Sunday, July 11, 2010

What is the Number 1 killer of women?

Janet Bond Brill, a registered dietitian and author of Cholesterol Down (Three Rivers Press), shares 10 tips to reduce the bad stuff.

Cholesterol and Heart Disease
In the annual physical, your doctor checks your cholesterol levels. But what is it? And what do the numbers say about your health?

Cholesterol is a type of lipid or fat. In our bodies, it travels through our blood stream in particles called lipoproteins. Low-density lipoproteins (LDL) are bad because they can lead to a buildup of plaque in arteries.

A mass of plaque can narrow your arteries and restrict blood flow – much like trying to sip juice through a clogged straw. Eventually, the plaque ruptures and a blood clot forms, cutting off the flow of blood, oxygen and nutrients to the brain.

Hello, heart attack and stroke!

High-density lipoproteins (HDL), on the other hand, are good because they pick up the LDL clogging your arteries and take it to the liver, where it’s processed and eventually excreted.

A total blood cholesterol level of 200 and above is cause for concern, according to the American Heart Association.

Chow Down
“Lowering your cholesterol reduces your risk of contracting heart disease and dying from a heart attack,” Brill says.

What you eat can affect the amounts of HDL and LDL flowing through your bloodstream, and Brill has a cholesterol-lowering eating plan that’s tasty and effective.

“My diet is about what you can eat – not what you can’t,” she says.

What’s on her list? Try these 8 super-foods. Aim to eat all eight daily and heed the two bonus tips as well:

1. Oatmeal
Oats are rich in beta-glucan, a soluble fiber that acts like a sponge to soak up cholesterol.

How to sneak it in: Add cinnamon or dried cranberries to your morning oatmeal for a flavor boost. Oat-bran is a highly concentrated source of beta-glucan and it’s easy to mix into homemade bread, muffin and pancake batter.

Brill’s daily Rx: 3 grams of beta-glucan, found in a half cup of dry oatmeal or oat bran.

2. Almonds
Almonds contain two powerful antioxidants – vitamin E and flavonoids – which prevent the oxidation of LDL, a precursor to plaque buildup.

How to sneak it in: Eat almonds with their skins, which pack a hefty dose of flavonoids. Stir a handful into yogurt or spread two tablespoons of almond butter on whole-wheat bread.

Brill’s daily Rx: One ounce of dry-roasted, unsalted almonds.

3. Flaxseeds
Flaxseeds contain lignan and soluble fiber, which block the production of LDL and increase your body’s ability to get rid of cholesterol.

How to sneak it in: Eat ground flaxseeds rather than whole ones, because your body can better absorb its nutrients. Brill likes to sprinkle them into her morning oatmeal. New studies also show that whole flaxseeds are better than flaxseed oil for lowering cholesterol.

Brill’s daily Rx: 2 tablespoons of ground flaxseeds.

4. Garlic
Garlic impedes the liver’s ability to make cholesterol.

How to sneak it in: Chop garlic into small pieces to release its flavor. Sauté it with steamed spinach, add it to sauces and soups or purée roasted garlic with cooked potatoes and olive oil for a heart-healthy version of everybody’s favorite: mashed potatoes.

Or try this Creamy Cauliflower Puree:

Preparation Time: 15 minutes Level: Easy
Cook Time: 30 minutes Serves: 4
This savory side dish is a healthy stand-in for mashed potatoes. Change it up by adding shredded low-fat cheese or chopped fresh herbs.

Creamy Cauliflower Puree

* 8 cups bite-size cauliflower florets (about 1 head)
* 4 cloves garlic, crushed and peeled
* 1/3 cup buttermilk or equivalent buttermilk powder
* 4 teaspoons extra-virgin olive oil, divided
* 1 teaspoon butter
* 1/2 teaspoon salt, or to taste
* Freshly ground pepper to taste
* Snipped fresh chives for garnish


1. Place cauliflower florets and garlic in a steamer basket over boiling water, cover and steam until very tender, about 12 to 15 minutes. (Alternatively, place florets and garlic in a microwave-safe bowl with 1/4 cup water, cover and microwave on High for 3 to 5 minutes.)
2. Place the cooked cauliflower and garlic in a food processor. Add buttermilk, 2 teaspoons oil, butter, salt and pepper; pulse several times, then process until smooth and creamy. Transfer to a serving bowl. Drizzle with the remaining 2 teaspoons oil and garnish with chives, if desired. Serve hot.

Brill’s daily Rx: One clove and one Kyolic One Per Day Cardiovascular aged garlic extract supplement.

5. Phytosterol-Containing Foods
Phytosterols are a fat found in plant foods such as fruits, nuts, seeds and vegetable oils. They interfere with cholesterol absorption by blocking it from your intestinal cells.

How to sneak it in: Even a vegetarian diet provides no more than 300-400 mg of plant sterols a day, well below Brill’s recommendation.

So supplement this with foods containing added phytosterols – chocolate bars, margarine, cheese, granola bars and cookies, to name a few – but keep an eye on saturated fat and trans-fat content.

Brill’s daily Rx: 2-3 grams of phytosterols a day spread over two meals.

6. Apples
Apples, particularly the skin and outer flesh, are rich in polyphenols, powerful antioxidants that help prevent plaque buildup.

How to sneak it in: Chop, slice or dice ’em, but leave the peel on for maximum health benefits.

Brill’s daily Rx: One apple – to keep the doctor away, of course.

7. Beans
Beans contain a special soluble fiber that’s fermented in the colon. Healthy bacteria eat the fiber and bean sugars to form short-chain fatty acids, which travel to the liver and inhibit LDL cholesterol production.

How to sneak it in: Brill loves Adzuki beans, which are used in Japan to make sweet red bean paste.

She also recommends cannelloni beans (try them in Tuscan soups, an Italian bean-based soup) and kidney beans, perfect in Southwestern chili.

Make this Pasta Bean Soup:

Preparation Time: 15 minutes Level: Easy
Cook Time: 35 minutes Serves: 8
Using basic canned goods and a few other staples, you can make this comforting soup in just minutes. The trick to achieving a full-bodied homemade flavor from canned chicken broth is to freshen it up with a handful of herbs, some garlic cloves and crushed red pepper. For a meatier flavor, add a little crumbled cooked Italian turkey sausage to the soup.


* 4 14-ounce cans reduced-sodium chicken broth
* 6 cloves garlic, crushed and peeled
* 4 4-inch sprigs fresh rosemary, or 1 tablespoon dried
* 1/8-1/4 teaspoon crushed red pepper
* 1 15-1/2-ounce or 19-ounce can cannellini, (white kidney) beans, rinsed, divided
* 1 14-1/2-ounce can diced tomatoes
* 1 cup medium pasta shells, or orecchiette
* 2 cups individually quick-frozen spinach, (6 ounces) (see Ingredient note)
* 6 teaspoons extra-virgin olive oil, (optional)
* 6 tablespoons freshly grated Parmesan cheese


1. Combine broth, garlic, rosemary and crushed red pepper in a 4- to 6-quart Dutch oven or soup pot; bring to a simmer. Partially cover and simmer over medium-low heat for 20 minutes to intensify flavor. Meanwhile, mash 1 cup beans in a small bowl.
2. Scoop garlic cloves and rosemary from the broth with a slotted spoon (or pass the soup through a strainer and return to the pot). Add mashed and whole beans to the broth, along with tomatoes; return to a simmer. Stir in pasta, cover and cook over medium heat, stirring occasionally, until the pasta is just tender, 10 to 12 minutes.
3. Stir in spinach, cover and cook just until the spinach has thawed, 2 to 3 minutes. Ladle the soup into bowls and garnish each serving with a drizzle of oil, if desired, and a sprinkling of Parmesan. Variation: Substitute chickpeas (garbanzo beans) for the cannellini beans; use a food processor to puree them.

Ingredient Note: Individually quick-frozen (IQF) spinach is sold in convenient plastic bags. If you have a 10-ounce box of spinach on hand, use just over half of it and cook according to package directions before adding to the soup in Step 3.

Brill’s daily Rx: 1/2 cup of legumes (beans, peas or lentils).

8. Soy Protein
Soy protein contains phytoestrogens – compounds that increase the number and effectiveness of LDL cholesterol receptors, improving the liver’s ability to get rid of cholesterol in your bloodstream.

How to sneak it in: Order a soy latte at your favorite coffeehouse, throw tofu into a fruit smoothie, use soy flour when baking, or mix a handful of roasted soy nuts with dried fruit for an energy-boosting trail mix.

Brill’s daily Rx: 20–25 grams.

Two More Tips
A healthy diet isn’t your only defense against cholesterol.

“Every step works to lower cholesterol in a specific way,” Brill says. “By combining them all, you get an extremely powerful LDL-lowering approach.”

Here are two of her favorite non-food-related tips:

9. Take Metamucil (Psyllium Husk)
Metamucil contains psyllium husk, a fiber that prevents cholesterol from entering intestinal cells. This fiber soaks up cholesterol so you excrete it rather than absorb it into your body.

It’s “the most powerful LDL-lowering viscous soluble fiber in existence,” Brill says.

How to sneak it in: Adults should consume 10-25 grams of soluble fiber a day, advises the National Cholesterol Education Program, but most get only 3-4 grams.

Brill says you should get half your fiber from a supplement and the rest from food.

Take half your daily dose of Metamucil before breakfast and half after dinner to avoid overloading your body on fiber, which can cause gas, constipation or diarrhea.

Brill’s daily Rx: Work up to 12 capsules a day, for a total of 6 grams of psyllium husk.

Or use the powdered version, which you can mix into water. It varies by product, but most Metamucil powders contain 3.4 grams of psyllium husk per serving.

10. Work Up a Sweat
Brisk exercise speeds blood flow in your arteries, reducing your chances of inflammation and clogging (two precursors to hardening of your arteries).

How to sneak it in: You don’t have to hit the gym to get some exercise. Clip on a pedometer while you run errands and aim for 10,000 steps a day.

Brill’s daily Rx: 30 minutes of exercise.