Nutrition  Nutrition  Reducing Cholesterol  Fats Glossary (courtesy, NHLBI) 1. Choose foods that are low in saturated fat. All foods that contain fat are made up of a mixture of saturated and unsaturated fats. Saturated fat raises your blood cholesterol level more than anything else that you eat. It is found in the greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils like coconut, palm kernel, and palm oils. The best way to reduce your blood cholesterol level is to choose foods low in saturated fat. One way to do this is by choosing foods such as fruit, vegetables, and whole grain foods naturally low in fat and high in starch and fiber. 2. Choose foods that are low in total fat. Since many foods high in total fat are also high in saturated fat, eating foods low in total fat will help you eat less saturated fat. When you do eat fat, you should substitute unsaturated fat for saturated fat. Unsaturated fat is usually liquid at room temperature and can be either monounsaturated or polyunsaturated. Examples of foods high in monounsaturated fat are olive and canola oils, those high in polyunsaturated fat include safflower, sunflower, corn, and soybean oils. Any type of fat is a rich source of calories, so eating foods low in fat will also help you eat fewer calories. Eating fewer calories can help you lose weight -- and, if you are overweight, losing weight is an important part of lowering your blood cholesterol. 3. Choose foods high in starch and fiber. Foods high in starch and fiber are excellent substitutes for foods high in saturated fat. These foods -- breads, cereals, pasta, grains, fruits, and vegetables -- are low in saturated fat and cholesterol. They are also usually lower in calories than foods that are high in fat. Foods high in starch and fiber are also good sources of vitamins and minerals. Diets low in saturated fat and cholesterol, and high in fruits, vegetables, and grain products -- like oat and barley bran and dry peas and beans -- may help to lower blood cholesterol. 4. Choose foods low in cholesterol. Dietary cholesterol also can raise your blood cholesterol level, although usually not as much as saturated fat. So, it is important to choose foods low in dietary cholesterol. Dietary cholesterol is found only in foods that come from animals. Many of these foods also are high in saturated fat. Foods from plant sources do not have cholesterol but can contain saturated fat. 5. Move it... Be more physically active. Moving it -- being physically active -- helps your blood cholesterol levels; it can raise HDL and may lower LDL. Being more active can also help you lose weight, lower your blood pressure, improve the fitness of your heart and blood vessels, and reduce stress. 6. Lose weight, if you are overweight. People who are overweight tend to have higher blood cholesterol levels than people of desirable weight. And overweight people with an "apple" shape -- bigger (pot) belly -- tend to have a higher risk for heart disease than those with a "pear" shape -- bigger hips and thighs. Whatever your body shape, when you cut the fat in your diet, you cut down on the richest source of calories. An eating pattern high in starch and fiber instead of fat is a good way to lose weight: many starchy foods have little fat and are lower in calories than high fat foods. If you are overweight, losing even a little weight can help to lower LDL-cholesterol and raise HDL-cholesterol. You don't need to reach your desired weight to see a change in your blood cholesterol levels. To lower your blood cholesterol, remember to: Choose foods low in saturated fat and cholesterol; Be more physically active; and Lose weight, if you are overweight. Heart-Healthy Eating: The Step I and Step II Diets All Americans should follow the general rules to lower blood cholesterol. In fact, this is a way that the whole family can eat (except infants under 2 years who need more calories from fat), because these guidelines are similar to those recommended for the general population. And if the whole family eats in this way, it will help you make your blood cholesterol-lowering diet your everyday way of eating. If you have high blood cholesterol, you will have to pay attention to what you eat by following either the Step I diet or Step II diet, as advised by your doctor. Step I Diet On the Step I diet, you should eat: 8-10 percent of the day's total calories from saturated fat. 30 percent or less of the day's total calories from fat. Less than 300 milligrams of dietary cholesterol a day. Just enough calories to achieve and maintain a healthy weight. (You may want to ask your doctor or registered dietitian what is a reasonable calorie level for you.) If you do not lower your blood cholesterol enough on the Step I diet or if you are at high risk for heart disease, your doctor will ask you to follow the Step II diet. If you already have heart disease, you should start on the Step II diet right away. The Step II diet helps you cut down on saturated fat and cholesterol even more than the Step I diet. This helps lower your blood cholesterol even more. Step II Diet On the Step II diet, you should eat: Less than 7 percent of the day's total calories from saturated fat. 30 percent or less of the day's total calories from fat. Less than 200 milligrams of dietary cholesterol a day. Just enough calories to achieve and maintain a healthy weight. (You may want to ask your doctor or registered dietitian what is a reasonable calorie level for you.) To get the full benefits of the Step II diet, you should have help from a registered dietitian or other qualified nutritionist. To find a registered dietitian, contact: The National Center for Nutrition and Dietetics' Consumer Nutrition Hotline at 1-800-366-1655, Your local hospital and/or public health department, or Your doctor. If your levels do not go down enough, you may need to take medicine along with your diet. The recommendations for saturated fat and total fat are based on a percentage of the calories you eat; the actualamount you should eat daily will vary depending on how many calories you eat. See the chart below to get anidea of the number of grams of saturated fat and total fat you should be eating. Counting Saturated Fat and Total Fat on the Step I & Step II Diets If you eat this many calories... 1, 200 1, 500 1, 800 2, 000 2, 500 Your recommended amount of saturated fat (grams)* for each day is... Step I 12 15 18 20 25 Step II 8 10 12 13 17 Your recommended total amount of fat (grams)** for each day is... Step I and Step II 40 50 60 65 80 *Amounts are equal to 9% of total calories for Step I and 6% of total calories for Step II. Remember 1 gram of fat equals 9 calories. **Amounts are equal to 30% of total calories (rounded down to the nearest five); your intake should be this amount or less. Healthy Heart Handbook, Neal Pinckney