Emily Lopez

USE ♥    FOR EVERY ♥

Cardiovascular disease (CVD) is accountable for nearly half of all non-communicable disease deaths, making it the world’s number one killer. World Heart day is marked annually in September, stressing the importance of beating CVD and reducing its global burden. In Gibraltar, CVD has persistently been one of our top three causes of local deaths…

Cardiovascular diseases (CVDs) are disorders of the heart and blood vessels, they include:

• coronary heart disease

(a disease affecting the blood vessels that supply the heart muscle)

• cerebrovascular disease

(a disease affecting the blood vessels that supply the brain)

• deep vein thrombosis and pulmonary embolism

(where blood clots form in the leg veins, and can dislodge and move to the heart and lungs)

Heart attacks and strokes are usually acute events that ensue when blockages prevent main blood vessels from supplying the heart or brain; these events are responsible for more than 85% of global CVD deaths.

Love your ♥

The main modifiable risk factors for CVD are: 

• unhealthy diet and obesity

• physical inactivity

• tobacco use

• harmful use of alcohol 

The World Health Organisation stress that by controlling these behavioural risks at least 80% of premature deaths from heart disease and stroke can be avoided. 

Working to reduce chronic stress will also reduce the risk of heart disease. The World Heart Federation attest that psychological stress can double the risk of having a heart attack. By resisting any harmful coping mechanisms and taking steps towards a healthier lifestyle, we can maximise our individual heart health.

Find out more…

Take a few minutes to review your heart-healthy lifestyle today; check the “Heart Age tool” on nhs.co.uk and see suggestions on how to gain extra years!

If you wish to learn more about CVD, about prevention and healthy rehabilitation after a coronary event (including use of the rehabilitation gym) contact:

GHA Cardiac Rehabilitation Team: 

CardiacRehabCentre@gha.gi 

The Gibraltar Cardiac Association:

GibraltarCardiac@gmail.com

Story of self, story of us, story of now

Every year the first week of August is used to promote breastfeeding.
This year, the World Alliance for Breastfeeding Action (WABA) are
asking us to look at the “Warm Chain” and ‘step up for Breastfeeding’.

The Warm Chain campaign considers all the various roles we play in supporting mums and babies to successfully breastfeed, helping to ensure that continuum of care throughout the first 1000 days.

Breastfeeding is recognised as the best way to feed babies under 6 months meeting all their nutritional requirements whilst providing numerous immunological and attachment benefits for baby AND health benefits for mum. 

In Gibraltar breastfeeding rates are not as high as they could be. The Gibraltar Breastfeeding Association state around 70% of women wish to breastfeed but that this drops to around 40% after day 10; thus 30% of women who had hoped to continue have not been able to. 

Is it really a big deal?

Numerous studies highlight the benefits of breastfeeding. By scaling up breastfeeding to a near universal level it is said that around 823 000 annual child deaths (below 5 years of age), and 20 000 annual deaths from breast cancer, could be prevented. Benefits also extend beyond health. Children that are breastfed are associated with higher levels of intelligence and the economic losses attributed to a lack of breastfeeding are said to be about £242 billion per year.

So why not breastfeed?

The choice of how to feed a baby is incredibly personal. There are a number of considerations that can act as either facilitators or barriers to breastfeeding, they include:

•
breast-related health (for example, women may have mastitis, breast engorgement, cracked nipples etc.)

• emotional wellbeing

• amount of sleep

• time available

• accuracy of information provided

• the amount of support available

With the right support it is proven that many more mothers would be able to breastfeed to 6 months and beyond. 

HM Government of Gibraltar passed an amendment Bill in 2017 (reference the Equal Opportunities Act 2006) ensuring women have the right to breastfed in ‘any public space’ should they chose to; highlighting the importance of breastfeeding as a right. 

How can you support this week?

Breastfeeding is a skill that can take time to get the hang of. You can support a family’s breastfeeding journey in various ways. Identify your role in the Warm Chain and use the tips provided on the WABA information cards for ideas. Examples include: empowering parents to combine breastfeeding and work, collaborating with others to ensure support in different environments and/or sharing evidence-based information on the importance of breastfeeding.

For more information see WABA.org.

If you have any breastfeeding worries or concerns, speak to your midwife or health visitor. You can also find support from other breastfeeding mothers (See: Gibraltar Breastfeeding Association)

#WABA #breastfeeding #WarmChain #StepUpForBreastfeeding

Most of us will admit to spending some days at home, lazing on the couch and grazing on snacks, particularly when the weather is bad. However the summer months in Gibraltar, that boast plenty of sunshine, provide a great opportunity to get outdoors and enjoy some physical activity! 

According to the Gibraltar Health & Lifestyle Survey (2021) 47.1% of adults report doing little or no physical activity during their daily routine. Only half of us walk to work, and around a quarter of us do no regular exercise at all…

Exercising and keeping active is essential to healthy living; it helps to maintain bone health, encourage muscle strength and flexibility, improves co-ordination and can prevent weight-gain which in turn is associated with cancer, type2 diabetes and heart disease. Physical activity is also seen to reduce stress levels and lift mood.

In order to stay at our healthiest, recommendations are for:

• Adults to be active for at least 150 minutes each week; with at least 10 minutes each day participating in activity that gets your heart beating faster, and your lungs working a bit harder.

• Children aged five to 16 to be active for at least 60 minutes each day.

• Children under five to get three hours of activity every day.

All activity counts and you can build it into your day by, for example, taking the stairs, getting active whilst doing housework or going for a walk. It is a good idea to participate in activities you enjoy with friends, family or as part of a group, as this can help to keep you motivated. You can search Change4Life for tips on family activities, and children can take a quick 3 question quiz to find inspiration for activities that may suit them.

Whilst the weather is hot, it is important to stay mindful of good hydration before/ during/ after physical activity. Water makes up two thirds of our body and is vital to ensuring healthy body functions. Drinking plenty of water throughout the day and after bursts of exertion will help to prevent headaches, constipation, urinary tract infections (UTIs) and other health problems. 

If you are outdoors in direct sunlight, you will also need to use sufficient sun cream to cover exposed body parts; reapplying after swimming if applicable. Most of us do not apply enough sunscreen, and as a guide you should use two teaspoons to cover your head, arms and neck (use two tablespoons to cover the entire body).

Walk, run, skip, cycle, swim, kick a ball, fly a kite… find any activity that will keep you moving this summer!

Read more: HealthyGibraltar.org/Physical-Activity

Stigma associated with mental health has been an issue faced worldwide. This has stopped people from promptly seeking help when they need it or taking steps to address the on-going causes for their own poor health. 

The importance of mental well-being and mental resilience cannot be overstated.

Good mental health assures our ability to fulfil key functions and activities in life; it affects how we think, feel, communicate, make decisions, form relationships and act. Knowing the importance of mental health and wellbeing, the question remains – Are we doing enough to keep healthy?

According to the Gibraltar Health and Lifestyle Survey (2021) the most common chronic condition experienced locally is anxiety (32.5% of respondents), and more than 10% of us report feelings of depression. Although participant feedback last year was very likely to have been influenced by the impact of the Covid-19 pandemic, health experts warn that the increased levels of stress, anxiety and fear witnessed may persist for a while to come. 

According to the Mental Health Foundation, mental health problems are one of the main causes of the overall disease burden worldwide. They state that depression is the second leading cause of disability and a major contributor to increased risk of suicide and ischemic heart disease.

Early warning signs of potential mental health problems:

• Inability to perform usual daily tasks

• Eating or sleeping too much or too little

• Using drugs, smoking or drinking more than usual

• Experiencing mood swings

How can we stay mentally healthy?

There are many ways to improve and maintain our own mental health, and build upon our mental resilience. Some people will feel improvements with minimal support or changes; others may benefit from more specific treatments (such as counselling or medication). It may not be easy to seek support, especially if feeling anxious or low in self-esteem, but a good point of contact is always your GP who can provide support and advice (Tel: 200 52441).

The following are 10 methods of self-care, how many do you use?

1.
Sharing your feelings – this can help us work through concerns, help us feel supported, and help build stronger relationships with those around us.

2.
Keeping active – Adults should be active for around 30 minutes a day at least 5 times a week, and this does not have to include a trip to the gym. All forms of activity count.

3.
Eating well – Foods we eat can affect how we feel both immediately and in the longer term. Regular healthy meals full of wholegrains and vegetables, plus plenty of water, are ideal. Reducing your intake of caffeine and refined sugar; and try to plan meals in advance, particularly if you know you may be stressed, 

4.
Drinking sensibly – We often drink alcohol to change our mood, however more often than not it will exacerbate it. Remember, the ability to escape feelings of fear or loneliness is only temporary. 

5.
Staying connected – Relationships are key to our mental health. Try to ensure you maintain your friendships and family relationships, a work–life balance is important. Some studies suggest loneliness may be as bad for our health as smoking 15 cigarettes a day.

6.
Taking a break – A change of scene or pace is important for your mental health. Give yourself some ‘me time’. Mindfulness is a form of meditation that involves paying deliberate attention to what is happening, as it happens. Mindfulness practices can help us to increase our ability to regulate emotions, decrease stress, focus our attention, and observe our feelings without judgment. Mindfulness app such as Headspace or Calm may be useful.

7.
Doing something you are good at – What do you love doing? What activities can you lose yourself in? What have you enjoyed doing in the past? Doing something you enjoy can help beat stress and boost self-esteem. 

8.
Accepting yourself – Self-acceptance and self-care can be very hard when you have a mental health problem – a challenge we must continue to work on. This involves excepting our flaws, our failures, our beauty, our brilliance; and our differences. You may practice gratitude, noting daily things you are thankful for, or trying to reframe negative thoughts.

9.
Caring for others – This may sound like a contradiction when trying to care for yourself, but the act of caring for another can be hugely significant for mental health. Helping can make us feel needed and valued; it can boost our self-esteem and help to put our own problems into perspective. 

10.
Asking for help – We ALL will find ourselves (at some point in our lives) feeling tired, nervous or overwhelmed. Knowing when to ask for help, in whatever form may be beneficial to you, is important.

Some helpful contacts:

• Mental Health Crisis – Call 111
• Mental Health Support –  Email: MHS@gha.gi 
• GibSams – free to call service available 6pm to midnight daily; if you want to talk to someone in confidence. Call: 116 123
• Clubhouse Gibraltar –Email: support@clubhousegibraltar.com or see their website: clubhousegibraltar.com
• Childline – free to call service available from 5pm – 9pm daily, Call: 8008

World Asthma Day (WAD) is an annual awareness event supported by Global Initiative for Asthma (GINA), US based National Heart Lung and Blood Institute (NHLB) and the World Asthma Foundation. The day is commemorated on the first Tuesday in May each year and aims to raise support for sufferers and their families. 

Asthma is a chronic lung disease, which causes breathing difficulties due to swelling and inflammation of the bronchial tubes. This inflammation is often in reaction to a specific trigger(s) e.g. allergens or exercise. Asthma is not usually curable but can be controlled to a certain extent by prevention medication for chronic symptoms and relief medication for flare-ups. Asthma attacks can be physically and emotionally distressing, but symptoms vary in intensity and frequency from person to person; the most common signs include breathlessness, coughing and chest pains.

Main Causes of Asthma 

According to the WHO: “The strongest risk factors for developing asthma are a combination of genetic predisposition with environmental exposure to inhaled substances and particles that may provoke allergic reactions or irritate the airways.” 

Different people will have different triggers, but the most common causes of asthma attacks are:

•
exposure to allergens (for example, dust particles, pets, pollen and mould) 

• tobacco smoke and air pollution

• vigorous exercise

• viral infections like the common cold or flu

•
extreme emotional states (for example, anger, fear, distress).

The World Health Organisation (WHO) estimates around 235 million people are effected by asthma globally. The 2022 theme for this year’s WAD is ‘Uncovering Asthma Misconceptions’. These include:

• asthma is infectious

• everyone grows out of their childhood asthma

• asthma is only controllable with high dose steroids

• people with asthma shouldn’t exercise

Coping with Asthma

There is no cure for asthma. Some people will notice an alleviation of symptoms with age, but not all. Education and understanding are key to effective asthma control, which can be fatal if not managed properly. People who suffer from asthma are able to live full and happy lives by following certain steps such as:

Seeking the advice of a medical professional, following the treatment plan prescribed and reviewing medication regularly.  

Being prepared – always carry a reliever inhaler and an identity card that tells people what to do in the event of an emergency.

Keeping fit – exercise raises your heart rate, boosts the strength of your lungs/immune system, improves your mood and helps you maintain a healthy weight.

Avoiding asthma triggers – learn to recognise and manage what triggers personal asthma attacks. 

Quitting smoking if you are a smoker – in the case of children, if possible, limit the amount of time spent in highly polluted areas. 

Good oral hygiene is linked to general well-being.  It helps prevent bad breath, tooth decay and gum disease. Additionally, studies link oral health- particularly periodontal (gum) disease- to the increased risk of various chronic conditions; including diabetes, heart disease and stroke.

How can I improve my oral health?
Brush for two minutes, twice a day, using a fluoride toothpaste. You may also choose to rinse with a fluoride mouthwash or chew sugar-free gum after meals and snacks. Replace your toothbrush every three months or sooner if the bristles are frayed.

Floss or use an interdental brush every day to remove food, debris and plaque lodged between your teeth. It is advisable to use interdental brushes in addition to brushing as part of your daily oral routine from the age of 12. Flossing is a great alternative for those who do not have large enough spaces in between their teeth.

Cut down on sugar, and drink water between meals. This is key to preventing tooth decay. Sugars occur naturally in foods such as fruit. It is important to keep this in mind when deciding how we consume these foods. For example, when fruit is juiced, sugars are released which causes damage to teeth. This means it is best to limit the consumption of fruit juices and smoothies or consume at mealtimes.

Do not smoke, and be sure to limit alcohol. Research estimates that heavy drinkers and smokers have a 38 times increased risk of developing mouth cancer, compared to those who do not drink or smoke.

Brush baby teeth as soon as they come through (usually around 6 months). Parents or carers should supervise tooth brushing ensuring all exposed teeth are cleaned. It is also important to ensure children get into a good teeth-cleaning routine. 

Straighten crooked teeth with braces. Straightening teeth helps facilitate the ease of caring for teeth and gums. It can also improve biting to make eating more comfortable. Orthodontic treatment is available through GHA for young people at no cost, following referrals via the dentistry team.

Have regular check-ups and don’t delay treatments. Most oral health conditions are largely preventable and can be resolved quickly in their early stages. The sooner you seek treatment, the better your outcomes are likely to be.

The on-going pandemic and related restrictions have meant that many of us push dental check-ups to the back of our priority lists. However, maintaining good oral hygiene and regular check-ups are key to our general well-being. If you are due a dental check-up, this World Oral Health Day is a great reason to book your appointment!