88


Chapter 5 Macronutrients


Fat Components and Cardioprotective Nutrition Therapy


Total Fat, Saturated Fat, and Trans Fat


• Tailor the cardioprotective eating pattern to the indi- vidual’s needs to provide a total fat intake of 25% to 35% of calories, with less than 7% from saturated fat and trans fats. Trans fat should be as low as pos- sible and cholesterol should be less than 200 mg/d. (See Chapter 4 and Table 4.1 on pages 66–67 for a summary of the controversy regarding recommenda- tions for dietary cholesterol.) The majority of total fat should be from unsaturated fat sources. For individu- als at appropriate body weight, saturated fat calories can be replaced by unsaturated fat and/or complex car- bohydrates. This can decrease low-density lipoprotein cholesterol (LDL-C) values up to 16% and decrease risk of coronary heart disease (CHD) and CHD risks. (lipid disorder [LD], Strong)7


• Replace saturated fat calories with complex carbo- hydrates contributed by fruits, vegetables and whole grains, protein, and/or unsaturated fat. For overweight or obese clients, where the goal is reduction of total energy, reduction rather than replacement of saturated fat calories may be warranted. (LD, Strong)7


• Persons with diabetes are encouraged to consume a cardioprotective eating pattern within the recom- mended energy intake. (DB, Strong)4


Omega-3 Fatty Acids


• Encourage food sources of marine-derived omega-3 fatty acids, preferably from fish, to reduce risk of cardiovascular disease (CVD). For clients without


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