Healthy Eating for Women

Your heart is a fragile thing. Not much bigger than your closed hand, it sends blood and oxygen to every part of your body. At the end of a long, hard workday, when your tired arms and legs get a welldeserved rest, your heart keeps on pumping, never taking a break. A surprising number of people give their bodies a real beating with unhealthy foods, smoking, and stress. And their hearts cannot take it. In Western countries, heart attacks are the leading cause of death, and the same trend is beginning in developing countries as well.
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You arrive at your doctor’s office asking for advice about keeping your cholesterol down. Or perhaps your doctor is offering it without your having to ask. The “heart healthy” diet most physicians prescribe comes from what is called the National Cholesterol Education Program, a federal program based, unfortunately, on research conducted a couple of decades ago. As first glance, the diet seems reasonable enough. It advises you to shift your menu from red meat to white meat, remove the skin from chicken, choose leaner cuts, and switch from whole milk to skim. In the mid-1990s, however, researchers put this diet to the test. It turns out that it barely lowers cholesterol levels at all. Even with strict adherence, this chickenand fish diet reduces the amount of cholesterol in your blood only about 5 percent—not nearly enough to prevent heart problems.

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One issue was not solved by this early research study: Will it work for women? Most of the original participants were men. And just as heart problems tend to occur at older ages in women, they might be more resistant to the effects of diet and lifestyle changes, too. An important new piece of information came from research done by Dr. Neal Barnard and his colleagues at the Physicians Committee for Responsible Medicine in Washington, D.C., some of whom are on the expert panel producing this series of books. Dr. Barnard tested a diet similar to that used by Dr. Ornish in a group of thirtyfive women. The result: Their cholesterol levels plummeted. In fact, the cholesterol-lowering power of the diet was the greatest ever reported in premenopausal women—three times greater than that achieved with the National Cholesterol Education Program diet.

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Before we look at a healthy diet in detail, let’s make a quick review of what heart disease is and how nutrition affects it.

Your heart needs a good blood supply to carry oxygen to its hardworking muscle cells, just as your arms, legs, brain, and internal organs need wide-open blood vessels to function. And arteries that ring the heart like a crown, called coronary arteries, provide it.

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Certain types of fat stimulate the liver to manufacture more and more cholesterol, and it is easy to tell which ones they are. The problem fats are those that are solid—such as butter, chicken fat, or beef fat—as opposed to liquid vegetable oils. Animal fats are solid because they are loaded with saturated fat, and that is what stimulates your liver to make cholesterol. Vegetable oils, on the other hand, are rich in unsaturated fats, which do not have this effect.
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A doctor measuring your cholesterol level is actually checking several different values. Here is what the numbers actually mean (the numbers in parentheses come from the new international system): Total cholesterol. This includes all the different types of cholesterol added together and provides a good quick check of your risk of a heart attack. If your total cholesterol is:
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Here is how to plan meals to lower your cholesterol level; keep it low; and, if you have artery blockages, to have the best chance of opening them up again. Use these guidelines along with your doctor’s guidance about diet or other treatments that may be appropriate for you.

1. Build your menu from these four food groups: . whole grains such as brown rice, whole grain pasta, bread, oatmeal, and cereal . legumes such as beans, peas, and lentils . vegetables of any variety: broccoli, carrots, cauliflower, spinach, sweet potatoes, Swiss chard, etc. . fruits such as apples, bananas, grapefruit, oranges, pears, strawberries, and watermelons
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Certain foods have unusual abilities to lower your cholesterol or to protect your heart in other ways. Don’t try to use them to counter the effects of a bad diet, but they do work along with a healthy diet for added power.

. Oat products are loaded with soluble fiber, which traps cholesterol in the digestive tract and carries it out with the wastes. You’ll also find soluble fiber in beans, barley, vegetables, and fruits.
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The vast majority of people with high cholesterol levels can bring them down with diet changes alone. However, some people, perhaps as many as one in ten, have a genetic tendency toward cholesterol problems. To find out whether you are in this category, follow the above diet guidelines for six to eight weeks and then check your cholesterol. If it is still high, your doctor may decide to recommend cholesterol-lowering drugs. They should always be used along with a good diet, not in place of it.

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Hormone replacement is not the way to cut the risk for heart disease. As we saw in chapter 5, large studies have disproved the once widely held notion that estrogen by prescription protects the heart.

Although initial studies seemed promising, a large trial funded by Wyeth-Ayerst, the manufacturer of Premarin, the most widely used estrogen brand, proved otherwise. Over a four-year period, women taking Premarin had as many heart attacks and heart-related deaths as women taking a placebo—and, if anything, they had them slightly earlier. The studies also called attention to the drug’s link to blood clots and gallbladder disease. The bottom line: Don’t look to HRT to prevent heart attacks.

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