MDAdvice.com - Heart: The Healthy Heart Handbook: Research: New Focus on Women

As you have read through this handbook, you may have noticed the recurring words: "more research is needed." This is true. Until very recently, men were the main subjects of heart disease research. We now know, however, that coronary heart disease is indeed a woman's concern. We know that we need to understand more about women's heart problems if we are to prevent and treat these problems successfully. As a result, several major research projects are now under way. They include studies on:

These and other important research projects will give us new information and tools to better protect ourselves from coronary heart disease. They will also help doctors identify and treat women's heart problems more successfully. Where women's hearts are concerned, knowledge is power--the power to improve our health and enrich our lives.

Getting serious about heart health may seem like a huge project. Because it means making basic changes in health and living habits, for many it is a major effort. But it doesn't have to be an overwhelming one. Some people find it easier to tackle only one habit at a time. If you smoke cigarettes and also eat a high-fat diet, for example, work on kicking the smoking habit first. Then, once you have gotten used to life without cigarettes, begin skimming the fat from your diet.

And remember: nobody's perfect. Nobody always eats the ideal diet or gets just the right amount of exercise. Few smokers are able to swear off cigarettes without a slip or two along the way. The important thing is to want to make healthful changes, and then to follow a sensible, realistic plan that will gradually lessen your chances of developing cardiovascular diseases.

Women are taking a more active role in their own health care. We are asking more questions and we are seeking more self-help solutions. We are concerned not only about treatment, but about the prevention of a wide range of health problems. Taking steps to prevent cardiovascular diseases is part of this growing movement to promote and protect personal health. The rewards of a healthy heart are well worth the effort.

Meal Planning: a Change of Heart
Average American Diet (37% Fat)	A New Low-Fat Diet (30% Fat)

Breakfast 1 fried egg 2 slices white toast with 1 teaspoon butter 1 cup orange juice	Breakfast 1 cup corn flakes with blueberries 1 cup 1% milk 1 slice rye toast with 1 teaspoon margarine 1 cup orange juice black coffee or tea
Snack 1 doughnut	Snack 1 toasted pumpernickel bagel with 1 teaspoon margarine
Lunch 1 grilled cheese (2 ounces) sandwich on white bread 2 oatmeal cookies black coffee or tea	Lunch 1 tuna salad (3 ounces) sandwich on whole wheat bread with lettuce and tomato 1 graham cracker tea with lemon
Snack 20 cheese cracker squares	Snack 1 crisp apple
Dinner 3 ounces fried hamburger with ketchup 1 baked potatoe with sour cream 3/4 cup steamed broccoli with 1 teaspoon butter 1 cup whole milk 1 piece frosted marble cake	Dinner 3 ounces broiled lean ground beef with ketchup 1 baked potatoe with low-fat plain yogurt and chives 3/4 cup steamed broccoli with 1 teaspoon margarine tossed garden salad with 1 tablespoon oil and vinegar dressing 1 cup 1% milk 1 small piece homemade gingermade with maraschino cherry and sprig of mint
Nutrient Analysis Calories 2,000 Total fat (percent of calories) 37 Saturated fat (percent of calories) 19 Cholesterol 505 mgs	Nutrient Analysis Calories 2,000 Total fat (percent of calories) 30 Saturated fat (percent of calories) 10 Cholesterol 186 mgs

Variety is the spice of life. Choose foods every day from each of the following food groups. Choose different foods from within groups, especially foods low in saturated fat and cholesterol (the Choose column). As a guide, the recommended daily number of servings for adults is listed for each food group. But you'll have to decide on the number of servings you need to lose or maintain your weight. If you need help, as a dietitian or your doctor.

MEAT, POULTRY, FISH AND SHELLFISH (up to 6 ounces a day)	Choose Lean cuts of meat with fat trimmed, like: - beef-round, sirloin, chuck, loin - lamb-leg, arm, loin, rib - pork-tenderloin, leg (fresh), shoulder (arm or picnic) - veal-all trimmed cuts except ground - poultry without skin - fish, shelfish Decrease "Prime" grade fatty cuts of meat like: - beef-corned beef brisket, regular ground, short ribs - pork-spareribs, blade roll Goose, domestic duck Organ meats, like: liver, kidney, sweetbreads, brain Sausage, bacon, frankfurters, regular luncheon meats Cavier, roe

DAIRY PRODUCTS (2 servings a day; 3 servings for women who are pregnant or breast feeding)	Choose Skim milk, 1% milk, low-fat buttermilk, low-fat evaporated or nonfat milk Low-fat yogurt and low-fat frozen yogurt Low-fat soft cheeses, like: cottage, farmer, pot Cheese labeled no more than 2 to 6 grams of fat an ounce Go Easy On 2% milk Part-skim ricotta Part-skim or imitation hard cheeses, like: - part-skim mozzarella - "Light" cream cheese - "Light" sour cream Decrease Whole milk, like: regular, evaporated, condensed Cream, half-and-half, most nondairy creamers and products, real or nondairy whipped cream Cream cheese, sour cream, ice cream, custard-style yogurt Whole-milk ricotta High-fat cheese, like: Neufchatel, Brie, Swiss, American, mozzarella, feta, cheddar, Muenster

EGGS (no more than 3 egg yolks a week)	Choose Egg whites Cholesterol-free egg substitutes Decrease Egg yolks

FATS AND OILS (up to 6 to 8 teaspoons a day)	Choose Unsaturated vegetable oils like: corn, olive, peanut, rapeseed (canola oil), safflower, sesame, soybean Magerine or shortening made with unsaturated fats listed above: liquid tub, stick Diet mayonnaise, salad dressings made with unsaturated fats listed above Low-fat dressings Go Easy On Nuts and seeds Avocados and olives Decrease Butter, coconut oil, palm kernel oil, palm oil, lard, bacon fat margarine or shortening made with saturated fats listed above Dressings made with egg yolk

BREADS, CEREALS, PASTA, RICE, DRIED PEAS AND BEANS (6 to 11 servings a day)	Choose Breads, like: white, whole wheat, pumpernickel, and rye breads; sandwich buns; dinner rolls; rice cakes Low-fat crackers, like: matzo, pita; bagels; English muffins; bread sticks, rye krisp, saltines, zwieback Hot cereals, most cold dry cereals Pasta, like: plain noodles, spaghetti, macaroni Any grain rice Dried peas and beans, like: split peas, black-eyed peas, chick peas, kidney beans, navy beans, lentils, soybeans, soybean curd (tofu) Go Easy On Store-bought pancakes, waffles, biscuits, muffins, cornbread Decrease Croissants, butter rolls, sweet rolls, Danish pastry, doughnuts Most snack crackers, like: cheese crackers, butter crackers, those made with saturated fats Granola-type cereals made with saturated fats Pasta and rice prepared with cream, butter, or cheese sauces, egg noodles

FRUITS AND VEGETABLES (2 to 4 servings of fruit and 3 to 5 servings of vegetables)	Choose Fresh, frozen, canned, or dried fruits and vegetables Decrease Vegetables prepared in butter, cream, or sauce

SWEETS AND SNACKS (avoid too many sweets)	Choose Low-fat frozen desserts, like: sherbet, sorbet, Italian ice, frozen yogurt, popsicles Low-fat cakes, like: angel food cake Low-fat cookies, like: fig bars, gingersnaps Low-fat candy, like: jelly beans, hard candy Low-fat snacks, like: plain popcorn, pretzels Nonfat beverages, like: carbonated drinks, juices, tea, coffee Go Easy On Frozen desserts, like: ice milk Homemade cakes, cookies, and pies using unsaturated oils sparingly Fruit crisps and cobblers Potato and corn chips prepared with unsaturated vegetable oil Decrease High-fat frozen desserts, like: ice cream, frozen tofu High-fat cakes, like: most store-bought, pound, and frosted cakes Store-bought pies, most store bought cookies Most candy, like: chocolate bars Potato and corn chips prepared with saturated fat Buttered popcorn High-fat beverages, like: frappes, milkshakes, floats, eggnogs

LABEL INGREDIENTS To avoid much fat, saturated fat, or cholesterol, go easy on products that list first any fat, oil, or ingredients higher in saturated fat or cholesterol. Choose more often those products that contain ingredients lower in saturated fat or cholesterol.	Choose Ingredients Lower in Saturated Fat or Cholesterol: Carob, cocoa Oils, like: corn cottonseed, olive, safflower, sesame, soybean, sunflower Nonfat dry milk, nonfat dry milk solids, skim milk Decrease Ingredients Higher in Saturated Fat or Cholesterol: Chocolate Animal fat, like: bacon, beef, ham, lamb, meat, pork, chicken or turkey fats, butter, lard Coconut, coconut oil, palm-kernel or palm oil Cream Egg and egg-yolk solids Hardened fat or oil Hydrogenated vegetable oil Shortening or vegetable shortening, unspecified vegetable oil (could be coconut, palm-kernel, palm)


Source: Adapted from Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, NHLBI, 1989.

Melt margarine in medium saucepan. Add celery, onion, and green pepper and saute‚ for 2 minutes. Add corn, potatoes, water, salt, pepper, and paprika. Bring to a boil; reduce heat to medium; and cook, covered, about 10 minutes or until potatoes are tender. Place 1/2 cup milk in a jar with tight-fitting lid. Add flour and shake vigorously. Add gradually to cooked vegetables and add remaining milk. Cook, stirring constantly, until mixture comes to a boil and thickens. Serve garnished with chopped fresh parsley.

4 servings, 1 cup each

Place turkey breast in a large 6-qt pot. Cover with water (at least 3/4 full). Add peeled onions, cut in large pieces. Wash celery stalks, slice, and add. Simmer covered for about 2 1/2 hours. Remove carcass from pot and cool soup in refrigerator. After cooling, skim off fat. While soup is cooling, remove remaining meat from carcass. Cut into pieces. Add meat to skimmed soup along with herbs and spices. Bring to boil. Add pastina. Continue cooking, low boil, 20 minutes until pastina is done. Serve at once or refrigerate and reheat later.

16 servings, 1 cup each

Place chicken in a 13x9x2 glass baking dish. Mix lemon juice, vinegar, lemon peel, oregano, and onion. Pour over chicken, cover, and marinate in refrigerator several hours or overnight, turning occasionally. Sprinkle with salt, pepper, and paprika. Cover and bake at 300 degrees for 30 minutes. Uncover and bake 30 minutes more or until done.

4 servings

Place chicken in a 13x9x2 pan. Arrange onion over the top. Mix together vinegar, Worcestershire sauce, brown sugar, pepper, hot pepper flakes, chili powder, and stock. Pour over the chicken and bake at 350 degrees 1 hour or until done. Baste occasionally.

8 servings

Place fish in a lightly oiled 10x6 flameproof baking dish. Sprinkle with salt and pepper. Mix wine, stock, and lemon juice in small bowl and pour over fish. Cover and bake at 350 degrees for 15 minutes. Melt margarine in small saucepan. Remove from heat and blend in flour. Gradually add milk and cook over moderately low heat, stirring constantly until thickened. Remove fish from oven and pour liquid from baking dish into cream sauce, stirring until blended. Pour sauce over fish and sprinkle with grapes. Broil about 4 inches from heat 5 minutes or until sauce starts to brown.

4 servings

Prepare marinade mixing together wine, soy sauce, sugar, and ginger. Marinate meat in mixture while preparing vegetables. Heat 1 Tbsp oil in large skillet or wok. Stir-fry onions and mushrooms 3 minutes over medium-high heat. Add celery and cook 1 more minute. Add remaining vegetables and cook 2 minutes or until green pepper is tender crisp. Transfer vegetables to warm bowl. Add remaining 1 Tbsp oil to skillet. Stir-fry meat in oil about 2 minutes or until meat loses its pink color. Blend cornstarch and water. Stir into meat. Cook and stir until thickened. Return vegetables to skillet; stir gently and serve.

6 servings

Combine yogurt, salad dressing, vinegar, salt, parsley, mustard, garlic, and pepper in large mixing bowl. Add vegetables; mix well. Refrigerate until serving time. Variation: cauliflower salad--omit radishes and potatoes and substitute 6 cups diced, cooked cauliflower (about 1 lg head).

16 servings, 1/2 cup

Drain and coarsely chop tomatoes. Reserve liquid. Mix together tomatoes and reserved liquid, onion, green beans, okra, green pepper, lemon juice, and herbs. Cover and bake at 325 degrees for 15 minutes. Mix in zucchini and eggplant and continue baking, covered, 60-70 more minutes or until vegetables are tender. Stir occasionally. Sprinkle top with parmesan cheese just before serving.

18 servings, 1/2 cup

Preheat oven to 350 degrees. Lightly oil two 9x5x3 pans. Cook apricots in water in a covered medium-size saucepan 10 to 15 minutes or until tender but not mushy. Drain; reserve 3/4 cup liquid. Set apricots aside to cool. Cream together margarine and sugar. By hand, beat in egg and orange peel. Sift together flour, dry milk, baking powder, soda, and salt. Add to creamed mixture alternately with reserved apricot liquid and orange juice. Stir apricot pieces and pecans into batter. Turn batter into prepared pans. Bake 40-45 minutes or until bread springs back when lightly touched in center. Cool 5 minutes in pans. Remove from pans and completely cool on wire rack before slicing.

2 loaves, 36 1/2-inch slices

Heart
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Research: New Focus on Women

The Heart of the Matter

Recipes for a Healthy Heart

Corn Chowder

Homemade Turkey Soup

Very Lemony Chicken

Barbecue Chicken

Fish Veronique

Stir-Fried Beef and Vegetables

Picnic Potato Salad

Italian Vegetable Bake

Apricot-Orange Bread

Rainbow Fruit Salad

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