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56 CARDIOVASCULAR HEALTH FROM PAGE 55 like to cook, which could encourage them to refocus on doing some cooking at home rather than getting processed takeaway. “We’ve got to remember as well, we’re not dietitians,” Mr Quigley cautioned in terms of the pharmacist and pharmacy assistant’s role in providing dietary advice. “And we have to be careful we don’t get into territory where we don’t have the qualifications. But there’s some general risk minimisation that’s worth considering.” He suggests another simple course to take is to recommend following “the anti- inflammatory eating guide”. “This is very simple,” he said. “You know, \\\\\\\[plenty of\\\\\\\] fruits and vegetables, legumes and beans. So, that Mediterranean-style diet. I have a handout, which I give my patients and I just take them through it and most accept it really well.” He adds that nuts, seeds, herbs and spices are also beneficial, and suggests including “grains, so brown rice, barley oats, sourdough, quinoa ... more extra virgin olive oil, avocados and fish” – these food options are important from the anti-inflammatory perspective and are heart protective. “A lot of it is just plain ordinary common sense,” Mr Quigley added, referring to the role of diet in heart disease risk and management. He also points to the importance of going back to the basics. “It’s what \\\\\\\[we\\\\\\\] used to eat back in the old days before packaged food was so readily available and you were bombarded with fast food,” Mr Quigley said. On the role of vitamins, minerals and supplements, Mr Quigley adds that while there’s “no magic pill” that can reduce the risk of CVD, “aged garlic extract has been clinically proven” to help. “I’m a fan of multivitamins,” Mr Quigley said. “I think antioxidant multivitamins are very important ... so, we’re thinking here of coenzyme Q10, vitamin C and the B groups ... as well as potassium, magnesium.” Dr Barclay also believes that pharmacists and pharmacy staff can get involved in “promoting healthy eating” and to recommend that “people who have those heart disease risk factors either before or after a heart event, see a dietitian”. “Or even having a dietitian at the pharmacy ... \\\\\\\[to\\\\\\\] provide health and eating information,” he said, pointing to the importance of promoting dietary guidelines “to help both before and afterwards to really encourage ... to make sure that ... everybody within the healthcare team is providing really the same consistent education information and providing support, because changing your diet \\\\\\\[for one\\\\\\\] isn’t easy for most people. So, having ongoing support from the whole healthcare team is really important.” Key takeaways “Always ensure that you understand that cardiovascular disease is not a single disease, it’s a package of diseases,” Mr Quigley said when asked about the key facts pharmacy assistants need to know when working with customers who may have, or be at risk of, heart disease. “We haven’t mentioned stress,” he continued. “Stress is a big driver of inflammation, and inflammation causes elevated risk of cardiovascular disease. Understand what an anti-inflammatory \\\\\\\[diet\\\\\\\] is and what it means and get to know and become confident in recommending that people focus on those things \\\\\\\[diet, stress management and physical activity\\\\\\\],” he said, adding that regular exercise plays a “fundamental role” in the management of CVD. “And as I always say, you’ve got to walk the talk,” Mr Quigley said. “There’s no point talking about these things and then going off and having a hamburger and a \\\\\\\[can of soft drink\\\\\\\] at lunch. Because then you become a preacher and not a person who understands what they should be doing.” Mr Quigley says that in terms of helping reduce the risk, pharmacy assistants also play an important role in “reinforcing the doctor’s instructions to make sure things work out”. He advises that assistants should take “a holistic view” of the heart patient. “What can you be involved in, in terms of lifestyle, nutrition, supplements, to either help \\\\\\\[with or\\\\\\\] reduce their heart attack risk, or reduce any adverse effects that medications might be causing?” he said. “\\\\\\\[And\\\\\\\] be available at any time for people who come in with questions about their heart health.” References 1. finder.com.au/death-statistics- australia?msID=29784d75-9881-482c-8870- 7760a9487699 \\\\\\\[Accessed 26/3/21\\\\\\\] 2. finder.com.au/death-statistics- australia?msID=29784d75-9881-482c-8870- 7760a9487699 \\\\\\\[Accessed 26/3/21\\\\\\\] 3. victorchang.edu.au/heartdisease?gc lid=CjwKCAjw6fCCBhBNEiwAem5SO1- ddrUPembDO9QJ0hYPuYV_EgwVd2A2H_ rDEdE_8eIwJnSFakBcIRoCJ6sQAvD_BwE \\\\\\\[Accessed 26/3/21\\\\\\\] 4. heartresearch.com.au/heart-disease/what-is-heart- disease/ \\\\\\\[Accessed 26.3.21\\\\\\\] heartresearch.com.au/heart-disease/what-is-heart- disease/ \\\\\\\[Accessed 26/3/21\\\\\\\] 6. heartresearch.com.au/heart-disease/risk-factors/ \\\\\\\[Accessed 26/3/21\\\\\\\] RETAIL PHARMACY ASSISTANTS • APR 2021