I woke up in the mood for brunch. It was the weekend after all. I had been sent a photo of a breakfast dish made by my niece and had it in mind for days. I happened to have the ingredients in the fridge. So it was a joy to plate it up in my kitchen and a fine meal it was too.
In addition to tasting really good, this dish is packed with good fats and the feelgood factor while lowering cholesterol.
Serve with a large pot of tea.
For 4 people:
2 ripe avocados, mashed
4 slices of smoked salmon
4 large eggs
4 thick slices of sourdough bread
Begin by preparing the avocado. Mash lightly – add some freshly ground black pepper. I don’t think it calls for salt as the smoked salmon is salty but add some if you want to.
Cut four thick slices of sourdough and toast. Spread with the avocado and lay the smoked salmon on top.
Poach the eggs – I poach for a minute or two – remove with a slotted spoon and then drain on kitchen paper.
Pop an egg on top of each toast, avo and smoked salmon combo. Add a grinding of black pepper and eat.
When I first started writing about reducing cholesterol over three years ago, I realised that there was a lot to learn. What I didn’t know at the time was quite how difficult it would be to know what guidelines to follow. At first it seemed straight forward – reduce saturated fats, essentially – and replace with good, unsaturated fats such as olive oil, oily fish nuts, avocados and low fat dairy products. As regular readers of my blog know, I set about this project with zeal and, along with regular exercise, my cholesterol level dropped within three months.
Since those early and naïve days, I have discovered that the relationship between a raised cholesterol level and mortality is far less clear than I first understood. Many people who suffer heart attacks have normal cholesterol levels. If this is so, then constantly trying to reduce cholesterol levels in order to extend our longevity might not be the simple solution I supposed it to be.
Over the past few years the notion of saturated fats being the devil incarnate has also come under scrutiny. Sugar is now in the spotlight as the number one killer and sad to say, low fat products are packed with the white stuff.
This week a very interesting article was published in the New York Times which had me scratching my head. It is an important addition to the ever increasingly muddled picture of what to believe, who to believe and what to do to preserve our cardiovascular health.
Entitled, A Study on Fats That Doesn’t Fit the Story Line, Aaron E. Carroll, professor of paediatrics at Indiana University School of Medicine, reports on an article published in the British Medical Journal (BMJ) on that controversial topic of how our diet affects our cardiovascular health.
The article in the NY Times points out that questions were being raised about saturated fats as far back as the late 1960s and 1970s. Guess what happened to this data? It wasn’t published. The study was called The Minnesota Coronary Experiment and was a well –designed study that collected data on the cholesterol levels of over 2 300 participants. They were put on a diet that reduced their saturated fat intake and increased their unsaturated fat intake. Over the course of the study their overall cholesterol levels dropped. No surprises here – many of us have found this to be the case when we replace saturated fats with unsaturated fats.
However, the study showed that there was no decreased risk of death from this reduced cholesterol level. In fact, it showed an increased mortality especially in the group of participants who were 65 years and older. Most surprisingly, perhaps, was the finding that those whose cholesterol level had reduced the most, were also at the greatest risk of dying from any cause – ie not just from cardiovascular disease.
Since this time studies have proven and disproved these findings. The question is – why was the Minnesota study not published? Why was the Sydney Diet Heart Study (1966 – 1973) not published until three years ago? Could it be because it too found that eating a diet higher in unsaturated fats resulted in more deaths from heart disease? What might have happened to the health advice given over the past decades if all this research had been published? Where would the low fat food industry be then? Would we have grown fat on the sugars we have been eating as part of our low fat diets?
If this is sounding like a conspiracy, perhaps there has been one. The NY Times article suggests that perhaps these studies were not published because they contradicted the accepted wisdom of the time that saturated fats were the big bad wolf.
As Professor Carroll concludes “the state of nutrition research in general is shockingly flawed. It’s hard enough to debate the data we can see. Knowing there’s probably data out there that people haven’t shared makes everything much, much harder.”
So there we have the conundrum. No-one knows what to believe, which studies to follow, whose advice to take and what is being hidden from the public. Most of all, I don’t know whether to put butter on my toast and a steak in the pan or to just continue trying to get my cholesterol down. Who knows if that is more likely to extend or curtail life expectancy?
Next time: The Sugar Conspiracy
In the meantime you may like to read my fully saturated fat article published today in The Boston Globe: https://www.bostonglobe.com/lifestyle/food-dining/2016/04/18/what-like-eat-heston-blumenthal-hinds-head/8Z8utjEVDdnTECx2cYbXCN/story.html
I look forward to the blood orange season each year. They are one of the few fruits that are truly seasonal these days. Eating strawberries in winter is all very well if you don’t mind air miles or summer fruit when it is snowing. But there is something authentic about a fruit that only comes once a year and for a short season at that.
Having eaten a lot of blood oranges as nature intended, without adornment, I had a go at a little light cooking. First I cut the oranges into slices and then dry fried them in a nonstick pan until they took on a little bit of colour.
Wanting to keep the bright colours on the plate I added a bunchof ruby chard leaves and their colourful stalks.
I used a Lancashire cheese purely because I had a chunk in the fridge that needed using up. I could otherwise have used feta. I liked the Lancashire though because it had a pleasantly chalky texture which contrasted well with the juicy oranges and the chard. As we are trying to lower cholesterol, keep a light hand on the cheese.The fresh mint added extra freshness to the salad
I ate this for lunch with a slice of wholemeal bread on the side.
For 4 people:
2 blood oranges, skins left on, sliced into rounds, then rounds cut in half
1 large bunch of ruby chard, washed and shaken dry
250g Lancashire cheese or Feta, sliced
A couple of teaspoons of good quality extra virgin olive oil
A handful of mint leaves, shredded
Dry fry the oranges in a nonstick pan until they take on a bit of colour. Set aside.
Steam the ruby chard until they are just wilted.
Slice the cheese. Slice the mint leaves finely into shreds.
Lay out the oranges, chard and cheese on a platter. Scatter over the mint.
Finish off with a trickle of good quality extra-virgin olive oil and a grinding of black pepper.
I am supposed to be sitting at my computer writing a blog post on lowering cholesterol. But the truth is that I am simply passing the time until the evening episode of The Archers is broadcast. Archers fans will understand that nothing much else matters this week. Of course it does. It is just that sometimes the real world is too filled with real pain. So we turn hungrily to the made up world which, ironically, can also reduce us to shaking with fear in our own kitchens. If non-Archers fans do not know what I am on about, Radio 4 has a particularly disturbing story line about domestic abuse right now that is gripping middle England.
But back to the real world. I was greatly moved last week –as were many others around the globe – by the announcement that the great Zaha Hadid had died. One of the world’s greatest architects, whose buildings I adore, she suffered a heart attack while in hospital in Miami where she was being treated for bronchitis. Now I know nothing about Ms Hadid’s health history but it struck me that even while in a hospital her heart attack turned out to be fatal. You would think that having a heart attack in a hospital would give one a better than normal chance of survival.
What disturbed me most about her passing away was not only that the world will not see any more magnificent buildings with her instantly recognizable style, but that so much talent is cut short by cardiovascular disease. Considering how much is known now about preventing this disease, it seems especially cruel.
Yet, how many of us really change our lifestyles to lower our own risks? I count myself as part of the group of people who know the right things to do but find it so hard to keep up. At the moment I feel in the doldrums health wise. I am struggling to shake off a nasty virus that is doing the rounds and leaves people feeling exhausted. But in truth it has been some time since I have attended in a meaningful way to lowering cholesterol and taking general care. My weight is up, my eating is pretty much free for all and my exercise is at a three year low. What I do keep up is a daily bowl of oats for breakfast and almonds as a snack. The only downside of this cholesterol lowering behaviour is that my helpings are too generous by far – probably enough for two. Each morning I remind myself of this but as I tip the oats and milk into my pot I resolve to start cutting back the next day. And the day after.
The positive news is that Spring seems to be here – on a very short walk this week, I marveled at the buds bursting out on trees in the woods. Which makes me think that nature knows what to do to keep replenishing life. If only we could keep in tune with it.
I don’t think I have ever put a recipe with puff pastry on the blog before. This is because puff pastry is not good for cholesterol lowering purposes. So why now? Simply because I made it for dinner this week and it was so delicious that I just had to share it. Next time I will try it with phyllo pastry which has a lower fat content. I like to think that all the goodness from the vegetables counter balances the butter in the pastry – and after all, isn’t butter the new ‘good’ fat?
You may have some roast veg left over in which case put in the fridge and use the next day either reheated as a pasta sauce or as a side dish. It goes well with meat, fish or fowl. Often I eat cold roast veg mixed with lettuce leaves and a scoop of cottage cheese as a lunchtime salad.
Serve this tart with a large green salad for a tasty meal.
For 4 people:
1 roll of puff pastry – I use the kind that is already rolled rather than the block
3 – 4 beetroot, peeled and chopped into chunks
2 red onions, peeled and chopped into large wedges
3 courgettes, chopped into chunks
2 -3 peppers (a mix of red and yellow), seeded and chopped into chunks
1 large aubergine – chopped into chunks
2 cloves garlic
2 tablespoons olive oil
1 log of goat cheese
A handful of basil leaves
Begin by roasting the vegetables. Heat the oven to 200 C.
Chop the vegetables into bite sized chunks and place in a roasting dish.
Crush the garlic and mix with the olive oil. Pour over the vegetables and place in oven to bake for about an hour. At this point the vegetables should all be soft to the point of a knife but not collapsed.
Roll out the puff pastry and place on a baking sheet. Cut thin strips off each end, score the pastry around the edges with a fork and then place the strips on top. You are making a border which will puff up and contain the vegetables as the tart bakes.
Heat the oven to 220 C .
Place the veg on the pastry. Then cut the log of goat cheese into rounds and place on top of the vegetables. Place in the oven and bake for about 20 minutes. Keep an eye so that it does not begin to burn.
As you are about to serve the tart, tear up a handful of basil leaves and scatter over the tart. A grinding of black pepper will complete the dish.
Having recently celebrated International Women’s Day my thoughts have turned to women’s health. A story that caught my eye this week appeared in The Washington Post. It was alarming and a cautionary tale so I share it here.
Last January, a woman aged 46 woke in the early hours of the morning feeling unwell. Soon after she threw up. She got back into bed intending to try to get back to sleep. She felt very cold and threw up again. She assumed that she had one of those 24 hour stomach bugs. Fortunately her husband was awake. He was concerned about how clammy she felt and said he was taking her to the hospital. She thought he was over reacting. But he persisted as he thought she might be having a heart attack.
Hang on a minute – aren’t the symptoms of a heart attack pain in the chest? That was the symptom that her father-in-law had experienced when he suffered a fatal heart attack aged 64. But she was just 46 – fit, slim, a non-smoker, a healthy eater with normal cholesterol level and no family history of heart disease.
Probably most husbands would murmur a few reassuring comments like ‘you’ll feel better in the morning’ or ‘remember how much I vomited when I had that tummy bug?’ Her husband insisted they go to the hospital and got her to the front of the queue by saying that they thought she was having a heart attack.
The initial tests at the hospital were a bit abnormal but not suggestive of a heart attack. The tests were repeated shortly afterwards and suddenly the room filled with medical staff. It turned out that she was indeed in the early stages of a heart attack. Fortunately an interventional cardiologist was on duty and he operated immediately, literally stopping a major heart attack in its tracks by removing the blood clot and inserting two stents into her right coronary artery. What the surgeon had found was that her right artery was totally blocked while her central artery, called the LAD, was 70% blocked. Blockage of this artery causes sudden death and is known as the widow maker.
What would have happened had she gone back to sleep? She may never have woken up or, if she did survive, might have had serious damage to her heart.
Most women would probably say that they are more concerned about breast cancer than cardiovascular disease. Yet more women in the UK and the USA die of heart attacks than from breast cancer.
So let us all be warned. Heart attacks can and do happen to healthy women with normal cholesterol and healthy lifestyles. Women do not always have the classic symptoms of heart attack ie pain in the chest. Women are more likely to experience nausea or vomiting, pain in the back or the jaw, and shortness of breath. Because most of us don’t like to make a fuss and are used to plodding on even if we are not feeling so well, it can be difficult to make an assessment of when to call an ambulance or hasten to the hospital. Better safe than sorry seems to be the moral of this story.
I love to eat out although it is usually not good for cholesterol lowering purposes. Sometimes I come across a dish that tastes good and inspires me to have a go at my own version at home. Recently I ate lunch at The Wallace – the restaurant in the Wallace Collection – and was delighted with a crab salad as a starter. I lost no time in making one for myself at home and, while no match for the chef at The Wallace, I enjoyed my version too.
One of the new tastes I discovered at the restaurant was cubed apples that had been soaked in cider vinegar. It was fabulous and paired so very well with the crab meat. As with all vinegar, use the best you can afford as cheap and nasty will taste just that and will ruin your dish.
If I was on a summer holiday at the seaside I would buy fresh crabs and spend a lazy afternoon winkling out the meat. However, in the city I buy fresh crab meat from a good supermarket and simply wish that I really was on that summer holiday at the seaside!
For 4 people:
4 generous tablespoons of white crab meat
A small bunch of chives
4 handfuls of soft salad leaves
1 fennel bulb – reserve the fronds for decoration
1 ripe but firm avocado
2 granny smith apples
A few teaspoons of good quality cider vinegar
Begin by chopping the chives very finely. Add to the crab meat along with some lemon juice. Taste a little to see if you have the balance to your liking. You may want to add a few more chives or a little extra lemon juice.
Peel and cube the apples and put in a small bowl. Pour over a few teaspoons of cider vinegar and toss the apple cubes gently so that they absorb the vinegar on all four sides.
Using a cheese slicer, shave the fennel into very thin slices.
Neatly cut the avocado into cubes a similar size to the apple cubes
Place a handful of salad leaves in the centre of four plates.
Using two tablespoons, shape the crab meat into a quenelle and place in the centre of the leaves.
Scatter the fennel shavings around the crab meat.
Space the apple and avocado cubes around the perimeter of the plate.
Finish off the dish with a squeeze of lemon juice and a grinding of black pepper.
Enjoy with a slice of rustic wholemeal bread – a pat of butter would be a wonderful addition but I leave that to your discretion regarding your cholesterol level.
I was talking to a friend about the controversy around fats that continues to confuse me and, no doubt, many other people attempting to lower their cholesterol. As if healthy eating is not itself enough of a long term challenge, the conflicting advice makes my head spin. Should we be eating saturated fats or not? Is cholesterol directly linked to cardio vascular disease or are sugar and inflammation the real culprit? Am I avoiding eating too much saturated fat for good reason or just feeling smug while believing incorrect science? Could I be eating ice cream rather than no fat yoghurt? So many questions and no way to really get to the bottom of it – at least I find it difficult.
One of the clearest and most useful articles I have read recently on the subject was published in January in The Observer. The Science of Healthy Eating was written by a science writer, Dara Mohammadi and a cardiologist, Dr Ali Khavandi.
The article began by debunking the health benefits of low fat foods pointing out that something has to replace the reduced fat content – that something is often extra sugar. I have written several times in the blog about the sugar content of low or no fat yoghurts and encourage you to have a look at the small print next time you are in the dairy section of the supermarket. It is an eye opener.
Addressing the debate about fats, the authors returned to the 1950s when saturated fats began to get bad press. Studies revealed that people eating a Mediterranean diet – high in olive oil (an unsaturated fat) had a lower risk of heart disease. When the food industry responded to these findings (around the 1970s) they replaced saturated fats (butter, for example) with trans fats. Trans fats were made from unsaturated fats that were transformed through the process of hydrogenation. This was good news for the food industry as trans fats could increase the shelf life of biscuits and cakes and processed foods. It seemed like a win-win situation – a healthier fat that could fatten the profits of the food industry.
The belief that trans fats were healthier because they were made from unsaturated fats had a rather different outcome than expected. During the 1980s and 1990s there was an escalation of cardiovascular disease. Not only were trans fats implicated in this increase but it was also found to increase risk of type 2 diabetes. You may have noticed that in the last few years supermarkets have been trumpeting the fact that they have reduced or eliminated trans fats from their products.
Now that trans fats were bad news, saturated fats have come back into fashion. Time magazine had butter on its front cover. Talk about reinventing the wheel. Weren’t we all eating saturated fats back in the 1950s before we were rerouted by food scientists and the food industry?
Well, the authors of this article don’t believe that eating as much unsaturated fat as you desire is a good idea. They suggest that unsaturated fats (not trans fats made from unsaturated fats) are the way to go. In other words – olive oil, seeds and nuts, oily fish and avocados. Well, what a relief since that is what I have been eating and writing about for the past three years.
After addressing the debate about processed meat and what they term the ‘gluten-free con’ (only 1 % of the population has coeliac disease and will benefit from a gluten free diet yet 20 % of the population now buy gluten free products) – the authors move on to consider cholesterol. They stress the importance of understanding one’s lipid profile is an oversimplification. Do be aware of this when sitting with the GP who is reaching for the prescription pad with Statins written on it. Ask for a printout of your blood test result so that you can have a good look at the ratio. Many of us have been able to increase the levels of ‘good’ cholesterol and reduce the ‘bad’ cholesterol through changing eating habits and increasing exercise levels.
The authors dismiss concern about the cholesterol content of eggs and prawns as ‘almost irrelevant’ and focus instead on what you should be adding in to your diet. I was gratified to read that this includes oats, nuts and seeds and oily fish. I would add pulses to this list. Things to avoid are excess sugar and refined carbohydrates – so keep on eating wholemeal pasta and couscous, wholemeal bread, brown rice and the like.
It is not enough to eat healthily if you want to reduce cholesterol. Exercise has a key role to play as I tell myself every time I reluctantly put on my walking shoes.
It may be cold outside but those of us trying to lower cholesterol always need a treat even if it is ice cream in the depths of winter. I found a recipe for banana ice cream in a new cookbook by Dannii Martin called Hungry Healthy Happy. I have been frustrated by banana ice cream before as its texture was unpleasant. This recipe pointed out what to do to improve the texture and it really worked. I added raspberries as I had some in the freezer and thought they would add colour, taste and extra vitamins. When I served it to the family they were surprised at just how good a no-added sugar, fat –free ice cream could taste. That’s what I call a result.
You need to start the day before as the bananas need to freeze overnight.
Making this recipe for 4 people involved more banana than my food processor was happy with all at once. I thought it would explode. Next time I will process it in two batches.
For 4 people:
4 -5 ripe bananas – just peel them and slice. Then pop into a freezer bag or a Tupperware and freeze.
A handful of frozen raspberries
Crème de cassis – optional
When you are ready to make the ice cream, place the frozen bananas in a food processor and let the motor run until the bananas have become creamy. In the past I have stopped too soon and landed up with an unpleasant crumbly texture. Dannii suggests stopping from time to time to scrape down the sides. After a while it really does become creamy.
I added a handful of frozen raspberries to the mix after a few scrape downs.
I served the ice cream right away. It would be lovely with a raspberry coulis that you can make by processing another handful of raspberries and pushing the pulp through a sieve to remove the pips. A shot of crème de cassis would not go astray either!
Keeping healthy can be very rewarding but also rather boring. Healthy meal after healthy meal has to be put on the table, so keeping interested in cooking is important. As I have said many times before, it is a lifestyle change not just a matter of lowering the cholesterol or losing the weight before returning to old habits.
New ideas in the kitchen are such an important part of keeping on track. I love paging through magazines and cookbooks to get my enthusiasm up for the seemingly endless number of meals. As the New Year rolls around so does a new collection of healthy cookbooks. One of these new books made its way to my door thanks to blogger friend, Dannii Martin, who tells the story of how she lost a lot of weight and has continued to maintain her healthy eating habits.
Called Hungry, Healthy, Happy, this cookbook (as well as Danii’s blog, www.hungryhealthyhappy.com) is packed with recipes that will pep up the weekly cooking. What I like most about this book is that the recipes are perfect for everyday cooking. Most of the time I have to put a meal on the table for the family dinner while also trying to eat healthily myself. I have to balance my needs with those of growing teenagers which is not always easy. Sometimes I eat too much fat or they eat too much lean.
Cooking one’s favourite dishes in a lower fat manner is the way to go when trying to maintain healthy eating habits. We all hark after the meals we love and it is too much of a deprivation to give them up forever. A tweak here and there can make all the difference. So I was pleased to find a recipe for a club sandwich (made with fat free yoghurt rather than mayonnaise), chicken tikka masala (fat free yoghurt again replacing the cream) and even mac and cheese which adds cauliflower and yoghurt rather than the full quotient of pasta and cheese.
Each recipe is labelled as vegetarian, gluten or dairy free, where appropriate. This is a useful time saver when paging through the book looking for a suitable dish. Each recipe sets out the nutritional value of the recipe which is such important information for those watching their salt, sugar, fat and calorie intake.
Whenever I look at a healthy eating cookbook I take particular note of the dessert section. This book has far more on offer than fruit platters. I was pleased to find a recipe for banana ice cream which I have previously tried, unsuccessfully. What I really appreciated was that this version of the recipe anticipates the problem the cook will encounter – the banana crumbles – and tells you exactly what to do to remedy this situation and to successfully end up with a smooth and creamy ice cream. When I served my adaptation (I added raspberries) to my family they could not actually believe that it was pure fruit with nothing added. ‘No cream?’ asked my younger son. ‘Not even sugar?’ asked the older one. They were mightily impressed and banana ice cream will now be part of my repertoire. It is a lovely example of a dish that suits the whole family – cholesterol lowering adults and growing teenagers. Wait until I try the chocolate avocado mousse – I will not be telling them the ingredients until after I have seen their faces – looks of pleasure I hope.