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This month, the American Heart Association is asking everyone to have a heart - and make some changes in their diet to promote cardiac health.


It's not as simple as health experts once thought, Mahaska Health Partnership dietitian Elaine Hammes said, but it can be done.

"We used to just tell people to lower their cholesterol," Hammes said. "We found out it's not that simple. Cholesterol is now taking a back seat to everything else we're trying to accomplish."

While people still should keep their cholesterol intake to less than 200 mg a day, they need to go beyond that for heart-healthy eating by tracking low-density lipoproteins - commonly referred to as "bad cholesterol," which can clog the arteries - and high-density lipoprotein - the "good cholesterol," which removes cholesterol from tissues and brings it back to the liver where it is either recycled or broken down and excreted from the body.

There are also different kinds of fats, or triglycerides, to worry about - saturated, monounsaturated and polyunsaturated. Throw in trans fatty acids and omega-3 fatty acids, and it gets even more confusing to a person taking the first steps toward better cardiac health.

"It has really become complicated," Hammes said. "We've got all of this stuff we're looking at now. It's no longer about the total fat, but the kind of fat we're eating."

According to the latest dietary recommendations, up to 35 percent of a person's daily calories can come from fat - but that doesn't mean anyone should be loading up on bacon cheeseburgers. Instead, Hammes said, people should be eating foods that contain essential fatty acids the body can't manufacture.

One of those essentials is omega-3 fatty acid, which protects the heart by making blood cells less "sticky" and likely to clot, thus reducing the risk of strokes caused by blood clots. Omega-3 fatty acids also stabilize the heart's muscle cells and help to prevent life-threatening arrhythmias, changes in the beat of the heart. Good sources of omega-3 fatty acids are walnuts, soy nuts, canola or soybean oil, spinach and fish such as sardines, salmon and white tuna. Flax oil and flaxseed, a high-fiber food that can be sprinkled on cereal or salad, also are good sources.

While omega-3 fatty acids are a heart's best friend, trans fatty acids are the enemy. It can raise a person's "bad" cholesterol while lowering the levels of "good" cholesterol.

"If a food says '
hydrogenated' or 'partially hydrogenated,' it has trans fatty acids in it," Hammes said. "It's the worst fat yet - very bad for you."

Trans fatty acid often lurks in vegetable oils used in commercial baked goods and sometimes in the oils used in restaurant cooking.
Prepackaged snack food and desserts are full of trans fatty acid, Hammes said.

While trans fatty acids - hydrogenated fat - is definitely something to avoid, people also should try to reduce their intake of saturated fats. Less than 7 percent of a person's daily calorie intake should come from saturated fat, which tend to raise blood cholesterol levels. Foods to avoid include coconut, palm and palm kernel oils and any margarine or shortening that contains hydrogenated or partially hydrogenated fat or oil. Bacon, butter, cream, half and half, cream cheese and sour cream also are high in saturated fats.

Better choices in fats are the polyunsaturated and monounsaturated varieties.

Polyunsaturated fats, such as safflower, corn, soybean and sunflower oils - along with walnuts - may help lower blood cholesterol levels when used in moderation. Monounsaturated fats are an even better choice for lowering low bad cholesterol. Good sources are olive and canola oil, avocados, almonds, peanuts and peanut butter.

In fact, Hammes said, the newly revised food guide pyramid recommends that people eat two to three servings of nuts a day.

"But that doesn't mean we should sit in the recliner with a can of nuts in the evening watching TV," she added. "Portion control is important."

One serving of almonds, for example, is six nuts, while a serving of peanut butter is 2 tablespoons.

Along with nuts, soy products can cut cholesterol, Hammes said. The Food and Drug Administration recently approved the claim that 25 grams of soy protein per day has a cholesterol-lowering effect. Good sources are soy milk, soy nuts and soy flours.

Fiber, particularly soluble fiber, also helps keep cholesterol in check. Soluble fiber is found in oats, peas, beans, whole-grain food products, some fruits and cereals. Most people eat only 10-12 grams of fiber a day, Hammes said, while they should be aiming for 25 to 35 grams daily.

Weight control and physical activity are also great ways to lower the level of bad cholesterol in the body, Hammes said, while folic acid and vitamins B6 and B12 can help prevent blood clotting and keep blood vessels flexible.

Excellent sources of folic acid include spinach, lentils, pinto beans, black beans, asparagus, Romaine lettuce, soybeans and enriched cereals. Beets, kidney beans, tomato juice, broccoli, orange juice and oranges are also good sources.

The best choices for B6 are bananas, garbanzo beans, fortified cereals, and light meat chicken and turkey. Other good sources are pork, halibut, dark meat chicken and turkey, beef, herring, tomato juice, sweet potatoes, sesame seeds, sunflower seeds, carrots and brown rice.

B12 is most abundant in oysters, herring and crab, while salmon, sardines, lobster, beef, tuna, shrimp and fortified cereals are also high sources. Other good choices are milk, cod, cottage cheese and pork.

Taking a daily multivitamin also may help people meet their daily requirements, Hammes said.

"People need to work with their health care provider and know what their (blood cholesterol) levels are," she said. "Then they can make the right choices with physical activity and food for optimal heart health."


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