake, boil or steamstarchy foods, rather than frying them. And avoid adding fat once they

are cooked for example, dont add butter to mashed potatoes orchappatis, or creamy sauces to pasta or rice.

About a third of the food you eat needs to be made up of the

foods in this food group, and you should include some with each

meal. The exact quantity needed varies from person to person. Themore active you are, the more you will need to eat.

If I buy wholemeal bread, the kids wont eat it.

It can be dicult, but do persist. Try giving them wholegrainproducts in dierent ways, to get them used to the taste andtexture. Wholegrain cereals, pitta breads, wraps or rolls are allgood options. Or try half and half sandwiches with one sliceof white bread and one of wholegrain.


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Meat, sh, eggs, beans and othernon-dairy sources of protein

Its important to include meat, sh, eggs or vegetarian

alternatives in your diet, as these provide vitamins andminerals including iron, and also provide protein.So include these foods two or three times a day.

Both red and white meat can be included within a balanced diet, butchoose lean cuts, remove visible fat and skin, and cook them withoutadding fat wherever possible. If youre using minced meat, go for theextra lean version.

Its also important to have sh, especially oily sh. Oily sh provides arich source of omega-3, a type of polyunsaturated fat that can help tokeep your heart healthy and improve survival after a heart attack. Oilysh includes, for example, sardines, trout, pilchards, herring, fresh tunaand salmon. Aim to have one portion of oily sh a week oneportion = 140g/5oz. People who have had a heart attack will needto eat more oily sh than this. If you have had a heart attack, have twoto three portions of oily sh a week. If you have recently had a heartattack, and are unable to eat the recommended amount of oily sh, talkto your doctor about the possibility of taking omega-3 supplements.

If your family isnt keen on eating sh, try making baked sh cakes ora sh pie to gradually get them used to the taste and texture. Or try therecipe for potato salad with aked mackerel on page 99. Try to choose shthat has been sustainably caught and farmed. You can do this by checkingthe information on the packaging and on supermarket websites.

You can also get omega-3 from vegetable sources such as axseed oil

and rapeseed oil, from some nuts and seeds such as walnuts andaxseeds and from omega-3 enriched foods. However it is uncertainif eating these foods has the same heart benets as oily sh.


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Processed and convenience foods are foods that have been madeinto a product and then need very little preparation before eating for example, ready meals, sh ngers, sausages and pies. These foodsoften contain a lot of hidden fats and salt. Its ne to include these

foods in your diet from time to time. But generally try to cook mealsusing basic ingredients and if you do eat these foods, see page 47for more information on what to look for on labels.

If you or your family are vegetarian, or if you include vegetarian mealsas part of a varied diet, its important to include foods from this foodgroup such as beans, pulses and soya and not to rely too heavilyon dairy foods for your protein.

This will help to make sure you get enough iron and protein in yourdiet and also help to keep the saturated fat content down. Make sureyou choose a variety of foods from the wide range of beans, lentils,tofu, micoprotein like Quorn, and eggs and nuts.

Soya

Soya is a good source of protein and soluble bre which may help tolower your cholesterol. It also contains lots of vitamins and minerals

and is low in saturated fat, so if you eat soya as part of a healthybalanced diet, its likely to be good for your heart. Examples of soyainclude soya beans, soya milk, soya yogurt, tofu, and texturedvegetable (soya) protein.

How many eggs can you eat a week?

There is no recommended limit on how many eggs people

should eat. Eggs can be included in a healthy, balanced diet,but remember that its a good idea to eat as varied a diet aspossible and to use healthier cooking methods when you dohave eggs. Boil or poach them rather than frying and avoidadding butter to scrambled eggs. Try to eat a variety of foodseach week to get the wide range of nutrients you need.


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Foods and drinks highin fat and/or sugar

The smallest section on the eatwell plate on page 4

but needing a big mention are the foods and drinkshigh in fat and/or sugar. This group includes things likecakes, crisps, sweets, chocolate, and sugary, zzy drinks.These tend to be the items we need to cut down on, ormake changes to, in order to eat more healthily. Whilethey are nice to eat and can be included within abalanced diet, they are not essential, everyday foods.

Aim to have only small amounts of these foods.


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You can use food labels to guide you to healthierversions of these foods or healthier alternatives (seepage 47). Also, remember that, if you have more of

these foods on certain days of the week or for specialoccasions, you should try to balance this by avoidingthem altogether on other days.

This food group includes not only the foods that arehigh in fat and sugar, but also the fats and sugars thatwe add to food ourselves. This means the oils and fats

we use in cooking, spreads and butter that we use forspreading or baking, as well as the sugar, syrup, treacleand honey that we add to some foods and drinks. Try tokeep down the amount of fats you add by using only athin spread on breads and toast, and by measuring oilwith a spoon or using spray oil.

Barriers to healthy eating

The biscuits I like are often on special oer, so its

cheaper to buy three packets than to buy them singly.

This is often the case but, if you dont need three packets,it can mean you end up eating more than you had planned.Think about splitting the oer with a friend so that you benetfrom the cost saving, but dont end up eating three times theamount of biscuits. Or even better, try looking for alternative

snacks that are lower in fat, and sugar.


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Fats explained

As well as keeping an eye on the total amount offat you eat, choosing the right type of fat is alsoimportant for heart health. We explain more about

the dierent types of fats below. Keep to a minimumthe amount of saturated fat you have, by avoiding fatslike butter, lard, ghee and dripping. Instead, chooseunsaturated fats like olive, rapeseed, sunower, cornand soya oils and spreads.

All fats and oils are high in calories, so they should beused only in small amounts. However, its also importantto know about the dierent types of fats and whichfoods they are found in.

Saturated fats Avoid these wherever possible.

Saturated fats are found in high amounts in fats like butter, lard, ghee,palm oil, coconut oil and dripping. Saturated fat can increase total

cholesterol and the harmful LDL cholesterol. (LDL cholesterol increasesthe risk of fatty deposits developing in your arteries.)

Monounsaturated fats Have these in small amounts.

The main sources of these fats in the diet are olive oil and rapeseed oiland spreads made from these oils, as well as meat, and some nuts andseeds. Monounsaturated fats can help to lower the LDL cholesterol level.

Polyunsaturated fats Have these in small amounts.

Polyunsaturated fats are found, for example, in soya, sunower andcorn oil and spreads, as well as in nuts and seeds and in oily sh. Theyare an important part of the diet, as they provide essential fatty acids.Omega-3fats found in oily sh are a particular type of polyunsaturatedfat that can help protect heart health. Try and have at least one portionof oily sh a week. Or, if you have had a heart attack, have two to threeportions a week.


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Trans fats Avoid these wherever possible.

Trans fats occur naturally in small amounts in dairy foods and meat,but industrially produced trans fats are produced when oils areprocessed into a solid fat through the hydrogenation process. The

trans fats formed in this way have a dierent eect on the body to theoriginal liquid oils and instead have a similar eect to saturated fats.These fats are most likely to be found in foods like biscuits, cakes,pastries and deep fried foods but the good news is that many foodmanufacturers now remove trans fats from the fats and oils they use.

Cholesterol in foods

There is some cholesterol in certain foods for example eggs or

prawns. However, eating these foods does not usually contribute toyour own blood cholesterol level. It is more important to reduce yoursaturated fat. For more information about cholesterol please see ourbooklet, Reducing your blood cholesterol.

What about foods with added plant stanols and sterols?

Plant stanols and sterols are substances that are added to some

foods, including spreads, soft cheeses and yoghurts. Plant stanolsand sterols are not routinely recommended, but there is evidencethat consistently eating 2g of plant sterols and stanols a day canhelp reduce cholesterol. Research studies have suggested thathaving this amount on a regular basis could reduce LDLcholesterol levels by 10% to 15%, but the eect varies betweenindividuals. (LDL cholesterol is the harmful type of cholesterol.See the page above.)

However, its important to remember that plant stanols andsterols are not a substitute for a healthy diet, and are not areplacement for cholesterol-lowering drugs. If you decide to usethese products, follow the manufacturers instructions on howmuch of the food you need to have each day in order to get 2gof the plant stanol or sterol.

Plant stanols and sterols are not recommended for childrenunder ve, or for breastfeeding or pregnant women.


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Flavouring food Salt

Eating too much salt can increase the risk of developinghigh blood pressure, but it can be a dicult habit tobreak because we get used to a certain amount of salt

in our food.The recommended maximum amount of salt foradults is 6 grams a day about a teaspoon but atthe moment adults in the UK, on average, have morethan that. All types of salt count including sea salt,akes and crystals. Its also important for children to cut

down on salt, to help prevent them becoming used toa high-salt diet from an early age. If they dont getused to salty foods when they are young, they aremore likely to carry on a preference for less saltyfoods into adulthood.

But its not just about the salt that you add to your food

yourself. You may be surprised to know that most ofthe salt we eat comes from processed foods. Foodshigh in salt include soups, sauces, cheese, savourysnacks, biscuits, ready meals and fast foods. There canalso be a lot of salt in everyday foods like bread andbreakfast cereals.

Although salt levels in foods in the UK have been gettinglower, were still eating too much salt, so make sure youcheck the food labels to see how much salt is in theproducts you are buying and go for the ones with theleast salt in them. (See Salt labelling on the page below.)


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It is the sodium in salt that contributes to highblood pressure, so some food labels give guresfor sodium rather than salt.

To convert sodium into salt you need to multiplyby 2.5. For example, 0.5g sodium = 1.25g salt.

Recommended maximum amounts of

salt per day for adults and children

Salt Sodium

Adults Men and women 6g 2.5g

Children

11 years and over 6g 2.5g7-10 years 5g 2.0g

4-6 years 3g 1.2g

1-3 years 2g 0.8g

Salt labelling high and low salt

To nd out if a particular food is low, medium or highin salt, nd the per 100g gure for salt or sodium onthe nutrition information panel on the food packaging,and compare it with the gures below.

Low

A healthier

choice

Medium

OK most of the

time

High

Just

occasionally

Salt 0.3g or less per100g

0.31g to 1.5gper 100g

More than 1.5gper 100g

Sodium 0.1g or less per100g

0.11g to 0.6gper 100g

More than 0.6gper 100g

What is healthy eating?


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Variety is the spice

Instead of automatically reaching for the salt, why not

think of other ways to pack avour into your food?Fresh herbs add both colour and avour, while driedherbs and spices are convenient to keep in the storecupboard to add avour when you need to. Dontforget to use other avourings too like lemon, garlic,ginger, chilli or a grind of black pepper.

Avoid ready-made mixed seasonings, as many ofthese include a lot of salt.


Food has no avour if you take the salt out of it.

Should I use a reduced-salt alternative?

Replacing table salt with a reduced-salt alternative will reducethe amount of sodium you consume (although these

products do still contain some sodium), but as it still tastessalty, it wont help you to adjust to a less salty taste. Reducethe amount of salt you use gradually, to give your taste budstime to adjust. And try using herbs, spices or lemon juice toavour your food instead of salt.

Reduced-salt alternatives are not suitable for some people for example, people with kidney problems or heart failure so check with your doctor before using these products.

Drinks


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Drinks

Its also important to think about what you drink.Keeping hydrated is an important part of keepinghealthy, so you need to have regular drinks.

The amount of uid you need each day will vary.If you do more activity than usual, or if you have atemperature, or if its a hot day, you will need to drinkmore. We get some of our uid from the food we eat,but we need to drink some too.

As a guide, we need about 6 to 8 drinks a day.


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Cold drinks

Water is a good choice, but you can include othernon-alcoholic drinks as part of your uid intake. Pure

unsweetened fruit juices are nutritious options andcount as one of your ve portions of fruits andvegetables. If you have these juices, its better toinclude them as part of a meal rather than as a drinkto quench your thirst throughout the day.

Although pure fruit juices are nutritious, they are quite

acidic so its better for your teeth if you have them aspart of a meal. Try to avoid zzy drinks that containa lot of sugar and therefore energy (calories), andchoose sugar-free alternatives instead. Again, becausethese drinks are acidic, it is best to have them only atmealtimes, to help protect your teeth.

Tea and coee

You can include a moderate amount of tea and coeewithin your uid intake but its important that this isntyour only source of uid. This is because there arecompounds in these drinks that can bind with iron in thefood you eat, making it harder for your body to absorbthe nutrient. So try not to drink tea or coee with meals.

This is particularly important for people who arevegetarian and for children, especially young children.If youre pregnant, its important not to have too muchcaeine. Pregnant women should have no more than200mg of caeine a day. A mug of instant coee contains100mg of caeine, and a mug of tea contains 75mg.

Alcohol


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Alcohol

If you drink alcohol, it is important to keep within thesensible limits whether you drink every day, once ortwice a week, or just occasionally.

Men should not regularly drink more than3 to 4 units of alcohol a day.

Women should not regularly drink more than2 to 3 units of alcohol a day.

1 unit of alcohol =a small glass (100ml) of wine (10% ABV [alcoholby volume])orhalf a pint (about 300ml) of normal-strength lager,cider or beer (for example, 3.5% ABV)ora pub measure (25ml) of spirits

There may be some benets to heart health frommoderate drinking (1 or 2 units a day). But this is nota reason to start drinking alcohol if you dont already.There are healthier ways to protect your heart. Drinking

more than the sensible limits can be harmful it canlead to muscle damage, high blood pressure, strokeand some cancers.

Its also important to remember that alcohol has quite ahigh energy (calorie) content and so this can be a factorif youre trying to manage your weight.


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How to nd out how many unitsof alcohol there are in a drink?

Some drink bottles and cans now state how many unitsof alcohol are in the drink. Or, to work out how manyunits of alcohol there are in a drink, just multiply thevolume in millilitres by the ABV (alcohol by volume)gure and divide by 1,000.

Example: For a 300ml can of beer of 5% ABV:

300 x 5 1,000 = 1.5 units of alcohol

How many units are there in a glass of wine?

A standard small glass of wine in a pub is 175ml and alarge glass is 250ml. So, a 175ml glass of a 12% ABVwine will contain 2 units of alcohol and a 250ml glasswill contain 3 units. The ABV varies between dierent

wines check the label on the bottle.


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Because my parents are French, wed

always have salad at mealtimes, andI like my greens. Having kids reallyhelps to focus your mind on eatingwell too. Were lucky because,although my children are pickyeaters, they dont like fat or cream

and dont even put salt on their food.Not that were perfect far from it.

When were very busy we sometimesfall back on ready meals, but aftera few days it really makes you wanthealthy, home-cooked food. Trygrowing your own veg if you can they taste better and it gives youa real sense of satisfaction.


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Feeding the family

Healthy eating is suitable for the whole

family. But as well as thinking about whatwe eat, its also important to think abouthow we eat. Families are changing andour lives are getting busier, and this hasundoubtedly had an impact on our

eating habits.

Feeding the family

Having regular meals


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g g

Try to make sure that you and your family especiallygrowing children have a regular meal pattern. Havingthree meals a day, with nutritious snacks in between if

required, is important to make sure they (and you) getthe variety and amount of food needed to have abalanced, nutritious diet.

Its also important not to go for long periods betweenmeals, to make sure that you dont get too hungry.This can help you to avoid over-eating when you have

your next meal, or picking at unhealthy snacks inbetween meals.


We dont have time to eat breakfast in the morning.

Breakfast doesnt have to be at home! Take a bowl and a boxof cereal to keep on your desk at work for when you get in.

If you nd it dicult to eat in the morning, try having just apiece of fruit or a yoghurt to start with. Or try the recipe fora banana breakfast smoothie on page 88.

Once you get used to eating something in the morning, youcan build it up to make a more balanced breakfast. If you havechildren, their school might have a breakfast club that theymight enjoy, especially if they dont like eating rst thing inthe morning.


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Healthy eating for the under-ves

Children under ve have slightly dierent dietaryrequirements to older children. They need a lot ofenergy (calories) relative to their size and they havesmall stomachs which means that they cant eat a lotof food in one go. As a result, young children need toeat more fat in order to meet their energy needs, andthey should have nutritious snacks to supplement theirmain meals.

A pattern of oering three meals and three to foursnacks a day is about right, but remember that theirappetite will vary from day to day. It may be better togive them a smaller portion and let them have moreif they want it, rather than giving them a large portionthat they are overwhelmed by before they have even

started to eat.

Feeding the family


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Feeding the family 33

Eating a diet thats slightly higher in fat doesnt meanthat toddlers should have lots of cakes, crisps andbiscuits. The early years are a time when children are

learning about eating norms and are developing eatingpatterns, so its important to establish good eatinghabits early on.

Like older children and adults, toddlers can quicklydevelop a preference for sugary, salty and fatty foods,and while it is ne to have these foods every now andthen, childrens energy (calories) should come from avariety of sources which not only provide energy andprotein, but which will also give them vitamins andminerals, making the most of every eating opportunity.

While for older children and adults we recommendlow-fat versions of milk and dairy products, its a goodidea to keep young children on full-fat milk as a main

drink until the age of two. After that, and if they aregrowing well, they can start having semi-skimmed milk.However, dont start giving them skimmed milk or 1%milk until they are ve.

As children move from being toddlers to school-agedchildren, the fat content of the diet can be gradually

reduced so that, by the age of ve, children are eatinga mixed and varied diet that includes low-fat dairyproducts and lean meats as the norm.


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How do I know what changes I need to make? 35

How do I know what changesI need to make?

People tend to under-report what theyare eating and over-estimate the amountof physical activity they do. So people canoften think they are already eating foodsin the right proportions for a healthy diet

when really theyre not.

Try lling out a food diary for a fewdays and you might be surprised! Seepage 37.

Keeping a food diary isf l f th


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useful for three reasons It can help to show you which changes to your diet

are likely to be most useful to you.

It can show you patterns in your eating that you maynot have noticed before.

You can use it to monitor whether you have achievedyour healthy eating goals. (See pages 40-43.)

Its very easy to keep a food diary. For a few days or a

week, just write down everything you eat and drinkthroughout the day. Keep a food diary like the onebelow in a notebook that you can carry around withyou, so you dont forget to write things down. You canuse the information on pages 9-17 to nd out whichfood groups your food comes from.

Check to make sure that you are having foods from therst four food groups every day and that you are havingthe right number of portions. And keep an eye on theamount of food and drinks high in fat and sugar thatyou are having. See pages 16 and 17.

Use the information you get from your food diaryto help you to work out which areas you mightneed to work on.

Fill i f d di


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37

Fill in your food diary

Day and

Time

What I ate or drank

Include how much

(for example, 1 cup,1 teaspoon, 2 slices)

Food groups

Fruitandveg

Starchyfoods

Meat,sh,eggsand

vegetarianalternatives

Milkanddairyfoods

Foodshighinfatand

sugar

How do I know what changes I need to make?


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M ki it h !


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39

Making it happen!

Sometimes, even if you have a key

motivating factor for eating more healthily such as losing weight, or preventing heartdisease, or managing a heart condition it can be dicult to stick to the changesyou want to make.

When youre trying to make any changesto your eating habits, you might nd ithelpful to set yourself some goals.

Making it happen!

Setting goals

O d k h i b ll


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Once you are ready to make a change, it can be reallyhelpful to set yourself goals, as they help you to focuson making realistic changes that will make a dierence

to your lifestyle. If you set your own goals, they willbe personal to you which means that youre morelikely to achieve them.

When setting your goals make


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41

When setting your goals, makesure they are S.M.A.R.T

SpecicBe clear about the change you are making. Instead of saying Ourfamily is going to eat more healthily, think about exactly how that willhappen. For example, do you need to eat more fruit and vegetables, ormake sure everyone eats breakfast, or perhaps change the foods youhave as snacks?

MeasurableBe able to measure your success. How many portions of fruit andvegetables are you going to eat? Or, on how many days will you eatbreakfast? By making your goal measurable, you will be able to checkwhether you have been successful in making the change.

AchievableBe realistic about the changes you plan to make. Youre more likelyto succeed if you make small, gradual changes rather than trying todo everything at once. Envisage your end goal and break it up into

small, achievable steps that you can work towards until you reachyour nal goal.

RelevantSetting goals to change things that dont really need changing wonthelp you. For example, if you already eat 5 or more portions of fruitand vegetables a day, theres no need to set a goal for this.

Time-specicMake your goals time-specic. Specify when or how often you willmake the change for example, every day, or every weekday morning,or twice a week, and when you will have achieved it by. This will makeit easier for you to work out if you have achieved your goal.

Making it happen!

Test yourself

Whi h f h f ll i h S M A R T l ?


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Which of the following are the S.M.A.R.T goals?

Question 1

A I will never eat chocolate again.B I will only eat a fun-size chocolate bar after my

evening meal twice a week.

C I will eat less chocolate.

Question 2

A I will eat ten dierent fruits and ten dierentvegetables every day (including weekends)from now on.

B I will eat an apple instead of a pear after myevening meal.

C I will swap my biscuits in the morning for a

piece of fruit on weekdays.

Question 3

A I will draw up a list of healthy snacks with thekids this week so we can agree what to buynext week.

B I will make the kids eat healthily this week.

C I will give the kids carrot sticks in place of allother snacks from now on.

Answers


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Making it happen! 43

1 = BA is unlikely to be achievable C is not measurable

or time-specic.2 = CA is unlikely to be achievable every day B is nota relevant change.

3 = AB is not measurable. C is probably unachievable

and unrealistic.

Write your rst S.M.A.R.T goals hereJust set yourself one or two goals to start with. Once you haveachieved these, you can set yourself some more goals. If you needhelp with setting your goals, ask your practice nurse for advice.

1.

2.


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Going shopping


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45

Going shopping

A trip to the shops to buy food should

be simple, but how often have you goneto buy one item, only to return with abasketful of food? Or how often have yougone shopping without a list and comeout with a range of foods which its then

dicult to make meals from?

Going shopping

Next time you go shopping,try these tips to help you.


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y p p y

1. Always take a list

Work out what you need and when you are going touse it. Doing this before you go shopping will help tomake sure you have all the ingredients you need tomake the healthy meals youve planned. It could alsohave a cost benet. If you only buy what you need,theres likely to be less going to waste.

2. Never go shopping when youre hungry

Its an old tip, but a good one. Its much more dicultto avoid temptation if youre hungry. Go to the shopsafter a meal, or have a healthy snack like a piece of fruitbefore you go. Youll nd it much easier to buy justthe foods you had planned to buy.

3. When is a bargain not a bargain?

We all love to save money, but if the special oers areon foods that are high in fat, saturated fat, salt or sugar,you need to ask yourself whether you really need them.

Just because they are cheaper doesnt mean youneed to put them in your trolley. With oers like buyone, get one free or three for two, it also means thatyou might end up with large amounts of less healthyfoods in your cupboards. And if theyre there, youremore likely to eat them.

Be a food detective!


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47

There is a lot of information on food packets that wecan use to inform our choices, but often we dont use it.

Get to grips with front-of-pack food labels, to help youto compare products and make healthier choices.

Food labelling

Use food labels to give you the inside information onthe food you are buying. There are several dierenttypes of labels.

Most foods have a nutrition information panel like theone on page 48, either on the back or side of the pack.Find the per 100g gures, and compare them with thelow, medium and high gures shown in the box below.

For example, this food contains 0.4g of saturated fat per100g, so it is low in saturated fat and a healthy choice.

All measures

per 100g

LowA healthier choice

MediumOK most of the time

HighJust occasionally

Sugars 5g or less 5.1g - 15g More than 15g

Fat 3g or less 3.1g - 20g More than 20g

Saturates 1.5g or less 1.6g - 5g More than 5g

Salt 0.30g or less 0.31g - 1.5g More than 1.5g

Going shopping


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But to make it easier for people to make healthy choices,many manufacturers and retailers now provide at a


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49

many manufacturers and retailers now provide at aglance nutritional information on the front of packs.

Trac-light coloured labelsshow you if a food has high(red), medium (amber), or low (green) amounts of fat,saturated fat, sugars and salt in 100g of the food.

Some labels show how much a particular food contributes

towards your guideline daily amounts (GDAs) for key nutrients.

The guideline daily amounts for the most important nutrients listed onthe food labels are shown in the box below. For example, a serving ofthis food contains 8% of the guideline daily amount for calories, and7% of the guideline daily amount for total fat.

Guideline daily amounts

Men Women(also used as general

adult GDA gures

on packaging)

Children(aged 5-10 years)

Calories 2,500kcal 2,000kcal 1,800kcalTotal fat 95g 70g 70g

Saturates 30g 20g 20g

Salt 6g 6g 4g

Sugar 120g 90g 85g

For example, you can use this table to nd out if you are having toomuch fat in your diet. If a ready meal contains 50g of fat and you are awoman, this is more than half of your recommended daily fat intake.

Research has shown that consumers nd a labelling model thatcombines trac-light colours, GDAs and the words high, mediumand low the clearest and simplest way to understand nutritionalinformation about the food they buy. See our booklet Guide to foodlabelling for more information.

Going shopping


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Overcoming pester power


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51Going shopping

If you have children and you take them to thesupermarket with you when you do the shopping,

you may nd that they often pester you to buy certainfoods. The following ideas may help you havea stress-free shop.

Get your children involved by letting them help youwrite the shopping list. Give them some choicesabout what goes on it. For example, let them decide

what fruit to buy for their lunchboxes. Listen to them when they ask for certain foods, rather

than immediately saying No. Sympathise, but thenexplain why they cant have it.

When you say No, mean it! If your children think youmight change your mind, theyll carry on asking.

If you have older children, relieve the boredom offood shopping by giving them items from the list togo and get from dierent aisles. It will speed up thewhole shopping trip too.

Try to go to shops that dont have sweets on thecheckout. If you were a child, would you be able to

resist the temptation?


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I was very frightened when I foundout I had to have a heart bypass. Itnever occurred to me I was at risk,even though I weighed 15 stone,smoked and didnt exercise. The

fear made me turn my lifestylearound overnight, but it wasnt easyat rst, especially changing my diet.I had to learn to love a dierentkind of food.

I feel much better now, and allow

myself occasional treats, but Imalways careful to check theingredients on food labels. We oweit to ourselves and our kids toeat healthily. I did it, and so can you!

Weight management


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Weight management overweight and underweight 53

overweight and underweight

It can be dicult for people to achieveand maintain a healthy weight for avariety of reasons. Some people nd itdicult to put on enough weight, whileothers struggle to keep the weight o.

But whether you are trying to lose or gainweight, its important not to forget thebasics of healthy eating in the process.

Keeping to a healthy weight will help tokeep your heart healthy and will also helpwith many of the risk factors for heartdisease (see page 3).

Are you a healthy weight?

Use the chart below to nd out if you are a healthyweight Take a straight line up or down from your weight


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weight. Take a straight line up or down from your weight,and a line across from your height (without shoes). Put

a mark where the two lines meet to nd out if you needto lose weight. This is only an approximate guide.

.

.

.

.

..

.

.

.

.

.

.

.

.

.

..

.

.

.

.

.

.

.

.

.

.

.

.

.

+

+

Heightinfee

tandinches

Weight in Kilograms

Weight in Stones

Heightinmetres

Adapted from height/weight chart by kind permission of the Food Standards Agency

Unde

rweigh

t

Ideal

Overw

eigh

t

Ob

ese

Does body shape matter too?


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55Weight management overweight and underweight

People who carry too much weight around their middlehave a greater risk of developing heart problems, high

blood pressure and diabetes. Measure your waist tond out if you are at a higher risk of health problems:

Your health is at riskif you have a waistmeasurement of:

Your health is at high riskif you have a waistmeasurement of:

Men over 94 centimetres

(about 37 inches)

over 102 centimetres

(about 40 inches)

SouthAsianmen

over 90 centimetres(about 35.5 inches)

Women over 80 centimetres(about 31.5 inches)


SouthAsianwoman


For more information and how to measure your waist,see our booklet So you want to lose weight for good.

If your waist size puts you at risk or if you are

overweight, it is important to reduce, or preventany increase in, your waist size or weight. This willhelp to keep you healthy and protect your heart.

Trying to lose weight?

If you want to lose weight, your aim is to consume lessenergy (calories) than you use up, so that you have a


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energy (calories) than you use up, so that you have ashortfall of around 600kcal per day.

Make sure you have a regular eating pattern of threemeals a day, including breakfast.

Cut down on high-fat and high-sugar foods that areenergy-dense (high in calories), and eat more fruit,vegetables and salad.

Even if you already have a balanced diet, you can still

have too much of a good thing. Check that yourportion sizes havent crept up.

Get moving. Try to reduce the amount of time youspend in sitting-down activities like working on thecomputer or watching TV. Use the stairs where youcan, walk instead of using the bus or car for short

journeys, and think of active leisure activities thatyou might enjoy.

It can be tempting to go for a diet that oers a quick x,but gradual weight loss really is a better option. Thisway you are more likely to keep the weight o for good.

Aim to lose no more than 0.5kg to 1kg

(1 or 2 pounds) a week.For more information on losing weight, see ourbooklets So you want to lose weight for goodwhichincludes an eating plan that will help you to lose weightand make changes to your diet, or Take control of yourweightwhich is helpful if you have a lot of weight to lose

and want to know what options are available to you.

Trying to gain weight?

F l i i i ht b lif l


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57

For some people, gaining weight can be a life-longstruggle, but if you have lost weight suddenly or

unintentionally you should see your GP.If you want to increase your weight, you need to beconsuming more energy (calories) than you are using up.

Aim for a steady increase of 0.5kg to 1kg(1 to 2 pounds) a month.

To achieve this, you will need to increase the amount offood you eat and increase the energy (calorie) contentof your meals. The most ecient way to do this is byincreasing the amount of starchy carbohydrates andfat that you eat.

Make sure you have a regular meal pattern and eatthree meals a day, including breakfast.

Try slightly increasing the size of your portions. Havean extra slice of toast at breakfast, or another spoonof pasta, rice or potato with your evening meal.

Include more healthy fats in your diet. For example,use unsaturated spreads on bread and toast and insalad dressings, and snack on unsalted nuts and seeds.

Weight management overweight and underweight


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What does a healthy dietlook like?


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59

look like?

Healthy diets are diets that vary fromday to day and include a wide varietyof foods. To give you an idea of what ahealthy diet might look like, weve createdan example eating plan for a day.

What does a healthy diet look like?


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Healthy eating plan

Breakfast Wholegrain cereal with semi-skimmed milk


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Breakfast Wholegrain cereal with semi-skimmed milk 1 slice of toast with low-fat spread and jam

Small glass of orange juice

Mid-morning 3 dried apricots

Lunch Tuna and cucumber sandwich (using low-fatspread, on two slices of bread)Banana1 slice of malt loaf or scone (no spread)

Afternoon 2 rich tea biscuits

Dinner Lean minced beef/soya/Quorn chilli cookedwith a small amount of oil and tinnedtomatoes1 medium baked potatoBroccoli

CarrotsFresh fruit salad or tinned fruit in juiceLow-fat yoghurt

During theevening

Cup of low fat milky drink orsmall glass of wine

Through the day Water or sugar-free squash with mealsOne third of a pint of semi-skimmed milk

Children and weight

Were hearing more and more about our childrensweight and this is a real concern for parents these days.A hild d d l th i b d h


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As children grow and develop, their body shapeschange, so it can be dicult to tell if children are theright weight for their height.

If your child is overweight, or you are worried that theymight be, its a good idea to get some advice from atrained health professional. Talk to your practice nurseor health visitor. They may be able to give you advice orrefer you to a dietitian if necessary. Weight loss diets

designed for adults are not suitable for children, sogetting support from a health professional can helpyou to tackle this as a family.

Prevention is always better than cure, so get yourchildren on the right path from the start. Simpleideas to help keep your children at a healthy weight


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ideas to help keep your children at a healthy weight

Avoid zzy drinks. Oer water or sugar-freesquashes instead.

Always have fruit available as a snack in aneasy-to-reach place.

Dont give in to pester power at the supermarket,to avoid having tempting snacks at home later.

Try to make the journey to school as active aspossible by walking or using public transportrather than going by car.

Get children involved in active hobbies outsideschool. They dont have to be sports teams.Try any sort of activity clubs.

Be a good role model. Your child is more likelyto eat healthily if you do too!


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Planning meals

Knowing what you and your family are


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Planning meals 65

Knowing what you and your family are

going to eat is a great way to make surethat your diet is balanced and healthy,and it can save you money too!

To help you with your shopping, make ashopping list based on the meals you are

going to eat over the next few days orduring the week.

Weekly meal planner

Use the Weekly meal planner below to help makesure you get a variety of foods and meals throughoutthe week.


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the week.

Fruit and vegetablesEat at least ve portions a day.

Bread, rice, potatoes, pasta and other starchy foods

Basis of all your meals.

Milk and dairy foods

Drink and eat moderate amounts

Meat, sh, eggs, beans and other non-dairy sources of protein

Choose lower-fat versions. Grill or bake rather than fry.

Foods and drinks high in fat and/or sugar

Eat small amounts only.

Fluid

Have regular, sugar-free drinks.

Some ideas for balanced meals

Breakfast ideas Snack meal ideas Main meal ideas

Cereal and milkwith banana

Toast andorange juice

Low fat yoghurt

with muesli on top

Baked potato withtuna or beans anda salad

Tuna pasta andbroccoli

Poached eggs ontoast with glass oforange juice

Vegetable soup

Chicken or hamsalad sandwich

Spaghetti bologneseand salad

Baked chicken,potatoes andvegetables

Pasta with tomatoand mushroomsauce and a littlegrated reduced fatcheddar style cheese

Potato salad withaked mackerel

Day Breakfast Snack meal Main meal

Mon


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67

Tues

Wed

Thurs

Fri

Sat

Sun

Planning meals


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Sometimes it can be dicult to plan ahead, so its agood idea to have some healthy meals tucked away inyour freezer by making extra portions of soups, stews

d hl t f f th d


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Planning meals 69

or dahl to freeze for another day.

Make the most of your store cupboards by keepingtins of low-sugar, low-salt baked beans and otherpulses, tinned tomatoes, rice and pasta for quick andeasy meals in minutes.

Ideas for meals in minutes

Cous cous with tinned tuna and spicy tomatosauce (made with tinned tomatoes, onion anddried chilli or paprika)

Baked beans on toast or with a microwavedjacket potato

Chick pea curry served with rice that has frozenpeas stirred through it.

Packing up a healthy lunch

Making an interesting and nutritious packed lunchevery day can be a dicult task. But dont resort topre-prepared lunchbox foods, sweets and crisps!


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Packing a healthy lunch is vital to make sure you havethe right energy and nutrients needed to get youthrough the afternoon.

One of the diculties with the daily task of makinga packed lunch can be nding the inspiration abouthow to oer variety while still keeping it healthy. Togive you a hand, see the week of lunchbox ideas on

the following page. These include tried and testedfavourites that the whole family will love and thatare nutritionally balanced. Adapt our ideas or createyour own using the guide below.

Get the balance right by remembering to

Include a good helping of fruit and vegetables.

Aim for a portion of each. Have some starchy food like bread, rice, potatoes

or pasta.

Choose some lean protein. Try tuna or salmontinned in water, boiled eggs, beans or lean meat likechicken or turkey.

Go for some low-fat dairy food like low-fat yoghurt,fromage frais or reduced-fat cheese.

Add in a drink water, pure unsweetened fruit juiceor low-fat milk.

Use front-of-pack labelling to help you to make thehealthiest choices in relation to saturated fat, totalfat, salt and sugar (see page 49).

Mon Tues Wed Thurs Fri

Pittabreadt d

Egg and cresssandwich on

h l l

Granaryroll withh

Tuna(tinned in

i

Home-made mini

i


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Planning meals 71

stued

withchickenandtomatoslices

wholemeal

bread

hoummus,

lettucetomatoandcucumber

spring

water) andsweetcornpastasalad withredpeppers

pizza

Tinnedpeaches in

juice

Choppedtomato andcucumber

Pear TwoSatsumas

Smallhandful ofdriedapricots

Low fatcustard

Reduced-fatfromage frais

Low-fatfruityoghurt

Low-fatfruityoghurt

Tzatzikidip withsticks ofredpepper

Smallhandful ofunsaltedpeanuts

Plain popcorn Currantbun

Water Orange juice Water Pineapple

juice

Apple

juice


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Childrens lunches

However balanced your lunchbox is when you makeit, there will be no nutritional value to it if it remains


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73Planning meals

,

uneaten. Avoid soggy sandwiches by trying ourtried and tested tips.

Tips to make sure your childs lunchboxcomes back empty

Keep it cool. If there is no refrigerator space forlunchboxes, use mini lunchbox coolers, or freeze

cartons of juice or bottles of still water to put in thelunchbox and keep it cool.

Avoid soggy sandwiches. Put wet vegetables liketomato slices in between the main lling and somelettuce, to protect the bread.

Make fruit and vegetables easy to eat. Cut them

into chunks, sticks or shapes rather than leavingthem whole.

Make it fun. Decorate sandwich bags or yoghurtpots with stickers, or draw funny faces on fruits likebananas, oranges and satsumas ones with peelthat you remove before eating.

Let your child choose their own lunchbox and addbrightly coloured napkins and coloured plastic cutlery.

Involve your children in deciding what goes intotheir lunchbox.

My parents always tried to makesure I ate healthily. When I wasyoung, I used to follow my mum

d th kit h I b bl


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around the kitchen. I was probablya bit annoying, but I picked upthe basics.

Now Im a student, I nd cookingreally therapeutic after a hard day.Its great because my atmates andI get together to prepare meals and

I think my enthusiasm for healthyeating is a positive inuence.

Its dicult at exam time, butmostly I eat well. I think itsimportant to try to make time tocook healthily. It makes me feel

better physically and mentally.

Small changes add up!

Changes to your eating habits dont


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75

necessarily have to be dicult or big. Infact, sometimes, making a few smallchanges slightly reducing the amountof fat you add to meals, changing thetype of milk or yoghurt you buy,swapping one of your fatty snacks forfruit, or being more careful aboutremoving all the fat and skin from meat can all add up to make a big dierence.

Think of changes you and your family

might benet from like reducing theamount of fat or saturated fat, orincreasing the amount of fruit andvegetables you eat, and then come upwith little tweaks you could make to your

diet that could help you to achieve that.


Making healthier choices

Dairy products

You may already know that choosing lower-fat milksand yoghurts helps you to reduce the saturated fatcontent of your diet but did you know that dierent


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content of your diet, but did you know that dierenttypes of cheese have dierent amounts of fat too?

Most cheeses are high in fat, and saturated fatin particular, but it is still possible to makehealthier choices.

Type of cheeseTotalfat

gramsper

10

0g

Saturated

fat

grams

pe

r100g

High fat (more than 20g per 100g)

Mascarpone 44 29

Stilton 35 23

Cheddar/Red Leicester/Double Gloucester 35 22

Parmesan 30 19

Edam 26 16

Camembert 23 14

Medium fat (3.1g - 20g per 100g)

Feta 20 14Mozzarella 20 14

Half-fat cheddar 16 10

Low fat (3g or less per 100g)

Reduced-fat cottage cheese, plain 2 1


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Changing cooking methods Try baking, boiling, steaming, poaching or

microwaving instead of frying, so that you dont


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79

need to add fat. Measure out oil with a teaspoon or use a spray oil,

rather than pouring it straight from the bottle.

Make sure you have a non-stick pan for dry-frying,or a non-stick roasting tray for roasting withoutadding fat.


My job as a freelance photographermade healthy eating pretty dicult


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made healthy eating pretty dicult when youre on the road you endup living out of service stations but after my heart operation Iknew I had to change all that.

My partners a naturally healthyeater, and shes been a really

positive inuence. Now Imteaching full-time, cookingtogether is a real pleasure. It givesme a sense of achievement, and Ifeel more energetic and alert. Justthink about whether youd rather

have a healthy home-cooked mealor something horrible out of themicrowave its a no-brainer!

Eating out

Having the odd indulgent meal when


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81

youre eating out is unlikely to make adierence to your heart health in the longrun, but eating foods that are high in fat,salt and sugar on a regular basis can, andthese days were eating out more thanever before.

Eating out has become much moreaccessible, to the point where for somepeople it is a regular part of the foodthey eat.

Eating out

Nowadays, its not just the special occasion meals weeat away from home; its also the coee and a cake whileyoure shopping, the takeaways or fast foods whenyou dont want to cook, meals or snacks in the pub,sandwiches bought on the run, and sweets and crispsor hot dogs when you visit the cinema or bowling alley.


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All of that can add up. Also, when youre eating out youmay nd you eat larger portions than you would at home.And often the healthy choices are not that obvious.

But eating out doesnt have to mean eatingunhealthily. Use some of the following tips to helpyou to choose wisely and stick to your healthyeating plan, wherever youre eating.

Portion sizes are often bigger when eating out. Dontfeel you have to nish what is on your plate justbecause its there.

Think about sharing a starter or pudding rather than

having your own. Ask for dressings and sauces on the side so you can

decide how much to add, or ask if you can have salador vegetables with your meal rather than chips.

Look for vegetable-based or tomato-based saucesrather than cream, coconut or cheese-based sauces.

Some companies now print the calorie content ofdishes on their menus. You can also use the nutritioninformation on company websites to help to guideyou towards the options on the menu with the leastfat, salt and sugar.


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Keeping it going

Healthy eating shouldnt be dicult, butthere may be times when you nd itharder to make healthy choices or stick to


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your goals. Remember that, as withanything new, eating healthily is alearning process. If youve eaten in acertain way for a long time, there will betimes when it may feel easier to go back

to your old habits.

But remember that your changes will benet not onlyyou, but the whole family. Eating healthily will help youto reduce the risk of heart disease by helping to controlcholesterol levels and blood pressure, and by keeping


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85

you all a healthy weight. Sticking to it will help you torealise these benets, and the choices you make willbecome easier too.

Need more help?

If you would like more information on healthy eating,there are lots of websites that can help you:

bhf.org.ukwww.eatwell.gov.ukwww.5aday.nhs.ukwww.nhs.uk/Change4Lifewww.units.nhs.ukwww.msc.org

Find out if there are any local groups that focus onhealthy eating. Your local authority or primary caretrust may have some suggestions, or talk to yourpractice nurse.

Keeping it going

Getting creativein the kitchen

Getting creative in the kitchen means you

dd i t t ti ll


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can add variety to your eating as wellas being in control of how much fat, saltand sugar goes into your meals. Its agreat thing to do with children too fun,but also helping them to develop skillsthat will set them up for life.

Recipes

The recipes on the following pages are easy andquick to make. They give you some ideas for breakfasts,

l h d i l hi h i th l h l


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87

lunches and evening meals which you can incorporateinto a healthy eating plan.

Breakfasts

Banana breakfast smoothiePorridge with mixed berry compote

Light meals

Tomato and lentil soupChicken and rice saladHoummus and vegetable dip

Main meals

Tuna and courgette risottoCottage pie

Bean and vegetable chilliPotato salad with aked mackerel

Desserts

Spiced apricot bread puddingBlackberry yoghurt fool

Getting creative in the kitchen

Banana breakfastsmoothie

Smoothies are a great way to getreluctant breakfast eaters into thehabit of making a healthy start tothe da Serves 2


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the day. Serves 2

Youll need:

2 medium bananas, peeled and cut into chunks300ml ( pint) semi-skimmed milk1 tablespoon clear honey1-2 tablespoons smooth peanut butter (low-salt version)

Method1. Blend all the ingredients together until mixed.

You can use either a hand-held blender or jug blender for this.

2.Pour into glasses and serve immediately.

Porridge with mixedberry compote

The whole family will love this

fruity breakfast Make extra


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fruity breakfast. Make extracompote and freeze it so that youcan have some ready at any time.Serves 4

Youll need:

For the fruit compote:

3 tablespoons unsweetened red grape juice3 tablespoons unsweetened apple juice1 tablespoon clear honey350g (12oz) mixed fresh berries such as raspberries, blackberries,blueberries and small strawberries (halved)

For the porridge:

115g (4oz) porridge oats400ml (14 oz) semi-skimmed milk

400ml (14 oz) waterMethod

To make the fruit compote

1. Place the fruit juices and honey in a saucepan and heat until almostboiling, stirring. Remove the pan from the heat. Place the mixedberries in a bowl and pour the hot fruit juice mixture over them.Stir gently to mix and then set aside. Serve warm, cold or chilled.

To make the porridge2. Place the oats in a non-stick saucepan and stir in the milk and water.

Bring gently to the boil, stirring all the time. Simmer for 3-5 minutesor until the desired consistency is achieved, stirring occasionally.

Getting creative in the kitchen Breakfast


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Tomato and lentil soup

This delicious, thick, wholesome soup creates a lovelywinter warmer. It is ideal served with thick slices ofwholemeal or granary bread. Serves 2

Th ti id l f i l h


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These are generous portions ideal for a main course or lunch.

Youll need:

2 teaspoons olive oil1 small onion, nely chopped1 leek, thinly sliced1 stick celery, nely chopped55g (2oz) dried split red lentils, rinsed and drained227g (8oz) tin chopped tomatoes550ml (20 oz) vegetable stock1 teaspoon dried mixed herbsFreshly ground black pepper, to tasteChopped fresh parsley, to garnish

Method

1. Heat the oil in a medium non-stick saucepan. Add the onion, leek

and celery, and cook gently for 5 minutes, stirring. Add the lentilsand cook for 1 minute, stirring.

2. Add the tomatoes, stock, dried herbs and black pepper, and stir tomix. Bring to the boil, then reduce the heat, cover and simmer,stirring occasionally, for about 20 minutes or until the vegetablesand lentils are tender.

3. Remove the pan from the heat and set it aside to cool slightly. Pure

the vegetable mixture in a blender or food processor until smooth.4.Return the soup to the rinsed-out pan, add most of the chopped

parsley and re-heat the soup gently until hot, stirring occasionally.

5. Ladle into warmed soup bowls and garnish with the remainingparsley.

Getting creative in the kitchen Light meals

Chicken and rice salad

This makes an interesting change to sandwiches andprovides a balanced mix of foods in one dish. Serve witha mixed green salad and fresh crusty bread. Serves 6

Youll need:

225g (8oz) long grain brown rice


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g ( ) g g350g (12oz) cooked skinless, boneless chicken, chopped cucumber, halved lengthways and thinly sliced1 bunch of spring onions, chopped1 red pepper, seeded and chopped115g (4oz) sugar-snap peas, chopped200g (7oz) tin sweetcorn kernels, rinsed and drained8-10 tablespoons ready-made fat-free or reduced-fat

French-style dressing2 tablespoons chopped fresh basil or at-leaf parsleyFreshly ground black pepper, to tasteFresh basil or at-leaf parsley sprigs, to garnish

Method

1. Cook the rice in a pan of boiling water until just tender. Drain, rinseunder cold running water, and drain again. Transfer to a salad bowl.

2. Add the chicken, cucumber, spring onions, red pepper, sugar-snappeas and sweetcorn kernels and stir to mix.

3. Add the French-style dressing, chopped herbs and black pepperand toss together to mix well.

4.Garnish with basil or parsley sprigs.

Variations

Use tuna (canned in spring water), a tin of chick peas, or choppedcooked turkey in place of chicken.

Use any ready-made fat-free or reduced-fat salad dressing of yourchoice, such as thousand island, herb and garlic, or honey and mustarddressing, in place of French-style dressing.

Hoummus andvegetable dip

You can vary the quantities of

coriander and cumin to make thispopular Middle Eastern dip as


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Getting creative in the kitchen Light meals 93

coriander and cumin to make thispopular Middle Eastern dip asaromatic as you like. It is perfectfor sharing with family and friends.Serves 4 as a starter or snack

Youll need:

420g (15oz) tin chick peas, rinsed and drainedJuice of 1 lemon4 tablespoons extra virgin olive oil2 tablespoons light tahini (sesame paste)1 or 2 cloves garlic, crushed (optional)/ -1 teaspoon ground coriander/ -1 teaspoon ground cuminFreshly ground black pepper, to taste

A selection of prepared fresh raw vegetables such as pepper, carrotand cucumber sticks, baby sweetcorn or cherry tomatoes to serve

Method

1. Blend the chick peas, lemon juice, olive oil, tahini, garlic (if using),coriander, cumin and black pepper together in a food processor orblender until they form a coarse paste.

2.Arrange the prepared raw vegetables on one large or four smaller

serving plates. Spoon the hoummus into one large or four smallerserving bowls and serve with the vegetables.

Variation

Serve with hot toasted bread ngers, breadsticks or crackers and halvethe quantities given in the recipe above.


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Tuna and courgette risotto

The secret to making a good risotto is to keep addingjust enough hot stock in stages throughout the cookingprocess and to stir the rice frequently while it iscooking. Serves 2-3


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Getting creative in the kitchen Main meals 95

gYoull need:

1 tablespoon sunower oil1 small red onion, chopped1 clove garlic, nely chopped1 small red or yellow pepper, seeded and diced1 courgette (about 200g/7oz), diced

115g (4oz) chestnut mushrooms, thickly sliced175g (6oz) arborio risotto riceAbout 600ml (1 pint) good-quality vegetable stock125ml (4 oz) dry white wine200g (7oz) tin tuna chunks in spring water or brine, drained and aked2 tablespoons at-leaf parsley, choppedFreshly ground black pepper, to taste

Method

1. Heat the oil in a heavy-based saucepan. Add the onion, garlic andred or yellow pepper and cook for 5 minutes or until softened,stirring occasionally. Add the courgette and mushrooms and cookfor 1 minute, stirring. Add the rice and cook for a further 1 minute,stirring. In a separate small pan, bring the stock to the boil, coverand keep the stock simmering gently.

2. Add the wine to the rice mixture and cook rapidly for 1-2 minutes or

until the wine has almost totally evaporated, stirring continuously.Reduce the heat to medium-low. Gradually add the hot stock to therice, a ladleful at a time, allowing each addition to be absorbed beforeadding more, and stirring very frequently, until the rice is tender. Thiswill take about 20 minutes. You may not need to add all of the stock.

3. Gently stir in the aked tuna and heat gently for about 2 minutes oruntil the tuna is hot, stirring once or twice. Stir in the parsley andseason with black pepper. Serve hot.


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Cottage pie

Extra-lean minced beef, additional vegetables and alow-fat potato topping all contribute to creating thistasty and healthier version of a traditional cottage pie.Serve with cooked green vegetables such as broccoli,green beans or peas for a hearty meal.Serves 2-3

Youll need:

1 small onion, chopped1 clove garlic, crushed225g (8oz) extra lean minced beef1 carrot (about 85g-100g/3-3oz), peeled and nely chopped85g (3oz) button mushrooms, sliced1-2 sticks celery, nely chopped1 tablespoon plain our1 tablespoon tomato pure225g (8oz) tin chopped tomatoes1 teaspoon dried mixed herbs150ml ( / pint) good-quality beef stock5 tablespoons red wineFreshly ground black pepper, to taste750g (1lb 10oz) potatoes, peeled and cut into chunks2-3 tablespoons semi-skimmed milk

Method

1. Place the onion, garlic and minced beef into a non-stick saucepan.Cook over a medium heat stirring frequently for 4-6 minutes oruntil the mince is browned all over. Add the carrot, mushroomsand celery and cook for 4-5 minutes. Add the our and tomato

pure and cook for 1 minute, stirring.2 Stir in the tomatoes herbs stock wine and black pepper mixing


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Getting creative in the kitchen Main meals 97

2. Stir in the tomatoes, herbs, stock, wine and black pepper, mixingwell. Bring to the boil, then reduce the heat, cover and simmerfor 40 minutes, stirring occasionally. Remove the lid for the last10 minutes of cooking time to thicken the meat sauce a littlemore, if desired.

3. While the meat is cooking, pre-heat the oven to200C/fan 180C/gas mark 6.

4.Also while the meat is cooking, boil the potatoes in a separatepan for 15-20 minutes or until tender. Drain well and return to thepan. Mash or crush the potatoes, stir in the milk, mixing well, andseason with black pepper.

5. Spoon the meat mixture into an ovenproof dish. Pile the mashedpotatoes on top, covering the meat completely, and score thesurface of the mash decoratively using a fork. Place the dish on a

baking tray, if desired. Bake in the oven for 20-25 minutes or untilthe topping is golden brown. Serve hot.

Cooks tip

Use the minced meat mixture in this recipe as the basis forother dishes such as spaghetti bolognese or chilli con carne,adding additional ingredients and spices to suit your taste.

Bean andvegetable chilli

A delicious alternative to meatchilli, this nutritious bean andvegetable chilli can be served with

crusty bread or on a bed of herbyboiled brown rice or cous cous


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boiled brown rice or cous cous.Serves 2 (These are generous portions)

Youll need:

2 teaspoons olive oil1 small red onion, sliced1 small red pepper, seeded and diced1 fresh red chilli, seeded and nely chopped1 clove garlic, crushed1 teaspoon ground coriander1 teaspoon ground cumin teaspoon hot chilli powder (optional)1 carrot, sliced175g (6oz) cauliower orets227g (8oz) tin chopped tomatoes

200ml (7 oz) vegetable stock1 tablespoon tomato pureFreshly ground black pepper, to taste220g (8oz) tin red kidney beans, rinsed and drained300g (10oz) tin cannellini beans, rinsed and drainedFresh coriander sprigs, to garnish

Method

1. Heat the olive oil in a medium non-stick saucepan. Add the onion,red pepper, fresh chilli and garlic, and cook gently for 4 minutes,stirring occasionally. Add the coriander, cumin and chilli powder (ifusing) and cook for 1 minute, stirring.

2. Add the carrot, cauliower, tomatoes, stock, tomato pure and blackpepper, and stir to mix. Bring to the boil, then reduce the heat, coverand simmer for 20-25 minutes, stirring occasionally.

3. Stir in the tinned beans. Bring the mixture back to the boil and cookfor a further 10-15 minutes, or until the vegetables are tender.

4. Garnish with coriander sprigs.


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Spiced apricotbread pudding

You will nd this lightly spiced,healthier version of a traditionalbread and butter pudding hard to

resist. We have replaced the butterwith a smaller quantity of reduced-fat spread and


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with a smaller quantity of reduced fat spread andapricot jam, and using semi-skimmed milk also helpsto keep the fat content down. Dried apricots addextra avour and nutrients. Serves 2-3

Youll need:

3 medium slices (pre-sliced) wholemeal or white bread15g (oz) reduced-fat spread, plus a little extra for greasing25g (1oz) apricot jam100g (3oz) ready-to-eat dried apricots, chopped teaspoon ground mixed spice25g (1oz) light soft brown sugar1 egg300ml ( pint) semi-skimmed milk

Method

1. Lightly grease a shallow ovenproof dish, and set it aside. Thinlyspread one side of each slice of bread with fat spread, and spread

jam over the top. Cut each slice into triangles. Arrange half of themin the base of the prepared dish, jam-side up.

2. Mix together the apricots, mixed spice and half of the sugar, andsprinkle this apricot mixture evenly over the bread in the dish.Arrange the remaining bread triangles over the top, jam-side up,

and sprinkle evenly with the remaining sugar.3. Beat the egg and milk together in a bowl or jug, and pour evenly

over the bread. Set aside for 30 minutes to allow the bread toabsorb some of the liquid.

4. Meanwhile, pre-heat the oven to 180C/fan 160C/gas mark 4. Bakethe bread pudding in the oven for 35-40 minutes or until lightly setand golden brown. Serve either hot or at room temperature.

Blackberryyoghurt fool

This refreshing fruit fool is easy to

prepare and makes the most ofautumn blackberries. Freeze themh h


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when they are in season to enjoythis dessert all year round. Servewith oat biscuits or sponge ngers.Serves 2

Youll need:

225g (8oz) fresh ripe blackberries1-2 tablespoons clear (runny) honey, or to taste100ml (3 oz) thick low-fat plain yoghurt2 tablespoons reduced-fat crme frache

Method

1. Put the blackberries in a blender or food processor, and blend untilsmooth. Press the pure through a sieve into a bowl, reserving the

juice and pulp and discarding the seeds. Or, thoroughly mash theblackberries in a bowl and press the pure through a sieve as above.

2. Add the honey to the blackberry pulp and mix well. Gently fold inthe yoghurt and crme frache until well combined.

3. Spoon into serving glasses or dishes. Chill before serving.

Variations

Use mixed fresh berries such as strawberries, raspberries andblueberries in place of the blackberries. Or use the same quantityof peeled, stoned ripe mango esh instead of the blackberries.

For a blackberry custard fool, pure and sieve the blackberries asabove. Add 1 tablespoon of honey, if desired. Fold in 100ml (3 oz) ofready-made, cold, low-fat custard instead of the yoghurt, and then foldin the crme frache. Serve chilled.

Getting creative in the kitchen Desserts

How the British HeartFoundation can help you

We are the nations heart charity, dedicated tosaving lives through pioneering research, patientcare, campaigning for change, and providing vital

information.You might nd some of the following


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You might nd some of the followingresources helpful:

Booklets

Our heart health catalogueFor you, for family and friends, for health professionals

Get active, stay activeEnjoy being active and keep your heart healthy

Be active for lifeOver 50? Keep your heart healthy with physical activity

Put your heart into walkingIts easy, its free, its great for your heart

Physical activity and your heartFor people who have a heart condition or are at riskof developing heart disease

Take control of your weightSafe ways to lose weight for heart health

Cut down on salt

Its easy to do and good for your heart

Stop smokingHow to quit for a healthy heart

Coping with stress

How to manage stress and help your heart

DVD

Risking itThis DVD follows ve ordinary people, all of whom have one or morerisk factors for coronary heart disease. They have decided to starttaking responsibility for their health and take positive action.

For information on other BHF booklets and DVDs ask for a copy

f O h h l h l


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103How the British Heart Foundation can help you

ofOur heart health catalogue.

How to order our resources

To order any of our booklets or DVDs:

call the BHF Orderline on 0870 600 6566

email [email protected] visit bhf.org.uk/publications

You can also download many of our publications from our website.

Our booklets are free of charge, but we would welcome a donationso we can continue our vital work. (Turn the page to see how you canmake a donation.)

Heart MattersHeart Matters is our free, personalised service to help you livewith a healthy heart. Join Heart Matters today to access benetsincluding heart matters magazine, a HelpLine and an onlinemembers area with recipes, articles and lifestyle tools. Registeronline at bhf.org.uk/heartmattersor call 0300 330 3300(calls are charged at a similar cost to 01 or 02 numbers).

We need your helpto continue our life-saving workAs a charity we rely on the generosity of people likeyou to fund our vital work. Thousands of people withheart disease turn to us for help every year and even

more will need us in the future. We want to be therefor them.


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Please donate today and together we can beatheart disease for good.

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please call our donation hotline on 0300 330 3322,

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Become a volunteer and help run our shops, events orservices for local communities. To nd out more, call0845 130 8663 or visit bhf.org.uk/volunteer

Have fun on a sponsored run, bike ride or walk. For moreon this, call 0844 477 1181 or visit bhf.org.uk/events

Join our Heartstartinitiative and learn to save lives with theskills of emergency life support. Over 2.6 million people alreadyhave. For more information contact [email protected]

Donate goods to your local BHF shop. To nd out whereyour nearest BHF shop is, call 0844 412 5000.

Give in celebration by oering your party guests thechance to donate to us instead of buying gifts, forexample for your wedding anniversary or birthday.Visit bhf.org.uk/celebrate for more information.

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