Weight loss and heart disease
Being overweight means that your heart has to work harder to pump blood around your body. This extra pressure can cause wear and tear on your heart and blood-vessel system. Many people who are overweight for a long time develop high blood pressure or diabetes, which are both risk factors for heart disease. In the last 10 years there has been an increase in the number of people who are overweight or obese. Obesity damages our hearts and our joints, and is mainly the result of too many calories in our diet and too little activity. So, if you are overweight, taking action now will help prevent you becoming obese.

If you are overweight or obese, you should check with your family doctor if you have other risk factors such as high blood pressure, diabetes, high cholesterol and smoking. Even losing a small amount of weight will improve your overall health and help reduce your risk of heart disease.

You can get more information about other risk factors from us or your local health board.

If you have already had a heart attack, bypass surgery or an angioplasty, it’s important that you follow these tips to lose weight :

• choose oily fish (for example, sardines, salmon, mackerel or trout) twice a week;
• choose at least four or more portions of fruit and vegetables every day; and
• choose rapeseed or olive oil if you use oil or oil-based dressings.

Are you ready to lose weight

• Is your weight creeping up each year?
• Do you have less energy than you used to?
• Do you get breathless running for a bus?

Your answer is likely to be ‘Yes’ as more than half of Irish adults are overweight or very overweight (obese).

By losing some of your extra weight you will:

• feel better;
• look better;
• lower your chances of heart disease,
• diabetes and high blood pressure;
• and help to reduce or even stop your medication for angina,
• high blood pressure or raised cholesterol.
• You may, of course, have your own reasons for wanting to lose weight.
• If you are overweight, start now and use the tips in this leaflet to change your eating habits and get more physically active. Even making small changes now will stop you from gaining extra weight over the next few years.

Are you always on a diet?

Forget about dieting. Instead, follow a weight loss plan for life. Make small gradual changes to the food you eat and get more active. Even losing a small amount of weight has health benefits. Start with changes that are easy to make and that you can keep up for life - this will help you to reach a healthier weight and then to stay at this healthier weight. Being a healthy weight isn’t about being as thin as a model, in fact it is quite the opposite. You can be a stone overweight but if you eat healthily, regularly take brisk walks and are generally active, it could be a healthy weight for you.

Are you an apple or pear shape?
If you are overweight, it is where your body stores the extra fat that can affect your risk of suffering from heart disease.

If the extra fat is stored around your waist, this gives you an apple shape. This shape is linked with a higher risk of heart disease, high blood pressure, diabetes and some cancers. If extra fat is stored around your hips this gives you a pear shape and this shape is less harmful to your health.

Use a measuring tape to measure your waist and then check the table below to assess your risk.

Waist measurement table

	Women	Men
Healthy waist measurement	Less than 80cms (32")	Less than 94 cms (37")
Moderate risk	Between 80 and 88 cms (32" - 35")	Between 94 and 102 cms (37 " and 40")
High Risk	More than 88 cms (35")	More than 102 cms (40")

Are you ready to lose weight?
There are two important things you need to do to lose weight successfully:

1. Get motivated to lose those extra pounds. Keeping a diary of the food you eat and the activities you do will help get you focused and keep you motivated.

2. Be prepared. Planning ahead helps you feel more in control of your weight loss. Have plenty of healthy foods in your fridge, lots of fresh fruit and vegetables, low-fat snack foods like low-fat yoghurt and a light oil spray for cooking. Have your tracksuit and trainers ready for your walking or exercise programme. This will make it easier for you to start your new eating and activity plan.

Motivation!
Motivation is most important when it comes to achieving a healthy weight. Motivation gets you started and keeps you going.

• Start by making a list of the reasons why you want to lose weight. Keep this list and look at it when your willpower is low.
  
• Next, keep a food and activity diary. Just write down what you eat for three days and when you do any activity. This will help you focus on what you’re eating and what you need to change. People who keep food and activity diaries are more successful at losing weight than those who don’t.
  
• Set realistic goals that you can reach over time - one kilogram (one to two pounds) per week. This way, you will be more likely to reach your target weight and stay there.
  
• Put your favourite photo of yourself on your fridge. This will make you think before you open the door - ‘Do I really need this food’.
  
• Lose weight with a friend or with a recognised weight loss group - you are more likely to succeed.
  
• Relax! Try to manage your stress by taking time out to do some activity. You are likely to eat and drink more when you are under stress.
  
• Picture yourself in your mind when you’ve lost some weight. Think about this image three to four times a day. Seeing a mental picture of yourself thinner can make you more confident that you can achieve your goal.

Successful tips for losing weight

• Look carefully at the size of your food portions, especially when you are eating out.
• Follow the  Food Pyramid  guidelines. Focus on what you can eat rather than on what you can’t. Be strict and limit your food choices from the top shelf. For lunch and dinner, use a smaller dinner plate and fill it mostly with vegetables.
• Have three regular meals each day. Research shows that people who eat breakfast regularly are more likely to keep their weight down.
• Some people find that having two smaller courses rather than one large main meal makes them feel more satisfied. Try choosing fruit, vegetables or salad as a starter, or fruit to finish off your meal.
• Learn to recognise hunger. If you are not really hungry at meal times, just eat small portions.
• Each week, write out a shopping list of the healthy foods you need to help you lose weight. Bring this list with you every week when you’re doing your family shopping. Try not to shop when you are hungry.
• Swap foods that are high in fat for healthier choices. You should choose the following;

- Low fat spread instead of butter or margarine
- Low fat milk instead of full fat milk
- Low fat cheese like Blarney or Edam or light cheddar instead of cheddar or cream cheese
- Lean meat, chicken (no skin) or fish instead of beef burgers, sausages and streaky bacon rashers
- Low fat salad dressing instead of mayonnaise and high fat dressings
- Fruit instead of cake and biscuits
- Small amounts of hard boiled sweets occasionally, instead of chocolate

Choose healthy low-fat ways of cooking

• Oven-bake, grill, boil, poach, stir-fry or microwave food instead of frying it.
• Boil, steam, dry-roast or bake potatoes instead of having chips.
• Try a light cooking spray instead of cooking oil.
• Cut all visible fat off meat and take the skin off chicken
• Drain fat off meat and sauces when they are cooked.
• Choose tomato-based sauces instead of creamy sauces for pasta and rice dishes.

Emergency supplies

• Have low-fat ready meals in the freezer - home-made or bought.
• Have a good supply of raw vegetables and plenty of fruit.
• Home-made soup is a great comfort food, especially on cold days.
• Freeze it in microwave-proof cartons so they are easy to thaw out and reheat as needed. Get into the habit of carrying a bottle of water. It is important to drink at least eight cups of fluid each day. Water can also help you feel full up between meals.

Alcohol
If you are serious about losing weight, you will be more successful if you cut out alcohol altogether until you reach your target weight. Alcohol is high in calories and can also make you hungrier.

Choose water or diet drinks every second drink. If you really need to have an alcoholic drink, try white wine spritzers or light beer instead of other drinks, and try to drink more slowly.

Do not drink more than the recommended upper limits: 21 standard drinks a week for men and 14 standard drinks a week for women, spread out over the week.

One standard drink
= one half pint of beer, stout or lager
= one small glass of wine
= one glass of spirits (whiskey, vodka or gin).

Support and reward
Get support from your family and friends. They can help you keep motivated, become more active with you and help you limit the high-fat snack foods you eat.

Reward yourself when you make positive progress. To check your progress, use a measuring tape or weighing scales (remember that scales vary and if you’re retaining fluid for any reason they may not give you a true picture of your progress), or consider how your clothes fit. Weigh yourself once a week at the same time in similar clothes. Choose a non-food treat for your reward - a magazine, a video, a CD, a film, a football match, a new haircut or even a top or shirt when you have lost some weight.

Be active to lose weight
Regular physical activity is as important as what you eat for losing weight and keeping your heart healthy. Being active helps burn calories, tone your muscles and control your appetite.

To lose weight, you need to use up more energy (calories) than your body takes in from food and drink. The best way to lose weight is through a combination of:

• eating and drinking fewer calories;
• and using up more calories by being more active.

For weight loss any activity is better than no physical activity at all so you could start off by being a little more active in your day-today routine. Just do more routine activities such as cleaning the house, or the car or gardening. For better results aim to do some activity on most days of the week. The activity can vary from the routine activities to leisure activities such as walking, dancing or sport.

Daily menu plan
Regular meals stop you feeling hungry and ensure that you have a daily supply of essential nutrients. Try out the meal suggestions below or check out our Good Eating section and our delicious heart healthy recipe ideas.

Breakfast

• One bowl of wholegrain cereal with chopped fruit and low-fat milk
• One slice of wholemeal bread or toast
• Tea or coffee

Mid morning

• Fruit or raw vegetables
• Tea, coffee or water

Lunch

• Plenty of cooked or raw vegetables
• 25 to 50 grams (one to two ounces) of lean meat, poultry, sardines, salmon, eggs or low fat cheese.
• Two slices of wholemeal bread or a roll
• Low-fat yogurt or a glass of low-fat milk
• Fresh fruit
• Tea, coffee or water

Mid afternoon

• Fresh fruit or raw vegetables
• Tea or water

Main meal

• 75 to 100 grams (three to four ounces) of lean meat, poultry, fish (preferably oily), eggs, low-fat cheese or nine dessertspoons of peas or beans
• Plenty of vegetables
• One medium baked or boiled potato, or three dessertspoons of pasta or rice
• Low-fat yogurt or a glass of low-fat milk
• Fresh, cooked or tinned fruit (in its own juice)
• Water

Supper

• Tea or water
• Fresh fruit

If you feel hungry between meals, choose fresh fruit or raw vegetables to snack on.