Low fat is out and healthy fats are in. Heres how to make heart-smart choices.
The American Heart Association recently revised its Heart Check food certification program in a way many people might find surprising: When it comes to qualifying for the red checkmark labeling, some fats are now OK. The changes reflect the evidence that monounsaturated and polyunsaturated fats are part of a heart-healthy diet. Foods such as nuts and fish that are high in these healthy fats, while low in unhealthy saturated fat, can now receive the associations sign of approval.
We know that consumers have relied on the American Heart Associations Heart Check mark to easily identify heart-healthy foods for more than 15 years, said spokesperson Rachel Johnson, PhD, RD. Adding nuts, fish and other foods that are rich sources of good fats, monounsaturated and polyunsaturated fats, enhances the program and gives more healthy options consumers can choose with the same trust factor.
That guidance may be welcome. A recent survey found that while Americans are getting the message that not all fats are bad for you, many are still confused about which to choose. The 2011 Consumer Attitudes about Nutrition Survey, conducted by a soybean industry group, reported that only 9% of the 1,000 people surveyed still think reducing all fats is the best strategy. But just one-third correctly identified monounsaturated and polyunsaturated fats as healthier choices. Nearly 1 in 10 wrongly called saturated and trans fats very or somewhat healthy. Similar confusion reigned over butter versus margarine and spreads, with 54% picking butter (high in saturated fat) as healthier than margarine and spreads, which are typically made from vegetable oils and are high in polyunsaturated or monounsaturated fat and low in saturated fats. At least consumers do get it about heart-healthy omega-3 fats, with 79% rating them as healthy.
The oversimplified low fat is healthier message reigned in the American consciousness for decades, says Alice H. Lichtenstein, DSc, director of Tufts HNRCA Cardiovascular Nutrition Laboratory-with unfortunate results. Simply eating less fat doesnt improve your diet if you replace fat with carbohydrates such as sugar or refined grains; you could actually be increasing your risk of heart disease.
The emphasis should be on displacing saturated fat and trans fat with unsaturated fat, particularly polyunsaturated fat, because that is what the data supports in terms of heart health, says Lichtenstein. Moderate-fat diets-if the fat is unsaturated, as in liquid vegetable oil-are actually better heart-wise than low-fat diets, especially compared to diets high in refined carbohydrates.
We need to stop worrying about individual dietary components, Lichtenstein adds. Its the whole package that makes the difference. So, even though polyunsaturated fat is heart-healthy, that doesnt mean its a good idea to douse everything with vegetable oil.
Lichtenstein says, If you add something healthy to the diet, you need to take something out, preferably something that is less healthy-otherwise you add calories, hence weight gain. For most individuals, that should be avoided.
Saturated vs. Un-
So how do you make smart choices about fats and oils, in the context of an overall healthy diet? If you remember nothing else about fats as you go to the grocery store, keep in mind this rule: Pick cooking oils that are liquid at room temperature. (What about spreads? See the box on the next page.)
Saturated fats, mostly obtained from animal sources, are solid at room temperature, like butter, or are found in animal foods such as meat and dairy. Foods from plants that contain saturated fat include coconut, coconut oil, palm oil and palm kernel oil-often called tropical oils-and cocoa butter.
Monounsaturated fats and polyunsaturated fats, typically derived from plants, are liquid at room temperature. Indeed, the chemical manipulation required to make them solid and thus more convenient and stable is what led to the invention of partially hydrogenated vegetable oils-trans fats, which we now know are at least as unhealthy as saturated fats. Monounsaturated and polyunsaturated fats are primarily found in liquid vegetable oils such as soybean, corn, safflower, canola, olive and sunflower. The especially heart-healthy omega-3 fats, such as those found in fish, are also polyunsaturated fats.
Does the type of fat really make a difference to your health? A 2010 analysis found that replacing saturated fat with polyunsaturated fat reduces the risk of heart disease. The review of randomized clinical trials concluded that those who switched from saturated to polyunsaturated fat cut their risk of coronary heart disease by 19% compared to control groups. For every 5% increase in calories from polyunsaturated fat, while reducing saturated fat, heart disease risk dropped by 10%.
Other studies have touted the benefits of monounsaturated fat, such as in canola and olive oil, which is also a key component of the so-called Mediterranean diet shown to have a variety of health benefits. The Optimal Macronutrient Intake Trial for Heart Health (OmniHeart), for example, found that replacing a high-carbohydrate diet with one rich mostly in monounsaturated fat improved cholesterol and other lipid levels and reduced blood pressure.
As long as you avoid saturated and trans fats, does it matter for cardiovascular health whether you opt for monounsaturated fats versus polyunsaturated fats? Tufts Lichtenstein advises, The current thinking is that polyunsaturated fat is better than monounsaturated fat, but that may be a bit like splitting hairs. The important thing to remember is to displace sources of saturated and trans fat with unsaturated fat, and always keep calories in check.
- Substitutions Encouraged
Keeping calories in check means not overdoing it even with healthy fats. All fats and oils contain about 90 calories per tablespoon (9 per gram). The American Heart Association advises:
- Consume a diet in which 25%-35% of calories come from fat, primarily unsaturated fats.
- Limit saturated fat intake to less than 7% of total calories.
- Limit trans fat intake to less than 1% of total calories.
For example, a sedentary woman who is age 55 or older needs about 1,600 calories each day. So she should consume less than 12.4 grams of saturated fat, less than 1.8 grams trans fat and between 44 and 62 grams of total fat each day, with most of it coming from sources of polyunsaturated and monounsaturated fats, such as liquid vegetable oils, fatty fish, nuts and seeds.
Knowing exactly how many calories you consume in a day-much less keeping track of calories from each type of fat-can be a challenge, however. Thats why the best strategy is to follow an overall healthy eating pattern. If you eat more fruits, vegetables, whole grains and fish while limiting meats and added sugar and keeping an eye on portion size, youll naturally tend to consume a healthy mix and amount of fats. Pick low- or no-fat dairy products and avoid fried foods, too. Use liquid vegetable oils when preparing foods. And when you do eat meat, go for leaner cuts lower in saturated fat.
During the 1990s we became afraid of fat, which led us to overconsume refined carbohydrates, Lichtenstein concludes. In the 2010s the emphasis is on healthy fats and calorie balance. You can eat the healthiest diet we can configure, but if it is eaten in excess of energy needs, the positive effects are going to be greatly diminished.
Buying cooking oil is relatively straightforward, but buying a spread when you dont want the saturated fat found in butter can be mind-boggling. All claim to taste buttery, most boast about zero trans fats, and some brag about their olive oil or canola oil content. A few even contain omega-3s or plant sterols/stanols.
To guide you through the spread maze at the supermarket, weve assembled a list of the most popular brands and their leading options-plus butter and stick margarines, for comparison. They are listed here in ascending order of total saturated plus trans fat; keep in mind, though, that labeling rules allow products containing up to 0.5 gram trans fat to claim zero. Where a complete breakdown of fats is available, weve also listed polyunsaturated and monounsaturated fats.
Other Considerations: Omega-3s-Some brands also tout their content of heart-healthy omega-3s, although most contain only the plant-derived ALA, which the body converts inefficiently to the omega-3s found in fish oil (DHA and EPA). Among those brands that disclose specific amounts of ALA, those with the most (400 mg/Tbsp or more) are: Imperial Soft Margarine, Promise Light, Promise Buttery Spread, I Cant Believe Its Not Butter Sticks and Original, Promise activ Light, Olivio Original Spread, I Cant Believe Its Not Butter Olive Oil and Olivio Spreadable Butter. Only two of the brands in our chart list DHA/EPA omega-3s-Smart Balance Omega-3 and Smart Balance HeartRight Light; at 32 mg per tablespoon each, youd have to eat 34 tablespoons to get the amount in three ounces of salmon.
Plant Sterols-Proven to improve cholesterol levels (see story on page 1 of this issue), these compounds are listed as ingredients in four spreads: Smart Balance HeartRight Light (1.7 g), Promise activ Light (1 g) and Benecol Spread and Light (0.85 g each).
Dietary Cholesterol-Most spreads contain no dietary cholesterol, which is in any case a less-important factor in blood cholesterol levels than saturated fat. A tablespoon of butter contains 31 mg of cholesterol; only those brands labeled as butter or spreadable butter on our chart contain more than 5 mg, and all contain less than plain butter.