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Expert Q&A: Heart-Healthy Eating

An interview with Dean Ornish, MD.
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Why is fiber an essential component of a heart-healthy diet? continued...

The difference between refined carbs and complex carbs is that the complex, fiber-containing carbs aren't just not bad for you -- they are truly good for you. When you go from white to brown rice or from white flour to whole-wheat flour, you are going from bad carbs to good carbs.

That does two good things from a weight standpoint. You fill up before you get too many calories. And you slow the absorption of foods into your bloodstream.

If you eat high-fiber carbs, your blood sugar level goes up a little and stays there -- so you're getting a good source of energy. But bad carbs get absorbed very quickly. Your blood sugar is going to zoom way up. Your pancreas pumps out insulin to bring it back down, and the insulin accelerates the conversion of sugar into fat.

This causes all these swings in energy. Your blood sugar doesn't just go back to where it started before it got too high -- it goes way down. That increases your carb craving, and you're stuck in a vicious cycle.

It is not necessary to avoid bad carbs altogether, but to limit them and use them in combination with other foods. If you're going to have dessert, have it after a high-fiber meal. Don't have it on an empty stomach.

How much can soluble fiber lower cholesterol levels? How much soluble fiber do you need to eat to get this benefit?

It depends on the individual. There is variability, and this is partly genetically determined. The best thing is to find out what works for you.

The issue is, lowering cholesterol is not just one thing. So often people are looking for a magic bullet: Oat bran is going to cure it, or Lipitor is going to cure it, or whatever. What you want to do is combine a number of different things that make a difference.

If you are eating mostly foods that are plant-based, they tend to be rich in fiber anyway. It's just that it all comes organically and naturally instead of having to add a spoonful of fiber to your food.

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