Heart Helpers

Centuries ago, Native Americans followed heart-healthy diets while foraging salmon from streams, plucking wild berries from forests, baking with the “good” fat from acorn nuts, and extracting blood-thinning compounds and heart stimulants from tree bark and roots. These days, we have been turning back time to follow their example, as physicians readily prescribe basic foods to help prevent and treat heart ailments. Not only are whole ingredients still added to meals to target heart health, technology has advanced through the years to concentrate relevant substances, recommend synergistic combinations, and select for beneficial plant genetic strains.

Cholesterol deleted 

Beta-glucan soluble fiber, fish omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and plant phytosterols, including plant sterols and stanols, all can help lower “bad” low-density lipoprotein (LDL) cholesterol, and are among the few ingredients recognized by the FDA for cardiovascular disease (CVD) health claims.

The industry frequently uses sterols now that technological processes can efficiently extract them from vegetable oils like sunflower, soy and canola. Esterifying the sterols allows easy incorporation into dairy applications, baked goods, nutritional beverages, spreads, dressings and nutrition bars without issues related to off-flavors or instability.

“Plant sterols are structurally similar to cholesterol and compete with cholesterol at the receptor sites in the intestine, blocking LDL-cholesterol uptake by 8% to 15%. They actually perform better with higher cholesterol levels in the diet,” says Dr. Joe Keenan, professor, Department of Food Science and Nutrition, Family Practice and Community Health, University of Minnesota, Minneapolis. To meet the FDA qualified CVD health claim, the food must contain at least 0.65 grams of plant sterol esters per serving or at least 1.7 grams of plant stanol esters per serving, as part of a diet low in total fat, saturated fat and cholesterol (see “Getting to the Heart of Sterol Fortification” on page 29 for more on sterols and stanols).

Alpha-linolenic acid (ALA), an essential omega-3 fatty acid found in soy and nuts, can also help reduce cholesterol. “Walnuts are one of the most ALA-dense whole food sources. Research shows that California walnuts are a safe, effective way to reduce LDL ‘bad’ cholesterol by as much as 16%, reduce triglycerides, reduce blood pressure, improve the elasticity of arteries and reduce inflammation. There are many substances in walnuts believed to be responsible for these beneficial effects, including the omega-3 fatty acids, plant sterols, dietary fiber, and various antioxidants. One to 1.5 oz. per day will provide a beneficial effect,” explains Amy G. Myrdal, R.D., marketing director, North America, California Walnut Commission/ Walnut Marketing Board, Sacramento (see “Omega-3s: Focus on the Future” on page 17 for more on omega-3s).

The nutmeat isn’t the walnut’s only functional component. “The skin on the walnut meat is called the pellicle. The pellicle color—light to dark brown—can be correlated to the amount of tannins in the pellicle. Tannins are created by the walnut tree during times of stress, and the more tannins, the more antioxidants in the nut. Tannins are associated with reducing risk of heart disease,” says Myrdal.

Fiber, particularly a soluble type called beta-glucan, is also associated with reduced cholesterol. The FDA allows makers of low-fat cereals and other foods that contain sufficient barley and oat beta-glucan to carry labels regarding the products’ ability to lower serum cholesterol. In the gut, beta-glucan forms a viscous gel around cholesterol- rich bile acids, which limits their reabsorption by the blood. This causes the liver to churn out more bile acids, which in turn, removes more cholesterol from the blood.

Soy foods are another way to lower LDL cholesterol and increase high-density lipoprotein (HDL) cholesterol. Studies show that 25 grams of soy protein per day may help decrease risk of heart disease. Although the FDAapproved heart-health claim focuses on soy’s protein content, other physiologically active components might contribute to soy’s cholesterol-lowering effect. These include amino acids, saponins, phytic acid, trypsin inhibitors, fiber, globulins and isoflavones. Some believe soy’s isoflavones have the most impact on its heart-healthy effects, but this is still a controversial theory.

Heartbeat treats 

Some consumers might compare cafés that serve wine, tea, fruit smoothies and chocolate to health resorts due to the phytochemicals and antioxidants found in their ingredients. Antioxidants are correlated with free radical quenching processes that help prevent cell damage. Food ingredients contain a wide variety of antioxidants, including epigallocatechin gallate (ECGC) in green tea, isoflavones in soy protein, phenolic compounds in spice extracts, quercetin in color-rich fruits and vegetables, and vitamin C in many fruits and vegetables. Research suggests that antioxidant flavonols like epicatechin, found in chocolate, wine, licorice and tea, signal the muscles in the blood vessel walls to relax, increasing blood flow and circulation, and reducing fatty deposits on arterial walls.

CocoaVia® chocolate bars are a result of a Mars, Inc., patented process to retain cocoa flavonols. “Years of scientific research indicates that cocoa flavonols, naturally occurring compounds found in the cocoa bean, appear to enhance vascular health, which is critical to cardiovascular health,” explains Marlene M. Machut, director, health, science & nutrition communications, Masterfoods N.A., a division of Mars, Inc., Hackettstown, NJ. “There are a variety of steps during the process of selecting raw cocoa beans to producing finished cocoa and chocolate that can impact the level of flavonols retained in the final product. These include bean selection, ripeness, fermentation, roasting and formulation, among others,” she says.

Red fruits are abuzz with healthy press and scientific studies linked to heart benefits. Researchers at the Preventive Medicine Research Institute, Sausalito, CA, found that 1 cup of pomegranate juice per day improved blood flow to the heart by 17%. Research suggests that polyphenol ellagic acid is one of the primary functional antioxidants of pomegranate extract. Ongoing research projects on strawberries also show healthful benefits related to CVD. “A 2003 controlled study of 20 adults showed that eating about eight strawberries daily for four weeks increased blood levels of folate, a B vitamin important to a healthy heart. After eight weeks, the study group showed a 4% drop in systolic blood pressure and a decrease in C-reactive protein, a measure of artery-damaging inflammation,” explains Carolyn O’Donnell, public relations specialist, California Strawberry Commission, Watsonville. One serving of strawberries also provides more vitamin C than an orange.

“Functional synergies exist with other berries—blue, black or raspberries —and pomegranate due to antioxidant content and composition,” says Chris Bartley Christian, trade relations and nutrition director, California Strawberry Commission.

Ticker stickers 

Manufacturers must consult regulations before making a label statement concerning heart-healthy foods to verify that all the requirements are met. “An inappropriate label statement could unintentionally transform a traditional food or dietary supplement product into a drug,” cautions Eric F. Greenberg, principal attorney, Eric F. Greenberg, PC, Chicago.

The FDA divides label claims into three categories: health claims, nutrient- content claims and structure/function claims. “Any explicit or implied label statement linking a substance with a disease or health condition will likely be considered a health claim by the FDA and must comply with one of several grounds: Nutrition Labeling and Education Act regulations based on significant scientific agreement, appropriate qualified health claims, or an authoritative statement of a government body,” explains Greenberg. FDA supports CVD health claims for plant sterol and stanol esters, soy protein, whole grains, soluble fiber, nuts, omega-3 fatty acids, monounsaturated fatty acids from olive oil and low levels of total fat, saturated fat and cholesterol. Nutrient-content claims can characterize a product’s percent content of a dietary ingredient per serving, nutrients compared to Daily Values, or “free,” “high,” “low” and healthy nutrient descriptive terms. Structure/function claims make reference to maintaining normal healthy structures or functions in the body as opposed to disease- or health-related conditions.

While the FDA has limited health claims on phytochemicals and cardiovascular health, it permits many heart-health claims for whole plants, fruits and vegetables. Many consumers perceive a phytochemical health benefit from a product, even without direct mention on the label. Companies can also opt for a seal of approval from nongovernmental organizations like the American Heart Association, Dallas. Demand is soaring to associate foods with heart health, and many creative routes exist to formulate and market functional products. 

Amy Schauwecker, a Chicagoarea R&D manager, has an M.S. in Food Technology from the Illinois Institute of Technology. She may be contacted at [email protected].