Figuring Out Fat

Your personal "fat allowance" depends on how many calories you take in each day. If you do not have a cholesterol problem and have no coronary heart disease, you can use the general diet in the chart below -- saturated fat should be less than 10 percent of daily calories and total fat no more than 30 percent.

If you have an elevated cholesterol level that needs to be lowered with a specific treatment program but you don't have coronary heart disease, you should begin with the Step I diet -- saturated fat should be 8-10 percent of daily calories and total fat no more than 30 percent.

If you have heart disease, you should go right to the Step II diet -- saturated fat should be less than 7 percent of daily calories and total fat no more than 30 percent. Step II is also for those who do not get enough cholesterol lowering from Step I.

The chart shows examples of upper limits on saturated fat and total fat grams, depending on how many calories you consume each day. For the three diets, the grams of total fat are the same for the various calorie levels, but the saturated fat grams change. Check food product labels to find out the number of fat grams (saturated and total) in each serving.

	General Diet	Step I Diet: Elevated Cholesterol/ No Heart Disease	Step II Diet: Heart Disease	All 3 Diets
Total Calories Per Day	Saturated Fata (in grams)	Saturated Fatb (in grams)	Saturated Fatc (in grams)	Total Fatd (in grams)
1,200	13 or less	12 or less	8 or less	40 or less
1,500	16 or less	15 or less	10 or less	50 or less
1,800	19 or less	18 or less	12 or less	60 or less
2,000	22 or less	20 or less	13 or less	65 or less
2,500	27 or less	25 or less	16 or less	80 or less

^a Amounts are equal to just under 10 percent of total calories
^b Amounts are equal to 9 percent of total calories
^c Amounts are equal to 6 percent of total calories
^d Amounts are equal to 30 percent of total calories (rounded down to the nearest 5)

Now You're Cookin'

Planning and cooking meals aimed at reducing blood cholesterol does not have to be complicated. Here are some suggestions:

• Choose fish, poultry, and lean cuts of meat, and remove the fat and skin before eating. You can eat up to 6 ounces per day.

• Cut down on sausage, bacon, and processed high-fat cold cuts.

• Limit organ meats, such as liver, kidney, or brains.

• Instead of whole milk or cream, drink skim or 1 percent milk. Try nonfat or low fat yogurt and cheeses.

• Instead of butter, use tub or liquid margarine or liquid vegetable oils high in poly- and monounsaturated fats. The softer the margarine, the more unsaturated it is. Softer margarines are also less likely to contain "trans" fats, which appear to raise blood cholesterol but not as much as saturated fat (see box above). Use all fats and oils sparingly.

• Eat egg yolks only in moderation. Egg whites contain no fat or cholesterol and can be eaten often. In most recipes, substitute two egg whites for one whole egg.

• Eat plenty of fruits and vegetables, as well as cereals, breads, rice, and pasta made from whole grains (for example, rye bread or whole wheat spaghetti).

• Broil, bake, roast, or poach foods, rather than fry them.

• Liquid vegetable oils are a good choice for sauteing vegetables, browning potatoes, popping corn, and for making baked goods, and pancakes and waffles.

• Many store-bought packaged foods are high in saturated fats. Read product labels and choose products that are lowest in saturated fat, total fat, and cholesterol. Baked goods have been developed that contain very little saturated fat and no cholesterol. But keep in mind that they still may be high in calories.

• As you plan your meals, remember to create a balanced diet that includes foods from the following basic food groups: breads, cereals, rice, and pasta (6-11 servings daily); vegetables (3-5 servings daily); fruits (2-4 servings daily); milk, yogurt, and cheese (2-3 servings daily); and meat, poultry, fish, dry beans and peas, eggs, nuts, and seeds (2-3 servings daily). Use fats, oils, and sweets sparingly.

A Word About Margarine

You may have heard that margarine has a type of unsaturated fat called "trans" fat. "Trans" fats appear to raise blood cholesterol more than other unsaturated fats, but not as much as saturated fats. "Trans" fats are formed when vegetable oil is hardened to become margarine or shortening through a process called "hydrogenation." The harder the margarine or shortening, the more hydrogenated or saturated it is and the more "trans" fat it has. So buy soft or liquid margarine for spreading or cooking. Also, choose those containing liquid vegetable oil as the first ingredient.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.