Shun fats, smokes, get out and about for a healthy heart.

OTTAWA - Changes in the way people eat and exercise and improvements to health care could sharply reduce the death toll from heart attacks and strokes and save billions of dollars, a federal panel said Tuesday.

The Canadian Heart Health Strategy and Action Plan, a body set up two years ago to look at ways of tackling cardiovascular disease, the country's No. 1 killer, says it's time to fight back.

The action plan recommends that government spend $700 million over seven years in a comprehensive approach to the problem. The return, it said, would be a $22-billion savings in direct and indirect costs by 2020.

It recommended new laws and regulations to promote healthy lifestyles; labelling rules to tell people how much fat and salt lies hidden in their food; new ways of delivering health care, and bans or tight limits on products such as trans fats.

It also calls for more education on healthy eating and exercise and changes to the way the health system deals with heart and stroke problems.

Health Minister Leona Aglukkaq welcomed the recommendations, but said in an email statement that she will need some time to review them.

Dr. Eldon Smith, a Calgary heart doctor who was chair of the panel, said he believes the minister is on side.

"My personal view is that our minister is very keen on most of the stuff that we've come up with," he said.

"I don't think that our governments can afford not to do this. I think there'll be a lot of support for some of the very practical things that are involved."

Smith said the panel had to pull a lot of information together.

Now, there aren't even proper statistics on the problem.

"I cannot tell you how many Canadians had a stroke or heart attack last year," Smith said. "Comprehensive national statistics just don't exist."

Tobacco use withered dramatically under new rules and laws and the same approach can work with cardiovascular disease, he said.

Some of the recommendations are common sense.

"We are too fat, spend too much time in our cars and on our couches and don't eat enough healthy foods," Smith said.

Smith's panel was set up to assemble a scattering of programs and policies into a unified approach.

"We already have a strategy for cancer, diabetes and lung disease but, until now, did not have a comprehensive strategy for the No. 1 killer and public-health threat in the country," he said.

Changes in the system could bring new health-care teams into the community - not necessarily doctors - to offer care and advice close to home. People should be able to have their blood pressure tested at a drug store or some other handy location.

People also need more information, Smith said.

"Everybody in a country like ours ought to know their risk factors. They ought to know what their cholesterol is, they ought to know what their blood pressure is, they ought to know what their blood sugar is. They ought to know what their waist circumference is."

Most men, when asked their waist size, will give their belt size.

"You know that we wear our belts well below the largest part of our waist."

By 2015, Smith hopes to see a 20 per cent drop in obesity among adults and a one-third cut in the number of obese children.

By 2020, the strategy aims to cut deaths from cardiovascular disease by a quarter and reduce hypertension in adults by a third.

It also hopes to halve the risk of heart attack and stroke in the native population. Aboriginals are currently twice as likely to develop cardiovascular disease compared to the general population.

Smith said the health minister, who is from Nunavut, recognizes the scope of the problem in native communities.