Dr Zahrin Shaikh, a consultant cardiologist, qualified with a medical degree over 18 years ago. She has not only studied but also lived through the lifestyle change she advocates. We at Nutritank St Andrews, a group that aims ‘to raise medical students’ awareness around the importance of nutrition and lifestyle medicine for all stages of healthcare from prevention to wellbeing’, were excited to have the opportunity to chat with her about why she initiated the FRESH Heart Project.
Nowadays, pills and potions are prescribed for conditions which are solvable through the right food, exercise and sleep – such as high blood pressure, type 2 diabetes, certain dermatological conditions, and ischaemic heart disease, one of the biggest causes of death worldwide. Also called cardiovascular disease (CVD), the condition occurs when fatty plaques are deposited within arteries, decreasing blood flow. 80% of CVD deaths are attributed to lifestyle factors such as eating the wrong food, getting no exercise, and having too little sleep. To put it into perspective, CVD accounts for 28% of all UK deaths, killing twice as many women as breast cancer.
Although many students will be right in thinking decades separate them from heart issues, Dr Shaikh’s FRESH Heart Project offers more than great heart health. It offers balance. She herself struggled in the search of a balance between work and self-care. “As years of cardiology training went by, I didn’t take time off. In looking after others, I had neglected my own well-being”, she shares. Her sleepless nights and anxiety matured into physical symptoms, which remained problematic despite medications. “I couldn’t go on like this. I made the decision that at the end of my training, I would take a month off and prioritise myself.” That month of self-healing not only made her symptoms disappear but revolutionized the way she looked after herself and her patients.
The FRESH Heart Project is an acronym for Food, Relaxation, Exercise, Sleep, and Happiness. Without further ado, I share with you the secrets the cardiologist shared with us.
The first pillar, food, is a controversial one, since nutritional studies take long to complete and are hard to analyse. Even then, in our modern era of extreme opinions, we’ve acquired tunnel vision which disregards the potential benefits from the different diets of others. A keto diet is the way to go! Actually, you’re wrong – its veganism! Paleo anyone? We have become tribal in our philosophies to food.
Nonetheless, a bad diet is thought to be responsible for 1 in 5 premature deaths. But what is a good diet, then? Dr Shaikh shared a few beneficial foods to eat: “fruits and vegetables, wholegrain products and marine fish – those definitely reduce the risk of CVD. Nuts and legumes, too. Fermented dairy products as well– likely due to their high probiotic content.” Notice those are all unprocessed, nutrient-dense foods, and the fats are predominantly unsaturated. What should we avoid, then? “Processed meat is definitely linearly associated with CVD”, Dr Shaikh states confidently. “As for unprocessed meat – the organic, grass-fed, hormone/antibiotic-free one – the jury’s still out on this one.”
Moving onto the second pillar, relaxation. Being online all the time, we experience staggering levels of stress. Our brain desperately needs time away from a screen. In 2016, stress-related health issues cost the NHS £2.4 billion. Stress triggers autonomic dysfunction, heightening blood pressure, and making the heart electrically unstable and more susceptible to arrhythmias. “Identify your key stressors and learn how to manage them,” Dr Shaikh advises. “Mindfulness techniques, exercise, nature walks, books – calm your mind away from the artificial beam of your screen.” If all else fails, take 2 minutes out of your day, close your eyes and focus on your breathing.
Exercise, the third pillar, is beneficial all-round. It’s hard to find something that exercise DOESN’T help. Those most active throughout the day have a 30-40% lower risk of developing CVD. If your job enquires you to sit behind a desk, “stretching every hour or so helps, and try to be active before or after work,” Dr Shaikh proposes. Interestingly, from a cohort of people with sedentary jobs, those most active still have the lowest risk of heart problems.
The fourth pillar is sleep, and this cardiologist loves her sleep – so much so that she based her PhD around the subject. She explains to us the 4 stages of sleep. “Stage 1 is really light sleep. During Stage 2, you begin making room for memories to form. Stage 3 is the deep and restorative sleep.” Deep sleep is the time vital for memory retention and emotional detoxification. “After spending some time in Stage 3, you begin to emerge into lighter sleep again,” Dr Shaikh points out. We enter REM sleep, which is when we’re typically dreaming. “Those 4 stages of sleep make up a 90-minute cycle, which is repeated throughout the night.” The earlier you go to sleep, the more beneficial the sleep is. That’s because the amount of deep sleep gets shorter as the night progresses, and the amount of REM in each cycle gets longer.
7-8 hours of undisturbed sleep is protective – it minimises your risk of heart attack and stroke. Chronic lack of sleep leads to increased weight, hypertension and poor glycaemic control. A situation whereupon the body is in state of consistent inflammation.
Dr Zahrin’s top sleep tips are simple. Minimize artificial lighting (including LED screens), as it confuses our circadian rhythms. “We also need a cooler temperature for sleeping – naturally, it gets colder when the sun goes down. Mimic that with an open window or a cold shower before climbing into bed”, she shares. Lastly, establishing a regular routine helps your body understand when it’s time to hit the pillow.
The last pillar, the “H” is the FRESH heart project stands for happiness. Is happiness a choice? It can be! Studies illustrate that people watching only 3 minutes of negative news in the morning are 27% more likely to report having a negative day in the evening. “Positivity in the morning breeds a more positive outlook,” Dr Shaikh believes. “Happiness is contagious, too – you return other people’s smiles. It’s due to the mirror neurons in our brains. We mirror what’s around us – think about the chain reaction caused by a yawn!” Our mirror reactions are due to our fundamental need for connection with others.
That said, bereavement and depression are very real and serious issues, and require specialist attention. Depression puts you at increased risk of developing coronary heart disease – so do anxiety, PTSD, anger and hostility.
The FRESH heart project is not about setting short term goals. “It is a lifestyle change, and it doesn’t come easy. Find the natural rhythm of your body” Dr Shaikh urges. What works for you may not work for someone else “Different pathways may all lead to the same place of growth, it is not a ‘one size fits all’ approach.” The cardiologist’s final tips were:
- Use technology to benefit your health. Try tracking your daily steps, join an online community to keep you motivated. Counting calories works for some but frustrates others – see what works for you.
- “Eating healthy” does not mean “eating expensive” – buying a can of chickpeas and a few fresh tomatoes will cost you less than your average £3 Tesco meal deal.
- Limit caffeine to earlier in the day – caffeine’s half-life is 6 hours and may be disrupting your sleep, keeping you awake.
We all have times where we feel burnt out. It’s a truth Dr Zahrin has lived through. “Recognise when you’re feeling unwell, rest and recuperate”, she advises. With a little more balance, we can all strive for a happy heart and a happy life.