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Grace Van Blerk tells her ordeal- falling victim to heart disease. Learn what to avoid to keep your heart healthy.
Going up a dress size every year as you get older isn't normal - and it has serious consequences for your heart, warns Karena du Plessis.
When Grace van Blerk was in her late 30s, walking across a room was hard going. "I would take two steps then have to stop to regain my breath," remembers Grace from her Gauteng home."Our family has a history of lung disease and I assumed that I had fallen victim to this as well. So did my doctors. They gave me a nebuliser and left me to get on with it. I was also on cortisone, which meant I ballooned to an enormous size 22."
But being treated for lung disease brought Grace no relief, and in desperation she went to a physician for a thorough examination. "He checked my lungs," said Grace, "and told me to go home. But I felt that I needed an electrocardiogram (ECG), and asked for one. After that I had an angiogram."
These results were so startling, that the doctor booked Grace in for heart bypass surgery almost immediately. Grace goes on to explain that being diagnosed with heart disease was shocking and knocked her confidence in the most fundamental way. She was young, had two small daughters care for and the spectre of heart disease was furthest from her mind.
"The operation was successful," recalls Grace, "but I was completely ignorant. I'm the first to admit that my lifestyle was 90% to blame for my condition. Nobody sat me down and explained that if I didn't make some radical changes, I would end up in the same situation again.
Post-operatively, I could breathe better and felt healthier, but I carried on smoking and eating fatty food and whatever I felt like." Her pressured job in the financial department of a big corporation didn't help with her stress levels and, not surprisingly, Grace's arteries didn't stand a chance. She went in for her second heart operation a year later. She also hit all-time low and had to deal with crippling depression as well. Grace is now 51 and, three bypasses and eleven angiograms later, she's finally tackling her condition head-on.
"I've stopped smoking, I've lost tons of weight (she now wears a size 12 pants and size 14 top), I exercise and I manage my stress levels. It's hard because I'm not the type of person who's happy sitting around doing nothing, but my health was so bad that I was eventually boarded. I also manage my cholesterol and have changed my eating pattern completely. My cholestorol level has dropped from around 7 or 8 to 4.2," says Grace with obvious pride.
Grace is not alone. Most of us are highly-sensitised to breast cancer and yet, explains, Shan Biesman-Simons, director of Nutrition and Education of the Heart and Stroke Foundation South Africa, "the statistics speak for themselves: women are six times more at risk of dying from heart disease than breast cancer."
Just why we're facing a heart health tsunami is the result of a complex web of interrelated factors. One of them is the rising level of obesity in both men and women. While levels of overweight and obesity vary across the different race groups, 56% of all South African women are overweight. A quick look at the stats gives you some idea of just how many of us are packing too many kilograms: White 49,2%; Indian 48,9%; African 58,5%; and Coloured 52,2%.
Even more frightening, though, are the results of our perceptions of weight. Just 22% of women think they are fatter than they should be, which means we've come to accept as inevitable going up a dress size every year. And, while this is a disaster for your wardrobe and favourite pair of jeans, it's even more serious for your heart.
Professor Krisela Steyn, former director, Chronic Diseases of Lifestyle Unit of the Medical Research Council and honorary professor, Department of Medicine, University of Cape Town, explains that smoking, unhealthy diet, obesity and lack of exercise combine to make up a lethal cocktail.
This results in high rates of hypertension, diabetes and high blood cholesterol and these are all major risk factors for heart disease. "In South Africa, patterns of heart disease, hypertension and stroke differ from one population group to the other," she explains. "It's now common knowledge that as people become more urbanised and adopt a Westernised lifestyle, their risk for heart disease increases dramatically.
The other problem we face in Africa is that heart disease has a low detection rate and is often misdiagnosed. You've got a far better chance of being diagnosed and treated early on in the UK or Australia, for instance. As a result, people often realise they're in trouble when it's too late or when they've already suffered a heart attack or stroke."
Even more worrying is that women are less likely to survive a heart attack than men. Nobody knows why. Some suggest it might have something to do with a woman's smaller heart and arteries, but the more probable reason is that medics continue to think of heart disease as a male problem and don't treat women as aggressively, even when they're in the emergency room.
A warning: even if you're not overweight and exercise regularly and don't smoke, you can't afford to sit back and assume heart disease has nothing to do with you. Professor Steyn goes on to explain, "When women have children they become less active for all the obvious reasons and your body weight and body mass index creep up on you. When we're busy, we also eat a lot of food on-the-go, and fast food is usually highly processed and contains plenty of hidden fats and salt. There are some supermarkets that seem to be tackling the problem, but there isn't enough awareness about just how bad take-aways are for you if you're eating them regularly.
"Women also need to realise that from a very early age, they either curse or bless their children by laying the foundation for their eating habits. Everybody needs to learn to read labels more carefully and find out what products are low-fat and sugarfree. The dietary guidelines are clear - we all need to eat more roughage, increase our intake of fruit and vegetables, and watch what kind of fats we eat. In the past, South Africans were very blase about their lifestyle and how much meat, butter and alcohol they consumed. As a nation we are paying the price," Prof Steyn adds.
And, if you think you're too young to worry about boring things like steamed veggies and brown rice meals, it seems the potential for things to go wrong start when we're young and have your whole life ahead of you.
"One famous study looked at the hearts of young American and Korean men killed in the Korean War during the 1950s," continues Professor Steyn. "Although the majority of the men were in their early 20s, the American hearts already showed a build-up of plaque and a narrowing of the arteries, while the Korean hearts were in much better shape.
We don't have a comparable study for women but, in the end, your lifestyle will catch up with you regardless of your gender. Professor Harry Seftel from the University of Witwatersrand wryly jokes, 'You've got to work long and hard to get your heart attack,' and he's right." If you're used to eating a hamburger and chips for lunch, or your snack of choice is a choccie bar, changing your ways can be a daunting prospect.
"One of the areas of concern for us is people's lack of knowledge around good fats versus bad fats," says Biesman- Simons. "There are so many myths, such as 'cut out all fats', 'never eat meat or any carbohydrates' and consumers need to be educated properly.
"The Heart and Stroke Foundation SA recommends that South Africans not only decrease their amount of total fat intake, but also look at the type of fat they consume. Saturated fat raises blood cholesterol levels so people should aim to reduce this type, which is typically found in meats, butter, eggs and cheese. These fats are generally solid at room temperature. Polyunsaturated and monounsaturated fats tend to lower blood cholesterol levels and should make up more of the fat intake and are found in vegetable oils and fats. "We usually hear from people after they've had a heart attack - we want to reach them before this happens.
People need to know if they are at risk, and simple blood tests will show whether their cholesterol levels or blood sugar levels are higher than they should be. You should also know if your blood pressure is raised then definitely kick the smoking habit."
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