The Great Cholesterol Myth (34 page)
Read The Great Cholesterol Myth Online
Authors: Jonny Bowden
Fast Action Plan:
Stop eating fast food. On all packaged foods from the supermarket, check the ingredients list for “partially hydrogenated” or “hydrogenated” oils. If either of those is listed, don’t eat it. Look in particular at margarines, cookies, cakes, pastries, doughnuts, and, as mentioned, fast food.
Processed meats contribute to both inflammation in general and heart disease specifically.
Harvard researchers investigated the effect of eating processed meat versus unprocessed meat. Processed meat was defined as any meat preserved by curing, salting, smoking, or with the addition of chemical preservatives, such as those found in salami, sausages, hot dogs, luncheon meats, and bacon. (Previous studies had rarely separated processed meat from unprocessed meat when investigating the relationship between disease and meat eating.) The researchers analyzed twenty studies that included a total of 1,218,380 people from ten countries on four continents (North America, Europe, Asia, and Australia). They found that each 1.8-ounce daily serving of processed meat (about one hot dog or a couple slices of deli meat) was associated with a 42 percent higher risk of developing heart disease. (In contrast, no relationship was found between heart disease and nonprocessed red meat.
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Although the study didn’t identify which specific ingredients in processed meat could be responsible for the association, many health professionals believe that the high levels of sodium and nitrates might be responsible. “When we looked at average nutrients in unprocessed red and processed meats eaten in the United States, we found that they contained similar average amounts of saturated fat and cholesterol. In contrast, processed meats contained, on average, four times more sodium and 50 percent more nitrate preservatives,” said Renata Micha, a research fellow in the department of epidemiology at the Harvard School of Public Health and lead author of the study. “This suggests that differences in salt and preservatives, rather than fats, might explain the higher risk of heart disease and diabetes seen with processed meats, but not with unprocessed red meats.”
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Fast Action Plan:
Cut out processed (e.g., deli) meats.
Vegetable oils (corn, canola, and soybean) are mostly made up of pro-inflammatory omega-6 fats, and you should reduce (not necessarily eliminate) your consumption of them while increasing your consumption of anti-inflammatory omega-3 fats.
This is the one recommendation that comes with an asterisk. Omega-6 fats, the ones that are most prevalent in vegetable oils, are not in and of themselves
“bad.” But they
are
pro-inflammatory, and they need to be balanced by an equal (or near-equal) intake of anti-inflammatory omega-3s. (You can review this information in
chapter 5
, “The Truth about Fat.”) The optimal ratio of omega-6 to omega-3 in the human diet is no higher than 4 : 1, and many believe the ideal ratio is 1:1. In the average Westernized diet, the ratio is anywhere between 15 : 1 and 25 : 1, which creates a highly inflammatory state in the body. Because heart disease is primarily a disease of inflammation, such a state should be avoided as much as humanly possible.
And by the way, it’s not just the oils you use for cooking that tip the scales into inflammation land. Omega-6 fats are everywhere in the food supply—you can’t swing a rope without hitting a food product loaded with omega-6s. Nearly all processed foods contain them. They’re used almost exclusively in restaurants, for frying, sautéing, and baking, so virtually anything you order from the menu has got a ton of omega-6 fats.
So choose your omega-6 fats carefully and use them sparingly. (The best choices are cold-pressed, unrefined oils—sesame oil is a particularly good choice.) Use highly processed supermarket oils (such as corn oil) infrequently or not at all. When you sauté food, try substituting monounsaturated fats such as olive oil and macadamia nut oil for high omega-6 oils such as canola or soybean. And, above all, increase your intake of omega-3 fats to help balance your intake of omega-6s (see the “Eat This!” section below).
Fast Action Plan:
Never use generic processed oils such as Wesson or Crisco. Cut down on corn oil, safflower oil, soybean oil, and canola oil (see Dr. Sinatra’s personal story on canola oil in
chapter 5
). Whenever possible, use olive oil, sesame oil, or macadamia oil. And pay attention to the “Eat This!” section in this chapter on omega-3s.
Both of us are frequently interviewed about the best foods for health. Virtually every reporter either of us has ever spoken with winds up asking, “How much of this food do you need to eat to get its benefits?” It’s a reasonable question, but there’s almost never a perfect answer. We know of no study, for example, that has systematically tested the effects of eating five portions of blueberries a week as opposed to three, or compared eating two portions of salmon per week with eating it daily. Our recommendation is to put these foods in heavy rotation in your diet, enjoying them as frequently as you like.
Here are the foods you want to include in your diet on a regular basis.
Salmon is one of the best sources of anti-inflammatory omega-3s. But not all salmon is created equal. Wild Alaskan salmon is far superior to the farm-raised variety. (According to independent lab tests by the Environmental Working Group, seven out of ten farmed salmon purchased at grocery stores were contaminated with polychlorinated biphenyls [PCBs] at levels high enough to raise health concerns.) Wild salmon is far cleaner, and it has the added benefit of containing one of the most powerful antioxidants on
the planet,
astaxanthin
. A 4-ounce serving also contains 462 mg of heart-healthy potassium, the same amount in a medium banana.
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Both of us have been buying our salmon from a wonderful company called Vital Choice for many years. Vital Choice is run by third-generation Alaskan fishermen who are scrupulous about using sustainable fishing and equally scrupulous about testing their fish thoroughly for contaminants and metals. They ship in dry ice, and they have the best fish we’ve ever tasted.
Fast Action Plan:
Eat wild salmon twice a week.
All berries are loaded with natural anti-inflammatory properties and natural antioxidants. They’re also very low in sugar. Blueberries contain a beneficial compound called
pterostilbene
, which helps prevent the deposit of plaque in the arteries and also helps prevent some of the damage caused by oxidized cholesterol.
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Raspberries and strawberries contain another substance,
ellagic acid
, which offers similar protection against oxidized LDL.
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And all berries—blueberries, raspberries, strawberries, and others—contain
anthocyanins
, plant compounds that help lower inflammation (see “Cherries” below).
Fast Action Plan:
Eat berries three (or more) times a week.
Cherries and cherry juice have long been known to be effective against the pain of gout, and scientists believe that the compounds in cherries responsible for this are
anthocyanins
. Anthocyanins act like natural COX-2 inhibitors. “COX” stands for
cyclooxygenase
, which is produced in the body in two forms called COX-1 and COX-2. COX-2 is used for signaling pain and inflammation.
The popularity of arthritis drugs such as Vioxx and Celebrex was based on their unique ability to block the pain and inflammation messages of COX-2 while leaving the non-inflammatory COX-1 alone. Unfortunately, there were some really unpleasant side effects associated with Vioxx, and it was taken off the market. But anthocyanins produce a similar effect with none of the problems of such drugs. Cherries (along with raspberries) have the highest yields of pure anthocyanins. In one study, the COX inhibitory activity of anthocyanins from cherries was comparable to that of ibuprofen and naproxen. Researchers feel that in addition to helping with pain and inflammation, consuming anthocyanins on a regular basis may help lower heart attack and stroke risk.
Fast Action Plan:
Eat cherries two (or more) times a week.
We’re not anti-meat guys, but we are very much against factory-farmed meat. The majority of the meat we consume, unfortunately, is feedlot-raised meat from factory farms. It’s loaded with antibiotics, steroids, and hormones; it’s very high in inflammatory omega-6 fats; and it contains virtually no anti-inflammatory omega-3s.
Grass-fed meat is a whole different “animal.” (Okay, bad pun, sorry, we couldn’t resist.) Raised on pasture, it
contains less omega-6s plus a fair amount of omega-3s, resulting in a much better omega-6: omega-3 ratio. Grass-fed meat is almost always raised organically, and, in any case, it never has hormones, steroids, or antibiotics. If you eat meat, grass-fed is the only way to go.
Fast Action Plan:
Eat only grass-fed meat when you eat meat.
No matter what kind of diet you’re on—from vegan to Atkins—you can probably benefit from eating more vegetables than you already do. The entire vegetable kingdom is loaded with natural anti-inflammatories, antioxidants, and other plant compounds, such as flavonoids, that are good for your heart.
In two long-running Harvard-based research projects, the Nurses’ Health Study and the Health Professionals Follow-up Study, the higher the average daily consumption of vegetables and fruits, the lower the chances of developing cardiovascular disease. Compared with those in the lowest category of fruit and vegetable intake (fewer than one and a half servings daily), those averaging eight or more servings per day were a whopping 30 percent less likely to have had a heart attack or stroke.
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Although all vegetables and fruits probably contributed to this stunning effect, the researchers felt that the most outstanding contributors were the green, leafy veggies (such as spinach and Swiss chard) and the cruciferous ones (broccoli, Brussels sprouts, kale, cabbage, and cauliflower). (In the fruit department, citrus fruits such as oranges, lemons, limes, and grapefruit were particularly protective.
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When researchers took the Harvard studies mentioned above and combined them with several other long-term studies both in Europe and the United States, they found a similar protective effect. Individuals who ate more than five servings a day of vegetables and fruits had a roughly 20 percent lower risk of coronary heart disease,
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and a similar reduction in the risk of stroke.
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The reason we’re not as over-the-top enthusiastic about fruit is that despite its terrific benefits, it still contains sugar, which can be a problem for many folks. For the large number of people whose blood sugar rises when they merely look at a candy bar, unlimited fruit is a bad idea. Low-sugar fruits (such as apples, grapefruit, cherries, berries, and oranges) are fine in moderation. Vegetables, on the other hand, can be virtually unlimited.
Fast Action Plan:
Eat 5 to 9 half cup servings of vegetables and fruit a day.
Although an apple a day may indeed keep the doctor away, the same can also be said of a handful of nuts. People who eat nuts regularly are less likely to have heart attacks or die from heart disease than those who don’t. Five large studies—the Adventist Health Study, the Iowa Women’s Health Study, the Nurses’ Health Study, the Physicians’ Health Study, and the CARE Study—have all found a consistent 30 to 50 percent lower risk of heart attacks or heart disease associated with eating nuts several times a week.
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In a fascinating and much-discussed article that appeared in the December 16, 2004, issue of the
British Medical Journal
, researchers put forth an idea called the
polymeal
.
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They examined all of the research on foods and health to see whether they could put together the ideal meal (the polymeal) that, if you ate it every day, would significantly reduce your risk for cardiovascular disease. They came up with a theoretical meal that, eaten daily, would reduce cardiovascular risk by a staggering 75 percent (there’s not a pill in the world that can do that!).
The ingredients of the polymeal?
Wine, fish, almonds, garlic, fruits, vegetables, and dark chocolate.
One of the many reasons for the protective effect of nuts may be an amino acid named
arginine
. Remember our earlier discussion about the endothelium, (the inner lining of the arterial walls)? Arginine has a role in protecting this inner lining, making the arterial walls more pliable and less susceptible to atherogenesis. Arginine is needed to make an important molecule called
nitric oxide
, which helps relax constricted blood vessels and ease blood flow.
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In addition, nuts are a great source of numerous
phytonutrients
—bioactive chemicals found in plants. These compounds have powerful health benefits, not the least of which is their antioxidant activity, which is linked to the prevention of coronary heart disease. And if you’re worried about calories, consider this: In the Nurses’ Health Study out of Harvard, nut consumption was inversely related to weight gain.
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Several large studies, including the Physicians’ Health Study (22,000 men) and the Adventist Health Study (more than 40,000 people), have demonstrated a link between nut eating and a reduction in heart disease.
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Just keep portions reasonable—an ounce or so a day is great.
Fast Action Plan:
Eat 1 ounce of nuts five times a week.
Fact number one: Fiber is good. (High-fiber diets have been associated with lower rates of a host of diseases, including heart disease.) Fact number two: We don’t get enough of it. (Most health organizations recommend a daily intake of 25 to 38 g daily; the average American gets 11 g.) Fact number three: Beans are a fiber heavyweight.