Transcript Total fat (g)

Eight Weeks to Wellness
Week 3:
Choose Healthy Fats
Prepared by
Don Hall, DrPH, CHES and
Gerard McLane, DrPH, CHES
© 2013, LifeLong Health. All rights reserved.
What is a Healthy Fat?
There are basically two kinds of fats
1. Healthy fats (oils)
– Polyunsaturated fats (essential for life)
• Linoleic acid (n-6): found in corn,
safflower, sunflower, most vegetable oils
• alpha-Linolenic (n-3): found in soy, flax,
walnuts
– Monounsaturated fats
• Found in olives, Canola, avocado, nuts
2
What is an Unhealthy Fat?
2. Unhealthy fats (solid fats)
– Saturated fats
• mostly animal fats
– Trans fatty acids
• hydrogenated fats
– Neither are essential for life,
are not needed by the body,
and both raise risk for heart
disease and diabetes.
3
Saturated Fats and Health
• Saturated fats come mostly from animal sources
• All cholesterol is from animal sources
• Diets low in saturated fats and
cholesterol help reduce the risk for:
–
–
–
–
Heart disease and stroke
High blood pressure
Diabetes
Certain cancers
• Bowel, prostate, and breast cancer
– Obesity
American heart Association and the American Institute for Cancer Research
Unsaturated Fats and Health
• Unsaturated fats are essential to health and when
used moderately:
–
–
–
–
Reduce blood cholesterol levels
Help maintain HDL levels
Help reduce insulin resistance and diabetes
Are protective against heart disease and stroke
• Unsaturated fats are found mostly in plants,
primarily in the seeds
– Polyunsaturated fats
– Monounsaturated fats
Trans Fats and Health
• Trans fatty acids are also damaging
to the body
• Trans fats come from
hydrogenating vegetable oils
• Primary sources include:
– Hard stick margarine
– Vegetable shortenings
– Most baked goods and deep fried
foods
– Processed foods (to increase shelf life)
Harvard’s Nutrition Source
Physiological Effects of Fats
Saturated & Trans Fats
Unsaturated Fats
– Raise cholesterol
– Lower cholesterol
– Raise blood pressure
– Help to maintain healthy
HDL levels
– Lower HDL levels
– Increase insulin resistance
– Provide the body with
essential fatty acids
– Increase the risk for
– Lower insulin resistance
•
•
•
•
Heart disease
Stroke
Certain cancers
Diabetes
Harvard’s Nutrition Source
– Lower the risk for heart
disease, stroke, and
diabetes
7
Plant Stanols/Sterols
• Plant stanols and sterols are substance found in
some plants (e.g. soy beans) that lowers cholesterol
• It is put in some margarines such as
– Benecol
– Take Control
• Research shows that if you eat 2 grams/day of plant
stanols/sterols, it lowers serum cholesterol by about
6-15 percent.
• This is an easy way to lower risk of high cholesterol
NCEP, ATP 3, Guide to Therapeutic Lifestyle Change
8
Making the Right Choice
Disease
Good Health
|------------------------------------t------------------------------------|
Poor choices
Healthier choices
- High cholesterol
- High saturated fats
- High trans fats
- Solid fats
- Animal source fats
- Cholesterol free
- Mono-unsaturated fats
- Poly-unsaturated fats
- Alpha-linolenic fatty acids
- Vegetable source fats
9
The Goal
• The goal for good health is not to
eliminate all fats but rather eat less
of those that are damaging to the
body:
– Saturated fats
– Trans fats
• And eat moderately of healthier
fats:
– Vegetable oil (unhydrogenated)
– And plant foods containing healthy
fats:
• Nuts, seeds, olives, avocado, flax meal,
soy, and others
Harvard’s Nutrition Source
10
Comparison of Fats from
Animal and Plant Sources
Coconut
11.8
Butter
0.8
7.2
3.3
Sat fat
Beef
6.4
Mono
5.4
Linoleic
Pork
5
Chicken
5.8
3.8
Canola
1
0
5.7
8.2
5
2.5
2.8
Fat
Linolenic
1.3
10
Grams per Tablespoon
1.3
15
USDA Nutrient Database
Composition of Vegetable Oils
Butter
7.2
Cottonseed
3.5
Peanut
2.3
Soybean
2
Sesame oil
1.9
Olive oil
1.8
Corn oil
1.7
Sunflower
1.4
Flaxseed
1.3
Canola
1
Safflower
0.8
0
3.3
2.4
Butter added to compare
7
6.2
4.3
3.2
6.9
5.4
10
3.3
Mono
Linoleic
Linolenic
8.9
2.2
8.0
8.2
10.2
Fat
1.1
7.9
2.7
2.5
Sat fat
5.6
2.8
2
5
10
(Grams per Tablespoon)
15 USDA Nutrient
Database
Total Fat Intake as % of Calories
100
Relative
Risk of
CHD
100
101
103
104
37%
41%
46%
91
80
60
40
20
n=80,082
0
29%
34%
Total fat intake as % of total calories (quintiles)
NEJM, Nov. 20,
Saturated Fat as % of Calories
140
138
Relative
Risk of
CHD
120
111
100
100
97
100
80
n=80,082
60
40
10.7
12.8
14.3
16
18.8
Saturated fat intake as % of calories (quintiles)
Harvard Nutrition Source, Nurses Health Study
Sat. Fat Intake & Mortality from CAD
• Health Professional Study
• 43,757 men free of disease
at start
• Saturated fat intake and risk
of death from heart disease
in six years of follow-up
• Those eating the most
saturated fat had a 72%
increased risk of heart
disease.
2.0
Men
1.5
1.72
1.0
1.00
0.5
0.0
Top 1/5
(14.8%)
Bottom 1/5
(5.7%)
Saturated Fat Intake
Quintiles (% of calories)
British Med. Journal; 13:84-90
Polyunsaturated Fat (% calories)
Relative
Risk of
CHD
100
100
80
94
88
81
68
60
40
n=80,082
Women
20
0
2.9
3.9
4.6
5.3
6.4
Polyunsaturated fat intake as % of cal. (quintiles)
Harvard’s Nutrition Source, Nurses’ health Study
Trans Fatty Acids (% calories)
160
Relative
Risk of
CHD
153
140
120
116
100
124
109
100
80
n=80,082
women
60
40
1.3
1.7
2.0
2.4
2.9
Trans fatty acid intake as % of calories (quintiles)
Harvard’s Nutrition Source, Nurses’ Health Study
Trans Fatty Acids and CAD
2.0
2.00
1.5
1.34
1.0
1.00
0.5
0.0
First
n=667 men
The Lancet, Vol. 357:746-51
Second
Trans Fat (tertiles)
Third
Saturated Fat and Breast Cancer
A study compared the
highest and lowest
intake of saturated fat.
– Women who ate the
least saturated fat had
17-19%% less breast
cancer.
– Women who ate large
amounts of meat had a
17% increase in breast
cancer.
– Researcher’s conclusion:
A high consumption of
animal fat increases risk
for breast cancer.
Breast Cancer (RR)
n=600,000
1.00
0.75
1.00
0.83
0.81
Low
Moderate
0.50
0.25
0.00
British Journal of Cancer 89:1672-85
High
Saturated Fat Intake
(Tertiles)
Goal #1 – Eat less Saturated Fat
The National Cholesterol
Education Program (NCEP)
recommends:
– Total fat, less than 35%
of calories
– Saturated fat, less than
7% of calories; less than
5% for optimum
reduction of cholesterol
NIH, National Cholesterol Education Program
Sources of Saturated Fat in the Diet
•
•
•
•
•
•
•
•
•
Pizza
Hamburgers
Hot dogs
Cheese (No. 1 source of
SF in American diet)
Cream, butter
Fried chicken
Whole milk
Beef tacos
Steak
•
•
•
•
Fast foods
Baked goods
Snack foods
Convenience foods with
added fats
• Shortening
• Fat back
• Lard
21
Beef Intake and Heart Disease
2.5
Relative
Risk of
Fatal
Heart
Attack
Men
2.31
2
1.93
1.5
1
1.00
0.5
0
Never
n=26,473
<3/wk
3+/wk
Frequency of Beef Consumption
Arch Intern Med Vol 152 P.1416
What Cholesterol Does to an Artery
Moderate atherosclerosis
There are
usually no
signs of
disease
until an
artery is
90-95%
plugged
Total Cholesterol and Heart Disease
12
Relative Risk of Death, CHD
• Chicago Heart Assoc. Study,
11,017 men, 25 years
follow-up
• Risk of death from heart
disease in young men is 3.5
times higher if cholesterol is
240+ vs. < 200
• Persons lived up to 6 to 9
years longer with chol.
levels of <200 vs 240+
11.9
8
6.6
4.6
4
2.5
1.0
0
<160 160- 200- 240- 280+
199 239 279
Cholesterol level (mg/dL)
JAMA 284:311-318
Cholesterol Level and Heart Disease Risk
40.0
n=361,662
30.0
20.0
10.0
0.0
160
180
200
240
Serum Cholesterol (mg/dL)
Source: NCEP, MRFIT Study
300
Cholesterol Lowering Diet
300
Cholesterol level. mg/dL
• Cholesterol levels can drop
quickly if you make the right
changes in your diet.
• In dietary feeding study at
LLU, the average serum
cholesterol level in the
study group dropped 29%
(triglycerides 40%) in 4
weeks.
• On a cholesterol free diet of:
fruits, vegetables, legumes,
whole grain breads and
cereals, soy, non-fat dairy,
and an egg substitute.
Loma Linda University Nutrition Department
285
240
250
205
200
200
190
150
100
0
1st
2nd
3rd
Weeks on Diet
4th
Goal #2 – Eat Less Trans Fats
Sources of Trans Fat in the Diet
• Fast foods
• Baked goods
• Snack foods
• Hard stick margarine
• Vegetable shortening
• Convenience foods with
added fats
• Deep fried foods
To see if foods have trans fat
in them, read the label, and
look for these words:
“Partially hydrogenated”
vegetable oils
28
Trans Fats in Common Snack Foods
Food
Trans fat, g*
BK French fries, L
6
DD cake doughnut 1-5
Cinnabon
5
LD snack cake
0-4
Buttermilk biscuit
0-4
KFC chicken
3
Food
Trans fat, g*
Pre-fried potatoes 0-3
Tater tots
9
Cookies
0-5
Oreo cookies
3
Crackers
0-4
Triscuits
7
Microwave popcorn 0-5
*Read product labels to see how much trans fat is in foods.
Harvard Nutrition Source
29
Use Trans Fat Free Spreads
• Trans fat free margarines
• Margarines that contain
plant stanols and sterols
– Take Control or Benecol
•
•
•
•
•
•
Hummus
Tahini (sesame butter)
Olive oil
Peanut butter (natural)
Almond butter
Mashed avocado
Examples of healthy
spreads.
Goal #3 – Eat Healthy Fats
Linolenic Fatty Acid Intake
Mortality from Heart Disease
n=40,000 men
1.0
1.00
Relative Risk
• A higher intake of linolenic
fatty acids (an n-3 or
omega-3 fatty acid) was
found to be very protective
against heart disease.
• Relative risk was 0.41 for a
1% increase in calories from
linolenic acid (about 2-3
grams/day).
0.8
0.5
0.41
0.3
0.0
Top 1/5
Bottom 1/5
Linolenic Fatty Acid Intake
Top quintile v. Bottom quintile
Health Professional Follow-up Study, BMJ, 13:84-90
Alpha-Linolenic Fatty Acid in Foods
Food
(g)
Flaxseed oil, 1 T
6.9
Flax meal, 1 T
2.5
Walnuts, 1 oz
1.9
Canola oil, 1 T
1.3
Soy oil, 1 T
1.0
Mayonnaise, 1 T
0.9
Corn & olive oil, 1 T
0.1
Spinach salad (60 g)
0.1
Summary of Good Sources
• Flax seed
• Walnuts
• Canola oil (salad dressing
and mayonnaise)
• Soy oil
• Soy beans, soy milk, tofu
New DRI for linolenic acid is 1.6
grams/day for men and 1.1
grams/day for women.
(Institute of Medicine)
Eat Nuts and Seeds Daily
Examples
• Almonds, walnuts, cashews,
Brazil nuts, hazelnuts,
pecans, peanuts
• Sunflower seeds, flax seed,
pumpkin seeds, sesame
seeds
• Peanut butter, almond
butter, tahini
Aim for at least 5 servings of
nuts per week for best health.
Nut Consumption and Heart Disease
• Frequent consumption
of nuts protects against
risk of heart attacks.
• People who ate nuts
frequently (5+ times/
week) had a 51%
reduction in heart
attacks and a 48%
reduction in death from
heart attacks compared
to those who seldom
ate nuts.
Relative risk of heart attack
100
100
80
76
60
52
40
20
0
n=26,743
< 1/wk
1-4/wk
5+/wk
Frequency of Nut Consumption
Arch Intern Med, Vol. 152, p. 1416
Harvard Nut Study
• Compared to women
who seldom or never ate
nuts, those who ate an
ounce of nuts five times
per week had a 35%
lower risk of heart
disease.
• These results held true
even after holding
constant for smoking,
exercise, blood pressure,
obesity, and diabetes.
100
100
80
Relative
risk of 60
heart
attack 40
or CAD
65
20
0
Seldom ate
nuts
Ate nuts 5+
times/wk
n=86,000 Women, 10 year study
Harvard Nutrition Source, Nurses’ Health Study
Health Fats Improve Absorption of Key Nutrients
• Fat soluble vitamins
– Vitamin E an antioxidant that
protects cell membranes
• Beta-carotene
– A precursor for vitamin A,
important for vision
• Lycopene
– A antioxidant that is helps
prevent prostate cancer and
lowers risk for some cancers
• And other healthy
carotenoids (see next slide)
Harvard Nutrition Source
Change in serum carotenoid content (nmol/L)
Full fat salad
dressing
Low fat salad
dressing
Fat free salad
dressing
Using a full fat salad
dressing improves
absorption of
nutrients in a salad
compared to no fat
or low fat.
Amer J of Clin Nutr
80(2):396-403
Hours After Eating Salad
Guidelines
Practical steps to
reduce saturated
fat and trans fat in
your diet.
Calculate Saturated Fat Intake Goal
Example
• Saturated Fat (g/day)
• If calorie intake is
2,000/day
• Goal of 5% of calories
2000 X 0.05 = 100
100 / 9 = 11.1 g/day
(there are 9 cal/g of fat)
© LifeLong Health
Daily
saturated fat goal
At 7% of cal = 15.5 g
At 5% of cal = 11.1 g
Calculate your saturated
fat intake for one day
40
Eat More Fruits and Vegetables
Total fat Sat. fat
(g)
(g)
Fruits and vegetables
0-1
0
Bread, cereal, pasta
1-2
0
Peas, beans, lentils
1-2
0
Note: grams of fat are per serving
Use Vegetable Oils Instead of Solid Fats
Total fat (g)
Sat. fat (g)
Butter, 1T
12
7
Palm oil, 1T
14
12
Margarine, 1T, stick*, tub
11
2
Vegetable oils, 1T
14
1-3
Shortening, 1T *
12
3+
Hummus spread, 2T
3
trace
Peanut butter, natural, 2T
16
3
* Check the nutrition label for trans fatty acids
USDA Nutrient Database
Limit High Fat Meats
Total fat (g) Sat. fat (g)
Hamburger patty, 3.5 oz.
Hot dog, 1
Sausage, 2 slices
Bacon, cured, 3 slices
Bacon, Canadian, 3 slices
Bacon-turkey, 3 slices
Fried chicken, serving
Skinless chicken, serving
Fish, fried, 3 oz.
Salmon, baked, 3 oz.
Tuna, water-packed, 3 oz.
USDA Nutrient Database
21
13
10
50
6
9
26
3
11
4
3
8
5
4
16
2
2
7
1
3
1
1
Limit Baked Goods
Total fat (g) Sat. fat (g)
Chocolate chip cookie, 2
3-7
1-2
Doughnut, frosted, 1
6-11
2-6
Cinnamon roll, frosted
4-26
2-7
Muffin, 1 small
1-13
1
Angel food cake, 1 piece, not frosted
trace
trace
Fruit pie, 1/8 of 9”, or 1/6 of 8” pie
14-22
3-5
Bagel, 1
1
trace
Apple/Peach cobbler, 1 crust
half the fat of a 2-crust pie
Cake, 1 piece with icing
3-14
1-4
Cheese cake, 1 small piece
16
9
USDA Nutrient Database
44
Use Non-Fat Dairy Products or Soy
Total fat (g) Sat. fat (g)
Whole milk, 1 cup
Reduced fat milk, 2%
Nonfat milk, 1 cup
Cheddar cheese, 1 oz.
Cottage cheese, ½ cup
Low-fat cot. Cheese, ½ c
Ice cream, ½ cup
Sherbet, ½ cup
Egg, hard-boiled, 1 large
Fried egg, 1 large
USDA Nutrient Database
8
5
trace
9
5
1
7-15
2
5
7
6
3
trace
6
3
1
4-9
1
2
2
Eat Fewer Fried Foods
Total fat Sat. fat
grams grams
French fries, medium
10-23
2-5
Corn chips, 1 oz
4-9
1-2
Potato chips, 1 oz.
10
3
11-16
1-4
Hashbrowns, 1/2 cup
USDA Nutrient Database
Read Food Labels
Nutrition Facts
• You can be a much wiser
shopper if you read labels.
• The cholesterol and grams
of fat are shown on all foods
including:
– Total fat
– Saturated fat
– Polyunsaturated fat
– Monounsaturated fat
– Check for trans fats
Gardenburger®
Serving size 2.5 oz., 1 patty
Calories per serving 130
Calories from fat
25
% Daily Value
Total fat 3g
Saturated fat 1g
Polyunsaturated fat
Monounsaturated fat
Cholesterol 0 mg
Protein 8g
5%
5%
0.5g
1.5g
0%
Be Careful When Eating Out
• Most restaurant foods are high in fat.
• You can reduce saturated fat intake.
– Ask for salad dressing on the side.
– Ask for olive oil (with garlic!) for your bread.
– Choose entrees with marinara sauce instead of meat
sauces and cream-based sauces.
– Hold the butter, sour cream, and whip cream.
– Choose restaurants with lower fat options .
– Limit desserts or choose low-fat sherbet or fruit.
© LifeLong Health
48
Calculate Saturated Fat in Meals
High-Fat Meal
Food
Sat. fat g
Hamburger
____
Mayonnaise, 1T
____
Cheese, 1 oz.
____
French fries, small
____
Ketchup
____
Glass of whole milk
____
Total
____
Low-Fat Meal
Food
Sat. fat g
Gardenburger®
____
Low fat mayo., 1T
____
Nonfat cheese,1 oz ____
Oven baked potato
wedges, ketchup,
+ canola oil, 1T
____
Glass of skim milk
____
Total
____
Reducing Saturated Fat in Meals
High-Fat Meal
Food
Sat. fat g
Hamburger
8
Mayonnaise, 1T
2
Cheese, 1 oz.
6
French fries, small
5
Ketchup
0
Glass of whole milk
6
Total
27g
Low-Fat Meal
Food
Sat. fat g
Gardenburger®
1
Low fat mayo., 1T
0.5
Nonfat cheese,1 oz 0
Oven baked potato
wedges, ketchup,
+ canola oil, 1T
1
Glass of skim milk
0
Total
2.5g
Fat Quiz
1. Cholesterol is found only in ________ foods.
2. Saturated fats ________ the risk for heart disease.
3. The only kind of fat required by the body is _____.
4. Total fat intake ought to be no more than ___% of cal.
5. Trans fatty acids are found in foods with ____ ____
vegetable oils.
6. T/F There are no trans fatty acids in corn oil margarine.
7. T/F Olive oil has no saturated fat in it.
8. T/F Ounce for ounce, there is more saturated fat in
American and Swiss cheese than in red meat.
9. Low-fat milk has ____ g of saturated fat.
10. T/F The kind of fat eaten is more important than the
amount of fat eaten.
Week 3 Assignments
1. Read Week-3, “Choosing
Healthy Fats”
2. Review Fat in Food handout
3. Choose healthy fats daily.
4. Reduce unhealthy fats and
track healthy fats eaten
daily (see page 15) such as
flax meal, nuts, olive oil,
olives, avocado, etc.).
5. Continue tracking your
exercise miles, and other
health goals
Thank you for your attention
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