Question:

Hello. Both of my cholesterols are borderline, and my doctor and I agreed not to start on any medication. Instead, a low-carb, low-fat diet is what I’m looking forward to doing. What should I look for in food labels? Fat grams? Total fat? Carbs? Trans fat? There’s so much info. I’m confused. How much do I need of what? Thanks.

– Patricia D.

Answer:

Hi Patricia! Exact nutrition targets would depend on your full lipid profile, so you should consider taking your lab results to a Registered Dietitian Nutritionist for a personalized prescription. You’re right that there is so much information – because it is such a complex situation with multiple factors. While I can’t clarify how much YOU need, I can explain which fats and carbs impact each lipid, and what are the major sources of those macronutrients.

  • If total cholesterol is too high AND it is due to the low-density lipoprotein (LDL) or other undesirable components being elevated, then take action to reduce those measures. Having a very high level of the desirable high-density lipoprotein (HDL) could push total cholesterol to a high number, but that situation may not be a concern.
  • If the LDL cholesterol is high, then decreasing total fat, saturated fat, and trans fat while increasing fiber may help reduce LDL.
  • If HDL cholesterol is low, then decreasing trans fat, opting for unsaturated fats, consuming alcohol in moderation, quitting smoking, increasing exercise, and losing extra weight may raise HDL levels.
  • If triglycerides are too high, then decreasing refined carbohydrates and saturated fat, limiting alcohol and increasing omega-3 fat, losing excess weight, and exercising may improve triglycerides.

TOTAL FAT – The daily reference value for total fat in a 2,000-calorie diet is 65 grams per day, representing a limit of 30% calories. Major sources are fried foods, animal products including dairy products, nuts, seeds, avocados, and olives. Oils and butter and pure fat. Some desserts and condiments are nearly all fat calories.

SATURATED FAT – The daily reference value for saturated fat in a 2,000-calorie diet is 20 grams, representing a limit of 10% calories. Saturated fat is the type which is solid at room temperature. Mainly from animal sources, palm and coconut. Major sources include cheese, butter, cream, ground beef, bacon, fatty cuts of meat and foods fried in lard or sautéed in butter.

TRANS FAT – Created during the hydrogenation of vegetable oils, this very harmful fat is found primarily in processed foods and animal products. No known safe amount. In 2015 the FDA stated, “…there is no longer a consensus among qualified experts that partially hydrogenated oils, which are the primary dietary source of industrially-produced trans fatty acids are generally recognized as safe (GRAS) for any use in human food.

UNSATURATED FAT – Monounsaturated and polyunsaturated fats are liquid at room temperature and are predominantly found in plant foods. Avocados, olives, vegetable oils, nuts, and seeds are major sources.

OMEGA-3 FAT – A particular kind of polyunsaturated fat that is predominantly from mackerel, herring, tuna, salmon and trout. Notable sources include other fish and seafood, walnuts, flaxseed, and canola oil.

FIBER – The daily reference value for dietary fiber in a 2,000 calorie diet is 25 grams, representing a minimum of 1.5 grams per 100 calories. Soluble fibers are the type that directly help to reduce cholesterol. Major sources include oats, beans, peas, lentils, apples, pears, barley, and prunes.

REFINED CARBOHYDRATES – Albeit from natural sources, white flour and added sugars are not the same as their wholesome counterparts. Refined carbs include pastries, many cereals, flour tortillas, breading on fried foods, regular pasta, pretzels, and the ingredient maltodextrin.  Added sugars should comprise no more than 10% calories according to the 2015 Dietary Guidelines for Americans. Added sugars can come from sugars (any kind; usually end in “ose”), syrups, glazes, honey, fruit juice concentrate, and molasses in products such as candy, desserts, soft drinks, and sweetened cereals.

ALCOHOL – A moderate consumption of ethanol-containing beverages means 1 drink per day for men and no more than 2 drinks per day for women. A serving size depends on the beverage’s alcohol percentage: 1.5 oz liquor (80 proof = 40% alcohol); 5 oz wine (12% alcohol); 12 fl oz beer (5% alcohol).

Sources:

American Heart Association

  1. http://heartinsight.heart.org/Summer-2015/How-Do-I-Increase-My-Good-Cholesterol/
  2. http://www.my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_425988.pdf

Web MD

  1. https://www.webmd.com/heart/how-to-boost-your-good-cholesterol
  2. https://www.webmd.com/cholesterol-management/lowering-triglyceride-levels#1

Mayo Clinic

  1. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/hdl-cholesterol/art-20046388
  2. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186
  3. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol/art-20045192

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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