From an energy source to athletic performance to chronic disease risk, dietary fat is a complex topic to cover with clients. On the one hand, dietary fat is essential to health; on the other, too much of the “wrong” type of fat can be detrimental. And if we were to add another hand, it would be that fat is confusing — from reading nutrition labeling to making the right food choices. As with many intricacies of nutrition, it can be challenging for our clients to take science to the grocery store and ultimately, the kitchen — where it matters the most.
Health authorities say what?
Rules on dietary fat can be particularly difficult to apply. There is polyunsaturated fat, monounsaturated fat, saturated fat, and trans fat, and it’s often confusing knowing which type of fat is best. There may also be several types of fat in a single food item, which contributes to more confusion. In addition, limitations on what can be listed on the nutrition facts panel and conflicting messages from the media and health community add to the challenge. Never mind what the media says, even the health and fitness community has several recommendations for how much and what type of fat we should choose, and unfortunately, few recommendations for how this should be implemented.
Dietary Fat Guidelines for Adults (as a percent of daily calories)
|
| | DGA 2005a | ADA—DCb | NCEP ATPIIIc | AHAd | IOMe | FAO/WHOf |
| Total Fat | 20–35% | 20–35% | 25–35% | <30% | 20–35% | <30%; <35% for highly active |
| Saturated Fat | <10% | As low as possible | <7% | <7% | As low as possible | <10%; <7% for high risk |
| Trans Fat | As low as possible | As low as possible | As low as possible | <1% | As low as possible | <1% |
| Monounsaturated Fat | Most of the fat in the diet | Up to 25% | Up to 20% | Most of the fat in the diet | 10–25% | 15–30% |
| Polyunsaturated Fat (N-6) | | 3–10% | Up to 10% | | 5–10% | 5–8% |
| Polyunsaturated Fat (N-3) | | 0.6–1.2% | | | 0.6–1.2% | 1–2% |
a Dietary Guidelines for Americans 2005
b American Dietetic Association—Dietitians of Canada
c National Cholesterol Educational Program Adult Treatment Panel III
d American Heart Association
e Institute of Medicine
f Food and Agriculture Organization of the United Nations/World Health Organization
Just how confused are we?
Registered dietitians’ experiences will likely reveal that clients/consumers are confused about how to make the right choices when it comes to dietary fat, and their attitude does not always match their actions. In an effort to really assess consumer attitudes about food, their perception, and whether there’s a connection between what they think and the evidence, the International Food Information Council (IFIC) has since 2006 conducted a yearly food and health trends survey. In this survey, they explore consumer knowledge and attitudes towards key
nutrients like fat, sugars, and carbohydrates, along with information sources such as the Nutrition Facts Panel and MyPyramid for making dietary choices. Explore any section of www.ific.org, and you will learn about the concerns, awareness, and food perceptions of your
clients.
Fat findings
For this article, we’ll focus on fat. Given the IFIC data of 1,000 respondents, you’ll find that
there are significant concerns about dietary fat, varied levels of awareness, and different levels of perception. Here is a summary of their findings, to help you gain insight that can help you work with clients.
Fat Finding #1: People are concerned about dietary fat.
- 70% report that they are concerned with the amount of fat they eat
- 68% are concerned with the type of fat
Those that are more likely to be concerned are people that:
- Are women
- Are over age 55
- Have no children
- Report a healthful diet and their health status as “very good” or “excellent”
- Have incomes over $100,000 (versus less than $35,000)
- Have made changes to their diet in the past six months
- Are concerned about their weight
- Are trying to lose or maintain their weight
- Perceive themselves as overweight or obese
- Are physically active four or more days per week
Fat Finding #2: People are aware that there are many types of fats.
- 91% have heard of trans fats
- 90% have heard of saturated fats
- 85% have heard of vegetable oils
- 72% have heard of omega 3 fatty acids
- 78% have heard of unsaturated fats
- 71% have heard of polyunsaturated and monounsaturated fats
Fat Finding #3: People’s perception of the healthfulness of fats doesn’t match the facts.
Perceived Healthfulness of Types of Dietary Fats
How would you rate the healthfulness of each of the following types of fat? |
| Type of Fat | Healthful | Neither | Not Healthful |
| Unsaturated Fat | 37% | 39% | 24% |
| Saturated Fat | 4% | 16% | 80% |
| Trans Fat | 7% | 14% | 79% |
| Polyunsaturated Fat | 23% | 34% | 43% |
| Monounsaturated Fat | 28% | 34% | 38% |
| |
| |
Perceived Healthfulness of Oils
How would you rate the healthfulness of each of the following types of oils? |
| Type of Fat | Unaware | Healthful | Neither | Not Healthful |
| Olive | 8% | 6% | 11% | 75% |
| Canola | 10% | 12% | 20% | 59% |
| Corn | 12% | 22% | 30% | 37% |
| Sunflower | 15% | 7% | 20% | 58% |
| Soybean | 15% | 6% | 19% | 60% |
| Palm | 30% | 25% | 25% | 20% |
| |
Focus on fat — or focus on food
Consumers are concerned, but they’re confused. The saturated fat message has reached a high percentage of consumers (80% agree that it’s not healthful), but figuring out which are the healthy types remains a challenge. Our national guidelines provide recommendations for grams and percentages of total calories, but we don’t put those things on the grocery list. As dietitians, let’s take it down to the basics and focus on food — tangible, tasty food they can cook — actual food choices.
Here’s my take on where we can start:
1. Help your clients make a “Foods I Love” list. Start with foods they like. Using a list of foods that contain good fats, walk your client through them to identify which ones they love. According to IFIC, taste has the biggest impact on the decision to buy foods and beverages.
Here’s a sample “good fats” list of foods that have less than 2 g of saturated fat per standard serving, and which have more healthful fats.
- Almonds, dry-roasted
- Pecans, dry-roasted
- Walnuts
- Sunflower seeds
- Flaxseed oil
- Olive oil
- Canola oil
- Soybean oil
- Safflower oil
- Soft spread, 70% vegetable oil spread
- Sardines
- Herring
- Salmon
- Snapper
- Trout
- Shrimp
- Tuna, light, canned in water
- Cod, Atlantic
- Omega 3-fortified egg
2. Then, make a “Minimize for the Health of It” list with them. Now that you’ve begun with the foods to choose, review with them the foods that should be reduced simply for health reasons.
Here’s an example of a “Minimize for the Health of It” list:
- Butter
- Whole-fat dairy, such as whole-fat yogurt, whole-fat milk, and whole-fat ice cream
- Ground beef with >10% fat
- Skin on poultry
- Stick margarine
- Lard
- Deep-fried foods
- Foods with >1 gram of trans fat on the Nutrition Facts panel
- Potato and snack chips
- Shortening
- Doughnuts
- Store-bought baked goods
3. Now make meal ideas! Take the foods from the “Love List” and the “Minimize List” and create some meal ideas. Consider how they spend their time, with whom they share meals, and what fits their schedule — but make meals.
4. It’s time for a grocery list. Put it all together! A grocery list is probably the most important tool you can send your client out the door with.
Just like many rules and recommendations for what we eat, dietary fat can be a confusing topic for your clients. Keep it simple and applicable, since the national guidelines may be perceived as inconsistent or difficult to implement. We RDs can help consumers apply the national recommendations by focusing on the foods they love, and helping them take that list straight to the grocery store!
References:
International Food Information Council. 2007 Food & Health Survey: Consumer Attitudes toward Food, Nutrition & Health. Last accessed 10/18/08 from http://www.ific.org/research/2007foodandhealthsurvey.cfm.
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