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Just how important is diet and exercise to improve your heart?

Good morning and Happy Wednesday! I hope you've had a great week so far. We've had a busy week here at Clinical Exercise - lots of new enquiries, lots of fab chat over on our Healthy Hearties Facebook group, a HUGE batch cooking session on Monday (fish pie, fish chowder and fish cakes - yes a lot of fish this week!) and an old client has returned from overseas and is getting restarted on his exercise programme.

This week I'm talking all about Heart Health - obviously I'm always talking about heart health but I wanted to really focus on what you can do to ensure you are reducing your risk of having future heart problems.  This is particularly relevant if you have a history of heart problems in the family or if you are recovering from a heart event or currently have a heart condition.

There are so many do's and don'ts to look after your heart - below are the top 5 things you should be doing to ensure your heart is in tip top condition.

Also, this week I have a simple exercise that you can do any time of day to tone up the back of your arms - easy!


Looking after your heart

Cardiovascular disease (heart disease) is the world’s biggest killer, causing over 17 million deaths a year and many of these deaths are preventable through lifestyle changes.

Most people know someone or have themselves been directly affected by heart disease and a lot of times it is avoidable by changing lifestyle habits. If you've had heart problems in the past it's never to late to make improvements to improve your health for the future.

Simple changes in diet by reducing your salt intake and eliminating processed foods from your diet and trying to get a couple of hours of exercise a day can make a huge difference.
A healthy diet reduces the risk of coronary heart disease and prevents weight gain which puts pressure on your heart, the introduction of a healthy diet also helps to prevent further worsening of existing heart disease and it’s not too late to start eating healthily.
To help prevent heart disease here are five ways to change your lifestyle and take better care of your heart.

1. Follow the Mediterranean diet

A 2013 study showed the Mediterranean diet reduces the risk of coronary heart disease by 30% and prevents weight gain which puts pressure on your heart, the diet also helps to prevent further worsening of existing heart disease and it’s NEVER too late to start eating healthily. Recent attention has been drawn to the benefits of the Mediterranean diet by cardiologist Aseem Malhotra who has recently filmed the ‘Cereal Killers Movie’ about his quest to find out the secret to a long life in the Mediterranean. Check it out here.

2.  Reduce salt
Too much salt can cause high blood pressure, which increases the risk of developing coronary heart disease. Reduce your consumption of crisps, take aways, packaged snack foods and processed sauces. As a cardiac nurse this is one of the biggest misconceptions people have – they think if they don’t add salt to their food then their diet is low in salt.  However salt is hidden in so many things you wouldn’t even think – cans of tuna, ham, tomato paste and roasted peanuts.  Always check the label – if a serving size contains more than 10% of your daily recommended intake, avoid or reduce the amount you have.

3.  Say no to processed foods
There are lots of hidden saturated fats, sugars and salts in processed food, fast food and ready meals.  Even foods that may appear ‘healthy’ traditional meals such as lasagne are usually made with cheap ingredients and are laden with salt. I would strongly advise people to check the content of the ingredients of any food they buy and start cooking from scratch together – it’s more fun too!

4.  Quit smoking
Smokers are twice as likely as non-smokers to have heart disease with all the health issues it causes it is the most important thing you can do for your heart. Try a nicotine replacement to reduce your cravings – electronic cigarettes, patches, gum or lozenges are a great help when you’re quitting.

5.  Exercise more

The heart is the most important muscle and just a small amount of exercise will keep it functioning properly. Exercising for as little as ten minutes a day can make a huge difference. If you haven’t exercised for some time start out with gentle walking and build up – we should be aiming for a minimum of 30 minutes of exercise 5 days per week.

Aim to improve in one of the above areas each week and you’ll soon be on your way to a healthy heart.

Let me know if you have any specific questions at all!

Exercise of the week - Tricep Dips

1.  Sit up straight on the long edge of a stable, heavy chair or a bench. Your legs should be slightly extended, with your feet flat on the floor.
2. Place your hands on both sides of the bench just outside your thighs. Your palms should be down, fingertips pointing towards the floor.
3. Without moving your legs, bring your bottom forward off the bench.
4. Steadily lower yourself. Beginners: Bend your elbows 1-2 inches and push yourself back up. Advanced: When your elbows form 90˚ angles, push yourself back up to starting position.
5. Repeat up to 10 reps, rest and then repeat up to 2-3 times.

Some people find that this exercise is too much on their wrist joints. If so, you may need to change the exercise to triceps kickbacks, which we will cover in the next couple of weeks.

Do let me know if you have any questions at all!



Eggsellent breakfast ideas!

Good morning and Happy Wednesday! I hope you are having a great week so far.

I'm keeping this week's email short and sweet - I've just read some statistics that Wednesdays are the most productive of the week and you are all busy with heads down on a Wednesday! Apparently the least productive day is a Monday morning (obvious!) followed by Thursday and Friday afternoons. Let me know if that's true for you too!

If I can get organised enough then next week's email should be hitting you on a Monday morning :)

Food of the week

This week’s ‘Food of the Week’ is the humble egg.  Now, eggs have received a bad rep over the last few years – often overlooked for their fat content and deemed as bad for the cholesterol, people often shy away from eating eggs.

It was previously thought that eggs raised blood cholesterol levels - one of the main causes of heart disease. The yolk in a single large egg contains five grams of fat, so it was only natural for nutritionists to assume that eggs clogged up people's arteries, especially since they also contain dietary cholesterol. 
However, evidence is now showing that eating a lot of dietary cholesterol doesn't increase blood cholesterol.  A 25-year study revealed that people who consume two eggs each day with low-fat diets do not show signs of increased blood cholesterol levels.
So what does raise blood cholesterol? One of the main theories is that saturated fat does.  Of the three types of fat (saturated, monounsaturated and polyunsaturated), saturated fat raises blood cholesterol and LDL (bad cholesterol) levels.  It so happens that eggs contain mostly polyunsaturated fat, which can actually lower blood cholesterol if one replaces food containing saturated fat with eggs.
Other benefits of eating eggs are below:

  • Eggs are great for the eyes.  According to recent studies, an egg a day may prevent macular degeneration and cataracts due to the carotenoid content, specifically and zeaxanthin.  Both nutrients are more readily available to our bodies from eggs than from other sources.
  • One egg contains 6 grams of high-quality protein and all 9 essential amino acids
  • According to a study by the Harvard School of Public Health, regular consumption of eggs may help prevent blood clots, stroke and heart attack.
  • Eggs are a good source of choline, which is an important nutrient that helps regulate the brain, nervous system, and cardiovascular system.
  • Eggs contain the right kind of fat.  One egg contains just 5 grams of fat and only 1.5 grams of that is saturated fat.  One egg (including yolk) contains 90 calories – a hardboiled egg is the perfect snack!
  • Eggs are one of the only foods that contain naturally occurring vitamin D, something most of us are deficient in if we don't get enough sunlight
  • Eggs promote healthy hair and nails because of their high sulphur content and wide array of vitamins and minerals.  Many people find their hair growing faster after adding eggs to their diet, especially if they were previously deficient in foods containing sulphur or B12. 

Having eggs for breakfast once or twice a week, a hard boiled egg for a mid morning snack regularly and having an omelette for dinner once a week is a way of bringing more eggs into your diet.  Having them as part of a full English breakfast is not what I'm promoting!

Try the following tasty breakfasts:

  • 2 eggs scrambled with one large slice smoked salmon and 1/4 avocado
  • 2 poached eggs on 1 piece rye bread
  • 2 eggs whisked with a splash of milk - pour into a medium heat pan with some melted coconut oil, sprinkle over some chopped veg - spinach,peppers, mushroom etc. Cook until bottom is set and top is still runny, then place under grill for 2-3 minutes until top is also cooked. Easy omlette!

Let me know any other ideas you have.

Have a wonderful week and see you soon!




An easy weigh to lose weight...

Good morning and Happy Wednesday!

I hope that you are enjoying the warm weather this week and are staying hydrated - where did the heat come from?! British weather hey!?  Predictably unpredictable. Also, it feels like my garden could wither at any moment if it isn't watered every 5 minutes (which once a week is probably the best it gets, sorry plants!).

This week I have put together a guide to portion sizes which should be helpful.  It's difficult if you are having a stir-fry or someone else is cooking but this is a guide for the ideal portion size of each nutrient.  You may need to adjust slightly depending on your activity levels and metabolism.  These sizes are for main meals (lunch and dinner).  Breakfast should be slightly smaller in size.

For snack sizes:

A piece of fruit with a handful of nuts is a great snack mid morning or mid afternoon. Keep to a small handful – around 10-15 unsalted/unroasted nuts.

Sticking to these portions should help you to lose weight!

Please let me know if you have any questions at all about what portion is right for you.

Have a fantastic week and see you soon!


Use your hands to gauge the correct portion sizes for you.

Protein: Size of your palm (bigger hands = bigger portion, sorry small hands!).


Vegetable portion size: two handfuls of non starchy vegetables


Carbohydrate portion size: small palm (when cooked) - this could be wholegrain pasta, brown rice, cous cous, quinoa, potato, oats, starchy vegetables (potato etc) 


Good fats: pinch or one thumb sized portion – avocado, olive oil, seeds, nuts


Your plate should look like this:


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Have a great week! 

Kind regards,

Angela Hartley

Cardiac Specialist Nurse, Nutritionist, Exercise Coach



Healthy food myths....busted!

Good morning and Happy Tuesday!  I hope you had a wonderful weekend. Please do keep sending me new ideas and questions for my weekly email as it is very useful to base these on your queries. Thank you so much for your fabulous reviews - I feel honoured to have helped so many people and am glad that you've found me so helpful :)

There are many different views, stories, myths and scare tactics amongst the media when it comes to food. One week coffee is good, the next week it is bad.  I thought I would put down a list of some of the myths and questions that come up and what the latest research shows.


Does olive oil prevent heart disease?

Short answer: Yes. The health benefits of olive oil come from the presence of polyphenols, antioxidants that reduce the risk of heart disease and some cancers. But to get these healthy compounds, consumers should buy good-quality, fresh "extra-virgin" olive oil, which has the highest polyphenol content.  Try having a sprinkle on your salads to increase your intake of good fats.

Do drinks high in sugar lead to diabetes?

Short answer: Yes. The majority of health research has shown soft drinks and high sugar juices to be bad to our health. A 2004 study in the Journal of the American Medical Association found that those who drank one or more sugary drinks per day increased their risk of developing type 2 diabetes by 83% compared to those who consumed less than one of these beverages per month.

Do nuts make you fat?

Short answer: No. As much as 75% of a nut is made up of fat.  But eating fat doesn't necessarily make you fat.  The bigger factor leading to weight gain is portion-size.  Luckily, nuts are loaded with healthy fats that keep you full and (hopefully) prevent you from overeating.  They're also a good source of protein and fiber. Stick to 10-15 nuts in one serving, which is around 150-300 calories, depending on the type of nut (cashews are one of the lowest, macadamias are the highest).

Is walking as effective as running?

Short answer: Yes. Studies have shown that how long you exercise is more important than how hard you exercise.  Running is a more efficient form of exercise, but not necessarily better for you. A six-year study published in the journal Arteriosclerosis, Thrombosis and Vascular Biology found that walking at a moderate pace and running produced similar health benefits, so long as the same amount of energy was expended. Walking the same distance is as good as running, it just takes longer!

Is drinking fruit juice as good for you as eating fruit?

Short answer: No. Calorie for calorie, whole fruit provides more nutritional benefits than drinking the pure juice of that fruit.  That's because when you liquefy fruit and throw away the pulp, many ingredients like fiber, calcium, vitamin C and other antioxidants are lost. For comparison, a 200ml glass of orange juice contains 120 calories and 30 grams of sugar but only 0.3 grams of dietary fiber and 16 milligrams of calcium, whereas one orange contains 60 calories, 12 grams of sugar but has 3.1 grams of fiber and 60 milligrams of calcium.

Are all wheat breads better for you than white bread?

Short answer: No. Not all wheat breads are created equal. Wheat breads that contain all parts of the grain kernel, including the nutrient-rich germ and fiber-dense bran, must be labeled "whole grain" or "whole wheat." Some wheat breads are just white bread with a little bit of coloring to make the bread appear healthier, so keep an eye out for the words ‘whole grain/whole-wheat’ to ensure you receive all the benefits. In fact, give most breads a miss altogether - have you looked at the ingredient list lately? 

Does coffee cause cancer?

Short answer: No. Coffee got a bad reputation in the 1980s when a study linked drinking coffee to pancreatic cancer, however research since then has disproved this.  More recently, health studies have swung in favor of the caffeinated beverage. Coffee has been linked to a lower risk of type 2 diabetes, Parkinson's disease and liver cancer.  One to two coffees per day is fine, any more and you start to rely on caffeine for your energy levels, can cause your blood pressure to rise and adversely affect your sleep.

Do eggs raise cholesterol levels?

Short answer: No. Although egg yolks are a major source of cholesterol, researchers have learned that saturated fat has more of an impact on cholesterol in your blood than eating foods that contain cholesterol. Healthy individuals with normal blood cholesterol levels should now feel free to enjoy foods like eggs in their diet every day, the lead researcher from a 25-year on cholesterol concluded. One to two eggs on several days per week is a healthy addition to your diet. Try having scrambled or poached eggs for breakfast when you have more time, have an egg sandwich for lunch one or two days or make an omelette for dinner one night per week.

Can yogurt ease digestive problems?

Short answer: Yes. Our digestive tract is filled with microorganisms — some good and some bad. Yoghurt, especially natural yoghurt, contains beneficial bacteria, which helps to maintain a healthy balance in the gut. Probiotics can also relieve several gastrointestinal problems, including constipation and diarrhoea.

Is red wine better for you than white wine?

Short answer: Yes. Red wine contains much more reservatrol than white wine, which is an antioxidant found in the skin of grapes that has been shown to fight off diseases associated with ageing.
Here is a link to some more myths and old wives tales -

Have a fantastic week and do keep your suggestions coming! 




An easy morning detox; what is AF?

Good morning and happy Monday! Wow this must be the first time I've been organised enough to get an email out on Monday morning - must be the fact that I'm on holidays! All is well in the sun, we are keeping active (I've joined the gym for 2 weeks), walking lots and swam in the surf a few times.

I've added a new section to my weekly emails - Heart Fact of the Week. As my interest is all things cardiac and heart related, I'm going to put more info up for you about how to keep your heart healthy, signs and symptoms to be aware of, and how to keep your blood pressure and cholesterol at healthy levels. Let me know if you have any ideas or requests.

Food of the week
Apple cider vinegar

For years my friend has been taking apple cider vinegar regularly and as I was visiting this week I noticed it again in her kitchen.  She swears it has helped improve her skin as well as reduced her knee pain so this week I have been looking into how and why it may help.
Apple cider vinegar contains several minerals including magnesiumphosphorus,calcium and potassium.  

It has been found that mineral deficiency can worsen joint pain, so a diet rich in essential minerals is an important step to relieving the pain of arthritis. The potassium in cider vinegar may be especially beneficial because it works to prevent acid build-up in the joints, which is linked to joint stiffness.
Apple cider vinegar is also rich in beneficial enzymes and acids that improve digestive health. Taking a tablespoon of apple cider vinegar before a meal will encourage proper digestion of food and absorption of nutrients. This is vitally important for those with arthritis or any digestion issues, as poor digestion can lead to deficiencies in minerals and other nutrients. These nutrients are crucial for joint health, so it is imperative that the body be capable of absorbing and using them. With apple cider vinegar, this is made possible even if you have arthritis.
Studies suggest that joint pain and arthritis may be linked to toxins accumulating in the joints, since metabolic waste is often stored in connective tissues. At the same time, people with joint pain tend to shun activities that might trigger more pain, and the lack of movement may cause toxins to build-up even more. The pectin in apple cider vinegar helps absorb toxins and move them out of the system, while the acids in cider vinegar work to purify and detoxify the entire body.
Unfortunately there has been no concrete scientific research that proves apple cider vinegar helps with joint pain however most doctors conclude that it will not cause any harm and may have a placebo effect. So why not!

How to Use Apple Cider

All of the benefits of apple cider vinegar can only be achieved with vinegar that is organic, raw, unfiltered and unprocessed. Your apple cider vinegar should be ruddy-colored with a noticeable amount of residue floating around in the bottle. This is the natural accumulation of beneficial enzymes and nutrients.
The simplest way to incorporate apple cider vinegar into your diet is to mix 1-3 teaspoons in a glass of water three times per day, preferably just before meals. You can sweeten the drink with a small amount of honey if you like. 

I'll be honest, the taste isn't amazing, but it tastes....healthy!


Interactions to be aware of

Apple cider vinegar interacts with the following medications in large doses so be cautious if you take the following:
Digoxin, insulin, diuretics.


Normally, your heart contracts and relaxes to a regular beat. Certain cells in your heart make electric signals that cause the heart to contract and pump blood. These electrical signals show up on an electrocardiogram (ECG) recording. Your doctor or cardiac specialist nurse can read your ECG to find out if the electric signals are normal.

In atrial fibrillation (AFib or AF), the heart’s two small upper chambers (atria) don’t beat the way they should. Instead of beating in a normal pattern, the atria beat irregularly and too fast, quivering like a bowl of jelly.  The heart will still pump blood around the body, but it won't be as effective.  You may also experience symptoms such as fatigue, breathlessness, or feel dizzy.

Your heart has a natural pacemaker, called the “sinus node,” that makes electrical signals. These signals cause the heart to contract and pump blood. With atrial fibrillation, random electrical activity interrupts the normal conduction rhythm. This prevents the atria from properly contracting.

It’s important for the heart to pump properly so your body gets the oxygen and fuel it needs. 

How do I test for AF?

If you have any symptoms such as fatigue, breathlessness, palpitations (feeling your heart pounding in your chest), dizziness or faint, have your doctor perform a full cardiac check including an ECG. You can perform a simple pulse check on your wrist to feel if your heart is regular (normal) or irregular (possible AF).  Watch this video here to see how it's done. 

What happens if I have AF?

There are many different treatment options for AF, including a range of medications, cardioversion and catheter ablation. The treatment recommended to each individual is based on their symptoms, length of time they have been in AF and response to medication. You may need to take anticoagulation to prevent stroke.

To find out more, read here or ask me for more information.