Diet therapy

 Healthy Heart Heros

We may feel surprised when we hear that young people or a well-known, seemingly healthy athlete or celebrity has died from heart disease.

But heart disease can affect us all.

How big is the ‘heart disease’ problem? 1

  • Every 90 minutes a New Zealander dies of coronary heart disease (CHD), that’s 16 deaths each day. Across ‘the ditch’ an Australian dies every 12 minutes, that’s 118 deaths per day.
  • 170,000 New Zealanders live with CHD
  • 1 in 3 deaths in NZ are due to CHD
  • CHD is the number one killer of women globally and yet people still think men are the most at risk.
  • CHD kills twice as many women in NZ than any other cause of death
  • Women who smoke are three times as likely to die from CHD than those who don’t smoke.

Although CHD can be due to hereditary and congenital factors, for most of us, it is a non-communicable disease (just like obesity and diabetes) which is preventable. Better health is something that the NZ Heart Foundation (NHF) has been promoting for the past 60 years.

How does the Heart Foundation promote health?

Building community awareness about living a heart-healthy lifestyle is the goal of the Heart Foundation. They do this by translating the results of clinical research into accessible, practical information and resources that we can all use. They also support health professionals in their work to prevent, diagnose, treat and manage heart disease.

On both ‘sides of the Tasman’, the Heart Foundations of NZ and Australia have adopted innovative health promotions over the years many of which you may recognize:

  • The Healthy Food Pyramid
  • Eat to Beat and Beyond Eat to Beat promoting healthy eating
  • The Heart Foundation tick program on the front of food packaging (replaced in 2016 by the Healthy star rating system)
  • The Jump Rope for Heart campaign getting children skipping (and no doubt many parents too) in an effort to have fun and increase physical activity.
  • Healthy Cafeteria’s Awards in school tuck shops and workplace cafeteria’s

Check your weight was the theme for Heart Week in 1982 when along with other Dietitians I helped to man a tent in Christchurch’s Cathedral Square where locals were invited to have their weight and height measured, Body Mass Index calculated and using computer technology, they could also have the heart healthfulness of their lunch assessed.

Such a direct approach would probably be frowned on today however back in 1980 the rate of obesity amongst adult NZ’s was just 12.7%; in 2008 it had reached 23.6% and last year we recorded a staggering 35.9% 2sadly, ahead of Australia (at 31.3%) 3 Now there’s a project we can all help with…more on how later.

Education is the key to changing heart health stats and today the NHF funds:

  • Training and grants for NZ cardiologist and heart research
  • Research into the links of heart disease with mental health
  • Dietitians and Nutritionists to act as nutritional advisors around NZ
  • Teaching nutrition resources for teachers to use in schools
  • Regional Heart Health support groups
  • Online nutrition resources offering news, recipes and blogs
  • Cooking resources, cookbooks, fact sheets, teaching plans etc
  • Smoking cessation guidelines

Has the nutrition message changed over the years?

The Heart Foundation has consistently recognized the importance of nutrition to heart health. In the 1970-80’s the key message encouraged people to:

  • Eat more fruit and vegetables
  • Enjoy bread and cereals
  • Choose fat reduced milk and dairy products
  • Choose lean meat and reduce serving sizes
  • Drink water and if drinking alcohol to do so responsibly
  • Exercise regularly
  • Keep a healthy weight

After years of research and health promotion the Heart Foundation, WHO, NZ and Australian Ministries of Health, are now providing much more specific dietary guidelines that recognize the environmental factors affecting our food intake.

Such as the effects that portion size, eating out, takeaways and ‘fast foods’ are having on our health along with acknowledgement that we need to be thinking about sustainability by incorporating more plant-based foods into our diet and eating more real and less processed foods. They recommend that we:

  1. Eat more vegetables and fruit
  2. Swap from refined cereals and grains to whole grains
  3. Choose reduced fat-varieties of dairy products
  4. Eat healthy fats source from nuts, seeds, plant oils (other than coconut and palm), avocado and oily fish in place of animal fats
  5. Focus on reducing unprocessed red meat to < 350g/week (cooked) spread across 3 meals per week (with an individual portion size of 100g cooked red meat).
  6. Swap some red meat meals for plant protein such as soy, legumes and nuts
  7. Limit or avoid processed red meat
  8. Reduce highly processed and refined foods such as junk food, takeaways, deep-fried foods, pastries, pies, sweet bakery items, lollies, processed snack foods and sugary drinks.
  9. The Heart Foundation’s recent position paper on alcohol consumption has altered the most over time and concludes that “the relationship between alcohol and cardiovascular disease is complex, and for most people there will be little, or no, overall benefit.
    Alcohol can have a range of harmful health effects. As there is no safe drinking threshold for many of the impacts, there is no potential ‘window of benefit’ where benefits can be gained without risk of harm. Alcohol shouldn’t be thought of as a safe or effective treatment for heart disease. 
    Alcohol is also high in calories, so, if you are trying to lose weight, reducing your alcohol intake, eating a heart healthy diet and regular physical activity could help you reach your goal.4

Are these measures working?

Over the past 10 years, with the exception of higher blood pressure, our heart health in NZ has improved.

Table 1: Prevalence of Cardiovascular Health in New Zealand during times indicated

Heart Condition 2011/2012 2021
Ischemic heart disease (diagnosed angina or admitted to hospital with a heart attack 5.5 4.2
Stroke (diagnosed, excluding transient ischemic attack 1.8 1.6
Heart failure (diagnosed) 2 1.6
High cholesterol (diagnosed and currently taking medication) 10.5 10.3
High blood pressure (diagnosed and currently medicated) 16 16.7
Raised blood pressure (measured) 22.7 22.5

MOH Survey Data 2

While the effects of Covid 19 on heart health has yet to be measured, research funded by the NZ Heart Foundation around mental health has found that people with serious mental illness are at greater risk of cardiovascular disease than their counterparts in the general population but are not being identified soon enough. Research shows people with mental illness die up to 20 years earlier, with heart disease being the mental health sector’s third biggest killer after suicide and cancer.5

Health promotion starts from within

While the Heart Foundation works hard to provide resources and research that can guide us in our food and lifestyle choices in the end each of us needs to try to take responsibility for our own health and offer a hand up to support and encourage those who are struggling.

If we can see health as a positive dynamic state that we need to keep working at throughout our lives, rather than merely the absence of disease, then we may be better equipped to stay in good health.

By setting up healthy behaviours we stand a better chance of avoiding illness (or at least detecting it early), of maintaining our bodily functions and our mobility and preserving our mental health for as long as we can. The sooner we start the more choices we will have.

If you have tried to make dietary changes but are struggling to keep fit; to control your weight or other health issues and would like personalized help then do contact me today.

For more articles by Lea on similar topics:

Unlock your potential with food
Our attitude is the key to better health
Accept responsibility for your own success
Overcome misconceptions about weight for better family health
The support of friends aids weight loss


  1. The NZ Heart Foundation website
  2. MOH Survey Data!/explore-topic
  3. Obesity trends in Australian adults’ 4 May 2021. Obesity Evidence Hub
  4. The NZ Heart Foundations Position paper on Alcohol
  5. Cunningham, R, Sarfati, D;. Peterson, D. Stanley,J. Collings,S. (2014. Premature mortality in adults using New Zealand psychiatric services. New Zealand medical journal, 127(1394), 31-41.

About the author View all

Lea Stening

Lea is one of New Zealand’s leading paediatric dietitians and also specialises in Sports Nutrition. She has specialised in Paediatric Nutrition for 31 years and in 1985 was the first paediatric dietitian to enter private practice in New Zealand. Lea helps families through her private consultations, public lectures, newspaper and magazine articles as well as television and radio interviews. Read more »

View all posts by Lea Stening »


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