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February is American Heart Month, which brings to mind the care of that organ we all come to love in the center of our chest, the heart. In efforts to care for their hearts, many people are thinking of eating right, exercising, stopping smoking, and decreasing stress. Heart disease is the number one killer of men and women in the U.S. Perhaps your relatives have heart disease or perhaps you are at risk for heart disease due to high blood pressure, high cholesterol, or diabetes. Diet can help control heart disease: eating 5 servings or more daily of fruits and vegetables, consuming sodium in moderation, and consuming less fat and cholesterol. A lesser known ingredient in a heart healthy diet is plant sterols or stanols.

You may have heard of plant sterols or stanols in the news or seen them in products on the grocers’ shelf. Sterols and stanols help form plants’ cell membranes. Studies from as far back as the 1950s have shown that plant sterols block cholesterol absorption in the intestine, which can reduce cholesterol levels in humans with no negative side effects. They can be a first step for people trying to lower their cholesterol levels.

Where can we find plant sterols and stanols? They are present in small quantities in fruits, vegetables, seeds, nuts, and legumes. Because the sterol content of these foods is usually not concentrated, food manufacturers began extracting plant sterols from vegetable oils and fortifying foods with them to help consumers obtain higher amounts. For example: margarine, orange juice, yogurt , cheese, and milk may be fortified with plant sterols. Another source is plant sterol supplements in the nutrition section of stores.

Foods that contain plant sterols can claim heart health benefits on their label, and this is the best way to identify these foods when shopping. You will need to consider the cost for these products as they can be expensive. Three tub margarine brands in local grocery stores claim to contain plant sterols: Promise Activ®, Smart Balance® and BENECOL®. Also consider the following milk and orange juice: Smart Balance® HeartRight® Fat Free Milk and Minute Maid® Heart Wise® Orange Juice. Other products are also available.

The American Heart Association states that 2 grams per day of plant sterols/stanols achieves the maximum effect for lowering cholesterol from 6 to 15 percent, with an average cholesterol-lowering effect of 10 percent. For example, if your total cholesterol is 240mg/dl and you regularly consumed 2 grams per day of plant sterols /stanols, you could lower your cholesterol approximately 24 mg/dl to 216mg/dl.

Reading the label will guide you to know the amount of plant sterol/stanol in each product. For best absorption, plant sterols/stanols should be consumed with meals. Remember that plant sterols/stanols are no replacement for cholesterol lowering medications prescribed by your doctor but can be a helpful addition to your diet. Studies show that consuming more than 2-3 grams plant sterols/stanols does not lower cholesterol any more than 10%. Also keep in mind that high fat products may add extra calories to your diet.

When looking at the nutrition fact label of margarine fortified with plant sterols, you will find that the serving size is 1 tablespoon, and the total calories are 70-80 for regular and 45-50 for the light spread. Total fat is about 7 grams for the regular spreads and 5 grams for the light spreads. You may also notice olive oil or omega-3 oils — other heart-healthy ingredients — added to these margarines.

As you continue in 2015, by eating right, exercising, stopping smoking, or decreasing stress, perhaps you will find plant sterols on the grocers’ shelf and try one of these products. This salad recipe would pair nicely with whole grain bread and 1-2 teaspoons margarine fortified with plant sterols/stanols to make part of a healthy meal.

Fish taco salad from diabetes self-management

Ingredients

  • 2 cups shredded romaine lettuce
  • 1 cup medium cucumber, seeded, chopped
  • ⅔ cup cherry or grape tomatoes, halved
  • ½ cup chopped celery
  • ¾ cup (about 6 ounces) flaked, cooked cod or other firm white fish
  • Juice of ½ lime
  • 1 tablespoon olive oil
  • ¼ teaspoon black pepper
  • ¼ cup fat-free sour cream
  • ¼ cup reduced sodium salsa
  • 1 teaspoon sugar or sugar substitute
  • 11-15 (about 1 ounce) baked corn or tortilla chips

Directions

Layer romaine, cucumber, tomatoes, celery, and fish in large bowl

Whisk together lime juice, oil and pepper in small bowl. Pour dressing over salad; and toss. Divide salad evenly into 2 servings

Whisk together sour cream, salsa and sugar in small bowl. Pour evenly down the center of each salad. Crumble tortilla chips down each side of the sour cream mixture.

Nutrition information: Per serving: Calories: 286, total fat 9 g, saturated fat 1 g, protein 25 g, carbohydrate 28 g, sodium 305 mg (bread with margarine not included)

Cathy Daus is a registered dietitian at Mayo Clinic Health System in La Crosse.

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