HEART Insight:
doi: 10.1097/01.HEARTI.0000429708.00193.b4
Features: Nutrition Know-How

Face the Fats

Gordon, Sandra

Free Access

Whether you're curled up with a good book or running to catch a plane, your heart works hard for you—a healthy one beats 100,000 times and pumps about 2,000 gallons of blood each day. To help it do its job and keep it healthy, take stock of the fat in your diet.

Conventional wisdom once held that the heart-healthiest diets were practically fat-free. But that notion has changed in recent years. Today, a more moderate approach prevails. “A diet that's lower in fat protects against heart disease,” says Kristie J. Lancaster, Ph.D., R.D., associate professor of nutrition at New York University in New York City. In other words, you need some fat in your diet. In fact, up to 35 percent of your daily calories can come from fat and still qualify as a heart-healthy diet, especially if it's the type of fat that helps reduce the risk of heart disease. The fat you consume can strongly affect the cholesterol in your blood and the tendency for plaque to build up in your arteries over the long run, more so than the amount of fat you eat.

Considering that plenty of not-so-healthy options are just a drive-thru away, though, we could all use a little inspiration and guidance. To beat heart disease, use these fat strategies to put up a food fight.

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To help keep your arteries clear, steer clear of saturated fat. It's solid at room temperature and is typically found in animal products such as beef, veal, lamb, pork, lard, poultry fat, butter, cream, milk, cheese and other dairy products made from whole or 2 percent milk. Limit trans fat, too, which is processed vegetable oil to which hydrogen (hydrogenation) has been added to make it more solid and give it a longer shelf life. Commercially prepared fried foods and baked goods and other processed foods are often loaded with saturated fat, trans fat and calories, which can contribute to weight gain and increase your risk for heart disease.

Both of these “bad” fats raise your body's level of total and “bad” low-density lipoprotein, or LDL, cholesterol. When too much LDL cholesterol circulates in the blood, it can slowly build up on the walls of arteries feeding your heart and brain, forming thick, hard plaque deposits that can narrow arteries and make them less flexible. This is called atherosclerosis, which can lead to coronary heart disease and stroke. Trans fat also lowers “good” high-density lipoprotein, or HDL, cholesterol, making it doubly bad for your heart. HDL cholesterol may reduce plaque buildup by ushering excess cholesterol from cells and artery walls back to the liver, where it's passed from the body.

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Cook with “good” fats. Put olive, canola, corn or safflower oil on your grocery list. These unsaturated fats are liquid at room temperature and come from plants. Use them instead of saturated and trans fats like butter, shortening, lard and hard stick margarine in cooking and baking. Unsaturated fats don't raise LDL cholesterol and may even help lower it if you also eat less trans and saturated fat. According to the results of a study recently published in the medical journal Lipids, people who replaced some of the saturated fat in their diet with polyunsaturated fat—a type of unsaturated fat found in soybean, corn and safflower oil as well as in fatty fish like salmon, mackerel, herring and trout—reduced their risk of coronary heart disease by about 10 percent.

Use healthier spreads. Use liquid margarine or soft tub margarine instead of butter or hard stick margarine on your morning toast. Liquid/soft margarine is made with less hydrogenated fat than hard stick margarine. The best margarine choices contain “0 g trans fat” on the Nutrition Facts label. If you can't stand the thought of a bagel or toast without butter, “just spread a very thin layer,” Lancaster says.

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Avoid fried foods and ready-made baked goods, such as French fries, doughnuts, pastries, cookies and crackers. These high-fat foods are typically made with shortening or partially hydrogenated oils; such trans fats may account for up to 50 percent of the fat they contain. Saturated fat may make up the rest. Instead, look for processed foods made with non-hydrogenated oil such as canola or olive oil and 0 grams of trans fat. For easy ways to read food labels and spot the fats you need—and avoid the ones you don't—visit heartinsight.com to read our online bonus article, “Label Lingo: Deciphering % Daily Value.” But keep in mind that many foods that are high in trans fat, such as fast food, don't have labels.

Remember that less is more. Because fat is calorie dense—1 gram of fat packs 9 calories compared to just 4 calories for a gram of protein or carbohydrate—it adds up fast. Good fats have just as many calories as bad fats (120 calories per tablespoon), so go easy to avoid weight gain. Too much fat, especially around your mid-section, increases your risk for high blood pressure, high cholesterol and diabetes. That's why substitution is so important; you want to add healthful fats to your diet while subtracting not-so-healthful ones to keep your daily calorie intake on an even keel.

Choose lean meat. Pick skinless poultry and look for little to no marbling on red meat. Trim all visible fat from meat before cooking. Consider eating a meatless meal at least once a week.

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Look for the Heart-Check Mark

Wondering how to know which foods are heart healthy without spending hours reading every nutrition label? The Heart-Check mark makes it easy to spot heart-healthy foods in the grocery store or when dining out. Simply look for the name of the American Heart Association along with our familiar red heart with a white check mark on the package or menu. But not all red hearts you see are from the American Heart Association; look for the AHA name to be sure. When you spot the American Heart Association's Heart-Check mark, you'll instantly know the food has been certified to meet our guidelines for a heart-healthy food. It's a good first step in creating an overall sensible eating plan. For more information, visit heartcheckmark.org.

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Fish, especially cold-water fish like salmon, albacore tuna, mackerel and herring, are rich in heart-healthy omega-3 fatty acids. These fatty acids, which are a type of unsaturated fat, are amazing multi-taskers because they simultaneously combat several heart disease risk factors. They help reduce the rate of plaque buildup, decrease triglycerides and slightly lower blood pressure. Foods such as soybeans, walnuts and flaxseed also contain omega-3 fatty acids. The American Heart Association recommends eating two 3-ounce fish meals per week. A six-ounce serving of salmon, herring or tuna provides a gram or more of healthy omega-3s.

Add an easy-to-make fish like salmon to your weekly menu. (Sorry, deep-fried fish fillets don't count.) If you're new at cooking fish, try this basic preparation: Rub fish with olive oil, season with salt and pepper and bake at 400° F until opaque throughout, about 15 to 20 minutes. In general, eating heart-healthy isn't about making drastic change all at once. It's a growing process: Once you find a fish recipe you like that's easy to prepare, add another. And so on.

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While it's true that dietary cholesterol, or cholesterol that comes from food, doesn't affect your blood cholesterol as much as saturated and trans fats can, the dietary cholesterol in egg yolks can add up. A typical yolk contains 185 milligrams of dietary cholesterol. This is about 62 percent of the daily limit of 300 milligrams, and it may contribute to high levels of LDL in your body. Still, an egg can be heart healthy if your LDL cholesterol is normal and you limit cholesterol from other sources, such as meat, poultry and dairy products. In which case, “Having a couple of eggs a week isn't going to hurt,” Lancaster says. If you already have high cholesterol, however, try to eat less than 200 mg of dietary cholesterol daily.

Work in more whites. If you're an egg lover or cook with eggs often, keep your dietary cholesterol intake low by using just the egg whites or opting for commercially prepared egg substitutes whenever possible. In baking, replace each whole egg with two egg whites and a tablespoon of canola or safflower oil to moisten the texture.

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While you're making healthier choices to reduce saturated and trans fat and subbing in unsaturated fat, load half your plate with fruits and vegetables, which help reduce the risk of heart disease. The AHA recommends eating at least 4½ cups of fruit and vegetables each day. Filling half your plate with produce ensures that you're getting lots of the good stuff, like heart-healthy antioxidants and fiber, while crowding out meat and other sources of saturated fat, trans fat and cholesterol.

Sneak ‘em in. Can't seem to find room in your diet for a whole orange or an extra serving of green beans? Add fruits and vegetables to foods you already eat. Top off your morning cereal or yogurt with fruit. Add pureed fruit to homemade breads, cakes and cookies. Add vegetables to sauces, stews, meatloaf, pizza and soup. Store cut-up vegetables and fruit at eye level in the fridge so they're the first thing everyone sees when you open the door.

Raise the salad bar. A trip to the salad bar is a convenient way to come close to or even meet your daily produce quota in one meal. But watch out for salad dressing—a sneaky source of saturated fat. Sprinkle on a little oil-based salad dressing like Italian on salads instead of creamy types like Ranch and blue cheese. At home, make your own vinaigrette with olive or canola oil and a flavorful vinegar. Nuts and seeds are high in heart-healthy unsaturated fat, so go ahead and sprinkle some on your salad.

For more ideas on cooking with the right fats, check out the AHA's Low-Fat, Low-Cholesterol Cookbook. It features more than 200 easy-to-prepare dishes and contains the latest information on the role of trans and saturated fat (including nutritional values for every recipe). It's available at your local bookstore or on amazon.com.

© 2013 by the American Heart Association