Of course, no lab test can tell you whether or not you will ever have a heart attack or develop heart disease.  All we can do estimate your risk based on various risk factors like cholesterol.  And I want to emphasize that none of these risk factors are perfect predictors. Some people with normal cholesterol levels get heart disease and some people with high cholesterol levels don't.  Secondly, it's important to realize that no one number tells the whole story.  That's why I think its important to look at the big picture.  Despite their limitations, I still think its useful to "know your numbers."

Here are some of the details from Vanessa's results, compared with her numbers from the beginning of our Heart Health Challenge.

Total Cholesterol is a fairly crude measure, which lumps all the types of cholesterol into a single reading.  It's a quick way to assess whether more tests are needed.

Vanessa's total cholesterol before beginning our program was 235, which is considered high. After eight weeks of working to make her diet healthier, her total cholesterol dropped to 211.  Although 211 is still a bit over the target of 199 or lower, a 10% drop in total cholesterol in eight weeks is a fantastic step in the right direction. 

LDL Cholesterol is often referred to as "bad" cholesterol. Vanessa's LDL cholesterol levels remained unchanged at 134--right at the borderline of what is considered acceptable for someone of Vanessa's age and health history. However, many people believe that HDL cholesterol levels are much more significant than LDL in assessing risk, and there we have some great news.

HDL Cholesterol is the "good" cholesterol and higher levels are linked with lower risk.  Vanessa's HDL went from 55 to 67. This alone moves Vanessa from a "moderate risk" category to the "low risk" category for heart disease.

Total Cholesterol / HDL Ratio is another preferred way of interpreting cholesterol tests. The lower the ratio, the better.  Here again, there was good news to report. Vanessa's ratio improved from 3.6 (high) to 3.1 (low). 

Triglycerides are another important risk factor, which respond very directly to the amount of sugar and refined carbohydrates in the diet. Vanessa worked hard to cut back on added sugars and simple carbohydrates and her efforts were rewarded. In eight weeks, her triglycerides went from 72 (good) to 49 (excellent).

Adding it all up: Realizing once again that risk estimations are just that: estimates based on statistics and not guarantees, it's still exhilarating to see one's risk slashed, and that's just what Vanessa has done. Based on a common risk calculation equation, Vanessa's risk of developing heart disease was roughly twice that of an average woman her age when she started our program. Today, it is half that of an average woman her age. Vanessa has slashed her risk of heart disease by 2/3! 

Congratulations to Vanessa on her hard work and determination. We at Nutrition Data couldn't be happier for her or more honored to have lent a helping hand.

What's Your Risk?

You can calculate your risk of heart disease with this simple calculator. For a more thorough analysis, fill out this questionnaire.  Not happy with your results? Take a page from Vanessa's book. It's possible to dramatically improve your odds, ssing just diet and lifetsyle changes. For help getting started, see our Heart Health Resource Center.

How did she do it?

Although each one may seem small, the changes Vanessa made to her eating habits added up to a healthier diet.  And, because they were small changes, I'm hopeful that it will be easier for Vanessa to sustain those changes over the long haul.

By way of review, here are a few of the things I think made a big difference in Vanessa's diet. I hope these new habits continue to do long after our eight-week challenge draws to a close:

1.  Replace sweetened beverages such as iced tea and "vitamin" waters with water or selzer. (Read more.)

2. Make potato chips and French fries an occasional treat rather than a daily staple. (Read more.)

3. Shop proactively: Fill the grocery cart with fruits, vegetables, and high-fiber snacks, so that you're not forced to depend on the coffee cart, vending machine, drive-through, or take-out to get you through a busy day. (Read more.)

4. Make sure breakfast includes some protein. (Read more.)

5. Be sodium conscious.  Packaged and prepared foods account for 70-80% of the sodium in most people's diets.  Read labels and "budget" your sodium throughout the day. (Read more.)

In other words, it's not realistic to aim for a "perfect" diet. But as Vanessa has proven, even small changes like these can translate to dramatic results.

In real life, it's harder.  In particular, a majority of people (including Vanessa) often fall short on calcium, fiber, folic acid, and vitamins D and E--even when they're making an effort to eat well.  So, perhaps a multi-vitamin is a good idea?  Well, a multi would probably help you ring the bell on folic acid, vitamin D and E but won't provide much (if any) calcium or fiber. 

Another solution is fortified foods, and this seems to work well for Vanessa--on a couple of levels. For a few weeks, Vanessa was eating a Luna Lemon Zest bar as a snack almost every day. When analyzing her diet records, I noticed that on days when she had one, she was much more likely to meet her folic acid and fiber requirements.  I also noticed that on days when her diet records didn't include a Luna Lemon Zest bar, that spot was usually occupied by a chocolate chip cookie from Panera bread.

For Vanessa,  a vitamin-fortified snack bar (especially one that's high in fiber) serves two purposes: it helps her cover some hard-to-cover nutritional bases and it seems to edge out less healthy choices.

So, as to whether to supplement or not, my philosophy is:

1. Do the best you can with your diet. Maximize your nutrient intake by choosing wholesome nutrient dense foods and avoiding empty calories.

2. Fortified foods can help cover shortfalls--especially when you use them as an alternative to less healthy choices. Some examples are: calcium-fortified orange juice, high-fiber snack bars, omega-3 fortified eggs,

3. A basic multi-vitamin is an inexpensive form of nutrient "gap insurance"--but is no substitute for a healthy diet.

Our tracking tools can help you see where the nutritional gaps in your diet might be (and how to fill them).

It was hard to remember to fill and bring my water bottle with me when I left the house.  Motivation wasn't enough. I needed better preparation. Once or twice, when I'd forgotten to bring it, I actually decided to go without water until I got home. It's not like I was dying of dehydration. I've just gotten used to sipping water all the time.  Going without definitely helped me remember to bring the water bottle along the next time.

What does this have to do with Vanessa?

Vanessa is plenty motivated to improve her diet. She wants to reduce her risk factors for heart disease. She wants to  look and feel better. She wants to set a better example for her kids.  And when she's prepared, she does a great job.

• When she has a high fiber snack bar in the car, she doesn't grab a cookie at Starbuck's.
• When she has a refrigerator full of vegetables, she's likely to cook a healthy meal.
• When there's a bowl of fruit on the table, she'll have fruit for dessert.
• When she's planned ahead where and what she's going to eat that day, she makes better choices than if she's making those decisions as she's pulling into the drive through.

My suggestion for Vanessa this week is to think about preparation rather than motivation.  When can I shop? What do I need to buy so that I have what I need  before the week starts? What should I make sure to have with me for snacks before I leave the house? What can I make this weekend for dinner later this week? Which restaurant is most likely to offer the best choices? 

I know from personal experience that will power is at least half planning.  If I start thinking about what I'm going to eat BEFORE I'm a quarter-past hungry, I'll make better choices.  If there are veggies in the fridge, I will cook them for dinner rather than see them go to waste.  If I have a small baggie of almonds in my car to snack on, I am able to keep driving past the muffin store.   

And then it hit me: Vanessa, like many Americans, gets a lot of her calories and protein every day from meat. In reviewing her diet logs, I see that she often eats meat twice a day: some chicken for lunch and some pot roast for dinner, for example.

What if meatless meals were to become a bigger part of the family repertoire?

If you were raised the way Vanessa and I were, sometimes it takes a little imagination to think of meals that don't start out with a hunk of meat in the center of the plate.  But going meatless once or twice a week (or eating meat for only one meal a day) can be an easy way to save money on groceries and work more healthy vegetables, beans, and legumes (and all the fiber and folate that goes with that) into your diet.

Beans make a great stand-in for meat, offering  protein and a satisfying heft.  Plus, they are as versatile as the day is long. A hearty bean or lentil soup makes a terrific dinner, for example. (Leftovers also make a great lunch later that week.)  Many take-out places now offer veggie burgers as an alternative to burgers.  I like to toss whole wheat pasta with sauteed greens, garlic, and cannelini beans. The possibilities are literally endless. (Here's a few recipes to get you started.)

For more inspiration, check out the ideas and recipes at the Meatless Monday website.

Maybe I should explain why I think its so important for Vanessa to get enough folate.  You may have read that folate (or folic acid--same thing) helps prevent spinal birth defects.  And since the U.S. government mandated that flour products be fortified with folate, we've seen a steep decline in these types of birth defects.

How folate helps protect against heart disease

But there are lots of other good reasons to make sure your diet contains enough folate.  One of folate's jobs in the body is to help recycle the amino acid homocysteine (a by-product of protein digestion) into another amino acid, methionine.  If you don't get enough folate, this recycling process may stall. As a result, homocysteine can build up in the blood--and this increases your risk of heart disease, Alzheimer's disease, and bone loss.

You can use our nutrient search tool to find foods that are high in folate.  You'll see that leafy greens, soy and other beans, fortified breakfast cereals, and products made with fortified flour top the list.  (And when you choose beans and greens as your favored folate sources, you'll also get more fiber!) When all else fails, traking an inexpensive multivitamin can also be a way to make sure you've got your folate needs covered.

For all of you who, like Vanessa, are interesting in reducing your risk of heart disease, I encourage you to start paying attention to this important nutrient. Track your diet for a few days to make sure you're consistently getting enough folic acid.  The recommended daily intake is 400mcg.

In this particular study, the researchers found that people were drinking an average of 350 calories each day in the form of sugar-sweetened beverages.  This amounted to one-fifth of their total calorie intake! Cutting back on these drinks is not only (according to this study) the most effective way to lose weight, I think it may also be the easiest. As I pointed out to Vanessa, the calories we drink don't fill us up. So cutting them out won't make you feel any hungrier. 

Imagine being able to cut your calorie intake by 20% without impacting your hunger meter. Not only that, but drinking fewer sweetened beverages lowers your risk of heart disease. 

Vanesa's decision to replace sugary drinks with water may be the single most important change she's made so far during our 8-week heart health challenge.

To help Vanessa increase her intake of this important nutrient, I encouraged her to eat more vegetables, especially leafy greens like spinach, which are loaded with folic acid.  Fortified breakfast cereals and snack bars can also be a good source of folic acid.

Vanessa took my suggestions to heart, but no-one likes to eat the same things day after day. As a result, Vanessa's intake of folic acid tends to be high one day and low the next. But, guess what? On average, Vanessa is coming very close to meeting her target of 400mcg per day.  And that's good enough for me! 

It is important to eat nutritious foods every day, and eating a variety of healthy foods helps ensure that you cover all your nutritional basis.  But it would take an awful lot of planning to hit 100% of every nutrient every day. Don't get me wrong: It's certainly possible--and if ever there were a place to help you do it, it's here on NutritionData.com.  But it's really not necessary.

From my perspective, you don't have to sweat it if your nutrient intake on any given day is a bit higher or lower than the recommended amounts. As long as your average daily intake of nutrients (including things like calories, fat, and protein) is on target, you're doing fine. 

When I was in culinary school, one of my favorite units was on soups and stocks.  It was also one of the most practical. With a few basic techniques, you can make an almost infinite variety of delicious soups, using whatever is on hand.   To this day, making a big pot of nutritious soup on the weekend is one of my best strategies for getting through a busy work week. 

Soup practically makes itself. Throw some fresh, frozen, or left-over vegetables, pasta, rice, or beans, a bit of meat or ham for flavor if you like, some seasonings, and and some good stock into a pot and a couple of hours later, you have a meal--with plenty left over for later in the week.

Pureed vegetable soups are creamy and satisfying without being high in fat and calories. They're also  packed with fiber and nutrients.  Hearty bean, lentil, or split pea soups are a great source of fiber and protein. And when you make them yourself, they have a fraction of the sodium of premade soups. Add a salad, some crackers, or a piece of fruit and you've got a quick, healthy weeknight meal .

Here are a few of my favorite healthy soup recipes. You can add these analyzed recipes to your My Recipes to make diet tracking that much easier.

Curried Lentil and Spinach Soup   [Bonus: super high in folate!]

Indian Spiced Carrot Soup with Ginger

Vegetable Barley Soup with Poached Egg

Kale and Chickpea Soup

Goulash Soup

Not only does she obviously enjoy them, but I think the health halo surrounding green tea and other antioxidant-charged beverages may have led Vanessa to believe that drinking these things makes her diet a bit healthier. After all, green tea....fruit...antioxidants...what could be better for you?   If you've fallen for this bit of marketing magic, you are far from alone.

Here's the thing, though: These beverages are like that famous Trojan horse.  Riding along with those antioxidants is a whole whopping amount of sugar. Unfortunately, the negative effects of that sugar far outweigh any benefits you might get from the antioxidants.  If that weren't bad enough, those bottled, sweetened green tea drinks have almost none (less than 10%) of the antioxidants that make green tea so good for you, anyway. 

There's no time like the present

I've been trying to think of a good time to bring this up with Vanessa.  And then, just this morning, I happened across this study, pointing out that women who drink two or more sweetened beverages a day have a 35% higher risk of heart disease.  Reducing Vanessa's risk factors for heart disease is the whole point of this challenge!

Over the last three weeks, Vanessa's made a lot of positive changes in her diet. And, as her diet records are beginning to show, her diet has gotten healthier, more balanced, and more nutritious as a result!  I know this may be tough, but I think the next big nutrition upgrade for Vanessa to consider is cutting back (or cutting out entirely) sweetened teas and fruit juices. 

Let me try to sweeten the deal

On average, Vanessa has two or three sweetened beverages (iced teas or fruit juices) per day. Replacing those with unsweetened iced tea or sparkling water would trim a couple hundred calories per day, which is one of Vaness'as goals.

But Vanessa has also expressed some concern that cutting back on calories will leave her feeling hungry. Guess what? Studies show that calories that you consume in beverages don't fill you up at all.  People feel just as full after drinking plain water as they do when they drink calorie-laden drinks.

You'll never miss those calories, Vanessa! In fact, if you cut out those empty calories, that's more calories you get to spend on FOODS that make you feel more satisfied.  What do you think? Are you ready to take the next step towards a healthier heart?