II. Efficacy
- Reasonable Cholesterol restriction is most effective
- Study of 444 men with Hyperlipidemia on Low Fat Diet
- 30% fat, 300 mg/day Cholesterol: 5.7% LDL reduced
- 26% fat, 200 mg/day Cholesterol: 13.4% LDL reduced
- 22% fat, 100 mg/day Cholesterol: 8.4% LDL reduced
- 18% fat, 100 mg/day Cholesterol, 13.0% LDL reduced
- Confounders
- Men taking <26% fat had trouble with compliance
- References
III. Types: Low Fat Diet
- New NCEP/ATPIII Guidelines recommend only one diet
- Total calories from fat:25 to 35%
- Saturated fat <7% of total calories
- Examples: Cheese, Whole milk, Red meat
- Includes trans Fatty Acids (some margarines)
- Polyunsaturated fat 10% or less of total calories
- Examples: Olive oil or canola oil
- Monounsaturated fat 20% or less of total calories
- Examples: Corn oil, peanuts
- Saturated fat <7% of total calories
- Carbohydrates 50-60% of total calories
- Complex Carbohydrates preferred
- Examples: Whole grains, fruits, vegetables
- Protein 15% of total calories
- Dietary Fiber: 20 to 30 grams per day
- Cholesterol <200 mg per day
- Total calories from fat:25 to 35%
- Stage I and II listed for historical purposes
- Stage I Diet
- Total calories from fat: <30%
- Total calories from saturated fat: <8-10%
- Total daily Cholesterol: <300 mg/day
- Stage II Diet
- Total calories from fat: <30%
- Total calories from saturated fat: <7%
- Total dietary Cholesterol: <200 mg/day
- Stage I Diet
- Popularized Low Fat Diets (low fat, high Carbohydrate diets)
- Dean Ornish
- Rosemary Conley
IV. Approach: Meat - under 5-6 ounces per day
- Lean Meat
- Poultry without skin
- Fish (not fried) <5-6oz/d
- Cold water fish have unsaturated Omega-3 Fatty Acids
- Omega-3 Fatty Acids have goof effect on lipids
- Decrease Triglycerides
- Minimal effect on LDL
- No effect on HDL
V. Approach: Eggs
- Egg yolks <2-4 per week
- Substitute 2 egg whites for one whole egg in recipes
VI. Approach: Dairy - 2-3 servings per day (Low fat products)
- Skim milk
- Low fat yogurt
- low fat cheese
- Cottage cheese (0-2% fat)
- Frozen yogurt
- Low fat creamer
- Low fat or nonfat sour cream
VII. Approach: Fats and Oils <6-8 teaspoons per day
- Use Unsaturated oils
- Safflower oil
- Sunflower oil
- Corn oil
- Soybean oil
- Canola oil
- Cottonseed oil
- Olive oil
- Peanut oil
- Margarine made from unsaturated oils (soft or liquid)
- Avoid trans Fatty Acids (higher risk of CAD)
- Oomen (2001) Lancet 357:746-51 [PubMed]
- Salad dressings made from unsaturated oils
- Seeds and nuts (e.g. peanut butter)
- Cocoa powder
- Avoid Saturated oils
- Coconut oil or coconut
- Palm kernel oil
- Palm oil
- Milk Chocolate
VIII. Approach: Breads and Cereals >6 servings per day
- Use low fat breads, cereals and grains
- Whole grains
- English muffin
- Bagels
- Cereals
- Oats
- Wheat
- Corn
- Multigrain
- Pasta
- Rice
- Dry beans or peas
- Low fat crackers
- Home baked goods with unsaturated oil and skim milk
- Avoid
- Croissants
- Granola
IX. Approach: Vegetables - 3-5 servings per day
- Avoid fried vegetables
- Avoid Cream sauce
- Avoid Cheese sauce
X. Approach: Fruits - 2-4 servings per day
- Avoid fried fruits
- Avoid Cream sauce
- Avoid Butter sauce
XI. Approach: Sweets and Other Items
- Beverages
- Fruit flavored
- Lemonade
- Punch
- Candy made with sugar, syrup, honey, jam, or preserves
- Candy corn
- Gumdrops
- Hard candy
- Gelatin (e.g. Jell-O)
- Frozen treats
- Frozen yogurt
- Ice milk
- Sherbet or sorbet
- Popsicles
- Low fat cookies, cakes, pies, or pudding
- Contents
- Egg whites or egg substitute
- Skim milk
- Unsaturated oil or margarine
- Examples
- Ginger snaps
- Fig or fruit bars
- Angel food cake
- Contents
- Soups - Avoid high fat contents
- Whole milk
- Cream
- Fats or skin
- Avoid
- Milk Chocolate
- Coconut oil
- Palm oil
- Palm kernel oil
- Commercial pies or cakes
- Doughnuts
- Cream pies