It was the buzzword of the Nineties, and today, just about everyone has heard that fat and cholesterol are bad for you. Fat, we’re told, makes you overweight, and may be linked to some types of cancer. Too much cholesterol can lead to a heart attack.
Yet we all know very old folks who have cholesterol-laden eggs for breakfast each day. And now we hear reports about “good” cholesterol and “better” kinds of fat. Things are not as simple as they seemed.
There’s good and bad news in this. On one hand, we now have to worry about the kind of fat we eat. On the other, we don’t have to eliminate every scrap of it from our diets.
How Fat Fits In
First of all, it’s important to differentiate between the fat we wear and the fat we eat. In addition to the muscles, bones, and other organs that make up lean body mass, humans have body fat distributed throughout the tissues, beneath the skin, and floating free within the bloodstream. Fat accounts for about 15 to 18 percent of the total weight of a healthy, physically fit man. For a woman, the proportion is slightly higher: about 20 to 25 percent.
Everyone needs a reasonable amount of body fat. It provides you with the essential fatty acids (linoleic and linolenic acids) needed for normal reproduction and growth. It is also essential in the production of several hormone-like compounds, such as prostaglandins, that help regulate blood pressure and other vital bodily functions. Fat maintains healthy skin and hair, cushions the bones and vital organs, protects the body from extremes of temperature, and carries essential nutrients (notably vitamins A, D, E, and K) throughout your system. Its main function, however, is to serve as fuel for the muscles. Fat alone provides about 65 percent of the energy your muscles require.
Our bodies manufacture this fat from a wide variety of substances, including protein, carbohydrates… and other fats. Any portion of our diet not immediately needed as fuel gets converted into body fat. Since the fat in our food is the easiest part to convert, a high-fat diet is more likely to leave us with the excess pounds that we dread. That, however, is only one of the problems with too much fat.
Fat Formula #1: Your Fat Allowance You should get no more than 30 percent of your calories from fat. But what exactly does that mean in terms of your own daily diet? Here's a simple way to tell.Multiply your daily calorie intake by .30 (the percentage of your calories that should come from fat) and then divide the resulting total by 9 (because there are 9 calories in every gram of fat).(daily calorie allowance x .30)/9 = total fat allowance in gramsIf you eat 1,800 calories a day, you would multiply 1,800 by .30 for a total of 540, then divide 540 by 9. The new total is 60, so your total daily fat allowance is 60 grams.If you don't want to be bothered with an exact calculation, the table below will give you a fair approximation of your allowance. But remember: however you get the figure, it's still a ceiling. Just because you have a budget of a certain number of fat grams per day, doesn't mean you have to spend it. The less fat you eat, the better off you are.
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How Much Fat Can We Handle?
All fat is a treasure trove of calories. At 9 calories, one gram of fat has more than twice the calories of a gram of protein or carbohydrate. What does this mean in terms of your daily diet? A cheeseburger contains about 30 grams of fat. For that same 30 grams, you could eat 80 cups of broccoli, or 30 cups of pasta, or 45 pears, or 30 cups of kidney beans.
Many experts feel that we should get no more than 30 percent of our daily calories from fat. This works out to 73 grams of fat in a 2,200-calorie diet. Nevertheless, the average American diet is still over 35 percent calories from fat. Just eating the recommended number of servings from each of the major food groups (milk, vegetable, meat, fruit, and bread) automatically gives you up to half your daily allowance of fat—even if you pick low-fat foods and add no fat or oil during preparation. Indeed, a single tablespoon of corn oil is enough to meet your entire daily physiological requirement for fat. In contrast, the average American actually consumes eight times that amount—the equivalent of a full stick of butter every day.
Total intake is only part of the story, however. There are many types of fat; and not all fats are created equal.
Saturated Versus Unsaturated
Most of the fats we eat are triglycerides—three fatty acids attached to a glycerol molecule. These fatty acids vary in the extent to which they are saturated with hydrogen atoms. Fats containing mostly saturated fatty acids are called “saturated;” those with fatty acids that are mostly polyunsaturated or monounsaturated are labeled “unsaturated.” In general, the more saturated the fat, the more likely it is to be solid at room temperature—and the more dangerous it is for your health.
Vegetable Oils: The Best and the Worst The lower the level of saturated fat and the higher the level of unsaturated fat (including both mono- and polyunsaturates), the better the oil. It is important to note that coconut and palm kernel oils—two of the so-called "tropical oils"—are even higher in saturated fat than butter (included here for purposes of comparison only). Canola, almond, safflower, and sunflower are among the oils lowest in saturated fats (and, therefore, highest in unsaturated fats). Olive, almond, and canola oils are the highest in monounsaturated fats, believed by experts to lower the level of cholesterol in the blood without producing a reduction in levels of HDL, the "good" cholesterol. |
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Saturated Fats
Because these fats tend to raise your cholesterol level, they represent the biggest threat to your heart. Often solid at room temperature, they congregate in well-marbled meats and whole-milk dairy products. Some vegetable fats—including palm, palm kernel, and coconut oils—are also saturated.
Butter, whole milk, cheese, ice cream, egg yolks, and fatty cuts of beef, pork, and lamb are all particularly high in these potentially dangerous fats. Because these are among most Americans’ favorite foods, we tend to consume two to three times as much saturated fat as we should (a recommended 8 to 10 percent of total calories).
Monounsaturated Fats
Many experts believe that if you substitute monounsaturated fat (olive, peanut, canola, avocado, and certain fish oils) for the saturated fat in your diet, you can lower your blood cholesterol levels and thereby reduce your risk of heart disease. In Mediterranean countries, where olive oil is a major part of the diet, people do in fact have fewer heart problems.
Up to 15 percent of your caloric intake should come from monounsaturated fats.
Polyunsaturated Fats
Fats from such sources as corn, soybean, safflower, sunflower, and sesame seed oils—and certain fish—help to lower blood cholesterol and should make up 10 percent of your calories. The “omega-3” oils, a type of polyunsaturated fat found in tuna, salmon, mackerel, and other fatty fish, seem to act as a blood thinner, decreasing the risk of lethal blood clots and possibly staving off hardening of the arteries. The best way to get omega-3 oils is to eat two to three servings of fish per week. Fish oil capsules should be taken only with your doctor’s approval.
Even though polyunsaturated oils appear to be better for you, don’t make the mistake of adding fat to your diet. In general, the less fat you eat, the better off you are. Instead, switch from the more harmful saturated fats to the more benign unsaturated varieties.
Hydrogenated Fats
Many food manufacturers solidify unsaturated liquid fats through a process called hydrogenation. This technique is used to create margarine or shortening for use in deep-fat frying or as an ingredient in baked goods and candy. However, hydrogenation turns an unsaturated fat into a polyunsaturated fat containing trans-fatty acids. Some studies indicate that because they increase blood levels of the “bad,” artery-clogging type of cholesterol, trans-fatty acids may increase your risk of heart disease. The extent of this danger remains to be proven, but if you want to cut down on trans-fatty acids in the meantime, substitute oils and tub margarine for the stick variety and cut back on fried foods.
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Fat and Heart Disease
Heart disease is, unfortunately, as American as baseball and apple pie. It is the nation’s chief killer, accounting for about 950,000 deaths a year—nearly one out of every two. Over 6 million people in the U.S. suffer from angina pectoris—severe, recurring pain caused by partial blockage of the coronary arteries. And the economic burdens are staggering: In 2001, the total cost of cardiovascular diseases and stroke in the U.S. is expected to hit $300 billion.
One in three men can expect to develop a cardiovascular disease before age 60. But the threat to women is even more chilling. In terms of total deaths, in every year since 1984 heart disease has taken the lives of more women than men. In fact, cardiovascular diseases are the Number 1 killer of women, claiming the lives of more than half a million each year—with a mortality rate 12 times that of breast cancer.
Many factors contribute to the risk of developing heart disease. High blood pressure, diabetes, and too much cholesterol in the blood all can play a role. Lifestyle factors such as cigarette smoking, obesity, and physical inactivity can add to the danger. Indeed, the majority of heart attacks occur in people whose total blood cholesterol levels are between 180 and 240 and who have other risk factors—for example, smoking, a sedentary lifestyle, or a family history of heart disease.
None of these risk factors—or even a combination of them—guarantee that you’ll develop a heart problem. A majority of people with high cholesterol, for instance, never die of heart disease. However, since the experts have no way of predicting whether or not you’ll be among the lucky ones, the only wise course is to keep the odds in your favor. This means attacking all the risk factors you can, and, on the dietary front, working to reduce your cholesterol levels. For every one percent decrease in cholesterol, according to many experts, your chance of having a heart attack declines by two percent. And for every 10 percent decrease in cholesterol, your chance of developing heart problems drops by an impressive 30 percent.
Dangerous Plaque |
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| Excess cholesterol becomes a threat when it begins forming deposits at points inside the arterial walls. Mixed with debris from the wall itself, the resulting buildup narrows the vessel and stiffens the wall, leading to the condition called atherosclerosis. If the constriction occurs in an artery serving the brain, there's danger of the total blockage called a stroke. If a coronary artery becomes clogged, the result is a heart attack. |
The Truth About Cholesterol
Cholesterol is not intrinsically bad. This waxy, fat-like substance is, in fact, a necessary part of your body chemistry. It is found in all animals and in all animal products (such as meats, eggs, milk, and cheese). There is no cholesterol in any plant product—fruits, grains, legumes (dried peas and beans), vegetables—or the oils made from them.
There’s no need for any cholesterol in our diet; the human liver is able to produce all we require. Excessive cholesterol, whether manufactured by the body or eaten, finds its way into the arteries, where it is deposited as a thick, fatty gunk called plaque. White blood cells attack the plaque, creating debris. At the same time, the artery tries to heal itself by growing more cells in its walls. The buildup of plaque, debris, and additional cells narrows and stiffens the artery, creating a condition called atherosclerosis. If this happens in a vessel supplying the heart muscle, it can slow down the flow of oxygen-rich blood that the muscle requires and eventually lead to a heart attack. There may not be any signs or symptoms of atherosclerosis until it’s too late—after a stroke or heart attack has already occurred.
Special carriers called lipoproteins transport cholesterol through the bloodstream. Two of the most critical carriers are low-density lipoproteins (LDL) and high-density lipoproteins (HDL). The more abundant form is LDL, commonly referred to as “bad cholesterol.” High levels of LDL are associated with an increased risk of heart disease. High levels of HDL—the “good cholesterol”—seem to prevent the disease (while low levels seem to encourage it). So the lower your total and LDL cholesterol levels and the higher your HDL level, the better off you are.
According to the National Cholesterol Education Program you should aim for:
- a total blood cholesterol level less than 200 milligrams per deciliter (one tenth of a liter) of blood;
- an LDL level based on your risk of heart disease:
- an LDL level less than 100 milligrams per deciliter if you already have heart disease; or have a condition that puts you at high risk of developing heart disease, such as diabetes.
- an LDL level less than 130 milligrams per deciliter if you have two or more risk factors, including smoking, high blood pressure, low HDL cholesterol, family history of premature heart disease, and advancing age (greater than 45 years for men and 55 years for women).
- an LDL level less than 160 milligrams per deciliter if you have no more than one risk factor.
- an HDL level greater than 40 milligrams per deciliter.
Understanding Blood Cholesterol Readings | ||||||||||||||||||||||||||||||||||||||
| Doctors now recommend that you should have your blood cholesterol levels checked regularly, beginning at age 20. Since heredity and lifestyle factors are critical variables, your doctor is in the best position to interpret the results and suggest a course of action. (The most common therapy for high cholesterol includes a low-fat diet, regular exercise, losing weight, giving up smoking, and—for some people—medication.) The classifications shown here will be part of the physician's evaluation. Remember that LDL cholesterol is " bad " and should be low, while HDL cholesterol is " good " and should be high. If your LDL level is too high, chances are that your triglycerides will be high as well. |
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A man with a total blood cholesterol level of 240 is twice as likely to have a heart attack as one with a level of 200, all other factors being equal. A level of 300 carries five times the risk of a level of 200. Conversely, a 25 percent drop in blood cholesterol levels can cut the risk of a heart attack in half.
Total blood cholesterol tells only part of the story, however. The type of cholesterol makes a big difference, too. While LDLs contribute to artery-blocking deposits of plaque, the HDLs seem to vacuum excess cholesterol from the bloodstream. So a high level of LDLs is not good. Neither is a low level of HDLs. A good measure of risk, therefore, is the ratio of total cholesterol to HDLs. You can figure your ratio by dividing your total cholesterol level by your HDL level. A ratio of 2.5 or lower is good; a ratio of 4 warrants further discussion with your doctor.
A low triglyceride (blood fat) level is also important to the health of your heart. Doctors now believe that there’s a direct link between high triglyceride levels and atherosclerosis, and excessive triglycerides often accompany higher total cholesterol and LDL levels and lower HDL levels. Ideally, your triglyceride levels should be less than 150 milligrams per deciliter. The same dietary and lifestyle changes that reduce total cholesterol and LDL levels should have a positive impact on triglycerides as well.
Lowering Your Cholesterol
When you attack your cholesterol, cutting it out of your diet is only part of the answer. Don’t forget that saturated fat can also raise blood cholesterol, and in fact is by far the worst offender. Keeping it under 10 percent of your total calories is a crucial first step.
Nevertheless, with dietary cholesterol too, a good rule of thumb is “less is best.” Try to limit your cholesterol intake to no more than 300 milligrams per day. A three-ounce serving of broiled liver, for example, contains 331 milligrams of cholesterol; an equivalent portion of beef has 76. The cholesterol count for packaged foods appears on the label under Nutrition Facts.
Dietary Cholesterol Counts Too much cholesterol in your food can leave you with too much in your blood; and for many people, that can mean an increased risk of heart disease. According to the American Heart Association, the average American woman consumes about 320 milligrams of cholesterol a day; the average man, 450 milligrams. People's tolerance of cholesterol varies, but as a general rule of thumb, your dietary intake should be no more than 300 milligrams daily. How much is that? The chart below will give you an idea.
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For most people, relatively minor changes in the diet, (eliminating butter and rich desserts, for example) can lower cholesterol by 10 to 15 percent. Keeping your quota of meat to about 6 ounces per day can also work wonders, since it cuts down your intake of both cholesterol and saturated fat. And regular exercise—the only proven way of raising your “good” HDL levels—is yet another essential weapon in the war against high cholesterol. The results can be rewarding. An 8 to 20 percent reduction in blood cholesterol levels means a 20 to 40 percent reduction in heart attacks.
When cholesterol levels do not respond to diet and exercise, your doctor may prescribe a medication. Several types are available. Drugs called bile acid sequestrants prompt the liver to pull excess cholesterol from the bloodstream. They include Colestid, Questran, and WelChol. Another group, called fibric acid derivatives, break down fat particles in the blood. Included in this category are Atromid-S, Lopid, and Tricor. Large doses of Niacin (Niaspan) reduce cholesterol by cutting its rate of production in the liver. Finally, the popular group of drugs known as “statins” attack cholesterol in two ways, clearing harmful LDL out of the blood and limiting the body’s ability to produce new LDL. These drugs—including Lescol, Lipitor, Mevacor, Pravachol, and Zocor—have turned out to be especially effective. Pravachol and Zocor, for instance, have been proven to substantially reduce the odds of a heart attack in people with high cholesterol.
Nevertheless these drugs can be expensive and may occasionally cause side effects, so your doctor is likely to prescribe one for you only if you already have heart disease or are threatened by some of the other risk factors that can lead to it.
Kids and Cholesterol
According to the American Health Foundation, one in four children in the U.S. has a high cholesterol level—not surprising given American eating habits. Depending on age, a child in the U.S. gets between 10 and 15 percent of his or her daily calories from snacks and fast foods, traditionally high in fats and cholesterol. While you don’t have to eliminate all these treats from your child’s diet, most cardiologists agree that limiting fat intake—from age two on—will help reduce the risk of heart disease later in life. All high-risk children, such as those with a parent or grandparent who develops any cardiovascular disease (including high cholesterol) before the age of 55, should have a cholesterol test—if only to establish a basis for later comparison.
Limit fat to 30 percent of your child’s total daily allotment of calories, with less than 10 percent of those calories coming from saturated fat. Keep cholesterol consumption to no more than 100 milligrams for every 1,000 calories consumed.
Beware of starting the program too early, however. Dietary fat and cholesterol are critical for normal brain development in infants and toddlers, so wait till the child is two to start him or her on the path to a lifetime of healthy, low-fat eating.
Health Boosters The following foods are the richest sources of the omega-3 fatty acids that help to reduce the risk of heart disease by lowering blood pressure and reducing the likelihood of blood clots. Experts recommend two to three servings of omega-3 fish every week.
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Fat, Cancer, and More
The link between fat intake and certain types of cancer is controversial. Although a recent study conducted by the Harvard Medical School found no relationship between fat intake and breast cancer, there’s no denying that the disease occurs more frequently in countries where women have high average intakes of both total fat and saturated fat. (American women, for instance, are six times more likely to develop breast cancer than Japanese women, who eat far less fat.) Some studies indicate that a high-fat diet also increases the risk of cancer of the colon and possibly even of the ovary, uterus, endometrium, and prostate. One theory suggests that as dietary fat intake increases, so do sex hormone levels, which may cause cancer in the reproductive organs. We do know that diets high in fat increase the amount of cholesterol and bile acids in the colon. The bacteria that live in the lower digestive tract may then convert these substances into cancer-causing by-products. (For more information, see “Cut Back on These Foods to Cut Your Cancer Risk.”)
Other serious health problems associated with a high intake of fat include diabetes and high blood pressure.
Fat is not only a high-calorie food that threatens your waistline, it’s also a demonstrated health risk. Remember the number 30: No more than 30 percent of your daily caloric intake should come from fat.
Fat Formula #2: The Food Fat Percentage Supermarket shelves, and freezer cases overflow with "lite" and "low-fat" goods. Many manufacturers tout the fat content of their products (for example, "only 5 grams of fat per serving"). But calorie for calorie, some foods will use up your daily allowance of fat much faster than others. To find out whether a product is out of balance, you need to check the share of its calories delivered by fat. Look on the food label for Nutrition Facts, and find the amount of calories from fat. Divide that number by the number of total calories, then multiply by 100 to get the fat percentage.(calories from fat ÷ total calories) x 100 = percent of calories from fatFor example, one serving of ready-to-eat roasted chicken thigh, without skin, totals 160 calories, 90 of which come from fat. Ninety fat calories divided by 160 total calories equals .5625, which, when multiplied by 100, equals 56.25 percent. In other words, more than half of the calories from that single serving of chicken are coming from fat calories.Since the American Heart Association recommends that only 30 percent of your daily caloric intake come from fat, the rest of your meal will have to be very shy of fat calories if you hope to keep them within recommended bounds. Remember, it's perfectly acceptable to eat foods that are over 30 percent fat—as long as you're willing to counterbalance them with items below the 30 percent target. |
Heart-Friendly Choices Reducing your fat intake is not as hard as it seems. It's really just a matter of making a series of relatively easy substitutions. None is any real hardship, yet together they will have a major impact on your diet. Following is a list of commonly available lower-fat substitutes you and your family can learn to love. Fat content is based on average single-portion servings.
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Key Facts
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Keeping Your Fat Intake at Safe Levels
Cutting the amount of fat in your diet not only improves your odds of continued good health, it also makes it easier to lose weight. Remember that while the body readily burns carbohydrate and protein calories, it stores fat calories as body fat. Moreover, the body uses more energy burning carbohydrate and protein calories than fat calories.
Whether you are interested in reducing your fat intake to look and feel better—or because it could be a matter of life and death—the following tips may make the process a little easier.
| • | Read labels carefully to determine both the type and amount of fat in processed foods, and check the calorie figures, too. The Food Fat Percentage Formula (see the box "Fat Formula #2") can be especially helpful here. For example, if you think that 2 percent milk is low in fat, you're wrong. That "2 percent" refers to fat content by weight. In terms of calories from fat, it registers a hearty 33 percent—a bit more than the 30 percent balance you should strike in your diet as a whole. |
| • | Eat less saturated fat and cholesterol. In practical terms, that means eating less meat, cheese, eggs, and whole dairy products. Replace fat-laced meat with leaner cuts, or with skinless chicken, turkey, and fish. Instead of whole eggs, use egg whites. And dip your bread in olive oil instead of slathering it with butter or margarine. |
| • | Go meatless occasionally. Prepare legumes (dried peas and beans), pasta, and rice dishes for your main course, using low-fat or nonfat dairy products. Don't think automatically of cheese as a healthy meat-substitute. Like ice cream, many cheeses have a fat calorie ratio of 60 to 70 percent. Do, however, consider adding a few nuts to your diet. Surprisingly, experts say that nuts—which derive as much as 85 percent of their calories from fat—can actually be heart-healthy when eaten in small quantities. The fat they contain is the unsaturated kind that tends to reduce cholesterol. Plus nuts are loaded with beneficial compounds, including vitamins B and E; the minerals calcium, selenium, and zinc; and various amino acids. |
| • | When you do eat meat, eat less and eat leaner. The American Heart Association recommends eating no more than 6 ounces of cooked lean meat, skinless poultry, fish, or seafood per day. (A 4-ounce portion is the size of a deck of cards.) Choose cuts with a minimum of visible fat. "Select" grade meats tend to be lower in fat than "Choice" or "Prime." Wild meats such as venison, buffalo, and rabbit tend to have even less fat. Avoid domestic duck and goose, which are very high in fat, in favor of turkey and chicken. And choose white meat over dark, which can be as much as six times higher in fat. Be sure to trim all visible fat from meat and remove the skin from poultry before eating. |
| • | Eat more unprocessed whole grains, fruits, vegetables, and beans. These filling foods not only serve as stand-ins for richer meat and dairy products, but also deliver powerful arterial plaque fighters: carotene, vitamins C and E, selenium, and soluble fiber. The exceptions to the rule are coconut, olives, and avocado, which are high in fat. If you want to indulge occasionally, eat small portions of avocado and olives—they are high in monounsaturates—but try to avoid coconut, which is high in saturated fats. |
| • | Beware of "hidden" fat. A large handful of peanuts, granola cereal, egg-laden breads and pastas, nondairy creamers, even some fast food "diet" meals can be astonishingly high in fat. A fish filet sandwich at McDonald's, for example, has almost 26 grams of fat and 45 milligrams of cholesterol, more than the same restaurant's cheeseburger. A large bucket of unbuttered movie theater popcorn that has been popped in coconut oil has the equivalent of three days' allotment of heart-clogging saturated fat. |
| • | Watch the portions. A 3-and-a-half-ounce helping of meat or fish is sufficient for one serving. In general take a serving that is about the size of the palm of your hand or a deck of cards. |
| • | Try to steam, bake, or broil foods instead of sautéing them. If you do want to sauté, use a nonstick skillet and substitute broth for fat. Don't even think about deep-fat frying. |
| • | Avoid undermining healthy foods by dressing them in butter, margarine, mayonnaise, or other high-fat sauces. One tablespoon of Caesar salad dressing, with 8 grams of fat, can raise the fat ratio of half a cup of Romaine lettuce to 88 percent. Experiment with spices to add palate-pleasing flavor. Reduced broth or puréed vegetables make a healthful low-fat alternative to conventional—and risky—cream- or butter-based sauces. |
| • | Use skim or low-fat products instead of the full-fat varieties. Choose skim or 1 percent milk instead of whole milk, a frozen fruit juice bar or low-fat frozen yogurt over ice cream, a slice of angelfood cake over a brownie. Don't, however, assume that "low-fat" is the same as "low-calorie." Because fat is what helps you feel full, it's easy to overindulge in lower-fat foods. If you are taking in more calories than you can burn up, those calories will be stored as fat, even if they come from carbohydrates and proteins. |
| • | Don't assume that vegetarian or "health" foods are low in fat. Check the labels. A half cup of granola has a fat calorie ratio of 50 percent . . . that's a higher percentage of fat than a Snickers bar (45 percent). |
| • | Graze all day—on low-calorie munchies. Snack frequently, but stick with modest portions of low-fat foods: rice wafers, dry cereals (but not high-fat granolas!), whole grain breads, fruits and vegetables, nonfat or low-fat cottage cheese. |
| • | Remember: You are what you eat. |