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About the Author ---------------- The mission of the American Heart Association is to build ier lives, free of cardiovascular diseases and stroke. Its bestselling library of cookbooks includes Grill It, Braise It, Broil It; y Slow Cooker Cookbook; Go Fresh; The Go Red For Women Cookbook; Low-Salt Cookbook, 4th edition; and The New American Heart Association Cookbook, 8th edition. americanheart.org Read more ( javascript:void(0) ) Excerpt. © Reprinted by permission. All rights reserved. -------------------------------------------------------- Introduction s, Cholesterol, and Heart 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 uny ents including sodium, added sugars, saturated , and trans . Saturated and trans s 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, ier 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 es, 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 care provider and find out what they are. Be sure to schedule regular visits with your care 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-y 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- dairy products. Your liver produces more cholesterol when you eat a diet high in saturated and trans s. 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-y diet, it’s important to replace foods that are high in saturated and trans , as well as in sodium and added sugars, with tious foods. Being Physically Active In addition to eating tiously, we know that maintaining a y 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 care 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 es. COMMIT TO A LIFETIME OF Y CHOICES Finally, managing your risk means committing to a lifestyle that promotes a longer, ier life. If you eat wisely, stay physically active, take statins (if prescribed), and follow the recommendations of your care 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 y 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. y food, y heart One of the best ways to take care of your heart is to understand the fundamentals of good tion 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 y diet while limiting the less y foods. Follow these basic tion guidelines for an overall y eating pattern: Eat lots of different fruits and vegetables. Make sure at least half of the grains you eat are whole-grain foods. Include -free and low- dairy products. Eat fish (especially those rich in omega-3 ty s) at least twice a week. Choose lean meats and poultry without skin and prepare them without added saturated and trans s. Limit foods that contain “bad” s (saturated and trans) and replace with those that contain “good” s (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 ent-rich foods whether they are fresh, frozen, or canned. They are low in calories but provide important s, minerals, fiber, and other ents. 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. y 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-ful choices. For canned fruits, read the ingredient labels to find options with the least a of added sugar. Fruits that are canned in water are lower in calories than fruits canned in juice or . 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 , and they are a ier choice than refined grains. Whole grains contain the entire grain—the bran, germ, and endosperm. y 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 s, iron, and dietary fiber. Most refined grains are enriched, which means that some of the B s 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. y 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 ents. 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 , but check tion labels for partially hydrogenated oils before you buy. Dairy Products Dairy foods are an important part of a y diet, providing calcium and protein. All adults ages 19 to 50 should to consume 1,000 milligrams of calcium each day (for maximal calcium retention). For adults ages 51 and older, that a increases to 1,200 milligrams. Most care providers encourage women in particular to eat -free and low- dairy products to get calcium. This helps reduce their risk of developing the disease osteoporosis. So many -free and low- dairy options are now available that you can easily avoid the high levels of saturated found in whole milk and whole-milk products. y choices include -free or low- milk, cheeses, yogurt, sour cream, and cream cheese. To see the difference, take a look at the tion labels and compare a cup of whole milk to a cup of -free milk, for example. By choosing the -free version, you’ll save about 65 calories and 4.5 grams of saturated . y Hints Keep in mind that many cheeses are high in saturated and that many -free or low- products have high levels of sodium and added sugars. Be sure to read the tion facts labels and compare products. If you’re used to whole-milk products (3.5% ), you may find it easier to taper off slowly. Try 1% low- milk first, then change to ½% low- milk. Soon you’ll be able to switch to -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 ty s—such as salmon, lake trout, herring, sardines, mackerel, and albacore tuna—reduces the risk of death from coronary artery disease. to eat at least two servings of fish that’s rich in omega-3 ty s every week. If you already have heart disease or high blood triglyceride levels, your care professional may recommend fish oil supplements to help increase your intake of omega-3 ty s. Shellfish, such as shrimp, squid, scallops, mussels, and clams, is low in saturated , so it’s a good source of heart-y protein. There are also several tasty and y ways to prepare shellfish that don’t add a lot of saturated and trans s or sodium. y 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 as of mercury or other contaminants, the risks from mercury exposure depend on the levels of mercury in the fish itself and the a 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, fish, and king mackerel. For most people, however, the benefits of eating fish far outweigh the risks. Choose low-sodium, low- seasonings, such as spices, s, 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. y 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. y Hints Choose whole turkeys or turkey s that haven’t been injected with broth or s. Buy USDA Select grades of meat. They have less marbling than Prime or Choice. Be sure to did any visible . 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 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 and sodium. Reduced-, low-, and/or -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 , 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 . Also include a variety of legumes, such as green peas, black-eyed peas, chickpeas, kidney beans, navy beans, and lentils. s and Oils It’s the type of more than how much you consume that most affects your blood cholesterol level. The main types of in foods are saturated , trans , and unsaturated . Saturated s are found in animal products and in some tropical oils. Trans is found primarily in commercial products made with or fried in partially hydrogenated oils. Both of these types are the harmful s and raise LDL cholesterol in the blood. to get no more than 5 to 6 percent of calories from saturated and to reduce the percentage of calories from trans . For example, if you eat about 2,000 calories a day, you should limit your consumption of saturated 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 ). You can find how much saturated is in foods by reading the tional analyses for recipes and reading the tion Facts panels on food labels. Read more ( javascript:void(0) )