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Putting the squeeze on saturates.

If you could make only one change to your diet, what should it be?

Cut back on saturated fat. That's because the evidence is so solid that sat fats increase the risk of heart disease.

Scientists may argue whether the Asian diet (lowfat) is better or worse than the Mediterranean diet (high in monounsaturated olive oil). But they all agree on one thing: both diets are low in saturates.

Yet two stumbling blocks make it difficult for people to eat a diet that's low enough in saturated fat:

* Health authorities have so far refused to tell the public how much--make that how little--saturated fat offers the most protection against heart disease, because they're afraid it will scare people off.

* Even if the experts issued more honest advice, most people wouldn't know how to translate it into tonight's dinner.


How much sat fat should people eat?

If you've been paying attention to the National Cholesterol Education Program (NCEP), the American Heart Association (AHA), or most other health authorities, you'll know their answer: less than ten percent of your calories.

But that's not ideal.

Populations with rock-bottom-low rates of heart disease--like the Japanese fishermen studied in the 1950s--get only three percent of their calories from sat fat.

So do the diets devised by Nathan Pritikin or Dean Ornish, director of the Preventive Medicine Research Institute in Sausalito, California. They're very low in all fats, and even seem to clean out clogged arteries in people who already have heart disease.

No health experts have urged the general public to cut down to three percent. But four years ago, the National Academy of Sciences' Diet and Health report did inch closer. Although it, too, recommended ten percent, the report added: "It is highly likely that a further reduction, to 8 or 7 percent of calories or lower, would confer greater health benefits."

So why doesn't everyone recommend seven or eight percent...or lower? "We're afraid that people won't make any change if it's too drastic," says Scott Grundy, a leading heart disease researcher at the University of Texas Southwestern Medical Center in Dallas who chairs the NCEP's Adult Treatment Panel. The panel's charge is to help physicians treat patients who have high cholesterol.

Last January, 16 heart disease experts signed a letter urging Grundy's panel to recommend that all physicians do what many already do.

"We start people with high cholesterol or coronary artery disease on a diet that is seven percent of calories from saturated fat," says Virgil Brown of the Emory University School of Medicine in Atlanta.

Grundy's panel is likely to advise doctors to first figure out how much sat fat their patients are eating. "If it's 15 to 16 percent," says Grundy, "they should lower to ten percent and see if that's enough."

But that approach has two drawbacks. Even if physicians take the time to analyze a diet questionnaire, it's not clear that they'll get an accurate reading.

What's more, ten percent sat fat doesn't always work. And when that happens, patients are often too discouraged to switch to seven percent.

"It's easier to motivate people to make big changes than little ones," says Dean Ornish. "Moderate changes give patients the worst of both worlds. They feel diet-deprived, but they don't get the positive biological changes, so they feel disappointed."

And if diet fails, the next step is drugs.


Few people expect Grundy's panel to start all patients out on a seven-percent sat fat diet. At best, it may recommend eight to ten percent as a "Step One" diet, and less than seven percent if that fails.

That's some progress. And at least it should clear up the confusion about the current ten-percent advice.

"Many people read ten percent as a target, when it's really an upper limit. Even the American Heart Association has been guilty of this," says Virgil Brown, who is an AHA past president.

"People should be in the seven to ten percent fat range--and below that if they have a problem."

But if the experts are afraid to tell patients to cut sat fat way down, you can imagine how uneasy they feel about telling healthy people to make that change.

"If you ask any dietitian, they'll tell you that it's incredibly tough for a person to stay on a seven-percent saturated fat diet," says Neil Stone of the Northwestern School of Medicine, who chairs the Heart Association's Nutrition Committee. "Because of the [limited] food choices, you'll get an incredibly high dropout rate."

Still, sooner or later health authorities will get up the nerve to tell people the truth: The less saturated fat the better.

But you could start today on a diet that's only seven percent sat fat (or less). To see how, turn the page.

"Squeeze Out the Sat Fat" System

Here are two ways for you to eat no more than seven percent of your calories from saturated fat. Alternative #1 is easier, but you pay for the simplicity by giving up more "splurge" foods than you do with Alternative #2.


Eat only "Free" or "Low Sat Fat" foods

None of them has more than 1 gram of sat fat per serving (after rounding), and many have less than half a gram. So even though most people eat 20 to 25 foods a day, you're unlikely to consume more sat fat than you should.

You can still splurge, but no more than one meal a week. (Splurging more often might be okay, but since you're not counting sat fat grams, you have to play it safe.)


Use the "Target Table"

1. Check the Target Table to find your "Sat Fat Target." If you're a typical eater, about half of the grams in your "Target" will be used up by the 15 to 20 "Free" and "Low Sat Fat" foods you're likely to eat each day. (Each could have up to one gram.)

2. Look for how much of a "Splurge Allowance" you are left with each day.

3. Find your favorite foods in the list of Splurge Foods on p. 7, and splurge away. Of course, if your tastes run to cheese pizza (14 grams) or Haagen-Dazs (16 grams), you may have to save up your "Splurge Allowance" for a couple of days to be able to afford them.

4. Make sure you eat at least five--better yet, eight to ten--servings of fruits and vegetables every day to keep your sat fat low and reduce your risk of cancer.

Splurge Foods
 Low Sat Fat
 (1/2- 1 gram)
 Grain Foods
Bread, whole wheat (2 sl.)
Cookies, Oatmeal raisin, Molasses,
 or Ginger snaps (1 oz.)
Doritos Light (+) (1 oz.)
Graham crackers (1 oz.)
Quaker Chewy Honey & Oats
 Granola Bar (1)
Waffles, frozen (2)
Hash browns, McDonald's (1)
Ruffles Light (+) (1 oz.)
 Dairy Foods
Chocolate pudding (1 can)
Cottage cheese, 1% (1/2 cup)
Ice cream, Sealtest Free(*) (1 cup)
Milk shake, low-fat, McDonald's (1)
 Protein Foods
 Ground beef, Healthy Choice
 Extra Lean
Chicken breast
Hot dog, Healthy Choice or
 Healthy Favorites (1)
Luncheon meats, at least 96%
 fat-free (2 oz.)
Rockfish, Scallops, or Trout
Tuna, canned in oil (2 oz.)
Turkey wing
 Fats, Sweets, and
Salad dressing, Kraft reduced calorie,
except Blue Cheese (2 Tb.)
Margarine, diet (1 Tb.)
Mayonnaise, light (1 Tb.)
Safflower or Canola oil (1 Tb.)
 Mixed Foods
Campbell's Chicken Noodle
 Soup (+) (1 cup)
Lean Cuisine Macaroni & Beef (1)
McDonald's Chunky Chicken
 Salad (1)
McDonald's Hotcakes w/margarine
 & syrup (1 order)
Turkey sandwich w/mustard on
 whole weath or white (1)
Tyson Healthy Portion Herb, Salsa,
 or Mesquite Chicken Dinner (1)
Weight Watchers Spaghetti with
 Meat Sauce (1)
 Medium Sat Fat
 (1-1/2-3 grams)
 Grain Foods (grams)
Bran muffin (1)
Corn or Tortilla chips (1 oz.) 1
Biscuit (1) 2
Pancakes (3)
Brownie with nuts (1) 3
Danish, except cheese (2 oz.)
Dunkin' Donuts doughnut(*) (1)
Pepperidge Farm Milanos (3)
Ore-Ida Crinkle Fries (+) (3 oz.) 2
Potato chips (1 oz., or 14 chips) 3
 Dairy Foods
Cottage cheese, 2% (1/2 cup) 1
Milk, 1% (1 cup) 2
Sherbet (1 cup)
Yogurt, low-fat, fruited (1 cup)
Cheddar cheese, light (1 oz.) 3
Cream cheese, light, tub (2 Tb.)
Milk, 2% (1 cup)
Sour cream (2 Tb.)
 Protein Foods
Salmon, Atlantic or pink 1
Tofu (4 oz.)
Turkey leg
Beef, eye of round 2
Chicken breast, with skin
Chicken drumstick
Pork, tenderloin
Turkey bologna (2 oz.)
Beef, top or bottom round 3
Chicken thigh
Peanut butter (2 Tb.)
Pork, top loin
Turkey breast, with skin
 Fats, Sweets, and
Corn or Olive oil (1 Tb.) 2
Margarine or Mayonnaise (1 Tb.)
 Mixed Foods
Burger King BK Broiler (1) 2
McDonald's Chicken Fajita (1)
Taco Bell Bean Burrito (1)
Tuna salad on whole wheat
 or white (1)
 High Sat Fat
 (4 - 7 grams)
 Grain Foods (grams)
Chocolate cake with chocolate 4
 icing (3 oz.)
Nabisco Striped Chips Ahoy! (2)
Cookies, Girl Scout Samoas (2) 6
French fries, McDonald's (lg.) 5
 Dairy Foods
Ice milk (1 cup) 4
Milk, whole (1 cup) 5
Cheese, Blue, Gouda,
 Provolone, or Swiss (1 oz.)
Dairy Queen Cone, vanilla (reg.)
Cheese, American, Cheddar, 6
 or Colby (1 oz.)
Cream cheese (2 Tb.)
 Protein Foods
Beef, sirloin 4
Beef, top round, untrimmed
Cashews or Peanuts (1/4 cup)
Chicken drumstick, with skin
Chicken McNuggets,
 McDonald's (6)
KFC Original Recipe, breast (1)
Pork loin, center rib
Turkey leg or wing, with skin
Chicken thigh, with skin 5
Beef, eye of round, untrimmed 6
Chicken wing, with skin
Hot dog, beef, Oscar Mayer (1)
Beef bologna (2 oz.) 7
Beef, chuck arm pot roast
Beef, sirloin, untrimmed
Ground beef, extra lean (83% lean)
 Fats, Sweets, and
Thousand Island dressing, 5
 McDonald's (1 packet)
Butter (1 Tb.) 7
Milk chocolate (1.4 oz.)
 Mixed Foods
Burger King Hamburger (1) 4
Kraft Macaroni & Cheese (1 cup)
McDonald's Chef Salad (1)
McDonald's McLean Deluxe (1)
Wendy's Baked Potato w/cheese (1)
Nissin Oodles of Noodles 6
 Chicken (1)
Arby's Regular Roast Beef (1) 7
 Sat Fat
 (8 grams and above)
 Grain Foods (grams)
Coconut cream pie (4.5 oz.) 9
Hostess Iced Honey Bun (1) 10
 Dairy Foods
Ice cream, regular (1 cup) 9
Vanilla shake, Burger King (lg.)
Cheesecake (4.5 oz.) 14
Ice cream, Haagen-Dazs(*) 16
 (1 cup)
Ben & Jerry's Rainforest 17
 Peace Pop (+) (1)
Dairy Queen Heath Blizzard (reg.)
 Protein Foods
Ground beef, 80% lean 8
KFC Extra Tasty Crispy, thigh (1)
Ground beef, regular (73% lean) 9
Porterhouse steak, untrimmed 10
Beef, chuck blade roast 11
Pork, spare ribs, untrimmed 12
Beef short ribs, untrimmed 20
 Fats, Sweets, and
Chocolate mousse (1/2 cup) 19
 Mixed Foods
McDonald's Big Mac (1) 9
Pizza Hut Cheese Pan Pizza,
 medium (2 sl.)
BLT sandwich (2 oz. bacon) 11
McDonald's Quarter Pounder
 w/Cheese (1)
Dairy Queen Hot Fudge 14
 Brownie Delight (1)
Pizza Hut Trad. Hand-Tossed
 Cheese Pizza, med. (2 sl.)
Taco Bell Taco Salad
 without shell (1)
Grilled American cheese 15
 sandwich (2 oz. cheese)
Burger King Whopper 16
 with Cheese (1)
Taco Bell Taco Salad 19
 with shell (1)
Pasta (1 cup) w/Contadina 20
 Alfredo Sauce (1/2 cup)
Burger King Double Whopper 24
 w/Cheese (1)
All meats trimmed and all poultry skinned, unless otherwise
noted. Serving size for meat, poultry, and fish is 4 oz.,
cooked. (*) line average (+) estimate
COPYRIGHT 1993 Center for Science in the Public Interest
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:includes related articles; reducing saturated fat in the diet
Author:Hurley, Jayne
Publication:Nutrition Action Healthletter
Date:May 1, 1993
Previous Article:In search of the whole-y grain.
Next Article:Take the diet quiz.

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