COMFORT FOOD

First day of 5th grade!

It might be the cold, rainy fall days, the start of school for my boys, or the fact that I just could use a little comforting these days, but I've been making some serious comfort food this week - mac and cheese, tomato soup, chicken fingers, pumpkin bread. And before you start worrying, I used heart-appropriate recipes or safe substitutions for these comfort faves and came up with a few winners I deem good enough to share with you.

Bundle up and enjoy!

RECIPE: LIGHTER MAC & CHEESE

Sounds weird, is good. Trust me. The sweet nuttiness of the squash combines with the salty, tangy cheeses to create a great approximation of cheddar Bechamel, but with only 6 grams of saturated fat for a really generous serving (vs. 36 grams for the real stuff). I've had other squash mac-and-cheese dishes and this one is the best one I've tasted so far.

First day of Pre-K!

RECIPE: PUMPKIN BREAD

Ooo this one is so good! It has a great, silky texture and is spicy and pumpkin-y and delicious. It is not sweet, so I served it with maple butter (to my brunch guests), though I loved it plain or, gulp, with my Smart Balance margarine (I really can't believe I'm saying that). Total fat per slice: 3.75 grams, 0.25 saturated.

RECIPE: ROASTED RED PEPPER AND TOMATO SOUP
The way your house smells when the veggies are roasting is the best part of this soup, but it tastes only slightly less amazing. Super easy and super healthy -- did you know tomatoes are a heart-health super food? If you use fat-free Greek yogurt you're looking at about 2 grams of fat per serving, 0 saturated.

RECIPE: CHICKEN FINGERS WITH RASPBERRY SAUCE
I bought this little American Heart Association kids cookbook because Owen likes to cook with me. We made the chicken fingers and I probably loved them more than either Owen or Noah did. I guess they are just one of those kid foods I never outgrew. But, Scott liked them too, so you can confidently embrace your inner child and enjoy, for only 3 grams (and 1 gram of saturated fat) per serving.

RECIPE: CHICKEN FINGERS WITH RASPBERRY SAUCE

From the American Heart AssociationServes 4

I bought this little American Heart Association kids cookbook because Owen likes to cook with me. We made the chicken fingers and I probably loved them more than either Owen or Noah did. I guess they are just one of those kid foods I never outgrew. But, Scott liked them too, so you can confidently embrace your inner child and enjoy, for only 3 grams (and 1 gram of saturated fat) per serving.

1/2 cup fat free plain yogurt
1 lb chicken tenders, all visible fat removed
Vegetable oil spray
1/2 cup yellow cornmeal
1/3 cup plain dry breadcrumbs
1 tbsp flour
1 tbsp + 1 tsp. Parmesan cheese
1 tsp paprika
1/2 tsp dried basil
1/2 tsp garlic powder
1/4 tsp salt
1/4 cup all fruit raspberry jam or preserves
2 tbsp low-fat mayonnaise
1/8 tsp ground cinnamon

Place chicken and yogurt in a bowl and stir to coat. Preheat oven to 375 and spray a baking sheet with cooking spray. Mix cornmeal, breadcrumbs, flour, Parmesan, paprika, basil, garlic powder, and salt in another shallow dish or bowl. Dip chicken into the coating mixture, turning over and patting to coat (push off excess yogurt with your fingers first). Arrange in a single layer and spray lightly with cooking spray. Bake for 20 minutes, or until chicken is done through and coating is crisp. For sauce, mix up jam, mayo, and cinnamon in a small bowl.

RECIPE: ROASTED RED PEPPER AND TOMATO SOUP

This is my sister, Anna Mayer's, recipe

Makes 8 bowls of soup (how many that serves is up to you!)

The way your house smells when the veggies are roasting is the best part of this soup, but it tastes only slightly less amazing. Super easy and super healthy -- did you know tomatoes are a heart-health super food? If you use fat-free Greek yogurt you're looking at about 2 grams of fat per serving, 0 saturated.

1 red bell pepper, quartered
2 or 2.5 pounds tomatoes, quartered (I used 40 ounces of canned whole tomatoes because I didn't want skins in my soup)
1 red onion, quartered and separated
Three cloves of garlic, smashed
1-2 red hot peppers, quarted and seeded (or leave seeds in if you like it really hot)
1 tbsp olive oil
1 tsp brown sugar
1 cup vegetable or chicken stock (or more, depending on how thick you want your soup)

Put all your veggies and garlic in a shallow baking dish (like an 8x8 baking pan; you want the veggies close together so they don't burn), and drizzle oil over all. Sprinkle with brown sugar and roast at 350 for two hours. Let cool a little, then add stock and blend til smooth. (I used my immersion blender; if using a regular blender follow advice to remove center of the blender top so it doesn't explode.) Serve with a dollop of Greek yogurt and some chopped fresh parsley.

RECIPE: PUMPKIN BREAD

Adapted from 100 Days of Real Food

Ooo this one is so good! It has a great, silky texture and is spicy and pumpkin-y and delicious. It is not sweet, so I served it with maple butter (to my brunch guests), though I loved it plain or, gulp, with my Smart Balance margarine (I really can't believe I'm saying that). Total fat per slice: 3.75 grams, 0.25 saturated.

1 ½ cups whole-wheat flour (I used King Arthur’s white whole-wheat flour)
1 ½ teaspoons cinnamon
1 teaspoon ground ginger
½ teaspoon nutmeg
1/8 teaspoon cloves
1 teaspoon baking soda
¼ teaspoon baking powder
½ teaspoon salt
2 eggs or 1/2 cup Egg Beaters (I used Egg Beaters)
1/4 cup canola oil
1/4 cup unsweetened applesause
1/2 cup honey
½ teaspoon vanilla
1 cup pumpkin puree

Preheat oven to 350 degrees. In a large mixing bowl whisk together the dry ingredients. Make a well in the center and add the eggs/Egg Beaters, oil, applesauce, honey, and vanilla. Stir together thoroughly with a fork, but do not overmix. Fold in the pumpkin puree. Generously coat a loaf pan with cooking spray and pour in the batter. Bake for approximately 30 – 40 minutes or until a toothpick inserted comes out clean. Cut into 16 slices.

RECIPE: LIGHTER MAC & CHEESE

From Cooking Light Magazine

Serves 8

Sounds weird, is good. Trust me. The sweet nuttiness of the squash combines with the salty, tangy cheeses to create a great approximation of cheddar Bechamel, but with only 6 grams of saturated fat for a really generous serving (vs. 36 grams for the real stuff). I've had other squash mac-and-cheese dishes and this one is the best one I've tasted so far.

3 cups cubed peeled butternut squash (about a 1 lb. squash)

1 1/4 cups fat-free, lower-sodium chicken broth

1 1/2 cups skim milk

2 garlic cloves

1 teaspoon kosher salt

1/2 teaspoon freshly ground black pepper

2 tablespoons fat-free Greek yogurt

5 ounces shredded Gruyère cheese

4 ounces grated pecorino Romano cheese

1 ounce finely grated fresh Parmigiano-Reggiano cheese

1 pound uncooked cavatappi

Cooking spray

1 teaspoon olive oil*

1/2 cup panko (Japanese breadcrumbs)

2 tablespoons chopped fresh parsley
 

Combine squash, broth, milk, and garlic in a medium saucepan; bring to a boil over medium-high heat. Reduce heat to medium, and simmer until squash is tender when pierced with a fork, about 25 minutes. Remove from heat. Place the hot squash mixture in a blender and add salt, pepper, and Greek yogurt. Remove the center piece of blender lid (to allow steam to escape) and place a towel over the opening. Blend until smooth.

Preheat oven to 375°. Place blended squash mixture in a bowl; stir in Gruyère, pecorino Romano, and Parmigiano-Reggiano. Stir until combined. Cook pasta according to package directions, omitting salt and fat; drain well. Add pasta to squash mixture, and stir until combined. Spread mixture evenly into a 13 x 9-inch glass or ceramic baking dish coated with cooking spray. Combine oil and breadcrumbs and sprinkle evenly over the pasta. Lightly coat topping with cooking spray. Bake for 25 minutes or until bubbly. Sprinkle with parsley.

*Next time I make this I'm going to try half olive oil, half truffle oil.

A TOTALLY NORMAL DAY

I hope everyone has seen this funny and really, far too realistic video, produced by Go Red for Women, the American Heart Association's women's heart health campaign.

The day of my heart attack started as a totally normal day, and I expected normalcy to resume at any moment (hmm, still waiting). I called Scott from the ER to make sure Owen's rain gear was packed for camp. I called again from the ICU to give instructions on what to pack for Noah's trip to my brother's house while I was in the hospital. I emailed work colleagues after surgery. At the time it didn't seem real. My head seemed to be the last thing to catch on.

Please watch and share this video, then check out the warning signs of a heart attack. It's not always what you think.

MY 12TH PILL

I now take 12 pills a day. Me, the self-righteous riot grrl who demanded to see the results of studies of this drug or that drug on women and then refused to take them when the doctor admitted there was no such thing. Me, the nervous first-time mother who wouldn't even take fish oil supplements while pregnant. Me, the healthy eating, marathon running, 37-year-old woman. Twelve. Per. Day.

There's the aspirin, metropolol, and birth control because I had a heart attack. Plavix because I have a stent. Zetia, Niacin, and Crestor for messed-up lipids. Synthroid for hypothyroidism and iron for anemia. And because of all that: Celexa.

Celexa is an antidepressant, in case you didn't recognize the name from TV commercials or four-page magazine ads. I waited four weeks to start it because my primary doctor wanted to see if I bounced back on my own first. No bouncing here, and I decided to cut myself some slack and insist on the drugs. I have enough going on without expecting to pull myself up from my bootstraps.

I'm told it takes up to four weeks to work, so it is hard to be patient. But then there's the placebo question: Am I feeling a little better because Celexa is doing its chemical job after just four days, or because I'm so happy to finally be taking it? Who cares. I feel better, and that's the point.

Depression is a common companion to heart disease and while that's unsurprising, it was unpleasant to discover that it is dangerous as well. Harvard Medical School reported that half of all heart attack survivors become depressed and the American Heart Association reports that women, and particularly younger women, are at an even higher risk. What's more, those who do become depressed are at a greater risk of another heart attack.

"Depression that occurs for the first time during recovery from a heart attack appears to be more dangerous than depression that started before the attack," the Harvard article states. "People with post–heart attack depression are two to three times more likely to have another heart attack or to die prematurely compared with survivors who don’t have depression."

And, it appears it might be all in my head - in my brain, that is. The journal Psychotherapy and Psychosomatics published a German study that found that persistent depression after a heart attack was associated with vascular changes in the brain, but that "more research is needed to determine whether depression causes these changes or vice versa."

But here's the thing: when I can't sleep or can't focus or can't formulate a plan more than an hour in advance, can't take care of my kids or can't return a phone call or follow through on dinner, or am somehow in greater danger of another attack, I don't care anymore about research studies or long-term effects or gender inequality. I just want it to stop.

So I take 12 pills a day. Gladly.


P.S. On to less, ahem, depressing subjects, here are the stats on two cheeses I forgot last time. Goat cheese earns 8 grams of total fat, 6 saturated, putting it in the "Not So Good" column. Fontina is 9 grams total, 5 saturated, placing it in "Pretty Bad for You." Drat.

NO SUBSTITUTIONS

It's a rare recipe that turns out well when you substitute a low-fat or fat-free version of something, especially dairy. And don't even get me started on margarine. For some ingredients, there really are no subsitutions.


See that walnut on the left? That's
good for me. The rest, not so much.

Since I plan to live and therefore must eat this way for decades, I'm determined that my food be foodie-worthy, not just fat-conscious fuel. Therefore, I embarked on a mission to learn everything there is to know about the fat levels in my favorite cooking cheeses. My hope was that at least a few of the best ones made the cut. (Julia Child maintained that there are only three worthy cheeses: cheddar, Swiss, and Parmesan; I hate to differ with Julia, but there have to be at least a couple others!)

The American Heart Association Nutrition Center, while appearing useful in other ways, was not helpful regarding cooking with dairy. Here is the extent of the information I could locate:

• Select fat-free (skim) or low-fat (1%) milk. Avoid milk that contains added flavorings such as vanilla, chocolate or strawberry. They usually have added sugars and calories.
• Choose fat-free, low-fat or reduced-fat cheeses.
• Use egg whites or egg substitutes instead of egg yolks. (Substitute two egg whites for each egg yolk in recipes that call for eggs.)
• Choose soft margarines that contain “0 grams trans fat” instead of buying butter. (These margarines usually come in tubs.)
• Don’t buy a lot of butter, cream and ice cream. Save those for special occasions and, even then, limit how much you eat. These foods have more saturated fat than whole milk.

Choosing fat-free, low-fat, or reduced-fat cheese is precisely what I'm trying to avoid. I can't makethat delicious couscous-edamame-feta salad? What about Cooking Light's recommendation to subsitute cream cheese to make low-fat mac and cheese? Caprese salad? That has to be okay, right? I don't need to pile on the creamy, gooey, salty, tangy, sweet, nutty goodness at every meal, but fat-free cheddar? Give me a break.

The USDA nutrition website was similarly unhelpful. Where was the index of cheeses by name with nutritional information? And where's the list of "good" cheeses that are approved for the heart attack survivor to eat? Am I the first to ask this question? Or, is it unavailable because I really, truly shouldn't eat cheese at all?

My daily total fat grams target (including the good-for-me kind) is 50 grams and my daily limit of saturated fat is 20. The nutritionist at the hospital told me to look a 2-to-1 ratio of total to saturated (e.g. 8 grams of total fat should have no more than 4 grams of saturated fat). Almost none of the cheeses I looked up meet that criteria, so any use would require careful fat-gram budgeting. I think that's what they mean by "use sparingly."

So, here's what I know, for better or worse (mostly worse). That vegan thing is looking better all the time.

All data below is for just 1 ounce, or about the size of a matchbox!

BETTER

Part-skim ricotta
Total fat = 2.25
Saturated = 1.4

Cottage cheese (1%)
Total fat = 2.5
Saturated = 1.5

Part-skim mozzarella
Total fat = 4.5
Saturated = 3

Fresh mozzarella
Total fat = 5
Saturated = 3

Cream cheese
Total fat = 5
Saturated = 3

Feta
Total fat = 6
Saturated = 4.5

NOT SO GOOD

American Cheese
Total fat = 7
Saturated = 4

Parmesan
Total fat = 7
Saturated = 5

Provolone
Total fat = 7.5
Saturated = 5

Swiss
Total fat = 8
Saturated = 5

Brie
Total fat =8
Saturated =5

Blue
Total fat = 8
Saturated = 5.3

Monterey Jack
Total fat = 8.5
Saturated fat = 5.5

PRETTY BAD FOR YOU

Cheddar
Total fat = 9
Saturated = 6

Gruyere
Total fat = 9
Saturated = 5

Havarti
Total fat = 10
Saturated = 7

This is just a sampling, not definitive information (see above, USDA). Some of this came from brand names so check your labels!

FAT FREE FOODIE

Those who know me know that I'm a serious cook and a serious eater. I love food and everything about it: the farmer's market, pretty linens, cookbooks, dutch ovens, china, my gourmet grocery store, aprons, my dining room, and people, always the people. Food is a language of comfort, of companionship, of caring, of fun. Food is my language of love.

Our first day of school celebratory dinner: shrimp, of course. It's Owen's favorite. The big bowl of raspberries on the table. ("I got those for you," I say as Scott's eyes light up. "I know," he replies.) A gorgeous bridal shower buffet. Baked mac and cheese that treats sadness and celebrates new babies. A birthday cake that looks like a back hoe.

I do love a cooking challenge and I'm determined that life as a fat-free foodie not be an oxymoron. Sure, the velvety bechamel I've perfected and the baked brie for which I am famous are a thing of the past, and probably that delectable beef ragu that once rendered me speechless is too. But really, it won't be so bad eating (saturated) fat free.

Here's the good news: I should eat all the vegetables, fruit, and nuts I want. Grains too (after years of dieting, I'm giddy that I'm actually supposed to eat them, especially oats, barley, and flax). I should eat more soy protein and seafood because I need those omega-3s even more now.

How about avocados? Yep. Mayo? Yep. Sushi? Uh huh. Oh, and I almost forgot, red wine.

Yummy. See how I suffer?

And here's what not to eat: Any animal that lives on land. Foods made from animal products. Anything artificial. Added salt.

Duh.

Okay, it's not quite that simple and the rules are not that draconian, but if I wanted to eat the most heart-healthy diet possible it would have to be vegan. I'm starting out with lots of vegetables, grains, seafood, and some turkey and chicken once in a while. I'm eating very little dairy other than skim milk and fat free yogurt, and that is a true cooking challenge. I've also had to give up Diet Coke, which is honestly harder to live without than butter.

I've just begun my fat free foodie education and my plan is to share Jen- and family-approved recipes on this blog, along with my experience integrating my heart-healthy diet into a busy family life (as well as onto my party table). I'm really more interested in talking about food than myself anyway.

So I'll start today with some good info for your nutritional inspiration, and one good recipe from this weekend.

• "Four Foods That Lower Your Cholesterol" an article in Time Magazine. 
• (Brace yourselves, Diet Coke lovers) "Daily Diet Soda Linked to Higher Risk of Stroke and Heart Attack"  on MSNBC and other sources
• "From Omnivore to Vegan: The Dietary Education of Bill Clinton" on CNN
• "Time to Revive Home Ec" from the New York Times (I loved home ec!)

ROASTED TOMATO SPAGHETTI
Serves 4 hearty eaters, with a bit left for you for lunch the next day
Adapted from Real Simple magazine

3 tablespoons olive oil
1 cup chopped red onion
1 tsp crushed garlic (from a jar)
1/3 cup pitted kalamata olives (about 12)
1 teaspoon anchovy paste
1/2 teaspoon crushed red pepper
1 teaspoon dried oregano
28-ounce can Italian plum tomatoes with juice
kosher salt and black pepper
1 pound spaghetti (I use Barilla Pasta Plus, for more protein and omega-3s.)
2 tablespoons chopped parsley

Heat oven to 450° F. 2. In a large ovenproof skillet or baking pan over low heat, combine the oil, onion, garlic, olives, anchovy paste, crushed red pepper, and oregano.

Bring to a simmer and cook, stirring, for two minutes. Remove from heat, pour the tomatoes over the top, and season with ½ teaspoon salt and ¼ teaspoon pepper. 

Transfer to oven and roast for 20 minutes until the sauce is hot and bubbly and the onions are soft. Meanwhile, cook the spaghetti according to the package directions.

Transfer the roasted tomato mixture to a food processor or blender and pulse once or twice to your desired consistency.Toss with the spaghetti and parsley.

Variation I'm going to try: This robust sauce, similar to puttanesca, would stand up well to tuna. I'm going to add some next time to get in another fish serving and up the omega-3s even more.

Nutritional Information
Calories   639 ;   Calories From Fat   141 ;   Fat   16g ;   Sat Fat   2g ;   Cholesterol   0mg ;   Sodium   853mg ;   Protein   19g ;   Carbohydrate   105g ;   Sugar   15g ;   Fiber   8g ;   Iron   5mg ;   Calcium   114mg

RECIPE: ROASTED TOMATO SPAGHETTI

Serves 4 hearty eaters, with a bit left for you for lunch the next day
Adapted from Real Simple magazine

3 tablespoons olive oil
1 cup chopped red onion
1 tsp crushed garlic (from a jar)
1/3 cup pitted kalamata olives (about 12)
1 teaspoon anchovy paste
1/2 teaspoon crushed red pepper
1 teaspoon dried oregano
28-ounce can Italian plum tomatoes with juice
kosher salt and black pepper
1 pound spaghetti (I use Barilla Pasta Plus, for more protein and omega-3s.)
2 tablespoons chopped parsley

Heat oven to 450° F. 2. In a large ovenproof skillet or baking pan over low heat, combine the oil, onion, garlic, olives, anchovy paste, crushed red pepper, and oregano.

Bring to a simmer and cook, stirring, for two minutes. Remove from heat, pour the tomatoes over the top, and season with ½ teaspoon salt and ¼ teaspoon pepper.

Transfer to oven and roast for 20 minutes until the sauce is hot and bubbly and the onions are soft. Meanwhile, cook the spaghetti according to the package directions.

Transfer the roasted tomato mixture to a food processor or blender and pulse once or twice to your desired consistency.Toss with the spaghetti and parsley. 

Variation I'm going to try: This robust sauce, similar to puttanesca, would stand up well to tuna. I'm going to add some next time to get in another fish serving and up the omega-3s even more. 

Nutritional Information

Calories   639 ;   Calories From Fat   141 ;   Fat   16g ;   Sat Fat   2g ;   Cholesterol   0mg ;   Sodium   853mg ;   Protein   19g ;   Carbohydrate   105g ;   Sugar   15g ;   Fiber   8g ;   Iron   5mg ;   Calcium   114mg

GET IT. GOT IT. GOOD.

Alright ladies, listen closely. If you haven't ever had your cholesterol checked, do it now. If you know you have high numbers, start working on it. If you have a family history, get yourself a cardiologist and have a full workup. Know your body and know your risks. Now.

As if you need a reason other than living past 40, consider this one: do you want kids? If you have kids, do you want more?

I have two sons and they are the center of my universe and my reason for living. And now I know they are even greater miracles and blessings, because yesterday I learned there will be no more babies. Ever. Apparently being a heart attack survivor and being pregnant are incompatible.

"You would be extremely high risk."

I figured.

"The increased blood volume is too much for your heart."

Okay.

"You already have children who need you to live."

Okay!!

"Furthermore, all the drugs you are on are not safe for pregnancy and it's not safe for you to go off them."

Okay, okay, I got it!

And to ice the cake: "But, you can't have any hormone-based birth control, and oh, when you get to menopause, you can't have hormone therapy then too."

Sweet.

I'm not really as bitter as this sounds, it's more like bittersweet. I'm even more grateful that I was able to have my two boys, and we had pretty much decided that we did not plan to have more children. It's just so weird when something so close to my definition of myself -- a woman, a mother -- is suddenly no longer my decision or even an option. I guess that's part of living with heart disease (or any disease for that matter). I can't decide that I don't like the idea of medications. I can't decide I'll just work off the extra calories if I want to eat that dulce de leche or mac and cheese. I can't decide, when my youngest turns eight or so, that I really did want one more baby.

But you can decide to be proactive and protect yourself as much as possible. What could you do to avoid this not-surprising-yet-life-changing side effect? Don't have a heart attack, if you can avoid it. Do everything you can to make yourself as safe as you can. If you know what you need to do, do it. If you don't, find out, and then do it.

Get it? Good.

THANKS, I NEEDED THAT

Her name was Ellen and she brought me dinner.

The parish nurse at our church has organized volunteers to bring over dinner a few times a week, and Ellen's day was Tuesday. She came to the door with a roast chicken, a salad from her garden, and a loaf of nine-grain bread. We chatted awhile, she asked how I was doing, and I replied that while my body felt fine, my head is another story. That we are all still in shock and I just don't feel like myself.

Ellen said she knew how I felt, having been diagnosed with diabetes in February. As we talked more about the challenges of special diets it hit me: Here's a woman (like me), with kids (like me), with a chronic health condition (like me), who, on a day she took off of work, is bringing me dinner.

Talk about humbling. But really, what good is a crisis without being taken down a peg or two?

When something bad or sad or scary or just hard happens to someone you love, or even someone you know just a little, the urge to help is strong. I know that this is true. I've been inundated with offers of help, and my own instinct when I hear of someone else's crisis is to start cooking, preferably pasta with some kind of cheese- or cream-based sauce. (Those were the days, but that's another post.) It's one of the best things about human beings, and no matter how cynical things may seem, it's alive and well. The better angels of our nature are with us still.

This isn't my first life crisis, and it probably won't be my last. Having learned a thing or two the first time around (the birth of my first baby nine weeks early by emergency c-section after I developed a life-threatening-for both of us-condition), I readily said yes to every offer of help I have received, and then asked for more. I've been clear about what we need, and what we don't. I've let friends see my house a mess. I've sat at my own kitchen table and watched someone else cook for my family. I've asked for favors I wouldn't dream of asking at any other time. And I haven't even sent my thank yous.

But I have noticed and I will remember. I was helped in innumerable ways then. I'm being helped now. I'll be helped again tomorrow. I can't do this alone, and I don't intend to try.

So, to Ellen and everyone who brought us dinner, took care of our children, provided transportation, bought groceries, supervised walks, hosted parties, cooked, cleaned, folded, shopped, played, emailed, wrote, and listened:

Thanks, I needed that.