Major Contributors of Dietary Saturated Monounsaturated and Polyunsaturated Fatty Acids and Cholesterol

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The major types of dietary fats and oils are generally broken down on the basis of animal and plant sources. The relative balance of animal and plant foods is an important determinant of the fatty acid profile of the diet. However, with the increasing prominence of processed, reformulated, and genetically modified foods, it is becoming more difficult to predict the fatty acid profile of the diet on the basis of the animal verses plant distinction.

According to the National Health and Nutrition Examination Survey (NHANES) recall data from 1999-2000, the 10 major dietary sources of saturated fatty acids in US diets are regular cheese (6.0% of the total grams of saturated fatty acids consumed), whole milk (4.6%), regular ice cream (3.0%), 2% low-fat milk (2.6%), pizza with meat (2.5%), French fries (2.5%), Mexican dishes with meat (2.3%), regular processed meat (2.2%), chocolate candy (2.1%), and mixed dishes with beef (2.1%). Hence, the majority of saturated fatty acids are contributed by regular dairy products (16%), and the top 10 sources contribute 30% of the total saturated fatty acids consumed. The increased prevalence of fat-free and low-fat dairy products provides a viable option with which to encourage a populationwide decrease in saturated fat intake. To put the value of decreasing populationwide intakes of saturated fat into perspective, it has been estimated that the isocaloric replacement of 5% of energy from saturated fatty acids with complex carbohydrate, on average, would reduce total cholesterol levels by 10mg/dl (0.26mmol/l) and LDL cholesterol by 7mg/dl (0.18mmol/l). For a person at moderately high risk of developing cardiovascular disease with a total cholesterol level of 220 mg/dl (5.69 mmol/l) and LDL cholesterol level of 140mg/dl (3.62mmol/l), such a dietary modification would decrease total and LDL cholesterol levels by 4.5 and 5%, respectively. Each 1% decrease in total cholesterol levels has been associated with a 2% reduction in the incidence of coronary heart disease. Using this example, that would theoretically translate into a 9% decrease in cardiovascular disease risk. However, it is important to note that decreasing the saturated fatty acid content of the diet should not necessarily be done by displacing fat with carbohydrate. As discussed in the next section, the quantity of dietary fat, relative to carbohydrate and protein, also impacts on blood lipid levels and lipoprotein profiles.

The 10 major dietary sources of monounsaturated fatty acids in US diets are French fries (3.3% of the total grams of monounsaturated fatty acids consumed), regular processed meat (2.5%), regular cookies (2.5%), regular miscellaneous snacks (2.4%), pizza with meat (2.4%), regular salad dressing (2.4%), regular cheese (2.3%), Mexican dishes with meat (2.3%), sausage (2.1%), and mixed dishes with beef (2.1%). There is little change in total or LDL cholesterol levels from the isocaloric replacement of monounsaturated fatty acids by complex carbohydrate. However, it is important to note that approximately one-half of the monounsaturated fatty acids consumed in the United States come from animal fats. Therefore, a decrease in saturated fatty acid intake would be predicted to decrease mono-unsaturated fatty acid intake unless vegetable oils high in monounsaturated fatty acids, such as canola or olive oil, replaced the animal fat.

The 10 major dietary sources of n-6 polyunsatu-rated fatty acids in US diets are regular salad dressing (8.8% of the total grams of polyunsaturated fatty acids consumed), regular white bread (4.2%), regular mayonnaise (3.0%), French fries (2.6%), regular cake (2.5%), regular cookies (2.1%), mixed dishes with chicken and turkey (2.1%), regular miscellaneous snacks (2.0%), regular potato chips (2.0%), and fried fish (2.0%). The distribution of polyunsaturated fatty acids among commonly consumed foods is wide. It has been estimated that the isocaloric replacement of complex carbohydrate with polyunsatu-rated fatty acids for 5% of energy, on average, will reduce total cholesterol levels by 5 mg/dl (0.13 mmol/l) and LDL cholesterol by 4 mg/dl (0.11 mmol/l). For a person at moderately high risk of cardiovascular disease with a total cholesterol level of 220mg/dl (5.69mmol/l) and LDL cholesterol level of 140mg/dl (3.62mmol/l), such a dietary modification would decrease total and LDL cholesterol levels by 2.1 and 3.6%, respectively, and potentially result in a 4% decrease in cardiovascular disease risk.

The 10 major dietary sources of cholesterol in US diets are fried eggs (16.6% of the total milligrams of cholesterol consumed), regular eggs including scrambled eggs (8.4%), mixed dishes with eggs (4.5%), mixed dishes with beef (2.9%), whole milk (2.6%), regular cheese (2.5%), fried fish (2.3%), mixed dishes with chicken and turkey (2.3%), lean cut meat (2.1%), and regular processed meat (2.1%). Eggs or foods high in eggs contribute approximately 30% of the total dietary cholesterol intake. It has estimated that reducing cholesterol intakes by 200 mg/day, on average, will reduce total cholesterol levels by 5mg/dl (0.13mmol/l) and LDL cholesterol by 2.6mg/dl (0.10mmol/l). Such a change would be predicted to have a similar risk effect as displacing 5% of energy as carbohydrate with polyunsaturated fatty acids—that is, reducing cardiovascular disease risk by approximately 4%.

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