ADVICE YOU CAN TAKE TO HEART MEDITERRANEAN-INSPIRED DIET FROM CLEVELAND CLINIC IS GOOD ... AND GOOD FOR YOU.

Byline: Natalie Haughton

Food Editor

You don't even think about it. Someone brings in brownies to your office. One won't hurt.

Will it?

You're healthy, right? Though a bit overweight, you exercise some. Your cholesterol is OK, not great, but you've never smoked.

Heart disease? You think it can't happen to you.

Unfortunately, a lot of people are in denial about how those brownies can add up -- even Dr. Ismael Nuno, chief of cardiac surgery at Los Angeles County/USC Medical Center.

"I had a heart attack in an airplane at 35,000 feet," he says, recalling running from his seat, locking himself in the restroom, passing out and ending up drenched in sweat and cold. "I didn't think I was having a heart attack, and I'm a surgeon."

Following a heart-healthy lifestyle and diet, even if you don't have cardiovascular disease, just might save your life.

Last year, 990,000 people in this country died from heart disease and stroke (known as cardiovascular disease), Nuno points out, adding that heart disease is the nation's No. 1 killer of men and women, with stroke at No. 3.

Family history, diabetes, hypertension, high cholesterol and smoking are the risk factors for developing coronary heart disease. And "no one is free of atherosclerosis (build up of plaque in the arteries)," says Nuno. "We all have plaque -- some more than others."

But heart disease is largely preventable because many of the risk factors are things you can control. That means it's never too soon to pay attention to the amount of saturated fat, trans fat, cholesterol and sodium you consume -- and to manage your weight with diet and exercise.

"A sound diet and healthy lifestyle will always be the bedrock of cardiovascular health," says Dr. Steven E. Nissen, chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic Heart and Vascular Institute. "A lifestyle that combines a Mediterranean diet, fiber, fruits, vegetables and whole grains, weight loss, relaxation, exercise and tobacco avoidance can lower blood pressure, bad cholesterol, blood sugar and insulin."

Not surprisingly, some people are turned off by food that's labeled heart-healthy.

"The minute recipes are labeled heart-heathy, everyone is automatically skeptical of them, because books in the past haven't contained flavorful recipes," says Melissa Ohlson, a registered dietitian and nutrition projects coordinator for preventative cardiology at the Cleveland Clinic.

Ohlson wrote the nutrition information, menu plans and recipe analysis in the recently released "Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook," by Bonnie Sanders Polin, Ph.D., and Frances Towner Giedt (Broadway Books; $29.95).

"We spent a year developing, testing and tasting the 150 recipes," she says, adding that excellent flavor, eye appeal, nutritional value and variety were

paramount.

"We are using whole foods, fresh ingredients and healthy fats (olive oils, nuts and seeds like flax seeds) -- and not all low fat. Low fat is not necessarily the way to a healthy heart -- it is choosing the right fats (olive oil, canola, olives, avocados, nuts and seeds, oily fish like salmon, mackerel, tuna, sardines and anchovies).

"Regardless of someone's risk, we should all be eating this way. The book's goal is to put the power of 'cardio-protection,' which is protection from heart and vascular disease, into your hands.

"People don't realize how powerful changing your lifestyle can be," stresses Ohlson.

Polin, who co-authored the book with Towner Giedt (recently deceased), has been writing cookbooks for 15 years, several geared to diabetics (she's a type 1 diabetic). The recipes in this volume have been designed to "run the gamut from quick and easy to gourmet so that the entire family -- including kids -- and friends -- can dine together on healthy, varied and delicious food, providing all with better heart health. I've been cooking this way 20 years," says Polin, adding that she had triple-bypass surgery at 48.

"It's not that difficult to learn to modify cooking styles. Anyone can adopt and live this lifestyle -- and 60 percent of the American population wouldn't be overweight if they did," she adds.

Avoid white foods, opting instead for whole-wheat bread, whole-wheat pasta (Polin favors Barilla brand multigrain pasta), brown rice, whole-grain couscous and the like. Polin cooks and bakes with Smart Balance (margarine), egg whites or Egg Beaters and low-fat sour cream or reduced-fat cream cheese. Remove skin from chicken breasts, buy beef tenderloin for parties and use rump roast rather than chuck or brisket, she advises.

Some recipes utilize shortcuts like reduced-sodium and fat-free organic broths, reduced-sodium canned tomatoes and even puff pastry filo dough and trans-fat-free cookies in small amounts for convenience. And they advise readers to buy canned beans, fat-free canned skim milk and reduced-fat cheeses.

Denial may be the easy route. But you must get honest with yourself and open your eyes to what you are eating and how much you're exercising. Figure out what you can do to protect yourself, and then stick with it. Be an informed and educated consumer -- and know how to read food labels.

Natalie Haughton, [phone]

[e-mail]

TUSCAN BEAN SPREAD

Olive oil cooking spray OR 1/2 teaspoon extra virgin olive oil

4 large shallots, chopped

4 garlic cloves, minced

1 1/2 tablespoons chopped fresh rosemary

1 tablespoon chopped fresh oregano 

1/2 teaspoon fennel seeds

2 (15-ounce) cans cannellini beans, drained

3 3/4 cups fat-free, reduced-sodium chicken broth OR vegetable broth

1/3 to 1/2 cup fresh lemon juice

Lightly coat bottom of a nonstick pot with cooking spray. Add shallots and garlic and cook, stirring, over medium heat until shallots are wilted, about 5 minutes. Add rosemary, oregano and fennel seeds. Cook, stirring, 1 minute more. Add beans and broth, and bring to a boil. Reduce heat and simmer on low heat 8 to 10 minutes. Remove from heat.

When bean mixture is cool, transfer it to a food processor or blender. Puree, adding lemon juice as needed for desired consistency. Use spread to make a sandwich on whole wheat bread with grated carrots, radish sprouts and chopped tomatoes or serve as a party spread with lavosh, crudites or small sesame bread sticks.

Makes 3 cups, 16 servings

NUTRITIONAL INFORMATION PER SERVING (3 tablespoons spread): 55 calories, 0 grams total fat, 0 milligrams cholesterol, 116 milligrams sodium, 11 grams carbohydrate, 3 grams dietary fiber, 3 grams protein, 245 milligrams potassium.

From "Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook," by Bonnie Sanders Polin, Ph.D., and Frances Towner Giedt.

CHICKEN BREASTS WITH TOMATO-KALAMATA SAUCE

(On the cover)

1 teaspoon dried oregano, crumbled

1/2 teaspoon paprika 

1/2 teaspoon chili powder

4 boneless, skinless chicken breasts halves (about 4 ounces each), all visible fat discarded

1 teaspoon olive OR canola oil

1/2 cup water

1 medium tomato, seeded if desired and chopped

12 Kalamata olives, coarsely chopped

1 medium garlic clove, minced

1/4 teaspoon pepper

1/8 teaspoon salt

1 1/2 ounces reduced-fat feta cheese, crumbled

In a small bowl, stir together oregano, paprika and chili powder. Sprinkle over chicken. Using your fingertips, press mixture firmly onto chicken so mixture adheres.

In a large nonstick skillet, heat oil over medium heat, swirling to coat bottom. Cook chicken with smooth side down 5 minutes. Turn and cook 4 minutes, or until chicken is no longer pink in center. Transfer to a serving plate.

Add remaining ingredients, except feta, to skillet. Stir. Increase heat to medium high and bring to a boil, scraping bottom and sides of skillet to dislodge any browned bits. Boil 2 1/2 to 3 minutes, or until sauce is reduced to 1/2 cup, stirring frequently. Spoon over chicken. Sprinkle with feta.

Makes 4 servings (3 ounces chicken and 2 tablespoons sauce each)

NUTRITIONAL INFORMATION PER SERVING: 196 calories, 7 grams total fat (1.5 grams saturated), 70 milligrams cholesterol, 476 milligrams sodium, 4 grams carbohydrate, 1 gram sugar, 1 gram fiber, 29 grams protein.

From "Love Your Heart," by American Heart Association, published by Publications International Ltd.

RUSTIC ITALIAN TOMATO SOUP

1 (16-ounce) package frozen mixed bell pepper strips (may be labeled stir-fry mix)

1 (14.5-ounce) can no-salt-added diced tomatoes, undrained

1 (14- or 14.5-ounce) can fat-free, low-sodium chicken broth

1/2 of a (15.5-ounce) can no-salt-added navy beans, rinsed and drained

3 tablespoons chopped fresh basil leaves

2 tablespoons snipped fresh parsley

1 tablespoon balsamic vinegar

1/2 teaspoon dried oregano, crumbled

1 medium garlic clove, minced

1/8 to 1/4 teaspoon crushed red pepper flakes

1 tablespoon olive oil (extra-virgin preferred)

1/4 teaspoon salt

In a food processor or blender, process bell peppers, undrained tomatoes, broth, beans, basil, parsley, vinegar, oregano, garlic and red pepper flakes until slightly chunky or smooth. Pour into a large saucepan. Bring to a boil over high heat. Reduce heat and simmer, covered, 20 minutes, or until flavors are blended. Remove from heat. Stir in oil and salt. Ladle into soup bowls.

Makes 4 (1-cup) servings

NUTRITIONAL INFORMATION PER SERVING: 136 calories, 3.5 grams total fat (0.5 grams saturated), 0 milligrams cholesterol, 215 milligrams sodium, 22 grams carbohydrate, 12 grams sugar, 5 grams fiber, 5 grams protein.

From "Love Your Heart," by American Heart Association, published by Publications International Ltd.

ASIAN SLAW

SLAW:

1 cup shredded red cabbage

1 cup shredded green cabbage

1 cup shredded carrots

2 cups mung bean sprouts

1/2 cup shredded daikon radish

DRESSING:

1 tablespoon canola oil

1 tablespoon rice wine vinegar

1 teaspoon honey

1/4 teaspoon sesame oil

1/2 teaspoon sesame seeds, toasted

For Slaw, in a large bowl, combine red and green cabbage, carrots, bean sprouts and radish. In a small bowl, whisk together Dressing ingredients. Drizzle over slaw and lightly toss. Serve at once as a bed for grilled chicken skewers or with grilled fish, etc.

Makes 4 servings

NUTRITIONAL INFORMATION PER SERVING OF SLAW: 80 calories, 4.5 grams total fat, 10 milligrams cholesterol, 39 milligrams sodium, 10 grams carbohydrate, 3 grams dietary fiber, 3 grams protein, 265 milligrams potassium.

From "Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook," by Bonnie Sanders Polin, Ph.D., and Frances Towner Giedt.

DECADENT CHOCOLATE SOUFFLE 

1 1/2 teaspoons trans-fat-free margarine

1/4 cup plus 1 teaspoon granulated sugar

1 tablespoon ground toasted almonds

3 tablespoons plus 1 teaspoon good-quality cocoa

4 large egg whites, at room temperatures

1 tablespoon Cognac OR 1/2 teaspoon vanilla

1/2 teaspoon ground cinnamon

1 teaspoon powdered sugar

12 strawberries, thinly sliced and fanned

Grease 4 (6-ounce) souffle cups with margarine. Mix 1 teaspoon granulated sugar with almonds and 1 teaspoon cocoa. Coat insides and bottom of souffle cups, tapping sides to make sure they are coated.

Heat 2 tablespoons water with remaining 1/4 cup granulated sugar in a nonstick small pot. Bring to a simmer and cook until mixture becomes thick, about 3 minutes. Do not allow syrup to color. Brush down sugar crystals on sides of pot with a wet pastry brush as syrup thickens. It will be quite hot, so be careful.

While sugar and water are simmering, beat egg whites until stiff in bowl of an electric mixer. While continuing to beat, slowly and carefully pour hot sugar syrup into egg whites. Beat in remaining 3 tablespoons cocoa, Cognac and cinnamon.

Spoon mixture into souffle cups, tapping each cup to make sure there are no bubbles. Bake in a preheated 375-degree oven 10 minutes, or until souffles are puffed and set. Immediately place souffles on dessert plates. Sift powdered sugar over tops and decorate each plate with 3 strawberries. Serve immediately.

Makes 4 servings

NUTRITIONAL INFORMATION PER SERVING: 130 calories, 2.5 grams total fat (0.5 grams saturated), 0 milligrams cholesterol, 70 milligrams sodium, 24 grams carbohydrate, 3 grams dietary fiber, 5 grams protein, 260 milligrams potassium.

From "Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook," by Bonnie Sanders Polin, Ph.D., and Frances Towner Giedt.

Tips for heart-healthy living

To help you make informed, heart-healthy choices when shopping, look for the American Heart Association's red heart with a white check mark on food packages. These products have met criteria for being low in saturated fat and cholesterol. For a complete list of 800 certified products, go to www.heartcheckmark.org and click on the "find healthy foods" link.

Limit fast food and sit-down restaurant dining to once a week.

A good strategy if you're craving a forbidden dessert is to set aside one day per week to allow a small indulgence or treat so you won't feel deprived.

Cut saturated fat in your diet. Instead of butter, regular cheese or ice cream, choose light or diet trans-fat-free margarine, low-fat or nonfat cheese, 1 percent or nonfat milk, nonfat frozen yogurt or sorbet, 1 percent or nonfat cottage cheese, or light or nonfat mayonnaise. Eat chicken without skin, and opt for egg whites or egg substitutes. Limit intake of high-fat and processed meats (like hot dogs and sausage).

Limit sodium intake to 2,300 milligrams (about 1 teaspoon salt) daily (1,500 milligrams for those with high blood pressure). Opt for fresh, frozen or canned foods without added salt. Instead of salt, enhance the flavor of foods with fresh or dried herbs and spices, lemon juice or assorted vinegars.

When it comes to grains, go for barley, brown basmati rice, buckwheat, bulgur wheat, stone-ground white or yellow cornmeal, whole wheat couscous, flax seeds, rolled oats, kasha, instant or regular brown rice, quinoa, wild rice or polenta.

Enjoy fatty fish such as tuna, salmon or lake trout twice a week to increase your intake of heart-healthy omega-3 fatty acids.

Substitute fish, poultry or plant foods for red meat (limit red meat to no more than once a week). Eat two or three skinless white meat poultry meals each week. Serve two meatless dinners a week -- there are plenty of options -- i.e. meatless chili, vegetarian lasagna, stir-fried vegetables with peanuts, tacos or burritos filled with brown rice, salsa, reduced-fat cheese, fat-free refried beans, lettuce, tomato, etc.

Snack wisely. Examples of some under-200-calorie snacks are 1 cup raw vegetables dipped in 2 tablespoons reduced-fat salad dressing; 1 tablespoon natural peanut butter on a medium apple or 2 celery stalks, topped with 2 tablespoons raisins; 1 cup cooked vegetables with 1 ounce melted 2 percent cheese; 3 cups air-popped or transfat-free microwave popcorn; 4 ounces nonfat or 1 percent cottage cheese with 1/2 cup canned fruit in its juice.

Aim for at least 30 minutes of physical activity daily.

Consume alcohol in moderation. Limit alcohol intake to one drink per day for women and two drinks per day for men. One drink is equal to 12 ounces of beer, 4 ounces of wine, 1.5 ounces of 80-proof distilled spirits or 1 ounce of 100-proof spirits.

-- N.H.

Sources: American Heart Association; "Cleveland Clinic Heathy Heart Lifestyle Guide and Cookbook."

CAPTION(S):

3 photos, box

Photo:

(1 -- cover -- color) HEART Smart in the kitchen

(2 -- color) Rustic Italian Tomato Soup

From "Love Your Heart," by American Heart Association, Publication International Ltd.

(3 -- color) Herb Roasted Beef Tenderloin

(4 -- color) TUSCAN BEAN SPREAD

Photo by Don Gerdal/Cleveland Clinic

Box:

Tips for heart-healthy living (see text)