Read the whole section from beginning to end, or follow these links to specific questions

That sounds pretty complicated. How much fat can I eat?
What foods are high in fat?
What are some foods that are low in fat and better to eat?
Some specifics of "how to do it"
What about when I go out to eat?
What about margarine? I’ve heard it might be bad.


If it’s not difficult enough to convince someone that they have a disease when their cholesterol is high, the next part is no easier . . . they need to follow that most un-American of programs – a diet. Let’s be honest from the start: no one likes to be told what to do, especially when it’s something we do three times a day and we associate with good times. But, and I’ll be just as honest here, let’s keep an open mind because it’s just not that bad. There are really a lot of ways to still enjoy meal time. It will take a little time to learn, so let’s get started.

The strategy we will use here is one designed to make the biggest differences for most people. Some patients will need a more specific diet to reach their dietary goals and will need to talk to a dietitian.

Things you won’t need to do:

Things you will need to do:

The amount of fat in the diet has a very important role in how all of the fats are digested and metabolized. A proper diet can take care of the vast majority of patients with high cholesterol, and save the expense of medications. Even modest changes in intake have the potential to make a big difference in a patients health outlook. Even patients on medications for cholesterol need to follow a diet.

Watch all fats, not just cholesterol

When we talked about high cholesterol in previous sections, we really concentrated on the levels of total cholesterol, HDL cholesterol, and LDL cholesterol. We’re going to change our focus now that we’re talking about diet and consider ALL fats, particularly saturated fats, in addition to cholesterol.

Total fats and saturated fats are important concepts to remember. It is these items which will drive the metabolism of all fats including cholesterol.

Saturated fats are often high in foods that are high in cholesterol. Foods that are low in cholesterol can be very high in saturated fats, and therefore the label of "No Cholesterol" does not mean the food is OK . . . check the saturated fat content.

The U.S. Departments of Agriculture, as well as Health and Human Services has recommended the following for healthy Americans (Step 1 diet):

For patients with problems with their cholesterol or who have manifest arteriosclerosis, these recommendations
(Step 2 diet) become:

This is not as hard as it may sound. For perspective, the current average American diet is estimated to include 34% of calories from fat, with 12% from saturated fat. Furthermore, the new food labels are required to list the total calories and the calories of fat – you just have to do a little math.

This doesn’t mean every food you eat has to equal 25-30% fat. It just means that your overall diet should equal this amount.

For those who are overweight, this reduction in fat intake will yield another bonanza. Proteins and carbohydrates have only 4 calories per gram. Fat has a whopping 9 calories per gram.

That sounds pretty complicated. How much fat can I eat?

It’s not as difficult as it seems. Let’s do a little math (you’ll only have to do it once, so let’s try it).

First of all, you have to figure your calories to figure your fat intake. Your daily caloric intake to maintain your weight, depending on your activity, is:

Don’t reward yourself for being overweight if you are. Use your ideal weight.

Let’s say you weigh 150 pounds, are moderately active, and are on a Step 1 diet. Your calorie intake should be 150 X 12 = 1800 calories. You can have 30% of your calories as fat, or about 540 calories a day. Each gram of fat contains 9 calories, so 540 divided by 9 = 60 grams of fat. That’s really quite a bit.

What foods are high in fat?

What are some foods that are low in fat and better to eat?

Some specifics of "how to do it"

What about when I go out to eat?

Many patients have found themselves very capable of eating properly at home but quickly fall into old habits when it's time to eat out. During the past 10 years or so, however, restaurants have become more aware that many of their patrons are on restricted diets. There is absolutely no reason to feel uncomfortable about ordering a baked potato and a salad in a fine restaurant. In fact, you can and should, make special requests for foods that are more appropriate to your needs. Keep the following tips in mind when you order a meal:

What about margarine? I’ve heard it might be bad.

Another one of those thorny questions. Margarine is created when liquid oils are partially "hydrogenated", converting some of the unsaturated carbon molecules to saturated. This gives a better taste, and makes the margarine solid at room temperature.

Even though it has some of these saturated fats, it does not contain nearly as much as butter, and has been considered a better alternative. However, a class of fats called "trans-fatty acids" are created which are suspected of reducing HDL cholesterol and raising LDL cholesterol, as well as other negative things. A study of nurses who used margarine and similar foods containing the trans-fatty acids actually showed an increase in mortality.

What’s the right answer? It’s still out. For what it’s worth, I use small amounts of butter.

ęCOPY;1997 HeartPoint  Updated September 1997

There’s really a lot more if you’re still interested in discovering it --Links to Cholesterol section

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