Eat to your heart's content?

What you eat can determine the health of your heart. Here's what you should know about fat and cholesterol.

I didn't know his name, but I liked him. A gray-haired man in his 60s. He walked the same route that I jogged every morning. "Good morning," he'd say with an open smile, in a warm and friendly manner.

Then one day I missed him. Maybe I'm a little later than usual, I thought. That afternoon a neighbor stopped me and asked, "Did you know Joe Watson? He walked along here every morning when you do. He died this morning."

"Oh no! Heart attack?"

"Yes."

It's not surprising that I was able to guess the cause of Mr. Watson's death, with coronary heart disease being the leading killer. My second guess would have been stroke. The underlying cause of both is often the same--atherosclerosis.

Things are changing. But the picture is not as bleak as it used to be. Even though heart attacks still claim 500,000 lives a year in the United States, compared to 30 years ago the death rate has declined nearly 45 percent. Part of this decrease is the result of better medical treatment, but most of the credit can go to lifestyle changes, especially changes in the way people eat and exercise. Somebody is doing something right! Here's what you can do:

* Watch your cholesterol. Years of research have shown that keeping your blood cholesterol level below 200 mg./dl. protects against atherosclerosis. Just a 1 percent decrease in blood cholesterol results in a 2 percent decrease in the incidence of heart attack, so a 25 percent drop (say from 300 milligrams to 225 milligrams) cuts the risk in half! Obviously, lowering your blood cholesterol level can be very worthwhile. Research shows it can even reverse existing plaques!

When you have your blood cholesterol level checked, have your high-density lipoprotein (HDL) level measured too, the "good cholesterol." The HDL carries cholesterol to be excreted, so it protects against plaque in the arteries.

Divide your total cholesterol number by your HDL number and compare the answer with the chart below.

For example, if your total cholesterol is 189 milligrams percentage and your HDL cholesterol is 60 milligrams percentage, your ratio is 189/60 = 3.15, less than half the risk of the average person. On the other hand, if your ratio is 4.5 or higher, read on.

* Eat less saturated fat. You'll find that cutting down on fat means eating less meat, cheese, eggs, and whole dairy products, so you will naturally increase grains, fruits, and vegetables. The most important change to make is to eat less saturated fat. Animal fats are mostly saturated fats.

Replace meat with legumes, pasta, and rice entrees, using low-fat or nonfat dairy products; partially replace whole eggs with egg whites or egg substitutes, and butter with margarine.

Did I say replace butter with margarine? But what about trans fatty acids? Even though the process of hydrogenation does produce a few trans fatty acids, they don't raise blood cholesterol levels as much as saturated fat does. But do choose a soft margarine with the first ingredient liquid vegetable oil. That way most of the fat is unsaturated. I'm partial to canola, a monounsaturated oil, for this reason. There are two types of unsaturated oils--polyunsaturates (like corn oil) and monounsaturates (like olive oil and canola). Both lower total blood cholesterol, but polyunsaturates also lower HDL (the good cholesterol), so the monos have the edge!

* Eat less cholesterol. For a healthy heart, we're urged to limit our cholesterol intake to 300 milligrams per day, which is about half what the average person eats. Since cholesterol is found only in foods of animal origin and is mostly in the fat, you will need to partially replace such foods with more fruits, vegetables, grains, and low-fat animal products. Eating more plant foods is also important because it's becoming more clear that carotenes, vitamin C, vitamin E, and selenium are powerful anti-plaque weapons. They also contain soluble fiber that helps lower blood cholesterol levels.

* Eat nuts with caution. Research at Loma Linda University has revealed a surprising discovery--eating nuts frequently (five times per week) protects against heart disease! Maybe it's the type of fat (polyunsaturated and monounsaturated) or the vitamin E or even the omega-3 fatty acid in nuts. Whatever the reason, nuts do consistently lower blood cholesterol! But because nuts are a high-fat food, they should be substituted for some other fat in the diet, not just added.

* Reduce salt. Many of us eat twice as much sodium as we need. But reducing salt intake is very important for people who have high blood pressure. Most of the sodium in food comes from added salt.

Every year the evidence becomes stronger that our way of life often determines our way of death. Fortunately, we're also learning how lifestyle changes can dramatically improve the quality and length of life. Make the right choices in your eating and other lifestyle habits and experience the rich rewards of a heart that can last a lifetime.