Complementary Alternative Cardiovascular Medicine

86 Alternative Cardiovascular Medicine
in MUFA and both classes of PUFA. Table 1 presents a summary of
major food fatty acid sources; fats frequently are incorporated into foods
and not consumed in isolation. Additional information about the fatty
acid profile and cholesterol and energy content of different fat-containing
foods is shown in Table 2, which provides more detailed information
about the type and quantity of fat found in popular fat-containing foods.
Notable differences are evident, including the amount of total fat, all
fatty acid classes, cholesterol, and energy. Tables 3 to 5 present information
about the trans fat, cholesterol, and CLA content of certain foods
that are high in these constituents. Note that the trans fat content of
certain margarines, commercial peanut butter, and special cholesterollowering
margarines is low. Table 6 shows the fatty acid profile of nuts
and seeds, all of which are good sources of unsaturated fat. The American
Heart Association 2000 Dietary Guidelines recommend achieving
a desirable cholesterol profile by limiting foods high in saturated fat and
cholesterol and substituting unsaturated fat from vegetables, fish, legumes,
and nuts. The ATP III report provides some examples of how to achieve
a higher fat level with the guidelines of the TLC diet. Some strategies
include using peanuts and almonds to replace carbohydrate calories.
Two menus are presented in Table 7 that show the range in fat recommendations
(from 20% to 35% of calories) that can be implemented to
promote heart health. They demonstrate how simple substitutions in a
low-fat diet can result in a moderate fat diet that is low in saturated fat,
trans fat, and cholesterol. Moreover, both dietary patterns are representative
of those that can be implemented readily in the United States.
SUMMARY
There has been a shift in the recommendation about total fat that has
redirected the emphasis from a low-fat to a moderate-fat message. It is
clear that healthy fats have benefits that result from their unsaturated
fatty acid profile, as well as other bioactive constituents. There is a range
of recommended levels of fat that can be incorporated in a heart-healthy
diet. The new recommendations for total fat provide flexibility in diet
planning. The option of varying fat level in a diet on an individual basis
should promote adherence to a healthy diet. To effectively individualize
implementation of the total fat recommendation requires a good understanding
of how to incorporate different amounts of total fat into a hearthealthy
diet that meets nutrient and energy needs.