Much has been written about the link between heart disease and cholesterol. So “Cook’s Corner” decided to ask Lori Kerns, a clinicial dietitian at Bluffton-Regional Medical Center with 32 years of experience; Kris Bischoff, a clinical dietitian at Adams Memorial Hospital with 24 years of service; and Julia Just of Parkview Health, a clinical dietitian with 16 years of service, about the effects of high cholesterol and what can be done about it.

Q. What part does diet play in lowering cholesterol numbers?

Kerns: Diet has a major impact on the cholesterol levels. What we eat can directly affect our cholesterol levels.

Just: Diet can help lower cholesterol numbers without the side effects and costs that prescription drugs have. Most recently a study at Johns Hopkins University reported that diet (particularly the DASH diet) reduced the risk of heart attack by almost 20 percent. I have taught for years that for every 1 percent decrease in dietary saturated fatty acid consumed, there is a 2 percent decrease in LDL cholesterol with leads to a 2 percent decrease in heart disease.

Q. Why is it important to lower the bad cholesterol?

Bischoff: It is possible for the bad cholesterol (LDL) to be elevated even if the total cholesterol is normal. Elevation of either one can be detrimental to your heart health and indicate a need for a low cholesterol diet. People should follow the advice of their physician on obtaining a lipid profile (a lab test to measure cholesterol, triglycerides, HDL, and LDL). Sometimes a simple Total Cholesterol check doesn’t tell us everything that we need to know.

Just: When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the arteries that feed the heart and brain. Together with other substances, this can form plaque – a condition know as atherosclerosis. When the artery eventually becomes occluded, a heart attack or stroke occurs.

Q. Which is better – changing your diet immediately or gradually?

Bischoff: Changing your diet isn’t easy. Eating habits often originate in childhood and have several emotional attachments to them. People also make food selections based on social and financial situations. … Some people change their eating habits abruptly because they want to know immediately that they are doing what is best for their body. Others develop a gradual plan, perhaps even marking a calendar week-by-week as to what changes to implement each week. There is no right or wrong way to do it, as long as you reach your goal of a healthy eating plan.

Kerns: Gradual change is better. If you change gradually, you will be more likely to stay with the change of habits. If you try to change everything at one time, you will have the tendency to go back to your habits because you have the feeling you are now depriving yourself.

Q. What encouragement can you give to those trying to change eating habits?

Kerns: Take small steps each day to change your old habits. Do not deny yourself everything. If you do splurge on something higher in fat or cholesterol, make it a small portion and only spurge occasionally. If you go off your low cholesterol meal plan one day, do not give up, but just start again the next day by trying to cut back on the fat and cholesterol in your meal plan.

Bischoff: Be patient with yourself. You won’t follow any diet perfectly, forever. If you can’t change everything immediately, then pick one food item that you can change in your routine and do that first. After a week of making that change successfully, congratulate yourself. Then pick the next part of your diet that you want to change and work on it. Food habits are not created overnight, and most people can’t successfully change their eating habits overnight on a long-term basis. Celebrate your successes and keep making progress. The most important thing is to achieve your goal of healthy eating.

Just: Talk with a registered dietitian to get a sensible, realistic plan. Surround yourself with positive and supportive people! Write down one small goal for the day and put it in a place that you will see every day.

North Atlantic Tomato/Basil Pan-Bake Cod

North Atlantic Cod fillets, as desired

1 tablespoon olive oil

6 tablespoons red wine vinegar

1/2 teaspoon garlic, minced

1 tablespoon fresh basil, fresh, or 1 teaspoon dried

6 tablespoons white wine

1 onion, cut into 6 slices

6 cherry tomatoes, quartered

Salt, to taste

Pepper, to taste

Place fillets in lightly oiled baking dish. Combine red wine vinegar, garlic, basil, white wine, salt and pepper in small bowl. Spoon 2 tablespoons of vinegar mixture over each fillet. Separate onion slices into rings and put on fillets. Top with cherry tomato quarters. Bake in preheated oven 375 degrees for 20 minutes. Serve.

– Submitted by Kris Bischoff; original source: Marriott Food and Services.

24-Hour Layered Salad

1 head lettuce, shredded

1 large red onion, sliced and separated into rings

1 cup diced celery

1 (8-ounce) can sliced water chestnuts, drained

4 hard-cooked egg whites, chopped

2 cups frozen peas, uncooked and thawed

1 cup plain low-fat yogurt

1/2 cup calorie-reduced mayonnaise

2 teaspoons sugar

6 ounces part-skim mozzarella cheese, shredded

In bowl layer vegetables in the order given: lettuce, onion rings, celery, water chestnuts, egg whites and peas. Mix together yogurt and salad dressing. Spread over layered vegetables and sprinkle with sugar. Top with shredded cheese. Refrigerate overnight. Toss and serve. Using the egg whites instead of the whole egg cuts out the cholesterol plus using the part-skim mozzarella cheese cuts back on fat. The recipe also cuts back on fat by using the low-fat yogurt and the reduced calorie mayonnaise for the dressing. Makes 8 to 10 servings.

– Submitted by Lori Kerns

Quinoa Berry Salad

1 cup quinoa

1 cup thinly sliced celery

1/3 cup dried cranberries

1/3 cup raisins

1/3 cup coarsely chopped fresh flat-leaf parsley

1/2 cup shelled raw unsalted pumpkin seeds

1 tablespoon minced shallots

1 tablespoon white wine vinegar

3 tablespoons fresh orange juice

Grated zest of 1 orange

Salt, to taste

Freshly ground black pepper, to taste

1/4 cup extra-virgin olive oil

Cook the quinoa according to package directions. Once cooked, add the celery, cranberries, raisins, parsley, and pumpkin seeds to the quinoa and stir to blend. Place the shallots, vinegar, and orange juice in a glass jar and let sit for 10 minutes. Add the orange zest, 1/4 teaspoon of salt, 1/4 teaspoon of pepper, and the olive oil and seal the lid tightly. Shake the jar vigorously to combine. Just before serving, add the dressing to the quinoa mixture and toss to coat. Serve the salad at room temperature. Makes 8 servings.

– Submitted by Julia Just

Slow Cooker Steel Cut Oats

2 cups steel cut oats, such as McCann’s (not instant or rolled oats)

6 to 8 cups water

1 tsp cinnamon

1 teaspoon vanilla

2 apples, peeled and diced

1 cup raisins

1 cup sliced banana

1/2 cup chopped walnuts

Rub slow cooker with canola oil to prevent oatmeal from sticking. If you’re planning to cook the oatmeal 8 hours or longer, use 8 cups of water. If you want to cook it less than 8 hours, use 6 cups of water. Put the first seven ingredients (through raisins) in a slow cooker and cook on low. Just before serving, stir in bananas and walnuts. Makes 8 servings.

– Submitted by Julia Just

Baked Tilapia

This is a great recipe because you can make as many individual servings as you want and add as many or as few peppers, onions and spinach as you desire. This is a low-fat recipe and the fish stays moist and flavorful with the vegetables.)

1 tilapia fillet

1/2 cup sliced green, red or yellow peppers

1/2 cup sliced red onion

2 cups fresh leaf spinach

Start with a sheet of foil and spray with non-stick spray coating. Place Tilapia fillet on the foil. Place sliced peppers, sliced onion on the fish and top with about 2 cups of fresh spinach. Fold the foil up and make a pouch and place in 350 degree oven for about 20 minutes. Makes 1 serving.

– Submitted by Lori Kerns