Introduction
Fats, Cholesterol, and Heart Health
Eating well is one of the joys of life. Because you want foods that both taste good and are good for you, this cookbook offers many choices ranging from appetizers to desserts, all high in flavor but low in unhealthy nutrients including sodium, added sugars, saturated fat, and trans fat. Saturated and trans fats are dietary villains that cause blood levels of harmful low-density lipoprotein cholesterol (LDL, the “bad” cholesterol) to rise. That’s a serious concern because higher levels of LDL cholesterol circulating in your blood are a major risk factor for heart disease.
You can take three important steps to help manage your risk of heart disease. First, evaluate your personal situation and identify all your risk factors. Second, take steps to control your LDL cholesterol level—and other risk factors—by making smart decisions about your diet and lifestyle. Third, commit to making good choices for the long term to live a longer, healthier life.
KNOW YOUR RISK
The first step is to assess your individual risk for heart disease. Risk factors are the behaviors and conditions that increase your chance of developing a disease. Some risk factors—aging, your medical history, and the medical history of your family—can’t be changed. (For more information, see Appendix E on page 348.) Fortunately, many risk factors can be changed. Lifestyle choices such as smoking and physical inactivity, as well as conditions such as high blood cholesterol, high blood pressure, being overweight or obese, and diabetes, are all factors that you can do something about. In fact, heart disease is largely preventable. If you don’t know your numbers for blood cholesterol, blood pressure, and blood glucose, visit your healthcare provider and find out what they are. Be sure to schedule regular visits with your healthcare provider to monitor your individual situation. Depending on your cholesterol levels and your other risk factors, decide together on target goals and the best approach for reaching them.
REDUCE YOUR RISK
By changing your habits, especially your dietary and lifestyle choices, you can help reduce your level of blood cholesterol as well as other risk factors. How much you have to modify your diet and lifestyle depends on several things, including your other risk factors and how your body responds to changes in your diet. For many people, relatively minor changes can reduce their risk significantly. Others need to make more extensive lifestyle changes. Eating well and being physically active are the best ways to control your LDL cholesterol level and other modifiable risk factors.
Eating a Heart-Healthy Diet
The more research we do, the more we understand how the foods we eat affect the levels of cholesterol in our blood. What actually is cholesterol? Cholesterol is a waxy substance that comes from two sources: your body and food. Your body, and especially your liver, makes all the cholesterol you need and circulates it through the blood. But cholesterol is also found in foods from animal sources, such as meat, poultry, and full-fat dairy products. Your liver produces more cholesterol when you eat a diet high in saturated and trans fats. That’s why it’s important to know what you’re eating and what to cut back on to keep your blood cholesterol low. To achieve a heart-healthy diet, it’s important to replace foods that are high in saturated fat and trans fat, as well as in sodium and added sugars, with nutritious foods.
Being Physically Active
In addition to eating nutritiously, we know that maintaining a healthy lifestyle—especially by staying physically active—is an important step to reduce your risk for heart disease and stroke. You can help lower your cholesterol primarily by getting regular exercise and managing your weight.
If your healthcare provider prescribes cholesterol-lowering drugs, you still should modify your diet and lifestyle. These changes not only lower cholesterol but also help control many of the other risk factors for heart disease, including high blood pressure, being overweight or obese, and diabetes.
COMMIT TO A LIFETIME OF HEALTHY CHOICES
Finally, managing your risk means committing to a lifestyle that promotes a longer, healthier life. If you eat wisely, stay physically active, take statins (if prescribed), and follow the recommendations of your healthcare provider, chances are you will:
Reduce your likelihood of developing high blood cholesterol if you don’t have it.
Reduce your cholesterol levels if they are high.
Reduce your risk of developing heart disease and having a stroke.
By consistently making healthy decisions throughout your life, you are taking an active role in managing your well-being. The smart choices you make today can bring long-lasting benefits to you and your family for many years to come.
healthy food, healthy heart
One of the best ways to take care of your heart is to understand the fundamentals of good nutrition and apply them in your everyday life. Once you have this information, you can build a heart-smart eating plan using our recipes and creatively adapting your own.
THE ESSENTIALS TO EATING WELL
As you plan your meals at home—and when you make food choices away from home—what matters most is to establish a well-balanced diet that provides variety among the food groups. If one day you eat too much of something you are trying to limit, be mindful of that and eat less in the following days to get back in balance. It is possible to satisfy your personal preferences and still be sure you get all the components of a healthy diet while limiting the less healthy foods.
Follow these basic nutrition guidelines for an overall healthy eating pattern:
Eat lots of different fruits and vegetables.
Make sure at least half of the grains you eat are whole-grain foods.
Include fat-free and low-fat dairy products.
Eat fish (especially those rich in omega-3 fatty acids) at least twice a week.
Choose lean meats and poultry without skin and prepare them without added saturated and trans fats.
Limit foods that contain “bad” fats (saturated and trans) and replace with those that contain “good” fats (monounsaturated and polyunsaturated).
Choose and prepare foods with little or no salt.
Reduce your consumption of beverages and foods with added sugars.
Fruits and Vegetables
Vegetables and fruits are great examples of nutrient-rich foods whether they are fresh, frozen, or canned. They are low in calories but provide important vitamins, minerals, fiber, and other nutrients. Try to eat the rainbow of fruits and vegetables to get the widest variety, such as (green) spinach, kale, collard greens, mustard greens, romaine lettuce; (red) tomatoes, beets, red bell pepper, raspberries; and (orange) carrots, sweet potatoes, pumpkins, mangoes, cantaloupes, apricots.
Healthy Hnts
Look for no-salt-added or low-sodium versions of canned vegetables and beans. Manufacturers continue to bring out new products to meet the demand for more-healthful choices.
For canned fruits, read the ingredient labels to find options with the least amount of added sugar. Fruits that are canned in water are lower in calories than fruits canned in juice or syrup. Rinsing and draining both canned fruits and vegetables before you use them reduces sugar and sodium even further.
Grains
Any food made of wheat, rice, oats, corn, or another cereal is a grain product. Bread, pasta, oatmeal, and grits are all grain products. There are two main types of grain products: whole grains and refined grains. Try to eat whole-grain products for at least half of your daily servings.
Whole grains are high in fiber and complex carbohydrates and low in saturated fat, and they are a healthier choice than refined grains. Whole grains contain the entire grain—the bran, germ, and endosperm. Healthy choices include whole-wheat flour, oatmeal, corn, whole-grain cornmeal, brown rice, quinoa, buckwheat, wild rice, barley, bulgur, and whole-grain cereals and breads.
On the other hand, refined grains have been milled (ground into flour or meal), which results in the bran and germ being removed. This process removes much of the B vitamins, iron, and dietary fiber. Most refined grains are enriched, which means that some of the B vitamins and iron are added back after processing. Fiber, however, is not added back to enriched grains. Some sources of enriched grains are wheat flour, enriched bread, and white rice.
Healthy Hints
To find grains in their whole form, look beyond the labeling on the packaging and read the ingredients list. When choosing a bread, cereal, or grain product, look for those that list the whole grain as the first ingredient on the label.
Most commercial muffins, cakes, pies, doughnuts, and cookies are not made with whole grains, and they are high in calories and low in important nutrients. To enjoy these occasional treats, bake them at home using whole-wheat flour, unsaturated oils, and fruits or vegetables. For some delicious ideas, see “Breads and Breakfast Dishes” (page 277) and “Desserts” (page 293).
Commercial products are being reformulated to avoid the use of trans fat, but check nutrition labels for partially hydrogenated oils before you buy.
Dairy Products
Dairy foods are an important part of a healthy diet, providing calcium and protein. All adults ages 19 to 50 should aim to consume 1,000 milligrams of calcium each day (for maximal calcium retention). For adults ages 51 and older, that amount increases to 1,200 milligrams. Most healthcare providers encourage women in particular to eat fat-free and low-fat dairy products to get calcium. This helps reduce their risk of developing the bone disease osteoporosis. So many fat-free and low-fat dairy options are now available that you can easily avoid the high levels of saturated fat found in whole milk and whole-milk products. Healthy choices include fat-free or low-fat milk, cheeses, yogurt, sour cream, and cream cheese. To see the difference, take a look at the nutrition labels and compare a cup of whole milk to a cup of fat-free milk, for example. By choosing the fat-free version, you’ll save about 65 calories and 4.5 grams of saturated fat.
Healthy Hints
Keep in mind that many cheeses are high in saturated fat and that many fat-free or low-fat products have high levels of sodium and added sugars. Be sure to read the nutrition facts labels and compare products.
If you’re used to whole-milk products (3.5% fat), you may find it easier to taper off slowly. Try 1% low-fat milk first, then change to ½% low-fat milk. Soon you’ll be able to switch to fat-free milk with no trouble.
If you choose not to consume dairy products, other good sources of calcium include green vegetables such as spinach, kale, and broccoli, and some legumes and soybean products.
Fish and Seafood
Research suggests that increased intake of oily fish that contain omega-3 fatty acids—such as salmon, lake trout, herring, sardines, mackerel, and albacore tuna—reduces the risk of death from coronary artery disease. Aim to eat at least two servings of fish that’s rich in omega-3 fatty acids every week. If you already have heart disease or high blood triglyceride levels, your healthcare professional may recommend fish oil supplements to help increase your intake of omega-3 fatty acids.
Shellfish, such as shrimp, squid, scallops, mussels, and clams, is low in saturated fat, so it’s a good source of heart-healthy protein. There are also several tasty and healthy ways to prepare shellfish that don’t add a lot of saturated and trans fats or sodium.
Healthy Hints
Canned tuna is an easy way to get in omega-3s. Choose a very low sodium product and be sure it’s packed in water or in a vacuum-sealed pouch.
Although nearly all fish and shellfish may contain trace amounts of mercury or other contaminants, the health risks from mercury exposure depend on the levels of mercury in the fish itself and the amount of seafood eaten. Eating a variety of fish will help minimize the possible adverse effects caused by pollutants in the environment. The FDA recommends that women who are pregnant, planning to become pregnant, or nursing—and young children—should avoid eating four types of fish with high mercury levels: tilefish from the Gulf of Mexico, shark, swordfish, and king mackerel. For most people, however, the benefits of eating fish far outweigh the risks.
Choose low-sodium, low-fat seasonings, such as spices, herbs, and lemon juice, when you cook fish.
Poultry and Meat
Lean skinless poultry and lean meat are delicious sources of essential protein. Protein helps you to feel full and satisfied until your next meal, and it’s critical for building muscle to keep you strong, especially as you grow older. The American Heart Association recommends consuming no more than 6 ounces of cooked lean skinless poultry or lean meat each day.
Healthy choices include skinless chicken and turkey, all cuts; lean beef cuts, such as sirloin, round steak, and rump roast; extra-lean ground beef; lean pork cuts, such as loin chops, tenderloin, and the lowest sodium available center-cut ham and Canadian bacon. Try to limit your consumption of red meat.
Healthy Hints
Choose whole turkeys or turkey breasts that haven’t been injected with broth or fats.
Buy USDA Select grades of meat. They have less marbling than Prime or Choice.
Be sure to discard any visible fat.
When figuring serving sizes, remember that poultry (and meat) loses about 25 percent of its weight during cooking. (For example, 4 ounces of raw poultry [or meat] will weigh about 3 ounces when cooked.)
Chill meat juices from cooking so you can easily skim off fat that hardens on the surface before you use those juices to make gravy, stews, or soups.
Limit processed meats, such as bacon, hot dogs, bologna, salami, and sausage. They are often high in saturated fat and sodium. Reduced-fat, low-fat, and/or fat-free versions of these meats are available, but watch out for high sodium. Compare labels to find the brands that are lowest in calories, saturated fat, and sodium.
Legumes, especially dried beans and peas, are also rich in fiber and provide protein. They are excellent alternatives to animal sources of protein that contain saturated fat. Also include a variety of legumes, such as green peas, black-eyed peas, chickpeas, kidney beans, navy beans, and lentils.
Fats and Oils
It’s the type of fat more than how much fat you consume that most affects your blood cholesterol level. The main types of fat in foods are saturated fat, trans fat, and unsaturated fat. Saturated fats are found in animal products and in some tropical oils. Trans fat is found primarily in commercial products made with or fried in partially hydrogenated oils. Both of these types are the harmful fats and raise LDL cholesterol in the blood. Aim to get no more than 5 to 6 percent of calories from saturated fat and to reduce the percentage of calories from trans fat. For example, if you eat about 2,000 calories a day, you should limit your consumption of saturated fat to less than 13 grams (6 percent of 2,000 calories is 120 calories, divided by 9 calories, which are roughly equal to 1 gram of fat). You can find how much saturated fat is in foods by reading the nutritional analyses for recipes and reading the Nutrition Facts panels on food labels.
Copyright © 2015 by American Heart Association. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
