II. Efficacy

  1. Reasonable Cholesterol restriction is most effective
  2. Study of 444 men with Hyperlipidemia on Low Fat Diet
    1. 30% fat, 300 mg/day Cholesterol: 5.7% LDL reduced
    2. 26% fat, 200 mg/day Cholesterol: 13.4% LDL reduced
    3. 22% fat, 100 mg/day Cholesterol: 8.4% LDL reduced
    4. 18% fat, 100 mg/day Cholesterol, 13.0% LDL reduced
  3. Confounders
    1. Men taking <26% fat had trouble with compliance
  4. References
    1. Knopp (1997) JAMA 278:1509-15 [PubMed]

III. Types: Low Fat Diet

  1. New NCEP/ATPIII Guidelines recommend only one diet
    1. Total calories from fat:25 to 35%
      1. Saturated fat <7% of total calories
        1. Examples: Cheese, Whole milk, Red meat
        2. Includes trans Fatty Acids (some margarines)
      2. Polyunsaturated fat 10% or less of total calories
        1. Examples: Olive oil or canola oil
      3. Monounsaturated fat 20% or less of total calories
        1. Examples: Corn oil, peanuts
    2. Carbohydrates 50-60% of total calories
      1. Complex carbohydrates preferred
      2. Examples: Whole grains, fruits, vegetables
    3. Protein 15% of total calories
    4. Dietary Fiber: 20 to 30 grams per day
    5. Cholesterol <200 mg per day
  2. Stage I and II listed for historical purposes
    1. Stage I Diet
      1. Total calories from fat: <30%
      2. Total calories from saturated fat: <8-10%
      3. Total daily Cholesterol: <300 mg/day
    2. Stage II Diet
      1. Total calories from fat: <30%
      2. Total calories from saturated fat: <7%
      3. Total dietary Cholesterol: <200 mg/day

IV. Approach: Meat - under 5-6 ounces per day

  1. Lean Meat
  2. Poultry without skin
  3. Fish (not fried) <5-6oz/d
    1. Cold water fish have unsaturated Omega-3 Fatty Acids
    2. Omega-3 Fatty Acids have goof effect on lipids
      1. Decrease Triglycerides
      2. Minimal effect on LDL
      3. No effect on HDL

V. Approach: Eggs

  1. Egg yolks <2-4 per week
  2. Substitute 2 egg whites for one whole egg in recipes

VI. Approach: Low fat dairy products - 2-3 servings per day

  1. Skim milk
  2. Low fat yogurt
  3. low fat cheese
  4. Cottage cheese (0-2% fat)
  5. Frozen yogurt
  6. Low fat creamer
  7. Low fat or nonfat sour cream

VII. Approach: Fats and Oils <6-8 teaspoons per day

  1. Use Unsaturated oils
    1. Safflower oil
    2. Sunflower oil
    3. Corn oil
    4. Soybean oil
    5. Canola oil
    6. Cottonseed oil
    7. Olive oil
    8. Peanut oil
    9. Margarine made from unsaturated oils (soft or liquid)
      1. Avoid trans Fatty Acids (higher risk of CAD)
      2. Oomen (2001) Lancet 357:746-51 [PubMed]
    10. Salad dressings made from unsaturated oils
    11. Seeds and nuts (e.g. peanut butter)
    12. Cocoa powder
  2. Avoid Saturated oils
    1. Coconut oil or coconut
    2. Palm kernel oil
    3. Palm oil
    4. Milk chocolate

VIII. Approach: Breads and Cereals >6 servings per day

  1. Use low fat breads, cereals and grains
    1. Whole grains
    2. English muffin
    3. Bagels
    4. Cereals
    5. Oats
    6. Wheat
    7. Corn
    8. Multigrain
    9. Pasta
    10. Rice
    11. Dry beans or peas
    12. Low fat crackers
    13. Home baked goods with unsaturated oil and skim milk
  2. Avoid
    1. Croissants
    2. Granola

IX. Approach: Soup - Avoid contents

  1. Whole milk
  2. Cream
  3. Fats or skin

X. Approach: Vegetables - 3-5 servings per day

  1. Avoid fried vegetables
  2. Avoid Cream sauce
  3. Avoid Cheese sauce

XI. Approach: Fruits: -2-4 servings per day

  1. Avoid fried fruits
  2. Avoid Cream sauce
  3. Avoid Butter sauce

XII. Apporach: Sweets

  1. Beverages
    1. Fruit flavored
    2. Lemonade
    3. Punch
  2. Candy made with sugar, syrup, honey, jam, or preserves
    1. Candy corn
    2. Gumdrops
    3. Hard candy
  3. Gelatin (e.g. Jell-O)
  4. Frozen treats
    1. Frozen yogurt
    2. Ice milk
    3. Sherbet or sorbet
    4. Popsicles
  5. Low fat cookies, cakes, pies, or pudding
    1. Contents
      1. Egg whites or egg substitute
      2. Skim milk
      3. Unsaturated oil or margarine
    2. Examples
      1. Ginger snaps
      2. Fig or fruit bars
      3. Angel food cake
  6. Avoid
    1. Milk chocolate
    2. Coconut oil
    3. Palm oil
    4. Palm kernel oil
    5. Commercial pies or cakes
    6. Doughnuts
    7. Cream pies

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