One of the things that stands out for me in my experience teaching nutrition-related programs to individuals and groups is the underappreciation of the damaging effects saturated fat has in promoting heart and vascular diseases.Key aspects of saturated fat and lipoprotein physiology help clarify the matter, allowing you to share this important message with patients.
Saturated Fat: Digestion, Absorption and Utilization
After digestion, saturated fat enters the bloodstream and travels to the liver within a chylomicron (a lipoprotein formed within intestinal epithelial cells). In response, the liver turns on cholesterol production in order to make the very-low-density lipoprotein (VLDL) that transports saturated fat. In turn, the VLDL is secreted into the bloodstream, where the saturated fat is extracted from the VLDL and stored in our fat cells, making us fatter. Some of the saturated fat is extracted from the VLDL by our muscles and burned for energy during light / moderate activity, including aerobic exercise.
As the saturated fat gets removed from the VLDL in this manner, the VLDL then becomes known as LDL, which still contains cholesterol (about 50 percent of the LDL is cholesterol). The LDL particle is then extracted by all the cells of the body and the cholesterol is used to make the cell membrane, and is the building block from which certain tissues make vitamin D, bile acids, estrogen, progesterone, cortisol and other steroidal hormones. However, once the cells of the body have an adequate amount of cholesterol, they close the door to further uptake of cholesterol from the bloodstream.
LDL Cholesterol and Atherosclerosis
The extra cholesterol-rich LDL particles circulate through the bloodstream for 3-5 days, on average, and have a propensity to stick to the walls of the artery, causing narrowing and obstruction to blood flow. As our arteries become more narrowed from this process occurring day after day, it sets us up for a fatal or non-fatal heart attack, stroke, kidney failure requiring dialysis, peripheral vascular disease that may lead to gangrene and amputation, and cerebrovascular disease contributing to dementia.1-2
|Low-Fat Protein Sources and Grams of
Available Protein Per Serving Size
|Food Portion||Protein (grams)|
|Chicken, 3 oz.||27|
|Turkey, three slices (3 ½" x 2 ¾" x 1 ¼")||28|
|Chicken, ¼ broiled||22.4|
|Most fish, 3 oz.||20|
|Tuna, ½ cup||15.9|
|Tuna, 3 oz.||24|
|Kidney beans, ½ cup||7.5|
|Corn, ½ cup||2.5|
|Green peas, ½ cup||4|
|White bread, 1 slice||2|
|Typical breakfast cereal, 1 serving||2-4|
|Tomatoes, 1 medium||1|
|Most fruits, 1 serving||0.3 – 0.8|
|Pasta, 1 cup cooked||7|
|Oysters, six medium||15.1|
|Egg white, one||7|
|Cottage cheese, 5-6 tbsp.||19.5|
|1% yogurt or milk, 8 oz.||8.5|
|Soy milk (low-fat), 8 oz.||4|
|Soy cheese (low-fat), 1 oz.||7|
|Rice, ½ cup cooked||2|
|Green beans, ½ cup||3|
|Baked potato, 1 medium||3|
|Whole-wheat bread, 1 slice||3|
|Saltines, four crackers||1|
|Banana, 1 medium||1.1|
|Bagel, 1 medium||7|
How to Reduce Saturated Fat Consumption in Your Diet
Limit consumption of animal products to skinless chicken and turkey breast, Cornish hen, fish, non-fat or 1 percent milk and yogurt and cheeses that are less than 4 percent milk fat (unfortunately, there aren't many). You should also avoid butter and items prepared with too much palm and coconut oil, and minimize your intake of foods containing hydrogenated and trans fats as well, as they act much like saturated fat. Don't consume deep-fried or heavy pan-fried foods, and use olive oil in salads and to saute or brown foods. As well, even if you have good genetics and your cholesterol is low, eating saturated fatty foods increases the stickiness of your platelets, increasing risk of a thromboembolism or deep vein thrombosis, both of which can be life-threatening.
In the end, limiting your intake of saturated fat is one of the most vital lifestyle choices you can make each day to reduce your risk of vascular diseases.1-6
Getting the Protein You Need Without Saturated Fat
When reducing your intake of saturated fat (as well as trans fats and deep-fried foods), it can be a challenge to still acquire the protein your body needs to support its muscle mass, bone mass, immune system and other functions served by dietary protein. As a rule, most adults require at least 1 gram of protein for every kilogram they weigh. For example, if you weigh 70 kg, then you need to consume at minimum of 70 grams of protein per day (to find your weight in kilograms, divide your weight in pounds by 2.2).
The more physically active and athletic you are, the more protein you require. Thus, most active people require between 1.25 and 1.5 grams of protein per kilogram of body-weight each day.
To help you achieve this goal by consuming protein foods that contain very little saturated fat and trans fats, refer to the table below. Remember that there are also many protein shake mixes in the market place (e.g., whey protein, egg white protein, soy protein) that can help you obtain your protein requirements if you have difficulty reaching your desired protein intake from the foods listed on the following table alone.
Most shake mixes provide 20-25 grams of protein per scoop, with virtually no fat and only a few grams of carbohydrate. Check out the table below and use these foods to acquire the protein your body needs each day. If you still can't get to the desired number of grams your body needs, then consider adding a protein shake to your daily fare to make up the difference.7
Assess Each Patient's Risk
Some researchers argue that saturated fat intake is not related to vascular disease, citing populations that consume moderate to high levels of saturated fat, yet have vascular-related mortality rates lower than would be expected. In regard to this argument, German and Dillard reference the scientific literature indicating that a multitude of risk factors that contribute to vascular disease in addition to LDL cholesterol. They state, "Factors that are known to contribute to this disease include intake of carbohydrates with high glycemic indexes, homocysteine, C-reactive protein, lack of exercise, high blood pressure, a family history of heart disease, oxidative stress, smoking, and obesity and diabetes."6
In addition, in developed countries where smoking rates are high and/or alcohol consumption is moderate, cancer rates tend to be higher; thus, fewer people die from vascular disease.8-9 Finally, it should be recognized that the recent obesity (with extension to diabetes) epidemic in North America has increased mortality rates from vascular disease, cancer and other health problems.10
In a comprehensive sense, the rise in LDL cholesterol levels due to saturated fat intake is a major contributing factor to premature atherosclerosis and related vascular disease, but other lifestyle and genetic risk factors also contribute to the overall risk profile. Practitioners should perform a global vascular disease risk assessment and provide patients with a lifestyle program involving diet, exercise, supplementation, weight reduction if necessary, and stress reduction. The program should be customized to each patient's unique risk profile and aimed at helping them lower their risk for premature heart disease, stroke and related vascular problems. In most cases, helping the patient consume less saturated, trans fats and cholesterol is a significant component of the lifestyle plan.
- Shils ME, et al. Modern Nutrition in Health and Disease, 10th Edition. Lippincott Williams & Wilkins 2006:96-110.
- Katan MB, Zock PL, Mensink RP. Dietary oils, serum lipoproteins, and coronary heart disease. Am J Clin Nutr, 1995;61(suppl):1368S-73S.
- Esselstyn Jr. CB. Resolving the coronary artery disease epidemic through plant-based nutrition. Preventive Cardiology, 2001;4:171-177
- Castelli WP, Garrison RJ Wilson PW, et al. Incidence of coronary heart disease and lipoprotein cholesterol levels: the Framingham study. JAMA, 1986;256(20):2835.
- Grundy SM. "Dietary Fat: At the Heart of the Matter. Science, 2001;293:801-2.
- German JB, Dillard CJ. Saturated fats: what dietary intake? Am J Clin Nutr, 2004;80;3:550-559.
- Colgan M. Optimum Sports Nutrition. Advanced Research Press, 1993:143-166.
- "Health Statistics: Heart Disease Deaths (Most Recent) by Country." NationMaster.com, online source of world statistics and country comparisons.
- "Health Statistics: Death From Cancer (Most Recent) by Country." NationMaster.com.
- "The Obesity Crisis in America." Office of the Surgeon General, U.S. Dept. of Health and Human Services, 2003.
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