Fuel and Fitness

The Power Twins That Lower Your Cholesterol

Cholesterol-laden plaque can gradually clog blood vessels, preventing blood flow to the heart, brain, and muscles and causing heart attacks and strokes. Help protect your blood vessels from plaque buildup by making lifestyle changes that wield a lot of power.

Smart Fat and Fiber Choices
Given that two thirds of American adults are overweight, it’s clear that what most people are doing isn’t working. Eating healthy fats and more fiber is essential to controlling both cholesterol and weight.

You want to limit the saturated fat that contributes to high cholesterol numbers, says Karla P. Shelnutt, PhD, RD, of the University of Florida.

“Trans fats [partially hydrogenated fats] are particularly harmful, so check food labels and avoid them,” Shelnutt says. “We’re still finding trans fats being used in restaurants and fast-food places, so prepare your own foods as much as possible.

“Aim to get more monounsaturated fats, like olive oil and canola oils, and omega-3 fatty acids [polyunsaturated fats] in your diet,” she adds. “These fats decrease inflammation and cut risk for cardiac disease.” Foods rich in omega-3s include walnuts, flaxseed oil, and salmon. Eat a small handful of nuts each day, have fish several times a week, eat cereals made with flax, sprinkle ground flax over yogurt, or add flax meal to your favorite baked goods.

Another weapon against runaway cholesterol, says Shelnutt, is phytosterols, also called sterols and stanols, which naturally occur in many foods. They block cholesterol absorption and can be a great part of your healthy eating plan. Look for them in products such as BENECOL Light Spread, Minute Maid Heart Wise orange juice, and CocoaVia chocolate bars.

Fish oil also seems to help change plaque composition so that it’s less likely to cause clogging. Studies show that fish and flaxseed oils can actually increase the level of “good” cholesterol (HDL) and reduce “bad” cholesterol (LDL). “If you’re going to take supplements, seek a pharmaceutical-grade oil that has been certified by the United States Pharmacopeia,” says Shelnutt. As with any supplement or drug, there can be side effects, such as the blood-thinning action of fish oil. Always check with your doctor first.

“Soluble fiber specifically affects cholesterol levels, blocking dietary cholesterol and fat from being absorbed in the intestines,” Shelnutt continues. “Both soluble and insoluble fiber are very good for your overall health, and you can now buy supplements of both kinds.”

Foods rich in soluble fiber include oats, barley, soybeans, dried beans and peas, psyllium seeds, oranges, and grapefruits. Vegetables, fruits, and whole grains have varying degrees of both fibers, and their antioxidants and phytochemicals are very beneficial.

Whole grains are also helpful. Since they’re absorbed more slowly than refined foods such as white flour and rice, they don’t cause insulin levels to spike, which in turn causes less cholesterol to be produced. Americans don’t get nearly enough fiber in their diets, Shelnutt says. For general health and to help control cholesterol, consume 30 grams of fiber per day, planning for 10 grams per meal. Fiber-rich foods can also help you feel fuller longer, making it easier to lose weight. Visit MyPyramid.gov, where you can read about fiber and construct your own healthy eating plan according to your goals.

Maintaining a healthy weight means having a healthy body mass index. (Check yours at www.cdc.gov/bmi.) Even if you eat sensibly, if you don’t step up your activity, the pounds can continue creeping up each decade. “Reducing caloric intake or increasing expenditure is key,” says Michael Miller, MD, director of preventive cardiology at the University of Maryland Medical Center in Baltimore. “As we age, our metabolism slows, so we will gain weight over time unless we make lifestyle changes.”

Fitness Reduces “Bad” Cholesterol
Working out puts you on the fast track to losing weight, and even modest weight loss usually improves cholesterol numbers. Exercise also changes the shape of cholesterol particles so they’re less likely to lodge in a vessel and create a blockage. In a review of 25 studies, researchers reported in the Archives of Internal Medicine that people who exercised an average of 40 minutes, three to four times a week, increased their “healthy” HDL cholesterol levels. In fact, the more minutes invested in exercise, the better the results.

A study from Duke University Medical Center proved that turning up the intensity in your workouts provides more cardioprotective benefits. Moderate activities like brisk walking, biking, swimming, or using cardio machines such as a treadmill are good choices. Begin working out a minimum of 30 minutes a day and increase by 10-minute increments, up to an hour, five or six days a week to line up with the American Heart Association guidelines. As always, check with your doctor before engaging in significant amounts of strenuous exercise.

— Michele Deppe

The Cleveland Clinic, one of the highest-ranking heart hospitals in the nation, has compiled an all-in-one guide for preventing heart disease, the Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook, with more than 150 appealing recipes, such as these.

Creole Beef and Vegetables With Cheese Grits

Bell peppers, onions, and celery are usually the flavor base of a Creole dish. This particular recipe was inspired by the Creole casserole dish called grillade, which is traditionally served with grits. We took our dish on top of the stove and serve it with grits flavored with cheese to take the place of the usual melting butter.

Makes 6 servings

1 1⁄2 pounds top round steak
Garlic powder
Olive oil cooking spray
1 teaspoon extra virgin olive oil
1 medium onion, coarsely chopped
1 medium red bell pepper, seeded and chopped
3 celery ribs, finely chopped
One 28-ounce can whole tomatoes with juice
Kosher salt, optional
Freshly ground pepper
1⁄2 teaspoon ground thyme
1 bay leaf
1⁄2 cup dry red wine
1 tablespoon Worcestershire sauce
1⁄4 teaspoon hot pepper sauce
One 10-ounce package frozen artichoke hearts, thawed
Cheese Grits (recipe follows)

1. Trim all visible fat from the beef. Wipe the beef with a damp paper towel and dry. Cut the beef into 1⁄2-inch cubes. Lightly sprinkle with garlic powder and pound 1⁄4-inch thick.

2. Lightly coat a Dutch oven with cooking spray. Add the oil and place the pan over medium-high heat. Working in batches, brown the beef about 2 minutes, turning once. Transfer the meat to a dish and set aside. Repeat until all the beef is browned.

3. Add the onion, bell pepper, and celery to the Dutch oven and sauté until the vegetables are limp, about 5 minutes. Cut the tomatoes crosswise into 1-inch slices. Add the reserved meat to the pot, along with the juice and 1⁄2 cup water. Season with salt, if using, and add the pepper, thyme, bay leaf, wine, Worcestershire sauce, and hot pepper sauce. Reduce the heat to low and stir to combine. Simmer, covered, for about 45 minutes, adding more water if necessary.

4. Arrange the artichoke hearts on top of the beef and cook covered for 15 minutes longer, until the meat is very tender. Uncover, raise the heat, and cook rapidly for 4 to 5 minutes to reduce the sauce to the desired thickness. Serve in a shallow bowl alongside a serving of the grits.

Per serving (beef only): 270 calories (20% calories from fat); 6 g total fat (2 g saturated fat); 36 g protein; 17 g carbohydrate; 5 g dietary fiber; 80 mg cholesterol; 410 mg sodium; 787 mg potassium

Cheese Grits

1⁄4 teaspoon kosher salt, optional
1 cup quick grits
1⁄2 cup shredded low-fat sharp Cheddar cheese

Bring 4 cups of water to a boil in a large pot. Stir in the salt, if using. Slowly add the grits to the pot, whisking constantly. Lower the heat to a simmer and continue to cook, whisking constantly, until the mixture is thick and smooth, 3 to 5 minutes. Remove from heat and stir in the cheese. Keep warm until ready to serve.

Per serving: 110 calories (8% calories from fat); 1 g total fat (0 g saturated fat); 5 g protein; 21 g carbohydrate; 6 g dietary fiber; 10 mg cholesterol; 60 mg sodium; 42 mg potassium

Key Lime Mousse Pie

This pie is light yet rich tasting and can be made ahead—a great dessert for any party. We use bottled Key lime juice since it can be difficult to find fresh Key limes. Buying cookies with no trans fats is becoming easier and easier. We readily found these chocolate wafer crisps, so there is no excuse for buying cookies high in any fat. To protect from salmonella you can use pasteurized packaged egg whites, available with the egg substitutes in your market.

Makes 8 servings

2 packets thin crisp chocolate wafers
Refrigerated butter-flavored cooking spray
1 packet unflavored gelatin
4 ounces fat-free cream cheese
1⁄2 cup reduced-fat ricotta cheese
1⁄4 cup Key lime juice
1⁄2 cup sugar substitute
Grated zest of 1 lime
1⁄2 cup plus 1 tablespoon pasteurized egg whites
1⁄8 teaspoon cream of tartar

1. Process the wafers in a food processor until you have a uniform fine crumb. Set 1 tablespoon aside for garnish. Generously coat a 9-inch pie pan with cooking spray. Sprinkle the crumbs over the pan, rotating the pan until the sides and bottom are covered, and press gently into a crust with your fingers if necessary.

2. In a small saucepan, sprinkle the gelatin over 1⁄4 cup cold water and let stand for a minute. Stir over low heat until dissolved, about 5 minutes. Set aside.

3. Place the cream cheese, ricotta, lime juice, sugar substitute, and half of the zest in a food processor. Process until well blended. Add the gelatin and process for a few seconds to incorporate.

4. In a medium bowl, beat the egg whites with the cream of tartar until they form stiff peaks. Gently fold the lime and cheese mixture into the egg whites. Pour into the prepared pie pan, swirling the top in a decorative manner. Refrigerate for about 2 hours, until cold and set. Garnish the rim of the pie pan with the reserved zest and chocolate crumbs.

Per serving: 80 calories (15% calories from fat); 1.5 g total fat (0.5 g saturated fat); 8 g protein; 9 g carbohydrate; 0 g dietary fiber; 5 mg cholesterol; 160 mg sodium; 60 mg potassium

From the book the Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook by Cleveland Clinic specialists Bonnie Sanders Polin, PhD, and Frances Towner Giedt, with a foreword by Steven E. Nissen, MD, published by Broadway Books, a division of Random House, Inc. Reprinted with permission.