You have talked about vitamin E. What about vitamin C - isn't this an antioxidant as well?

Yes, and it is safe to take, but medical trials have demonstrated no benefit for heart disease. It is found in citrus fruits (oranges, grapefruits, lemons), kiwi fruit, soft fruit (strawberries, raspberries, blackberries), red and green peppers and spring greens. Try to eat

150-200 g (6-8 oz) of this group a day and you will not need tablet supplements.

I have always believed taking vitamin supplements would protect me - are you saying this is not true?

Unfortunately yes. The Heart Protection Study involved thousands of patients and those taking vitamins did no better or worse than those taking placebos (fakes). In other words, vitamins do not protect against the effects of hardening of the arteries and are of no benefit to the heart. The vitamin story is a good example of an idea that is theoretically good but, when tested, does not work.

I know of people taking beta carotene supplements and our health food shop is always marketing it. What is beta carotene, and should I be taking it?

No. Beta carotene is converted in the body to vitamin A. It is an antioxidant and is found in brightly coloured fruit and vegetables (carrots, broccoli, tomatoes, melons, yellow and orange peppers, spinach, peaches). So you might think that extra supplements would be good for you. However, medical trials have failed to show that they have any benefit, and researchers are now worried that they may lead to an increased risk of some cancers and heart disease. Do not waste your money on beta carotene supplements - fruit and vegetables are all that you need.

I thought that people supplementing their diet with extra beta carotene from the health food shops had a lower chance of developing heart disease or cancer. You say that there may be risk of developing these conditions - which view is right?

This question is a good example of the need always to make sure that a good idea works when put into practice. Beta carotene has antioxidant properties and, in theory, could help prevent cancer and coronary heart disease. Indeed, people who took beta carotene supplements were observed to be less likely to develop these diseases -but an observation is not proof. Four research studies involving thousands of people set out to prove whether a benefit existed when beta carotene was compared to placebo (see the section Other treatments for angina in Chapter 3). These were proper scientific studies. Surprisingly and alarmingly, beta carotene supplements were shown to increase heart disease and cancer risks, especially in smokers and people exposed to asbestos. Ideas, whether based on good scientific theory, as in the case of beta carotene, or dreamed up in the bath, should always be validated! Beta carotene should be consumed normally in fresh fruit and vegetables.

There is so much advice about fat intake that I really don't know what to believe. How much fat should we eat a day?

This depends on whether you need to reduce weight, that is, reduce calories. Remember that fat, whether good (unsaturated) or bad (saturated) is high in calories. We need 50-90 g of fat a day of which 22-27 g, only, should be saturates. Always look on the food labels to help you choose foods that contain less saturated fats.

Let's work out some numbers. Doctors recommend that no more than 30% of your calorie intake is fat, and 10% of that is saturated fat, regardless of whether or not you are overweight. If your daily calorie intake is 1500 kcal, this means 50 g of fat at most (1 g of fat equals 9 kcal). If your daily calorie intake is 2000 kcal, this means 65-70 g of fat; if it is 2500 kcal, this means 85-90 g of fat. (See Chapter 9 for further information on fats in food. )

My father had a high cholesterol level and died aged 55. My wife is concerned that I may be like him -1 am now 52. Can this be inherited?

Some people may inherit a high cholesterol level (usually over )8.0mmol/litre). A good diet changes these people's levels only marginally and they will need medication. Make sure that all members of your family are checked for an inherited pattern and, if this is detected, you will be recommended medication. Other people inherit a tendency to a high cholesterol level but respond to diet, plant stanols or, more usually, a combination of diet and medications.

 
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