Chronic diseases include: diabetes, hypertension, heart disease, asthma, COPD, kidney disease, stroke and other vascular diseases.
With the exception of diabetes and asthma/COPD, patients with chronic diseases are currently invited for monitoring by the practice nurse team, and referred on to their Doctor if there are problems.
The nurses involved in monitoring diabetes and Asthma/COPD have specialist qualifications, and see patients in designated clinics. A Doctor works with the nurses in diabetic clinic.
In the new building we are hoping to improve our patients’ experience of chronic disease monitoring by setting up ‘Polyclinics’. These clinics will be run by teams of doctors, nurses and health care assistants, and should provide patients with a review of all their chronic diseases at one annual review.
Sr. Sharon Ashton – Nurse Chronic Disease Management Lead
Patient Information Leaflets
Cholesterol Lowering Diet
Mediterranean Diet
Lifestyle Changes for Raised Blood Pressure
Reducing Sugars in Your Diet
Severn Strollers
| RECOMMENDED | EAT OR DRINK WITH CARE | AVOID |
| Fish | ||
| All white fish Oily fish e.g. herrin, tuna |
Shellfish |
Fish roe |
| Meat |
||
| Chicken Turkey Veal, rabbit Game |
Lean portions of ham |
Visible fat on meat Sausages, pate, duck Goose, streaky bacon Meat pies and pasties |
| Fruit & Vegetables |
||
| All freshand frozen vegetables Dried beans and lentils are high in fibre Bakes potatoes - eat skins if possible Fresh and dried fruit |
Chips if cooked in suitable oil or fat Avocado pears Olives |
Potato crisps Chips cooked in unsuitable oil or fat |
| Cereal |
||
| Wholemeal flour, oatmeal Wholemeal bread Wholegrain cereals Porridge oats Crispbreads Wholegrain rice Pasta Sweencorn |
White flour, white bread Sugar coated breakfast cereals White rice |
Fancy bread e.g. croissants Savoury cheese biscuits Cream crackers |
| Nuts |
||
| Walnuts |
Almonds Brazil nuts Chestnuts Hazelnuts Peanuts |
Coconut Cashews |
| Dairy Produce |
||
| Skimmed/semi-skimmed milk
Skimmed milk cheese e.g. cottage and curd cheese Egg white (3 egg yolks per week only) |
Edam cheese
Camembert Parmesan |
Whole milk
Cream Hard cheese Stilton Cream cheese Excess egg yolks |
| RECOMMENDED FATS | EAT OR DRINK WITH CARE | AVOID |
| Benecol
Flora Pro-Active |
Margarine labelled 'high in polyunsaturates'
Corn oil Olive oil Sunflower oil Soya oil Safflower oil |
Butter
Dripping, suet Lard Margarine not 'high in polyunsaturates' Cooking/vegetable oil of unknown origin |
| Made-up dishes | ||
| Skimmed milk puddings
Low fat puddings e.g. jelly, sorbet Skimmed milk sauces Pastry puddings, cakes and biscuits made with suitable margarine or oil and wholemeal flour |
Pastry puddings
Cakes and biscuits made with suitable margarine or oil and white flour |
Tinned or whole milk puddings
Ice cream
Pastry puddings, cakes, biscuits and sauces made with whole milk, eggs or unsuitable fat or oil All proprietary puddings |
| Sweets, preserves and spreads | ||
| Bovril
Oxo Marmite |
Meat and fish pastes
Boiled sweets, fruit pastilles, peppermints Jam, marmalade, honey, sugar, peanut butter |
Lemon curd
Mincemeat Chocolate Toffees, fudge, butterscotch |
| Drinks | ||
| Tea, coffee
Mineral water Un-sweetened fruit juices Clear soups Homemade soups e.g. vegetable, lentil |
Packet soups
Alcohol |
Cream soup |
Mediterranean Diet
Eat more fish, olive oil, fresh fruit and vegetables, whole grains, moderate alcohol intake, less animal products, less unsaturated and hydrogenated fats and sugar. Regular meals with a high proportion of starchy foods e.g. potatoes, wholemeal bread, rich pasta, high fibre cereal. Avoid added salt.
Eat 2-3 portions of oily fish each week (mackerel, herring, salmon, trout, pilchards, sardines, and kippers), or fish oil capsules if unable/unwilling to eat fish.
Eat at least 5 pieces of fruit (including fruit juice), or vegetables (not including potatoes), a day.
Fats - cut down on most fats like lard, butter, hydrogenated vegetable oil and the fats in many processed food and change to healthier fats. Some fats, such as those in nuts, mono-unsaturated oils and oily fish, are beneficial in small amounts. So cut down on fats overall, but have a little of the healthy fats each day. In cooking or in salad dressings, use mono-unsaturated oil; try olive, rape seed or groundnut oil. Use skimmed or semi-skimmed milk.
Change to margarine high in mono-unsaturated or polyunsaturates or reduced fat spread and spread less on bread.
Use less cheese - up to 4oz (100g) of hard cheese each week or 8oz (200g) of reduced fat cheese (like Edam, reduced fat cheese or light soft cheese), or as much cottage cheese as wanted.
Trim all fat from meat and have smaller portions (2-3oz, 50-75g is plenty).
Cut down on all red meat and replace by fish and chicken (no skin).
Do not eat more than 3 eggs a week.
If meat juices are used to make gravy, carefully separate off all the fat.
Cut down on ready made, processed, manufactured foods. Avoid meat products (sausages, pies, Spam, and pate).
Avoid cakes and pastry, biscuits, crisps, crackers, chocolate, ice-cream.
Lifestyle Changes for Raised Blood Pressure
There is good evidence that certain lifestyle changes lower blood pressure. This may remove the need for drug treatment or reduce the dose or number of drugs required to control blood pressure. These lifestyle changes are:
* Weight reduction to achieve an ideal body weight by reducing fat and total calorie consumption. If you would like help, please make an appointment to see the dietitian
* Regular physical exercise designed to improve fitness (brisk walking rather than weight training). Please discuss STARS (formerly Exercise on Prescription ), with your Dr or Practice nurse.
* Limiting alcohol consumption to less than 21 units a week for men and less than 14 a week for women.
* Reduced use of salt when cooking and eating less excessively salty foods such as crisps and salted nuts.
* Increased consumption of fruit and vegetables.
Lifestyle changes that further reduce cardiovascular disease are:
* Stopping smoking . If you would like help to stop please make an appointment with one of the practice nurses trained in smoking cessation.
* Reducing the amount of saturated fat (e.g. butter, lard, suet) in the diet and replacing it with polyunsaturated fats (e.g. sunflower oil) and monounsaturated fats (e.g. olive, rapeseed or groundnut oil).
* Increasing oily fish in diet Please ask the practice nurses or reception for Cholesterol-lowering and Mediterranean diet sheets.
* Regular physical exercise.
Reducing Sugars in Your Diet
There is no longer a special ‘Diabetic diet’. Diabetics should follow a healthy eating diet suitable for all, and enjoy a wide variety of different foods. If you are overweight, losing weight will help you control your diabetes .You should aim to lose weight slowly. Weight loss of 1-2 lbs a week is good progress. You should not follow ‘crash’ diets. Even if you don’t reach your ideal weight, losing some weight and keeping it off still helps.
1. Eat regular meals ( 3 times a day), based on starchy foods such as ; bread, pasta, potatoes, rice and cereals. Choose high fibre varieties such as wholemeal bread and wholewheat cereal. By maintaining a constant energy level you avoid the fluctuations that have an effect on blood glucose levels.
2. Cut down on fat and fatty foods, especially saturated animal fats, because this type of fat is linked to heart disease. Eating less fat and fatty food will also help you to lose weight.
*
Choose low fat dairy products like semi-skimmed milk, low fat cheese ( edam , half-fat cheddar and cottage), and low fat (and low sugar) yoghurt
*
Grill, steam , ovenbake , boil, microwave or use a non-stick pan rather than frying food.
*
Buy lean meat, trim all yellow/white fat
*
Eat fish at least twice a week , especially oily fish such as salmon, mackerel, sardines, fresh tuna and trout, which contain omega –3 fats that can be protective against heart disease.
*
Choose poultry and pulses (beans)
*
Use low or reduced fat spreads (monounsaturated or polyunsaturated) such as ‘Benecol’ or ‘Olivio’.
*
Avoid cakes, chocolates ,biscuits ,pasties, pies and burgers.
3. Cut down on, or better still avoid, sugar and sugary foods. This may not mean a sugar –free diet, but avoid concentrated sources of sugar e.g. sugar rich pop/squash, as sugary drinks cause blood glucose levels to rise quickly
*
Choose diet, low sugar or sugar-free squashes and fizzy drinks
*
Choose artificial sweetners e. g. ‘Candarel’
*
Eat high fibre/low sugar cereals ( shredded wheat/weetabix)
*
Eat low sugar puddings such as ‘diet’ jelly, mousse, or low fat, sugar free yoghurt
*
Choose plain cakes , biscuits such as arrowroot/oatmeal and scones.
4. Use less salt
*
Try flavouring food with herbs and spices
*
Add salt after cooking
*
Remember pies, tinned meat and fish, cheese, crisps and other processed foods are high in salt.
5. Eat more fruit and vegetables. At least 5 portions a day, to provide you with vitamins and fibre as well as to balance your overall diet.
6. Don’t be tempted by special diabetic food and drink products. They are expensive, may be high in calories and are unnecessary. Instead try reduced calorie foods ,i.e. ‘diet’ brands
Severn Strollers
Walk Brisk - Reduce Risk
BRIDGNORTH DISTRICT WALKING THE WAY TO HEALTH SCHEME
FREE LED WALKS WITH TRAINED WALK LEADERS
MONDAYS 10.00 a.m exc. Bank Holidays Café after walk
THE SQUARE, MUCH WENLOCK
short walk & improver
MONDAYS 2pm exc. Bank Holidays
VISITORS CAR PARK, COUNCIL OFFICES
WESTGATE, BRIDGNORTH
Inclines/declines 30-45mins
1st & 3rd TUESDAY EACH MONTH 10.30 a.m.
SEVEN STARS BECKBURY off road walks 45-90 mins
WEDNESDAYS 10.30 a.m.
BROSELEY HEALTH CENTRE
10.30 a.m. inclines/declines. Refreshments after walk at Victoria Hall
WEDNESDAYS 2 p.m.
BRIDGNORTH COMMUNITY CENTRE
Mainly flat along riverside 30-60 mins. Refreshments after walk.
WEDNESDAYS 10.30 a.m.
CROWN CAR PARK ALBRIGHTON
Easy & improver. Refreshments at the Red House
MONDAY 10.30 a.m.
SEVERN CENTRE HIGHLEY
Easy and improver. Refreshments after walk
PLEASE NOTE
Strong shoes/trainers recommended
Please meet 10 minutes prior to walk. Why not bring a friend?
COME AND ENJOY NATURE’S FREE GYM
Scheme Co-ordinator 01746 713190
WHY IS WALKING GOOD FOR YOU?
* Gives you more energy
* Helps you to sleep better
* Keeps your heart strong
* Reduces blood pressure
* Helps to manage your weight
* To meet new friends
* It’s free
* Almost everyone can do it
!!! IMPORTANT DETAILS !!!
You will be asked to complete a short health questionnaire before your 1st health walk. If you are unsure of your fitness, please consult your GP.
Walking for 30 minutes per day, 5 times each week can really improve your health.
For further information about walks please contact the Walking for Health Co-ordinator on 01746 713190 or email mnewman@bridgnorth-dc.gov.uk
No walks in your area? Why not train to be a walk leader?
Free 1 day training.
Shropshire County Primary Care Trust