Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
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74 <strong>Alternative</strong> <strong>Cardiovascular</strong> <strong>Medicine</strong><br />
makes new recommendations for energy, carbohydrates, fiber, fat, fatty<br />
acids, cholesterol, protein, and amino acids. The DRI Report embraces<br />
the philosophy of making dietary recommendations that assure a nutritionally<br />
adequate diet, promote good health, prevent chronic disease,<br />
and avoid overconsumption. Recommendations suggest that adults<br />
should consume a diet that provides 45% to 65% of their calories from<br />
carbohydrates, 10% to 35% from protein, and 20% to 35% from fat. The<br />
report advises that saturated fat, trans fat, and cholesterol be as low as<br />
possible. Because polyunsaturated fatty acids (PUFAs) are essential<br />
nutrients, the DRI Report recommends 17 g/d for men and 12 g/d for<br />
women of linoleic acid (C18:2), an omega-6 PUFA. For α-linolenic acid<br />
(ALA), an omega-3 fatty acid, 1.6 and 1.1 g/d should be consumed by<br />
men and women, respectively. The recommendations for PUFA are<br />
based on average intakes in the United States. For simplicity, the report<br />
recommends that 5% to 10% of calories come from PUFA and 0.6% to<br />
1.2% come from ALA. Importantly, approx 10% of omega-3 fatty acid<br />
intake can come from long-chain, highly unsaturated fatty acids,<br />
eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Because<br />
of the total fat recommendation and the guidance provided about<br />
saturated fat, trans fat, and PUFA intake, the balance will be derived<br />
from monounsaturated fatty acids (MUFAs). The range of total fat from<br />
20% to 35% of calories recognizes that healthy diets can be planned over<br />
a reasonably broad range of fat intake, as long as saturated fat, trans fat,<br />
and cholesterol are kept as low as possible. This range in total fat reflects<br />
the health benefits of unsaturated fat in the context of a nutritionally<br />
adequate diet that promotes a healthy weight. The range of all macronutrients<br />
acknowledges that there are many healthy diets with respect to<br />
macronutrient profiles, as long as each diet meets the specific recommendations<br />
made in the DRI Report for saturated fat, trans fat, cholesterol,<br />
total fiber (38 g/d for men and 25 g/d for women), and added sugar (a<br />
maximum of 25% or fewer calories from added sugars).<br />
Although the DRI Report for macronutrients is made for healthy populations,<br />
it is consistent with the latest guidelines from the National Cholesterol<br />
Education Program Adult Treatment Panel (ATP) III (2) for<br />
primary and secondary prevention of coronary heart disease (CHD).<br />
These treatment guidelines target low-density lipoprotein (LDL) cholesterol,<br />
as well as other major risk factors for CHD. ATP III recommends<br />
a diet that provides fewer than 7% of calories from saturated fat<br />
and fewer than 200 mg of cholesterol per day. In addition, up to 10% of<br />
calories from PUFA and up to 20% of calories from MUFA are allowed.<br />
A total fat recommendation of 25% to 35% of calories is also made in<br />
ATP III. Collectively, both ATP III and the DRI Report have made