Download Fats and Cholesterol in Health

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Nutrition Scoreboard
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Fats and
Cholesterol
in Health
1 It is currently recommended that adults consume
diets providing less than 30% of calories from fat.
3 Cholesterol is present in every food.
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4 Saturated fat intake has a much stronger influence
on blood cholesterol levels than does cholesterol
intake.
Answers on next page
2 The types of fat consumed are more important to
health than is total fat intake.
• Fats are our most concen-
trated source of food
energy. They supply 9 calories per gram.
• Dietary fats “carry” the
essential fatty acids, fatsoluble vitamins, and
healthful phytochemicals
along with them in foods.
• Fats are not created equal.
Some types of fat have posi-
tive effects, and some
have negative effects on
health.
• Saturated fats and trans
fats raise blood cholesterol levels more than
does dietary cholesterol or
any other type of fat.
TRUE
Answers to Nutrition Scoreboard
]
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1 Recommendations for fat intake have changed! The
acceptable range of fat intake is now 20-35% of
total calories.
2 The types of fat consumed are more important to
health than the total amount of fat.1
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3 Cholesterol is present only in animal products.
4 Saturated fat, which is found primarily in animal
products, raises blood cholesterol levels a good deal
more than does dietary cholesterol.
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KEY CONCEPTS AND FACTS
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Changing Views about Fat Intake and Health
Scientific evidence and opinions related to the effects of fat on health have changed
substantially in recent years—and so have recommendations about fat intake. In the
past, it was recommended that Americans aim for diets providing less than 30% of
total calories from fat. Evidence indicating that the type of fat consumed is more
important to health than is total fat intake has changed this advice. The watchwords
for thinking about fat have become “not all fats are created equal: some are better
for you than others.” American adults are being urged to select food sources of
“healthy” or “good” fats while keeping fat intake within the range of 20–35% of
total caloric intake. Concerns that high-fat diets encourage the development of obesity have been eased by studies demonstrating that excessive caloric intakes—and
not just diets high in fat—are related to weight gain.2
New recommendations regarding fat intake do not encourage increased fat consumption. Rather, they emphasize that healthy diets include certain types of fat, and
that total caloric intake and physical activity are the most important components of
weight management. Diets providing as low as 20% of calories from fat, and those
providing 30–35%, can be healthy—depending on the types of fat consumed and
the quality of the rest of the diet.3 This unit provides facts about fats, explains the
reasons behind recent changes in recommendations for fat intake, and addresses the
practical meaning of it all.
Facts about Fats
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lipids
Compounds that are insoluble
in water and soluble in fat.
Triglycerides, saturated and
unsaturated fats, and essential
fatty acids are examples of
lipids, or “fats.”
Fats are a group of substances found in food. They have one major property in common: they are not soluble (or, in other words, will not dissolve) in water. If you have
ever tried to mix vinegar and oil when making salad dressing, you have observed the
principle of water and fat solubility firsthand.
Fats are actually a subcategory of the fat-soluble substances known as lipids.
Lipids include fats, oils, and cholesterol. Dietary fats such as butter, margarine, and
shortening are often distinguished from oils by their property of being solid at room
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ROLES OF DIETARY FAT.
• Provides a concentrated source of energy
• Carries the essential
fatty acids, the fatsoluble vitamins, and
certain phytochemicals
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Contributions of Dietary Fats
TABLE 18.1
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temperature. This physical difference between fats and oils is due to their chemical
structures.
Fats in Foods Supply Energy and Fat-Soluble Nutrients] Fats include the
essential fatty acids (linoleic acid and alpha-linolenic acid) and provide the fatsoluble vitamins D, E, K, and A (the “deka” vitamins). So, part of the reason we
need fats in our diet is to get a supply of the essential nutrients they contain (Table
18.1). Diets containing little fat (less than 20% of total calories) often fall short on
delivering adequate amounts of essential fatty acids and fat-soluble vitamins.4
Fats Increase the Flavor and Palatability of Foods] Although “pure” fats by
• Increases the flavor
and palatability of
foods
• Provides sustained
relief from hunger
themselves tend to be tasteless, they absorb and retain the flavor of substances that
surround them. Thus, fats in meats and other foods pick up flavors from their environment and give those flavors to the food. This characteristic of fat is why butter,
if placed next to the garlic in the refrigerator, tastes like garlic.
• Serves as a component
of cell membranes
Fats Contribute to the Sensation of Feeling Full] As they should, at 9 calo-
essential fatty acids
Components of fats (linoleic
acid—pronounced lynn-oh-layick and alpha-linolenic acid—
lynn-oh-len-ick) required in
the diet.
ries per gram! Fats tend to stay in the stomach longer than carbohydrates or proteins and are absorbed over a longer period of time. That’s why foods with fat “stick
to your ribs.”5
A Crucial Role of Fat Is to Serve as a Component of Cell Membranes]
Some types of fats give cell membranes flexibility and help regulate the transfer of
nutrients into and out of cells.6
Excess Dietary Fat, Carbohydrates,
and Protein Are Stored as Fat
Fats in the body include those consumed in the diet and those produced from carbohydrates and proteins. Humans eat only a few times a day, but we need energy
throughout the day. To ensure a constant supply of energy, the body converts carbohydrates and proteins, which have been supplied from foods and are not used to
meet immediate needs, to storage forms of energy. Some of the excess carbohydrate
and protein is converted to glycogen, the storage form of glucose under normal circumstances, but most of the excess is changed to fat and stored in fat cells (Illustration 18.1).
Body fat is not just skin deep. Fat is also located around organs such as the kidneys and heart. It’s there to cushion and protect the organs and keep them insulated.
Cold-water swimmers can attest to the effectiveness of fat as an insulation material.
They purposefully build up body fat stores because they need the extra layer of insulation (Illustration 18.2).
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Fats Come in Many Varieties
There are many types of fat in food and our bodies (Table 18.2). Of primary importance are triglycerides (or “triacylglycerols”), saturated and unsaturated fats, and
cholesterol (for definitions, see Table 18.3). The different types of fats have different effects on health.
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AP Photo
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Biophoto/Photo Researchers
Triglycerides, which consist of one
glycerol unit (a glucose-like substance) and
three fatty acids (Illustration 18.3), make
up 98% of our dietary fat intake and the
vast majority of our body’s fat stores.
Triglycerides are transported in blood
attached to protein carriers and are used by
cells for energy formation and tissue maintenance. A minority of fats take the form of
diglycerides (glycerol plus two fatty acids)
and monoglycerides (glycerol and one fatty
acid). Diglycerides are present in some oils
and small amounts are used in food products as emulsifiers—or to increase the
blending of fat- and water-soluble substances. Monoglycerides are present in
small amounts in some oils; we don’t consume very much of them in foods.
As far as health is concerned, the glycerol component of fat is relatively unimportant. It’s the fatty acids that influence
what the body does with the fat we eat; and
they are responsible, in part, for how fat
affects health. Many different types of fatty
acids are found in triglycerides. You’ve
heard of the major ones: those that make
fat “saturated” or “unsaturated.”
Illustration 18.1
A close look at fat cells
(color-enhanced
microphotograph).
Illustration 18.2
Although their body fat stores don’t fit
the image of the superathlete, coldwater swimmers need the fat to help
stay warm. Pictured here is the English
swimmer Mike Read, who had swum the
English Channel 20 times by age 39.
Saturated and Unsaturated Fats] Fatty acids found in fats consist primarily of
TABLE 18.2
BASIC FACTS ABOUT THE
TYPES OF FAT.
Fats can be:
• Monoglycerides
• Diglycerides
• Triglycerides
Fats can be:
• Saturated
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• Monounsaturated
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• Polyunsaturated
Unsaturated fats come in:
• “Cis” forms
• “Trans” forms
hydrogen atoms attached to carbon atoms (Illustration 18.4). When the carbons are
attached to as many hydrogens as possible, the fatty acid is “saturated”—that is,
saturated with hydrogen. Saturated fats tend to be solid at room temperature.
Except for palm and coconut oil, only animal products are rich in saturated fats
(Illustration 18.5 on p. 18–6).7 Fatty acids that contain fewer hydrogens than the
maximum are “unsaturated.” They tend to be liquid at room temperature. By and
large, plant foods are the best sources of unsaturated fats.
Unsaturated fats are classified by their degree of unsaturation. If only one
carbon-carbon bond in the fatty acid is unsaturated, the fat is called “monounsaturated.” If two or more carbon-carbon bonds are unsaturated with hydrogen, the fat
qualifies as “polyunsaturated.”
The Omega-3 and Omega-6 Fatty Acids
The essential fatty acids linoleic acid and alpha-linolenic acid are members of the
fatty acid families of omega-6 (also called n-6 fatty acids) and omega-3 fatty acids
(also known as n-3 fatty acids), respectively. Both are polyunsaturated, can be used
as a source of energy, and are stored in fat tissue. Because they are essential, both
linoleic and alpha-linolenic acid are required in the diet.
Linoleic acid is required for growth, maintenance of healthy skin, and normal
functioning of the reproductive system. It is a component of all cell membranes and
is found in particularly high amounts in nerves and the brain. A number of biologically active compounds, produced in the body, that participate in regulation of
blood pressure and blood clotting are derived from linoleic acid. The major food
sources of linoleic acid are sunflower, safflower, corn, and soybean oils.
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TABLE 18.3
Glycerol + 3 fatty acids = Triglyceride
+
+
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Triglycerides: Fats in which the glycerol molecule has three fatty acids attached to it; also
called triacylglycerol. Triglycerides are the most common type of fat in foods and in body
fat stores.
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Illustration 18.3
A triglyceride.
A GLOSSARY OF FATS.
Saturated fats: Molecules of fat in which adjacent carbons within fatty acids are linked
only by single bonds. The carbons are “saturated” with hydrogens; that is, they are attached
to the maximum possible number of hydrogens. Saturated fats tend to be solid at room
temperature. Animal products and palm and coconut oil are sources of saturated fats.
+
Unsaturated fats: Molecules of fat in which adjacent carbons are linked by one or more
double bonds. The carbons are not saturated with hydrogens; that is, they are attached to
fewer than the maximum possible number of hydrogens. Unsaturated fats tend to be liquid
at room temperature and are found in plants, vegetable oils, meats, and dairy products.
Glycerol: A syrupy, colorless liquid component of fats that is soluble in water. It is similar to
glucose in chemical structure.
Cholesterol: A fat-soluble, colorless liquid found in animals but not in plants. Cholesterol is
used by the body to form hormones such as testosterone and estrogen and is a component
of animal cell membranes.
Diglyceride: A fat in which the glycerol molecule has two fatty acids attached to it; also
called diacylglycerol.
Monoglyceride: A fat in which the glycerol molecule has one fatty acid attached to it; also
called monoacylglycerol.
Monounsaturated fats: Fats that contain a fatty acid in which one carbon-carbon bond is
not saturated with hydrogen.
Polyunsaturated fats: Fats that contain a fatty acid in which two or more carbon-carbon
bonds are not saturated with hydrogen.
Hydrogen
Oxygen
CH3
Oxygen
Carbon
Saturated fatty acid
CH
CH
Monounsaturated fatty acid
CH
CH
CH
CH
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Polyunsaturated fatty acid
Two hydrogens are missing from each of these
carbon-carbon links, making the fatty acid
polyunsaturated. With fewer hydrogens to
attach to, these carbons are doubly bonded to
each other. Monounsaturated fatty acids have
only one carbon-carbon bond that is
"unsaturated" with hydrogen atoms.
Illustration 18.4
A look at the difference
between a saturated and an
unsaturated fatty acid.
Illustration 18.5
Fat profiles of selected foods.
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Monounsaturated
Saturated
Polyunsaturated
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PERCENTAGE FATTY ACID COMPOSITION
DAIRY PRODUCTS
Brick cheese
Cheddar cheese
Cottage cheese
American cheese
Whole milk
Butter
30
3
67
30
3
67
30
3
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67
65
48
EGG (medium)
4
31
31
65
HUMAN MILK
3
30
67
4
12
40
37
48
15
OILS AND MARGARINES
Canola oil
Coconut oil
Corn oil
Corn oil margarine
Flaxseed oil
Olive oil
Palm oil
Peanut oil
Soybean oil
Soybean oil margarine
Sunflower oil
6
58
36
92
13
6 2
62
25
61
17
18
9
22
73
14
9
77
52
38
10
48
18
22
28
50
21
11
34
60
25
15
68
MEATS
Hamburger (21% fat)
53
Chicken, roasted (no skin)
Pork chop
Turkey, roasted
26
46
39
43
4
28
49
40
25
12
35
NUTS AND SEEDS
62
21
46
16
52
15
18
11
51
20
17
2
33
32
69
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Photo Disc
Cashews
Macadamia Nuts
Peanuts, dry-roasted
Peanut butter
Sunflower seeds (dried)
Alpha-linolenic acid, EPA (eicosapentaenoic acid—pronounced e-co-sah-penttah-no-ick) and DHA (docosahexaenoic acid: dough-cos-ah-hex-ah-no-ick) are primary members of the omega-3 fatty acid family. Alpha-linolenic acid is an essential
nutrient, but EPA and DHA are not. These two members of the omega-3 fatty acid
family can be produced in the body from alpha-linolenic acid. However, the con-
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—Penny Kris-Etherton, Distinguished Professor of Nutrition12
Eric Risberg/AP Photo
Omega-3 fatty acids are not just good fats,
they affect heart health in positive ways.
The Omega-3 Fatty Acids and Fish Oils] Many unsaturated fats
contain fatty acids with one or two unsaturated carbon-to-carbon
bonds. DHA and EPA found in fish oils, however, stand out in that they
contain from 4 to 6 double bonds. This high level of unsaturation gives
these omega-3 fatty acids the unique property of being highly fluid even
at cold temperatures. This property allows the fatty acids to keep cell
membranes and fat-containing tissues in fish flexible in cold water. Fatty fish and
fish that live in cold water contain the highest amounts of DHA and EPA (Table
18.4).
In humans, DHA and EPA form biologically active compounds that reduce
blood pressure and the tendency of blood to clot, and these properties confer health
advantages. Regular consumption of these omega-3 fatty acids (two or more fishcontaining meals per week) decreases the risk of heart attack, protects against irregular heartbeat and sudden death, decreases plaque formation in arteries, lowers high
blood pressure, and decreases the risk of stroke. Fish oil capsules are being increasingly viewed as potential sources of EPA and DHA. They are sometimes recommended for people at risk of heart disease and should be taken under medical
supervision. High levels of fish oils (over 3 grams per day) can prevent blood from
clotting.14
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Mercury in Fish and Fish Intake} Some fish contain high levels of mercury that can
end up in fish oil supplements.15 Mercury was found to be a potent fungicide over
100 years ago and was used extensively to prevent mold growth on crop seeds.
Some of it ended up in streams, lakes, and oceans, and it lingers there for many
decades. Several catastrophic outbreaks of mercury poisoning due to consumption
of contaminated fish occurred during the mid-1900s and brought a halt to the use
of mercury fungicides. Mercury is still found in some ocean and lake fish, but recent
studies indicate that the benefits of fish intake among people over the age of 40 far
outweigh risks related to mercury.16
Pregnant and breastfeeding women, and infants, are particularly susceptible to
the harmful effects of mercury and are advised to omit from their diets the top four
mercury-rich fish: shark, swordfish, king mackerel, and tilefish (also called golden
snapper and golden bass). Intake of all other fish should be limited to 12 ounces or
less per week among pregnant and breastfeeding women, and to 2 ounces or less for
children under the age of 6 years.17
Local advisories related to mercury levels of fish in lakes and streams are available online (www.epa.gov/ost/fish), and advice on intake levels of fish caught in
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version of this essential fatty acid to EPA and DHA is slow and results in the availability of relatively little EPA and DHA.9 Alpha-linolenic acid is a structural component of all cell membranes and is found in high amounts in cells of the brain and
eyes. Alpha-linolenic acid is also involved in the formation of biologically
active compounds used in regulating blood pressure and blood clotting;
but these compounds have the opposite effect on the blood pressure
and blood clotting, as do linoleic acid derivatives.10 Omega 3-fatty
Fishy eggs? An odd source of fish oil
acids are found in a few foods such as walnuts, flaxseed, canola oil, and
has become part of North Americans’
soybeans in the form of alpha-linolenic acid. The most beneficial sources
diets. Hens given feed with added cod
of omega-3 fatty acids, however, are marine oils—due to their content
liver oil produce eggs with yolks conof DHA and EPA.11 These two omega-3 fatty acids play important
taining 100 to 350 milligrams of highly
roles in disease prevention and health promotion.
unsaturated omega-3 fatty acids.8
OMEGA-3
FATTY ACIDS
(GRAMS)
SEAFOOD
(31⁄2-OUNCE SERVING
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SEAFOOD
(31⁄2-OUNCE SERVING)
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OMEGA-3 FATTY ACID (EPA & DHA) CONTENT OF SELECTED SEAFOODS.13
Sardines in sardine oil
Mackerel
Salmon, Atlantic, farmed
Lake trout
Herring
Salmon, Atlantic, wild
Tuna, white, canned
Salmon, sockeye
Whitefish, lake
Anchovies
Salmon, chinook
Bluefish
Halibut
Trout, rainbow, farmed
Oysters
Salmon, pink
Trout, rainbow, wild
Bass, striped
Swordfish
3.3
2.6
2.2
2.0
1.8
1.8
1.7
1.5
1.5
1.4
1.4
1.2
1.2
1.2
1.1
1.0
1.0
0.8
0.8
Oysters
Catfish
Flounder
Shrimp
Halibut
Pollock
Scallops
Whiting
Carp
Crab
Pike, walleye
Tuna, fresh
Catfish, wild
Clams
Fish sticks
Haddock
Lobster
Salmon, red
Snapper, red
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TABLE 18.4
OMEGA-3
FATTY ACIDS
(GRAMS)
0.6
0.5
0.2
0.5
0.5
0.5
0.5
0.5
0.3
0.3
0.3
0.3
0.2
0.2
0.2
0.2
0.2
0.2
0.2
them should be heeded. Large fish (longer than 20 inches) in general contain higher
concentrations of mercury than do smaller fish, so you may want to let the big ones
get away . . .
Fish such as flounder, cod, trout, sole, salmon, tilapia, haddock, pollack, and
“light” tuna—as well as shrimp and shellfish—generally contain low levels of mercury.18 Other sources of DHA and EPA include eggs enriched with omega-3 fatty
acids. The American Heart Association recommends that adults consume two or
more servings of fish per week, or a total of 0.65 gram of DHA and EPA daily.19
Balancing Intake of Omega-6 and Omega-3 Fatty Acids] The ratio of
omega-6 to omega-3 fatty acid intake is important because the functions of one are
adversely modified by the presence of disproportionately high amounts of the other.
Although an exact ratio has not been agreed upon, it is thought that people should
consume omega-6 fatty acids and omega-3 fatty acids in a proportion of roughly 4
(or less) to 1. Many Americans regularly consume vegetable oils but eat fish infrequently. Consequently, the ratio between the intake of omega-6 and omega-3 fatty
acids is over 9 to 1, indicating a need to increase intake of omega-3 fatty acids.20
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Modifying Fats
hydrogenation
The addition of hydrogen to
unsaturated fatty acids.
Unsaturated fats aren’t as stable as saturated fats. They are more likely to turn rancid with time and exposure to air and heat than are saturated fats. Additionally,
solid fats are preferable to oils for some cooking applications. These problems with
unsaturated fats have a solution. It’s called hydrogenation.
What’s Hydrogenation?] Hydrogenation is a process that adds hydrogen to liquid unsaturated fats, thereby making them more saturated and solid. The shelf life,
cooking properties, and taste of vegetable oils are improved in the process. Hydrogenation has two drawbacks, however. Hydrogenated vegetable oils contain more
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trans fats
Unsaturated fatty acids in fats
that contain atoms of hydrogen attached to opposite sides
of carbons joined by a double
bond:
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saturated fat than the original oil. Corn oil, for example, contains only 6% saturated fats; but corn oil margarine has 17%. The other negative is that hydrogenation causes a change in the structure of the unsaturated fatty acids. Specifically,
hydrogenation converts some unsaturated fats into trans fats.
Trans Fatty Acids] Up to 30% of the fatty acids in unsaturated fat molecules may
be converted from their naturally occurring “cis” to the “trans” form as a result of
hydrogenation.21 Fatty acids in this structural form raise blood cholesterol levels
more than dietary cholesterol, saturated fats or any other type of fat do.22 The bulk
of trans fat in our diet comes from hydrogenated vegetable oils. Trans fats are more
stable and have a longer shelf life than other fats and are preferred for use in margarine, snack foods, bakery products, and fried foods (Table 18.5). Ruminant animals like cows form some trans fat in the stomach; so milk, other dairy products,
beef, and lamb contain small amounts of this type of fat. People in the United States
consume an average of 2.6% of total calories from trans fat, or 5.8 grams per day.23
It is recommended that Americans consume as little trans fats as possible,24 and
new nutrition information labeling requirements are making that easier to accomplish. Nutrition Facts panels must include the trans fat content of food products by
January 1, 2006 (Illustration 18.6). The %DV column (for percent of Daily Value)
will not be used for trans fats because there is no recommended level of intake. Products labeled “trans fat–free” must contain less than 0.5 gram of both trans and saturated fats. It is expected that the requirement to label the trans fat content of food
products will increase the number of foods labeled “trans fat–free” and “no trans
fat” (Illustration 18.7) and decrease its use in foods. Food companies are busy developing other ways to produce foods without them.25
H
–CC
H
H H
–CC–
Cis fatty
acid
Trans fatty
acid
Fats containing fatty acids in
the trans form are generally
referred to as trans fats. Cis
fatty acids are the most common, naturally occurring form
of unsaturated fatty acids.
They contain hydrogens
located on the same side of
doubly bonded carbons.
Checking Out Cholesterol
Cholesterol is a lipid found only in animal products.
It is tasteless and odorless and contained in both the
lean and fat parts of animal products. Table 18.6 lists
some sources of cholesterol. Plants don’t contain
cholesterol because they can’t produce it and don’t
need it to function and grow normally.
Sources of Cholesterol
TABLE 18.5
TRANS FATTY ACID CONTENT OF FOOD PRODUCTS.
Values may change as companies lower the
trans fat content of foods.
FOOD
TRANS FATTY ACIDS (GRAMS)
Kentucky Fried Chicken pot pie
8
4–7
Cake doughnut
6
Breaded fish sticks, 3
5
Margarine, 1 tbs
4
Dutch apple pie
3–4
Wheat crackers
3
Chocolate chip cookie
2
The Contributions of Cholesterol
Snack crackers,1 2 oz
2
Shortening, 1 tbs
1
Would you be surprised to learn that cholesterol:
Tub margarine, 1 tbs
1
• is found in every cell in your body?
Butter, 1 tbs
0
• serves as the building block for estrogen,
“No trans fat” margarine
0
Olive oil
0
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French fries, large serving
The cholesterol used by the body comes from two
sources. Most (about two-thirds) of the cholesterol
available to the body is produced by the liver. The
rest comes from the diet (Illustration 18.8). Because
the liver produces cholesterol from other substances in our diet, it does not qualify as an essential nutrient.
testosterone, and the vitamin D that is produced in your skin upon exposure to sunlight?
Nutrition Facts
Serving Size 1 Entree
Serving Per Container 1
Amount Per Serving
Calories 380 Calories from Fat 170
%Daily Value
Total Fat 19g
29%
50%
Saturated Fat 10g
Trans Fat 2g
Cholesterol 85g
28%
34%
Sodium 810mg
Total Carbohydrate 33g 11%
12%
Dietary Fiber 3g
Sugars 5g
Protein 20g
Vitamin A 10%
Calcium 10%
Vitamin C 0%
Iron 15%
Percent Daily Values are based on a 2000
calorie diet. Your daily values may be higher
or lower depending on your calorie needs:
Calories
Less Than
Total Fat
Less Than
Sat Fat
Cholesterol Less Than
Less Than
Sodium
Total Carbohydrate
Dietary Fiber
2000
2500
65g
20g
300mg
2400mg
300g
25g
80g
25g
300mg
2400mg
375g
30g
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Illustration 18.7
Products that feature “no
trans fats” and “trans
fat–free” labels.
Richard Anderson
• cannot be used for energy (so it provides no calories)?
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• is a major component of nerves and the brain?
The body has many uses for cholesterol (Table 18.7). It doesn’t just accumulate in
arteries!
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Illustration 18.6
Trans fat: the newest addition to Nutrition Facts
panels.
Fat Substitutes
The fat content of processed foods can be partially or fully replaced by fat substitutes. Fat substitutes attempt to imitate the taste, texture, and cooking properties of
our favorite fats, but with fewer calories. Table 18.8 lists some of the more than 60
products that are already on the market; others are under development. The degree
to which these products succeed in imitating the qualities of fat varies. Making the
TABLE 18.6
FOOD SOURCES OF CHOLESTEROL.
Note that all the sources are animal products. Cholesterol in foods is a clear, oily liquid
found in the fat and lean portions of many animal products.
AMOUNT
CHOLESTEROL
(MILLIGRAMS)
Brain
3 oz
1746
Liver
3 oz
470
Egg
1
212
Veal
3 oz
128
Shrimp
3 oz
107
Prime rib
3 oz
80
Chicken (no skin)
3 oz
75
ANIMAL PRODUCT
Turkey (no skin)
3 oz
65
Hamburger, regular
3 oz
64
Pork chop, lean
3 oz
60
Fish, baked (haddock, flounder)
3 oz
58
Ice cream
1 cup
56
Sausage
3 oz
55
Hamburger, lean
3 oz
50
Milk, whole
1 cup
34
Crab, boiled
3 oz
33
Lobster
3 oz
29
Cheese (cheddar)
1 oz
26
Milk, 2%
1 cup
22
Yogurt, low-fat
1 cup
17
Milk, 1%
1 cup
14
Butter
1 tsp
10
Milk, skim
1 cup
7
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TABLE 18.7
perfect fat substitute is not an easy task. Not all of the fat substitutes that have
entered the marketplace have met the test of consumer acceptability.28
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HOW THE BODY USES
CHOLESTEROL.
Are Fat Substitutes Safe?
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• Cholesterol is a component of all cell membranes, the brain, and
nerves.
Consumers sometimes wonder about the safety of fat substitutes. Because most fat
substitutes are derived from ingredients of food such as carbohydrates, protein, and
vegetable oils, they are often assumed to be safe. Fat replacers that are made from
substances that do not occur naturally in foods must be tested for safety. Olean, a
non-naturally occurring fat replacer that cannot be digested, was tested extensively
before being approved for use. It can cause diarrhea and oily stools if consumed in
large amounts.29
When substituted for foods containing saturated fats, fat substitutes may benefit
health by lowering blood cholesterol levels. Studies suggest that the use of foods containing fat substitutes reduces total fat consumption, but whether they lead to weight
loss is controversial. So, although they may not be the answer to weight control, fat
substitutes may provide part of the solution to high fat intakes and the health problems related to them.30
Finding Out about the Fat Content
of Food
Other
foods
15%
Fats 5%
Not all of the fat in food is visible. To avoid being fooled, it helps to use
a reference on the fat composition of foods. Table 18.9 lists the fat content of common food sources of fat, including candy. Vegetables and
fruits (except avocado and coconut) and grains are not listed because
they contain relatively little fat. Other references can also be used, such
as the food composition tables in Appendix A, the Diet Analysis Plus
Program software, and the nutrition labels on food products.
Milk and milk
products 15%
Meats 36%
TABLE 18.8
SOME FAT SUBSTITUTES.27
CARBOHYDRATE-BASED
(0–4 CAL/G)
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Amalean I and II
CrystaLean
Instant Stellar
Juguar
Litesse
Maltrin
N-Lite
Oat fiber
Oatrim
Opta Grade
Pure-gel
Sta-Slim
Sta-Lite
PROTEIN-BASED
(1–2 CAL/G)
K-Blazer
Proplus
Simplesse
FAT-BASED
(0–5 CAL/G)
Benefat
Caprenin
Olean
Illustration 18.8
Food sources of cholesterol in
the U.S. diet.26
Percentages indicate the proportion of cholesterol each
type of food contributes to
the diet.
COMBINATIONS
Fitesse
Nutrifat
Prolestra
Photo Disc
Can Fat Substitutes Benefit Health?
• It is needed to produce
estrogen, testosterone,
and vitamin D.
Eggs
(egg yolk)
29%
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Knowledge of the caloric and fat content of a food can be used to calculate the
percentage of calories provided by fat. For example, suppose that a slice of cherry
pie provides 350 calories and 15 grams of fat. To calculate the percentage of fat
calories, multiply 15 grams by 9 (the number of calories in each gram of fat), divide
the result by 350 calories, and then multiply by 100:
15 grams fat 9 calories/gram 135 calories
135 calories/350 0.39
0.39 100 39% of total calories from fat
Fat Labeling
Nutrition labeling regulations for fat require food manufacturers to adhere to standard definitions of “low fat,” “fat-free,” and related terms used on food labels. Similarly, claims made about the cholesterol content of food products must comply with
standard definitions (Table 18.10, on page 18-14). If a claim is made about the fat
content of a food, the Nutrition Facts panel must specify the food’s fat, saturated
fat, trans fat, and cholesterol content. If a claim is made about cholesterol content
(and claims can be made only for products that normally contain cholesterol), the
nutrition panel must also reveal the product’s fat and saturated fat content. To prevent the use of unrealistically small serving sizes as a way to appear to cut down on
a product’s fat content, standard serving sizes must be used on food labels.
TABLE 18.9
THE FAT CONTENT OF SOME FOODS.
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FOOD
Fats and oils
Butter
Margarine
Oil
Mayonnaise
Heavy cream
Salad dressing
Meats and fast foods
Hot dog
Bologna
Sausage
Bacon
Salami
Pork steak
Hamburger, regular (20% fat)
Chicken, fried with skin
Big Mac
Quarter Pounder with cheese
Whopper
Steak (rib eye)
Hamburger, lean (10% fat)
Steak (T-bone), lean
Rabbit
Veggie pita
Ranch chicken pita
AMOUNT
GRAMS
PERCENTAGE OF
TOTAL CALORIES FROM FAT
1 tsp
1 tsp
1 tsp
1 tbs
1 tbs
1 tbs
4.0
4.0
4.7
11.0
5.5
6.0
100%
100
100
99
93
83
1 (2 oz)
1 oz
4 links
3 pieces
2 oz
3 oz
3 oz
3 oz
6.6 oz
6.8 oz
8.9 oz
3 oz
3 oz
3 oz
3 oz
1
1
17.0
8.0
18.0
9.0
11.0
18.0
16.5
14.0
31.4
28.6
32.0
9.9
9.5
8.9
7.0
17.0
18.0
83
80
77
74
68
62
62
53
52
50
48
47
45
44
38
38
34
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THE FAT CONTENT OF SOME FOODS. (CONTINUED)
AMOUNT
GRAMS
PERCENTAGE OF
TOTAL CALORIES FROM FAT
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TABLE 18.9
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Meats and fast foods—continued
Steak (round), lean only
3 oz
5.2
Chicken, baked without skin 3 oz
4.0
Turkey wrap
1
9.0
Hamburger, extra lean
(4% fat)
3 oz
2.3
Venison
3 oz
2.7
Subway, club
6"
5.0
Flounder, baked
3 oz
1.0
Subway, veggie
6"
3.0
Shrimp, boiled
3 oz
1.0
Milk and milk products
Cheddar cheese
1 oz
9.5
American cheese
1 oz
6.0
Milk, whole
1 cup
8.5
1
Cottage cheese, regular
⁄2 cup
5.1
Milk, 2%
1 cup
5.0
Milk, 1%
1 cup
2.7
1
Cottage cheese, 1% fat
⁄2 cup
1.2
Milk, skim
1 cup
0.4
3
Yogurt, frozen
⁄4 cup
0.0–6.6
Other
Olives
4 medium
1.5
1
Avocado
⁄2
15.0
Almonds
1 oz
15.0
1
Sunflower seeds
⁄4 cup
17.0
Peanut butter
1 tbs
8.0
1
Peanuts
⁄4 cup
17.5
Cashews
1 oz
13.2
Egg
1
6.0
Potato chips
1 oz (13 chips) 11.0
Chocolate chip cookies
4
11.0
French fries
20 fries
20.0
Taco chips
1 oz (10 chips)
6.2
Candy
Mr. Goodbar
1.7 oz
15.0
Peanut butter cups, 2 regular 1.6 oz
15.0
Milk chocolate
1.6 oz
14.0
Almond Joy
1.8 oz
14.0
Kit Kat
1.5 oz
12.0
M and M’s, peanut
1.7 oz
13.0
Nestlé’s Crunch
1.6 oz
11.0
Twix
2.0 oz
14.0
Baby Ruth
2.1 oz
14.0
Pay Day
1.9 oz
12.0
Snickers
2.1 oz
13.0
Butterfinger
2.1 oz
12.0
M and M’s, plain
1.7 oz
10.0
Milky Way
2.2 oz
11.0
3 Musketeers
2.1 oz
9.0
Tootsie Roll
2.3 oz
6.0
29
25
24
23
18
14
13
11
10
74
66
49
39
32
24
13
4
0–3
90
84
80
77
76
75
73
61
61
54
49
41
56
54
53
50
47
47
45
45
43
43
42
39
39
35
31
21
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TABLE 18.10
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WHAT CLAIMS ABOUT THE CHOLESTEROL CONTENT OF FOODS THAT NORMALLY CONTAIN
CHOLESTEROL MUST MEAN.
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• No cholesterol or cholesterol-free: Contains less than 3 milligrams of cholesterol
per serving.
• Low cholesterol: Contains 20 milligrams or less of cholesterol per serving.
• Reduced cholesterol: Contains at least 75% less cholesterol than normal.
• Less cholesterol: Contains at least 25% less cholesterol than normal. The percentage less
must be stated on the label.
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Reasons for the Revised
Recommendations for Fat Intake
Several lines of evidence led to the recent changes in recommendations for fat intake.
One line of evidence has taught us that although people tend to lose weight on lowfat diets, people also lose weight on high-fat, low- or high-carbohydrate, and low- or
high-protein diets. Whether people lose weight and keep it off depends strongly on
the acceptability of the dietary changes made, and not on the relative proportions of
fat, carbohydrate, and protein content in the diet that lead to weight loss.31
Fat consumption among Americans decreased from 43% of total calories in
1970 to around 33% of calories in recent years. Yet, the incidence of overweight
and obesity in the United States has increased since 1970. Consequently, it is difficult to argue that high fat diets are at the root of the obesity epidemic.32 As fat
intake has decreased, carbohydrate intake has increased. Scientists are asking the
question about whether high intakes of carbohydrate are related to rising rates of
obesity. Some evidence suggests that consumption of high-carbohydrate diets by
people with low levels of physical activity and obesity may hasten the development
of type 2 diabetes and other disorders related to insulin resistance.33
The experience of groups of people who have traditionally consumed high-fat
diets yet have average or below-average rates of heart and other chronic diseases has
taught us to view fat intake in the context of overall diet and lifestyle.34 A classic
example of the paradox between high-fat diets and low disease rates comes from
Greece and the traditional Mediterranean diet. This diet is based on whole grain
products, vegetables, fruits, nuts, olive oil, dried beans, wine, fish, and poultry (Illustration 18.9). Over 40% of the calories in the diet come from fat, most of which is
provided in the form of monounsaturated fats. People consuming the traditional
Mediterranean diet tend to be physically active and of normal weight or lean. Despite
this diet’s high fat content, populations consuming the diet and living the typical
lifestyle have low rates of heart disease and cancer, and long life expectancy.35
A different example making the point that fat intake and health relationships
should be evaluated in the context of the overall diet and lifestyles come from Nigeria. The Fulani pastoralists of Northern Nigeria subsist on a diet primarily composed of animal blood, meat, and dairy products. It is very high in fat and rich in
saturated fat—yet the Fulani have normal levels of blood lipids and are not at
increased risk for heart disease. The Fulani are highly physically active, lean, and
tend not to smoke.36
Rates of heart disease, cancer, type 2 diabetes, and obesity tend to increase in populations as they move from traditional diets and high levels of physical activity to
Western-type diets and sedentary lifestyles.37 In the new context, the relationship
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Good Fats, Bad Fats
Fats come in many types in foods, and with few exceptions, they serve as a source
of energy and provide a number of essential functions in the body. With regard to
raising or lowering the risk of heart disease and stroke, however, fats differ. Those
that elevate total cholesterol and LDL-cholesterol levels are regarded as “bad” or
“unhealthy” fats. Those that lower total cholesterol and LDL-cholesterol and raise
blood levels of HDL-cholesterol (the one that helps the body get rid of cholesterol
in the blood) are considered “good” or healthy.”39
The list of unhealthy fats includes trans fats, saturated fats, and cholesterol. Fats
labeled bad are generally solid at room temperature and are included in foods such as
high-fat meats and dairy products, hard margarines, shortening, and crispy snack
foods.40 Monounsaturated fats, polyunsaturated fats, alpha-linolenic acid, DHA, and
EPA are considered healthy fats and are present in food in the form of oils (Table 18.11).
Illustration 18.9
A look at the cuisine of the
Mediterranean diet.
REALITY CHECK
Good fats, bad fats
Good fats, bad fats
What foods provide
“healthy” fats
Who gets thumbs up
?
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Paprika:
How can I be wrong?
Low-fat food products are
best for healthy fat
because they contain
almost no fat!
Answers on next page
Butch:
I’m thinking foods like
fish, peanut butter, and
trans fat-free margarine
contain healthy fats.
Photo Disc
between fat intake and health changes—it becomes
similar to the situation in the United States and
Canada. High-fat diets in these two countries are
often high in calories and saturated fat and low in
vegetables, fruits, and whole grain products. General levels of physical activity in these countries tend
to be low, and rates of obesity high. A high-fat,
high-saturated fat diet under these circumstances is
related to increased blood cholesterol levels and the
risk of heart disease.38 New recommendations for
fat intake take into consideration the effects on
health of different sources and amounts of dietary
fat, and the potentially problematic influence of
low-fat diets on increasing carbohydrate intake in
populations that tend to be inactive and obese. Recommendations for fat intake are changing in part
because of evidence pointing to the fact that some
types of fat are better for health than others.
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REALITY CHECK
Low-fat foods contain less fat than the regular version of the foods. But that doesn’t
mean the products contain no fat, or only
good fats. Food sources of fish oils, unsaturated fat, and trans fat-free products provide
the healthy fats. As always, healthy diets
aren’t based on individual foods, they are
based on overall diets. You can emphasize
foods providing healthy fats without feeling
bad about occasionally eating foods branded
with the bad fat label.
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Good fats, bad fats
Good fats, bad fats
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ANSWERS TO
Paprika
Butch
Recommendations
for Fat and Cholesterol Intake
Current recommendations for adults call for consumption of 20–35% of total calories from fat. The AIs (Adequate Intakes) for the essential fatty acid linoleic acid is
set at 17 grams a day for men and 12 grams for women. AIs for the other essential
fatty acid, alpha-linolenic acid, are 1.6 grams per day for men and 1.1 grams for
women. It is recommended that intake of trans fats and saturated fats be as low as
possible while consuming a nutritionally adequate diet. Only a small proportion of
Americans consume too little linoleic acid, but intakes of alpha-linolenic acid tend
to be low. Americans are being encouraged to increase consumption of EPA and
DHA by eating fish more often. In addition, saturated fat intake averages 11–12%
of calories, an amount that increases the risk of heart disease.41
There is no recommended level of cholesterol intake, because there is no evidence to indicate that cholesterol is required in the diet. The body is able to produce
enough cholesterol, and people do not develop a cholesterol deficiency disease if it
TABLE 18.11
HEALTHY AND UNHEALTHY FATS AND EXAMPLES OF FOOD SOURCES.
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HEALTHY FATS
UNHEALTHY FATS
DHA, EPA (omega-3 fatty acids)
fish and seafood
Trans fats
Snack and fried foods, bakery goods
Monounsaturated fats
Olive and peanut oil, nuts, avocados
Saturated fats
Animal fats
Polyunsaturated fats
Vegetable oils
Cholesterol
eggs, seafood, and meat
Alpha-linolenic acid
Soybeans, walnuts, flaxseed
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is not consumed. Because blood cholesterol levels tend to increase somewhat as consumption of cholesterol increases, it is recommended that intake should be minimal.
Although cholesterol intake averages around 250 mg per day in the United States, a
more health-promoting level of intake would be less than 200 mg a day.42
Recent recommendations for fat intake represent an unusually large but necessary change in dietary intake guidance. The rationale for the changes has been developing for years as research results emerged, showing consistent results that
supported the new recommendations. Much remains to be understood about the
effects of dietary fats on health, and how other components of the diet and lifestyle
and genetic traits modify relationships between fat intake and health. A beneficial
by-product of the new recommendations for fat intake is that nutrient and health
relationships are much more likely to be studied in the context of overall diets and
lifestyles in the future.
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The Healthy Fats in Your Diet
FOCAL POINT: Identify your healthy fat food choices.
Are the fats in your diet the
healthy type? Check it out by
answering these questions:
How Often Do You Eat:
Seldom
or Never
1–2 Times
per Week
3–5 Times
per Week
Almost
Daily
1. Sausage, hot dogs, ribs, and
luncheon meats?
2. Heavily marbled steaks or roasts and
chicken with the skin?
3. Soybean products such as tofu
or soynuts?
4. Nuts or seeds?
5. Whole milk, cheese, or ice cream?
6. Soft margarine or olive oil?
7. French fries, snack crackers, commercial
bakery products?
8. Rich sauces and gravies?
9. Fish or seafood?
10. Peanut butter?
FEEDBACK (including scoring) can be found at the end of Unit 18.
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Key Terms
FO
essential fatty acids, page 18-3
hydrogenation, page 18-8
lipids, page 18-2
trans fats, page 18-9
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www.healthfinder.gov
Good source of information on fats, trans
fat, and cholesterol through search terms
such as dietary fat and healthy fats.
www.epa.gov/ost/fish
The Environmental Protection Agency’s site
for looking up national and local advisories
on fish contamination and consumption.
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www.nlm.nih.gov/medlineplus/
dietaryfat.html
Provides a menu that connects you to sites
such as good and bad fats, interpreting
blood lipid profiles, benefits of flaxseed,
and fat substitutes.
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www links
www.nal.usda.gov/fnic
Find out more about fats and fat substitutes from the extensive list of topics covered under the search term “fats.”
www.mayoclinic.org
Healthy fats, bad fats, know your fats, fats
and heart disease, and other topics are
intelligently covered in sites available
through the Mayo Clinic’s home page.
Notes
1. Dietary Reference Intakes, Energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Institute
of Medicine, National Academy of Sciences, Washington, DC: National Academies Press; 2002; and Mensink RP et
al., Effects of dietary fatty acids and carbohydrates on the ratio of serum total
to HDL cholesterol and serum lipids,
Am J Clin Nutr 2003;77:1146–55.
14. Kris-Etherton, New guidelines.
2. Dietary Reference Intakes.
17. Kris-Etherton, New guidelines.
3. Fat in your diet. How low should you
go? www.mayoclinic.com/invoke
.cfm?id=HQ00670, accessed 6/03.
18. Kris-Etherton, New guidelines.
4. Dietary Reference Intakes.
5. Fats: the good and the bad. www
.mayoclinic.com/invoke.cfm?id=NU00262,
accessed 9/03.
6. Connor WE. Importance of n-3 fatty
acids in health and disease. Am J Clin
Nutr 2000;71(suppl):171S–5S.
7. Hepburn FN et al. Provisional tables on
the content of omega-3-fatty acids and
other fat components of selected foods.
J Am Diet Assoc 1986;86:788–93.
15. Stone NJ. Fish consumption, fish oil,
lipids, and coronary heart disease. Am J
Clin Nutr 1997;65:1083–6.
16. Kris Etherton, New guidelines; and
Clarkson TW, Strain JJ, Nutrition factors may modify the toxic action of
methyl mercury in fish-eating populations, J Nutr 2003;133:1539S-43S.
19. Krauss et al., Revision 2000.
20. Kris-Etherton PM et al. Polyunsaturated
fatty acids in the food chain in the
United States. Am J Clin Nutr 2000;71
(suppl):179S–88S.
21. Walsh J. Low fat, no fat, some fat . . .
high fat? Envir Nutr 1998;21(April):1, 6.
22. Krauss et al., Revision 2000.
23. Stuppy P, Transitioning away from trans
fatty acids, Today’s Dietitian 2003;Jan.:
12–14; and Dietary Reference Intakes.
24. Dietary Reference Intakes.
8. Everything you always wanted to know
about those newfangled eggs. Nutr
Today 2003;38:75.
25. Vranico S. PepsiCo sets health-snack
effort. Wall Street Journal 2003, Sept.
23, p. B6.
9. Dietary Reference Intakes.
26. Sabar AF et al. Dietary sources of nutrients among U.S. adults. J Am Diet Assoc
1998;98:537–47.
10. Vanschoonbeek K et al. Fish oil, consumption and reduction of arterial disease. J Nutr 2003;133:657–60.
FO
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11. Krauss RM et al., Revision 2000: a
statement for healthcare providers from
the Nutrition Committee of the American Heart Association, J Nutr 2001;
131:132-46; and Kris-Etherton PM
et al. New guidelines focus on fish, fish
oil, omega-3 fatty acids. AHA Statement. Circulation, 2002;Oct. 18.
12. Kris-Etherton, New guidelines.
13. Connor, Importance of n-3 fatty acids;
and Hepburn et al., Provisional tables.
27. Gershoff SN, Nutrition evaluation of
dietary fat substitutes, Nutr Rev
1995;53:305–13; and Mattes RD, Position of the American Dietetic Association: fat replacers, J Am Diet Assoc
1998;98:463–8.
28. Mattes, Position of the ADA: fat replacers.
29. Bray GA et al. A 9-month randomized
controlled trial comparing fat-substituted
and fat-reduced diets in healthy obese
men: the Ole Study. Am J Clin Nutr
2002;76:928–34.
30. Mattes, Position of the ADA: fat replacers; and Bray et al., A 9-month randomized controlled trial.
31. Olson RE. Dietary fats: friend or foe?
Nutr Notes, American Society of Nutritional Sciences, 2000;Mar.:3.
32. Olson, Dietary fats: friend or foe?
33. Dietary Reference Intakes; and Schwartz
J-M et al., Hepatic de novo lipogenesis
in normoinsulinemic and hyperinsulinemic subjects consuming high-fat, lowcarbohydrate and low-fat, high
carbohydrate isoenergetic diets, Am J
Clin Nutr 2003;77:43–50.
34. Dietary Reference Intakes.
35. Trichopoulou A et al. Adherence to a
Mediterranean diet and survival in a
Greek population. N Engl J Med
2003;348:2599–608.
36. Glew RH et al. Cardiovascular disease
risk factors and diet of the Fulani pastoralists of Northern Nigeria. Am J Clin
Nutr 2001;74:730–6.
37. Hu FB. The Mediterranean diet and
mortality—olive oil and beyond. N Engl
J Med 2003;348:2595–6.
38. Dietary Reference Intakes; and Krauss et
al., Revision 2000.
39. Fats: the good and the bad (www
.mayoclinic.com/invoke.cfm?id=
NU00262); and Kris-Etherton et al.,
New guidelines.
40. Fats: the good and the bad (www
.mayoclinic.com/invoke.cfm?id=
NU00262).
41. Dietary Reference Intakes.
42. Krauss et al., Revision 2000.
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The Healthy Fats in Your Diet
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Nutrition
Feedback for Unit 18
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Give yourself a point for each time you checked the “3-5 Times per Week” or “Almost Daily”
columns for numbers 3, 4, 6, 9, and 10. These foods are sources of healthy unsaturated fats or
DHA and EPA. Take a point away for each time your answer ended up in the same columns for
foods listed in numbers 1, 2, 5, 7, and 8. These foods provide saturated or trans fats. If you have
any points left, your selection of food sources of fat regularly include healthy fats.