Dietitian Toby Morris, of the UCSF Nutrition Counseling Clinic, answers questions about nutrition and heart health.
What are some of the biggest myths about heart-healthy foods?
One myth is that they don't taste good! Eating healthy food should not feel like a chore. Healthy food also does not need to be complicated. There are so many healthy foods that are simple to prepare and delicious.
For example, fresh spinach sautéed in a bit of olive oil with garlic, finished with a squeeze of lemon and fresh pepper tastes amazing and takes only a few minutes to make. Another example is whole grains. I like to cook a cup of whole grains, such as bulgar, brown rice and steel cut oats, with water and spices in a crockpot overnight. In the morning I've got three days' worth of whole grain breakfasts.
Another positive is that heart-healthy foods leave you feeling light and energetic rather than bloated and full.
We read a lot about antioxidants. How do these promote good heart health, and what are some of the foods that are highest in antioxidants?
Antioxidants protect cells against damage. Many phytochemicals — compounds found in plants — act as antioxidants. There are many of these health-promoting chemicals, with more being discovered every day.
The role of antioxidants and heart disease prevention is unclear but being studied. Foods high in antioxidants, especially darkly colored fruits and vegetables, are good for the heart for a variety of reasons, including helping maintain a healthy weight — one of the best heart disease prevention strategies.
What's the best way to reduce the amount of cholesterol in my diet?
Simple — eat fewer animal products. Plants are naturally cholesterol-free; only animals (including humans) produce cholesterol. Any food from an animal source, whether meat, eggs or dairy products, contains cholesterol. Some foods, including egg yolks, shrimp, squid (calamari), liver and other organ meats are especially high in cholesterol.
It's wise to limit or avoid these foods, especially if you have high blood cholesterol. Try replacing cholesterol-containing foods with plant foods. For example, avocado instead of cheese, beans instead of beef, or marinara instead of alfredo.
What foods should I always have on hand to promote a heart-healthy diet?
I recommend keeping your kitchen stocked with heart-healthy staples and shopping frequently for fresh produce and proteins. Staples include whole grains, beans, lentils, frozen vegetables (I like spinach and broccoli) and fruit with no sugar added, canned or frozen fish and chicken, and a few different healthy fats like olive and canola oil, nuts and natural nut butters.
Fresh ingredients should include plenty of leafy vegetables, fresh fruit, proteins like fish, chicken, eggs and tofu, and nonfat or low-fat dairy foods such as yogurt and milk, or their soy equivalents. I like to keep on hand a few heart-healthy flavor boosters to spice up a meal, such as garlic, lemons and limes, fresh herbs, sundried tomatoes, olive tapenade and hummus.
Some people take aspirin or other nonsteroidal anti-inflammatories (NSAIDs) every day to reduce their risk of heart disease. Are there any foods that are natural blood thinners, which help facilitate blood flow and decrease the risk of heart disease and other cardiovascular conditions?
Omega-3 fatty acids promote heart health, perhaps in part because of their anti-inflammatory properties. Fatty fish, like salmon, lake trout and black cod are excellent sources of omega-3s. Vegetarian sources include walnuts, canola oil and flaxseeds.
We hear a lot about reducing, or even eliminating, our intake of carbohydrates. How many carbs should we eat?
Carbohydrates, or "carbs," are a hot topic. There's no pat answer to this question.
Carbohydrates are the body's main fuel source, so more active people need more carbs. In fact, athletes need up to 65 percent of their calories to come from carbs. For most of us, 40 to 50 percent of our calories can come from carbs.
Many people have become aware that lots of different foods contain carbs — a possibly positive result of the low-carb craze — so it's not difficult to eat an adequate amount. Grains and foods made from grains, fruit, some vegetables, milk and yogurt, and of course sweets of all kinds are high in carbs. Within these categories, some foods are healthier than others. Foods high in fiber, such as whole grains and fresh fruits, are healthy sources of carbohydrate.
If I have very limited time to cook, what simple steps can I take to have a heart-healthy diet?
Plan ahead when you have free time — map out your dinners for the week and go shopping for the ingredients. Go one step further and do some of the prep in advance to make things easier during the busy week. It's okay to buy things partially prepared. It'll cost a little more, but might be worth it to buy pre-chopped fruits and vegetables, or even pre-cooked chicken or marinated tofu.
I also recommend cooking large batches of healthy meals, such as soups, stews and casseroles, and freezing small portions for later. Lastly, think outside the box. Soup makes a tasty breakfast, and an egg white omelette filled with vegetables makes a great quick dinner.
Are organic foods more effective at promoting healthy hearts than non-organic food?
The organic issue is complicated. Organic does not mean sustainably farmed. Sustainably farmed organic food is definitely better for the environment than conventionally farmed food, and therefore better for our health. Organic, sustainably farmed food that is grown locally is the gold standard because it comes to your table very quickly after harvest, plus enables you to eat seasonal foods. I encourage my clients to shop at local farmers' markets or participate in a local community supported agriculture (CSA) program when possible.
The fact is, there is not conclusive evidence that organically grown produce is higher in nutrients than non-organic. However, we do know that nutrients degrade over time, through exposure to light and oxygen, so old produce is likely not as nutritious as fresh. Also, not everyone has access to these types of foods.
The bottom line is that any fruits and vegetables — even frozen, canned or dried — are better than none.
Do you recommend taking vitamin supplements, or do you think all of our vitamins should come from our food?
Food is definitely the best source of vitamins and minerals. Dietary supplements are important for some populations, including pregnant women, people on very low-calorie or vegan diets, elders or those with a nutrient deficiency. For most of us, a once-a-day multivitamin is acceptable, but probably not necessary if we're eating a balanced diet.
Supplements are not well regulated, so if you do take a supplement, research the company you're buying it from. Check with a health care provider about your supplement and be careful not to take too much — more is not better when it comes to vitamins and minerals.
Reviewed by health care specialists at UCSF Medical Center.
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.
Nutrition Counseling Clinic at Mount Zion
1701 Divisadero St., Fifth Floor
San Francisco, CA 94143-0310
Appointments: (415) 353-4174
Office: (415) 353-2291
Fax: (415) 353-2648
Nutrition Counseling Clinic at Parnassus
400 Parnassus Ave., 5th Floor, Ste. A550 in Endocrinology
San Francisco, CA 94143-0118
Appointments: (415) 353-4174
Office: (415) 353-2291
Fax: (415) 353-2648