Public Health Recommendations: Lipid Composition of the Diet


Recommendations for athletes regarding fat composition can and should be centered on supporting both long-term cardiovascular health and athletic performance. Science in these areas continues to evolve, pro- viding the basis for the types of dietary lipids athletes should strive to consume regularly during training and competition. Te 2013 report from the ACC/AHA task force provides guidelines for lipid intake based on a large expert panel's comprehensive review of the literature.21


Although the report centers on reduc-


ing risk factors for individuals at the highest risk for having a cardiovascular event, it also suggests that there is moderate to strong evidence that everyone would benefit from an energy intake relatively lower in saturated fatty acids than other dietary fatty acids. To be clear, this message is not to completely avoid sat- urated fat but to limit intake to align with the current AHA guidelines, which recommend less than 10% of total daily calories from saturated fat. Despite these guidelines, not all recommendations from the sci- entific literature or those expressed by the media are consistent with ACC/AHA guidelines. For example, the Dietary Guidelines Advisory Committee (DGAC) recently issued a report that addressed many ques- tions consumers and professionals commonly have regarding dietary fat intake.23


Te report recommended


a universal de-emphasis on saturated fat being classified as a nutrient of concern because the effect of sat- urated fat intake on disease end points is unclear. What is lost in the saturated fat controversy is the consistent message for recommended dietary fat


intake patterns. All organizations appear to agree that there should be a greater emphasis on consuming a larger proportion of MUFAs and PUFAs relative to total fat intake. Tis may be particularly help- ful in supporting cardiovascular health when these fatty acids replace a portion of energy intake from refined carbohydrates and sugar. Most dietary fats should come from monounsaturated or polyunsat- urated food sources as part of a diet emphasizing vegetables, fruits, whole grains, low-fat dairy, and seafood, with lower consumption of red meat and processed meat. Other prudent recommendations for both the general public and athletes are to limit trans fats to less than 1% of total calories and increase dietary intake of essential fatty acids to approximately 5% to 10% and 0.6% to 1.2% of energy for n-6 and n-3, respectively.6 Tese current lipid intake recommendations, on which most organizations seem to agree, not only pro-


mote cardiovascular health in athletes but also support athletic performance. Indeed, carbohydrate needs to support training demands and high-intensity efforts should be addressed first and not centered on high lipid consumption. Although the DGAC suggested that the most effective recommendation for the reducing cardiovascular disease would be to reduce carbohydrate intake and replace it with PUFAs, many athletes may experience performance decrements from following this strategy. Some athletes could instead benefit from reducing their intake of sugar-sweetened beverages (eg, soda) and confections in favor of carbohydrate-containing foods that are nutrient dense and higher in naturally occurring fiber. Widespread recommendation to reduce carbohydrate in favor of lipid intake should be cautioned against. Independent of carbohydrate considerations, there are many opportunities for sports dietitians to impact and influence the fat composition of an athlete’s diet. By increasing the proportion of MUFAs and n-3 PUFAs consumed, athletes may benefit from the metabolic advantages of reduced inflammation and the maintenance of proper vascular function, which may indirectly support athletic performance. Te federal 2015-2020 Dietary Guidelines for Americans provides additional guidance to further refine


our practical recommendations regarding health messages associated with dietary fat intake. In general, the new guidelines focus on the recommendation of limiting saturated and trans fats while concomi- tantly modifying the diet to include more nutrient-dense versions of foods within each food group. Te newest version of the Dietary Guidelines has not changed much from the last publication with regard to saturated fat intake. Te guidelines state that the intake of saturated fats should be limited to less than 10% of calories per day and that these calories should be replaced with unsaturated fats, while keeping total dietary fats within the age-appropriate AMDR. Although the guidelines now state that “oils should replace solid fats rather than being added to the diet,” the mention of solid fat consumption is no longer


CHAPTER 4: DIETARY FAT AND EXERCISE 65


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