Cooking for better heart health

Amrit Mediterrasian Indian Heart Healthy Cookbook

In 1916, shortly after cholesterol was first characterized and could be measure easily, a Dutchman C D deLangen was probably the first person to look at the link between food and heart disease. He was a public health officer stationed in East Indies. He observed that the natives had a much lower rate of heart diseases than the dutch who were living there. He hypothesized that this was due to their very different diets. In 1922, he conducted an experiment where he fed the natives the same diet that the dutch were eating - one that was rich in eggs and butter. Just 3 months later he observed that the natives who were in the study group now had 27% higher cholesterol levels.

In 1948 Farmingham Heart Study was started. This US based study has now gone on to look at three generations of human participants, and contributed to a plethora of discoveries that have furthered our understanding of contribution of different genetic and behavioral factors towards the development of cardiac diseases.

In 1952, right after world war II, another Dutchman J. Groen, observed that the rate of heart attacks had gone down dramatically and attributed this to the rationing of food during the war era.

In 1958, a Minnesotan scientist observed the same phenomenon and started the Seven Countries study to understand the differences among populations in the frequency of heart attacks and stroke. He looked at the physical characteristics and lifestyles of populations in different parts of the world, particularly composition of the diet, and especially fats in the diet. The study took more than ten years. The countries studied were: Finland, Italy, Greece, Japan, the Netherlands, the USA, and the former Yugoslavia. The main conclusion from the Seven Countries Study was that saturated fat intake was directly related to the percentage incidence of heart diseases. An interesting thing was observed during this study. For two countries, Greece and Japan, the populations had low intake of saturated fat (8% in Greece and 3% in Japan), but the male population percentage with heart disease was lower (2%) in Greece compared to Japan (5%). This came to be known as the Greek paradox.

By 1988, American Heart Association had come up with guidelines for a diet that promoted better heart health, based on scientific studies. A new study, the Lyon Heart study was put together where they tested the effectiveness of a Mediterranean style diet that was consistent with the American Heart Association guidelines, and measured recurrence rate after the first heart attack. After just 46 months, the study was stopped because of significant beneficial effects on the subjects. There was a 50% to 70% lower risk of recurrent heart disease in the group that was eating the Mediterranean diet!

Here is what the study group ate:
More whole grain bread, root and green vegetables
More fish
Poultry in place of beef, pork, and lamb
Fruit each day
alpha-linolenic spread in place of butter and cream
30% of calories in the form of fat (8% saturated, 13% monounsaturated, and 5% polyunsaturated)

The DASH "Dietary Approaches to Stop Hypertension" study conducted in 1995, showed that eating a diet with high proportion of fruits, vegetables, and low fat dairy products and overall reduction in total and saturated fat intake, significantly lowered blood pressure. And it also showed the importance of reducing the intake of sodium to 1,500 milligrams a day to manage blood pressure.

The OmniHeart study, design consisted of three different diets, was launched in 2002, to take DASH a step further by replacing some of its carbohydrates with unsaturated fat or protein. Investigators wanted to assess the impact of diet not only on blood pressure, but also on cholesterol.

At the end of the study it was found that a high-protein diet lowered multiple risk factors for heart disease: blood pressure, LDL cholesterol and triglycerides more than the high-carbohydrate DASH-like diet.

So, in brief, this is how our understanding of the connection between diet and heart health has developed.

With the information that we now have, it is up to us to convert the knowledge into practice. Let us understand who were the people with the lowest incidence of heart diseases in the Seven Countries Study, and what they ate. The people were the residents of the island of Crete. So, we are going to look at the Cretan diet from 50 years ago.

Here is what we know they ate:
Very little meat
Lots of fruits and vegetables
Lots of wild greens
High intake of fats, most of it in the form of olive oil (no animal fat)
Large quantities of whole meal flour bread
Dried, salted, or fresh fish once a week or during religious fasting periods

There are two common denominators in these foods; mono and polyunsaturated fats (a lot of omega3 fats), and antioxidants.

So, heart-healthy Mediterranean cooking, is one that includes the ingredients and proportions described above and uses cooking methods that preserve the fiber and the nutrient content of the ingredients.

The best method of preparing foods while preserving their nutrient values are:
1) Eating the food raw when possible.
2) Eating the whole food. Removing the husks, skins, seeds etc. results in a large loss of nutrient value.
3) Cutting the food in large (instead of small) pieces where possible.
4) Cooking using direct heat or using a container that contains the steam generated by the food within itself.

Combine these cooking principles, use the Cretan diet ingredients, with the understanding of high protein and low sodium proportions, and you have a diet plan that will help your heart.

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