Pinning Down the “How-To’s” for a Cholesterol-Lowering Diet
In This Chapter
� Evaluating foods to avoid
� Exploring healthy plant-produced foods
� Trimming the fat during food preparation
Chapters 4 and 5 give you plenty of information on good food and bad food for your cholesterol. This chapter tells you ex-act-ly how to put
that information to use in Real Life.
The info here is definitely hands-on, the tips you need to start changing your diet (though be sure to consult with your doctor before making any big diet changes). Naturally, the chapter is designed to be easy to follow, enabling you to turn these bits and pieces of nutrition advice into a healthful habit.
The experts call this a Good Food Plan. Go for it!
Avoiding Certain Foods (Or At Least Eating Them in Very Small Portions)
Yes, the foods listed in this section are high in fat, saturated fat, or cholesterol (or all three), but that doesn’t mean they’re gone from your table forever. The solution is portion control.
No, you can’t have butter morning, noon, and night.
Yes, a smidgen on your baked potato now and then is okey-dokey. So is an occasional schmear of chopped liver on a canapé cracker.
And a 1-inch cube of cheddar with a fresh, crisp apple once in a while isn’t all bad.
In other words, enjoy. But in moderation, please.
Butter
Butter is pure butterfat, the natural fat in milk. Just about the only redeeming virtue of butter (other than the heavenly flavor) is the fact that it’s a concen- trated form of energy. If you lived like your cave-person ancestors, toiling all day at manual labor, or if you lived in a very, very cold climate, you could make good use of that energy. But you don’t. So you won’t. And that’s it for the good news.
The bad news is exactly what you expect. Butterfat is very high in saturated fat. One measly tablespoon of butter has a whopping 11 grams (g) of fat, 7.1 g of which are saturated fats. Butter only contains 3.7 g of “good” fats — 3.3 g are monounsaturated fatty acids and a miniscule 0.4 g are polyunsaturated fatty acids.
Do the math (divide 7.1 by 11), and you can see that butter is 64.5 — oh heck, call it 65 — percent saturated fat, a real heart buster. And did I mention that one tablespoon has 31 milligrams (mg) of cholesterol, 10 percent of your total daily allowance according to the diet rules I describe in Chapter 4 and Chapter 5? Now I did.
So your vote goes to margarine, right? Well, yes. As long as it’s the right margarine. As you can plainly see in the section “Margarine with Trans Fatty Acids” a bit later on in this chapter.
Coconut
Nuts have been winning praise lately for their unsaturated fats, not to mention their dietary fiber. (I tell you about really good nuts later in this chapter.) But not the coconut. This big, bulky nut is a special — some may say “notorious” — case.
Yes, trying to knock open a fresh coconut uses up calories. Yes, coconut meat is high in dietary fiber, and like other nuts, it’s a good source of B vitamins. Yes, a single 2-inch-square piece of fresh coconut meat has 1.09 mg of iron (7.3 percent of the recommended daily allowance for a woman of child- bearing age), and 0.49 mg of zinc (3.3 percent of the recommended daily allowance for a man, 4 percent of the recommended daily allowance for a woman). And of course, the coconut, being a plant, has no cholesterol.
Can you sense a “but” coming here? Right you are. But that same 2-inch-square piece of coconut contains 15 g of coconut oil, the fat that accounts for 85 per- cent of the calories in coconut meat.
Coconut oil is 89 percent saturated fatty acids, which makes it an even more highly saturated fat than butter (see the “Butter” section earlier in this chap- ter). Oops.
Eggs
Confused about eggs? No wonder.
For years, nutritionists insisted that eating eggs raised the risk of heart dis- ease. Then new data from the long-running Nurses’ Health Study (women) and the equally long-running Physicians’ Health Study (men) turned up, showing no significant difference in risk between those who consume an average of one egg daily versus those who eat less than one egg a week.
And new laboratory analyses say that a yolk from one large egg contains only 213 to 220 mg of cholesterol, about 50 to 60 mg less than originally believed. What’s a body to do? Sit tight.
The American Heart Association has upped its allowances on egg consumption to one-a-day, just like that famous brand of vitamins, so long as you figure the egg’s 200+ mg of cholesterol into your daily total. In other words, if you’re pigging out on red meat, don’t toss a whole egg on top.
The key word there is whole. All the fat, including cholesterol and artery- clogging saturated fats, is in the yolk. The high protein white has none, but it does give you some minerals and some B vitamins, notably riboflavin (vitamin B2), a “visible vitamin” that may lend a faint green or yellow cast to the white.
So here’s the eggs-act solution: Eat the white part of the egg and toss the yellow. Or, if you make an omelet, make do with one whole egg plus two extra whites.
By the way, no-fat, no-cholesterol egg substitutes are made of vitamin- and mineral-fortified, pasteurized egg whites containing artificial or natural colors and flavors, plus texturizers, such as gums, to make the liquid look, taste, and cook a lot like whole eggs.
Big egg
In the United States, the eggs you buy at your local food store, bazaar or emporium, come in six basic sizes, based on the minimum weight for one dozen eggs. Starting at the top, these sizes are jumbo (30 oz per dozen), extra large (27 oz), large (24 oz), medium (21 oz), small (18 oz) and peewee (15 oz).
Useful, to be sure (the most popular are the large), but none of them even holds a candle to the beauty the California Egg Commission named the largest single chicken egg ever recorded: One full pound, with a double yolk and a double shell. Sorry, I don’t have any nutrition stats for this scenario.
Frankfurters
Modern hot dogs and other meat sausages are made from muscle meat similar to the fresh ground beef or pork sold at the supermarket. Like all meat products, they provide complete proteins with adequate amounts of all the essential amino acids, plus B vitamins and heme iron, the organic form of iron found in foods from animals. That’s good. Unfortunately, regular franks, like other sausages, are traditionally loaded with saturated fats and cholesterol.
But notice the word regular. The frank, remember, is an American success story, so the same know-how that gave the world no-fat ice cream and trans fat-free margarine has come up with skinny meat and poultry franks, not to mention fairly good soybean-based veggie versions.
As you can see in Table 6-1, the new breeds of dogs are acceptable at practically anybody’s table. The stats in this table come from three versions of one national brand of hot dogs. Others may vary, so check the label. Woof.
Lamb
Mary’s little lamb may be adorable on the hoof, but on your plate, it’s the red meat with the highest proportion of saturated fat per ounce.
A 4-ounce serving of lean beef has 6 g of fat, 2.3 of them saturated. A 4-ounce serving of lamb has 23 g of fat, 9.9 of them saturated. Lean pork is somewhere in between, with 9 g of total fat, 3 of them saturated, in a 4-ounce portion. Who knew?
Liver
If you hated liver as a kid and still can’t stand to see it on your plate, this is your moment to call your mom and say, “Nyah, nyah, I told you so.”
Like all foods from animals, liver is rich in high-quality proteins. It’s also the single best natural source of retinol (“true vitamin A”), one of the few natural sources of vitamin D, a gold mine of B vitamins (including vitamin B12), and an excellent source of heme iron (the form of iron most easily absorbed by your body).
But like other organ meats, such as brains and sweetbreads (pancreas), liver has much more cholesterol than even well-marbled red meat. For example, a 3-ounce serving of lean roast beef has 69 mg of cholesterol, but a 3-ounce serving of braised beef liver has — hold onto your hat — 330 mg of cholesterol, 30 mg more than you’re supposed to have in an entire day. Just thinking about what happens if you chop up chicken liver with chicken fat makes my head ache! (For an explanation of what all that cholesterol is doing in the brains, check out Chapter 2.)
Heart and tongue aren’t as high in cholesterol. They’re mainly muscle, not fat, so they clock in at about the same fat and cholesterol levels as other red meat. A 3-ounce serving of heart has 164 mg of cholesterol. A similar serving of beef tongue has 91 mg of cholesterol. I guess it proves you gotta have heart, not brains. Oooooooh boy, that’s lame!
Wieners
The frankfurter is a German culinary import, but stuffing the long skinny sausage into a matching bun was pure New World genius. Brooklyn butcher Charles Feltman opened the first sausage-on-a-roll stand in Coney Island in 1871. Thirty years later, cartoonist T.A. “Tad” Dorgan sketched baseball park vendors hawking the long skinny pups on buns and captioned the picture “hot dog” because he couldn’t spell “dachshund.”
Needless to say, the hot dog is still a favorite at baseball parks where, according to the National Hot Dog and Sausage Council, Americans gobble 7 billion total franks each summer. That’s enough dogs to stretch a chain from Dodger Stadium in Los Angeles, California, to the Baseball Hall of Fame in Cooperstown, New York.
Margarine with trans fatty acids
You may think that switching to margarine eliminates the risks associated with using butter on your bread. Well, as we native New Yorkers say, fuggeddaboudit!
The problem is that all margarines aren’t created equal. Some types are still made with the form of hydrogenated fat called trans fat, the fats New York City’s mayor and city council banned from use by chefs in the city’s restaurants in 2007.
As Chapter 5 explains, while trans fats aren’t necessarily saturated fats, they act just like saturated fats in your body. They raise rather than lower your blood levels of cholesterol.
The word trans refers to the placement of atoms on molecules. No, no, don’t roll your eyes. This stuff is interesting. Two molecules may contain the exact- same atoms but be totally different because of a small difference in the placement of the atoms. This small difference in atom placement makes a big difference in the way a molecule behaves.
In other words, trans fatty acids are fats behaving badly. So the margarine you want is one with the words “No Trans Fats” on the label. At least this week.
Poultry skin and dark meat
What? Poultry is bad for a heart-healthy diet? It depends on the poultry. And sometimes the part.
Ounce for ounce, skinless poultry has about the same amount of cholesterol and fat as lean red meat, but generally, poultry fat is proportionately lower in saturated fats and higher in unsaturated fats than the fat in red meats.
Decency almost prevented me from attempting to count the fat grams in crispy, crunchy chicken or duck skin, a total I feared may approach the level of the nutritionally obscene. But I figured you may want to know, so here goes:
� For chicken, serving the meat with the skin just about doubles the fat content.
� For duck, a 4-ounce serving of skin-free meat has 14 g of fat, already a pretty healthy (healthy?) helping. With the skin, a 4-ounce serving has 31.8 g of fat, 14.6 of them saturated.
Yipes!
Table 6-2 compares the fat, saturated fat, and cholesterol content of white- and dark-meat poultries with lean beef. Notice that the lean beef beats dark- meat poultry every time. My, isn’t that in-ter-esting!
Unfiltered coffee
In 1994, researchers at the Agricultural University in Wageningen (the Netherlands) identified two chemicals in coffee that may raise cholesterol levels.
The chemicals are diterpenes, substances found in the oils of the coffee bean that give coffee its wonderful flavor and aroma. The amount of diterpenes in your coffee cup varies with the brewing method.
Drip-brewed coffee, instant coffee, and percolated coffee contain only mini- mal amounts of diterpenes. But boiled coffees — Greek coffee, Turkish coffee, espresso, and the coffee brewed in French “press” coffee makers — may have 6 to 12 mg of diterpenes per 5-ounce cup.
This amount is significant, and the Dutch researchers estimate that continually drinking five cups of press-brewed coffee or 15 espressos a day may raise cholesterol levels 8 to 10 points.
(There are no statistics right now defining the risk for people who gobble up chocolate-covered coffee beans, but you can practically bet that some smart researcher somewhere is working on it.)
Drinking coffee may also increase homocysteine levels in your blood. Homo- cysteine is an amino acid produced in your body when you digest proteins. As I explain in Chapter 2, the American Heart Association has identified high levels of homocysteine as an independent risk factor for heart disease.
A 1997 study at Norway’s University of Bergen found that even moderate coffee consumption (five or fewer cups a day) is linked to higher blood levels of homocysteine. This may explain the results of a 1995 study at Boston University School of Public Health in Brookline (Massachusetts) showing the risk of heart attack was 2.5 times higher among women who drank ten cups of coffee a day than among those who averaged less than one cup.
Whole-milk products
Ice cream, cheese, yogurt, cream, sour cream, half-and-half, whipped cream, milk — what do all these things have in common?
Unless the label says “low-fat,” “reduced fat,” “skim,” or some variation thereof, every one of them contains whole milk — milk with 3.5 percent butterfat, which is how it comes from the cow.
An 8-ounce glass of whole milk has 8 g of fat, with 5.1 g of saturated fat. Compare that to an 8-ounce glass of 1 percent milk, which has only 3 g of fat,
1.6 of them saturated. Skim milk has less than 1 g of fat, with 0.3 g of satu- rated fat. The best part? All versions deliver about 300 mg of calcium, 8 g of protein, and 300 mg of vitamin D.
Playing with butterfat produces similar magic in other dairy products. Table 6-3 shows the value of reducing the fat in several kinds of milk treats.
Plant-Produced Foods That Help Control Cholesterol
Chapter 5 goes on for pages and pages — well, at least lines and lines — about all the foods that can help you control your cholesterol. Literally thou- sands of plant foods exist that you can use on a diet designed to help control your cholesterol levels.
However, the ones listed in this section are right at the top of the list, fruit- and veggie-wise. If you don’t like the foods in this section, hopefully
my explanations here will encourage you to have second thoughts and start adding them to your grocery list. These are the best of the best!
Apples
Like most fruit, every variety of apples has plenty of dietary fiber: insoluble cellulose and lignin in the peel and soluble pectins in the flesh. As Chapter 5 explains, the former keeps things moving through your intestinal tract, and the latter sops up cholesterol and other fats, preventing them from exiting from your intestinal tract into your body and blood vessels.
The U.S. Apple Association (www.usapple.org) wants you to know another fact: When scientists at the Université Paul Sabatier in Toulouse, France, fed apples to hamsters specially bred to develop high levels of cholesterol, the hamsters’ low-density lipoproteins (LDLs — the “bad” fat particles) went down and their high-density lipoproteins (HDLs — the “good” particles that carry cholesterol out of the body) went up.
The theory is that soluble pectins form a gel in your stomach that sops up fats and ferries them out of your body as waste. An added bonus: Pectins also help solidify stool, which justifies the reputation of raw apple shavings as a home remedy for diarrhea. (Purified pectin is the active ingredient in many over-the- counter, anti-diarrheal products.)
Finally, apples are rich in flavonoids, the naturally occurring antioxidant plant compounds that make green tea and red grapes serious players in the war against heart disease, stroke, and cancer. Sure seems to justify the time- honored adage, “An apple a day keeps the doctor away.”
Avocados
For years, dieters and folks concerned about heart health avoided avocados because the luscious green fruit (yes, the avocado is a fruit, not a veggie) is high in fat. A 1-ounce serving — 1 tablespoon or 2 to 3 thin slices — has about 4.5 grams fat, which may be one reason why some people call the avocado a “butter pear.”
But only a measly 0.5 gram of that fat is saturated. The rest is primarily cholesterol-lowering monounsaturated fatty acids plus polyunsaturated fatty acids (fats that don’t raise cholesterol levels), including the omega-3s the American Heart Association recommends substituting for saturated fats.
The avocado also serves up about 20 vitamins and minerals, including vita- min E, vitamin C, the B vitamin folate, iron, and potassium. In addition, the avocado delivers protective phytonutrients (phyto = plant, nutrients = well, nutrients), such as phytosterols — plant compounds that look like cholesterol but actually keep the body from absorbing the cholesterol in other foods.
Chapter 14 includes a delicious recipe for Creamy Avocado Dip; try it with veggies!
Beans
Beans are little treasure chests of soluble gums and pectins, two varieties of the soluble dietary fiber that grab and hold fats in your digestive tract. Because you digest beans very slowly, unlike other high-carb foods, such as pasta and potatoes, your insulin secretion doesn’t spike.
This news is good for people with diabetes. In fact, one well-known study at the University of Kentucky showed that eating a lot of beans may enable people with Type 1 diabetes (whose bodies produce practically no insulin) to reduce their daily insulin requirements by nearly 40 percent. Patients with Type 2 diabetes, whose bodies produce some insulin, may be able to cut insulin intake by 98 percent. This news is also good for people watching their cholesterol because a sudden rise in insulin has now been added to the list of risks.
But good as they are, beans aren’t perfect. The human gut can’t digest dietary fiber and some complex carbs, such as the sugars in beans. As a result, these guys sit in your intestines as fodder for resident friendly bacteria that munch on the carbs and then release carbon dioxide and (ugh) methane, a smelly gas.
Which leaves you with one of those conundrums that make life so interesting: Heart disease (and diabetes) or smelly gas? Smelly gas or heart disease (and diabetes)? Decisions. Decisions.
Brown rice
Score one for the original vegetarian foodies, the guys who were eating whole grains — especially brown rice — way back in the Nutritional Dark Ages before anyone even knew what cholesterol was.
Boy, were they smart cookies. All rice is low-cal, low-fat, and cholesterol-free. But when it comes to controlling your cholesterol levels, the rice to rave about is brown.
Brown rice gets its color and its nutty flavor from the germ (the fatty inner part of the seed) and the bran (the nutrient-rich outer hull).
Like oat bran, rice bran is a food worthy of respect in its own right. Oat bran gets the publicity, but as long ago as 1989, a U.S. Department of Agriculture (www.usda.gov) study showed that feeding rice bran to hamsters can reduce the animals’ cholesterol levels as effectively as the better-known oat stuff.
By the way, the USA Rice Federation (www.usarice.com) says that the aver- age American consumes about 25 pounds of rice a year. Right now, most of that consumption is white rice, without the bran. By increasing your consumption of brown rice versus white rice, you can strike a blow for low cholesterol.
Chocolate
No list of healthful foods can be considered complete if it doesn’t include chocolate — the treat that says, “Hey, I’ve been watching my cholesterol like crazy, and I deserve a reward!”
Contrary to popular wisdom, plain dark chocolate isn’t an empty-calorie food. Chocolate comes from the cocoa bean, which — like other beans — is packed with proteins, B vitamins, and vital minerals, such as iron, magnesium, and copper.
As a plant food, chocolate has no cholesterol at all. True, cocoa butter (the fat in cocoa beans) is a saturated fat, but some sweets companies have done a swell job creating chocolate products without cocoa butter, thanks to modern technology.
Wait! There’s more. The cocoa bean also has small amounts of caffeine (an average of 18 milligrams (mg) per cup of cocoa, versus 130 mg per 5-ounce cup of drip-brewed coffee), phenylethylalanine (PEA, a mood elevator some- times called “the love chemical”), and theobromine (a muscle stimulant). Zip-pi-dee-doo-dah.
And chocolate contains loads of flavonoids and catechins, the naturally occur- ring chemicals credited with making grapes, wine, and tea heart-healthy. In the spring of 2007, researchers reported to the annual meeting of the American Association for the Advancement of Science that consuming the flavonols in chocolate increases blood flow to the brain.
And a German study published in the June 2007 issue of the International Journal of Medical Science announced that cocoa consumption among the Kuna people, islanders living near Panama, reduces the risk of cancer, stroke, heart failure, and diabetes.
Is it any wonder that the Hershey Company has added Hershey’s Natural Flavonol Antioxidant Milk Chocolate, Hershey’s Whole Bean Chocolate, and Hershey’s All Natural Extra Dark Pure Dark Chocolate to its “goodness chocolate portfolio” of antioxidant-rich chocolate bars and bits with labels prominently touring the high levels of flavonols in the bar? Surely you jest.
Grapes
Grapes are great. A single serving of 20 green Thompson seedless or deep red Tokay or Emperor grapes has 70 to 80 calories, 12 to 16 percent of the recom- mended dietary allowance (RDA) for vitamin C, and up to 84 percent of the potassium found in 1⁄2 cup of orange juice.
Omega chocolates
On July 3, 2007, just in time to make every nutrition-conscious American chocoholic’s July 4th celebration even more celebratory, Ocean Nutrition of Canada issued a press release to announce that Canadian chocolate maker Les Truffes au Chocolat would be adding a dash of Ocean Nutrition’s omega-3 fatty acids to the recipe for its O Trois chocolate bars and chocolate “fingers.”
The Calgary confectioners plan to distribute these special chocolates first in western Canada, then across Canada, and finally down into the United States. Can’t wait for these treats to make it to your town? Check out the Les Truffes Web site (www.lestruffes.com) for mail-order goodies.
Mae West, the Madonna of a past time, used to invite her admirers to “Come up and peel me a grape sometime.” But your goal is to lower your cholesterol, so that advice isn’t for you.
Grape skins and pulp contain resveratrol, the flavonoid some folks credit with lowering cholesterol, reducing the risk of heart attack, and maybe even protecting against some forms of cancer.
Ounce for ounce, you get more resveratrol from grape juice than from plain grapes. The darker the juice, the higher the resveratrol. Purple grape juice has more resveratrol than red grape juice, which has more than white grape juice. As for individual grape varieties, in 1998, a team of food scientists from the USDA Agricultural Research Service identified a native American grape, the muscadine, as an unusually potent source of resveratrol. So aren’t you glad that about half of all muscadines grown in the U.S. are used to make grape juice?
Prefer your grape juice in the form of wine? Read all about that in Chapter 10.
Certain margarines
At the start of the margarine revolution, around the time when television sets broadcast only in black and white, margarine was a white paste in a plastic bag with a small button on top that you squeezed to release a yellow coloring to knead through the white stuff. Its only virtue was its price: lower than butter’s.
A few years later, with the discovery that butter was high in cholesterol and that cholesterol caused heart attacks, margarine was transformed into health food, the non-butter that can protect your heart. Until, that is, nutrition scientists linked hydrogenated fats — the stuff that made it possible to mold the original soft margarine paste into butter-like bars — to an increased risk of heart attack.
Today, some really healthful margarines are made with plant sterols, natural compounds found in grains, fruits, and vegetables, and stanols, compounds created by adding hydrogen atoms from wood pulp and other plant sources to sterols.
Both sterols and stanols, which are from plants, thus qualifying these margarines for inclusion in this list of plant foods that protect your heart, work like little sponges, sopping up cholesterol in your intestines before it can make its way into your bloodstream. Because of this sponge-like action, your total cholesterol levels and your levels of low-density lipoproteins (also known as LDLs or “bad” cholesterol) fall.
The studies show that one to two 1-tablespoon servings of stanol or sterol margarines a day can lower LDLs by 10 to 17 percent with results showing up in as little as two weeks.
Some eagle-eyed readers may take out their magnifying glasses and actually read the ingredient list on the product labels, a commendable act that helps you separate nutritious food from the not-so-hot possibilities. The problem is that those who do will find the words “hydrogenated fats.” The reaction may be, “Ugh! Don’t hydrogenated fats clog your arteries?” The simple answer is yes. But these margarines are specially formulated to carry fats (including hydrogenated fats) out of your body. The amount of hydrogenated fats in the margarines is less than the amount of fats the margarines remove. In other words, the net impact is good for everybody. Whew!
Nuts
Pass up the pretzels. Skip the chips. At snack time, reach for the nuts. At least the almonds and walnuts.
Although nuts are technically a high-fat food, the nutrition gurus at California’s Loma Linda University say that adding moderate amounts of nuts to a cholesterol-lowering diet or substituting nuts for other high-fat foods, such as meats, may cut normal to moderately high levels of total cholesterol and LDL as much as 12 percent.
These guys should know. Over the past several years, they’ve made headlines with nutty studies:
� In one, volunteers were told to follow one of two diets, both based on National Cholesterol Education Program (NCEP) recommendations. Diet #1 got 20 percent of its calories from fats in oils and fatty foods such as meat; Diet #2 got 20 percent of its calories from high-fat nuts (like wal- nuts) instead. Both diets appeared to lower cholesterol levels.
� In a second study, the Loma Lindans compared the standard NCEP diet with two almond diets, the first deriving 10 percent of its calories from nuts, the second, 20 percent. Like the walnut diet, both almond diets lowered cholesterol, lowered blood pressure, and so on.
The conclusions, dutifully reported in scientific journals such as the American Journal of Clinical Nutrition, are that nuts provide fatty acids and other substances that reduce the risk of blood clots, amino acids (such as arginine) that the body uses to build other clot-blocking compounds, and dietary fiber that ferries cholesterol out of your body.
In other words, it pays to be nuts about nuts (see Chapter 14’s recipe for Cinnamon and Spice Almonds).
Oatmeal
For more than 30 years, scientists have known that eating foods high in soluble dietary fiber (more about that in Chapter 5) can lower your cholesterol. Then along came oatmeal, a gee-whiz wonder food whose primary soluble dietary fiber — beta glucan — is a more super-effective cholesterol buster than other types of soluble dietary fiber, such as the pectin in apples (see the section “Apples” earlier in this chapter).
But guess what? Not every oatmeal gets the job done. The Right Stuff is oat- meal with oat bran, the brown outer covering of the oatmeal grain that’s often removed to make oatmeal cereal (especially the quick-cook kind).
Researchers at the University of Kentucky reported back in 1990, practically the Dark Ages for anti-cholesterol foodies, that people who add 1⁄2 cup dry oat bran (not oatmeal) to their regular diets may be able to lower their levels of LDL by as much as 25 percent.
Not to be outdone, scientists at Northwestern University’s Feinberg School of Medicine performed a study funded by Quaker Oats. The scientists found that 208 healthy volunteers whose normal cholesterol readings averaged about 200 mg/dL were able to reduce their total cholesterol levels by an average of 9.3 percent with a low-fat, low-cholesterol diet supplemented by 2 ounces of oats or oat bran every day.
Most of the volunteers in the Northwestern study were eating oatmeal, not oat bran, so look carefully at the difference in the numbers. At the University of Kentucky, the drop in cholesterol was 25 percent. At Northwestern, it was
9.3 percent. Even more interesting, the Northwestern folks said that only about one-third of the cholesterol reduction was due to the oats.
The cereal makers rounded the Northwestern number up to 10 percent. The risk of heart attack drops two percentage points for every one point drop in cholesterol, so the National Research Council called that a potential 20 per- cent drop in the risk of a heart attack, but how well eating oatmeal works for you really depends on how high your cholesterol is to start.
Suppose your cholesterol clocks in higher than 250 mg/dL. Lowering it 10 percent takes you down to 225 mg/dL. Now you’re within shooting distance of a safe level (under 200 mg/dL). Now assume your cholesterol level is already a safe 199 mg/dL or lower. A low-fat, low-cholesterol diet plus oats may drop it to 180 mg/dL, but the oats account for only 6 points of your loss. The rest is due to — get this — your low-fat, low-cholesterol diet.
In other words, at the lower cholesterol levels, what really matters is an over- all low-fat, low-cholesterol diet. Adding oats makes so little difference that if you hate the stuff, it’s okay to pass it by and get your soluble fiber from other foods, like brown rice (see more on that previously in this chapter).
Pomegranate
When is an apple not an apple? When it’s a pomegranate, of course. Historians suspect that the pomegranate was the “apple” Eve picked in the Garden of Eden. They know for sure it was such a favorite in ancient Egypt that Moses added it to the list of goodies waiting in the Promised Land. (Check it out in Deuteronomy 8:8.)
Also, this fruit figures big in Greek mythology as well: The goddess Persephone became a semi-permanent resident of the Underworld because she couldn’t resist the luscious seeds of an Underworld pomegranate.
The good part of the pomegranate (pome = apple, granate = seeds/grains) is the jelly-like red pulp in “juice sacs” surrounding the seeds. To get at it, slice through the stem end of the pomegranate, and pull off the top, taking care to avoid splashing red pomegranate juice all over you. Then slice the pomegranate into wedges and pull the wedges apart and bite into them.
Your reward as you crush the jelly around the seeds is a liquid rich in polyphenols, the antioxidant compounds that help lower “bad” cholesterol.
Nutrition researchers at Technion Faculty of Medicine and Rambam Medical Center in Haifa, Israel, rate pomegranate juice higher in polyphenols than all the current favorites, such as red wine, blueberry juice, cranberry juice, green tea, black tea, and orange juice.
Another team of Technion scientists says that the juice and the oil extracted from pomegranate seeds kill breast cancer cells in test tubes and may eventu- ally point the way to a new drug in the fight against breast cancer.
Maybe Eve and Persephone knew what they were doing when one picked and the other one enjoyed that funny apple.
Slicing the Cholesterol from Your Dinner Plate
Reducing the amount of cholesterol lurking on your dinner plate is simply a matter of knowing which foods have what fats, and wielding your knife — or fork or spoon — accordingly.
This section is chock-full of low- or no-cholesterol alternatives and strata- gems. For illustration only, I use some well-known, brand-name products as examples of low- or no-cholesterol alternatives. Feel free to substitute your own favorites. Just be sure to read the label first.
Finally, all the nutrient numbers used in this chapter come from the United States Department of Agriculture (USDA) Nutrient Database. For more on how to use this incredibly valuable tool, see the appendix.
Choosing low-fat or no-fat dairy products
Milk may not be quite the perfect food your grandmother thought it was, but modern good-food-people know that dairy products such as milk and cheese are the best natural sources of the calcium that keeps bones strong.
The problem is that these foods may be high in cholesterol and saturated fat. The solution is to opt for the low- or no-fat milk products stacked a mile high in every supermarket dairy case.
How much lower can you go? Well, one 5-ounce cup of whole milk has 33 mg cholesterol and 5 grams saturated fat. But lookie-here: one 5-ounce cup of skim (fat-free) milk has only 4.4 mg cholesterol and 0.3 grams saturated fat. If you absolutely have to have a smidgen of creaminess in your milk, one 5- ounce cup of 1-percent-fat milk has 9.8 mg cholesterol and 1.6 grams saturated fat.
One regular Kraft American Cheese slice has 20 mg cholesterol and 3 grams saturated fat; one slice of Kraft Free American cheese has no cholesterol and no fat. And here’s a bonus: the regular cheese has 70 calories per slice; the fat-free cheese has only 30 calories. Yum.
Serving stew instead of steak
No matter how you slice it, red meat is red meat, cholesterol, saturated fat, and all. To compensate, start by trimming all the visible fat — yes, that white stuff on the sides. Then stew your beef or lamb, rather than broiling or roasting it. (You can do this with pork, too.)
After the cooking’s done, stash your stew in the fridge for a couple of hours until a layer of white stuff — yes, more fat from the interior of the meat — hardens on top. Lift off the fat layer and away goes a whole lot of cholesterol and saturated fat.
How much? Hard to tell exactly, but clearly you’ve done a good-nutrition, weight-control deed for the day. You not only reduce the cholesterol and saturated fat content of the dish, but also lift away 100 calories with every tablespoon of fat.
Just thinking about that makes those tight jeans feel looser.
Washing the chopped meat
No kidding. Put a teapot of water on to boil. Put the chopped meat in a pan, breaking it into small pieces, and cook until the meat browns. Put the meat into a strainer and let the liquid fat run off, and then pour a cup of boiling water over the meat in the strainer.
Repeat the hot water bath twice. Once again, every tablespoon of fat that drains away saves you 100 calories, plus cholesterol and saturated fat.
Use the de-fatted meat in spaghetti sauce or to stuff a nutritious green pepper of cabbage leaf. Yum.
Peeling the poultry
Most of the fat and therefore most of the cholesterol in poultry is in the skin. For example, 3.5 ounces of raw chicken breast with skin has 64 mg choles- terol and 2.7 grams saturated fat. Take off the skin, and that same 3.5 ounces of chicken breast serves up 58 mg cholesterol and a miniscule 0.3 grams satu- rated fat.
Obviously, the way you cook the chicken may affect the fat and cholesterol levels. According to the USDA Nutrient Database, a chicken breast with skin fried in batter has nearly 30 percent more cholesterol (85 mg) and 30 percent more saturated fat (3.5 grams) than the raw stuff.
Fry the skinless chicken breast, and the saturated fat goes up 300 percent to 1.2 grams per serving — but that’s still less than the fat you get from fried chicken with skin.
Got the picture? Good.
Spritzing the fish
Naturally oily fish like salmon and mackerel are rich in omega-3 fatty acids that protect your heart. Don’t change the equation by drowning them in creamy, high-cholesterol, high-fat, high-calorie sauces when a spritz of lemon and some green seasonings (think dill) can do the trick.
Next.
Sparing the bread spread
Now that everybody knows vegetable oils are lower in saturated fats than butter, restaurants from pizza parlors to the fanciest white tablecloth establishments cater to their patrons’ sense of sophistication by substituting a small bowl of olive oil for the standard plate of butter pats.
Before you reach for the oil, though, consider this: Vegetable oils, including the ubiquitous olive oil, aren’t an unmitigated blessing. Yes, the oils have less saturated fat than butter. True, they’re cholesterol-free. But the bad news is that all dietary fats — butter, margarine, oils — have about the same number of calories per serving, 100 to 125 calories per tablespoon. These unnecessary calories can pile pounds onto parts of your body and that may raise your cholesterol levels. Try the bread as is. You might like it.
By the way, don’t assume that your bread is low-fat just because you didn’t butter or oil it. Some breads, such as foccacia, popovers, and muffins, come pre-buttered or oiled. To test the fat content of your bread, pick up a piece and put it on your napkin. Hand sticky? Oil spots on the napkin? You know what that means.
Keeping the veggies basic
Once upon a time, when vegetables were new to the Western table and people who were used to gnawing on a haunch of beef considered them suspect at best, the accepted cooking method was to boil the plant into a no-color no-texture-no-flavor lump.
Next came butter, cheese, and cream sauces, often broiled to a tasty, brown, fat-and-cholesterol crust. Today, the smart way to cook vegetables is as quickly and simply as possible. Steaming over bouillon works; so does broiling veggie kebobs.
Low-fat, cholesterol-free baking tip
Bake your own bread? Cake? Muffins? To reduce the fat content, don’t grease the pan. Instead, bake with parchment paper. Every tablespoon of butter you don’t use cuts 31 mg cholesterol and 7.3 grams saturated fat from the final product. And eliminating one tablespoon of any fat reduces the calorie count by 100 big ones.
As for flavorings, what could be better than those other plant foods: Herbs and spices. A pinch of thyme here, a sprinkle of oregano there, a dash of dill, some chives — terrific. For those of you who simply can’t give up thickened sauces, the solution may be a “reduction” (boiled-down bouillon) or a cream sauce made with trans-fat-free margarine and fat-free powdered milk instead of butter and cream. Purists may wince, but try it. You may like it — and so will your arteries.
Speaking the language
No matter how dedicated the dieter, good intentions tend to fade when eating out, especially when the menu hints at exotic foreign delicacies. Not to worry, Table 6-4 lists the good and bad in six, count ‘em six, popular ethnic cuisines.
Don’t punish your partner
Your cholesterol may be problematic but that doesn’t mean everyone else at the table is in the same situation. A considerate host or dinner partner makes accommodations. Table 6-5 shows how to adapt your controlled-cholesterol, low-fat diet for someone who doesn’t have to watch the fats.
Choosing low-fat desserts
No human being should have to give up dessert just to maintain a healthy diet. And that goes double for chocolate.
According to the Haagen Dazs Web site, one half-cup serving of Haagen Dazs chocolate ice cream has 115 mg cholesterol and (gulp!) 11 grams saturated fat. But one half-cup serving of Haagen Dazs low-fat sorbet has no, repeat no, cholesterol or saturated fat.
You can assume that similar differences apply to other varieties of frozen desserts, and take it from an expert (me), substituting the second for the first is no deprivation, particularly if you toss some fruit on the cold chocolate stuff and maybe add some Hershey’s Syrup. It says right here on the bottle I just took out of my refrigerator that the chocolate syrup has zero cholesterol and fat.
