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!