Pass the Spuds, Pass Up the Butter

Want to tank up on cholesterol-busting complex carbs? Follow these simple tips.

• Try to avoid processed foods, which tend to contain added fat, salt and sugar, advises dietitian Marilyn Guthrie, R.D., manager of health promotion for Virginia Mason Medical Center in Seattle. So eat baked potatoes instead of potato chips and whole-grain cereals instead of the highly refined, sugary kinds, says Guthrie. (You might also opt for plain white or brown rice instead of preseasoned rice mixes, which can be high in fat and sodium.)
• Make room for fruits and vegetables. Apples, bananas, blackberries, prunes, pears, parsnips, acorn squash, corn and yams are rich sources of complex carbs and fiber. If fresh vegetables aren’t available, opt for frozen-they’re just as high in fiber and nutrients.
• Learn to eat bread (preferably the whole-grain kind) without butter. You might top your morning toast with sugar-free jam or apple butter or even learn to enjoy the delicious simplicity of plain wholegrain bread.
• Jazz up vegetables with herbs instead of butter or cream sauces, says Sue Chapman, executive chef at Skylonda Fitness Retreat in Woodside, California. “Flavor broccoli with rosemary, and bok choy with chopped cilantro, chives or scallions,” she suggests.
• Sprinkle baked potatoes with Parmesan cheese, suggests Guthrie. You might also try nonfat sour cream or a dab of spicy brown mustard or low-fat salad dressing.
• Don’t drown carbo-packed pastas in fatty meat sauces and cheeses. Instead, flavor spaghetti with low-fat tomato sauce or a drizzle of olive oil, fresh garlic and parsley.

Can Pasta Make You Fat? The Facts

A while back you couldn’t turn on the television or pick up a newspaper without being confronted by this ugly little phrase: “Pasta makes you fat.” Well, does it or doesn’t it? Here’s what you need to know.
According to some experts, people who produce too much insulin-the hormone that helps metabolize starches and sugars-may gain weight on a high-carbohydrate, low-fat diet. These experts theorize that such “insulin-resistant” people may comprise up to 25 percent of the population.
But other health professionals say that for the remaining 75 percent of us who are not insulin-resistant, whether pasta leads to weight gain depends on how much of it we eat and what we ladle on top of it.
There’s some evidence that a high-carbohydrate diet can raise triglycerides (a type of blood fat implicated in heart disease) and lower levels of HDL cholesterol (the “good” kind) in insulin-resistant people, says Wahida Karmally, R.D., director of nutrition at the Irving Center for Clinical Research at Columbia-Presbyterian Medical Center
in New York City, a member of the American Heart Association’s nutrition subcommittee and part of a research study examining this issue. But you can’t blame pasta for your excess pounds “unless you eat loads and loads of it,” says Karmally. “It’s the overall carbohydrate intake that counts, not just pasta, or just rice, or just potatoes.”
“You have to distinguish between complex carbohydrates and simple carbohydrates,” says Dean Ornish, M.D., president and director of the Preventive Medicine Research Institute in Sausalito, California, and author of Dr. Dean Ornisb’s Program for Reversing Heart Disease. “Complex carbohydrates-fruits, vegetables and grains-do not raise your insulin level and blood sugar.” Dr. Ornish recommends that pasta-lovers avoid sauces and toppings containing fatty ingredients such as butter, oil, cream and sausage.

So feel free to enjoy that plate of pasta or that slice of fresh-baked bread. Prepared correctly and eaten in moderation, foods high in complex carbohydrates can make low-fat, low-cholesterol eating a breeze. Here’s how to power up your diet while helping to trim down your cholesterol.

Complex Carbohydrates: Simply Delicious
There are two types of carbohydrates: sugars (simple carbohydrates) and starches (complex carbohydrates). Simple carbohydrates are abundant in fruits, vegetables, honey, corn syrup, milk and sugarcane. Complex carbohydrates are found primarily in breads, pastas, rice and other grains, beans and potatoes.

There’s a lot to recommend complex carbohydrates. Starches release their energy more slowly than sugars, making you feel fuller longer. Further, foods high in complex carbohydrates tend to be low in fat and high in fiber-both soluble fiber, which has been proven to lower blood cholesterol, and insoluble fiber, which helps keep you regular and protect against colon cancer.
The government recommends that we eat 6 to 11 servings of reads, cereals, rice and pastas per day. While that may seem like a ot, filling up on complex carbs isn’t as hard as you might think, says Iindy Hermann, R.D., a nutrition consultant in Mount Kisco, New ok. “A couple of slices of toast for breakfast equals two servings,” says Iermann. “If you have a turkey burger for lunch, the bun counts as .’:10ther two servings. The bag of pretzels you have as an afternoon snack may count as two servings, depending on the size of the bag. And a big plate of pasta for dinner might add up to four servings. That’s ten servings right there.”

Researchers at Boston University polled 858 women hospitalized with a first heart attack and an equal number of healthy women on their health habits, including coffee consumption. Researchers found that compared with non-coffee drinkers, women who said they drank five to six cups of coffee a day had a 40 percent greater risk of having a heart attack; women who drank seven to nine cups, a 70 percent greater risk. But women who drank less than five cups of coffee a day had no higher risk than women who didn’t drink coffee at all.
Investigators at Kaiser Permanente Medical Center in Oakland, California, evaluated the relationship between coffee and tea intake and mortality rate-including deaths from coronary heart disease-in nearly 129,000 people. After an eight-year follow-up period, neither coffee nor tea was found to have increased the overall death rate in these individuals. Drinking four or more cups of coffee a day was tied to a slightly higher risk of death from heart attack. however. Researchers at Johns Hopkins Medical Institutions in Baltimore had 100 healthy men drink varying amounts of filtered coffee: 24 ounces of regular coffee, 12 ounces of regular coffee, 24 ounces of decaffeinated coffee or no coffee at all. After eight weeks, the men who drank the 24 ounces of regular coffee a day experienced small increases in their total cholesterol, due to slight rises in their “bad” LDL and “good” HDL cholesterol. The researchers concluded that these small increases in LDL and HDL together “should not affect coronary heart disease risk.” That’s because small changes in HDL can protect against much larger changes in LDL, explains Dr. Castelli.
In Israel, researchers analyzed coffee and tea consumption and cholesterol levels in 5,369 people. The investigators’ conclusion: The individuals who drank five or more cups of coffee a day had higher levels of total cholesterol-as much as 18 milligrams/deciliter higher-than the individuals who abstained from coffee. The researchers also noted that the people who drank the most coffee in their study were also the most likely to have negative health habits, especially smoking. “It is conceivable that the increased cholesterol levels in smokers may be confounded by coffee drinking,” wrote the researchers.
Some coffee drinkers may make other lifestyle choices that may be responsible for elevating their cholesterol levels, suggests Connie Diekman, R.D., a dietitian in St. Louis and a spokesperson for the American Dietetic Association. For example, “caffeine tends to stimulate hunger in certain people,” says Diekman. “Some people may respond by eating foods that increase their cholesterol levels. But it’s difficult to isolate the effect of caffeine on cholesterol and to determine whether the increases in cholesterol are caused by caffeine or by something else.”

Some studies suggest that coffee can raise cholesterol levels; others conclude just the opposite. Most of the studies conducted in the United States have found that people who don’t drink coffee have higher rates of coronary heart disease than coffee drinkers! In fact, the prestigious Framingham Heart Study concluded that drinking up to five cups of coffee a day may actually have lowered the risk of coronary heart disease, says William P. Castelli, M.D., medical director of the Framingham Cardiovascular Institute, a wellness program at Metro West Medical Center in Framingham, Massachusetts.

The good news is, consuming moderate amounts of coffee does not appear to raise the risk of heart disease. What’s more, some experts say that a cup or two of coffee a day shouldn’t significantly affect your cholesterol level. (No large studies have been conducted on the effect of other caffeinated foods or drinks-such as chocolate or cola-on blood cholesterol levels.)

But caffeine can affect the body in other ways. Consumed in large amounts, it can sap bone strength and accelerate the heart rate. Further complicating the coffee/cholesterol issue: the role of nicotine. Some studies note that avid coffee drinkers tend to smoke more than people who drink coffee in moderate amounts, and smoking has definitely been implicated in the development of coronary heart disease.

A STRIKE AGAINST DIABETES

People with diabetes run an increased risk of developing heart disease. For them, chromium may improve glucose tolerance, which is a measure of how well glucose, or sugar, is absorbed into the blood and transported into the cells, according to Richard A. Anderson, Ph.D., lead scientist at the U.S. Department of Agriculture Human Nutrition Research Center in Beltsville, Maryland.
Most people with diabetes have glucose intolerance, a condition in which blood sugar levels are out of control. That’s because insulin, a hormone that helps control blood sugar levels, doesn’t work properly. Chromium particularly benefits people who already have diabetes by making insulin work more effectively.

In one study, Dr. Anderson, a leading expert on chromium, had 17 people-8 of whom had mild glucose intolerance-eat a chromiumpoor diet. After a month, Dr. Anderson divided these people into two groups. While both groups continued on the low-chromium diet, the first group took 200 micrograms of chromium per day. The second group received placebo pills. Five weeks later, the groups were switched, with the first group receiving the placebo pills and vice versa.
The chromium supplements didn’t affect blood sugar levels in the glucose-tolerant folks. But the blood sugar levels of the glucose-intolerant people rose nearly 50 percent less when they were taking chromium supplements than when they didn’t take these supplements. The upshot? Chromium may reverse glucose intolerance, says Dr. An-
derson.

Some studies indicate that chromium, which helps control the way your body uses sugar and fat, may boost the body’s stores of “good” HDL cholesterol. “When people who follow a normal diet-which .ends to be marginally chromium-deficient-consume more chromium, their cholesterol and triglyceride levels benefit,” says Richard A. Anderson, Ph.D., lead scientist at the U.S. Department of Agriculture Human Nutrition Research Center in Beltsville, Maryland, and a leading expert on chromium. What’s more, chromium may help people with glucose intolerance avoid developing non-insulin-dependent (Type II) diabetes. Having diabetes increases the risk of developing heart disease. (See “A Strike against Diabetes.”)