Fats and Cholesterol

Foods with saturated fat and cholesterol can affect heart disease. While it may be important to avoid foods with cholesterol, claims of “cholesterol free” do not address the amount of saturated fat and hydrogenated fat in the food item. Knowing about dietary fats and cholesterol can help clear the confusion and guide you in making healthy food choices.

Fats

All fats are a combination of saturated, monounsaturated and polyunsaturated fatty acids. Each offers some health benefit to the body. The American Heart Association recommends limiting total fat to no more than 30%, 10% of which can come from saturated fat.

Saturated Fats are found in both animal and plant products. Sources include red meats and dairy products and tropical oils like coconut and palm oil and cocoa butter. Saturated fat is believed harmful because it raises LDL– the “Unhealthy” cholesterol. High levels of LDL increase risk for heart disease. However, some saturated fat may be beneficial for protection against stroke.

Polysaturated Fats are found in vegetable oils. Sources include corn, safflower and soybean oils and cold water fish. Polyunsaturated fats have both good and bad properties. While these fats lower LDL and total cholesterol, they also lower HDL - the "Healthy" cholesterol. Lowering HDL is not a desirable feature. That is why it’s important to eat a combination of both mono and poly-unsaturated oils. Essential fatty acids are a type of polyunsaturated fat with special features. These fatty acids promote a healthy immune system and help protect against heart disease and other diseases. Omega-3 is an essential fatty acid found in cold water fish like tuna, salmon, mackeral and cod. Omega-6 is an essential fatty acid found in flax seed oil (look for this in the refrigerator section of health food stores).

Monunsaturated Fats are found in plant oils. Sources include olive, canola and peanut oils. Monounsaturated fats protect HDL levels, the “Healthy” cholesterol. It is less susceptible to oxidation than polyunsaturated oils. This makes monounsaturated fats a heart-healthy choice. (Oxidation is believed to be a causative factor in the formation of atheroslerotic placque lesions on blood vessel walls). A recent study demonstrated a lower incident of heart disease in women who ate an ounce of nuts a day. The researchers speculated that the nuts were a good source of monounsaturated fat and, therefore, helped protect healthy HDL levels.

Hydrogenated and partially hydrogenated fats – also called “TRANS-FATS”–is a new cause for concern. Hydrogenation is a chemical process that changes a liquid vegetable oil into one that is more solid at room temperature. Hard stick margarine is a trans-fat. These are not naturally occurring fats.

Trans-fats are listed as "hydrogenated" or " partially hydrogenated" oils under the ingredients section of food labels. Trans-fats prolong shelf life and are found in many commercially prepared bakery items (e.g. cookies, cakes, crackers and other snack foods) and in processed peanut butter. A recent, large-scale study revealed that trans-fats raised LDL levels even higher than saturated fats. When buying margarine, choose one that is more liquid at room temperature. Tub margarine, and margarine from a squeeze or spray bottle have little or no trans-fats. Limit foods with hydrogenated and partially hydrogenated fat. Learn how to read and interpret food labels because, while total fat, saturated fat, polyunsaturated fat and monounsaturated fat are all listed on the USDA Nutrition Facts Food Label, Trans-fats are not. You must read the ingredients section to see if a product contains hydrogenated or partially hydrogenated fat.

Cholesterol

What is Cholesterol? Cholesterol is a waxy, fat-like substance carried in the blood stream and is found in every cell of the body. It is used to make hormones, build cell walls, insulate neurons and produce bile acid.

Cholesterol is essential for life.The liver produces all the cholesterol the body needs. Cholesterol in the food you eat adds extra cholesterol to the body. Feedback mechanisms regulate the manufacture of cholesterol by the liver, responding to dietary intake of cholesterol.

Dietary cholesterol is found in foods of animal origin and in whole fat dairy products. Cholesterol content is listed on food labels. The recommended limit is 300 mg/day or 200 mg/day for those with known heart disease.

A recent study reported on the effect of eating eggs on blood cholesterol levels (egg yolks contain cholesterol). This large-scale study found only minimal, if any, increase in blood cholesterol levels for egg-eaters. Ask your healthcare practitioner if you need to limit eggs in your diet.

High blood cholesterol is linked to heart disease. Other risk factors for heart disease include:

• Family History
• Smoking
• High Blood Pressure
• Being Male
• Being Post-Menopausal Female
• Overweight by 20 Pounds or More
• Physical Inactivity
• Diabetes

Blood tests can measure your total cholesterol. This includes the high-density lipoproteins (HDL)– the “healthy” cholesterol that cleanses arteries, plus the low-density lipoproteins (LDL) – the “unhealthy” cholesterol that builds up and clogs arteries. Triglycerides is also measured, but its exact relationship to heart disease is not fully understood.

Can you determine what your risk is for heart disease based on your cholesterol level? What is considered "High Blood Cholesterol"? Look at the chart below. If your cholesterol level places you in the borderline group and you have two or more risk factors listed above, you’re actually at high risk for heart disease. Those with a total cholesterol over 265 have a two and a half times greater risk of developing coronary artery disease than a person with 190 or less. How often you get your blood cholesterol levels checked depends upon your risk for developing heart disease.

Monitoring blood cholesterol and dyslipidemia (unhealthy cholesterol levels) is essential for early intervention. Every woman needs to know her individual risk factors for heart disease and what she can do to lower her risk. Here are some questions you may want to ask your doctor or healthare practitioner at your next visit...

• How is cholesterol a risk factor for heart disease?
• Do my cholesterol levels place me at risk?
• How often should I get my cholesterol checked?
• What are the different types of cholesterol?
• What are my target cholesterol levels? How low should my LDL (“bad”) cholesterol be and how high should my HDL (“good”) cholesterol be?
• How can I improve my blood cholesterol levels naturally?

By learning about blood cholesterol and knowing what the numbers mean, a woman can take a more active role in managing her own health risks.

Lowering Blood Cholesterol

Medications are available to lower blood cholesterol. Results from one study revealed dramatic results with decreased numbers of heart attacks for those taking cholesterol–lowering drugs – but not without risk. Cholesterol–lowering drugs can affect liver function and have other side–effects. Those taking cholesterol–lowering drugs must have regular blood tests to monitor liver function.

Lifestyle changes that may help promote healthier cholesterol levels include the following:

• Reducing intake of saturated fats and trans-fats. Choose liquid or spray margarines. Limit snack foods and bakery items with hydrogenated or partially hydrogenated oils. Cut down on red meats. Choose low-fat dairy products.
• Replacing unhealthy fats with monounsaturated fats (e.g. olive, canola and peanut oils). Monounsaturated fats lower LDL and leave beneficial HDL intact.
• Eating more fish. Even just one fish meal a week has been shown to be beneficial in decreasing heart disease risk.
• Eating whole–grain foods
• Eating an ounce of nuts a day (refer to the Nurse's Health Study)
• Incorporating soy protein into your diet (Some newer margarines containing soy protein claim to lower cholestesterol levels by as much as 14%.)
• Eating more fruits and vegetables (Fruits and vegetables contain micronutrients and phytochemicals that fight diseases and prevent oxidation of cholesterol.)
• Drinking 4 oz. of red wine a day (Wine and other alcoholic beverages can raise HDL levels somewhat, however, excess drinking can lead to high blood pressure and a weakened heart muscle. Excess alcohol intake is also related to other serious health problems and contributes to auto accidents, domestic violence and social problems, so, if you don’t drink, don’t start.)
• Getting regular, vigorous exercise. (Exercise may help raise HDL, but not everyone's blood cholesterol will respond in this way. Be sure to check with your healthcare professional before starting any exercise program.)

If you are concerned about heart disease and want to reduce your risk, it’s important to know about the role of dietary fat and cholesterol. Learn how to read and interpret food labels and know your cholesterol numbers.

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_{Source:
Sebastian,L., "Fat and Cholesterol", Nursing Spectrum, Dec 15, '97
Mary Johnson, M.S., R.D., C.D.E
Cholesterol graph: American Heart Association
Edited by Donna Gerome, R.D.}

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