Q: When are "heart healthy" foods not heart healthy?

A: When "heart healthy" is just a marketing claim with no real basis in reality or science.

In an ideal world, a food label proudly bearing the claim "heart healthy" truly would be heart healthy. But, it's not a perfect world.

I'm not talking about foods that are obviously unhealthy. You know these: fried foods, greasy cheeseburgers, French fries, bacon, sausage, etc. Nearly everyone knows that the fried oil content, sodium nitrite for "curing" in processed meats, low fiber, and overall low nutritional value of these foods are behind heart disease, hypertension, and a variety of cancers.

I'm talking about foods that people eat because they view them as heart healthy but they're not.

1. Low-fat or non-fat salad dressings - With rare exceptions, low-fat or non-fat or lite salad dressings are made with high-fructose corn syrup or corn syrup as one of the main ingredients.

What does high fructose corn syrup do? Triggers sugar cravings, makes triglycerides skyrocket, slows blood clearance of after-eating digestive products (a potent cause of carotid disease), increases uric acid (a possible coronary risk factor and cause for gout) and causes diabetes.

The average American now ingests nearly 80 lbs of this sweetener per year. You're far better off with olive, canola, soy, or flaxseed oil-based salad dressings.

2. Breakfast cereals - If you've been following these discussions, you know that the majority of breakfast cereals are sugar. They may not actually contain sugar as sucrose, but they contain ingredients that are immediately converted to sugar in your body, ingredients like whole wheat flour and cornstarch. By the way, wheat flour and cornstarch raise blood sugar higher and faster than table sugar.

Even if a breakfast cereal is low in sugar but made with wheat flour and cornstarch (as nearly all are), blood sugar skyrockets. These products may be cleverly disguised, bearing as "heart healthy" claims. Some, like Cocoa Puffs and Count Chocula, may even bear the Heart Association's Check Mark stamp of approval based on their low-fat and low-saturated fat content. Don't fall for it.   3) Pretzels - "A low-fat snack." It sure is. Pretzels are a low-fat snack that raises blood sugar like eating table sugar from the bowl. If you munch on pretzels as your between-meal snack, you are having an effect on your body no different than having a high-sugar candy bar.

4. Margarine - Most readers already know that margarine's made with hydrogenated, "trans," fats are unhealthy and should be avoided. They increase LDL, reduce HDL, and cause cancer.

But how about the new margarines with "no 'trans' fats" and "heart-healthy" claims because they contain added sterols to reduce LDL cholesterol? Sterol esters are an additive that do indeed reduce LDL cholesterol (at least transiently).

However, several studies now report that greater intake of sterols is associated with greater heart attack risk despite the lower LDL. Heart healthy? I don't think so. See my previous post, Are sterol esters the next "trans" fat?

5. Bananas - People will say to me, "I eat fruit. Two bananas a day." What I hear is "I don't really eat fruit with high nutrient value, fiber, and low sugar content. I reach for only bananas which yield extreme blood sugar rises."

A single 9-inch banana contains 34 mg carbohydrates, of which 18.5 grams are sugar, only 4 grams fiber. Bananas are among the least flavonoid-rich compared to high-flavonoid fruits like berries and citrus.

Aren't bananas high in potassium? Yes, but there are better sources. One 9-inch banana contains 550 mg potassium, while one avocado contains 660 mg, one medium grapefruit contains 356 mg, one cup of carrot juice contains 689 mg, an 8-oz container of yogurt contains 531 mg. (Source: USDA Food Database.)

Why the mis-perceptions?

Many of these misbegotten notions of "heart healthy" are holdovers from the low-fat nutritional mistakes of the past 40 years - the diet that has created a nation of obese diabetics. "Heart healthy" is also a popular marketing claim made by food manufacturers based on low fat and saturated fat content.

Of course, foods are meant to be enjoyed, but be informed about it. Choose foods for the right reasons, not because of some cleverly-crafted, but misguided, marketing campaign.

Don't be fooled: Many products bearing claims of "heart healthy" are the farthest from it.