Fresh-Pressed Olive Oil Club

The Olive Oil Hunter News #156

Salmon with Red Pepper Coulis Recipe & The Benefits of Culinary Brushes

Looking for a romantic Valentine’s Day dinner to enjoy by candlelight at home? With its pink and soft red hues, my recipe for salmon served on a pool of red pepper coulis checks off all the boxes! This edition of the newsletter also includes information about a new online health series—its focus is on how to protect yourself from the myriad toxins that are so pervasive in our lives.  

Salmon with Red Pepper Coulis

  • Salmon with Red Pepper Coulis Salmon with Red Pepper Coulis

    A purée of red peppers and onions makes a sweet accompaniment that won’t overpower the taste of the salmon. Coulis leftovers make a great sandwich spread and dip for crusty bread.

    Ingredients

    • 2 large red bell peppers
    • 1 medium sweet onion
    • 4 tablespoons extra virgin olive oil, divided use, plus more for drizzling
    • 2 teaspoons sherry vinegar, plus more to taste
    • Kosher or sea salt to taste, plus more for the salmon
    • 1-1/2 to 2-pound salmon filet, skin on
    • Freshly ground black pepper
    • A few springs of fresh thyme, chopped

    Directions

    Step 1

    Turn on your oven to broil. Halve the peppers and remove the stems and ribs. Peel the onion and cut it into 4 thick slices. Brush a tablespoon of olive oil on a rimmed sheet pan. Place the onion slices on the sheet pan and top each one with a pepper half (this allows the onions to cook without burning). Broil until the pepper skins have blistered and blackened, about 10 minutes. Place the sheet pan on a heat-safe mat and cover the bell peppers with a domed lid for 10 minutes; this makes it easier to peel off the charred skin. Peel when cool.

    Step 2

    Place the peeled peppers in your food processor or blender along with the onions, all the pan juices, a tablespoon of olive oil, and the vinegar. Process until very smooth, about 5 minutes. Season to taste with salt. Transfer to a bowl and set aside.

    Step 3

    Turn your oven to 350°F. Place a piece of parchment paper on the same sheet pan (no need to wash it) and brush on another tablespoon of olive oil. Place the salmon, skin side down, on the parchment, and brush with the final tablespoon of olive oil. Sprinkle on just a pinch of salt, sone black pepper, and the thyme, and bake until the top of the filet feels firm to the touch, about 15 minutes, depending on thickness.

    Step 4

    Use a sharp chef’s knife to slice the salmon into 4 portions. Place a pool of the pepper coulis on each of 4 dinner plates and top each with a salmon serving and a drizzle of olive oil. Pass the rest of the coulis separately.

    Yields 4 servings

Quick Kitchen Nugget: Culinary Brushes

Quick Kitchen Nugget

Culinary Brushes

Apples with a paring knife

Many kitchen tasks are made easier with the right brushes. A small and a medium or large silicone brush will answer many needs, like coating food with a wet rub, sauce, or egg wash, and basting a roast or turkey. Look for all-silicone styles rather than those wooden handles so you can easily wash them—dishwasher-safe tools are handiest. Silicone styles are also often heat-safe up to 600°F. I suggest separate brushes for sweet and savory cooking.

Other cooking tasks are better accomplished with a soft-bristled pastry brush, handy for sweeping away excess flour and when a more delicate touch is needed (silicone bristles may not be tight enough to give full coverage). Natural bristles are typically boar hair, but nylon is also available. These brushes require some special care when cleaning. Use a mild, unscented liquid dish soap and dry flat to preserve the shape of the bristles as well as to keep water out of the handle.

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The Olive Oil Hunter News #155

“Spiked” Apples Recipe, Spotlight on Apples, The Paring Knife, Cutting Calories May Boost Longevity, and Do You Have Aging Anxiety? Another Reason to Exercise!

If you’re like me, you love recipes that can be adapted to many dishes—and that’s why spiked apples are part of my winter repertoire. You’ll be tempted to eat them right out of the pan, but you should definitely explore the ways they can enhance other dishes. I’m also sharing two new discoveries—why just a small cut in daily calories can add years to your life and what you can do to quell anxiety over aging.

“Spiked” Apples

  • Spiked Apples “Spiked” Apples

    Calvados, the apple brandy from France’s Normandy region, adds great depth of flavor to apple dishes. Since most of the alcohol burns off, my spiked apples make a great addition to your morning oats or yogurt as well as a delicious filling for a tart or crêpes or the topping for a scoop of ice cream—vanilla and olive oil ice cream, of course! They’re equally delicious served alongside pork chops or a pork roast.

    Ingredients

    • 4 tablespoons extra virgin olive oil
    • 2 tart apples, such as Granny Smith, cored and sliced into 12 wedges
    • 2 sweet apples, such as Fuji or Honeycrisp, cored and sliced into 12 wedges
    • 1/4 cup calvados
    • 1/4 cup brown sugar or your choice of sweetener
    • Cinnamon to taste
    • 2 tablespoons unsalted butter

    Directions

    Heat a large frying pan over medium heat. When very warm, add the olive oil and the apples, arranging the fruit in one layer (do this in batches if your pan can’t hold them all at once). Let the apples cook until the edges brown slightly, then flip them and brown again. Add the calvados to deglaze the pan. After one minute, sprinkle on the brown sugar and cinnamon and toss. The sugar should melt, but don’t let it burn. Add the butter and swirl until it melts, then remove from heat. 

    Yields 4-6 servings

Apples

Healthy Ingredient Spotlight

Apples Galore

Baked apples with granola and homemade olive oil ice cream

There’s merit to the old adage that an apple a day keeps the doctor away—high in fiber and nutrients, apples are a great way to get you closer to the recommended daily five to seven servings of fruits and vegetables needed for good health. With over 2,000 varieties of apples now available and more being developed at leading agricultural universities, it would take years to try them all! Here are some of the most widely available varieties and how best to enjoy them.

  • Empire: a sweet-tart cross between Red Delicious and McIntosh, ideal for eating raw or baking
  • Fuji: crispy, sweet, and juicy, ideal for all uses
  • Gala: crisp, juicy, and very sweet, ideal for eating raw
  • Golden Delicious: mild, sweet flavor, ideal for eating raw or baking
  • Granny Smith: tart and crisp, ideal for salads or cooking
  • Honeycrisp: sweet and crispy, ideal for eating raw or making applesauce
  • Jonagold: a sweet-tart mix developed from Golden Delicious and Jonathan apples, ideal for baking
  • Macoun: very sweet, juicy, and aromatic, ideal for eating raw or making applesauce
  • McIntosh: tangy and tart, ideal for eating raw or making applesauce
  • Pink Lady: a highly flavorful cross of Golden Delicious and Lady Williams apples, ideal for all uses
  • Red Delicious: sweet, crispy, and juicy, ideal for eating raw

Quick Kitchen Nugget: The Paring Knife

Quick Kitchen Nugget

The Paring Knife

Apples with a paring knife

With all the stunning types of chef’s knives available, the chef’s knife’s sidekick, the paring knife, is often an afterthought in the kitchen. But it’s a very handy knife to have for precision work and when cutting smaller and soft foods, from a garlic clove up to an apple. (You’ll need to stick to your chef’s knife for hard foods like squash, potatoes, carrots, and melons.) A paring knife blade is typically between 3 and 4 inches long, and though the handle is smaller than that of other knives, you should still test it before you buy to make sure it feels comfortable in your hand.  

For Your Best Health: Cutting Calories May Boost Longevity

For Your Best Health

Cutting Calories May Boost Longevity

Calorie restriction—decreasing daily calories—without depriving yourself of essential vitamins and minerals and other key nutrients has long been known to delay the progression of age-related diseases in animal studies. New research, published in the journal Aging Cell, suggests it may do the same for people. 

Researchers at the National Institutes of Health and colleagues analyzed data from the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE), a study supported by the National Institute on Aging (NIA). For CALERIE participants, the goal was to reduce daily calories by 25%. However, over a two-year span, the best they were able to achieve was a 12% reduction. But it turns out that this was enough to rejuvenate muscle and activate key biological pathways that are important in healthy aging.

“A 12% reduction in calorie intake is very modest,” said corresponding author and NIA Scientific Director Luigi Ferrucci, MD, PhD. “This kind of small reduction in calorie intake is doable and may make a big difference in your health.”

The research team also sought to explain a finding of past studies: People practicing calorie restriction lost muscle mass (along with losing weight in general), but they did not lose all-important muscle strength. To understand this phenomenon, they looked at thigh muscle biopsies from CALERIE participants collected when people joined the study and at one-year and two-year follow-ups. They discovered that during calorie restriction certain genes were upregulated, meaning the cells made more mRNA, and others were downregulated, meaning the cells produced less mRNA. Specifically, a lower caloric intake upregulated genes responsible for energy generation and metabolism and downregulated inflammatory genes, leading to lower inflammation.

“Since inflammation and aging are strongly coupled, calorie restriction represents a powerful approach to preventing the pro-inflammatory state that is developed by many older people,” said Dr. Ferrucci.

Fitness Flash Icon: Do You Have Aging Anxiety? Another Reason to Exercise!

Fitness Flash

Do You Have Aging Anxiety? Another Reason to Exercise!

According to Sarah Francis, PhD, Iowa State University professor and Jane Armstrong Endowed Chair of Food Science and Human Nutrition, many people experience aging anxiety—fears and concerns about losing autonomy and relationships as well as physical and psychological changes and discomfort or lack of enjoyment being around older people. “Previous research has shown that if you have high anxiety about aging, you have poor health outcomes. But if you view it more positively as a life stage, you have better health outcomes. You’re more likely to make lifestyle changes that benefit you in the long run,” said Dr. Francis.

Since 2010, she has been part of a USDA multistate project bringing together experts in physical activity, clinical nutrition, and community health programming to support healthy aging. Part of their research has focused on identifying factors that influence physical activity, such as aging anxiety. One explanation for the negative link between aging anxiety and poor health is that anxiety can get in the way of being physically active, and not being active is often at the root of many health problems. 

To better understand how aging anxiety relates not only to physical activity but also to other factors like gender, marital status, and income, Dr. Francis and the team designed a 142-question online survey and recruited a cross-section of urban, suburban, and rural participants including people as young as 40 to understand how different aspects of aging anxiety shift with age. In total, 1,250 people from Washington, DC, and six states (Iowa, Illinois, Maryland, Rhode Island, South Dakota, and West Virginia) responded to the survey. 

“One of the most important findings is that higher positivity about physical activity relates to lower anxiety about aging,” said Dr. Francis. “Perhaps this is because the physical, mental, and social benefits of staying active contribute to overall well-being and a more favorable perception of the aging process, ultimately reducing anxiety related to growing older.”

It’s also well known that exercise, especially strength training, helps conserve bone mass and muscle, reduce the risk of dementia, and maintain motor control. But, Dr. Francis pointed out, many middle-aged and older adults face barriers to exercising, from being afraid they’ll get hurt to not having easy access to a gym or greenspaces for walking. For those who can’t overcome these barriers, the team’s next project is developing and testing a virtual program that would include at-home physical activities and an educational component to encourage eating healthy.

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The Olive Oil Hunter News #154

Bountiful Breakfast Quesadillas Recipe, Spotlight on Whole-Grains, The Cake Lifter, and The Mental and Physical Effects of Poor Sleep

Eat more whole grains—it’s at the top of most of our New Year’s health resolutions, yet it’s often so difficult to do. First, there’s the common misconception that whole grains aren’t as tasty as refined ones. Then there’s the problem of confusing package labels that don’t accurately describe what’s inside. This edition of The Olive Oil Hunter Newsletter homes in on the problem with easy fixes, starting with a delicious quesadilla—a great way to start your day! 

Bountiful Breakfast Quesadillas

  • Bountiful Breakfast Quesadillas Bountiful Breakfast Quesadillas

    This take on a quesadilla makes a festive presentation for brunch, and you can customize it with ingredients you love best.

    Ingredients

    • 3 tablespoons extra virgin olive oil
    • 1 onion, finely diced 
    • 1 bell pepper, any color, seeded and finely diced 
    • 1 chile pepper, such as a poblano or a jalapeño, seeded and finely diced 
    • 6 eggs
    • 4 corn or whole-wheat tortillas 
    • 1-1/2 cups grated Manchego, Monterey Jack, or cheddar cheese, or a combination 
    • 1 cup black beans
    • 1 avocado, cut into thin slices
    • Your favorite salsa

    Directions

    Step 1

    Heat a large skillet over medium heat. When hot, add two tablespoons of olive oil, the onions, and peppers. Sauté until the onions soften and turn a light brown. Whisk the eggs and add them to the pan; cook to a soft scramble.

    Step 2

    Heat a griddle over medium heat. When hot, drizzle on the remaining olive oil. Place two of the tortillas side by side on the griddle and layer on the ingredients, in this order, divided between the two: half of the cheese, the scrambled eggs, beans, avocado slices, and then the rest of the cheese. Top with the remaining tortillas and press down gently with a large spatula or cake lifter (see Quick Kitchen Nugget in Newsletter #154). 

    Step 3

    When the bottoms of the tortillas brown and the bottom layer of cheese has melted, flip them and continue cooking until the other cheese layer has melted. Transfer the quesadillas back to your cutting board and cut them into quarters. Serve with salsa as desired.

    Yields 4 servings

Healthy Ingredient Spotlight: Choosing Whole-Grain Tortillas 

Healthy Ingredient Spotlight

Choosing Whole-Grain Tortillas 

An easy way to get more whole grains and fiber is to use corn or whole-wheat tortillas in place of the traditional white flour kind. But it’s still important to read the list of ingredients to be sure you’re getting 100% of the grain (see For Your Best Health below for more) and choose brands with the least salt and additives. 

Quick Kitchen Nugget: The Cake Lifter

Quick Kitchen Nugget

The Cake Lifter

Picture a spatula the size of a 9-inch or 10-inch round or square cake layer—that’s a cake lifter. And it’s great not only for evenly stacking cake layers and transferring baked goods from pan to serving plate, but also for flipping tortillas and other foods cooked on a griddle. They’re available from well-known cookware companies like Wilton and Nordic Ware for under $20.

For Your Best Health: Are You Really Getting Whole Grains?

For Your Best Health

Are You Really Getting Whole Grains?

We know that whole grains are healthier than refined ones because they contain all parts of the grain, including all-important fiber. But according to research published in The American Journal of Clinical Nutrition, unclear or misleading labeling makes it difficult to really know what you’re getting in packaged foods. The researchers pointed out that some manufacturers use deceptive labeling tactics, like putting the words “whole grain” in the product name or listing the amount of whole grains present but not what percentage of total grains that represents. A product with a vague callout, like “made with whole grain,” may contain only minuscule amounts. And there’s no current government policy that requires a complete disclosure. 

What can you do to shop smarter? Look for products with the “100% Whole Grain Stamp” from the Whole Grains Council. This indicates that the food contains a full serving or more of whole grain in each labeled serving and that all the grain is whole grain. Whole-grain products not yet using this symbol may list the grams of whole grain somewhere on the package or use words like “100% whole wheat.” You can also look for the “50%+ Stamp” on products; it means that each serving of the food is at least half whole grain, with a minimum of 8 grams. There’s also the “Basic Stamp”these products have at least 8 grams of whole grain per serving but overall may contain more refined grains than whole grains.

Fitness Flash Icon: The Mental and Physical Effects of Poor Sleep 

Fitness Flash

The Mental and Physical Effects of Poor Sleep 

Missing out on needed sleep often leaves us dragging through the next day. But it can also take a mental toll that we often fail to appreciate. That’s because a good night’s sleep prepares us for activity and helps us be more productive, while not getting enough sleep affects how well we do at tasks that require attention, memory, and executive functioning, including driving safely. Many people now rely on so-called readiness scores given by their fitness and sleep trackers to let them know how restorative (or not) their sleep was, but they were designed to predict physical performance and may not tell you how you’ll perform cognitively. 

A group of scientists decided to test how well cognitive function tracked with physical function. Professor Michael Chee, MBBS, Assistant Professor Stijn Massar, PhD, and Alyssa Ng, PhD student, of the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine of the National University of Singapore, asked 119 university students to report their mood, motivation, and sleepiness after waking and before going to bed daily for between two and six weeks. Sleep was measured with Oura rings and cross-referenced with smartphone app-based self-reports that also captured daytime naps and their duration. 

They found that after nights with longer sleep than a given participant’s average, that person experienced a better mood, higher motivation, and lower sleepiness, and that a good night of sleep following a poor one could be helpful for restoring social functioning. For those who regularly missed out on sleep, taking naps helped ease some of the ill effects. Their findings also reinforce the idea that sleep is highly personalized, with significant differences from person to person in the amount of sleep necessary to maintain mental well-being.

“People say they know all they need about their sleep within a few weeks of using a sleep tracker, but our work suggests there is real value in continuing to measure sleep to help you judge when to push it and when to hold back in work or social settings,” said Dr. Chee, who has been a significant contributor to research evaluating the utility of wearable sleep trackers.

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The Olive Oil Hunter News #153

Baked Pears with Olive Oil Custard Sauce Recipe, Spotlight on Pears, How to Avoid Curdling Eggs and Protect Against the Biggest Heart Disease Risk Factors, Go Green to Clean

If you thought olive oil was only for savory dishes, you’ll want to try this delectable dessert right away! Roasting brings out even more of the pears’ natural sweetness and the custard is as creamy as the best pudding—and both are enhanced with olive oil. This issue’s research topics have to do with preventing health issues—avoiding toxic VOCs in cleaning products to protect your lungs and the greater environment and preventing or mitigating the five most damaging threats to heart health. The good news: We each have it within our control to make lifestyle changes that make a significant difference.

Baked Pears with Olive Oil Custard Sauce

  • Baked Pears with Olive Oil Custard Sauce Recipe Baked Pears with Olive Oil Custard Sauce

    Separately, roasted pears and rich vanilla custard are delicious. Together, they’re simply sublime. This dish can be served warm, with the pears just out of the oven and the custard right off the stovetop, or both can be chilled and served cold—the sauce will get thicker in the fridge.

    Ingredients

    For the pears:

    • 4 pears, such as Anjou, Bosc, or Concorde, ripe but still firm
    • 2 tablespoons extra virgin olive oil, plus more for the baking dish
    • 1/4 cup brown sugar
    • 1/2 teaspoon cinnamon
    • 1/4 teaspoon freshly grated nutmeg
    • 1/2 cup water

    For the custard sauce:

    • 2 teaspoons cornstarch
    • 1/2 cup granulated sugar
    • Pinch of sea salt
    • 2 egg yolks
    • 2 whole eggs
    • 1-1/2 cups whole milk 
    • 2 tablespoons extra virgin olive oil
    • 2 teaspoons vanilla extract or paste
    • 1/3 teaspoon almond extract

    Directions

    Step 1

    Preheat your oven to 350°F. Halve the pears and use a small spoon to scoop out the seeds; there’s no need to peel them. Lightly coat a baking dish large enough to hold the pear halves with the olive oil. Place the pears cut side down in the baking dish and drizzle them with the 2 tablespoons olive oil, then sprinkle on the brown sugar, cinnamon, and nutmeg. Pour the water into the baking dish and bake for 20 minutes. Turn the pears cut side up, carefully spooning the juices from the bottom of the dish over them and into the cavities. Bake for another 20 minutes or until tender—check with the tip of a knife (if they start to brown before they’re done, cover the dish with foil). 

    Step 2

    While the pears are baking, make the custard. In a heat-safe bowl, whisk together the cornstarch, sugar, and salt. Add the yolks and the whole eggs and whisk until the mixture is light yellow and slightly thick.

    Step 3

    Place the milk in a saucepan and scald it—it should start to form a light skin but not come to a rapid boil. Vigorously whisk 1/4 cup of the hot milk into the egg mixture, and then slowly whisk in the rest. Transfer the mixture back to the saucepan and bring to a low boil over medium heat, whisking constantly. Let it boil for 60 seconds until it thickens enough to coat a spoon (it should be the consistency of a cream soup). Remove from the heat. (If it looks at all lumpy, put it through a strainer.) Whisk in the olive oil and the extracts. Transfer to a 2-cup pitcher for pouring over the pears. Note: If you want to chill the sauce, press a small round of parchment paper over the surface to prevent a skin from forming as it cools down.

    Step 4

    To serve, plate two pear halves on each of four dishes and pour on generous amounts of the sauce and the juices from the baking pan.

    Yields 4 servings

Healthy Ingredient Spotlight: Pears

Healthy Ingredient Spotlight

Pears: A Powerhouse of Nutrients

A medium pear has only about 100 calories, but packs a wallop of nutrients. At the top of the list are its 6 grams of fiber—be sure to leave on the skins to get all of them. Rich in antioxidants, pears have potassium, magnesium, and even some vitamin C. They make a great dessert, a filling snack—try a slice on a cracker spread with goat cheese, and a sweet addition to salads. 

Because of that sweetness and their smooth, often buttery flesh, puréed ripe pears can add a sweet note to creamy vegetable soups or be the star of a dessert like a tart, but only the firmer varieties can stand up to cooking, whether poaching, baking, grilling, roasting, or sautéing. Enjoy Bartlett, Starkrimson, and Forelle varieties raw.

Store pears at room temperature. Refrigerate only to slow the ripening process. For instance, if you bought a bushel at the farmers’ market, you can delay ripening by putting some in the fridge and take them out a few days before you want to eat them. Some pears change color as they ripen—green Bartletts, for instance, become yellow. For varieties that don’t typically change color, test for ripeness by gently pressing your thumb near the stem end or on the neck, not the body. The surface should just barely give when ripe. If you want softer flesh for a purée or smoothie, wait for the wider bottom half to become soft to the touch—the inside will actually be overripe. 

Quick Kitchen Nugget: How to avoid curdling eggs

Quick Kitchen Nugget

How to Avoid Curdling Eggs

The reason to slowly add hot liquid to eggs for custards and pastry cream is to keep the eggs from curdling, the inevitable result of pouring in a large amount of scalded milk all at once. The cornstarch adds yet another layer of protection, which is why you can finish the cooking in the same pan you use to heat the milk rather than using a traditional double boiler. Still, it’s a must to whisk vigorously through every stage to avoid lumps and create a smooth texture. The cornstarch itself needs to be brought just to a boil and cooked for about a minute or else your custard will taste chalky—vigorously whisking during this stage and turning down the heat as needed are especially important steps to avoid burning. 

For Your Best Health: Imperfect calorie counting may be good enough

For Your Best Health

Go Green to Clean

A peer-reviewed study by Environmental Working Group scientists published in the journal Chemosphere detailed new information about the potential health risks of common household cleaning products. Their analysis of 30 products, including multipurpose and glass cleaners and air fresheners, showed that these everyday products may release hundreds of hazardous volatile organic compounds, or VOCs, into the air we breathe. 

Researchers tested both conventional products and “green” cleaning products and detected a total of 530 unique VOCs in the 30 products. Of these, 193 VOCs were hazardous, meaning they’ve been identified as having the potential to cause health harms such as respiratory system damage, increased cancer risk, and developmental and reproductive impacts. VOCs in cleaning products affect the quality of air both indoors and outdoors, but they contaminate indoor air two to five times more than outdoor air, with some estimates as high as 10 times more. Some products emit VOCs for days, weeks, or even months. 

“This study is a wake-up call for consumers, researchers, and regulators to be more aware of the potential risks associated with the numerous chemicals entering our indoor air,” said Alexis Temkin, PhD, a senior toxicologist at EWG. ”Our findings emphasize a way to reduce exposure to hazardous VOCs – by selecting products that are ‘green,’ especially those that are ‘green’ and ‘fragrance free.’” 

Products labeled green emitted fewer VOCs than did conventional products—about half the number, on average. The green products categorized as “fragrance free” also produced the fewest VOC emissions, nearly eight times fewer than conventional and four times fewer than green products that included fragrance on their label. 

That pattern also held true for the number of VOCs considered hazardous in the products. The green products emitted just four chemicals classified as hazardous, on average, compared to about 15 in green products with fragrance and 22 for conventional products. This suggests that choosing green or green and fragrance free cleaning products could be prudent for those concerned about indoor air quality and potential health risks, such as an increased risk for asthma.

“These cleaning products may hurt our health, but they may also harm the environment,” said Samara Geller, EWG senior director of cleaning science. VOCs emitted by consumer products can contribute to outdoor air pollution, adding to existing environmental concerns. 

“Going green with your cleaning products is an easy way to reduce exposure to harmful chemicals. This may be especially important for women’s and children’s health,” said Geller.

Fitness Flash

Protect Against the Biggest Heart Disease Risk Factors 

Scientists of the Global Cardiovascular Risk Consortium under the auspices of the department of cardiology at the University Heart & Vascular Center of the Medical Center Hamburg-Eppendorf (UKE) and the German Center for Cardiovascular Research (DZHK) have shown that the five classic cardiovascular risk factors—excess weight, high blood pressure, high cholesterol, smoking, and diabetes mellitus—are directly connected to more than half of all cardiovascular diseases worldwide.

Specifically, the numbers are 57.2% and 52.6% of cases of incident cardiovascular disease among women and men, respectively, and 22.2% and 19.1% of deaths from any cause among women and men, respectively. Their work, “Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality,” was published in the New England Journal of Medicine in August 2023.

They came to their conclusions after assessing data on 1.5 million people who took part in 112 different studies done in North America, Latin America, Western Europe, Eastern Europe and Russia, North Africa and the Middle East, Sub-Saharan Africa, Asia, and Australia. Their objective was to gain a better understanding of the global distribution, the significance of the individual risk factors and their effects on cardiovascular diseases, and overall mortality in order to derive targeted preventive measures.

Cardiovascular diseases cause approximately a third of all deaths worldwide. They often develop silently over decades. Frequently, without being recognized, the vascular walls change, giving rise to arteriosclerosis, in the wake of which coronary heart disease may occur, including complications such as heart attacks, acute cardiac death, or strokes. But there’s a silver lining—you can do something about each of those five risk factors.

“Our study clearly shows that over half of all heart attacks and strokes are avoidable by checking and treating the classic risk factors. These results are of the highest significance for strengthening prevention in this area. At the same time, approximately 45% of all cardiovascular cases cannot be explained with these risk factors; they should motivate us and the academic funders to further research efforts,” said Stefan Blankenberg, MD, professor and medical director of the University Heart & Vascular Center at the UKE.

“In principle, the five classic risk factors that we examined are modifiable, and thus responsive to preventive measures. So far, the proportion of preventable risk attributed to these five risk factors is still matter of debate,” lead author Christina Magnussen, MD, associate professor in the department of cardiology at the University Heart & Vascular Center of the UKE, explains.

The study shows that we can learn how to avoid cardiovascular diseases or reduce their effects for at-risk persons, or people with cardiovascular diseases, by improving their lifestyles and by lowering blood pressure or cholesterol. It also shows a linear relationship between high blood pressure and high cholesterol, and the occurrence of cardiovascular diseases. “High systolic blood pressure accounts for the largest share of cardiovascular risk. We should place a particular focus on the therapy of patients with high blood pressure to avoid cardiovascular diseases as much as possible,” said Dr. Magnussen. The scientists also identified a remarkable connection between cholesterol levels and overall mortality: Very low as well as high cholesterol levels increase overall mortality.

With the exception of BMI, which remains equally significant at any age, the significance of risk factors decreases with age. High blood pressure, for instance, is more damaging to a 40 year old than to an 80 year old. “This raises the question to what extent the target values for treating cardiovascular risk factors for the most elderly should be identical with those for the middle to older age bracket,” said Dr. Blankenberg.

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