Food for Life: How the New Four Food Groups Can Save Your Life (9 page)

When doctors measure cholesterol levels, they first look at your
total
cholesterol level because it is a good, quick guide to your risk. Then, for a more exact guide, they divide your total cholesterol by your HDL level because they know that the lower your total cholesterol, the better and the higher your HDL (“good cholesterol”) the better. The ratio of total cholesterol to HDL should, ideally, be about 3.0 to 1. Most Americans, unfortunately, are nowhere near that level. The average American male’s ratio is 5.1 to 1. A recent study showed that Boston Marathon runners have an average ratio of 3.5 to 1. Vegetarians do the best, averaging about 2.9 to l.2 Smoking and obesity appear to lower HDL, but HDL can be raised somewhat by vigorous exercise and vitamin C-rich foods.
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Triglyceride
is simply a technical term for the type of fat the body stores. From the various foods we eat, triglyceride molecules are assembled in the liver, packed into VLDL, and sent via the bloodstream to your thighs and hips and abdominal fat areas, where they wait until they are needed. Sometimes, of course, they wait a very long time.

Triglyceride levels above 200 mg/dl are generally considered to be elevated. But let your doctor interpret this level in light of your other cholesterol measurements. Some studies have linked high triglyceride levels to increased risk of heart disease, but some researchers believe that this only applies to those who also have high cholesterol levels.

People who follow low-fat, high-carbohydrate diets tend to have very low
cholesterol levels and a low risk of heart disease. But their triglyceride levels rise somewhat, which has puzzled some doctors. What is happening is that some of the carbohydrate in the diet is simply being converted to triglycerides for transport and storage in the body. This is normal, and apparently not related to heart disease.
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On the other hand, levels that are extremely high (greater than 1,000 mg/dl) can spell real trouble, particularly inflammation of the pancreas, and medical treatment is necessary.

Most people can lower their cholesterol levels quite dramatically. Do not be discouraged if the American Heart Association diet or a similar chicken-and-fish diet did not do much for you. These are very weak programs. Many people falsely conclude that they cannot lower their cholesterol levels because the diet they tried had little effect. Let’s try a more powerful program.

There are foods that are valuable allies, which you will want to include in your regular menu. There are others that you will want to avoid. First, the problem foods.

Animal products contain two ingredients that drive your cholesterol level up: cholesterol itself and saturated fat. They have other serious problems, too, including too much iron and an absence of fiber and antioxidant vitamins. First, let’s look at cholesterol.

Cholesterol is something animals produce in their bodies, and
all animal products contain cholesterol
. If you eat part of an animal or a glandular secretion like milk, you will get a dose of cholesterol. In turn, this will increase the amount of cholesterol in your blood. Every 100 mg of cholesterol you eat in your daily routine adds roughly five points to your cholesterol level. (Everyone is different, and this number is an average.) In practical terms, 100 mg of cholesterol is four ounces of beef, or four ounces of chicken, or half an egg, or three cups of milk.

It may surprise you to read that chicken has the same cholesterol content as beef. It does—about 25 mg per ounce.
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Chicken is not a health
food. It has received an undeservedly good reputation because it can be somewhat lower in fat than beef, depending on how it is prepared. But cholesterol is primarily in the
lean
portion of meats. There is a relationship between cholesterol and fat, as we shall see, but
cholesterol and fat are not the same thing
.

All fish products contain significant amounts of cholesterol, too. Shellfish, such as shrimp, lobster, or crayfish, are higher in cholesterol, ounce for ounce, than beef. But the point to remember is that all animal tissues contain cholesterol.

Eggs are packed with cholesterol. A single egg contains 213 mg, entirely in the yolk. That is a huge load, the most concentrated cholesterol in any common food.

Some people may believe that, since our bodies use cholesterol, we need it in our diet. Wrong. Our bodies make plenty of cholesterol for our needs, and we do not need to add any. And when we do, the cholesterol is left where it does not belong—in plaques in our arteries. There is no “good cholesterol” as far as foods are concerned. Simply put, cholesterol in food raises your cholesterol level. Animal products are the only source of cholesterol in the American diet.

But saturated fat is even worse.
Saturated
is a chemical term that means the fat molecule is completely covered with hydrogen atoms. If it is not, it is called
unsaturated
. If there is room for just one pair of hydrogen atoms to add on, it is called
monounsaturated
. And if there is room for more than one hydrogen atom, it is called
polyunsaturated
. Saturated fats stimulate your liver to make more cholesterol, while unsaturated fats do not.

Luckily, saturated fats are easy to spot because they are solid at room temperature, unlike unsaturated varieties, which are liquid. Beef, chicken, and most other animal products contain substantial amounts of saturated fat. Getting animal fat out of the diet has a dramatic effect on cholesterol levels. But do not get the idea that trimming the strip of fat off the outside of a cut of meat will eliminate the animal fat. Meats have fat not only on the outer edge but also marbled throughout the lean part. In the leanest cuts of beef, about 30 percent of the calories are from fat. In the leanest chicken, the figure is about 20 percent. Both of these are far higher than grains, beans, vegetables, and fruits, which are comfortably below 10 percent.

Unfortunately, the food industry has not been entirely honest in presenting its products, and consumers have not gotten much help in deciding what to buy. McDonald’s, for example, trumpeted the arrival of the McLean
Deluxe Burger, claiming that it was 91 percent fat-free. McDonald’s was reporting the fat content
by weight
. But when dietitians or scientists measure the fat content of foods, they are not interested in the percentage by weight because water content can throw off the measurements. For example, whole milk is only 3.3 percent fat by weight because most of it is water. But if you were to separate out the water, as the body does in the process of digestion, and see what you were left with, fully 49 percent of milk’s calories come from fat. That is the number dietitians care about.

As a percentage of calories, regular ground beef is 60 percent fat. Extra-lean ground beef is 54 percent. If you were to analyze the fat content of the McLean Deluxe burger patty by percentage of calories, you would find that it is 49 percent fat. This is not surprising because the burger’s main ingredient is—you guessed it—ground beef. The bun and toppings dilute it down to 29 percent fat, but the 9 percent figure is a McFib.

Likewise, when Empire Turkey Pastrami slices are marketed as 96 percent fat-free, it is an utterly meaningless statistic. Yes, it is 4 percent fat by weight. But when you pull out the water and measure fat as a percentage of calories, these turkey slices come out with a whopping 45 percent fat. And beware of words like
light
and
lean
. Oscar Mayer Light Beef Bologna calls itself 80 percent fat-free, but by percentage of calories it is actually 64 percent fat. The words
meat
and
low-fat
should never be used in the same sentence.

Animal products are not the only source of saturated fats. A few vegetable oils are naturally high in saturated fat. These are known as
tropical oils:
palm oil, palm kernel oil, and coconut oil. As far as your cholesterol level is concerned, they are as bad as lard. To remember which ones they are, picture a palm tree, with coconuts on the top. These are products to avoid.

Other vegetable oils can be chemically saturated by a process called
hydrogenation
. These solidified fats are then used in products such as margarine, and like animal fats, they will stimulate your liver to make cholesterol. Commercial bakers prefer hydrogenated vegetable oils because they last longer on the shelf. The shelf life of a Hostess Twinkee is lengthened by the partial hydrogenation of the vegetable oils with which it is impregnated. Your shelf life, however, will not be improved if you make such foods part of your routine. Look on the labels of foods you buy, especially baked goods, for the words
hydrogenated
or
partially hydrogenated
. This means that the
vegetable oils were chemically solidified into saturated fats, which will turn on the body’s cholesterol-production machinery.

Liquid vegetable oils are much better than animal fats and tropical oils, but all fats and oils are natural mixtures of saturated and unsaturated fats. Beef fat is about half saturated fat and the remainder is a mixture of monounsaturated and polyunsaturated fat. Corn oil is mostly polyunsaturated, but about 13 percent of it is saturated fat. That is a lot less saturated fat than is found in beef or chicken, but it still contributes to heart problems. The same is true of olive oil: about 13 percent of it is saturated fat. What about peanut or safflower oils? Seventeen percent and 9 percent, respectively. While vegetable oils do less harm than animal fats, none of them do your coronary arteries any good. This chart shows the percentages of saturated fat in different kinds of fat:

The saturated fat is the part that increases your cholesterol level, although the unsaturated parts have health problems of their own, including a tendency to increase free-radical production and an impairment of the immune system.

At this point, you may be wondering which oil you should use in cooking. Unfortunately there is not sufficient evidence to call any of them health foods. Liquid oils are certainly better than animal fats, tropical oils, and hydrogenated oils, but the best advice is to learn to prepare foods with little
or no added fats or oils. In
Chapter 8
, we show how to do just that, with cooking techniques and ways to modify recipes that minimize oils.

What about fish? All fish products contain both cholesterol and saturated fat. Although a substantial amount of fish fat is unsaturated, all fish fats are mixtures too, and they all include saturated fat. Of the fat in chinook salmon, for example, about 24 percent is saturated. And while fishes vary tremendously in their fat content, virtually all—haddock, halibut, cod, bass, catfish, and the rest—contain a similar mix of saturated and unsaturated fat. The saturated portion is usually about 15 to 30 percent of total fat content. This is lower than beef and chicken, but still a problem. See
Table 4
.

Also a serious problem, fish fats are unstable chemicals, encouraging the production of free radicals—the very sparks that start the process of plaque formation, as we will see shortly.

Table 4     
Percentage of Fat in Fish

Source: J. A. T. Pennington,
Bowes and Church’s Food Values of Portions Commonly Used
(New York: Harper and Row, 1989).

Although fish oils can lower your triglyceride levels somewhat, they do not lower cholesterol, as some people believe. They also make the blood less likely to clot in response to injuries. And many scientific studies have shown that supplements made of fish oils can impair the body’s immune responses to bacteria and viruses.
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,
7
While some older authorities recommended fish and chicken, I believe you are better off without them.