A LOW FAT DIET

Read the whole section from beginning to end, or follow these links to specific questions

That sounds pretty complicated. How much fat can I eat?
What foods are high in fat?
What are some foods that are low in fat and better to eat?
Some specifics of "how to do it"
What about when I go out to eat?
What about margarine? I’ve heard it might be bad.

 

If it’s not difficult enough to convince someone that they have a disease when their cholesterol is high, the next part is no easier . . . they need to follow that most un-American of programs – a diet. Let’s be honest from the start: no one likes to be told what to do, especially when it’s something we do three times a day and we associate with good times. But, and I’ll be just as honest here, let’s keep an open mind because it’s just not that bad. There are really a lot of ways to still enjoy meal time. It will take a little time to learn, so let’s get started.

The strategy we will use here is one designed to make the biggest differences for most people. Some patients will need a more specific diet to reach their dietary goals and will need to talk to a dietitian.

Things you won’t need to do:

• Give up your favorite foods
• Make a major production of measuring ingredients
• Do it all at once

Things you will need to do:

• Learn a little bit about foods
• Read some labels
• Make some substitutions for high fat food
• Use prudence and moderation

The amount of fat in the diet has a very important role in how all of the fats are digested and metabolized. A proper diet can take care of the vast majority of patients with high cholesterol, and save the expense of medications. Even modest changes in intake have the potential to make a big difference in a patients health outlook. Even patients on medications for cholesterol need to follow a diet.

Watch all fats, not just cholesterol

When we talked about high cholesterol in previous sections, we really concentrated on the levels of total cholesterol, HDL cholesterol, and LDL cholesterol. We’re going to change our focus now that we’re talking about diet and consider ALL fats, particularly saturated fats, in addition to cholesterol.

Total fats and saturated fats are important concepts to remember. It is these items which will drive the metabolism of all fats including cholesterol.

• Saturated fats are found in high quantities in foods of animal origin. These are converted to cholesterol by the liver,  and  should not be over-indulged in. These fats are solid at room temperature.
• "Polyunsaturated" fats are generally from non-meat sources, and are better for you. However, while they do lower the  bad cholesterol, they also tend to lower the good cholesterol. These fats are liquid at room temperature.
• "Monounsaturated" fats not only lower the bad cholesterol, but tend to increase the good cholesterol.

Saturated fats are often high in foods that are high in cholesterol. Foods that are low in cholesterol can be very high in saturated fats, and therefore the label of "No Cholesterol" does not mean the food is OK . . . check the saturated fat content.

The U.S. Departments of Agriculture, as well as Health and Human Services has recommended the following for healthy Americans (Step 1 diet):

• Total fats: less than 30% of total calories
          -Saturated fats: less than 10% of total calories
           -Monounsaturated: less than 15% of total calories
           -Polyunsaturated: less than 10% of total calories
• Cholesterol: less than 300 mg daily

For patients with problems with their cholesterol or who have manifest arteriosclerosis, these recommendations
(Step 2 diet) become:

• Total fats: 25-30% of total calories
                -Saturated fats: less than 7% of total calories
                -Monounsaturated: less than 10% of total calories
                 -Polyunsaturated: less than 10% of total calories
• Cholesterol: less than 200 mg daily

This is not as hard as it may sound. For perspective, the current average American diet is estimated to include 34% of calories from fat, with 12% from saturated fat. Furthermore, the new food labels are required to list the total calories and the calories of fat – you just have to do a little math.

This doesn’t mean every food you eat has to equal 25-30% fat. It just means that your overall diet should equal this amount.

For those who are overweight, this reduction in fat intake will yield another bonanza. Proteins and carbohydrates have only 4 calories per gram. Fat has a whopping 9 calories per gram.

That sounds pretty complicated. How much fat can I eat?

It’s not as difficult as it seems. Let’s do a little math (you’ll only have to do it once, so let’s try it).

First of all, you have to figure your calories to figure your fat intake. Your daily caloric intake to maintain your weight, depending on your activity, is:

• Sedentary or inactive: Your current weight in pounds multiplied by 12.
• Moderately active. Weight in pounds multiplied by 14.
• Very active: Weight in pounds multiplied by 16 to 18

Don’t reward yourself for being overweight if you are. Use your ideal weight.

Let’s say you weigh 150 pounds, are moderately active, and are on a Step 1 diet. Your calorie intake should be 150 X 12 = 1800 calories. You can have 30% of your calories as fat, or about 540 calories a day. Each gram of fat contains 9 calories, so 540 divided by 9 = 60 grams of fat. That’s really quite a bit.

What foods are high in fat?

• Dairy foods (whole milk, ice cream, creams)
• Fatty red meats
• Butter is not only high in fat, but saturated fat as well
• Oils are fat, although some may have lower saturated fat.
• Egg yolks, which are particularly high in cholesterol.
• Cheese (sorry, there are some that are better than others, though)
• Processed meats (sausage, salami, hot dogs, bologna)
  

What are some foods that are low in fat and better to eat?

• Fruits
• Vegetables
• Fish and shellfish
• Cereals, rice
• Pasta
• Nuts and seeds
• Vegetable oils are preferable to butter (see below)
  

Some specifics of "how to do it"

• Make a shopping list
• Eat more vegetables, fruit and grains.
• You don’t have to stop eating foods you enjoy that are high in fat, just cut down on the amount of their servings. Use bigger quantities of low-fat foods to accompany them.
• Instead of a steak that covers the whole plate, get a cut that you really like of modest size. 4 ounces of beef is recommended – that’s a steak about the size of a deck of cards.
• Flavor your stew with meat in modest amounts, don’t overpower it.
• Eat one egg instead of two.
• Eat fatty foods less often. You don’t have to quit your favorite foods completely. For example, you don’t have to have meat every day.
• Trim the visible fat. Remove all of the skin from poultry.
• Limit organ meats (liver, kidney)
• Use lunch meats sparingly (salami, bologna, sausage)
• Make egg dishes with egg whites rather than egg yolks.
• Drink skim or 1% milk (if you drink milk)
• Watch the cheese (sorry!). Look for low-fat varieties, especially for cooking.
• Don’t add fat as you cook. 
• Instead of frying--- Use these techniques (and use a rack to allow the fat to drain if possible):
                           -Roasting (on a rack if possible so fat drains away)
                           -Grilling
                           -Baking
• Don’t settle for dull. A little imagination can go a long way in keeping foods interesting:
                           -Try new spices
                           -Get a good low-fat cookbook with a number of recipes and alternatives. Invest a little time in planning some good alternatives.
                            -Come back and check out Bonnie’s recipes on HeartPoint!
• Cut down on added fats, such as salad dressing and butter. Try and use those which are low in saturated fats, and in moderation!
                                -Avoid  (These contain about 40% saturated fat)
                                             -- Butter
                                             -- Lard
                                             --Palm oil, coconut oil
  
                                 -Use     (These contain about 20% saturated fat)                               
                                            --Olive oil
                                            --Use a vegetable oil spray to brown or saute food.
                                            --Canola, safflower, sunflower, peanut, and corn oil.
• Read the labels (follow the links). Unfortunately, you really have to pay attention to some foods that say "Healthy" or  "No cholesterol". They may still contain large amounts of fat and saturated fat!
• Make some reasonable substitutions
• Use prudence when dining out
• KEEP ON TRYING ! !
  

What about when I go out to eat?

Many patients have found themselves very capable of eating properly at home but quickly fall into old habits when it's time to eat out. During the past 10 years or so, however, restaurants have become more aware that many of their patrons are on restricted diets. There is absolutely no reason to feel uncomfortable about ordering a baked potato and a salad in a fine restaurant. In fact, you can and should, make special requests for foods that are more appropriate to your needs. Keep the following tips in mind when you order a meal:

• Entrees covered with sauces, as well as creamy dressing, thick soups and casseroles should be avoided because they are usually rich in fat. Unfortunately, most desserts in good restaurants are terribly high in saturated fats. Ask for a dish  of fresh fruit instead or, as a treat, share a single "sinful" dessert with others.
• Avoid fried foods. Choose baked, broiled, boiled, roasted, steamed and grilled.
• Club soda, herbal tea, and decaffeinated coffee are good choices of beverages at a meal, as is a glass of ice water with a wedge of lemon or lime.
• Sourdough, whole-wheat, rye and French breads are lower in saturated fats than biscuits, white bread, and dinner roles.
• Salads are available almost everywhere. Order salads with reduced-calorie salad dressing. Choosing your meal from the salad bar is a good source of good foods (omitting the occasional fat-laden salads that are sometimes there!).
• Ask to have sauces and gravies omitted, or "on the side".
• Look for items labeled "heart-healthy" on the menu
• Don’t be afraid to ask how a dish is prepared.
• Substitute low-fat choices (steamed vegetables for creamed sauces, baked potatoes for french fries, etc.).
• Avoid items described with terms like battered, creamed, au gratin, scalloped, breaded. Good terms include au jus, poached, steamed, baked, etc.
• Pizza: choose thin-crust, avoid meat toppings and get small amounts of cheese.
• Pastas: good choices if accompanied by red marinara sauce or simple vegetables. Avoid cream or meat sauces.
• Sandwiches: choose lean and not processed meat, get extra lettuce and tomato, and hold the mayo.
  

What about margarine? I’ve heard it might be bad.

Another one of those thorny questions. Margarine is created when liquid oils are partially "hydrogenated", converting some of the unsaturated carbon molecules to saturated. This gives a better taste, and makes the margarine solid at room temperature.

Even though it has some of these saturated fats, it does not contain nearly as much as butter, and has been considered a better alternative. However, a class of fats called "trans-fatty acids" are created which are suspected of reducing HDL cholesterol and raising LDL cholesterol, as well as other negative things. A study of nurses who used margarine and similar foods containing the trans-fatty acids actually showed an increase in mortality.

What’s the right answer? It’s still out. For what it’s worth, I use small amounts of butter.

©COPY;1997 HeartPoint  Updated September 1997

There’s really a lot more if you’re still interested in discovering it --Links to Cholesterol section

 | Cholesterol: Gallery  | Cholesterol: Main Page  | The Big Points  |  The Facts  |  Treatment  |  Low Fat Diet  | New Food label |  Food Pyramid | Advanced cholesterol  |

|  Commentary  |  Food You Will Love  |  HeartPoint Gallery  |  In The News |  Health Tips   | What's New  |
|  Information Center  |  Home  |  Cholesterol: Main Page

This site presents material for your information, education and entertainment. We can assume no liability for inaccuracies, errors, or omissions. Above all, material on this site should not take the place of the care you receive from a personal physician. It is simply designed to help in the understanding of the heart and heart disease, and not as a diagnostic or therapeutic aid. You should seek prompt medical care for any specific health issues. Please feel free to browse the site and download material for personal and non-commercial use. You may not however distribute, modify, transmit or reuse any of these materials for public or commercial use. You should assume that all contents of the site are copyrighted. ©COPY;1997 HeartPoint