Making changes to your lifestyle

If you are at high risk of developing cardiovascular disease, or you have already had heart disease or a stroke, your GP or nurse should suggest ways to help you achieve a healthy lifestyle. You can also find information to help you at the NHS Choices website.

Stopping smoking

If you smoke, your GP, nurse or pharmacist should advise you to stop. If you decide you want to stop, they should give you support and advice. They should offer to refer you to a support service, such as the NHS Stop Smoking Services. However, if you can't or don't want to use this, you may be offered medication or nicotine replacement therapy instead.

See Other NICE guidance for details of our guidance on smoking.

Eating a healthy diet

Your GP or nurse should advise and support you to eat a healthy diet that helps protect your heart. They should take into account your individual circumstances when giving you advice. Healthy eating can include:

  • Eating less fat. Avoid foods that contain a lot of fat, such as fried or processed foods or takeaways.

  • Avoiding, in particular, a lot of saturated fat (for example, fatty meat, butter and cheese). Try to choose foods containing mono-unsaturated fats (such as olive oil and rapeseed oil) and polyunsaturated fats (such as corn oil and sunflower oil) instead.

  • Reducing your intake of sugar and of food products (such as cakes and processed meats) that contain refined sugars.

  • Choosing healthy ways of cooking and preparing your food. Don't fry food or roast food in fat such as butter or ghee. Instead, steam, poach, bake, casserole or microwave. Add flavour using spices, herbs and lemon juice instead of using buttery, cheesy or creamy sauces, which tend to be high in fat.

  • Choosing wholegrain varieties of starchy food (for example, wholegrain rice and pasta).

  • Eating at least 5 portions of fruit and vegetables a day. A portion is about 80 g (for example, an apple or 3 heaped tablespoons of peas).

  • Eating at least 2 portions of fish a week, including a portion of oily fish (such as herrings, sardines, mackerel or salmon). A portion is about 140 g (a fillet of fresh fish or a small tin). If you are pregnant you should eat no more than 2 portions of oily fish a week and avoid marlin, shark and swordfish.

  • Eating at least 4 to 5 portions of unsalted nuts, seeds and legumes (such as peas and beans) a week.

Getting enough exercise

Your GP or nurse should recommend that you take 150 minutes of moderate exercise or 75 minutes of vigorous exercise a week, or a mix of these. Examples of moderate exercise that you could include in your daily life are walking briskly, climbing stairs and cycling. If you can't do moderate exercise, for example because of health problems, you should try to do as much as you can safely. Running is an example of vigorous exercise.

You should also be advised to do muscle-strengthening exercises on 2 or more days a week that work all the main muscle groups (legs, hips, back, abdomen, chest, shoulders and arms).

Your GP or nurse should agree your exercise goals with you, taking into account your preferences and what you are able to do. They should give you written information about the benefits of exercise and about local opportunities to be active. These might include sports or cycling clubs, dancing classes, swimming pools or gyms.

See Other NICE guidance for details of our guidance on physical activity.

Becoming a healthy weight

If you are overweight, your GP or nurse should offer you advice and support to lose weight and keep it off. Even reducing your weight a little (by 5–10%, or 5–10 kg if you weigh 100 kg) can have big benefits.

See Other NICE guidance for details of our guidance on obesity.

Reducing your drinking

Your GP or nurse should advise you to limit the amount of alcohol that you drink.

  • Don't binge drink or drink more than the total recommended for men or women per week.

  • Women should have no more than 2–3 units of alcohol a day.

  • Men should have no more than 3–4 units of alcohol a day.

A unit is about half a pint of normal strength beer, lager or cider, or a pub measure of spirits. A medium-sized glass of wine is about 2 units.

Food products to help reduce cholesterol

If you are at high risk of cardiovascular disease, your GP or nurse should not recommend that you use spreads, drinks and yoghurts containing substances derived from plants, called sterols and stanols, to lower cholesterol because there is not enough evidence at the moment that these products help to prevent cardiovascular disease. Similarly, there is no evidence that omega-3 fatty acid compounds (such as fish oil supplements) help to reduce the risk of cardiovascular disease.

  • Information Standard