Nature's best cholesterol crunchers

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YOUR HEALTHY HEART

Your guide to the power and flavor of the top soluble-fiber superfoods

Believe it or not, there's a natural prescription to lower your cholesterol you don't have to go to a pharmacy to fill. If you know where to look, this powerful remedy is available right on the shelves of your supermarket. Just load your cart with fabulous foods that are high in soluble fiber (we'll show you which ones) and you'll be stocking up on the safest, healthiest and tastiest cholesterol-crunching substance there is!

That's the advice of Prevention editorial advisor James Anderson, M.D., preeminent researcher of the cholesterol-lowering effects of soluble fiber and the "discoverer" of oat bran as a top soluble-fiber storehouse. Scores of studies by Dr. Anderson (professor of medicine and clinical nutrition at the University of Kentucky) and others now have settled earlier questions about whether soluble fiber really does lower cholesterol. Today most heart experts, including those at the government's National Cholesterol Education Program, agree: It works!

In fact, so clear is the picture that the Food and Drug Administration now permits foods that are good natural sources of soluble fiber (and also low in fat and cholesterol) to state on their labels that diets with lots of high-soluble-fiber foods may reduce our risks of heart disease.

Though not everyone may respond the same, Dr. Anderson's research shows that for some people, combining soluble fiber with a low-fat diet can mean cholesterol reductions of 50 points or more! Adding soluble fiber to an already-low-fat diet could knock cholesterol down to a safe count and make cholesterol-lowering drugs unnecessary.
GREAT, GLORIOUS GOO

Where does soluble fiber come from? In every morsel of plant food we chew--vegetables, fruits, legumes and grains--there's an indigestible mixture of soluble and insoluble fibers.The insoluble fibers, such as wheat bran--the stuff we call roughage--help KO constipation and lower risks of colon and possibly breast cancer.

But the soluble fibers--the cholesterol-lowering heroes--form a surprising minority, averaging only a quarter of the total fiber in almost all foods. Even in sources rich in soluble fibers, like beans or oats, there's actually more insoluble fiber. As a result, it's all too easy to come out short on soluble fiber without realizing it. But that's where Prevention comes to your aid.

Though there are lots of different soluble fibers--beta-glucans in oats and barley, pectins and hemicellulose in fruits and veggies, and hemicellulose in beans--they all behave alike inside the body. The name soluble implies that these fibers dissolve in the presence of water, like sugar stirred in coffee. But in reality they swell like sponges, gathering water particles together in a kind of gummy gel. If insoluble fibers are roughage, a better name for soluble fibers might be "goo-age."

Scientists think it's probably this goo factor that makes soluble fiber work--by preventing the body from recycling a digestive secretion called bile. If soluble fiber is present in your small intestine, bile--which contains cholesterol--gets trapped in all that goo-age and is excreted. Presto, you've just removed some cholesterol! Without soluble fiber, your body reabsorbs its bile and recycles the cholesterol it contains.

Further cholesterol cutting may happen after soluble fiber passes along to the large intestine, where it becomes food for billions of harmless bacteria living there. These busy little guys brew substances called short-chain fatty acids, which are absorbed into the body. There, they may suppress the natural manufacture of cholesterol that occurs in the liver.
A LITTLE DOES A LOT

If you think you'll have to chomp your way through a mountain of oat bran--or even a hill of beans--to see results, relax. When researchers at the University of Minnesota combined the results of the 10 best-conducted studies of oat bran, here's what they found: Adding as little as 3 grams of soluble fiber per day (that's 1 cup of cooked oat bran) lowered cholesterol levels an average of 2 to 3 percent. And in people whose cholesterol was 230 and above, the average reduction moved up to 6 to 7 percent. The more soluble fiber subjects ate, the greater the reductions tended to be, too (Journal of the American Medical Association, June 24, 1992).

Several Anderson studies (conducted among hospital patients and using higher doses of fiber) have achieved better results. In one study, adding 6 to 9 grams of soluble fiber (11/2 cups cooked beans) brought cholesterol levels that were above 260 down an average of 23 percent.

Not everyone can expect as big a drop in cholesterol from a soluble-fiber boost. That's partly due to heredity--some people just don't respond to diet changes. But others do, with occasionally spectacular results. "Sometimes you get tremendous surprises," says William Castelli, M.D., director of the Framingham Heart Study, "such as people who go from cholesterol over 300 to below 200 just from changing diet alone--cutting down the fat and boosting the soluble fiber."

Research also shows that the higher your cholesterol, the more it's likely to drop with soluble fiber. "The bigger they are, the harder they often fall," says Dr. Anderson. But what if the reduction you get is "small"--5 percent, for instance? Sound like peanuts? Not to Dr. Castelli. "Since every 1 percent drop in cholesterol--especially at high levels--is thought to decrease the risk of heart attack by 2 percent, getting that little 5 percent drop means your chance of heart attack just went down by 10 percent," he says, "and that's not peanuts!"

Suppose your total cholesterol already is under 200, the level many physicians consider desirable. Is it worthwhile focusing on soluble fiber to get further (and possibly smaller) reductions? "Absolutely," says Dr. Anderson. He points out that, while a cholesterol level under 200 is desirable, some heart experts consider a level in the 150 to 170 range as ideal, conferring even stronger protection.

Besides crunching cholesterol, soluble fiber brings other healthy pluses, from helping control blood glucose and normalizing bowel function to making weight management easier by helping us feel full. High-fiber foods supply a treasure chest of vitamins and minerals, too. And menus full of fiber leave less room for the fatty foods we want to avoid. That's why every day we need 20 to 35 grams total fiber, about 10 grams of which should be soluble, says Dr. Anderson.

Important note: As potent as soluble fiber is for reducing cholesterol, it's not a magic bullet that makes it safe to shovel down bacon and eggs or other high-fat, high-cholesterol foods. Every heart expert we spoke with stressed this point. "I had a patient once who told me proudly that he'd had a cheeseburger, but it was O.K. because he had it on an oat-bran bun," says Prevention editorial advisor Dean Ornish, M.D., director of the Preventive Medicine Research Institute. To be effective, Dr. Ornish cautions, soluble fiber must go hand in hand with a low-fat, low-cholesterol diet--still the foundation of a heart-healthy lifestyle.
POWERFULLY GOOD FOODS

Question: What do dried apricots, artichokes and cereals high in wheat bran have in common? Surprise--they're all fabulous sources of soluble fiber. But most people can name few soluble-fiber foods--often it's only oat bran that comes to mind. So to help you meet soluble-fiber needs without oat-bran overkill, we've listed dozens of delicious sources boasting 1 gram of soluble fiber or more per serving. Even our editors were surprised by some foods that made the list. See "Soluble-Fiber Superfoods" on page 60.

When it comes to veggies rich in soluble fiber, most people think of carrots. But sweet potatoes, brussels sprouts and celery root, among others, actually beat carrots in solubles per serving. Among fruits, oranges and apples are the top sources many people know, but other fruits--such as mangoes, figs, plums, and kiwi fruit--are soluble superstars, too.

Foods that are the richest storehouses of soluble fiber? It's the luscious legumes and oat cereals--many with 2 grams of soluble fiber per serving or more. But a big surprise was the high-fiber wheat-bran cereals--best known as major sources of the rough stuff, insoluble fiber. Turns out some of them also have a very respectable 1 gram of soluble fiber per serving!

Maybe the most unexpected sources of soluble fiber are things you've been throwing away. Like the liquid in canned beans, for instance. According to Dr. Anderson, there's soluble fiber "dissolved" in that canning liquid--that's why it's soupy instead of watery. What about the salt it contains? Unless you've got salt-sensitive high blood pressure or congestive heart failure, Dr. Anderson thinks you're better off using the canning liquid, salt and all. Better yet, cook your own beans using little salt.

If you've been peeling apples, pears, peaches or potatoes, stop. There's a lot of soluble fiber in the peels, says Dr. Anderson. And you'll get more soluble fiber by eating whole grapefruit sections--membrane and all--than by spooning out the pulp from between membranes or by drinking just the juice. The same is true for oranges. Tip: The more of the white inner rind you leave on each section, the more soluble pectins you'll get.

It's too bad, but many popular foods are soluble-fiber fizzles. A cup of cornflakes, for example, has only a tenth of a gram. So does a cup of chopped mushrooms or iceberg lettuce or a medium tomato. Even many foods high in total fiber are light on solubles. Popcorn, with 3 grams of fiber per three-cup serving, has only a tenth of a gram of soluble fiber.

To lock in the cholesterol-cutting power of a high-soluble-fiber diet, you need to focus on eating a few of the top soluble sources every day. For how-to suggestions, see "Your Daily Soluble-Fiber RX" on page 58.

Health bonus: Even in top soluble sources like beans, more than half the total fiber is insoluble. So by enjoying lots of these foods, you're certain to get enough total fiber.
A SOLUBLE-FIBER BOOSTER SHOT

You've given a low-fat, high-soluble-fiber diet a try. Cholesterol levels are down, but not enough to put you under 200. For your next step, here's the advice of Dennis Sprecher, M.D., cardiologist and director of the Lipid Research Clinic, University of Cincinnati: Ask your doctor about adding psyllium supplements to your heart-healthy diet.

Psyllium (the "p" is silent) is a highly concentrated form of soluble fiber that's been used for 60 years as a bulk-forming laxative. But research by Dr. Sprecher and others shows that adding psyllium to an already low-fat diet can further reduce total and "bad" LDL cholesterol. In a recent study, Dr. Sprecher found reductions in total cholesterol of more than 4 percent and LDL levels of more than 6 percent when patients added 10 grams of psyllium per day to a low-fat diet (Annals of Internal Medicine, October 1, 1993).

For some people, that extra reduction may be enough to make cholesterol-lowering drugs--with their potential side effects--unnecessary. "If a patient can lower cholesterol with diet and psyllium alone, you can't get a whole lot safer than that," says Dr. Sprecher. Even if drug therapy proves to be necessary, the dose can sometimes be lower if psyllium supplements are part of the treatment.

Just be sure to check with your doctor before using psyllium, Dr. Sprecher advises. That's because it can alter the absorption of other medications you may be using. Be sure to drink lots of water if you're taking soluble supplements, too.

Why not just keep on boosting soluble fiber intake with foods alone? "Most people," Dr. Anderson says, "tend to 'max out' at about 10 to 15 grams of soluble fiber from foods a day. Unless they're supermotivated, they just can't eat much more than that on a steady basis." But adding psyllium, because it's so concentrated, is a practical way to get a lot more soluble fiber in a little package.

Usually taken as a powder mixed with water or juice, psyllium (sometimes it's labeled psyllium hydrophilic mucilloid) comes from the ground-up seed husks of a plant grown in India. Besides the powder form, less-concentrated psyllium combined with wheat bran is available in the cereal Bran Buds. Psyllium is also available in wafers, but be careful: They may also contain fat.

What about using other concentrated-soluble-fiber supplements on the market? Dr. Anderson's advice is to stick with psyllium. Some products, such as methylcellulose, psyllium-seed extract and hydrolyzed guar, have not been shown to be effective in lowering cholesterol. Unhydrolyzed guar may be effective, but it's less pleasant to take than psyllium. Several pectins are sold in health-food stores, but their effectiveness varies, according to Dr. Anderson.

Most of all, don't rely only on a fiber supplement and give up high-fiber foods. "If you did that," says Dr. Anderson, "you'd be missing all the other crucial nutrients that fiber foods come packaged with."

SOLUBLE-FIBER SUPERFOODS

Here are selected top foods to add soluble-fiber power to your heart-healthy diet. The specific amounts of fiber should be viewed as guidelines only--measuring soluble fiber is a complex procedure that fiber experts are still perfecting. That's why you may sometimes see slightly differing amounts of fiber given in other sources.

Please note that there are many processed foods high in soluble fiber that didn't make our list. That's because most manufacturers don't provide a soluble/insoluble-fiber breakdown for their products. If the main ingredients in a processed food are high in soluble fiber, it's a good bet that the product is a soluble-fiber winner. The number after each food represents grams of soluble fiber.

VEGETABLES
1 medium artichoke, cooked = 2.2
1/2 cup fresh celery root = 1.9
1/2 cup cooked sweet potato = 1.8
1/2 cup cooked parsnip = 1.8
1/2 cup cooked turnip = 1.7
1/2 cup baked acorn squash = 1.6
1 medium baked potato with skin = 1.6
1/2 cup cooked brussels sprouts = 1.4
1 cup fresh cabbage = 1.3
1/2 cup cooked green peas = 1.3
1/2 cup cooked broccoli = 1.2
1/2 cup cooked carrots = 1.1
17 1/2-inch-long raw carrot = 1.1
1/2 cup cooked cabbage = 1.1
1/2 cup cooked French-style green beans = 1.1
3/4 cup cooked cauliflower = 1.0
3/4 cup cooked asparagus = 1.0
3/4 cup cooked beets = 1.0

FRUITS (fresh unless noted)
1/2 mango = 1.7
2 figs = 1.7
2 dried figs = 1.5
2 kiwifruit = 1.4
1 orange = 1.4
2 plums = 1.4
1 small pear = 1.1
1/2 medium grapefruit = 1.1
3/4 cup blackberries = 1.1
11/4 cup strawberries = 1.1
7 dried apricot halves = 1.1
1 small apple with skin = 1.0
3 prunes = 1.0
1 medium peach = 1.0
1 cup raspberries = 1.0
3/4 cup canned fruit cocktail = 1.0

CEREALS
Quaker Oat Bran, 1 cup cooked or 1/2 cup dry = 3.0
Quaker Oat Bran Cereal, ready to eat, 1 1/4 cup serving = 3.0
SmartBeat High Fiber Oatmeal,*
1 packet instant = 3.0
3/4 cup cooked = 3.0
H-O Super Bran High Fiber Cereal,* 3/4 cup cooked = 3.0
Kellogg's Bran Buds, 1/3 cup = 3.0
Quaker Oatmeal (Quick Cooking, Old Fashioned
and Multigrain), 1 cup cooked = 2.0
Health Valley Healthy Crunch With
Almonds and Dates, 1/2 cup = 1.4
Raisin bran, 1 cup = 1.2
Quaker Instant Oatmeal, 1 packet = 1.0
Nabisco 100% Bran, 1/3 cup = 1.0
Kellogg's All Bran, 1/2 cup = 1.0
Post Oat Flakes, 2/3 cup = 1.0
Kellogg's Common Sense Oat Bran, 3/4 cup = 1.0
Cheerios, 1 1/4 cups = 1.0
Nabisco Shredded Wheat 'N Bran, 2/3 cup = 1.0
Post Bran Flakes, 1/2 cup = 1.0
Kellogg's Complete Bran Flakes, 3/4 cup = 1.0
Post grape-nuts, 1/4 cup = 1.0
Post Bran'nola, 1/3 cup = 1.0
Quaker Low-Fat 100% Natural Crispy Whole-Grain
Cereal With Raisins, 1/2 cup = 1.0

* Available in select markets; inquire with your supermarket manager.

GRAINS
Pearl barley, 1/4 cup uncooked or 3/4 cup cooked = 1.8
1/4 cup oat flour = 1.6
1/4 cup rye flour = 1.3
41/2 tablespoons wheat germ = 1.0

LEGUMES (BEANS, PEAS, LENTILS)
(1/2 cup servings, cooked)
Kidney beans = 2.8
Cranberry beans = 2.7
Butter beans = 2.7
Baked beans, canned = 2.6
Black beans = 2.4
Navy beans = 2.2
Lentils = 2.0
Pinto beans = 1.9
Great Northern beans = 1.4
Chick-peas = 1.3
Dried limas, canned = 1.1
Split peas = 1.1

BEANING UP

To give you some idea just how "full of beans" various legume dishes are, we figured portion sizes of six traditional recipes that yield at least 2.5 grams soluble fiber. (Consider fiber contributed by other ingredients a bonus.) Different recipes may yield different amounts.

3/4 cup bean soup (made with navy beans) = 2.5
3/4 cup vegetarian chili (made with pinto beans) = 2.5
3/4 cup 3-bean salad (made with kidney beans, chick-peas and
green beans) = 2.5
1 1/4 cups lentil soup = 2.5
1 1/2 cups split pea soup = 2.5
1 3/4 cups minestrone (made with kidney beans) = 2.5

See the February issues of Prevention in 1993 and 1994 for terrific legume recipes.

PHOTO: A kiwi fruit in a dish.

~~~~~~~~

by Holly McCord, R.D., with Teresa A. Yeykal

THE RESEARCHER WHO WAS A GUINEA PIG

Bet you can't guess the first human guinea pig to try oat bran! Back in 1977, when Prevention editorial advisor James Anderson, M.D., first suspected oat bran's cholesterol-cutting potential, he ordered a 100-pound load of the stuff from the only source--a company that milled oats to make face powder.

Once the oat bran arrived, Dr. Anderson himself became the first human to try it. He began eating a large bowl of cooked oat bran each morning and three to four oat bran muffins a day. In five weeks his cholesterol plummeted from 285 to 175--and he lost eight pounds! Compelled by his own experience, Dr. Anderson began the series of studies that boosted oat bran to a respected place in every heart-healthy kitchen.

Look for his new book, Dr. Anderson's High-Fiber Fitness Plan (University Press of Kentucky) in book-stores next month.

PHOTO: Dr. Anderson

YOUR DAILY SOLUBLE-FIBER RX

For maximum cholesterol crunching, power up your low-fat diet with soluble fiber. Here's how much Prevention editorial advisor James Anderson, M.D., recommends for our readers (along with the average cholesterol reductions he'd expect to see as a result*). Start with Level 1 and, if needed, move to higher levels. Give each level approximately four to six weeks.

LEVEL 1: 10 grams soluble fiber per day. This is a healthy level even for those with cholesterol under 200. Average cholesterol reduction: 5 to 10 percent. If more reduction is needed, move to Level 2.

LEVEL 2: 15 grams soluble fiber per day. Average cholesterol reduction: 10 to 15 percent. If more reduction is needed, move to Level 3.

LEVEL 3: 15 grams soluble fiber per day plus psyllium under your doctor's supervision. Average cholesterol reduction: 15 to 20 percent.

* Response to soluble fiber varies greatly from person to person, though the largest reductions usually are seen at the highest cholesterol levels.

A 10-GRAM DAY THE EASY WAY

Use our Soluble-Fiber Superfoods to get an easy 10 grams of soluble fiber a day (the minimum amount Dr. Anderson recommends):

1. Start the day with a high-soluble-fiber-cereal-and-fruit combo--enough for a minimum total of 2.5 grams.
2. During the day, work in a serving of cooked legumes that adds another minimum 2.5 grams. For most varieties of legumes, this works out to 1/2 to 1 cup. (See "Beaning Up" on page 117.)
3. Make sure at least two more of your fruit and vegetable servings are high-soluble-fiber choices. This adds another 2 grams or more.
4. Count 3 grams for the rest of the food you'll be eating during the day. Your soluble-fiber total will be at least 10 grams!

RUNNING OUT OF GAS

Eating lots of fiber, especially soluble fiber, makes some people feel bloated and gassy, especially at first. You can minimize these side effects by working up to any high-fiber intake slowly, adding a few grams a week. Many people who persevere find symptoms subside over time--and often (ahem) sound worse than they really are.

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