Delicious Heart Healthy Recipes from the Mankato

Heart Health Program

A program to reduce heart disease and stroke

In Cooking a la Heart you will find that something good happened in a Minnesota town, and you can apply it to your family's healthier litestyle.

Resey Blat khu Director, Minnesota Heart Health Program

Eating healthfully is neither difficult nor boring. Nor is it a life of deprivation and self denial. Rather, as diners who follow the guidelines, recipes and menu plans of Cooking à la Heart are destined to discover, healthful eating is a stimulating trip into new and familiar taste sensations that can help to keep you enjoying good food for many more years than you otherwise might.

Jane Brody, Personal Health Columnist for The New York Times

Cooking a la Heart offers a practical, hands-on guide to healthy eating. Up-to-date nutrition information and a wide variety of recipes with nutrient breakdown will family help the reader translate scientific information into day-to-day menun for h Liz Weiss, M.S., R.D.

Producer of CNN Nutrition News

Eating good food does make a difference to our health and quality of life! This book teaches preventive nutrition-not just for heart disease. I highly recommend it.

Kathy King Helm, R.D.

Nutrition

Mankato, Minnesota, set in a wooded river valley, is a typical midwestern small city.

What makes it unique are the people whose wide interests were focused in 1980 on their personal wellness by the Minnesota Heart Health Program. Mankato task forces pioneered numerous activities to develop an educational process to determine if a community could change its habits and customs to reduce the risk of cardiovascular disease.

Mankato's citizens have given a resounding "yes!" to this question.

Today, when we glance out the windows of the Program's office, located on the main intersection of town, we can see joggers and others walking briskly on the sidewalks. These same people, in the winter, enjoy walking in the nearby enclosed shopping mall or running on indoor tracks at the state university, up on the hill, or at the MCA. Many also record their time spent in physical activity for their businesses' part in the "Shape-Up Challenge" A restaurant in the same downtown mall is one of thirteen in town with hearts on the menu highlighting selections which meet the low-fat, low-sodium criteria of "Dining a la Heart"

• I his program began with restaurateurs and local citizens sitting around a

table brainstorming ways to help diners make healthy choices and feel good about them.

Grocery stores all over town have labels on their food shelves and in the meat and dairy cases designating foods which are low in sodium and fat and qualify for "Shopping Smart"

Down the street from the office a billboard proclaims "Check your blood pressure", offering free Blood Pressure Council measurements. Another, farther out, asks "Do you know your cholesterol level?"

Changes in school lunches went along with the "Hearty Heart" curriculum on diet and exercise; the children "Jog and Log" for 10 minutes a day in class; and they compete with their favorite recipes in the "Heart's Delight" recipe contest.

"Quit and Win" campaigns have helped to clean the air by motivating smokers to

• put out their cigarettes.

Early results from the study indicate that Mankatoans truly have benefitted from the variety of changes they've made and there is interest in continuing to move ahead into even healthier life-styles. In answer to the numerous requests from those who sincerely want to know how to prepare meals at home which are heart healthy, we have written this book.

We dedicate "Cooking a la Heart" to all those who have so enthusiastically supported the Mankato Heart Health Program.

Nadine Sugden

INTRODUCTION

A long Minnesota tradition, exploring the causes of heart attack and stroke, has resulted in the finding that there are sick (and well) populations just as there are sick (and well) individuals! This central idea led to the Mankato Heart Health Program and one of its many exciting community outcomes, Cooking à la Heart.

We and our colleagues overseas found people (e.g., Eastern Finland), having far more heart attacks than we, and others (e.g., the Greek islands and southern Japan) with almost none at all. We also demonstrated that the most consistent and powerful influence on the community-wide risk of heart attacks is the average blood cholesterol level. Where it is high, there are many heart attacks. Where it is low, there are virtually none. Where it goes up or down over time, so, after a few years, do the deaths from heart attack.

These findings in populations, combined with clinical and laboratory research, indicated to us some years ago that blood cholesterol level is the central factor in a community's risk of cardiovascular disease. Mass elevated cholesterol level is, in turn, most strongly influenced by the habitual eating customs of a community. Living then in a country where heart attack risk overall is relatively high, your and my individual risk depends importantly on other factors, especially our heredity, but also smoking habits and blood pressure.

Studies in Minnesota also established clearly that we can substantially modify our blood cholesterol level, that of our family and even whole communities. The cholesterol-lowering eating pattern is easy, palatable, attractive and economic. Preventive experiments indicate that heart attack risk is reduced in groups by about 2% for every 1% average cholesterol-lowering. Moreover, in Minnesota over the past 2 years more healthy eating and exercise patterns, decreasing smoking and control of high blood pressure have contributed to the recent 30% fall in coronary death rates.

But the background for Cooking à la Heart goes even farther back in time, to when all people on earth were either hunters or gatherers. Today we remain fundamentally adapted to that eating and lifestyle because it is only about 500 generations since agriculture and civilization began. It has been only 10 generations since the Industrial Revolution began and only a couple of generations since automation and automotion and affluence have affected most of us.

Few would choose to return to hunter-gatherer times, or even to the lifestyle of heart attack-free Mediterranean and Asian farmers. But to the extent we understand those earlier litestyles, the better we can adapt our ways to modern abundant eating and sedentary living.

As best we can piece it together, the hunter-gatherer lifestyle, to which our bodies adapted through the centuries, was characterized by regular physical activity to secure food and subsistence, up to 30 hours a week. This alternated with rest and socialization, in a harmonious cycle. It is likely that our major foods were plants, rich in starches, fiber, vegetable protein, minerals and vitamins. These plant foods were the staples that allowed humankind to survive and thrive throughout the ages.

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