Diet & Disease > The ABC'S of Hearty Nutrition

The ABC'S of Hearty Nutrition

Heart awareness programmes are not new to the public. The Ministry of Health as well as various health-related organisations like Nutrition Society of Malaysia, Malaysian Dietitian's Association and Yayasan Jantung Malaysia have conducted talks, healthy cooking demos and seminars to teach the public how to keep their hearts ticking well. 


In spite of all these education and nutrition awareness programmes, heart disease still remains the number one killer in Malaysia. The 1996 Malaysian Vital Statistics Report indicated that heart disease and disease of pulmonary circulation constitute 26% of the total certified deaths in government hospitals in the country. In 1997, 75% of cases admitted to Ministry of Health Hospitals were cases of heart disease and diseases of pulmonary circulation. The Ministry of Health's Lifestyle Campaign which focused on heart disease in 1991 has educated the population at large but still need to be sustained in the future. Worldwide, heart disease accounts for one out of every four deaths. Of the multiple contributors to heart disease, genetic and dietary factors appear to be most important.

 

If you ask Malaysians to name the top two dietary villains, they are most likely to say "fats and cholesterol". Diets high in fats and cholesterol relate to high rates of heart disease. Before we jump to any conclusions though, let us look into the ABC's of hearty nutrition. 

Facts about Fats 
Fats are also known as lipids. Lipids include all types of fats and oils. The physical difference between fats and oils is due to their chemical structure. Fats provide a concentrated source of energy. Fats carry the essential fatty acids, the fat soluble vitamins and certain phytochemicals. They increase the flavour and palatability of foods. Fats provide sustained relief from hunger and serve as a component of cell membrane. 

A Glossary of Fats 
Fats are divided into the following types: 

Triglycerides: A glycerol molecule with three fatty acids attached to it. Sometimes it is known as triacylglcerol. 

Saturated Fat: Fat with single bond fatty acids where the carbon is saturated with hydrogens. Saturated fats tend to be solid at room temperature. Animal sources i.e. dairy products, meats, milk and coconut oil are chief sources of saturated fat. 

Unsaturated Fat: Fat with fatty acids containing carbon-carbon bond(s) where the carbon is not saturated with hydrogens. Unsaturated fats tend to be liquid at room temperature and are found in practically all foods that we eat, namely plants, vegetable oils, meat and dairy products.

Cholesterol: A fat-like waxy component found in animals and in very low levels in plants. The body uses cholesterol to form hormones such as testosterone and estrogen and as a component of animal cell membranes. The recommended amount of cholesterol intake per day is less than 300mg. 

Monounsaturated Fat: Fat that contains a fatty acid in which one carbon bond is not saturated with hydrogen. Examples of monounsaturated fat are olives, canola, cashew nuts and peanuts. 

Polyunsaturated Fat: Fat that contains a fatty acid in which two or more carbon-carbon bonds are not saturated with hydrogens. Polyunsaturated oils tend to lower total blood cholesterol levels. Examples of polyunsaturated oils are soyabean oil, corn oil and sunflowerseed oil. 

Trans fatty Acids: Trans fatty acids (TFA) are formed during a process called hydrogenation. This is a process that adds hydrogen to liquid unsaturated fats, thereby making them more saturated and solid (hardened). The shelf life, cooking properties and taste of vegetable oils are improved in the process. Without hydrogen, there will be no margarine or shortening produced from vegetable oils. However, hydrogenation has two drawbacks. Hydrogenated vegetable oils contain more saturated fat than the original oil and it causes a change in the structure of the unsaturated fatty acids. Corn oil for example, contains 6% saturated fatty acids but corn oil margarine has 17%. Trans fatty acids are worse than the cholesterol-raising fatty acids and are therefore positively associated with the development of heart disease. They are also found in baked products such as biscuits, etc. Palm oil however, has an advantage, as the oil has semi-solid properties and therefore does not need hydrogenation. 

Well, now that you are aware of the chemistry of fat, let us go to the practical application of usage of fat in your daily life. Based on the Guidelines for Dietary Management of Hyperlipidemia 1999*, it is recommended that in order to reduce or maintain your cholesterol level, you should:-

  • Keep your total calories from carbohydrates to 50-60%. Excessive intake of carbohydrates can increase the level of triglycerides.

  • Go for complex carbohydrates that include brown rice, chapatti, wholemeal bread, oat bran and corn.

  • Increase fiber intake gradually to minimise discomfort.

  • Enjoy 5 servings of fruits and vegetables daily.

  • Choose lean cuts of meats, eat chicken without the skin and fat, and cut down on chicken wings and feet.

  • Enjoy more servings of fish, legumes and pulses such as lentils and tofu more often.

  • Enjoy 2-3 eggs per week (including hidden eggs too).

  • Drink low or non-fat milk.

  • Keep your total calories from fat less than 25-30%.

  • You can achieve this by reducing intake of coconut milk and other fried foods in your diet.

  • Use unsaturated oil in small amounts in your cooking. Try to reduce your intake of saturated fats such as ghee, coconut milk, butter and others.

  • Be aware that dietary cholesterol taken in excess can raise the level of LDL cholesterol (or "bad" cholesterol).

  • Limit your intake of prawns, crabs, squids and shellfish to once a week and in smaller quantities.

  • Discourage yourself from taking organ meats and offal.

  • Minimise the use of hydrogenated fats, which thus reduces the level of trans fatty acid in your diet.

  • Margarine containing trans may be used sparingly but not to replace cooking oil.

  • Limit the use of salt by avoiding rich sources of sodium such as salted fish, pickles, belacan and commercial sauces.

*Source: 2nd Consensus Statement On Management of Hyperlipidaemia

- By Mary Easaw 
Chief Dietitian, National Heart Institute, Member of the Nutrition Society of Malaysia & the Malaysian Dietitian's Association, Chairperson of the Guidelines for the Dietary Management of Hyperlipidemia 1999.

 

In spite of all these education and nutrition awareness programmes, heart disease still remains the number one killer in Malaysia. The 1996 Malaysian Vital Statistics Report indicated that heart disease and disease of pulmonary circulation constitute 26% of the total certified deaths in government hospitals in the country. In 1997, 75% of cases admitted to Ministry of Health Hospitals were cases of heart disease and diseases of pulmonary circulation. The Ministry of Health's Lifestyle Campaign which focused on heart disease in 1991 has educated the population at large but still need to be sustained in the future. Worldwide, heart disease accounts for one out of every four deaths. Of the multiple contributors to heart disease, genetic and dietary factors appear to be most important.

 

If you ask Malaysians to name the top two dietary villains, they are most likely to say "fats and cholesterol". Diets high in fats and cholesterol relate to high rates of heart disease. Before we jump to any conclusions though, let us look into the ABC's of hearty nutrition.

 

Facts about Fats

 

Fats are also known as lipids. Lipids include all types of fats and oils. The physical difference between fats and oils is due to their chemical structure. Fats provide a concentrated source of energy. Fats carry the essential fatty acids, the fat soluble vitamins and certain phytochemicals. They increase the flavour and palatability of foods. Fats provide sustained relief from hunger and serve as a component of cell membrane.

 

A Glossary of Fats

 

Fats are divided into the following types:



Triglycerides: A glycerol molecule with three fatty acids attached to it. Sometimes it is known as triacylglcerol.

 

Saturated Fat: Fat with single bond fatty acids where the carbon is saturated with hydrogens. Saturated fats tend to be solid at room temperature. Animal sources i.e. dairy products, meats, milk and coconut oil are chief sources of saturated fat.

 

Unsaturated Fat: Fat with fatty acids containing carbon-carbon bond(s) where the carbon is not saturated with hydrogens. Unsaturated fats tend to be liquid at room temperature and are found in practically all foods that we eat, namely plants, vegetable oils, meat and dairy products.

 

Cholesterol: A fat-like waxy component found in animals and in very low levels in plants. The body uses cholesterol to form hormones such as testosterone and estrogen and as a component of animal cell membranes. The recommended amount of cholesterol intake per day is less than 300mg.

 

Monounsaturated Fat: Fat that contains a fatty acid in which one carbon bond is not saturated with hydrogen. Examples of monounsaturated fat are olives, canola, cashew nuts and peanuts.

 

Polyunsaturated Fat: Fat that contains a fatty acid in which two or more carbon-carbon bonds are not saturated with hydrogens. Polyunsaturated oils tend to lower total blood cholesterol levels. Examples of polyunsaturated oils are soyabean oil, corn oil and sunflowerseed oil.

 

Trans fatty Acids: Trans fatty acids (TFA) are formed during a process called hydrogenation. This is a process that adds hydrogen to liquid unsaturated fats, thereby making them more saturated and solid (hardened). The shelf life, cooking properties and taste of vegetable oils are improved in the process. Without hydrogen, there will be no margarine or shortening produced from vegetable oils. However, hydrogenation has two drawbacks. Hydrogenated vegetable oils contain more saturated fat than the original oil and it causes a change in the structure of the unsaturated fatty acids. Corn oil for example, contains 6% saturated fatty acids but corn oil margarine has 17%. Trans fatty acids are worse than the cholesterol-raising fatty acids and are therefore positively associated with the development of heart disease. They are also found in baked products such as biscuits, etc. Palm oil however, has an advantage, as the oil has semi-solid properties and therefore does not need hydrogenation.

 

Well, now that you are aware of the chemistry of fat, let us go to the practical application of usage of fat in your daily life. Based on the Guidelines for Dietary Management of Hyperlipidemia 1999*, it is recommended that in order to reduce or maintain your cholesterol level, you should:-

 

  • Keep your total calories from carbohydrates to 50-60%. Excessive intake of carbohydrates can increase the level of triglycerides.
  • Go for complex carbohydrates that include brown rice, chapatti, wholemeal bread, oat bran and corn.
  • Increase fiber intake gradually to minimise discomfort.
  • Enjoy 5 servings of fruits and vegetables daily.
  • Choose lean cuts of meats, eat chicken without the skin and fat, and cut down on chicken wings and feet.
  • Enjoy more servings of fish, legumes and pulses such as lentils and tofu more often.
  • Enjoy 2-3 eggs per week (including hidden eggs too).
  • Drink low or non-fat milk.
  • Keep your total calories from fat less than 25-30%.
  • You can achieve this by reducing intake of coconut milk and other fried foods in your diet.
  • Use unsaturated oil in small amounts in your cooking. Try to reduce your intake of saturated fats such as ghee, coconut milk, butter and others.
  • Be aware that dietary cholesterol taken in excess can raise the level of LDL cholesterol (or "bad" cholesterol).
  • Limit your intake of prawns, crabs, squids and shellfish to once a week and in smaller quantities.
  • Discourage yourself from taking organ meats and offal.
  • Minimise the use of hydrogenated fats, which thus reduces the level of trans fatty acid in your diet.
  • Margarine containing trans may be used sparingly but not to replace cooking oil.
  • Limit the use of salt by avoiding rich sources of sodium such as salted fish, pickles, belacan and commercial sauces.
  •  

*Source: 2nd Consensus Statement On Management of Hyperlipidaemia

By Mary Easaw
Chief Dietitian, National Heart Institute, Member of the Nutrition Society of Malaysia & the Malaysian Dietitian's Association, Chairperson of the Guidelines for the Dietary Management of Hyperlipidemia 1999.

 











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