A matter of the heart
Ten years ago there was a paradigm shift that affected millions of hearts, but first, a very short story.
In the late 1990s, I stood at a checkered tablecloth covered table in front of a store in Northgate Mall that was selling my cookbooks and offered tasting samples from those books. A normal-sized, healthy looking young man walked up to me, asked for a small brownie sample and then questioned me closely about the fat content in my recipes. Overcome by curiosity, since more women than men buy my books, I asked him if he cooked.
“Oh, no," he said, "I had a heart attack at 38 years old."
I looked at this lean guy and asked, "Were you heavier then?"
"No, same weight as today."
Then he volunteered: "But the odd thing about that attack; at that time my cholesterol was absolutely normal."
"Did the doctors know why you had your attack?"
"No, just that sometimes normal weight and cholesterol levels don't guarantee a heart attack can't happen. My doctors suggested I still watch my fat intake and keep my cholesterol in the normal range, though."
Now, the old paradigm: The key indicator for a potential heart attack? Highly elevated cholesterol levels and a bad ratio of HDL to LDL cholesterol.
That's the problem with focusing on a single element; it may not be the right or only factor.
Ten years ago, newspaper articles appeared across the country like the one originating from Boston by the Associated Press: "... the top health concern (cholesterol) of millions of Americans is about to be trumped by what doctors say is an even bigger trigger of heart attacks."
What's trumps cholesterol and shifted the paradigm? Low-grade internal inflammation.
At that time, the AP then wrote: "Doctors call it a revolutionary departure from viewing the world's top killer as largely a plumbing problem blamed on cholesterol-clogged arteries."
The U.S. government immediately got involved by writing new recommendations urging doctors to test for inflammation in millions of men and women. If that test indicates elevated inflammation levels, heart attack risk doubles. Elevated inflammation and high cholesterol multiplies that risk by an almost unbelievable nine times.
That’s why, not long ago when I donated blood at a local hospital, they tested my blood for an inflammation indicator and shared the results with me later on. That’s a healthy idea.
Here's what you can do: Have your inflammation levels tested soon; a generic test runs about $10. Have your cholesterol checked, too. If those tests show elevated levels, your doctor should be able to discuss ways of reducing inflammation.
Doctor's prefer, for elevated cholesterol, a change in diet including reducing intake of saturated and eliminating trans (or hydrogenated) fat from your food plan. Increase fish consumption to two or three times a week; especially fish high in Omega-3 fats, like wild-caught salmon, mackerel or sardines. Consume more unprocessed vegetables and fruits, especially cabbage and broccoli especially those high in dietary fiber.
I'll bet my man at the mall had one of those: "Oh, my, God," moments when he heard about low-grade inflammation, something they knew nothing about when he had his attack; it sure explains a lot.
The following recipe has zero trans fats and is low in fat and especially saturated fat, yet tastes delicious. Enjoy!
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This Ain't Cincinnati Chili, But It's Darn Good
1/2-pound 93-percent lean ground beef
1 small onion, chopped
1 large jalapeno pepper, seeded and minced
1 teaspoon ground cumin
1 tablespoon olive oil
1/4 cup all-purpose flour
1 1/2 cups 1-percent milk
1 1/2 cups fat-free, lower-sodium chicken broth
1 pound whole grain elbow macaroni
1 (15-ounce) can tomatoes, chopped, juice reserved
3/4 pound grated reduced-fat Monterey Jack cheese
1/2 teaspoon fresh-ground black pepper
2 cups fresh breadcrumbs
Fill a 4- to 6-quart saucepan two-thirds full with cold water, place over high heat and bring to a boil. Stir in a teaspoon of salt and cook the macaroni in the boiling water for 8 to 10 minutes or until done. Drain well, but do not rinse.
While the macaroni cooks: Place a large nonstick skillet over medium heat, add the ground beef, onion, jalapeno and cumin and cook, stirring and breaking up the ground beef, until the meat loses its pink color.
While the beef mixture cooks: Place a medium saucepan over medium heat, add the olive oil and when it's hot add the flour and cook, stirring for 3 minutes. Whisk in the milk and broth, raise the heat and bring the mixture to a boil, stirring; reduce the heat and simmer for 2 minutes, or until thicker.
Set the oven rack in the lower-middle position and begin heating to 350 degrees.
Add the meat mixture, sauce, macaroni, tomatoes, cheese, and pepper to a large bowl and, using a large rubber spatula or kitchen spoon, stir and toss until combined. Lightly spray a large baking dish with vegetable oil, spoon the macaroni mixture into the dish, smoothing out the surface, sprinkle the top with the breadcrumbs; lightly spray the crumbs with vegetable oil and bake for 1 hour or until bubbling and the crumbs become a light golden brown. Serve immediately. Makes 8 to 10 servings.
Nutrition values per one-tenth serving: 375 calories (25 percent from fat), 10.5 g fat(4.9 g saturated fat), 45.6 g carbohydrates, 1.8 g fiber, 24.1 g protein, 8 mg cholesterol, 566 mg sodium.
SaltSense: Did you notice there’s no added salt?
The cheese, canned tomatoes and chicken broth seem to contribute enough sodium to produce a satisfactory flavor, which is why no salt has been added.
Don Mauer’s “Lean and Lovin’ It” column appears every other Wednesday. Don welcomes comments, suggestions and recipe makeover requests at firstname.lastname@example.org.