About the Author
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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
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Excerpt. © Reprinted by permission. All rights reserved.
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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.
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