Back in the day, heart disease was always thought of more as a “man’s disease.” However, we now know coronary artery disease, peripheral artery disease, arrhythmia, and congestive heart failure do not discriminate among genders — 1 in 4 women dies from heart disease in the United States. Starting at about 20 years old, approximately 1 in 16 women will begin to develop coronary heart disease, the number one cause of death for women in the U.S. The risk of heart disease for women increases as we age.

Heart disease is preventable. Like many other illnesses, it often starts in the gut. As we mentioned in parts 1 and 2 of our “Aging Gracefully…Other BS” series, exercise and nutrition help combat heart disease.

We know what you are thinking — heart disease is all about building plaque on the walls of the arteries that supply blood to the heart, right?! Yes, that is correct. You have also likely heard the heart-healthy guidelines: Eat healthy, stay active, don’t smoke, and limit alcohol use to lower your chance of heart disease. This article will focus on heart-healthy guidelines: Eat healthy because what we eat can make a difference in the health of our hearts❤️.

Fiber. Number one element to preventing heart disease from beginning to develop in your gut. We discussed fiber’s importance here: https://amysmargulies.medium.com/womans-series-part-2-your-food-your-gut-your-immunity-a07a6ab3e1bd — so take a look if you missed it!
Healthy fats. Fat was a word formally banished from our plates until science revealed how healthy fats play one of the most essential roles in our bodies. Healthy fats help you absorb specific vitamins and minerals, and they provide certain vitamins and minerals. Fat is needed to build cell membranes and the sheaths surrounding nerves. Furthermore, healthy fats are essential for blood clotting, muscle movement, and inflammation. These healthy fats are monounsaturated and polyunsaturated. AVOID industrial-made trans fats!
Fats are both naturally and industrially created. The chemical structure of fats is what makes them both similar and different. A simple explanation — without feeling like you are back in 8th-grade science — is that all fats contain a chain of carbon atoms bonded to hydrogen atoms. Seemingly slight differences in fat structure translate into crucial differences in form and function:
Unhealthy fats:

• Trans Fat — Thankfully, no longer permissible in the US and other countries. The food industry created it to extend the shelf life of foods, not people…
• Saturated Fat — when your carbon atoms are covered or “saturated” with hydrogen atoms. These saturated atoms cause both your LDL cholesterol (the plaque-building cholesterol) and total cholesterol to increase. These fats are solid at room temperature, including red meat, whole milk, other full-fat dairy foods, cheese, coconut oil, and many commercially prepared baked goods. As Waze would say — Please make a U-turn, ” which is not the direction we want to go.

Healthy fats:
Now we are on the right road! Less is best for bonding and fats (but not bonding and friends, of course). With fewer hydrogenated atoms bonding to their carbon chains, you have a liquid at room temperature. Some food sources include vegetables, nuts, seeds, and fish.

• Polyunsaturated Fat — These are the essential dudes — required for normal body functions — built with double bonds or more in their carbon chain. They are necessary for nerve function, blood clotting, brain health, and muscle strength. They may reduce your total cholesterol and triglycerides. Your body can’t make these essential dudes, so you must get them from food. There are two main types, omega-3 fatty acids and omega-6 fatty acids, which differ in structure and, therefore, differ in benefits. Like friends with benefits, they come fully loaded…lol..Most importantly, for our topic today, both help prevent heart disease. Sources of omega-3 fatty acids include fatty fish such as salmon, mackerel, and sardines, flaxseeds, walnuts, canola oil, and non-hydrogenated soybean oil. Sources of omega-6 fatty acids include vegetable oils such as safflower, soybean, sunflower, walnut,
  and corn oils.
• Monounsaturated Fat — These are the happy-to-be solo fats — single bonding structures, living the Mediterranean lifestyle🏝. Good sources include olive, peanut, canola, avocado, most nuts, nut butter, and high-oleic safflower and sunflower oils. Monounsaturated fats may lower your total and low-density lipoprotein (LDL) cholesterol levels but maintain your high-density lipoprotein (HDL) cholesterol levels. So, they are essential to include in your heart-healthy food repertoire.

Let’s dip more into monounsaturated fats or MUFAs (a much more fun name when you say it out loud). Yes, they include the olive oil you may dip into when dining out (when…). These heart-healthy food sources are tasty, as well as calorically dense. All fats, including MUFAs, are high in calories, so even when making this healthy fat choice, use MUFAs in moderation. Therefore, when dipping your bread in that olive oil, enjoy it, but try not to overdo it. Choose MUFA-rich foods instead of other fatty foods, not in addition to them. For example:

• You can use crushed or sliced nuts 🥜 in your salad instead of croutons (the crushed or sliced nuts are just to make a small serving go a longer way).
• Adding avocado🥑to your salad or sandwich instead of bacon.
• Adding olives to your pizza🍕instead of pepperoni or fried chicken.
• Using canola oil instead of shortening when baking🍞(and even then, reduce the amount).
• Snack on a serving of nuts 🌰instead of chips or crackers.

Always keep in mind that we are not asking for perfection. No one is perfect, and you are not perfect (no offense). But by removing that vocabulary from your repertoire, it all becomes a whole lot easier. Just keep moving forward. And when you fall back, pick yourself up and keep on movin’. Regarding fat sources, making these small changes will eventually make a big difference to your heart❤️!
Let’s cook up some MUFA!

photo by McCormick

CHICKEN KIEV-STYLE
This is based on the more famous Chicken Kiev, but lightened up and heart-healthy! The original recipe leaves the chicken with the skin, stuffs it with butter, dips it in egg and bread crumbs, and then deep fries it. This version has much less fat and uses a monounsaturated oil, fresh whole wheat bread crumbs, and lots of herbs, spice, and flavor, creating something moist, delicious, and healthy for your heart. With that said, this is a longer recipe, so perhaps a weekend dish or an evening when you feel you can commit and embrace your time in the kitchen…just sayin ;).

INGREDIENTS
4 boneless, skinless chicken breasts
3 1/2 Tablespoon extra virgin olive oil, divided
1 1/2 cups chopped onion
8 ounces fresh mushrooms, washed and dried, chopped into small pieces
3–4 garlic cloves of garlic, chopped
1 teaspoon freshly ground pepper, divided
1/2 teaspoon salt
4 Tablespoons chopped fresh cilantro, divided (or basil, thyme, or other favorite herb)
2 cups fresh whole wheat bread crumbs (created by removing crusts and processing 4 slices whole wheat bread in the food processor until just crumbly)
1/4 cup nonfat milk
​
PREPARATION
Preheat the oven to 400 degrees. For the filling, Heat 1 1/2 tablespoons of olive oil in a large skillet over medium heat. Add the onions and sauté for about 2 minutes. Stir in the mushrooms, salt, 1/2 teaspoon pepper, and garlic. Cover and cook for about 3 minutes. Then, remove the lid and cook until the liquid fully evaporates from the skillet. Remove from heat and stir in 2 tablespoons of your herb of choice. Place on a dinner-size plate, divide into 4 equal portions, and set aside to cool for about 20 minutes.
For the coating, combine the bread crumbs, 2 tablespoons olive oil, 2 tablespoons of your herb of choice, and 1/2 teaspoon black pepper in a medium bowl.
For the cookin’: Spray a baking sheet with nonstick cooking spray. Arrange the prepared chicken on the sheet. Bake in the preheated oven for 20–25 minutes. The chicken should be cooked through but still moist. Serve immediately, sliced for a fancy look, or whole, topped with herbs. Makes 4 servings.

Photo by Sophie Mikat on Unsplash

MUFA FLATBREADs
It’s a goofy name, but it makes a point. Any flatbread can be made into a balanced, heart-healthy meal. Choose whole grain and top with your MUFA favorites, and we are all set. It is a great way to use leftovers or grab some of those frozen veggies that have been in there for perhaps a little while…you know which ones I mean :).

INGREDIENTS
1 whole grain flatbread — i.e., whole wheat Naan, whole wheat pita bread, whole wheat tortilla
1 teaspoon olive oil
1 clove garlic, crushed
1 1/2 cups cooked veggies: broccoli, mushrooms, zucchini, spinach
1/2 cup chopped arugula and/or tomatoes
1/2 cup low-fat cheese — any mix of mozzarella, cheddar, feta, goat, etc.
1/2 cup protein from your fridge or pantry: chopped cooked chicken, white beans, cooked lean steak, cooked shrimp, etc.
1/4 teaspoon freshly ground pepper
optional garnish: fresh basil leaves

PREPARATION
Preheat the broiler on low. Place the flatbread on a baking sheet lined with nonstick foil. Brush flatbread with olive oil. Mix veggies with garlic and spread veggies, protein, and cheese evenly on top of your flatbread, with cheese on top.
Place in oven and broil for 2–3 minutes or until cheese begins to brown.
Makes one serving, but feel free to double, triple, or quadruple as needed.

ROASTED TILAPIA WITH ALMONDS AND OLIVES
Roasting helps to bring out the natural juiciness of the food, creating a moist, flavorful, and satisfying dish. This fish dish is topped with some of our MUFAs, of course, creating a delicious mix of tender fish and moist crunch to make your taste buds and heart smile big. If you’re not a fan of fish, you could easily substitute a veggie here, too, like asparagus or string beans.

INGREDIENTS
4 6-ounce tilapia fillets
1/3 cup lime juice
1/2 Tablespoon freshly ground black pepper
1/2 Tablespoon fresh tarragon, chopped
1/2 Tablespoon minced shallots
3 Tablespoons tomato paste
2 ounces white wine
1/2 cup black olives, pitted and chopped
2 Tablespoons almonds, crushed
Fresh chopped tarragon for optional garnish

PREPARATION
Combine lime juice, pepper, tarragon, and shallots in a large sealable bag. Add the tilapia fillets (or vegetables) and turn to coat all sides with the marinade. Let it marinate at room temperature for about 20 minutes. While the fish is marinating, place nonstick foil on a rimmed baking sheet. Preheat the oven to 400 degrees.
Remove the fish from the marinade and place it on a baking sheet. Roast in the oven for 10–12 minutes, or until fork tender.
While roasting the fish, prepare the sauce by placing a small skillet over medium heat. Add the tomato paste and white wine. Bring to a simmer for 5–6 minutes. Remove from heat. Stir in the olives and almonds.
Once roasting is complete, remove fish from oven and place on serving dish. Top with sauce and additional tarragon for garnish. Makes 4 servings.

Survival is the new success. ​

~ Jerry Seinfeld

RESOURCES:

*Abdelhamid AS, Martin N, Bridges C, Brainard JS, Wang X, Brown TJ, Hanson S, Jimoh OF, Ajabnoor SM, Deane KH, Song F, Hooper L. Polyunsaturated fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2018 Jul 18;7(7):CD012345. doi: 10.1002/14651858.CD012345.pub2. Update in: Cochrane Database Syst Rev. 2018 Nov 27;11:CD012345. doi: 10.1002/14651858.CD012345.pub3. PMID: 30019767; PMCID: PMC6513571.

* Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC Jr, Sperling L, Virani SS, Yeboah J. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019 Jun 25;73(24):3168-3209. doi: 10.1016/j.jacc.2018.11.002. Epub 2018 Nov 10. Erratum in: J Am Coll Cardiol. 2019 Jun 25;73(24):3234-3237. doi: 10.1016/j.jacc.2019.05.012. PMID: 30423391.

*Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, Himmelfarb CD, Khera A, Lloyd-Jones D, McEvoy JW, Michos ED, Miedema MD, Muñoz D, Smith SC Jr, Virani SS, Williams KA Sr, Yeboah J, Ziaeian B. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019 Sep 10;74(10):e177-e232. doi: 10.1016/j.jacc.2019.03.010. Epub 2019 Mar 17. Erratum in: J Am Coll Cardiol. 2019 Sep 10;74(10):1429-1430. doi: 10.1016/j.jacc.2019.07.011. Erratum in: J Am Coll Cardiol. 2020 Feb 25;75(7):840. doi: 10.1016/j.jacc.2019.12.016. PMID: 30894318; PMCID: PMC7685565.

*Lloyd-Jones DM, Morris PB, Ballantyne CM, Birtcher KK, Daly DD Jr, DePalma SM, Minissian MB, Orringer CE, Smith SC Jr. 2017 Focused Update of the 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol. 2017 Oct 3;70(14):1785-1822. doi: 10.1016/j.jacc.2017.07.745. Epub 2017 Sep 5. PMID: 28886926.

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