Eating Right for Your Heart Health

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The best way to achieve a healthy diet is to get in the habit of eating more fresh, wholesome, natural foods like fruits and vegetables.

More horsefeathers get tossed about regarding the subject of nutrition than just about anything else. This modern snake-oil salesmanship used to be the stamping ground of the quacks, selling you “vitamin B93” to cure baldness, or psoriasis, or impotence. Now the food industry itself has jumped in.

Health sells. A third of all new food products introduced in 1988 boasted a health claim. It’s certainly encouraging to see powerful companies compete to bring us lighter, healthier, lower-fat foods. Let’s face it: We need all the help we can get.

But as corporations search for competitive advantage in the marketplace, the truth is sometimes lost along the way. This product claims it has no cholesterol, but it turns out to be high in tropical oils such as palm, which is mostly saturated fat, which raises blood cholesterol (the kind that counts) even more dramatically than does the intake of dietary cholesterol. Yet another argues it’s a better breakfast cereal because it has more vitamins than its whole-grain brother, as if the purpose of breakfast were to supply us with a sugar-coated vitamin pill, rather than with nourishing, energizing complex carbohydrates.

Basics of a Heart Healthy Diet

Must the quest for a healthy diet really be confusing? Not at all. In fact, it’s rather astoundingly simple, as it turns out. Listen to The Surgeon General’s Report on Nutrition and Health. The number one rule: Cut fat. More specifically: “Reduce consumption of fat (especially saturated fat) and cholesterol. Choose foods relatively low in these substances, such as vegetables, fruits, whole grains, fish, poultry, lean meats, and low-fat dairy products. Use preparation methods that add little or no fat.”

The reasons behind such recommendations are many. A diet that’s too high in fat, especially the saturated type that’s found mostly in animal foods such as dairy fat (butter, cream, whole milk) and meat fat (heavily marbled beef, pork fat, chicken skin), increases the blood levels of such fats as cholesterol, and that can increase the risk of heart disease. A high-fat diet may also predispose to cancer. And diabetes. And gallbladder disease. Not to mention obesity, which can complicate other health problems.

Perhaps you’ve heard recently that there’s a controversy over the relationship between cholesterol and heart disease. There has been, although it focuses mostly on the wisdom of a federal program, the National Cholesterol Education Program, which may encourage doctors to put too many patients who have high cholesterol on cholesterol-lowering drugs. No one really disputes the finding that a high level of cholesterol increases the risk of heart disease, or that lowering your cholesterol level to below 200 through diet will reduce that risk.

Of course, there’s more to preventing heart disease than lowering blood cholesterol. Family history is one risk factor; if your biological relatives have had early heart disease, then it’s especially important to reduce other risk factors. Besides cholesterol, those include smoking and high blood pressure. Obesity, if it leads to high blood pressure or high cholesterol, also increases the damage.

Fortunately, all of these risk factors, except for smoking, can be reduced through regular exercise and a good diet. Nor is the best way to build a healthy diet just to avoid fat. Once the food industry comes out with fat substitutes–at least two are now up for approval by the Food and Drug Administration–you’ll be encouraged to eat low-fat ice cream and potato chips. But no matter how low-fat your ice cream, eating it all day long will never make you healthy. It lacks many of the nutrients our bodies need.

Instead, the best way to achieve a healthy diet is to get in the habit of eating more fresh, wholesome, natural foods. Like fruits and vegetables. They’re low in lots of stuff: low in fat, low in sodium, low in calories. But they’re high in something, too. Nutrients. Vitamins and minerals. Don’t forget them! One medium-sized carrot contains an average individual’s required daily supply of vitamin A. Better yet, it’s in the form of beta-carotene, the plant precursor to vitamin A that may help prevent lung and other cancers. Carrots also are high in fiber.

But why eat a carrot instead of taking a beta-carotene pill? Well, there’s probably nothing wrong with taking beta-carotene in a supplement. But doing so gets us off the track intellectually, gets us thinking of individual nutrients as magic bullets. Lots of ads feed that notion, too, whether they’re for oat bran or calcium. It’s true that beta-carotene looks promising from a research perspective. But here’s the real news: Scientific studies find that people who eat more fruits and vegetables of all kinds have a lower incidence of certain cancers than do people who eat only a few types of fruits and vegetables, or none at all.

So take an apple to your desk for an afternoon snack, or slice some carrots into a plastic bag and put them in the fridge for your kids to munch on, and get in the habit of including a green salad with dinner. The darker the green, the more vitamins it has.

Eat More Fruits, Vegetables, and Whole Grains

The National Research Council’s 1989 report, Diet and Health: Implications for Reducing Chronic Disease Risk, puts great emphasis on fruits and vegetables and on whole grains. This is the NRC’s advice: “Every day eat five or more servings of a combination of vegetables and fruits, especially green and yellow vegetables and citrus fruits. Also, increase intake of starches and other complex carbohydrates by eating six or more daily servings of a combination of breads, cereals, and legumes.” (A serving, the report explains, is equal to a half cup of most fresh or cooked vegetables, fruits, dry or cooked cereals, and legumes. A serving is also defined as one medium piece of fresh fruit, one slice of bread, or one roll or muffin.)

Legumes, such as pinto beans, soybeans (even tofu), or split peas, are worth special attention. They’re rich in protein and iron, and so can replace red meat for a weekday supper. They’re inexpensive. They store well. They’re rich in many vitamins, too, and full of fiber, including the type of soluble fiber–also found in oats–that tends to lower blood levels of cholesterol. And they taste pretty good in chili.

Meat and Dairy

Does all this emphasis on grains and greens mean that beef is out? Not really. Beef, like all red meat, tends to be fairly high in fat and saturated fat, but a small portion (three or four ounces) of very lean beef provides good amounts of such nutrients as iron, zinc, manganese, and B vitamins (though not B93). It’s all a question of balance. Chicken without the abdominal fat and the skin is a low-fat food. So is fish, which tends to be low in fat and especially low in saturated fat, and contains Omega-3 fatty acids, which can lower blood cholesterol and may lower blood pressure as well.

The same concern over fat goes for dairy products. From the butter on our bread to the cream in our coffee, dairy foods supply a lot of fat. But 1% milk provides lots of calcium and protein with little fat. Skim milk has essentially no fat. Eating low-fat frozen yogurt instead of premium ice cream can slice calories off your evening’s dessert. Adding a little nonfat dry milk to stews and soups can add calcium without any fat at all.

The key is balance. Most of us grew up with the idea that the center of the dinner plate should feature a big chunk of meat–a steak, a hamburger, fried chicken–graced with little sideshows of starch and vegetables. But a healthy dinner plate has just the opposite look: lots of starches and greens, with small portions of meat and dairy. The best diet is based on complex carbohydrates and supplemented by sources of protein. It’s not that the meat is a bad idea; it’s just that the rice pilaf–or the mashed potatoes, or the cornmeal, or the vegetable stir-fry–should dominate the plate. Try to keep protein sources–fish, chicken, beef, even beans–to about six (or at most, 12) ounces a day, suggests the NRC’s Diet and Health.

It’s easy to get into the grain-based way of eating. Make a pizza with whole wheat flour, with lots of vegetables and tomato sauce, some cheese, and maybe a little meat. What you’re eating is mostly complex carbohydrates (whole wheat flour, vegetables) made more nutritious by small amounts of protein foods (cheese, meat). These protein foods do tend to carry fat, but if you don’t use too much of them, you’ll add their nutrition without adding to your waistline.

Consider this recipe, from the cookbook The New American Diet, by Sonja and William Connor (Simon and Schuster Fireside Books, 1989):

Chicken and Vegetables Provençale

1 small head cauliflower or broccoli
2 large ripe tomatoes, sliced
2 medium carrots, pared and thinly sliced
1 large onion, thinly sliced
3 tablespoons chopped fresh parsley, divided
1 tablespoon basil leaves, divided
1/2 teaspoon (or less) Lite salt or regular table salt
1/4 teaspoon pepper
1/2 cup chicken broth
2 cloves garlic, minced
Juice of 1 lemon
4 chicken breasts, skinned

Preheat oven to 350°F. Trim outer leaves and tough stalks from cauliflower; break into small pieces. Combine cauliflower, tomatoes, carrots, and onions in 2-quart shallow baking dish. Sprinkle with 1 tablespoon parsley, 2 teaspoons basil, salt, and pepper. Pour chicken broth over vegetables.

Make a paste of remaining 2 tablespoons parsley, 1 teaspoon basil, garlic, and lemon juice. This can be done by using a mortar and pestle or by chopping parsley and garlic finely and mixing with lemon juice and basil in a small cup or bowl with the back of a spoon. Spread paste over each chicken breast.

Place chicken over vegetables in baking dish; cover with foil. Bake 1 1/2 hours, then uncover and brown. Baste chicken occasionally with pan juices during baking. Makes 4 servings.

It’s a fairly simple recipe; you might serve it with rice, perhaps brown rice. So what’s so unusual about it? It’s a chicken dish, but not just a hunk of chicken in the center of the plate. It includes lots of vegetables: cauliflower, maybe broccoli, tomatoes, carrots. You could add more. The chicken breasts are cooked without skin (skin is mostly fat). If this mixture were served with rice, your dinner would consist mainly of complex carbohydrates, with a reasonable amount of protein and very little fat. You’d be getting grains and vegetables. Have a piece of fruit for dessert, wash it down with low-fat milk, and nutritionists would applaud you!

Or consider this pasta recipe from Eat Right, Eat Well–The Italian Way (Alfred A. Knopf, 1988), by artist and author Ed Giobbi:

Spaghetti with Cauliflower

This recipe is of Sicilian origin and has a lovely delicate flavor.

2 tablespoons plus 1 teaspoon olive oil
2 cloves garlic, finely chopped
4 cups chopped tomatoes, fresh if possible (drain if canned)
2 tablespoons finely chopped Italian parsley
2 tablespoons yellow raisins, soaked in warm water for 15 minutes and drained
2 tablespoons pine nuts
Salt and freshly ground pepper to taste
Hot pepper flakes to taste (optional)
1 1/4 pounds cauliflower florets
3/4 pound spaghetti
Chopped Italian parsley for garnish

Heat the oil in a medium skillet or shallow saucepan. Add garlic. When it takes on color, add tomatoes. Cover, and cook over moderate heat for 5 minutes. Add parsley, drained raisins, pine nuts, salt, pepper, and optional hot pepper flakes. Cover, and simmer over low to moderate heat for 10 minutes. In the meantime, blanch cauliflower in boiling water for 1 minute. Drain, then cut the florets into bite-sized pieces, and add to the sauce. Cover, and continue cooking 5-8 minutes. Cook pasta in rapidly boiling water until done al dente, then drain well.

Toss pasta with sauce, and serve hot, garnished with chopped parsley.

Here you have another reasonably simple, delicious recipe. With a green salad, it could serve as a light, meat-free dinner. What about protein? you might ask. Sure, it’s not packed with protein, like a burger or even a vegetarian chili loaded with beans. But we’ve been tremendously oversold on protein. In this recipe, the spaghetti and even the cauliflower contribute a little protein. (You might also notice that the oil used is olive oil. It’s a good oil to get acquainted with–it’s low in saturated fat, high in monounsaturated fats. Research studies indicate that monounsaturated oils tend to lower blood cholesterol in humans. Canola oil is another good, mostly monounsaturated cooking oil.)

Maintaining a Healthy-Heart Lifestyle

The three main principles in nutrition are moderation, balance, and variety. Over the last few years, scientists have discovered much about the healing power of certain substances in specific foods. Garlic is a potent antibiotic; it may also help prevent stomach cancer and protect the blood against a tendency to form clots. Cabbage-family (cruciferous) vegetables such as broccoli, cauliflower, and radishes may contain chemicals called indoles that could help prevent certain cancers.

The list goes on and on, but the basics don’t change: moderation, balance, and variety. Base your diet on whole grains, fruits, and vegetables, with essential supporting parts played by animal foods such as beef, chicken, fish, milk, yogurt, and cheese. Cut back on fat, and boost carbohydrates whenever you can. Eat green stuff. Don’t pig out. Exercise enough so you can eat enough so you can be nourished without getting fat.

Learn to make some fairly minor adjustments in your eating and cooking habits, and the rest will fall into place.

Robert Barnet is nutrition editor for American Health magazine.