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Start your cholesterol lowering journey today! Cholesterol Lowering Guide Learn what you can do to help lower cholesterol with simple easy hints and tips that fit into your everyday life! Introduction Cholesterol plays a vital role in the day-to-day functioning of the body. However, too much cholesterol in the blood can affect heart health. The good news is that lowering it, and keeping it at the recommended level, is much simpler than you might think. A healthy balanced diet is important for everyone. Plant sterols (the active ingredient in Flora pro.activ) are clinically proven to lower cholesterol by 7–10% in 2–3 weeks* as part of a healthy diet and lifestyle. To help on your cholesterol lowering journey, we’ve created this booklet to give you some top tips and to help track the changes you are making to your diet and lifestyle. ! y o j En Making these simple changes can be an effective, fulfilling and enjoyable way of lowering your cholesterol and improving your health…now! 01 *A daily intake of 1.5–2.4g plant sterols can lower cholesterol by 7–10% in 2-3 weeks as part of a healthy diet and lifestyle. High cholesterol is a risk factor in the development of coronary heart disease. As coronary heart disease has multiple risk factors, more than one may need to be improved to reduce overall risk. Not be nutritionally appropriate for children under 5 and pregnant or breast feeding women, people already taking cholesterol lowering medicines should consult their doctor first and pro.activ is intended exclusively for people who want to lower their cholesterol. 02 Lowering cholesterol CLINICALL PROVENY What is cholesterol? Flora pro.activ and plant sterols Eating too much saturated fat is a common cause of high cholesterol, although there are lots of other factors that can affect blood cholesterol levels. Plant sterols in Flora pro.activ products are clinically proven to significantly lower cholesterol. High cholesterol is a risk factor in the development of coronary heart disease.* Cholesterol travels around the bloodstream in special carriers: LDL-(‘bad’)cholesterol – takes cholesterol from the liver to the body tissues. l l HDL-(‘good’)cholesterol – returns cholesterol back to the liver where it is eliminated. How can I reduce cholesterol? l Reduce intake of (bad) saturated and trans fats by replacing them with (good) monounsaturated and polyunsaturated fats. To help increase your ‘good’ cholesterol, keep active and aim to do at least 30 minutes of exercise every day. Incorporate 3 portions of foods with added plant sterols (such as Flora pro.activ) into your daily diet. l Plant sterols naturally occur in small quantities in vegetable oils, nuts, seeds, grain products , fruit and vegetables, but you would 150 s apple need to eat 150 apples, 210 carrots or 425 tomatoes to get the same amount of plant sterols as one Flora pro.activ mini drink, or three portions of Flora pro.activ spread. A healthy diet is essential when you want to lower your cholesterol and the plant sterols in Flora pro.activ can help lower cholesterol. 210 carrots 425 tomatoes l 03 *A daily intake of 1.5–2.4g plant sterols can lower cholesterol by 7–10% in 2-3 weeks as part of a healthy diet and lifestyle. High cholesterol is a risk factor in the development of coronary heart disease. As coronary heart disease has multiple risk factors, more than one may need to be improved to reduce overall risk. 04 The Flora pro.activ LLY A C I N range I L C N PROVE Taking control of cholesterol may seem to be very challenging but with the help of Flora pro.activ, it doesn’t have to be hard. How does Flora pro.activ work? Flora pro.activ is different to other spreads as it contains plant sterols which are clinically proven to actively lower cholesterol. Plant sterols actively remove cholesterol from the body by partly blocking the absorption of cholesterol in the gut. Cholesterol that isn’t absorbed is then removed from the body, resulting in a lowering of total and LDL-(bad)cholesterol levels. Three portions of Flora pro.activ Spread or Milk, or just one Mini Drink, provides you with your daily intake of plant sterols. How much is a portion? Try the whole range to see what you like best. They’re all used differently so you can mix and match to suit your diet*. Flora pro.activ Spreads: one portion is 10g (two teaspoons). Three portions a day, eaten with your meal, is all you need to get the recommended amount of plant sterols. Try it on a sandwich or stirred into hot vegetables. Reduce cholesterol with 3 servings or 1 mini drink a day } Flora pro.activ Milk: one portion is 250ml (one glass). You can try a combination of Milk and Spreads, as long as you have three portions a day. Flora pro.activ Mini Drinks: one portion is one drink. With these, you only need one portion a day with your meal. These come in three flavours: Original, Strawberry and Pomegranate & Raspberry. Try pouring it over a bowl of fruit or drinking it with your lunch. Mix & match 3 servings or 1-a-day 1 serving equals or 10 g250 ml100 ml 2 slices of bread 1 glass 1 mini drink *It is not recommended to consume more than 3g plant sterols per day 05 06 diat e ris k fa ctor s High Cholesterol: a key modifiable risk factor for developing heart disease* rme Cardiovascular disease is the number one cause of death globally. physical inactivity l smoking l harmful use of alcohol rs l acto unhealthy diet isk f l inte The most important risk factors of heart disease are: l raised blood glucose avio u raised blood pressure ral r The effects of unhealthy diet and physical inactivity may lead to: l und erly ing cau ses overweight and obesity *A daily intake of 1.5–2.4g plant sterols can lower cholesterol by 7–10% in 2-3 weeks as part of a healthy diet and lifestyle. High cholesterol is a risk factor in the development of coronary heart disease. As coronary heart disease has multiple risk factors, more than one may need to be improved to reduce overall risk. 07 unhealthy diet physical inactivity smoking beh raised blood lipids (including raised cholesterol) l l High blood pressure Being overweight or obese population ageing urbanization globalization Poverty stress Reference: WHO Fact sheet N°317 Cardiovascular diseases (CVDs), September 2011 http://www.who.int/mediacentre/factsheets/fs317/en/index.html 08 Food & Shopping Sometimes it feels like eating healthily is all about eating less. But actively lowering cholesterol doesn’t have to be about cutting things out of your diet. You may be surprised to know that enjoying your jacket potato or bread with a generous topping of Flora pro.activ is healthier than not using a spread at all. That’s because every time you eat Flora pro.activ it’s plant sterols work inside the body to filter out the LDL-(bad)cholesterol. Ten Tips for a cholesterol lowering diet 1.Know your fats – Saturated fats such as those found in butter, full fat dairy and fatty meat should be limited because they can increase your level of LDL-(bad)cholesterol. Replacing saturated fats with polyunsaturated and monounsaturated fats help to maintain healthy cholesterol levels. These good fats can be found in foods such as nuts, seeds, avocado, soft spreads and oily fish. 2.Choose low fat dairy foods – skimmed or semi skimmed milk, low fat yogurt and reduced fat cheese. Use low fat yogurt or fromage frais instead of cream when cooking or making desserts. 3.Opt for fish and poultry over fatty meat products, which can be high in unhealthy fats. Try substituting some meat with beans or lentils. 4.Include oily fish, such as herring, mackerel, salmon or trout, one or two times a week. 5.Get plenty of fibre in your diet – swap white bread and pasta for brown and wholegrain varieties. Oats, vegetables, fruits and pulses such as beans and lentils are also sources of fibre. 09 6.Get your five-a-day – eat a mix of fruit and vegetables to get the vitamins, minerals and fibre you need. The more colourful your meals are, the more likely you are to be getting the nutrients you need. 7.Include plant sterols – these are found at low levels in everyday foods like fruits, vegetables, nuts, seeds and cereals. But to get a significant cholesterol lowering effect, you can include foods with added plant sterols like Flora pro.activ as part of your daily diet. 8.Try to use seed or nut oils instead of butter – oils from seeds and nuts are rich in unsaturated fats. Switch from butter to a good quality spread, such as Flora pro.activ, which is made from these fats. 9.Snack on nuts and seeds instead of cakes and biscuits. Why not make up your own mix of seeds, nuts and dried fruit for healthy snacking at your fingertips? 10.Eat no more than five grams of salt a day. Experiment with herbs and spices instead and avoid salty snacks like crisps, which are also usually high in bad fats which can raise cholesterol. 10 Dietary changes and statins, working together Everyday exercise Try to do 30 minutes of moderate exercise a day. You can break it into three 10-minute sessions throughout the day if you like. Start with what you can and build your way up, you’ll be surprised by how responsive your body is! Even everyday activities can be turned into moderate exercise. Put in extra energy to get your heart-rate going: Walking l Gardening l House work l Washing the car l The more active you are the better. Quick tricks that really help: Take the stairs instead of the escalator l Get off the bus a stop early and walk l Park the car further from where you’re going l Walk briskly instead of strolling l There are also simple changes you can make to your lifestyle: Avoid smoking l Maintain a healthy weight l Limit alcohol consumption l Learn to control stress and relax l Statins and Cholesterol Statins are the most commonly prescribed medication for high cholesterol. Statins work by inhibiting the production of cholesterol. The lower the better When it comes to LDL-cholesterol, you want to reduce your level as much as possible for a healthy heart. What you may not realise is that you can enjoy further LDL-cholesterol reductions on top of statins by moving to a healthier diet and by including products which contain plant sterols into your diet. In fact, combining your statins with a move to a healthy diet and lifestyle (and foods with added plant sterols) can lower LDL-cholesterol by up to 40% as opposed to 25% average for statins alone. Flora pro.activ and statins – working together If you are taking cholesterol lowering medication talk to your doctor first 11 Cholesterol-lowering effect of phytosterols is additive to healthy diet & statins 0 LDL-cholesterol reduction, % Exercise and lifestyle -10 healthy diet* healthy diet* healthy diet* foods with added phytosterols** Statins -20 -30 plant sterolenriched foods** -40 *low in saturated fat and cholesterol **2-3 g/day of plant sterols in the form of enriched foods Chen et al, Lipids 2009; Cleghorn et al, EJCN 2003, Jones et al, AJCN 1999; Katan et al, Mayo Clin Proc 2003; Edwards & Moore, BMC Family Practice 2003 to see if you can include foods with added plant sterols like Flora pro.activ in your diet. Plant sterols provide additional cholesterol lowering benefits on top of cholesterol lowering medication – because they work in a different way, actively removing cholesterol from the body by partly blocking the absorption of cholesterol in the gut. Combining medication with foods with added plant sterols as part of a healthy diet can help to maximise cholesterol lowering. 12 Track your Progress Now help keep it low My Cholesterol Levels My Results Target Dates Total Cholesterol Less than 5.0 mmol/l LDL-Cholesterol Less than 3.0 mmol/l Top Tip! Using the advice in this booklet Keep your goals realistic and look for and guidance from your health care professional, set some specific goals on small changes you can incorporate into the changes you will make to your diet your everyday life – setting goals which are too stretching can make them & lifestyle to help lower cholesterol. difficult to stick to, so strike a balance. If you’ve been following the tips in this booklet you have made positive changes towards a healthier diet and lifestyle. your cholesterol rechecked – and understand what difference your hard work has made to your cholesterol level. Sticking to change can be hard but keep at it… don’t worry if you have the occasional slip – it happens to us all, and it’s no reason to give up your good habits entirely. Have a conversation about the changes you’ve made and agree how you can stick to these long term. My goals Exercise (eg, swimming or a brisk walk) Eat less of (eg, saturated fat) Eat more of (eg, have oily fish twice a week and get my 5 a day of fruit and vegetables) Make sure you go back to your health care professional to get For cholesterol lowering hints, tips and recipes and to see how hundreds of people like you have lowered cholesterol with Flora pro.activ, visit www.floraproactiv.co.uk 13 My key food swaps (eg, use Flora pro.activ spread instead of butter and switch from cheese to chicken salad sandwiches at lunchtime) 14 Diet Sheet and Recipes Diet Sheet Advice to move to a balanced diet Food Group Bread, cereals and potatoes Base all meals (and snacks) on a serving from this group Fruits and Vegetables At least five or more portions every day. Best choice Occasionally Best avoided Wholegrain varieties of bread, pasta, rice, noodles, breakfast cereals, oats. Couscous, (sweet) potatoes, yam. Mashed potatoes. Croissants, waffles, fried potatoes, roast potatoes, sugar coated breakfast cereals. Fresh, frozen, dried or canned (in natural juice) fruits and vegetables. Canned fruit in syrup (drain the syrup). Fruit juice. Vegetables fried in batter or in creamy sauce. (Extra) lean pork, ham, lamb, (minced) beef, chicken and turkey (without skin), veal. Lean bacon, reduced fat sausages, burgers, meatballs. Fatty cuts of meat, belly pork, lamb, duck, goose. A portion (80g) of fruit and vegetables is: 1 cereal bowl of mixed salad, 1 piece of fruit, 2 pieces of small fruit, 1 handful of grapes or strawberries, 1 tablespoon dried fruit, 3 tablespoons vegetables or fresh fruit salad. Meat, fish & alternatives Eat a moderate amount (1-2 portions a day). Vary by choosing lean meat, 2-3 times a week. On the other days choose fish or non-meat alternatives. Try to eat fish at least 2 times a week incl 1 portion (140 g, the size of a pack of playing cards) of oily fish. A portion = 1 egg. 30 g (1.5 tablespoons) of nuts/ seeds daily. A portion (4 cooked tablespoons) of cooked beans, peas or lentils daily. Streaky bacon, sausage (rolls), (pork) pies, pasties, chicken nuggets. All fish: cod, plaice, sole, whiting, (fresh, canned) tuna, shellfish. Oily fish: (fresh, canned) mackerel, sardines, pilchards, salmon, trout, herring. Fish in creamy, cheesy sauces. Fried fish in batter. Roasted nuts in oil and salt. 3 eggs per week. All nuts and seeds, especially almonds, walnuts, linseed, pumpkin, sesame, sunflower seeds. (Chick) peas, lentils, sweetcorn, kidney beans, lentils. Rinse if canned in salt, sugar. Soya mince, -beans, tofu. Milk/dairy foods & alternatives Skimmed milk (with plant sterols/stanols), soya milk. Semi-skimmed milk, reduced fat evaporated milk. Full fat milk, evaporated or condensed milk. 2-3 portions a day. Low fat, fat-free, ‘light’ fruit yogurts. Yogurts and mini drink (with plant sterols/stanols). Half-fat yogurt. Clotted, double, whipping, soured, single cream. Half-fat cheddar, mozzarella, feta, light’ cheese spread, quark. Creme fraiche. A portion is a medium glass of milk (200ml), a small pot of yogurt/light fromage frais (150g), a matchbox of medium fat cheese (40g), a small matchbox of high fat cheese (20g), 2 small matchboxes of ‘light’ cheese spread (80g) or a large pot of cottage cheese (200g). Oils and Fats Small amounts are essential in the diet. When considering fats, remember, not all fats are equal. Replace saturated fats with ‘good’ unsaturated fats, which are healthy essential components of a balanced diet. Use saturated fats as little as possible. Water 19 Reduced fat, half-fat, cottage, curd cheese, ‘extra light’ cheese spread. Full fat yogurt. Unsaturated fat spreads, spreads with plant sterol/stanols. Liquid margarine. Butter, lard, suet, dripping, ghee, hard margarines. Cream cheese, mascarpone, brie, camembert, stilton, edam, parmesan, full fat cheese spread. (mineral) water, coffee, tea 20 Ingredients • 200g wholewheat penne pasta • 1 aubergine (about 200g) • 1 red pepper • 1 small courgette (about 150g) • ½ tbsp olive oil • 1 tbsp pine nuts • 2 sundried tomatoes (soaked in water) • 1 bunch fresh basil (about 30g) • 1 small bunch fresh parsley (about 15g) • 4 tsp Flora pro.activ Buttery or Light Extra: Hand blender Method Tip Italian Roasted Vegetable & Fresh Pesto Pasta e Instead of pin of nuts, add 50 g finely chopped n cooked chicke to the pesto. 1. Preheat the oven to 200°C. 2. Cook the pasta according to the packet instructions, without salt. Drain. 3. Cut the aubergine and pepper into 10 pieces each and the courgette into 6 pieces. 4. Brush the vegetables lightly with the olive oil and place them into a baking dish. Roast them for 25-30 minutes until done. Turn twice during roasting. Sprinkle with black pepper. 5. Meanwhile, toast the pine nuts in a dry frying pan until golden brown. Leave to cool. Nutritional Information per portion + %* (using Flora pro.activ Buttery) Fat of which saturates Carbohydrates 2199kj /527kcal 14.4g 2.3g 83.5g 8.9g 18.7g 0.2g 6. Put a few basil leaves to one side. Place the sundried tomatoes, remaining herbs, toasted pine nuts and the Flora pro.activ into a bowl and whizz with the blender. Season with black pepper. Stir in a large spoonful of cold water. 26% 21% 12% 32% 10% 37% 3% 7. Add the pesto and roasted vegetables to the pasta and toss well to coat. Energy of which Protein sugars Salt 8. Divide the pasta over 2 plates, garnish with the reserved basil leaves and serve immediately. *Reference intake of an average adult (8400 kJ/2000 kcal) 21 22 Ingredients • 3 fresh dill sprigs • 3 fresh parsley sprigs • 3 fresh chive sprigs • 1 tsp French mustard • 4 tsp Flora pro.activ Buttery or Light • 2 thick salmon fillets (150g each), skin on Extra: Greased shallow oven dish with lid or tinfoil to cover the dish Method 1. Preheat the oven to 200°C. 2. Finely chop the dill, parsley and chives. Place them in a bowl, add the mustard and Flora pro.activ and mash with a fork. Season with black pepper. Tip d Add the grate on rind of ¼ lem . to the dill glaze Oven Baked Salmon with a Dill Glaze 3. Place the salmon, skin down, into the oven dish. Squeeze over the lemon. Cover the dish and bake in the preheated oven for about 10 minutes (thicker pieces of salmon may take a few minutes longer). 4. Remove the dish from the oven. Spread the dill glaze over the salmon. Cover and leave for 2 minutes. 5. Serve the glazed salmon on 2 plates immediately. Nutritional Information per portion + %* (using Flora pro.activ Buttery) Energy Fat of which saturates Carbohydrates of which Protein sugars Salt 1553kj /372kcal 26.4g 5.8 0.2g 0.1g 30.9g 0.4g 19% 38% 29% <1% <1% 62% 7% *Reference intake of an average adult (8400 kJ/2000 kcal) 23 24 Ingredients • 3 ripe tomatoes • 1 small red onion • 1 garlic clove • 6 fresh coriander sprigs • 1½ lime • 200g kidney beans (tinned) • 100g corn kernels (tinned) • chilli powder • 1 tsp hot pepper sauce (optional) • 150g skinless boneless chicken breast (or minced chicken) • 4 tsp Flora pro.activ Buttery or Light • 6 taco shells Method Tip Chicken Tacos with Tomato Salsa & a bean salad min Toast 1 tsp cu utes in seeds for 2 m pan g n in a dry fr yi th and add to e lime mix ture. Nutritional Information per portion + %* (using Flora pro.activ Buttery) Energy Fat of which saturates Carbohydrates 2258kj /542kcal 18.4g 4.6g 52.0g 7.7g 30.2g 1.3g 27% 26% 23% 20% 15% 60% 22% *Reference intake of an average adult (8400 kJ/2000 kcal) 25 of which Protein sugars Salt 1. Preheat the oven to 125°C. 2. Chop the tomatoes into very small pieces. Peel and finely chop the onion and garlic. Roughly chop the coriander. 3. Grate the lime rind. Halve the lime. Squeeze 1 lime half and cut the remaining half into 2 wedges. 4. Rinse and drain the beans and corn. 5. Mix for the bean salad the beans, corn, two-thirds of the chopped tomato, half the onion, half the coriander and half the lime juice and a pinch of chilli powder together. Add the hot pepper sauce (if using). Place in the fridge and leave for the flavours to mingle. 6. Mix for the salsa the remaining tomato and onion with half the garlic, half the remaining coriander, 2 tsp lime juice and a pinch of ground chilli. 7. Finely chop the chicken - you want it to resemble minced meat. Mix with ½ tsp chilli powder and the remaining garlic. Place the taco shells in the preheated oven according to the packet instructions. 8. Mix the Flora pro.activ, lime rind, a few drops of lime juice and ½ tbsp coriander together in a small bowl. 9. Stir-fry the chicken in a dry, non-stick wok for 5-6 minutes. Turn off the heat, stir in the lime mixture and leave for 1 minute. Adjust the seasoning. 10. Fill the warm taco shells with chicken and tomato salsa. Sprinkle with the remaining coriander. Serve them with the lime wedges on 2 plates. Eat the tacos with the bean salad. 26 Ingredients • 150g skinless roast chicken breast • 20 cherry tomatoes • 10 fresh chive sprigs • 1 tsp minced horseradish • 4 tsp Flora pro.activ Buttery or Light • 2 multi-grain tortillas • 60g lettuce leaves • 50g mixed sprouts Method 1. Finely shred the chicken. Tip l T his w rap w il h it w ly taste love ry le ce chopped of leaves instead l. el w chives as Roast Chicken, Tomato & Horseradish Wrap 2. Quarter the cherry tomatoes. Finely chop the chives. Place in a small bowl with the horseradish and Flora pro.activ and mash together with a fork. Add the chicken and black pepper to taste. 3. Spread the chicken and horseradish mixture evenly over the wraps. Top with lettuce leaves, tomatoes and mixed sprouts. Fold the wraps around the filling. Place on 2 plates and cut in halves. Nutritional Information per portion + %* (using Flora pro.activ Buttery) Energy 2387kj /569kcal 28% Fat of which saturates Carbohydrates of which Protein sugars Salt 21.9g 6.5g 61.2g 8.2g 28.2g 1.7g ?% 32% 24% 9% 56% 30% *Reference intake of an average adult (8400 kJ/2000 kcal) 27 28 Ingredients • 2 slices (about 35g each) smoked salmon • 4 tsp Flora pro.activ Buttery or Light • 4 eggs • 400g fresh spinach • 500g new potatoes, peeled • ½ tbsp olive oil Extra: Double boiler or a bowl over a pan with boiling water Method 1. Cut 1 slice of salmon into small pieces. Place into a small bowl and mix with the Flora pro.activ and black pepper to taste. Halve the other slice of salmon. 2. Peel the potatoes and cook them for about 10 minutes in boiling water until they are done. Tip Scrambled Eggs with Spinach & Smoked Salmon so T his dish is al e nice when mad w ith rocket d (arug ula) instea of spinach. 3. Meanwhile, heat a large saucepan with a heavy bottom and pour in the oil. Beat the eggs, season with black pepper and pour them into the saucepan. 4. Cook over a low heat, stirring all the time, until almost set. Add 1/4 of the spinach and keep stirring until it has wilted. Remove the pan from the heat, stir in the salmon mixture and adjust the seasoning. Set aside and keep warm. 5. Quickly stir-fry the remaining spinach in a frying pan until wilted. Nutritional Information per portion + %* (using Flora pro.activ Buttery) Energy Fat of which saturates Carbohydrates of which Protein sugars Salt 2141kj /512kcal 20.3g 5.0g 49.1g 3.3g 27.5g 1.5g 26% 29% 25% 19% 4% 55% 25% 6. Place the halved salmon slices on 2 plates, spoon the scrambled eggs on top and serve immediately. Serve with the boiled potatoes and extra spinach on the side. *Reference intake of an average adult (8400 kJ/2000 kcal) 29 30 Ingredients • 1 garlic clove • ½ tbsp olive oil • 6 slices multigrain baguette • 1 tbsp pine nuts • 4 tsp Flora pro.activ Buttery or Light • 3 artichokes hearts (tinned) • 1-2 tsp (fresh) lemon juice • 25g rocket (arugula) Extra: Hand blender Method 1. Preheat the oven to 175°C. 2. Peel and crush the garlic. Mix with the oil and pinch of black pepper. 3. Lightly spread the slices of bread on both sides with the garlic mixture. Place them on a baking sheet and bake for about 10-15 minutes in the oven until light brown. Use the crostini preferably when still hot. Multigrain Crostini with Artichoke Spread & Rocket 4. Meanwhile, toast the pine nuts in a dry frying pan until golden brown. Leave to cool. 5. Using the hand blender, whizz the Flora pro.activ, artichoke hearts and pine nuts into a coarse spread. Add lemon juice and black pepper to taste. 6. Divide the artichoke spread over the crostini, place them on 2 small plates and sprinkle with the rocket. Nutritional Information per portion + %* (using Flora pro.activ Buttery) Energy Fat of which saturates Carbohydrates of which Protein sugars Salt 869kj /209kcal 13.6g 2.2g 12.9g 2.7g 5.6g 0.4g 10% 19% 11% 5% 3% 11% 7% *Reference intake of an average adult (8400 kJ/2000 kcal). A daily intake of 1.5-2.4g plant sterols can lower cholesterol by 7-10% in 2-3 weeks as part of a healthy diet and lifestyle. High cholesterol is a risk factor in the development of coronary heart disease. As coronary heart disease has multiple risk factors, more than one may need to be improved to reduce overall risk. 31 32 Ingredients • 400g broccoli • 100g fresh salmon fillets • 100g fresh cod fillets • 300g fresh mussels, shell on • 2 tsp lemon juice • 1 tbsp pine nuts • 1 bunch fresh basil (about 40g) • 4 tsp Flora pro.activ Buttery or Light Extra: Hand blender, tinfoil Method 1. Preheat the oven to 200°C or light the barbeque. 2. Cut the broccoli into florets and cook for 3 minutes in boiling water. Drain well. 3. Meanwhile, halve the salmon and cod fillets. Mixed Fish Parcels with Broccoli & Basil Topping 4. Tear off 2 large pieces of tinfoil. Divide the broccoli, fish and mussels over the sheets; place in the middle. Drizzle with ½ tsp lemon juice each. Fold the foil over the filling and scrunch the sides together tightly to seal. 5. Toast the pine nuts in a dry frying pan until golden brown. Leave to cool. 6. Put a few basil leaves to one side. Using the hand blender, whizz together the Flora pro.activ, basil, toasted pine nuts and the remaining 1 tsp lemon juice. Season with black pepper. Nutritional Information per portion + %* (using Flora pro.activ Buttery) Energy Fat of which saturates Carbohydrates of which Protein sugars Salt 1790kj /429kcal 20.1g 3.8g 14.6g 3.8g 43.8g 1.5g 21% 29% 19% 6% 4% 88% 25% 7. Cook the mixed fish parcels for 15-20 minutes in the oven or on the barbeque. Place them on 2 plates. Carefully open the foil and spoon some basil topping on the broccoli and fish. Close the foil back up again and leave for 30 seconds. Serve immediately. Serve with baby potatoes. *Reference intake of an average adult (8400 kJ/2000 kcal). A daily intake of 1.5-2.4g plant sterols can lower cholesterol by 7-10% in 2-3 weeks as part of a healthy diet and lifestyle. High cholesterol is a risk factor in the development of coronary heart disease. As coronary heart disease has multiple risk factors, more than one may need to be improved to reduce overall risk. 33 34 Ingredients • 200g wholewheat spaghetti • 50g shelled walnuts • 6 spring onions • 300g cherry tomatoes • 1 garlic clove • 1 tsp olive oil • 50g rocket • 4 tsp Flora pro.activ Buttery or Light • 2 tbsp grated Parmesan cheese Method 1. Cook the spaghetti according to the packet instructions, without salt. Drain. Tip Spaghetti with Rocket, Walnuts & Cherry Tomatoes so T his dish is al e very nice mad w ith brow n rice instead of spaghet ti. 2. Roughly chop the walnuts. Halve the cherry tomatoes. Finely slice the spring onions. Peel and chop the garlic. 3. Heat the oil in a frying pan. Sauté the tomatoes for 2 minutes. Add the spring onions and garlic and cook for 1 minute. Add the walnuts, spaghetti, half the rocket and black pepper to taste. Mix well and heat for 1 minute. Take the pan off the heat, stir in the Flora pro.activ, cover and leave for 1 minute. Adjust the seasoning. 4. Divide the spaghetti over 2 plates or bowls and sprinkle the rest of the rocket and the Parmesan cheese over it. Serve immediately. Nutritional Information per portion + %* (using Flora pro.activ Buttery) Energy Fat of which saturates Carbohydrates of which Protein sugars Salt 2746kj /657kcal 28.0g 4.4g 84.2g 6.2g 23.3g 0.4g 33% 40% 22% 32% 7% 47% 7% *Reference intake of an average adult (8400 kJ/2000 kcal). A daily intake of 1.5-2.4g plant sterols can lower cholesterol by 7-10% in 2-3 weeks as part of a healthy diet and lifestyle. High cholesterol is a risk factor in the development of coronary heart disease. As coronary heart disease has multiple risk factors, more than one may need to be improved to reduce overall risk. 35 36 3 week challenge 3 Know your fats. week cholesterol lowering challenge Week 1 Follow this plan to help lower cholesterol within 3 weeks. Flora pro.activ is clinically proven to actively lower cholesterol by up to 7-10% as part of a healthy diet and lifestyle by eating 3 portions a day.* Read on for more tips and advice to help you on your cholesterol lowering journey. Try swapping your regular spread for Flora pro.activ Buttery. With a rich buttery taste and creamy texture, you’ll be surprised at how tasty cholesterol lowering can be. As well as using on sandwiches or toast, why not melt some on your vegetables or jacket potato with your evening meal? Saturated fats such as those found in butter, full fat dairy and fatty meat should be limited because too much of them can increase bad cholesterol. So replace saturated fats with good fats such as mono-unsaturated and polyunsaturated fats. These can be found in foods such as nuts, seeds, avocados, soft spreads and oily fish. Opt for fish and poultry over fatty meat products. Replace fatty meat and meat products with beans, legumes, lentils, fish, poultry or lean meat. Try substituting some meat with beans or lentils. Snack on nuts and seeds instead of cakes and biscuits. Why not make up your own mix of seeds, nuts and dried fruit for healthy snacking at your fingertips? Spread Flora pro.activ spread on a sandwich. Try to use seed or nut oils instead of butter. One portion is 10g (two teaspoons). Three portions a day, eaten with your meal, is all you need to get the recommended amount of plant sterols. Try it on a sandwich or stirred into hot vegetables. Oils from seeds and nuts are rich in unsaturated fats. Switch from butter to a good quality soft spread based on vegetable oils, such as Flora pro.activ, which is made from these fats. Get moving. - Get off the bus a stop early and walk - Park the car further from where you’re going - Walk briskly instead of strolling Take the stairs instead of the escalator. It may be tougher at first but it’s an excellent way of getting regular exercise without having to plan. Take a 30 min brisk walk. Find time in the day whether it’s winter or summer, sunny or raining. Just dress appropriately. It’ll be easier to make the time once you get into the habit. Most of all enjoy it. Even everyday activities can be turned into moderate exercise. Think of walking, gardening, house work, washing the car. *A daily intake of 1.5-2.4g plant sterols can lower cholesterol by 7-10% in 2-3 weeks as part of a healthy diet and lifestyle. High cholesterol is a risk factor in the development of coronary heart disease. As coronary heart disease has multiple risk factors, more than one may need to be improved to reduce overall risk. 39 40 Week 2 Try using Flora pro.activ milk in cereal as 1 of you 3 portions a day or simply enjoy one tasty Flora pro.activ mini drink with breakfast, a great way to start the day. Include plant sterols in your diet. Plant sterols are found at low levels in everyday foods like vegetable oils, nuts, seeds, grain products, fruit and vegetables. But to get a significant cholesterol lowering effect, include foods with added plant sterols like Flora pro.activ* in your diet. Simple changes you can make to your lifestyle. • Avoid smoking • Maintain a healthy weight • If you drink alcohol, do it in moderation • Learn to control stress and relax Get plenty of fibre in your diet. Swap white bread and pasta for brown and wholegrain varieties. Oats, vegetables, fruits and pulses such as beans and lentils are also sources of fibre. Eat no more than 6 grams of salt a day. Experiment with herbs and spices instead and avoid salty snacks like chips. 41 Get your five-a-day. Choose low fat dairy foods. Skimmed or semi skimmed milk, low fat yogurt and reduced fat cheese. Use low fat yoghurt or fromage frais instead of cream when cooking or making desserts. Eat a variety of fruit and vegetables to get the vitamins, minerals and fibre you need. The more colourful your meals are, the more likely you are to be getting the nutrients you need. Exercise Everyday. Try to do 30 minutes of moderate exercise a day. You can break it into three 10-minute sessions throughout the day if you like. Start with what you can and build your way up, you’ll be surprised by how responsive your body is! *A daily intake of 1.5-2.4g plant sterols can lower cholesterol by 7-10% in 2-3 weeks as part of a healthy diet and lifestyle. High cholesterol is a risk factor in the development of coronary heart disease. As coronary heart disease has multiple risk factors, more than one may need to be improved to reduce overall risk. 42 Week 3 Go for it! Be creative with pro.activ spread Why don’t you try topping your jacket potato or vegetables with pro.activ to help get your 3 servings a day. Enjoy healthy eating. A diet based on many different foods is both more interesting and more enjoyable. Sitting down to a meal and sharing it with family and friends makes eating pleasurable and often allows a more healthy and varied diet. Try to avoid situations where food is eaten on the run and viewed merely as necessary fuel. 43 Healthy eating doesn’t have to be boring! Look on the internet or in magazines for new healthy recipe ideas, printing or tearing out ones that catch your eye. Get cycling again. Go swimming. Choose a safe route. It’s surprising how much is within striking distance on a bike. Soon you might even be cycling to work. Swimming is a brilliant aerobic non-impact exercise. Why not try and get out at lunchtime or if not after work. Try to manage your stress level. You have managed to lower cholesterol. Some stress if good and a natural part of life but too much stress is bad for your heart. Look after yourself by recognizing the triggers of your stress and by finding ways to relax in these situations. Try to stick to your new routine of healthy diet and lifestyle and 3 portions of Flora pro.activ daily. Take time to relax. Try to reduce your stress levels. Take a brisk walk, go cycling, go to yoga or meditation classes. 44 Heart health facts Fact 1 Heart disease is the leading cause of death globally. Many people think that heart disease occurs more in men than in women. The reality is that heart disease occurs equally in men and women.There are many risk factors of heart disease and it’s important to take care of all of them. Making small changes to your diet and lifestyle can already have a significant impact. 47 What can I do to take care of the risk factors? Eat a healthy diet l Reduce intake of saturated fat and trans fat by replacing them with monounsaturated and polyunsaturated fats l Avoid smoking l Take regular exercise l Cut back on salt l Maintain a healthy weight l Manage stress levels l Limit alcohol consumption l 48 Fact 2 High cholesterol levels alone are estimated to cause 1/3 of the world’s coronary heart disease. High LDL – cholesterol is widely accepted to be a key modifiable risk factor in the development of heart disease. Making small changes to your diet and lifestyle can have a significant impact on your cholesterol levels. Simple things like following a healthy diet, doing regular exercise, and drinking less alcohol can help to maintain overall wellbeing. How can I lower my cholesterol levels via dietary changes? educe intake of saturated fat R and trans fat by replacing them with monounsaturated and polyunsaturated fats l Eat plenty of fruits and vegetables l Include foods with added plant sterols, like Flora pro.activ*, in your daily diet l Maintain a healthy weight l *A daily intake of 1.5-2.4g plant sterols can lower cholesterol by 7-10% in 2-3 weeks as part of a healthy diet and lifestyle. High cholesterol is a risk factor in the development of coronary heart disease. As coronary heart disease has multiple risk factors, more than one may need to be improved to reduce overall risk. 49 50 Fact 3 Being overweight is considered an important risk factor of heart disease. Being overweight is a modifiable risk factor for heart disease. Making dietary changes and taking regular exercise can help to control weight. How can I control my weight? E at a healthy, balanced diet with plenty of fruits and vegetables. l Keep active and aim to do at least 30 minutes of exercise every day– whether it’s three ten-minute sessions or one half-hour burst. l 51 Why not…? Take the stairs l Park the car further away from your destination l Get off the bus a stop earlier l Go for a brisk walk before breakfast l Cycle on an exercise bike while watching TV l Get stuck into some vigorous gardening l Use a pedometer and try to take more steps each day l Dance around to a CD or tape l Have a swim during your lunch hour l Record your activity and try to do a little more each day l 52