How to Eat for a Healthy Heart
A local cardiologist’s nutrition prescription
Darren Gygi (Illustration)
In an ideal world, Dr. Elizabeth Klodas says her food-as-medicine company wouldn’t exist.
“I would love to see Step One Foods being a conduit to better eating overall so that people would eventually not need our products anymore,” she says.
Since poor eating habits seem as engrained in modern American culture as, well, apple pie, Klodas’ line of foods formulated to help prevent cardiovascular disease has a strong potential customer base. While products claiming to be “heart-healthy” line grocery store shelves, Step One products are perhaps the first designed to counteract a specific disease and reduce dependence on prescription medications.
Step One’s bars and mixes incorporate whole foods that are widely known to be healthful but rarely fill shoppers’ grocery carts (chia seeds, flaxseed, cranberries, almonds, oat bran, dried berries). The idea is that patients can reduce or replace statins, a drug used to lower cholesterol levels, by swapping out a less-nutritious breakfast and snack for, say, Step One pancakes or smoothies. Each product is rich in fiber, antioxidants, and omega-3 fatty acids, and contains more phytosterols than one could possibly consume—roughly the equivalent of 1,250 pounds of broccoli over a year.
Klodas’ patients at her Edina-based cardiology practice inspired her to launch her food business: Many expressed enthusiasm for improving their nutrition but would return three months later, deflated. “I couldn’t do it,” they admitted,” she says. “It was too hard.”
It was obvious to Klodas that nutrition was the missing link, so she and business partner Barb Birr, a food-industry veteran, launched Step One in 2012 from a nondescript warehouse in St. Louis Park. Today, Klodas splits her time between Step One and her medical practice.
“This whole endeavor rose from watching patients fail at the nutrition piece,” she says. “At the same time, I was realizing that we were chasing our tails in terms of treatments: No amount of medicine I could put people on could counteract what they were inadvertently doing to themselves.”
The premise of Step One, then, is to help customers take a baby step toward improved nutrition. Were a patient to substitute Step One pancakes for a plain bagel breakfast and Step One chocolate bars for Snickers over a year, Klodas estimates the person would lose 18 pounds and reduce salt intake by one cup.
Clinical research studies linking measurable results with Step One consumption, including one at Mayo Clinic, are still in the early stages, but anecdotally, evidence is building. Birr says one of her favorite jobs at Step One is answering the phone and hearing customer success stories.
For example, when Laura Harpestad, 54, of Minnetonka was told she had high cholesterol last year, her doctor recommended statins. Wary of the side effects (the most severe of which include liver damage and muscle and neurological problems), she instead ordered Step One’s smoothie mixes and chocolate bars. After eating one of each per day, a blood test four months later showed that her LDL, or “bad,” cholesterol had gone down 57 points. She was no longer a candidate for statins. “From an emotional, mental standpoint, I feel like I’m taking charge of things,” Harpestad says.
Of the dozens of results people have shared with Klodas and Birr so far, LDL cholesterol goes down an average of 39 points when people eat the products for 30 days, the equivalent to a low- or even medium-dose statin. Some doctors have even started recommending Step One products.
“Without question, better nutrition can help improve health and stay off meds,” says Holly Willis, director of nutrition at St. Catherine University. In some cases, she explains, medicines act as a sort of Band-Aid over a festering wound. “Whereas choosing a healthy diet does so much more than prevent disease—it can improve energy, sleep, body image, and self-esteem.”
For patients, the trick isn’t in knowing what to do, but in actually doing it. For example, the Portfolio Diet, which is high in soluble fiber and plant sterols, has been shown to lower lipids (organic compounds including fats that are insoluble in water) as well as statins, but even its creator admitted that few people would find its abundance of soy products and Metamucil palatable. By contrast, Step One’s foods mimic or surpass the convenience, flavors, and textures of their mainstream counterparts—Birr and Klodas spent six months sourcing a chocolate that would impress sweets snobs.
As a practicing cardiologist, Klodas can only reach so many patients. But through Step One, she hopes to empower far more people to make healthy lifestyle choices. “Professionally, this is the most rewarding thing I’ve done in my entire career,” she says. “I hope we are the beginning of a wave of health-care transformation.”