Eat Eggs—No Yolking!

Earlier this year I posted an Egghead Quiz.  We love to hear from readers about our posts and this one got lots of responses. One reader indicated she wished I had also addressed eating egg whites vs the whole egg.  This got me thinking and doing some additional research in this area.

Like many of you, I’ve been teaching healthful living and nutrition-related topics for many years and the “bad guys” seem to come and go.  This is based on current research and longitudinal studies.  As I tell my students, as we learn more, we know more and things change.

Eggs (and specifically the yolks) used to be one of the “bad guys”. What we were talking about here was cholesterol and the belief that eating eggs and other foods containing dietary cholesterol increased the risk of heart attack and cardiovascular disease.  Early versions of the Dietary Guidelines for Americans (DGA) recommended that cholesterol intake be limited to no more than 300 mg per day.  This is no longer believed! 

The 2015 DGA do not contain this recommendation because research does not show a relationship between dietary cholesterol and serum cholesterol.  Cholesterol is no longer considered a nutrient of concern for overconsumption.  The American Heart Association recommendations agree with this.

The 2015 Dietary Guidelines for Americans encourage the consumption of healthy dietary patterns that contains all foods and beverages at an appropriate calorie level while limiting saturated fats, added sugars and sodium.

Saying that, where do eggs fit in?

They can be part of a well-balanced healthful diet. According to the USDA Nutrient Data Base one large (50 grams) hard-cooked egg contains 78 calories, 6 grams protein and 5 grams of fat (1.6 g is saturated, 2 g monounsaturated and .7 polyunsaturated) and varying amounts of 13 essential vitamins and minerals. While egg whites contain almost half of the egg’s protein along with riboflavin and selenium, the majority of the nutrients are found in the yolk.  If you break it down, the yolk contains all of the egg’s fat and 76% (59) of the calories, 42% (2.52 g) of the protein and all of vitamins A, D, and B6, zinc, iron and choline.  Egg yolks are one of the only foods that naturally contain vitamin D.

The biggest concern about eggs would be about in the area of saturated fats.  Animal products, including eggs, do contain saturated fat, which can raise blood cholesterol. Too much bad (LDL) cholesterol in the blood can contribute to formation of plaque and narrowing of the arteries. The DGA recommendation is that less than 10% of your total daily calories come from saturated fats. For someone eating 2000 calories a day that’s about 13 grams of saturated fats.

While the numbers are small, if you are concerned about saturated fats and calories you could choose to eat one whole egg plus two egg whites instead of two whole eggs. But, don’t skip the yolk altogether, it contains a lot of the “good guys”.

A calorie comparison shows that portion control is important so you eat a 2 egg equivalent instead of 4:

  • 4 egg whites (2 egg equivalent) = 68
  • 1 egg plus 2 egg whites (2 egg equivalent) = 112
  • 2 eggs = 156
  • 4 eggs = 312

Cost comparison shows real eggs are cheaper by 50%:

  • Egg substitute (nonfat) = .16 ounce or about .32 for one egg equivalent
  • Eggs .16 each average cost (averaging store brand and free range eggs at $2 per dozen)

The real issue with eggs may be the high-saturated-at additions often added to eggs and omelettes:

  • Cheese – just one ounce is 110 calories, 20 grams of fat and 6 grams of saturated fat
  • Butter – just one tablespoon is 111 calories, 11 grams of fat, and 7 grams of saturated fat
  • Whoa – this means a 4 egg omelette cooked in a tablespoon of butter with one ounce of cheese would rake in 533 calories and over 30 grams of fat.

Solution:

Go with a 2 egg equivalent and prepare them scrambled with a little cooking oil spray in a nonstick skillet or poached or hardboiled. Skip the butter and cheese.

Cheryle Jones Syracuse, MS

Professor Emeritus, The Ohio State University

 

References:

https://health.gov/dietaryguidelines/2015-scientific-report/pdfs/scientific-report-of-the-2015-dietary-guidelines-advisory-committee.pdf   Part D, Chapter #1, page 1

https://www.incredibleegg.org/egg-nutrition/cracking-the-cholesterol-myth/

http://www.eggnutritioncenter.org/science-education/health-professional/eggs-cholesterol-getting-heart-matter/

http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437740.48606.d1 2013 American College of Cardiology and the American Heart Association Guidelines on Lifestyle Management to Reduce Cardiovascular Risk

https://ndb.nal.usda.gov/ndb/ USDA Food Composition Databases

http://peapod.com for cost comparisons

Want heart healthy teaching tools? You are in luck:

Eat More Oatmeal!

How are you doing with making small changes to your eating pattern that can make a difference in your health? One of the ideas in my New Year’s resolution article was to “eat more oatmeal.” Did you try it? How are you doing?

The concept behind that little goal is to have oatmeal instead of processed cereal. There are several things going on here: saving money by not buying expensive boxes of cereal, knowing exactly what you’re adding to the cereal, and knowing that oatmeal is good for you.

How good? Well, oatmeal is naturally low in fat and sodium and high in fiber. It’s also a good source of iron and provides protein, B vitamins, and other minerals. Oatmeal is an excellent source of whole grains too. Eating oats may even help protect against high blood cholesterol, diabetes, high blood pressure, and obesity.

There used to only be a couple different types of oatmeal available, but now the choices are many. All this variety can get a little confusing, so let me clear some things up. All types of oatmeal start with oat groats, which are oat grains without the hulls. Choose your oatmeal based on the time you have to prepare it, the texture you prefer, and any added ingredients you may or may not want.

  • Scotch or Irish oats have been cut but not rolled. They have a hearty texture with a nutty flavor. The traditional version can take up to 30 minutes to cook, though there are quicker-cooking options.
  • Steel-cut oats are whole oat groats that have been sliced into pieces. These cook in about 20 minutes with a chewy, coarse texture.
  • Rolled or old-fashioned oats are whole oat groats that are steamed and rolled to flatten them; they cook in about five to ten minutes.
  • Quick oats are rolled oats that have been cut into even smaller pieces. These cook in about one to five minutes.
  • Instant oats are whole oat groats that are rolled thinner and cut finer than the others. Since they’re also pre-cooked, you can just add boiling water or heat them in the microwave for about 90 seconds.

According the USDA Nutrient Database, all plain oatmeal types are about the same when it comes to nutrients. One cup of cooked (with water and no salt) old-fashioned or quick oats has 166 calories, 3.5 grams of fat, no sodium, 4 grams of dietary fiber, and less than a gram of sugar. Watch out for instant oatmeal packets, since most of them have added flavors which usually add calories, sodium, and sugars. To steer clear of these, keep an eye on the ingredients list and Nutrition Facts label.

You can make oatmeal in the microwave as quickly as you can pour a bowl of cereal and milk.

To try it for yourself, don’t miss this edition of one of Chef Judy’s recipes:

Ingredients:

  • 1/2 cup old-fashioned oatmeal
  • 1 cup water
  • 1/4 teaspoon ground cinnamon

Directions:

  1. Place all ingredients in a large glass or ceramic bowl. Microwave on high for 3 minutes. The big key here is to make sure you have a large bowl, so that it won’t overflow! I like to make it in a 1 quart measuring cup and then just eat out of the cup. Voilà! Only one dish to clean.
  2. Add your own skim milk, fruit, nuts, raisins, dried cranberries, and spices to the cooked oatmeal — you are in control. To save even more time in the morning, make your own little “instant oatmeal” packs, adding spices or dried fruits. That way, all you’ll need to do in the morning is add water, microwave, and eat!

And what if you don’t think that you have time to make oatmeal every day? My solution is to make a large batch of oatmeal over the weekend and reheat single servings quickly in the microwave. That way, you’ll have a speedy meal without losing any of its nutritional benefits. Cooked oatmeal will keep in the refrigerator for up to a week and makes a quick and healthful breakfast.

By Cheryle Jones Syracuse, MS, Professor Emeritus at The Ohio State University

Here are a few of the other top breakfast resources, just for you!

Quick Quiz: What is This?

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Quick Quiz: What food is blue/grey and bumpy on the outside, bright orange in the middle, and full of vitamin A?

On a recent visit to a local farmers’ market, I found this item in an outside bin with lots of others of various sizes.  It was on sale for half its regular price and it seemed that there weren’t many people buying whatever it was.

I carried one around while I was shopping and several people asked me what it was. Others asked if it was blue on the inside and what was I planning on doing with it.

Quiz Answer: This mystery veggie is a Blue Hubbard Squash!

It turned out that my mystery gourd was a Blue Hubbard Squash. However, when I asked the clerk what people do with it and how to cook it, she said she didn’t know.

Always inquisitive about food,  I bought it.

(Fortunately it was sold by the piece and not by the pound because the one I picked up weighed 13 pounds)!

When I got home, the squash remained a curiosity. My husband had fun asking about the “monster Smurf gourd,” while visiting neighbors were quick to google it. This veggie was definitely a conversation starter!

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So now let’s talk about the Blue Hubbard Squash. This winter squash is known for its ability to be stored in a cool, dry place for long time. Seed catalogs describe it as sweet, dry, and fine-grain. Some people consider this one of the “heirloom” varieties of winter squash, since it was first introduced in the early 1900s.

I admit that the hardest part was cutting into the hard outer shell of the squash.  I “cheated” a little by washing it completely on the outside and putting it whole in the microwave for 10 minutes. This softened the outside enough to allow me to cut into it.  After cutting it in half and cleaning out the seeds and strings, I experimented by baking part of it in the oven and then putting another part in the microwave. Both were equally good, though baking allowed for more caramelization of the natural sugars in the squash.

Hubbard is just one of many winter squash varieties that are readily available now. These vegetables contain fiber and are low in fat. Plus, squash with yellow-orange flesh are rich in vitamin A, which in turn is vital for healthy eyes, skin, and fighting infections. Diets rich in vitamin A may even help reduce your risk of heart disease and cancer.

Winter squash are also a good source of vitamin C. These squash get their name from their ability to last through the winter in a cool dry place (not the refrigerator). Other varieties of winter squash include banana, delicata, turban, butternut, spaghetti, and acorn.

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We’ve gotten several meals from this huge Blue Hubbard. At first we just ate it as a vegetable on the side. Then I made some into a soup with apples (it was so sweet, no added sugar was needed). Finally, I added some to brown rice for a risotto-like meal and also put three packs of cooked squash into the freezer for use later.

Don’t want to bother with the cutting and cleaning? Many companies are now doing the work for you by selling raw winter squash already cut and ready-to-use. Here’s a food safety tip: once cut, the squash they should be kept refrigerated and used within a week.

Technically — or should I say botanically — squash are fruits, since the fruit is the part of the plant that develops from the flower and contains seeds. But we usually consider squash a vegetable because it’s more savory in flavor.

Finding a new (or old in this case) variety of squash can increase interest and perhaps add a few more items onto that list of foods you like. How will you incorporate new fruits and vegetables into your eating pattern?

By Cheryle Jones Syracuse, MS, Professor Emeritus at The Ohio State University

As a bonus, here’s a free handout that features fun facts about the Blue Hubbard Squash!

blue-hubbard-squash

And here are a few great fruit and vegetable resources…

It’s National High Blood Pressure Education Month!

It’s National High Blood Pressure Education Month!

Help educate your audience about hypertension with these free slides, which are excerpted from the top-selling presentation Blood Pressure 101, available now in the Nutrition Education Store.

BloodPressure101 Slide 1

This little preview will also include the speaker’s notes for each slide, so welcome to today’s show! At this presentation, we’ll discuss what blood pressure is and how to measure it. We’ll also cover the effects of hypertension and how you can lower your health risks.

Blood Pressure101 Slide 2

First let’s talk vocabulary. Blood pressure measures the way your blood presses against the walls of your arteries. To measure it, first a doctor will measure the pressure on your arteries during each heartbeat. Then that doctor will measure the pressure on your arteries between each heartbeat.

When you measure pressure on the arteries during each heartbeat, it’s called taking the systolic pressure. When you measure pressure on the arteries between each heartbeat, it’s called taking the diastolic pressure. As you age, your diastolic pressure generally decreases and you should pay more attention to systolic blood pressure. However, you should never ignore your diastolic blood pressure. In fact, when you’re young, that’s the number you really want to watch.

A doctor generally looks at both your systolic and diastolic numbers when determining whether or not you have high blood pressure. How the two factors interact is important, as is the level of each. High blood pressure is also called hypertension.

BloodPressure101 Slide 3

Now let’s take a look at how to interpret blood pressure results. Normal blood pressure is 119/79 or less. If your blood pressure is between 120/80 and 139/89, then you have prehypertension. If your blood pressure is 140/90 or more, then you have hypertension.

BloodPressure101 Slide 4

Ah! It’s time for a quiz. Now, If a person has a systolic reading of 118 and a diastolic reading of 78, what is that person’s blood pressure? The correct answer is 118/78.

Let’s move on to the next question. True or false? High blood pressure is also called hypertension. That answer is true!

The PowerPoint goes on to explore the health effects of high blood pressure, how to test blood pressure and interpret the results, and how to treat and even prevent hypertension. The presentation is peppered with quick quizzes to test knowledge and promote participant engagement too. If you like what you see, consider getting the whole show!

And of course, here are PDF copies of the slides we featured today. What will you do with yours?

BloodPressure101 Collection

And here are some more materials for High Blood Pressure Education Month!

Sodium Math: What We Learned

Sodium Math PosterHave you seen the Sodium Math poster yet? We released it shortly after the Dietary Guidelines for Americans debuted earlier this year. It’s a fantastic resource for displays, presentations, and even simple office decoration. With engaging questions and alluring graphics, this poster teaches valuable lessons about salt in a memorable way.

Of course, putting it together was no mean feat.

Today I want to walk through the process of creating this poster — I figured it would be useful for your own designs and displays. There were even 3 top lessons that we learned as we put the poster together! Plus, sodium is one of those food elements that most people don’t know enough about.

You see, once the latest edition of the Dietary Guidelines for Americans was officially released, I just knew that we had to create some kind of visual guide to dealing with sodium. But what? And how?

There’s always a lot of confusion about where sodium comes from in our daily diets. People hear the word “sodium” and they automatically equate that with “salt shaker.” However, the salt shaker is only responsible for a tiny amount of the sodium that most people consume each day. Most of the sodium (about 75%) comes from what is present in restaurant meals and packaged meals from the grocery store.

The Sodium Math poster is an engaging visual that shows how much sodium we are actually consuming versus how much is the maximum for good health.

SALTIt’s a bit of a shock to see the big pile of sodium that we eat each day and to see the teaspoons of sodium that each food contains! To balance that shock, the poster also showcases many fresh foods that are low in sodium. The poster clearly illustrates the lesson that a little work to eat 1,000 mg less sodium per day can make a big change in blood pressure.

This infogram poster was fun to work on and we learned a lot. Here are the top 3 lessons we learned in the making of this poster…

Lesson #1: True Sodium Content

One of the biggest shocks to us in the research was about how much sodium is in fast food. Turkey sandwiches sound healthy, but a turkey deli sandwich has 2,810 mg of sodium. That’s almost a 2 day supply!

Lesson #2: Planned Overs

After reading this poster, we devoted more effort to making “planned overs.” (That’s when we cook extra food for dinner and eat it for lunch the next day). Cooking your own meals at home can make a huge difference in your health, especially when it comes to sodium.

Behind the Scenes: Sodium ContentLesson #3: Small Shifts Are Important

The Dietary Guidelines for Americans 2015 recommend that just a small shift to lower sodium intake by 1,000 mg per day can make a positive impact on lowering blood pressure. This lesson was new to us and it seems relatively easy to implement. Plus, everyone loves an easy math lesson! We chose math because we wanted a way to explain sodium, salt, sodium intake, recommended sodium intake and changes needed, along with engaging food photos that can illustrate the whole lesson quickly.

So there you have it! A little peek behind the curtain and 3 lessons we learned while creating the Sodium Math poster.

As a special bonus, here’s a copy of one of our top printable sodium handouts! Reduce Salt has lots of tips and tricks for lowering the sodium in your diet. Get your free copy today!

Sodium Reduction Handout

And there are lots of other amazing sodium resources in the Nutrition Education Store! Here are a few fan favorites…

Water Fitness — It’s Not Just for Seniors

Water Fitness ClassWe all know that regular exercise is important for good health. We also know that it’s vital to find something you like or you won’t continue it. If you’re struggling with finding a program that works for you, needing to mix it up a little, or looking for a change, why not try my favorite activity?

Water fitness.

You may think that this is something just for older people (yikes!) but there are different programs and types of classes for all ages and fitness levels. Water fitness (or water aerobics) programs and classes can help develop flexibility, muscular strength and endurance, and even deliver cardio-respiratory benefits. Other physical benefits include increased range of motion, improved balance and coordination, and a chance for some relaxation.

Exercising in water is different than land exercise. These differences create a great environment for a fitness program.

Resistance. Since the viscosity of water is greater than that of air, the resistance to movement is greater. Water provides 12 to 14 times more resistance than air during exercise. This resistance is also evenly distributed. As an added bonus, water works the opposing muscles too. Kickboards, water weights (or hand buoys), or water noodles are often used to create additional resistance for strength building.

Using ResistanceInertia. This is the force needed to move from a stopped position or to change direction. In water fitness, the inertia is against both the water and current. Once the momentum in one direction has been achieved, it takes additional energy to reverse the direction of motion.

Body Surface Area. The water itself creates drag as it moves against the body, which can add intensity to the workout. Moving through the water creates more drag. Equipment such as webbed gloves and paddles increase these drag forces of the water, which can help build fitness.

Thermal Regulation. Water maintains the core temperature and establishes a balance between metabolic heat production and heat loss. The water naturally cools the body down and therefore your core temperature tends to be lower and you don’t even realize you’re sweating.

Intensity. The intensity of a workout can be increased or decreased with speed. Also, moving/traveling or working in deeper water increases intensity.

Yay for water fun!Buoyancy. This is one of the major positive aspects of water fitness. In water, the body has buoyancy. This makes water fitness easier on joints and bones. Because of the buoyancy, participants can jump without the limitation of gravity and the fear of falling and getting hurt. Being submerged or partially-submerged gives more and enhanced range of motions and freedom of movement. All of this allows workouts to become less painful.

Water fitness is something you can do alone, with a friend, or in a class. On top of all these good things, the water can relax your body — enjoy that water massage! With water fitness, you’re sure to have fun!

By Cheryle Jones Syracuse, MS, Professor Emeritus at The Ohio State University

Here are more fitness resources, fresh from the Nutrition Education Store!

Calorie Balance Poster

Home Exercise PowerPoint and Handout Set

Exercise Poster

And finally, last but not least, here’s a free PDF handout with great information from today’s post!

Water Fitness

Sneak Peek: Weight Management PowerPoint Show

It’s time for an exclusive look at of the most popular new presentations in the Nutrition Education Store. The Just Lose 10% PowerPoint presentation covers ways to live a healthful lifestyle while successfully managing your weight. Emphasizing the latest health and nutrition research, this life-changing presentation has been a hit for many dietitians and other health educators.

Today this blog will feature 2 of the sections in this show, just for you, for free. The full rundown includes…

  • Assess Your Weight
  • Set Your Goal
  • Benefits of 10% Loss
  • Weight Control 101

This post features the Set Your Goal and Benefits of 10% Loss sections. Are you ready for this?

Why Choose 10%

Speaker’s Notes: Okay, first things first. Why choose 10%? Why is this the goal of the show? Well, the answer is twofold. One, if you’re overweight or obese, losing only 5-7% of your current body weight can prevent or delay the onset of type 2 diabetes. And two, losing 10% of your body weight can decrease your heart disease risk. Both of these are key for a long and healthy life. Improve your health with a little weight management!

The First Attainable Goal

Speaker’s Notes: Another reason to set “lose 10% of your body weight” as a weight management goal is that successful weight loss requires a sustained effort over time. Quick fixes are often hard to keep up and make it easy to backslide into less healthful habits. That’s why setting a goal is so important – it gives you something to strive for. And losing 10% of your body weight is attainable and will make a significant difference to your health.

Benefits of Weight Management

Speaker’s Notes: Let’s take a closer look at the benefits of managing your weight well.

What's In It for You?

Speaker’s Notes: So, what’s in it for you? Why is it so important to reduce your weight if you’re overweight or obese? The short answer is that it’s key for your health. When you get your weight into a healthy zone, you reduce your risk of heart diseases like hypertension or even a heart attack. You also reduce your risk of stroke, certain cancers, and type 2 diabetes. This in turn means that you are more likely to live longer, while being less likely to have to take medications to combat these chronic conditions. Getting to skip those medications further improves your quality of life.

Even More Health Benefits

Speaker’s Notes: These are all benefits that accompany a healthful lifestyle and gradual weight loss. When you adopt a healthful lifestyle in your quest to manage your weight, you are more likely to sleep better, have more stamina, have more energy, improve your flexibility, and find it easier to do the things you love.

Do you like what you see? There’s a lot more in the show — over 35 slides of the latest research about weight management, health, and wellness. Check out the full presentation!

And here’s a PDF copy of the slides we featured today…

Just Lose 10%

 

Remember, we’re here to help you look your very best, right now. Don’t miss these other great weight management resources…

12 Lessons of Wellness and Weight Loss

Weight Control Poster Value Set

PowerPoint: Exercise to Lose and Control Weight

Be the One

I’m sure you’ve noticed that healthful options are rather limited at most pot luck meals. These events tend to bring out the fat, sugar, sodium, and calorie-laden foods from everyone’s recipe boxes.

Shared Meal My husband and I were recently invited to such a party and he asked “will there be anything there I can eat?” (If you’ve been following my posts, then you know that my husband had a heart attack a year ago and is trying very hard to maintain a heart-healthy diet and lose some weight).

I was glad he asked. It shows that he’s thinking ahead.

Planning is always one of the suggestions offered to folks who are trying to maintain a special diet at social events. When in doubt, take something that you know you can eat.

With this thought in mind — and the holiday party season approaching quickly — I asked the participants in my heart-healthy cooking class what they would take to a pot luck party. Here are their ideas…

  • Chocolate angel food cake (no egg yolk and no frosting)
  • Apple squares (made with fresh apples, using apple sauce to replace any fat)
  • Quinoa salad with fresh spinach and a lemon dressing
  • Fresh greens tossed with strawberries, almonds, and homemade vinaigrette
  • Baked spinach balls
  • Baked tortilla chips with homemade salsa
  • Low-salt potato chips*
  • Swedish meatballs made with ground chicken and low-sodium gravy
  • Slices of Honeycrisp apples

I added a few suggestions of my own as well:

  • Veggie sticks and hummus
  • Dried fruit and nuts
  • Fresh fruit with a yogurt dip

I think my class members get it. They understand the need to be the ones to bring the healthful stuff. However, this doesn’t mean that they don’t have reservations and concerns. I heard comments like  “we’ve done this before and no one ate the healthy foods,” “no one else will eat it,” and “I’ll end up taking it home.”

That’s okay. In fact, it may actually be a bonus. Take it home and you’ll have something for tomorrow. At least you were the one that took something healthful. Yes, I know it’s hard to eat apple slices when there’s a gooey dessert available. But eating a few apple slices means that you’ll be more full and have less room when you slice yourself a bit of that gooey dessert.

Start a trend. Be the one.

By Cheryle Jones Syracuse, MS, Professor Emeritus, The Ohio State University

Want to encourage your clients to be the one? Here are 10 great (and free!) recipes for healthful pot luck options…

And, as always, there’s more right here in the Nutrition Education Store. Here are some great holiday survival materials…

Holiday Secrets: Healthy Holiday Recipes

Holiday Challenge: Strategies to Help People Stay on Track During the Holidays

Poster: Holiday Survival Tips

*I have a little problem with this response, since there is still a lot of fat in this product. At least she was thinking about the sodium!

Substitute a Fruit for a Fat

I’ve been looking for more ways to modify recipes to make them more healthful.  This quest started as part of my recent Heart-Healthy Cooking class, but it has continued as part of my regular life. Revising recipes to make them better for your health can be an objective for anyone who wants to eat a little less fat, cholesterol, and sugar.

Prunes in BlenderLet’s start small.

Two great replacements for butter, oil, and sugar in baking projects are applesauce and prune puree.

Why?

Well, both applesauce and prune puree can replace half of the fat in many recipes. So if the recipe calls for 1 cup of oil, you can use ½ cup of applesauce and ½ cup of oil. You may also need to reduce the baking time by up to 25%. Watch your baked goods closely and pull them out as soon as they’re cooked through.

So why do applesauce and prunes make decent fat replacements in recipes? The answer lies in the fruit. You see, the fruit provides both moisture and structure to the baked goods. That’s why this substitution is best for foods like apple cakes or brownies, though it works well in cookies and cakes too.

Let’s take this a little further. There are other benefits to these substitutions.

For example, when you add applesauce or prune puree to a recipe, you may be able to reduce the amount of sugar. The natural sugars in the applesauce and prune puree provide additional sweetness, which can be balanced by a reduction in the sugar you add to the recipe. To avoid over-the-top sugar content, be sure to purchase unsweetened applesauce.

By making this substitution, you’re also adding a little more fruit to the recipe! Yay! That’s more fiber and nutrients than you would have gotten with the original recipe.

So, how can you put this plan into action?

You can buy ready-made prune puree or just make your own by combining six tablespoons of hot water and eight ounces of prunes (about 23) in the blender. This makes about ¾ cup of prune puree.  Note: for diabetics, this approach does increase the carbohydrate count in the end product.

And of course, you can make your own unsweetened applesauce or pick up a jar at the store.

Brownies, ReimaginedSubstitution Tips:

Applesauce seems to go best with lighter colored and flavored products. Think apple cakes or oatmeal cookies.

The prune’s flavors and colors go well with chocolate and spicier treats like gingerbread, spice cake, and brownies.

These substitutions do work with box mixes, but you have more control over the other ingredients if you make the entire recipe from scratch.

By Cheryle Jones Syracuse, MS, Professor Emeritus at The Ohio State University

Yes, there’s totally a free handout too. Check it out!

Healthful Holiday Baking

There are tons of other ways to make your holiday celebrations more healthful! Check out these wonderful holiday education resources

Holiday Challenge Kit

Holiday Challenge Kit

Holiday Secrets Book and Cooking Demo Program

Holiday Secrets Book and Cooking Demo Program

Holiday Poster Value Set

Holiday Poster Value Set

Holiday Fruit Lights Cards

Holiday Fruit Lights Cards

 

Heart Attack Prevention: Are Statins or Eating Habits More Important?

Medication or Diet?If elevated low density lipoprotein cholesterol (LDL-C) levels were the only source of cholesterol deposited in the artery wall, then high doses of potent statins should be reversing (rather than reducing) the build-up of atherosclerotic plaques, largely eliminating deaths from coronary heart disease (CAD). Sadly, the number one cause of death in Americans taking statins to lower their elevated LDL-C to prevent heart attacks is still heart attacks?

Yes, statin drugs are very effective for reducing high LDL-C levels, and they do slow the progression of cholesterol-filled plaques. However, they rarely reverse the build-up of cholesterol in the artery wall. More importantly, statin drugs alone do not come close to eliminating the risk of heart attacks and most strokes despite impressive reductions in LDL-C levels. Research now shows that other lipoproteins besides LDL particles can and do carry cholesterol from the blood into the artery wall, promoting the growth of cholesterol-filled plaques and CAD. These lipoproteins are neither LDL-C or high density lipoprotein cholesterol (HDL-C), but rather consist of the cholesterol-rich remnants of triglyceride-rich lipoproteins produced by the liver (VLDL) and the small intestine (chylomicrons)(1). Both genetic factors and dietary factors influence the amount of these triglyceride-rich lipoproteins produced and also the amount of cholesterol-rich remnant particles derived from each of them in the blood. Fat and cholesterol-rich meals can dramatically increase the production of chylomicrons and lead to greater amounts of cholesterol-rich chlyomicron remnants in the blood for several hours after each fat-rich meal (2).

Dr. Borge Nordestgaard’s recent study followed nearly 12,000 people with established CAD in Denmark and found that each 1 mmol (38.7 mg/dl) increase in non-fasting remnant cholesterol caused 2.8 times greater risk of a CAD event that was independent of HDL-C levels. The increased causal risk of CAD from elevated cholesterol remnant particles appeared much stronger than for changes in either LDL-C or HDL-C levels (3). Most doctors (MDs) now check only fasting blood lipids and focus largely on LDL-C and HDL-C to assess their patient’s future CAD risk. This was based on the simplistic notion that it was only the LDL-C particles delivering cholesterol to the artery wall, making it the “bad” cholesterol, while the HDL-C particles were removing the cholesterol from the artery wall and bringing it back to the liver, making their cholesterol content “good”. Of course, we now know HDL-C particles can actually become proinflammatory and proatherogenic “bad” HDL particles, perhaps partly in response to biochemical changes in the HDL particles triggered in part by chylomicrons and other remnant cholesterol particles in the blood.

Chylomicrons and their cholesterol-rich remnants remain in the blood for several hours after each fat-rich meal and likely play a major role in promoting inflammation (by increasing IL-6 & CRP), thrombosis (by activating clotting factor VII), and atherosclerosis (by delivering more cholesterol-rich remnant particles to the artery wall). The fact that damage to the endothelium (inside “skin” of the artery wall) as evidenced by reduced flow mediated dilation (FMD) occurs to a much greater extent after a single fat-rich meal than after a meal high in carbohydrate points to the fact that pathological changes must be occurring in the artery wall in response to fat and cholesterol-rich particles coming from the intestines (4). Indeed, this reduced FMD is likely the main reason why many people with angina tend to experience far more chest pain after a large, fat-rich meal than they do after a meal high in carbohydrate-rich plant foods. The only legitimate debate is not whether LDL-C or other cholesterol-rich remnant particles promote atherosclerosis and increase the risk of CAD, but rather which is more atherogenic. Clearly both LDL-C and other remnant lipoprotein particles deliver cholesterol to the artery wall and promote foam cell formation and atherosclerosis. Unlike LDL-C particles (which must first be oxidized), remnant cholesterol particles are readily taken up by scavenger receptors of macrophages in the cell wall to form foam cells (5,6). Increasing evidence suggests that damage to the artery wall from cholesterol-rich remnant particles appears to be at least as important as either fasting LDL-C or HDL-C levels for predicting future CAD events.

It should be noted that diets high in refined carbohydrates (particularly large amounts of refined sugars) combined with inactivity can contribute to a marked increase in the liver’s production of VLDL particles because the liver converts some of the excess carbohydrate (especially fructose) into triglyceride. This leads to more triglyceride-rich VLDL particles being released into the blood, which then degrade into cholesterol-rich remnant particles and eventually also LDL particles. This is particularly true in people who are genetically prone to develop insulin resistance and type 2 diabetes and who experience significant increases in fasting triglyceride levels as visceral fat stores accumulate.

Bottom Line: Reducing LDL-C levels with statin drugs alone is insufficient for stopping and reversing CAD and preventing most heart attacks and strokes. A diet low in fat, salt, cholesterol, and refined carbohydrates coupled with increased activity and loss of excess weight may also be necessary to stop and reverse CAD in part by reducing remnant cholesterol levels in the blood.

By James J. Kenney, PhD, FACN

Sources:

  1. Mark Nordestgradd BG, Freiberg JJ. Clinical relevance of nonfasting and postprandial hypertriglyceride and remnant cholesterol. Curr Vasc Pharm. 2011;9:281-6
  2. Mark Cesar TB, et al. High cholesterol intake modifies chylomicron metabolism in normolipidemic young men. J Nutr 2006;136:971-6
  3. Mark Varbo A, et al. Remnant cholesterol as a causal risk factor for ischemic heart disease. J Am Col Cardiol. 2013;61:427-36
  4. Mark Tomaino RM, Decker EA. High-fat meals and endothelial function. Nutr Rev. 1998;56:182-5
  5. Mark Zilversmit DB. A proposal linking atherogenesis to the interaction of endothelial lipoprotein and triglyceride-rich lipoproteins. Circ Res.1973;33:633-8
  6. Mark Nakajima K, Nakano T, Tnaka A. The oxidative modification hypotheis of atherosclerosis: the comparison of atherogenic effects of oxidized LDL and remnant lipoproteins in plasma. Clin Chim Acta. 2006;367:534-42

Looking for fun ways to improve your clients’ understanding of cholesterol and its health risks? Check out this free handout: Cholesterol Puzzle.

Cholesterol Puzzle Handout

And, as you well know, there are tons of other heart health education materials available in the Nutrition Education Store. Pay special attention to the posters, which have been flying off the shelves lately!

LDL Cholesterol Poster

Premium Heart Health Education Kit

Heart Health Brochure: Lower Your Heart Attack Risk

Blood Pressure Poster