Researchers consider ways food can improve health

Many people live to eat, but what if you could eat to live?

That's the idea behind using foods -- from avocados, barley and beans to nuts, oatmeal and soy -- to control the high blood pressure and elevated cholesterol levels that are ticking time bombs for heart disease.

Food is proving to be a powerful weapon that can rival the effectiveness of many medications in controlling blood pressure and cholesterol levels. Plus, food comes with other benefits: It costs less than most drugs, has no dangerous side effects and, of course, includes the pleasurable act of eating.

Take the Dietary Approaches to Stop Hypertension Diet, developed by the National Heart, Lung and Blood Institute. DASH is rich in fruit, vegetables, beans and whole grains. It includes lean meat, poultry (without the skin) and fish as well as low-fat and nonfat dairy products. Nuts, olives and healthy oils -- including olive and margarine -- are important parts of DASH.

Sodium intake also is reduced on DASH. Americans consume an average 3,375 milligrams of sodium daily, according to the National Health and Nutrition Examination Survey. Cutting sodium often cuts flavor. But a diet with 2,300 milligrams of daily sodium proved to be acceptable to participants in a DASH study that was recently published in the Journal of the American Dietetic Association.

As for lowering blood pressure, DASH cuts systolic blood pressure -- the pressure during heartbeats -- by an average of 12 millimeters of mercury, an accomplishment that rivals many blood-pressure medications.

Smart food choices also can have a big effect on cutting blood cholesterol. The National Cholesterol Education Program, the American Heart Association and the American College of Cardiology have long advised consumers to reduce the amount of unhealthy saturated fat, trans fat and cholesterol in their diets.

Now there's a new approach that can do even more: At the University of Toronto, David Jenkins and his colleagues have developed a list of foods that each lower blood cholesterol a little. Together, they can reduce cholesterol by as much as 30 percent, equal to the effects of some prescription statin drugs.

Dubbed the Portfolio plan, this mostly vegetarian approach includes plenty of fruit, vegetables and fiber-rich foods, from oatmeal and beans to whole grain bread, cereal and pasta. Soy is another important ingredient, as are nuts.

Foods fortified with plant substances called stanols and sterols also are key to the Portfolio plan. In the intestines, plant stanols and sterols compete with dietary cholesterol for absorption. Eating two grams per day can help lower the so-called bad cholesterol -- low density lipoprotein -- by 6 percent to 15 percent.

Among the foods now fortified with stanols and sterols are margarine (Take Control, Benecol and Smart Balance); orange juice (Minute Maid Heartwise), granola bars (Nature Valley Healthy Heart), cereal (Health Valley Heartwise), a smoothielike drink (Promise Activ SuperShot) and chocolate (CocoaVia.)

Cutting blood cholesterol levels used to mean eating very little fat -- and missing out on a lot of flavor. But the Portfolio approach proves otherwise. In a yearlong study, participants ate a moderate fat diet, with 30 percent of daily calories as fat. Nearly all of it came from healthy sources such as olive oil, avocados and nuts. (Participants ate about two ounces daily.)

Trouble is that none of these dietary approaches works for everyone. Body weight seems to be what separates those who respond well from those who don't. Overweight and obese people get about half the cholesterol lowering response from diet as those at a healthy weight, notes Penny Kris Etherton, professor of nutrition at Penn State University.

The difference may be C-reactive protein, a substance that rises as inflammation occurs in the body. Called "a fire within" the body, inflammation is caused by obesity, arthritis, inflammatory bowel disease, type 2 diabetes, insulin resistance and gum disease. Increased C-reactive protein levels appear to raise heart disease risk by promoting plaque buildup within artery walls. High C-reactive protein also hampers the ability of food to lower blood cholesterol levels.

How to combat that? Perhaps by adding more fiber to the diet. A study based on the National Health and Nutrition Examination Survey found that the higher the fiber intake, the lower the C-reactive protein levels in people of all ages and health conditions.

Also skip foods with processed white flour and added sugar. Research suggests those foods hike C-reactive protein levels, particularly in women.

Weight loss and more physical activity both cut C-reactive protein levels in men and women. So does following a high-fiber DASH Diet, suggesting yet again, new ways to eat to live.

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