The Great Cholesterol Myth (35 page)

Case closed.

One study found that one serving of beans on a daily basis lowered the risk of a heart attack by 38 percent.

Regarding heart disease, the big selling point of beans used to be that they lowered cholesterol.
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That’s definitely true, but, as you’ve learned, it’s not nearly as important as whether they actually lower
heart disease
. And they do. One study found that one serving of beans on a daily basis lowered the risk of a heart attack by an eyebrow-raising 38 percent!
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Another study found that individuals eating beans and legumes at least four times a week had a 22 percent lower risk of heart disease than individuals consuming beans/legumes less than once a week.
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Their high fiber content alone would make beans a top food for the heart, but beans offer a lot more than fiber. The U.S. Department of Agriculture ranking of foods by antioxidant capacity lists small red dried beans as having the highest antioxidant capacity per serving size of any food tested. In fact, of the four top-scoring foods, three were beans (red beans, red kidney beans, and pinto beans). Many bean varieties have a lot of folic acid (especially adzuki beans, lentils, black-eyed peas, and pinto beans). Folic acid is one of the key players in bringing down the inflammatory compound
homocysteine
, itself a risk factor for heart disease.

Fast Action Plan:
Eat a serving of beans or lentils at least four times a week. (One serving is
¹
/
₂
cup to 1 cup cooked beans.)

Study after study is confirming that plant chemicals in cocoa-rich dark chocolate called
flavanols
can lower blood pressure and reduce inflammation. A 2011 study in the
British Medical Journal
found that high levels of chocolate consumption are associated with a one-third reduction in the risk of developing heart disease. The highest levels of chocolate consumption were associated with a 37 percent reduction in cardiovascular disease and a 29 percent reduction in stroke when compared to the lowest levels.
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Flavanol-rich cocoa lowers blood pressure.
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And the Zutphen Elderly Study of 470 elderly men found that those who ate the most cocoa had literally half the risk of dying from heart disease than men who ate the least.
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Now the thing about chocolate is that all the good stuff is found in the cocoa that it’s made from, so you really want high-cocoa chocolate. We’re not talking about the candy bars you get at the 7-Eleven here; we’re talking about a cocoa-rich chocolate that contains all the flavanols that have been found to be so healthy. White chocolate and milk chocolate have hardly any flavanols to speak of, so it’s got to be dark. Many dark chocolate bars will now tell you their cocoa content in percentage form—look for at least 60 percent cocoa. (The higher the cocoa content, the less sweet the bar.)

You’ll also find that this kind of chocolate is easy to eat in small quantities—it’s not so sweet that it causes you to crave more and more of it, and it’s easy to be satisfied with just a square or two, which is all you need for the health benefits.

Fast Action Plan:
Eat one to two squares of dark chocolate four to six days a week.

Turmeric is the spice that makes curries yellow. It occupies a place of distinction in both Ayurvedic and Chinese medicine, largely because of its phenomenal anti-inflammatory properties. (It also has anticancer activity and is very helpful for the liver.) The active ingredients in turmeric are a group of plant compounds called
curcuminoids
(collectively known as
curcumin
). In addition to being anti-inflammatory, curcumin is a powerful antioxidant. Because oxidized LDL is a big player in the cascade that leads to inflammation and heart disease, turmeric’s antioxidant properties are a big benefit.

Fast Action Plan:
Put turmeric at the front of your spice cabinet and use it often. It goes well on veggies, eggs, sautéed dishes, meats, fish, and poultry.

Pomegranate juice is one of the few “trendy” health foods that actually lives up to its hype. Researchers at the Technion-Israel Institute of Technology in Haifa suggest that long-term consumption of pomegranate juice may help slow aging and protect against heart disease.

In a study published in the
American Journal of Cardiology
, forty-five patients with heart disease drank either 8 ounces of pomegranate juice or 8 ounces of a placebo drink for three months. The pomegranate juice drinkers had significantly less oxygen deficiency to the heart during exercise, suggesting that they had increased blood flow to the heart.

Pomegranate juice has the ability to inhibit the oxidation of LDL cholesterol.
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(Remember that LDL cholesterol is only a problem when it’s oxidized!) And an impressive number of studies have demonstrated a beneficial effect of pomegranate juice on cardiovascular health, including one that showed 30 percent reduced arterial plaque.
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Pomegranate juice also enhances the activity of nitric oxide, a molecule essential for cardiovascular health.
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One caution: Avoid “juice blends” and “juice cocktails,” because these have much less pomegranate juice in them and much more sugar. We like pure pomegranate juices such as Just Pomegranate, which are admittedly expensive but contain absolutely nothing but pure pomegranate juice. Another popular brand we like a lot is Pom Wonderful.

Fast Action Plan:
Put pomegranate juice in “heavy rotation” on your menu: 4 to 8 ounces a day, or as often as you like.

For years, it was believed that the reason the French could “get away” with eating high-fat foods—while still having remarkably lower rates of heart disease than Americans—was because of their regular consumption
of red wine, which contains numerous compounds that protect the heart. Chief among these is
resveratrol
, a polyphenol (plant compound) that’s found in the skins of dark grapes and is highly concentrated in red wine. Resveratrol is a potent antioxidant that can prevent harmful elements in the body from attacking healthy cells. Red wine has been shown to be cardioprotective in quite a number of studies.
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And resveratrol isn’t the only reason. Other compounds in red wine such as flavonoids inhibit the oxidation of LDL cholesterol, which is pretty darn important because oxidized LDL cholesterol initiates and intensifies the inflammatory process.
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Red wine also limits the tendency of compounds in the blood to clot and increases HDL cholesterol to boot.
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Interestingly, in one study, moderate consumption of red wine was associated with lower levels of three markers we told you about earlier: CRP, fibrinogen, and interleukin-6.
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It’s hard to think of a more heart-healthy drink.

Worth noting: The dark side of alcohol is well known, and we don’t have to recount it here. If you’re not a drinker, please don’t start because of the benefits of red wine. Not everyone can handle alcohol, and if you suspect you’re someone who doesn’t do well with it, for goodness’ sake, don’t drink it! (With all the talk about how the wine-drinking French have the lowest rates of heart disease in western Europe, it’s frequently forgotten that they also have the highest rates of liver cirrhosis!) The key to enjoying wine’s beneficial effects is moderate consumption, defined as about two glasses a day for men and about one a day for women, about three to four times a week. Also worth mentioning is that alcohol increases the risk for breast cancer in women who aren’t consuming enough folic acid, so make sure you’re getting at least 400 mg of folic acid a day through food or supplementation.

Fast Action Plan:
If you are a drinker, have a glass of red wine with dinner. (If you’re not, don’t start!)

Apart from water, tea is probably the most consumed beverage in the world, and it’s also one of the healthiest. That’s because it’s absolutely loaded with protective plant-based chemicals known as
polyphenols
. Green tea in particular has gotten a ton of attention in the media, largely for the anti-cancer action of one of its compounds,
epigallocatechin gallate
(EGCG).

But green tea also contributes to cardiovascular health. Although much has been written about its cholesterol-lowering effect, we find it much more interesting that green tea lowers fibrinogen, a substance in the body that can cause clots and strokes. In an article in the journal
Circulation
titled “Effects of Green Tea Intake on the Development of Coronary Artery Disease,” researchers from the department of medicine at Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan, concluded that “the more green tea patients consume, the less likely they are to have coronary artery disease.”
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Worth knowing: Just because green tea gets the lion’s share of attention from health writers doesn’t mean there’s not great stuff in other teas, such as black, oolong, white, and yerba matte. At Boston University’s School of Medicine, Joseph Vita, M.D., conducted a study
in which sixty-six men either drank four cups of black tea a day or took a placebo. The researchers showed that drinking black tea can help reverse an abnormal functioning of blood vessels that can contribute to stroke or heart attack. Best of all, improvement in the functioning of the blood vessels was visible within two hours of drinking just one cup of black tea!
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“What we found was that if you take a group of people with heart disease who have abnormal blood vessel function to begin with and asked them to drink tea, their blood vessels improved,” said Vita.
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Fast Action Plan:
Remember, any form of tea contains caffeine, so drink in moderation. Make a big pitcher of green tea and keep it in the fridge. Drink it in the earlier part of the day, up to two glasses.

Olive oil is the primary fat used in the Mediterranean area and the one most associated with what’s been called the Mediterranean diet. (There is no single “Mediterranean diet,” but all variations of it contain high amounts of fish, fruits, vegetables, nuts, wine, and olive oil.) There are countless studies on the Mediterranean diet and heart health and virtually all of them show enormous benefits for the heart and the brain. These studies have left olive oil with an unimpeachable reputation as one of the healthiest fats for the heart.

Research in the
Archives of Internal Medicine
concluded that greater adherence to the traditional Mediterranean diet (including plenty of olive oil and other monounsaturated fats such as nuts and avocados) was associated with significant reduction in mortality among people who had been diagnosed with heart disease.
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Another study in the same journal compared two groups of people with high blood pressure.
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One group was given sunflower oil, a typical high omega-6 oil used in Western diets, and one group was given the good stuff: extra-virgin olive oil. The olive oil decreased the second group’s blood pressure by a significant amount; it also decreased their need for blood pressure meds by a whopping 48 percent. As the English might say, “Not too shabby.”

Like red wine and green tea, olive oil contains polyphenols that are anti-inflammatory and act as powerful antioxidants. (Researchers have isolated one in particular,
oleocanthal
, which acts similarly to ibuprofen.
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) Because so many of these polyphenols have significant health benefits, some people believe that the fat in olive oil may not be the only reason olive oil is so darn healthy. They think that the main health benefits of olive oil come from the fact that it is a delivery system for these powerful polyphenols. Either way, the stuff is great, and you should make it a part of your heart-healthy diet.

Worth knowing: All olive oil is not created equal. Unfortunately, commercial manufacturers, trying to ride the health hype on olive oil, have rushed to market all kinds of imitation and inferior products that say “olive oil” on them but are highly processed and refined and have questionable benefits. That’s why you want “extra-virgin” olive oil, which is the least processed, the most like what you’d get if you walked around barefoot in barrels of olives. It’s made without the use of heat, hot water, or solvents, and it is left
unfiltered. (The first pressing produces the best stuff, known as “extra-virgin.”)

Once you begin machine harvesting and processing with very high heat, you start damaging the delicate compounds in olive oil responsible for all those great health benefits. The antioxidant and anti-inflammatory polyphenols are water soluble and can be washed away with factory processing. That’s one reason that factory-produced olive oil has a shorter shelf life—no antioxidants to protect it. Real olive oil—the extra-virgin kind, made with care and love and the absence of high heat and harsh chemicals—lasts for years.

Fast Action Plan:
Switch to extra-virgin olive oil. Use it for salad dressing, low-heat stir-fries, and sautées.

Garlic is a global remedy. More than 1,200 (and counting) pharmacological studies have been done on garlic, and the findings are pretty impressive. In addition to lowering lipids and preventing blood coagulation, it has antihypertensive, antioxidant, antimicrobial, and antiviral properties. Garlic has been shown to lower triglyceride levels. It can also reduce plaque, making it a powerful agent for cardiovascular health.

In one study, subjects receiving 900 mg of garlic powder for four years in a randomized, double-blinded, placebo-controlled study had a regression in their plaque volume of 2.6 percent; meanwhile, a matched group of subjects given a placebo (an inert substance) saw their plaque increase over the same time period by 15.6 percent!
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