CD-ROM Today 1996 January

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$Unique_ID{BRK01755} $Pretitle{} $Title{Cholesterol Control: A Lifetime Plan, part II} $Subject{Cholesterol high blood pressure pressures heart disease diseases Cigarette smoking diet dietary dieting dieter dieters diets animals fats fat blocked arteries artery LIPOPROTEINS LIPOPROTEIN low-density high-density very LDL HDL VLDL SATURATED UNSATURATED MONOUNSATURATED POLYUNSATURATED OMEGA-3 HYDROGENATED Cigarettes smoke circulatory system intermediate-density IDL} $Volume{Y-0} $Log{ How Cholesterol Levels Affect the Arteries*0002701.scf HDL Transports Cholesterol Back to the Liver*0002702.scf Exercise Increses HDL*0002703.scf Exercise Lowers Triglycerides and Raises HDL*0003203.scf The Effects of Smoking*0007301.scf Glossary*0174201.tid} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. Health Update by Dr. Allan Bruckheim Cholesterol Control: A Lifetime Plan, part II ------------------------------------------------------------------------------ DIETARY FATS: THE GOOD, THE BAD, AND THE UGLY The kinds and amounts of fats you eat can have a greater impact on your blood cholesterol than any single other factor. To add to the confusion, there are three different kinds of dietary fats. Cholesterol and saturated fats (those that are solid at room temperature) increase blood cholesterol. Certain unsaturated fats may help lower blood cholesterol levels by helping rid your body of LDL cholesterol. CHOLESTEROL: Like humans, other animals also produce cholesterol. It is heavily concentrated in egg yolks and organ meats like liver, and it is also found in meat, milk and other dairy products, poultry and seafood. Only animal products contain cholesterol. It does not occur naturally in fruits, grains or vegetables, although nonmeat and nondairy products can contain high levels of fat. Prepared foods, such as crackers or bakery goods, may contain high-cholesterol ingredients, such as lard, eggs or butter. SATURATED FATS: Cutting back on saturated fats is the single most important dietary change you can make to lower your blood cholesterol levels. The liver converts saturated fats from your diet into LDL ("bad" cholesterol). These fats raise your blood cholesterol more than anything else in your diet. One exception is stearic acid, contained in some low-fat spreads. This fat is technically saturated, but it does not appear to raise cholesterol levels in the blood. Foods that are high in cholesterol also tend to be high in saturated fat. Meat, butter, cheese, whole milk, cream and ice cream are high in both saturated fats and cholesterol, for example. Saturated fat also "hides" in certain vegetable products. Coconut oil, cocoa butter (found in chocolate), palm kernel oil and palm oil are high in saturated fat. These "tropical" vegetable oils are used in many commercially prepared foods, including cereals, baked goods (such as, breads, crackers, cakes and cookies), candies, snacks, nondairy creamers and whipped dessert toppings. Many manufacturers are replacing high-saturated-fat tropical oils with healthier alternatives. Check labels carefully when you shop to be sure the food is low in saturated fats--not just cholesterol. For example, nondairy creamers made with tropical oils may have more saturated fat than the dairy product they replace. UNSATURATED FATS: You should substitute unsaturated fats for saturated fats whenever possible. Unsaturated fats can help to lower your blood cholesterol levels. There are two types of unsaturated fat: polyunsaturated and monounsaturated MONOUNSATURATED FATS: Olives, canola (rapeseed), peanuts and avocados contain oils that are high in monounsaturated fats. Several scientific studies suggest that monounsaturated oils like olive oil lower LDL (or "bad") cholesterol without lowering HDL (or "good") cholesterol. POLYUNSATURATED FATS: This is the oil predominantly found in corn, soybean, safflower, sunflower, sesame and cottonseed oils. Foods containing these oils are healthier than their saturated alternatives: for example, corn oil margarine instead of butter. OMEGA-3 FATTY ACID: A special type of polyunsaturated fat, omega-3 fatty acid, is found in fish, especially salmon and mackerel. There has been a lot of publicity that omega-3 fatty acid can protect you from heart disease. The scientific research is not yet conclusive, and large quantities of omega-3 fatty acids can be harmful. Most doctors recommend that you put fish fat in your diet by eating fish in its natural form, rather than by taking omega-3 fatty acid supplements. HYDROGENATED FATS: Hydrogenation is a chemical process that makes unsaturated fat more solid at room temperature. Shortenings and margarines are made of partially or totally hydrogenated fats--for example, hydrogenation changes corn oil into corn margarine. The problem is that hydrogenation converts heart-healthy unsaturated fat into its heart-harmful saturated counterpart. When buying margarine, look for products that list liquid oil or stearic acid instead of hydrogenated oil as the first ingredient. Partially-hydrogenated fats are preferable to completely hydrogenated ones. Tub margarines are usually the best bet, but check the list of ingredients to be sure. EATING YOUR WAY TO A HEALTHY HEART The average American eats much more fat than the body needs to function. We need only one to two teaspoons of fat a day, but most of us eat six to eight teaspoons' worth. Most people get between 40 percent and 45 percent of their total daily calories from fat. Ideally, according to nutrition experts, you should limit total fat intake to 30 percent of your total daily calories, with no more than 10 percent coming from saturated fat. A bonus of a low-fat diet is that it will help you cut calories as well. Foods that are high in fat are also high in calories, because fats have twice as many calories as do either carbohydrates or proteins. CUT BACK ON FAT: Eating saturated fat raises your cholesterol level more than twice as much as does eating cholesterol itself. This is probably because saturated fat stimulates your body to produce more cholesterol. Keeping track of the different kinds of fat can be confusing. At first, just concentrate on reducing the total amount of fat in your diet. EAT NUTRITIOUS, HIGH-FIBER FOODS: You should also eat plenty of foods that are high in complex carbohydrates, like cereals, whole grains, fruits, and vegetables. These foods provide you with important nutrients and they are rich in dietary (soluble) fiber. Dietary fiber can bind to and remove some of the fat and cholesterol in your system. A word of caution: suddenly increasing your fiber intake can cause digestive problems, including bloating and gas, so add new fiber to your diet gradually. PREPARE FOODS HEALTHILY: Even heart-healthy foods can be made less healthy if they're improperly prepared. Bake, broil, poach, steam or microwave food instead of cooking it with oil, butter or cream. Herbs and spices, lemon juice, wine, low-fat yogurt, crushed tomatoes, and orange or pineapple juice are just a few of the flavorings that can impart delicious, nongreasy flavors to a variety of meats and vegetables. TIPS TO MAKE YOUR DIET SUCCEED It's not easy to change ingrained eating habits. Here are some tips on making changes that you can live with. Make changes gradually instead of making drastic overnight changes that will be hard to follow. Instead, try changing one aspect of your diet at a time. For example, you might start by switching from whole milk to low-fat dairy products. The next step might be to substitute fish and poultry for red meat, or to change your usual breakfast of bacon and eggs to cereal and fresh fruit. Plan your meals and snacks ahead of time, and shop wisely. Keep your kitchen stocked with tasty low-fat foods so it's easy for you to follow your diet plan. Avoid buying foods you can't resist that aren't on your diet. If another member of the family insists on them, keep them in a separate cabinet where they'll be "off limits" to you. Eat a well-balanced diet. A wholesome diet means eating something from each of the four food groups. Many people think that a cholesterol-lowering diet means they should cut out all dairy and meat products. The problem is that the calcium and protein these foods contain are vital to your health. Instead of eliminating them, opt for small portions and low-fat forms. For example, use low-fat yogurt instead of sour cream, or a small broiled pork chop instead of a big plate of spare ribs. Don't completely deprive yourself of the fatty foods you love, just limit their intake. Half a cookie tastes as good as two. Budget your saturated fat calories for the day so you can make choices about how to use them. For example, skip the grilled cheese sandwich for lunch and enjoy a bowl of ice cream after dinner. When you eat out, look for low-fat dishes prepared the way you would cook them at home--that is, baked, broiled, or poached. Ask if the food comes with a sauce--if it does, ask to have it served on the side. Even if the menu Says "no substitutions," most restaurants will give you skim milk instead of cream for your coffee, cole slaw instead of french fries, and so forth. Get smart about nutrition. Your doctor may have materials about a low-fat diet, and your local library will have books on nutrition and health. Local organizations such as the American Heart Association or your county health department can also suggest sources of reliable information. Don't cheat on saturated fats. An occasional indulgence won't hurt if you stay within your total allowance, but regular excesses will do damage. You may be able to fool yourself that you're staying within your limit, but you won't be able to fool your blood cholesterol level. THE LIFETIME APPROACH TO CHOLESTEROL CONTROL Effective cholesterol control requires lifestyle changes that you adopt not just temporarily but for a lifetime. The lifetime plan for a healthy heart includes exercise, weight loss, stress control, and a diet that is low in total fat and cholesterol and high in fiber and vital nutrients. This plan can be followed by every member of your family. Healthier eating habits will not only lead to healthier hearts but also protect you and your family against cancer and other nutritionally related diseases. Besides cutting back on saturated fats and cholesterol, make sure you get aerobic exercise on a regular basis. Quit smoking and lose weight if you need to. Make these lifestyle changes gradually, one step at a time. Don't try to give up cigarettes, cut back on cholesterol and start an aerobic exercise program all at once. The goal is to make permanent changes that last a lifetime. An occasional taste of a favorite high-fat or high-cholesterol food won't raise your blood cholesterol levels, but slipping back into your old patterns will. The lifetime approach to cholesterol control also requires regular monitoring of your blood cholesterol levels. Everyone over age 20 should have their cholesterol level checked; children's levels should be checked if either parent has a genetic tendency toward high blood cholesterol. If your blood cholesterol levels are desirable, continue a good diet to prevent them from rising, and have your cholesterol retested within five years. If the levels are borderline, start a cholesterol-lowering diet and have your levels retested within one year. If your levels are high, or if you have any additional risk factors for coronary heart disease, your physician or other health-care professional can advise you about an individualized program of follow-up treatment based on your particular needs. ------------------------------------------------------------------------------ This booklet has been researched by Margot Embree Fisher, with Dr. Robert DeMarco serving as contributing editor and medical consultant. Though all the information contained in this booklet is up to date as we go to press, research in this field is ongoing. Your physician is your first line of defense against any disease and should be consulted for the answers to the special questions that concern you individually. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.