You Gotta Have Heart-Healthy Ingredients

Advice on eating and health once was as simple as “An apple a day keeps the doctor away.” But now consumers are deluged with sometimes-conflicting information about foods and their impact on health. In the midst of all the confusion, one thing is certain: since 1918, heart disease has been the leading cause of death in the United States. The Atlanta-based Centers for Disease Control and Prevention (CDC) states 710,760 individuals died from heart disease in the United States in 2000. Current data shows that more than 60 million Americans have one or more types of cardiovascular disease, and more than 98 million Americans, roughly 52% of all adults, have high cholesterol.

Formulators are increasingly faced with the daunting challenge of developing healthful, good-tasting foods that also make a profit. Fortunately, a wide variety of heart-healthy ingredients can aid them in this task.

FDA has issued a heart-health claim for a sizable list of ingredients. In December 2002, FDA loosened its health-claim requirements so that claims do not need to meet the standard for significant scientific agreement. Rather, the scientific evidence in support of the claim must outweigh the scientific evidence against the claim. In lieu of this new ruling, quite a few more claims might appear on the horizon. Research reveals heart-health benefits for many other ingredients that don’t currently carry FDA health claims.

The skinny on fats

Any discussion of food ingredients and heart health should probably get started with fat. The Chicago-based American Dietetic Association’s primer on fats and oils notes the following guidelines (which apply to the total diet, not to individual food items) for consumers:• no more than 30% of total calories from fat;• 7% to 10% of total calories from saturated fat;• about 10% to 15% of total calories from monounsaturated fats; and• about 10% of total calories from polyunsaturated fats.

While experts have long considered diets high in total fat and saturated fat as risk factors for heart disease, newer research reveals that the effect of trans fatty acids on the ratio of LDL (“bad”) cholesterol to HDL (“good”) cholesterol is double that of saturated fatty acids. Epidemiologic studies have also linked trans fatty acids to increased risk of coronary heart disease.

FDA announced proposed labeling of trans fatty acids in November 1999, and the industry is still awaiting a final ruling. In anticipation of a final FDA rule, many food companies have already begun to replace some trans fats with alternate fats. Preliminary information from FDA indicates that products with less than 0.5 grams of trans fat can bear the claim “No trans fat.” Trans-fat levels will also affect claims for saturated fat and cholesterol, as well as the requirements for many heart-health claims.

Emerging research indicates that not all trans fatty acids have the same biological effects. Trans fatty acids from hydrogenated vegetable oil, which consist of trans double bonds in the 8 – 13 carbon positions, have been associated with an increased risk of cardiovascular disease. “Trans fat from ruminant fat, which consist mostly of a trans fatty acid with the double bond in the 11 carbon position, have not been associated with an increased risk of coronary heart disease,” notes Peter Huth, director nutrition research and scientific affairs, Dairy Management, Inc.™, Rosemont, IL. “This trans fatty acid, trans vaccenic acid, is a precursor of cis-9, trans-11 conjugated linoleic acid, a trans fatty acid found in milkfat which has been shown to inhibit the early stages of atherosclerosis in animal models.”

A variety of alternative oils are currently available, including olive oil, rice-bran oil, amaranth oil and specialty sunflower oils. The USDA Agricultural Research Service in Fargo, ND, notes that oat oil is rich in phospholipids and glycolipids, and manufacturers could add the oil to bread to improve its health attributes and texture. ADM Kao LLC, Decatur, IL (a joint venture between Archer Daniels Midland Company [ADM], Decatur, IL, and Kao Corporation, Tokyo) manufactures Enova™ oil, a healthful oil containing diacylglycerol (DAG). This vegetable sterol prevents the body from completely absorbing cholesterol after a meal, resulting in lower blood cholesterol, especially LDL cholesterol.

Finding the essentials

In the past decade, researchers have conducted more than 130 trials involving individuals with both high and normal triglyceride levels to investigate the benefits of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), two of the most common long-chain omega-3 fatty acids. Positive effects were reported in more than 80% of these studies. Studies have shown fish oils with high omega-3 fatty-acid content reduce triacylglycerol concentrations and elevate HDL cholesterol. However, fish oils have also been found to increase serum LDL cholesterol.

Scientists have proposed a DHA and EPA intake of at least 0.22 grams/ day, but in most Western countries, fish and seafood consumption is low. “A gaping nutritional imbalance in the American diet is in the quantitative and qualitative consumption of edible oils. The overabundance of omega-6 oils in the diet exasperates the insufficiency of long-chained omega-3 fatty acids that would otherwise have a dramatic cardiovascular benefit,” notes Herb Woolf, Ph.D., technical manager, nutraceuticals, BASF Corp., Mt. Olive, NJ.

DHA and EPA are frequently added to foods, but several issues arise when supplementing with fish oils. High levels of these oils can carry an unpleasant fish taste, and storage or heating subjects them to oxidation. One solution is microencapsulation, which stabilizes and protects the oils. Another option is to use high-quality oils at moderate levels to determine organoleptically acceptable omega-3 levels in specific foods. One study addressed supplementing soft spreads made from butter and vegetable oil with omega-3 fatty acids.

Angela Tsetsis, executive director of marketing, Martek Biosciences Corp., Columbia, MD, notes: “Our company is currently developing an emulsified form and a powder form (of DHA) to allow for use in other products. Dairy products, such as yogurt, milk and cheese, are good candidates for DHA supplementation. We find these products to be already viewed as healthy choices, and adding a healthy ingredient would be a natural fit. Also, the nutritional-bar market is growing rapidly and offers another opportunity for DHA inclusion.”

Interestingly, hemp oil is rich in omega-6 and omega-3 fatty acids, and it contains a favorable 3:1 ratio of these essential fatty acids. Hemp oil contains 80% polyunsaturated fatty acid (PUFAs), the highest ratio of any vegetable-seed oil.

Incredible eggs

Epidemiologic studies over the last decade have revealed that saturated fat and trans fats are the major dietary risk factors for cardiovascular disease, and Donald McNamara, Ph.D., executive director of the Egg Nutrition Board, Washington, D.C., notes that studies have not shown dietary cholesterol as a significant contributor to risk. “The American Heart Association (AHA) revised their guidelines in 2000 to allow up to seven eggs per week, and in 2002, they were revised again with no specific restriction on egg consumption,” he says. One egg contains 215 mg cholesterol, and the recommended dietary allowance for cholesterol is 300 mg per day. He adds that newer knowledge about the role of dietary cholesterol has actually led to an increased daily consumption of eggs in the United States over the past six years.

Modified “designer” eggs containing increased amounts of omega-3s and vitamin E are now on the market. “A regular egg yolk contains approximately 15 mg to 30 mg of DHA. Once the chicken is fed algae rich in DHA, the yolk contains over 150 mg of DHA,” notes Tsetsis.

Soy good

In October 1999, FDA approved a health claim for soy protein. “Recent research reveals that adding soy to the diet can result in a 5% to 9% cholesterol reduction,” notes Tony DeLio, corporate vice president of marketing, ADM. Most of soy’s benefits come from the protein, but the isoflavones also provide some benefits. The two create a synergy, with the isoflavones helping keep blood vessels pliable so that they can pump blood efficiently (arterial compliance).

DeLio adds that soy products are particularly important and targeted to women after menopause. After menopause, women’s risk of heart disease increases. More women die of heart disease each year than men, and they have different symptoms. So adding soy to the diet is an important part of a healthy lifestyle at that stage of life.

“The latest research on soy notes that soy isoflavones are involved in cholesterol reduction and decreased LDL cholesterol,” says Bonnie Gorder-Hinchey, culinary director of the Hazelnut Council and the United Soybean Board (USB). “Soy protein isolate (SPI) is the most versatile of the soy protein products and is used in many food products, including cereals, smoothies, energy bars, breads, cookies and dairy-type products, to enhance nutrition. It has physicochemical and functional properties that include hydrophobicity, water-holding capacity, solubility, emulsion and foaming.” This makes SPI well-suited for applications requiring emulsification and/or emulsion stabilization, water and fat absorption, and adhesive and/or fiber-forming properties.

“Soy protein isolates — which absorb five times the water to their weight — are used in meat, seafood and poultry products to add juiciness, viscosity, and cohesiveness,” adds Gorder-Hinchey. “They can be used to enhance the flavor and nutrition of tough meat, and help improve the sensory attributes. The isolates, which can be used to supplement or replace milk powder, are also used in dairy-type products, including imitation cheeses, frozen desserts and beverages.” She also comments that SPIs do not alter the flavor of food.

Nearly three-fourths of Americans perceive soy as healthy, according to a 2002 USB soybean-checkoff-funded survey on health and nutrition. The survey reveals an overall increase in consumer awareness, attitudes and perceptions of soy-based food products. Another 2002 USB study revealed 39% of consumers understand that soy has heart-health benefits. Since FDA granted soy a heart-health claim, consumer awareness of soy has increased. Soy sales have increased 15% per year to more than $3 billion annually, making it one of the fastest-growing ingredient categories. As soy becomes more mainstream, major growth areas include soymilk, veggie burgers, breakfast cereal, nutrition bars and pasta.

“To qualify for the heart-health claim, food manufacturers must use 6.25 grams of soy per serving,” says DeLio. “This is easy for some foods, but difficult or impossible for others. When the serving size is very small, sometime it is not possible to fit 6.25 grams of soy into a serving, for example a chocolate chew. It is certainly possible to fit this amount into a 50-gram candy bar. So far, no one has been able to fit 6.25 grams of soy into one slice of bread, but it is possible to fit this amount into two slices of bread. The other option is to declare that a product contains 3 grams of soy, which lets consumers know that the product contains soy and is still a significant source of soy protein.”

Soy is frequently incorporated into beverages. Generally, an isolated soy protein is used because it has the cleanest flavor. In liquid beverages, soy protein requires proper hydration, and both homogenization and stabilizers can be critical components of formulation. DeLio notes that adding the required amount of soy to meet a health claim in a low-solids beverage is difficult, but is possible in a smoothie.

Soy also puts less strain on the renal system than certain other protein sources. “Soy can also be used in combination with other heart-healthy ingredients, including soluble fiber and phytosterols,” says DeLio. “There seems to be a synergy in that soy blocks synthesis of cholesterol in the liver, while phytosterols block the sites on the intestine that absorb cholesterol.”

Grains are a good source of soluble fibers, which lower both total cholesterol and LDL cholesterol. It is proposed that these fibers assist in absorption of bile salts, leading to a loss of cholesterol from the body. Foods containing oat bran, oat flour or rolled oats qualify for a heart-health claim because of their levels of beta-glucan, a specific type of soluble fiber that lowers cholesterol.

Oats provide the best source of beta-glucan, but barley and rice also contain this fiber. Rice-bran oil contains unsaponifiable fractions, which lower total blood cholesterol and have an even greater effect in decreasing LDL cholesterol. Rice bran itself has the added advantage of increasing loaf volume and humectancy in bakery items.

Psyllium has a specific FDA heart-health claim, and extensive research reveals individuals consuming four daily servings of psyllium containing 1.7 grams of soluble fiber had an average 5% reduction in total cholesterol and a 9% reduction in LDL cholesterol. Psyllium is frequently added to cereals and may be used as a laxative supplement.

Flax, a good source of soluble fiber that helps lower blood cholesterol, also contains omega-3 fatty acids. The lignans in flaxseed also provide a positive heart-health effect. These antioxidative substances are capable of balancing natural hormone levels. Flax is particularly rich in lignans, providing up to 800 times more than other plants.

Lignans are associated with the fiber fraction of flax; however, while both the lignans and the fiber are present in flax, most legumes are not found in the refined oil. Although whole flaxseed is rich in lignans, they are not completely released during digestion. Using a concentrated source of flax lignans provides a solution to that problem. This stable ingredient, unlike traditional flax ingredients, resists oxidation, making it ideal for use in a variety of foods, such as nutrition bars.

Amaranth is another good grain-based fiber source. There is renewed interest in this ingredient, once grown by the Incas and Aztecs, since processing developments now make it suitable for inclusion in breads, muffins, cereals and snacks.

Nuts are emerging as another heart-healthy food, and a component of many high-end food items. Heart-health claims for nuts are currently under review by FDA. Tree nuts, such as almonds, hazelnuts, macadamias, pecans and walnuts, contain high levels of heart-healthy unsaturated fatty acids and no cholesterol. Several studies show that nuts, as part of a daily diet, significantly decrease the incidence of coronary heart disease. A study, published in the Archives of Internal Medicine, demonstrated that men eating 1 oz. of nuts at least twice per week, compared to men who ate no nuts at all, lowered their risk of sudden cardiac death by 47% and their risk of coronary heart disease death by 30%.

“Compared to other popular nuts, hazelnuts contain the highest levels of monounsaturated fatty acids (MUFAs) per serving and are one of the lowest in saturated-fat content. And because they originate from a plant source, hazelnuts are cholesterol-free,” comments Gorder-Hinchey. “In addition to being an excellent source of dietary MUFAs, hazelnuts are also a rich source of other beneficial nutrients, such as arginine, an amino acid that relaxes blood vessels; folate and vitamin B6; heart-healthy B vitamins; and the blood-pressure-lowering minerals calcium, magnesium and potassium. Nuts also contain phytosterols, which can inhibit fatty-acid absorption in the arteries.”

A preferred nut in the popular Mediterranean diet, hazelnuts are delicious and healthful. “Hazelnuts, also known as filberts, have an exotic flavor that is a rich addition to a variety of foods. Along with their sweet and nutty flavor, hazelnuts add a crunchy texture to bakery products such as breads, muffins, cookies, brownies and biscotti,” adds Gorder-Hinchey. They also add richness to confections, salads, dressings and sauces, and serve as a tasty and nutritious addition to snack foods.

Almonds reduce LDL blood-serum cholesterol levels without affecting HDL levels, thus lowering heart-attack risk. There is good reason to expect that eating a handful of almonds four to five times per week would reduce the occurrence of coronary heart disease by 50%, reports Gary Fraser, M.D., Ph.D., director for the Center for Health Research, Loma Linda University (LLU), Loma Linda, CA.

Almonds add taste and crunch, and have the broadest consumer popularity of any tree nut. According to a survey of 500 food technologists by the Modesto, CA-based Almond Board of California, specific advantages for almond use in formulations include lower rancidity, shelf-life, allergy and microbiological-load concerns. Almonds, diced almonds or almond meal can make a great addition to dipping sauces for chicken nuggets and popcorn shrimp. Almond meal or oil gives a gourmet taste to coffee and espresso drinks. Sliced or slivered almonds add pizzazz to stir-fry mixes. Several suppliers now offer flavored almonds to add a little something different to muffins, breads, salad toppings and snacks.

Walnuts are high in polyunsaturated fats: they contain 18 grams of fat/oz., but 16 grams is unsaturated. Just 2 oz. of walnuts provide 5 grams of omega-3 fatty acids. Results from a LLU study showed a 12.4% decrease in serum cholesterol levels of subjects fed walnuts as part of their diets.

Phytosterols, a group of plant compounds similar to cholesterol in chemical structure, generally inhibit cholesterol absorption in the gut. Clinical trials have shown that regular consumption of margarine with added sterols can reduce levels of LDL cholesterol by about 10%, leading to a significant reduction in coronary-heart-disease risk.

In February 2003, FDA expanded the use of the phytosterol heart-health claim to a broader range of foods and beverages, giving the food industry opportunities to incorporate phytosterols into more commercial products. Fred Shinnick, manager of regulatory and scientific affairs, Cargill Health & Food Technologies, Minneapolis, says this is a significant step toward propelling science-based functional foods and beverages into the mainstream. Products making the claim need 0.65 grams of phytosterol esters or 0.40 grams of free phytosterols per serving.

In February 2003, FDA also issued a health-claim letter that permitted the use of the phytosterol heart-health claim on Reducol™ wood-derived phytosterol products. Unlike vegetable sterols, wood phytosterols are not derived from genetically modified organisms (GMOs), an advantage in many international markets. Many consumers and food manufacturers worldwide have shown a preference for non-GMO products.

Teriaka Ltd.’s Diminicol® features plant sterols in a unique microcrystalline structure. This ingredient, proven to significantly reduce cholesterol, and available for use in functional foods, recently received GRAS status. Designers can incorporate the sterol into margarines, spreads, some baked goods and dairy products, health and snack bars, salad dressings, and mayonnaise.

Following closely on the heels of concern over heart disease is the increase in obesity in the United States, and its relation to heart health. CDC notes that 61% of U.S. adults are either overweight or obese. Excess weight is associated with insulin resistance and a condition known as Syndrome X. “The four risk factors that are associated with Syndrome X are central obesity, glucose intolerance, dyslipidemia and high blood pressure,” notes James Komorowski, vice-president of technical services and scientific affairs, Nutrition 21, Purchase, NY.

Individuals with Syndrome X are at greater risk of developing type 2 diabetes and heart disease. Komorowski adds: “An estimated 60 to 75 million Americans are believed to have Syndrome X. This is a condition where the body becomes resistant to its own insulin. Individuals with this condition then secrete excess insulin, which causes the body to store fat.”

Chromium is a trace mineral which functions as a cofactor for insulin, and is often hard to get from the diet. “In research studies, a daily dosage of 200 to 400 mcg of chromium as chromium picolinate shows efficacy,” adds Komorowski.

Previously used primarily in dietary supplements, chromium picolinate was recently affirmed GRAS, allowing its use in a variety of nutritional bars and beverages. The low dosage required has no effect on the taste, color or stability of the finished product. Chromium picolinate is frequently added to a nutrient mix and then blended into the finished product.

“A recent population-based study, ‘Coronary Artery Risk Development in Young Adults (CARDIA),’ reported that diets characterized by increased consumption of dairy foods were found to be strongly associated with reducing the risk of Syndrome X in overweight adults regardless of race or gender,” notes Huth. The study noted that each daily occasion of dairy consumption was associated with 21% lower odds of Syndrome X.

Many studies suggest that calcium and potassium may help lower the risk of hypertension and stroke. An association between lower dietary magnesium intake and higher blood pressure may also exist, although direct clinical evidence is lacking. The nutrients contained in dairy products, including calcium and potassium, help to lower blood pressure by widening blood vessels, and increasing water and sodium loss from the body. The risk of stroke-related deaths is inversely related to potassium intake over the entire range of blood pressures, and the relationship appears to be dose-dependent.

Based on expert conclusions by the National Academy of Sciences, manufacturers can use a health claim on food products that qualify — such as fat-free milk and orange juice — to promote the relationship of potassium-containing foods, and lower blood pressure and stroke risk. Tropicana, now a part of Gatorade/Tropicana North America, Bradenton, FL, promoted potassium’s heart-health benefits in its orange juice, and its market share rose significantly, proving that a heart-healthy message helps sell additional product.

Dietary Approaches to Stop Hypertension (DASH), a landmark clinical research study, evaluated the effects on blood pressure of a diet rich in fruits, vegetables and low-fat dairy products, and reduced in fat and saturated fat. “Subjects consuming the DASH diet, containing three servings of dairy foods, and eight to nine servings of fruits and vegetables, showed significant reduction in blood pressure,” notes Huth. “A follow-up study reaffirmed that the DASH diet significantly lowers blood pressure, and that the magnitude of reduction is similar to that seen in subjects on antihypertensive medications. Blood-pressure reductions of this magnitude are estimated to reduce the incidence of coronary-artery disease by 15% and stroke by 27%. Most dairy products in DASH were lowfat, but full-fat products were also used, demonstrating that a healthy diet can incorporate some higher fat products.”

Other research on potential health benefits of dairy foods has also incorporated three servings of dairy foods per day. Huth adds that “emerging research suggests that components contained in dairy products, including calcium, may enhance body-weight and fat loss. In a recent clinical study, subjects on weight-control diets that consumed three servings per day of milk, cheese and yogurt lost more body weight and body fat than those on a diet low in dairy products or one low in dairy and high in elemental calcium. These findings are consistent with outcomes on the association of dairy foods and weight from the CARDIA study. Further research to confirm these findings is currently underway sponsored by the National Dairy Council.”

An emerging area for heart-healthy dairy ingredients is whey peptides. “Certain fermented milks that have been produced using specific cultures and fermenting conditions have been shown to produce bioactive peptides that lower systolic and diastolic blood pressure,” notes Huth. Bioactive peptides can also be produced by hydrolysis of whey protein concentrate (WPC) 80 and whey protein isolate (WPI).

“A recent research study revealed that a particular whey protein isolate, BioZate® 1, reduced both systolic and diastolic blood pressure in untreated borderline hypertensives,” notes Polly Olson of Davisco Foods International, Eden Prairie, MN. A dosage of 10 grams provided a significant effect, so products may use the structure-function claim, “has been found to reduce blood pressure” if they contain 10 grams of this specific whey ingredient.

“This product is relatively bland and easy to incorporate in beverages, including chocolate milk,” adds Olson. It also can be added to pudding, applesauce and other foods. Whey proteins also contribute to water-binding, gelling and emulsification in foods. Depending on the choice of whey ingredients, formulators can develop either clear or opaque products. Their clean flavor profile and excellent solubility at lower pHs make whey proteins well-suited for fruit-flavored beverages, and they are especially popular in sports-nutrition products.

Several fruits and berries contribute to heart health. The cranberry is rich in phytochemical pigments, and in-vitro work indicates its extracts reduce oxidation of LDL cholesterol. Cranberries come in frozen and sweetened, dried forms, making them easy to add to a variety of baked goods, such as bagels, scones and muffins. Cranberries also make a great addition to cereal and snack items.

Apples can join the heart-health mix, too. A clinical study revealed that consuming 1-1/2 cups of 100% apple juice or two fresh apples daily slowed the oxidation process of LDL cholesterol. Oxidation of LDL cholesterol can clog arteries, a precursor of coronary heart disease, according to Scott Summers, director of quality and technical services at Tree Top, Inc., Selah, WA. Apples, even in the dried state, contain high levels of vitamin C, potassium and fiber. They are also rich in flavonoids and contain quercetin, a phytochemical found to have a stronger antioxidant effect than vitamin C.

The nutrient betaine is a natural component of many foods, including cereals (e.g. wheat), seafood (e.g. shellfish) and vegetables (e.g. spinach). “Betaine is an osmolyte (cell protection), methyl donor (via the methionine cycle) and lipotrope (enhances fat metabolism). Betaine can reduce serum homocysteine and improve the lipid profile, both risk factors for vascular disease. The lipotropic action of betaine can significantly lower serum cholesterol and increase serum phospholipids in subjects with atherosclerosis,” notes Ariella Gastel, health and nutrition business manager with Danisco USA, Inc., Ardsley, NY. The AHA recommends that anyone with a history of heart-health issues have their homocysteine tested.

Commercial betaine is extracted from sugar-beet molasses and is a natural ingredient. Betaine has a mild taste, no color issues and is extremely stable, which makes it easy to add to a broad array of products. Betaine is often used with B vitamins and folic acid in heart-healthy formulas for supplements, bars and beverages.

A variety of antioxidants offer heart-health advantages. “Large-scale human intervention trials for the prevention of cardiovascular disease (CVD) unfortunately have been inconsistent in showing that supplementation with vitamin E lowers the rate of mortality from heart disease or stroke,” notes Woolf. “However, many smaller clinical studies do show significant improvement of health status or retardation of disease progression by vitamin-E supplementation. Probable roles of vitamin E in the control of LDL oxidation is by scavenging of free radicals that cause oxidized LDL, which would lead to adverse atherogenic events. More recent information suggests that long-term intake of foods already rich in antioxidants along with foods fortified with vitamin E could work synergistically with other antioxidants and carotenoids to more effectively and consistently reduce the biomarkers related to heart disease.”

Vitamin E is an oil-soluble vitamin commercially available as a dispersion in vegetable oils. According to Woolf, these oils are miscible with other oils in foods, or designers can incorporate them into the lipid fraction of a formulated food, such as mayonnaise, spreads or salad dressings. Vitamin E is also formulated in a water-dispersible powder that enables incorporation into aqueous-based foods and beverages.

Vitamin C is one of the most common nutrients used to fortify foods. “Epidemiological studies are consistent with numerous prospective studies, which indicate that low levels of plasma ascorbate are associated with increased risk of cardiovascular disease,” comments Woolf. “In-vitro studies show promise for a synergistic effect between vitamin E and vitamin C, but this synergy has not yet been consistently demonstrated in human clinical studies.

“Beta-carotene’s benefits for cardiovascular health are indisputable upon review of large-scale observational studies, but this is not so clearly demonstrated in clinical studies,” adds Woolf. “The complexity of action and the interrelation with other important carotenoids, such as lycopene and lutein, makes this conclusion less obvious. The consensus to date is that beta-carotene for nonsmokers offers a potential cardiovascular health benefit.” Beta-carotene adds a pleasing golden color to various dairy and baked items.

Almost 90% of the American population does not consume, on a daily basis, enough of the USDA Food Guide Pyramid’s recommended amounts of fruits and vegetables. These foods are rich sources of the essential phytonutrients — such as antioxidant vitamins — beneficial for maintenance of a healthy cardiovascular system. Fortified foods help balance the nutritional equation.

It may sound too good to be true, but chocolate is good for you. Thus far, two commercially available chocolate products — Dove® dark-chocolate bars and M&M’s® Mini Baking Bits, both manufactured by Mars, Inc., McLean, VA — have been found to contain high levels of flavanol, a substance linked to heart health. These naturally occurring compounds, found in plants or plant-based foods such as vegetables, fruits, red wine and cocoa, are reported to have an effect on vascular dilations, or a relaxation of the muscles around blood vessels. Other products are untested or lack high flavanol levels, such as milk-chocolate bars.

In a study presented to the AHA, 21 participants ate 46 grams per day of either Dove dark chocolate or a milk-chocolate bar. Researchers found that the subjects who ate the flavanol-rich dark chocolate showed blood-vessel dilation two hours after eating the candy. (They did note that chocolate should be used in moderate amounts in a heart-healthy diet.) Flavanols are also believed to inhibit oxidization of lipids, specifically LDL cholesterol.

Sharon Gerdes writes and consults for various food-industry clients, with an emphasis in dairy products, baked goods and nutrition-specialty items. Gerdes holds a B.S. in food science and nutrition from Kansas State University, Manhattan.