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Introduction

You've heard the warnings loud and clear: cut back on meats, salt, eggs, butter, cream—all those rich, zesty, fatty, flavorful foods—or risk developing heart disease, high blood pressure, and cancer. You wonder what to do. Must you give up all the foods you love and face a lifetime of thin soup and boiled mush? Happily not! At least not if you take advantage of the variety of exciting flavors that Asian cooking has to offer. You can still eat delicious food, and lots of it, while automatically protecting your health and maintaining your ideal weight. Whether you have a family history of disease, or have no health problems at all and want to stay that way, the recipes in this book are for you.

Asian cookery is remarkable for its variety of delectable taste sensations and health-promoting benefits. The dishes I've selected and modified for this book retain the tantalizing flavors—the redolence of ginger and garlic, the zing of sweet and sour—while further increasing the nutritional advantages. The main health benefits of Asian cooking come from its emphasis on plant foods: vegetables, legumes, and starches. Meats play only a supporting role: in a meat recipe, just two or three ounces per portion, but it is appetizingly cooked with lots of vegetables that contain no cholesterol.

"Two or three ounces!" (I hear you protest), "What about protein?" If you're a Westerner, you were probably brought up with the idea that if your dinner plate wasn't dominated by a big slab of meat you'd suffer a dire protein deficiency. Science has proven that to be wrong. You were probably told that to be healthy and slim you'd have to cut out carbohydrates, including starches such as bread, rice, potatoes, and noodles, in favor of protein foods, such as meat, cheese, and eggs. Wrong again. In fact, red meat is loaded largely with fat, not protein, and that fat is packed with heart-threatening cholesterol. It may also lead to certain types of cancer, and ounce for ounce it contributes twice the number of calories that starches and other carbohydrates do. While droves of Western dieters following the protein myth have succeeded only in gaining weight and endangering their health, millions of people in the Far East have stayed fit and slim on little or no meat but large amounts of vegetables, legumes, and rice. So, by substituting chicken and fish for red meat and by emphasizing vegetables, legumes, and starches, the recipes in this book will help you to lower your risk of heart disease and cancer and to reduce automatically the number of calories you consume.

The high-fiber content of vegetables earns another plus for Asian cooking. Science now shows that a high-fiber diet reduces the risk of certain forms of cancer and helps to lower cholesterol levels. It also combats constipation and other intestinal disorders. And for weight watchers, fiber provides a very low-calorie way to satisfy the appetite.

Even some of the Asian cooking techniques deliver health benefits. Most notably, there's steaming and stir-frying, which not only seal in the flavor and original color of foods but also ensure a maximum retention of vitamins.

"Come on now," (the skeptics among you say), "aren't there any health shortcomings to Asian cookery?" Yes, there are three serious ones, but they are corrected in this book. In fact, that's what this book is all about. Asian cooking normally tends to rely on (1) salty condiments (bad news for people with high blood pressure), (2) monosodium glutamate (MSG, also sold as Aji-no-moto, a high-sodium taste enhancer to which many people are allergic), and (3) large quantities of fat for deep frying (inviting heart disease, cancer, and obesity).

The challenge I faced in developing the book was to choose the healthiest of Asian recipes and then to modify them to remain as delicious as the originals while containing no salt, no MSG, and very little fat. I believe I have succeeded. Very few of my recipes contain beef, pork, and lamb, because red meat is highest in cholesterol. Instead they contain chicken and fish. In place of salt, MSG, and large quantities of salty condiments, they achieve zest and pungency with ginger, chilies, garlic, and a range of other herbs and spices.

But before going on to the recipes, you may want to read a bit about the scientific findings concerning your health and what you eat. The sources from which I took these findings are listed in the back of the book.

Salt and High Blood Pressure

A high salt intake can lead to high blood pressure and its potentially fatal consequences, cardiovascular disease and stroke. The incidence of heart disease is practically nonexistent in pre-industrialized cultures where little or no salt is added to foods.

In the Solomon Islands of the South Pacific, scientists observed two tribes, one living in the hills and one on a lagoon. Each was similar to the other except for the high incidence of hypertension in one tribe and the low incidence in the other. The hill people ate almost no salt at all because they boiled their food in rain or well water. They had a low incidence of hypertension. The lagoon people cooked their food in salty sea water, thus taking in 15 to 20 grams of salt a day. They had a high incidence of hypertension.

In Japan, where hypertension is the leading cause of death, the disease is more frequent in the north than in the south. This is not surprising, since salt consumption is. highest in the north.

Your body needs salt, of course, or rather the sodium contained in it. But the amount of sodium required—about 230 milligrams per day—is miniscule compared with the 4,000 to 8,000 milligrams that Americans now consume. The 230 milligrams are easily supplied by the food you would eat daily in its natural state. So where do the other thousands of milligrams come from? Well, one teaspoon of salt contains about 2,000 milligrams. Hundreds and thousands of more milligrams come from processed foods bought at the supermarket, restaurant, and fast-food counter. One ounce of cornflakes, for example, contains about 350 milligrams; two slices of bread, about 260; one cup of canned chicken noodle soup prepared with water, 1,100 milligrams; a fast-food hamburger, about 990; and a fast-food chicken dinner, about 2,200. So cutting back on salt may be harder than it sounds if processed foods with hidden amounts of sodium are consumed regularly.

Heart Disease and Cholesterol, Fats, and Fish Oil

Cholesterol Is the way to a man's heart still through his stomach? It most certainly is. But the old saying has now taken on a second meaning. Give him a regular diet high in cholesterol and saturated fat and you will increase his risk of a heart attack.

Cholesterol—a soft waxlike substance found among the fats in the bloodstream—may build up on the inner lining of blood vessels and, over time, obstruct them. This narrowing of the blood vessels, called atherosclerosis, keeps oxygen-carrying blood from getting to the heart. The result can be severe chest pain and eventually heart attack.

Our bodies need some cholesterol to maintain health and we get it in two ways. Our livers manufacture it naturally no matter what we eat, and we ingest it by eating foods of animal origin such as egg yolks, meats, poultry, fish, and dairy products. No plant-derived foods, whether fruits, vegetables, grains, or nuts, contain cholesterol.

Studies have shown what can happen when people from a country with a low-fat diet move to a country with a high one. Japanese living in Japan, where fat consumption is low, have low blood cholesterol levels and a low rate of heart disease. Japanese who have migrated to Hawaii, where fat consumption is higher, suffer significantly more heart attacks than their stay-at-home cousins. Those who have settled in California, where fat in-take is even higher, suffer more heart attacks still.

The evidence mounts daily that most people, even those with an inherited tendency to heart disease, can substantially reduce their risk of heart disease by following a low-cholesterol diet. Some studies even show that cholesterol reduction helps reverse cholesterol deposits that have already formed. But cholesterol is not the whole story.

Fats—Saturated, Polyunsaturated, and Monounsaturated Perhaps equal in importance to the actual amount of cholesterol in the diet may be the amount of saturated fats that are consumed. They tend to raise the cholesterol level in your blood no matter how little cholesterol you ingest.

Saturated fats are the fats that become hard at room temperature. They're found primarily in animal products such as meats, cheese, butter, cream, whole milk, and egg yolks. They're also found in some vegetable products such as coconut oil, palm oil, and cocoa butter.

But now the fat story brightens. Two types of fat may actually be beneficial for cholesterol control. Polyunsaturated fats, such as safflower, corn, and sesame oils, and monounsaturated fats such as olive oil and peanut oil, may help to lower blood cholesterol levels. Of course our bodies need some fat to maintain health, but you shouldn't eat too much of these beneficial fats either, since all fats may pose a cancer risk.

Fish Oil Rapidly mounting evidence shows that eating certain ocean fish at least twice a week, in place of meat or eggs and butter fats, may diminish your risk of coronary heart disease. This new research from the University of Leiden in the Netherlands, the Oregon Health Sciences University, and Harvard Medical School* has shown that fatty fish, with their high levels of omega-3 fatty acids, may be even more useful than polyunsaturated vegetable oils when it comes to lowering blood cholesterol levels. In fact, fish oils may also affect another aspect of body chemistry beneficially: by reducing the stickiness of certain cells important in blood clotting, they may help prevent blood clots from forming and blocking your arteries, thereby reducing your risk of heart attack and stroke.

The discovery of the beneficial value of fish oils grew out of observations by Danish researchers in the 1970s that had long seemed contradictory to cardiologists. Why did Eskimos, who eat huge amounts of animal fats, have such a low rate of coronary heart disease? Similarly, in coastal regions of Japan where despite rampant high blood pressure caused by high salt intake, heart attacks are not a frequent cause of death. One logical explanation put forward was that Eskimos are genetically resistant to heart attacks. But it turned out that it was not their genes that protect them, because the few who move to Denmark and switch to the local diet are just as prone to heart disease as Danes.

The studies applied only to salt-water fish. It is unknown whether freshwater fish would produce the same results. Fish richest in these protective oils are those that live in deep, cold waters. Examples include salmon, tuna, and Atlantic mackerel. Shellfish, such as shrimp and lobster, though higher in cholesterol than fish, also have this protective fish oil and are now considered desirable alternatives to red meat once or twice a week.

Fats, Fiber, and Cancer

Eating too much fat (both saturated and unsaturated) not only increases the risk of heart disease but may also lead to cancer of the colon, breast, prostate, and lining of the uterus. Consider colon cancer, prominent in nearly all the countries where heart disease is a major killer. The scientific evidence suggests that a diet low in fat and high in fiber (especially from whole grains, fruits, and vegetables) can help prevent this cancer. In Japan, for example, with its traditionally low-fat, high-fiber diet, colon cancer is rare. But when Japanese migrate to the United States and ultimately adopt a largely Western diet, their rates of the disease approach the high U.S. rate.

Of course there are other risk factors that play a role in heart disease, high blood pressure, and cancer, such as heredity, overweight, inactivity, and smoking. With regard to heredity, there is some evidence to support the theory that though your genes may place you at high risk, it may be possible through changes in diet to minimize the consequences of genetic factors. Insofar as weight is concerned, cutting back on fats and meats in the diet reduces calories considerably, so weight control becomes much easier.

What Medical Experts Tell Us to Do

According to the American Medical Association dietary guidelines, your cholesterol intake should be kept to less than 100 milligrams per 1,000 calories and never more than 300 milligrams per day. Saturated fat should comprise less than 10% of calories, and total fat intake should account for less than 30% of total caloric intake. They also recommend that you reduce your sodium intake to about 1 gram per 1,000 calories, not to exceed 3 grams per day. For the average person eating about 2,000 calories a day, these guidelines mean a daily intake of no more than 200 milligrams of cholesterol and 2,000 milligrams of sodium.

The Heart Association also advises you to keep total calories low enough just to maintain your ideal body weight and to get your carbohydrates primarily from grains, fruits, and vegetables. The following is a summary of the dietary guidelines issued by the American Heart Association:

 Saturated fat intake should be less than 10% of calories.

 Total fat intake should be less than 30% of calories.

 Cholesterol intake should be less than 100 mg per 1,000 calories, not to exceed 300 mg per day.

 Sodium intake should be reduced to approximately 1 gram per 1,000 calories, not to exceed 3 grams per day.

Other specific dietary guidelines issued at,the same time by the American Heart Association were:

 Protein intake should be approximately 15% of calories.

 Carbohydrate intake should make up 50-55% or more of calories with emphasis on increasing sources of complex carbohydrates.

If alcoholic beverages are consumed, the limit should be 15% of total calories, not to exceed 50 cc of ethanol per day.

 Total calories should be sufficient to maintain the individual's best weight.

 A wide variety of foods should be consumed.

An example for an average person consuming 2,000 calories per day:

200 milligrams of cholesterol

2,000 milligrams of sodium

22 grams of saturated fat

66 grams of total fat (1 gram of fat yields 9 calories.)

Therefore:

(2,000 x 10%) ÷ by 9 = 22.

(2,000 x 30%) ÷ by 9 = 66.

To reduce the risk of cancer, the National Academy of Sciences in its report Diet, Nutrition and Cancer, recommends that fat comprise no more than 30% of your total calories and preferably less. The Academy also urges the consumption of more vegetables, fruits, and whole grains, and less salt-cured, smoked, and charcoal-broiled food (these are carcinogenic). It further recommends that you moderate your consumption of alcoholic beverages, get some exercise on a regular basis and stop smoking.

How to Apply These Recommendations to Everyday Life

Developing a healthy diet means following two basic rules: moderation and variety. In other words, cut down on the things that put you at risk and eat a wide range of other foods that are rich in specific nutrients. These rules are right for everyone, not just people with already established health problems. They hold particularly exciting promise for children, who can benefit by forming tastes for the right foods early in life that may protect them when they reach adulthood.

Moderation If your favorite foods today are high in sodium, fat, or cholesterol, you don't have to give them up entirely. Just eat less of them, and eat them less open. Don't expect to change your eating habits overnight. Do it gradually and steadily. For example, if you abruptly stop cooking with salt, you're likely to find your foods unpalatable. But if you gradually cut down on the amount you use, you'll hardly notice the difference.

The guidelines are simple and should guide you the rest of your life. Go easy on fatty meats, on animal products such as eggs, butter, and cream, and on rich desserts, processed foods, and salty snacks. Increase your in-take of fresh vegetables, fruits, poultry, fish, whole grains, dried beans, and low- or nonfat milk products.

Often it is a matter of trading off. For example, if you start the day with cholesterol-rich eggs and then have a high-sodium fast-food hamburger for lunch, just eat mostly vegetables for dinner. A stir-fry of broccoli, carrots, and onions (with perhaps an ounce or two of fat-free chicken) flavored with plenty of garlic and fresh ginger root will do very nicely.

Variety The need for a balanced diet cannot be overstressed. Eat a variety of foods with at least two servings of ocean fish per week. Include fresh fruits, vegetables, and whole-grain bread and cereals in your diet every day. For protection against certain forms of cancer, look to vegetables in the cabbage family (such as broccoli, cauliflower, cabbage, and turnips) and to fruits and vegetables that are rich in vitamins A and C (dark green vegetables and all yellow-orange fruits and vegetables such as carrots, sweet potatoes, pumpkins, squashes, cantaloupes, apricots, and citrus fruits).

In sum, good nutrition doesn't mean you have to become an extremist or food faddist. Nor does it mean you have to eat bland foods or miniscule amounts. As the recipes in this book prove, you can enjoy all the pleasures of good eating and still protect your health.

* Articles about the benefits of fish oils are listed in the bibliography under Dr. Daan Kromhart of the University of Leiden, Dr. Tak H. Lee of the Harverd Medical School, and Dr. Beverley E. Phillipson of the Oregon Health Sciences University.