What makes a recipe heart healthy?

Podcast Transcript

Announcer: Welcome to Love Your Heart, brought to you by Cleveland Clinics, Sydell & Arnold Miller Family Heart and Vascular Institute. These podcasts will help you learn more about your heart, thoracic and vascular systems, ways to stay healthy and information about diseases and treatment options. Enjoy.

Interviewer: Welcome. I'm here today with Kate Patton, who is a registered dietitian in our preventive cardiology program, and she talks a lot to patients and groups about eating heart healthy. So, Kate, what makes a recipe heart healthy?

Kate Patton: I think a heart healthy recipe, you should keep an eye on the nutritional value from basically how much fat is in that recipe, paying attention to the protein source maybe in that recipe and carbohydrates, so choosing whole grains is going to be a good source of of carbohydrates. Vegetables are good carbohydrates to include focusing on lean proteins and then really assessing the type of fat that's in the recipe. You want to lean towards more plant-based fats than animal fats, and also keep an eye on the extra things that might be added, so sugar is a not so good carbohydrate that we want to try to lower the intake of. At least, added sugar. Also, keep an eye on how much sodium is in that recipe too.

Interviewer: We were just at a talk together and so many people had questions about recipes for baked goods related to butter and what they could do with those favorite family recipes.

Kate Patton: Sure. A lot of recipes you won't change the taste or consistency if you replace up to half the amount of the added fat with something like an unsweetened applesauce or mashed bananas to help cut out some of that fat from say butter, but just up to half. You still want some in there to to have the right texture and flavor. A lot of other options too with butters is nowadays there are some lighter butter spreads that are half butter and half canola oil, so it's a little bit better mixture of the fats. Other recipes with baked goods, to help cut out fat, same thing. If a recipe calls for oil, you can cut out some of that oil for a softer consistency fruit blend. That would help.

Interviewer: Talking about oils, what are the best oils to use?

Kate Patton: Yeah, so as far as cooking with heat kind of oils, extra virgin olive oil has a lot of heart protective benefits but heating it can actually hurt and de-nature and kill the benefits that extra virgin olive oil has. So, that should just be used at room temperature just as a dressing or a dip. Other oils, though, like olive oil from the later pressings you can cook with and saute a little bit with. Canola oil, peanut oil, those are good. Canola oil often is used in baking. It has a little bit more of the the monounsaturated fats, which is a little better than a vegetable oil would be.

Kate Patton: So, yep, using small amounts of oils with sauteing, if you're really following a really low fat diet, patients could use broth instead of oil when you're sautéing or cooking.

Interviewer: Some people had questions about if they like to use mayonnaise, so that's another fat.

Kate Patton: Sure, so a good substitute for that would be if you really want that mayo texture and consistency, there are some healthier versions that are made from olive oil and canola oil so that would have a little bit more at least of the healthy fat and less of the saturated fat. Or, again if your cholesterol is high and you're really trying to cut back on saturated fat and cholesterol, then we'd want you to replace the animal fats with more of the plant-based fats, monounsaturated fat, so using avocado as a spread on a sandwich or using some hummus as a spread, or just using again olive oil and vinegar to either add to some tuna to keep it moist or drizzle on a sandwich to keep it moist.

Kate Patton: I definitely encourage using more oil-based salad dressings rather than the creamy salad dressing, so just real extra virgin olive oil and vinegar, or to give more flavor, you can add something like Dijon mustard. Some people use actually egg whites in salad dressings to whisk that up and give it some more texture. And, then just adding say garlic or onions. If you want to make it a little bit sweet, add a little bit of honey. But, I really encourage patients to try and make their own homemade salad dressing. A, because it's really quick and easy and B, you get a lot more healthy fats if you're using that extra virgin olive oil, and then you're getting a lot less sodium to because pre-packaged salad dressings have a lot of salt in them. And, some salad dressings can also have a lot of salt ... Excuse me ... sugar added, too, so this way you're controlling it.

Interviewer: What about we're getting some times for holidays or entertaining and things like that, and what if you like a lot of sour cream or dips, and things like that?

Kate Patton: Yeah, that's a great point. A great alternative for sour cream as far as dips and recipes, I think, is substituting nonfat plain Greek yogurt. I think it really tastes very, very similar. It has that same kind of taste, and so the 0% won't have any fat whereas regular sour cream is really high in fat, but it's the same consistency. You know, really thick and I think it still has that same tart flavor. So, for dips, yeah, definitely that Greek yogurt.

Interviewer: Okay. Is there anything else that we should know about dairy products or can we just use milk? Sometimes people say use whole milk, don't use whole milk.

Kate Patton: Sure. If it's a recipe that's calling for cream or a creamy soup, if you're trying to be more heart healthy, we want to try to limit the amount of animal fats from saturated fat. Obviously, a lower fat version better for most people. If it's a special occasion and you want to use a little bit of whole milk, and your cholesterol level's fine or you really want that thick taste, then again, in moderation use a little bit of whole, a little bit of 2% or something like that. But, yeah, going for those lower fat milks would be better, especially instead of something like heavy cream or real cream which is going to make it really thick.

Kate Patton: A lot of times in soup recipes, you can cut out cream and use some kind of pureed vegetable, too, to add that thickness. So, whether it's pureed potatoes or leeks, or some kind of pureed bean, that'll give it a lot of thick texture to the soup without the fat and more fiber.

Interviewer: There's a lot of questions about sugar, both in baking and then adding sugar to even your coffee.

Kate Patton: Yes, yeah. There's definitely room for some of the added sugar in our diets. There is room for that. It's just when you're drinking though a sugary drink, like a soda, and that has lots and lots of sugar, then you're easily going to go over your limit for the day if you're drinking soda and drinking sugary drinks. But, if it just adding one teaspoon of real sugar in your coffee here or there, I think that's definitely appropriate. When it comes to baked goods, obviously those have a lot of sugar in it. You're using that for a lot of flavor, but a lot of bakers and chefs say that you can easily substitute out just a third of whatever the recipe calls for sugar, and it's still going to taste sweet, so you could just automatically eliminate a third of the called for sugar, and if you want to replace that with a little bit for still extra sweetness, replace that with some kind of mashed fruits like unsweetened applesauce or banana in cookie and cake and bread or muffin recipes that still usually ... They hold up pretty well.

Kate Patton: As far as another idea, too, to give flavor if you're substituting out some of the sugar but want some extra flavor, maybe adding like a little bit more vanilla extract to give it that flavor, or using something like an almond extract or lemon or orange extract. That can give a lot of good flavor. Even some things like cinnamon, or if it's, like I said, lik ea bread or a cookie recipe, even just adding dried fruit, too. That way it gives it some natural sweetness from the dried fruit.

Interviewer: Somebody had a question during our talk about agave and using some of these other alternative sugars?

Kate Patton: Right, yeah. You could, depending on the recipe, do that. Agave has a little bit lower what we call glycemic index, so it digests and turns into sugar a little bit slower. It's still a form of sugar, though, so not going to make a significant difference.

Interviewer: Sometimes, people think because they're using something else that that's good for you and then it negates any negative-

Kate Patton: Right, it's better than say a white sugar but, right, it's still sugar.

Interviewer: We have a lot of patients that are on low sodium diets, so they have to watch their salt too. What tips do you have for that?

Kate Patton: Yeah, so that's a good question. I definitely, number one, encourage starting out by reading those nutrition facts labels and getting an eye for how much sodium is in some of the foods that they're using and salad dressings, and soups and condiments. That can be really eye opening, so start there and then try and find alternatives to those things.

Kate Patton: So, alternatives to actually just the salt shaker would just be using different herb and spice blends, so lots of options. Lots of different brands carry different spice blends. Just check the ingredients, too, though to make sure there isn't any other hidden source of sodium, that it's really just herbs and spices. Starting there. Also, using fresh herbs is a great ... Growing your own if you can. Basil and things like that will give foods a lot of flavor. I mentioned salad dressings, how to substitute making a homemade one rather than using the store bought versions. And, oils and vinegars and fruit juices, those are great to use as a marinade, too. A lot of store bought, pre-packaged marinades are really high in sodium, so watch out for that. Try using your own. So a lot of store bought pre-packaged marinades are really high in sodium. So watch out for that, try using your own, and then onion and garlic can give foods a lot of flavor without all that extra salt, too.

Interviewer: I'm a big pasta lover. I love pasta and bread and things like that. There's a lot of discussion about carbs and trying to decrease white flours and things like that. So, what do you do for replacement for that?

Kate Patton: Sure. So, we have a lot of patients who are on lower carb diets, you're right. A good alternative would be swap out some of that pasta for more of a vegetable-based pasta, something like using actual spiralized zucchini noodles or spaghetti squash is a great substitute for the pasta. There are pastas out there, too, that are made from beans. There's chickpea pastas out there, and black bean pastas. Those just have, again, a better composition with more protein and fiber than traditional white pasta would have.

Kate Patton: Also, rice as something that's high in carbohydrates and really dense just like pasta. Now, it's pretty easy to find a rice cauliflower, either freshly riced or frozen. You can even find rice vegetable blends with like carrots and broccoli, too, so that's a great alternative to either completely substitute rice or blend in with rice. If you're cutting back on carbs, you'd also want to watch out for the potato. A good alternative for potatoes is mashed cauliflower. A good way to get those veggies in. A lot of people, even in recipes like macaroni and cheese, people sometimes sub out the cheese for say butternut squash or even pumpkin to still give that same color but less of the fat from the cheese.

Interviewer: Okay. Wow, that would be-

Kate Patton: Questionable taste, right.

Interviewer: A new taste, but it sounds like it could be really some good ideas as far as switching things out and getting some new vegetables.

Kate Patton: Right.

Interviewer: So, when you talk to people, and they've lived one way for a long time and followed the same recipes as probably their mom's taught them, what are the challenges and what do you tell patients when they are a little skeptical about making all these changes?

Kate Patton: Well, I try to find out what they can live without, so where can they make some changes or substitutions, and then figure out what they want to keep the same and then try to have them modify recipes just slowly, like I said, by just using a little bit less sugar or now instead of frying, people tend to use air fryers a lot, so that's a great alternative. Just like I said, trying to make little swaps and substitutions, whether it's sodium or sugar and just give them the ideas and see what they can do. But, yeah, I take those baby steps and make small changes. You don't want to completely overhaul a recipe and not have it taste good.

Interviewer: Okay, so you've given us a lot of very good tips for people who are trying to eat heart healthy. I really appreciate your time here today.

Kate Patton: Sure, happy to be here.

Interviewer: Thank you for joining us.

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