ENJOYING A HEART-HEALTHY DIET: THE DIETARY FOUNDATION

The same dietary modifications that you’ll need for controlling your cholesterol will pay off in additional dividends. Without even thinking about kilojoules, cutting back on fat will help you lose those kilos you’ve been meaning to shed. If you’re diabetic, you’ll find it a lot easier to keep your glucose levels controlled. In the long term, a low-fat, low-cholesterol diet can also provide protection against cancer.
The best news is that the dietary changes necessary for good health don’t mean deprivation. You’ll find yourself eating as much as you want, never feeling hungry, and indulging in tasty treats that you’ll find mouth-wateringly delicious.
Hearing numbers regarding your foods can be bewildering. What does it mean to eat 30 per cent or 20 per cent or 10 per cent of your kilojoules as fat? Some nutritionists and certain publications have tried to illustrate such numbers in terms of teaspoons of fat. But have you ever seen fat listed in teaspoons on a package of food? There’s an easier, far more practical way to deal with all this.
First let’s assume that like most Westerners you now consume about 40 per cent of your kilojoules as fat. That means that an awful lot of your food has a significant amount of fat in it. Compare that with populations in the world who eat much less fat, about 15 per cent, and have virtually no heart disease. The Heart Foundation of Australia has long recommended a 30-per cent-fat diet, but while that may be fine for others, it’s just not effective for those of us who already have heart disease. On the other hand, a diet calling for only 10 per cent fat will be unacceptable for most people to follow for any length of time. While that may be very effective, it’s just not very practical.
I propose a 20 per cent fat diet. This comes close to the levels of fat intake in countries which are nearly free of heart disease. It allows a delicious choice of foods which can be enjoyed not only at home but while dining out in restaurants and at the homes of friends and relatives.
But, again, you won’t see percentages of fat listed on food packages or in magazine recipes. What you will see listed is the amount of fat measured in grams. That’s something we can all get a practical handle on for our own purposes.
Bear with me for the next few paragraphs and you’ll have your personally tailored prescription for gram intake to achieve a 20 per cent fat diet. We’ll start with the kilojoules you need daily.
The average, moderately active man needs about 145 kilojoules to maintain each kilogram of body weight. A very active man may need more kilojoules to maintain his weight. Less active men, and most women, will require fewer kilojoules. A middle-aged, moderately active woman, or a less active man, may need only 110 to 120 kilojoules to keep weight at the current level. Thus to determine your daily kilojoule needs, multiply either 145 or a greater or lesser number by your ideal weight. Notice that I say ideal weight. We’ll discuss that in a moment.
Let’s take an average man who weighs 68 kilos and is moderately active. He walks regularly, plays an occasional round of golf, and engages in leisure activities other than just watching television. He needs 145 kilojoules per kilogram to maintain his weight. Here’s his calculation:
68 X 145 = 9860 kilojoules/day
What if you’d like to weigh 68 kilos, but right now you tip the scales at 77 kilos? By consuming 9860 kilojoules daily you, our reference man, will feed only your ideal 68 kilos. Little by little, but in a very satisfying process, those extra kilos will come off. You’ll feed only your ideal weight; those extra kilos will be starved away.
Now that we know that our male example needs 9860 kilojoules daily, let’s assume that he’s going to get heart-healthy and consume 20 pet cent of those kilojoules as fat. The calculation is simply to multiply the daily kilojoules by 20 per cent.
9860 X .20 = 1972 kilojoules consumed as fat
While carbohydrates and protein supply only 17 kilojoules per gram, fat provides a full 38 kilojoules. Thus to translate those abstract kilojoules into practical grams, we do the next calculation of dividing our kilojoules consumed as fat by 38, the number of kilojoules in each gram.
1972 ^ 38 = 52 grams
There we have it. Out reference male example will want to consume no more than 52 grams of fat daily. That’s something he (and you and 1) can easily keep track of regularly.
Of that total amount of fat, no more than one-third should be saturated. The balance should come from polyunsaturated and mono-unsaturated fats. More about that in the coming paragraphs.
Of course, you’re not yet familiar with the number of grams of fat in foods. Begin by reading the labels on packages. Look at the labels on milk cartons, bread packages, TV dinners and almost every food that’s processed by a manufacturer. Next, familiarise yourself with the number of grams of fat found in commonly eaten foods including meats, fish, cheese and the like which are not processed when you buy them in the supermarket. Take a look at Table 6 (page 320) for a brief overview. For a listing of the fat, cholesterol, kilojoule, sodium, fibre, iron and calcium contents of foods, refer to the book Calorie Counter by Allan Borushek; it’s available in most bookstores or pharmacies.
When I first began to control my own cholesterol by keeping tabs on fat grams, I knew no more about those numbers than you do now. Within a remarkably short period of time, however, this all becomes second nature. You may not know that cheddar cheese packs about 10 grams of fat per 30 grams versus the 7 grams for mozzarella or Edam, but you’ll have a general idea that cheese has a lot of fat and that eating just 30 grams will account for a significant percentage of your daily fat-gram allowance. Pretty soon you’ll be selecting foods throughout the day and zeroing right in on your fat target without even consulting a chart or table. Millions have done it. Trust me.
But not all fat is the same. The difference is in the degree of saturation of the fat molecule. The more hydrogen atoms are attached to the fat molecule, the more saturated it is said to be. The more saturated a fat is, the more it tends to clog arteries. The saturated fats are solid or semi-solid at room temperature. The reason butter is harder to spread than margarine straight out of the refrigerator is that butter has more saturated fat.
Unsaturated fats fall into two categories: polyunsaturated and monounsaturated. The distinction comes, again, from the number of hydrogen atoms involved, or, conversely, how many spaces on the fat molecule are not occupied by a hydrogen atom. At first one might think, therefore, that polyunsaturated fats would be a far better choice than monounsaturated fats, since the former have more spaces unfilled by hydrogen atoms. For years, that was the consensus in the scientific and medical communities.
But there was one flaw in that reasoning. Many populations in the world consume a vast amount of monounsaturated fat in the form of olive oil, yet have very low rates of heart disease. To briefly summarise the many research projects that followed, we now know that monounsaturated fats can lower cholesterol levels as effectively as polyunsaturated fats when used to replace saturated fats in the diet. In fact, the monounsaturated fats may have a slight edge in view of the indication that they tend to reduce the bad LDL cholesterol selectively, leaving the good HDL untouched. Polyunsaturated fats tend to lower all types of cholesterol.
We’ll discuss specific fats and oils in the section of this chapter that deals with shopping and selecting foods. Needless to say, you’ll want to choose those with less saturated fats. But all foods contain a profile of saturated, polyunsaturated and monounsaturated fats. That’s true across the board, for butter as well as for oil. See Table 7 (page 329) for a comparison of fats and oils.
As much as we’ve heard about dietary cholesterol, and food manufacturers have rushed to satisfy consumer’s demands by advertising “Cholesterol-free” this and “No-cholesterol” that, it turns out that saturated fat raises cholesterol levels in the blood more than dietary cholesterol itself. Indeed, much of the advertising is sheer nonsense, since cholesterol comes only from animal foods, never from plant foods. Thus all olive oil and all peanut butter is cholesterol free.
Actually, by leaning towards foods of plant rather than animal origin, one can cut way back on saturated fats and can eliminate cholesterol entirely. There are only a few exceptions. Avocados, olives and nuts are high in fat and must be consumed in moderation. Again, don’t eliminate, but moderate. See Table 6 for specifics. And the so-called tropical oils—coconut oil, palm oil and palm kernel oil—are high in saturated fats. Fortunately, as a result of consumer demands, manufacturers are removing the offending oils from their foods.
Unfortunately, they’re replacing the tropical oils with hydrogenated oils. This has led to something of a controversy. By adding hydrogen atoms to corn oil, soybean oil and so forth, manufacturers prolong the shelf life and consumer acceptance of their food products. But this makes those oils mote saturated, and thus more likely to raise cholesterol levels in the blood and to clog arteries. While the hydrogenated or partially hydrogenated soybean oil in a food is a far cry better than the tropical oil or the lard it replaced, it’s not as good as the pure soybean oil would be.
Some researchers aren’t as concerned about this, however, pointing out that one must be more careful in observing what really happens to those fats during the hydrogenation process. First, some of the polyunsaturated fats may be converted to monounsaturated fats; as we’ve already seen, that’s not at all bad. Second, not all saturated fats are as artery-clogging as others. The one most commonly formed saturated fat during hydrogenation, stearic acid, apparently has little or no effect on raising cholesterol levels in the blood and, it would be expected, has less tendency to block arteries.
But another wrinkle has entered the hydrogenation dilemma. Some researchers are now concerned that such molecular manipulation changed the naturally occurring cis configuration of the molecule to the abnormal trans configuration. Apparently the trans fats are more artery-clogging than the cis types. You can expect to see and hear more about this in the coming months and years, as more research is done. In the meantime, bear in mind that the amount of trans fats fed in experimental diets being quoted is far higher than almost anyone could possibly expect to eat, even on a very high-fat diet.
The bottom line is to keep all fat intake as low as practical and possible. That’s especially true for saturated fats.
But what about cholesterol? A maximum of 300 milligrams should be consumed daily, no more than 100 milligrams per 4200 kilojoules eaten. But even that’s not good enough for someone who needs to lower his or her elevated cholesterol, especially those individuals who have established heart disease. For those of us in that situation, the ceiling should be 100 milligrams daily, certainly no more than 150 milligrams.
Actually that’s not so hard to do. When you get rid of the saturated fat in animal foods, you automatically get rid of the cholesterol. By switching from whole milk to skim milk you go from more than 10 grams of fat to a mere fraction of a gram. At the same time, you drop from 30 milligrams of cholesterol to only a fraction in a 250 ml glass. Choose a cheese substitute over the regular cheddar, and the cholesterol is completely gone.
Take another look at Table 6 and notice the amount of cholesterol in the foods you’re likely to eat. It’s not all that difficult to limit yourself to 100 to 150 milligrams of cholesterol daily.
You’ll be happy to learn that previous listings of cholesterol in shellfish were inaccurate. Clams, oysters, mussels and scallops are actually very low in both fat and cholesterol. Crab and lobster are extremely low in fat, and have a fairly reasonable amount of cholesterol. Only shrimp (prawns) are relatively high; but they’re virtually devoid of fat. Eating 115 grams of shrimp (obviously not deep-fried) will not exceed your cholesterol limit for the day.
The cholesterol-laden foods to avoid or completely eliminate are egg yolks and organ meats. Fortunately there are a number of very acceptable egg substitutes on the market. Remember, too, that egg whites have absolutely no cholesterol and virtually no fat. And very few of us will bemoan the loss of liver and kidneys and brains from the diet!
While discussing cholesterol, it might be worth noting that even though dietary cholesterol does not elevate cholesterol levels in the blood as much as saturated fat does, it might have problems of its own. Dr Jeremiah Stamler of Northwestern University in Chicago has found that cholesterol has an artery-clogging tendency above and beyond raising levels in the blood. He currently believes that cholesterol intake constitutes a separate and independent risk of atherosclerosis. For those of us whose arteries are already blocked, that’s a real consideration, and another reason to stick with the 100- to 150-milligram daily limit.
Since cholesterol is found only in animal foods, when we reduce the saturated fat by cutting back on those foods, we also limit our cholesterol intake. The foods that are particularly high in cholesterol, though relatively low in saturated fat, are egg yolks, shrimp, squid, crayfish and organ meats.
I can just picture the look of doom and gloom on your face by this point. “Damn it, I won’t be able to eat the kinds of foods that I love. Who wants to live like that?” I wish that you could see the way my family and I eat! That would completely change your attitude, and fast. We love meatloaf and mashed potatoes, pizzas, hamburgers, omelettes and all sorts of things that are probably your favourites as well. But we take advantage of the tricks I’ve learned over the past few years, along with the new foods that have hit the market recently. Believe me, my way of eating represents zero deprivation.
After writing The 8-Week Cholesterol Cure, I received hundreds of letters. Many admitted that they were amazed that they could reduce their cholesterol levels so effectively without feeling at all deprived. You can do it also. Maybe you’ll even write me a letter yourself. Send it to me at PO Box 2039, Venice, CA, United States 90294.
*109\85\2*
Cardio & Blood/ Cholesterol
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