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Cutting the Fat

Eating is one of the more enjoyable things life has to offer. That’s why what to eat and what not to eat – especially as it relates to our heart’s health – can be frustrating, complicated, and confusing. However, from your heart’s and circulatory system’s point of view, there seem to be two main things to worry about: fat, and fat!

The First "Fat" to Deal With
The first fat has to do with how much you weigh. The more baggage you carry around, the harder your heart must work. A rule of thumb suggests that, for a person with paraplegia (someone who is paralyzed in the legs but not the arms), the ideal body weight is about 5-10% less than the weight found in most height-and-weight charts for non-disabled people. For those with quadriplegia (people whose spinal cord injuries affect their arms too), it’s about 10-15% less.

Regardless of your optimal weight, how many calories do you really need to simply maintain your weight? Although your sex, age, activity level, weight, and height effect your needs somewhat, another rough rule of thumb is:

If you are a healthy quad, you need about 10.3 calories per day for each pound of your weight. For a 150 pound quad this works out to about 1545 calories a day. A healthy para needs around 12.7 calories per pound per day. If you weigh 150 lbs, that calculates to about 1905 calories daily.

If you want to actually lose weight – or, gain weight for that matter – you need to know that for every 3500 calories that you eat beyond what your body needs to maintain itself, you’ll gain about a pound; for every 3500 calories that you cut back, you should lose a pound. However, if you are wanting to lose weight, it’s good to reduce your calorie intake slowly. Don’t try to cut your total daily calorie intake to less than 1400 or 1500 calories.

The Other "Fat" to Worry About
The second fat has to do with the kind you put in your mouth. This includes many meats, baked goods, dairy products, things fried in oil, butter or margarine, and many, many "fast foods." These foods are high in fats like cholesterol, saturated fats, triglycerides, and trans-fatty acids.

The problem with fats is that they tend to glue themselves to the insides of our blood vessels. Eventually, they narrow or block our arteries, increase blood pressure, and generally drive up the risk of heart attack and stroke.

While we do need to eat some fat for our bodies to function properly, and we do need cholesterol to transport that fat to where it’s needed, our bodies typically manufacture all of the cholesterol they need; and virtually no one in our society could be described as fat-deprived. Worse yet, research in people with spinal cord injuries is showing that their cholesterol levels already tend to run higher. But there’s good news too: not all of the fats we eat are bad; some, if eaten in moderation, may actually help reduce cholesterol and counteract the bad fats.

Doctors measure two types of cholesterol that circulate in our blood – LDL (low density lipoprotein) a bad, artery-clogging cholesterol, and HDL (high density lipoprotein), a good cholesterol which scientists believe carries cholesterol away from the arteries and back to your liver, where it’s passed from your body. While higher levels of HDL seem to protect against heart attacks, there’s evidence that in spinal cord injured people HDL levels often go down. Researchers suspect this is related to changes in metabolism, and not just lack of exercise, smoking, or poor diet. However, exercise and the right diet can help play a role in returning lipids or fats to healthier levels.

Winning the Fat Battle
Exercise is one way to control weight. Diet is another very effective way. Here we’ll focus on diet and try to give you a few facts about fat that you can apply to your grocery shopping, meal preparation, and eating.

Learn to read the labels on food packages: Nutrition labels contain useful information, including the number of calories in the product, its fat content, and what the manufacturer considers to be a single serving.

Don’t be fooled by potentially misleading packaging that says things like "97% Fat Free!" Instead, you want to find out what percentage of food is fat. To do this you need only two bits of information found on the nutrition label:

  1. the total number of calories per serving.
  2. the number of calories per serving from fat.

Use the label information to help limit your fat calories: Your dietary goal is to limit the calories that come from all fats to less than 30% of your entire diet. However, because food labels rarely tell you what the fat percentage is, you’ll have to figure it out for yourself. On each food label, find both the number of calories per serving and the number of fat calories per serving. Make a fraction: put your fat calories on the top, and the total calories per serving on the bottom. If it’s equal to – or less than – 1/3 (or, about 30%), you’re within your target range. Consider a candy bar with 220 calories per bar, 126 of which come from fat: 126/220 = about 12/22 or 6/11, which is more than 1/3. (Or, if you carry a calculator, just divide the total calories into the fat calories – in other words, the bigger number into the smaller number: 126 divided by 220 = 0.572, or 57%, which is much more than 30%.)

Keep in mind that the manufacturer’s idea of a serving, and your idea of a serving may be different. According to the manufacturer, those tiny bags of potato chips contain two servings. This doesn’t mean that you’re bad if you eat the whole bag. It just means you need to figure carefully. And, while the percentage of fat in those potato chips will still be the same whether you eat one, two, or ten servings, the actual amount of fat you eat will increase, and you’ll quickly pass your target of limiting fat to 30% of your total calorie intake.

Replace the bad fats you eat with good ones: Good fats are those that help raise the HDL (high density lipoprotein) in your blood. Substitute them for the bad fats –which are typically saturated fats. The American Heart Association recommends that two thirds or more of the total fat calories you eat should be good ones.

Good fats include monounsaturated fats, which are found in canola oil, olive oil, peanut oil or natural peanut butter, and avocados; most are liquid at room temperature but begin to solidify or turn cloudy if placed in the refrigerator. Polyunsaturated fats are pretty good too. These remain as liquids, even in the refrigerator. Examples are safflower, sesame, sunflower, corn, and soybean oils, as well as oils from many other nuts and seeds.

Bad or saturated fats come from animal products – meats and poultry, egg yolks, and dairy products like butter, cream, cheese, and whole milk. Lard and other solid fats are bad, too, and so are vegetable oils that come from tropical plants – coconut, palm, palm kernel, and cocoa butter, for example. These oils are used a lot in packaged baked goods.

Watch out for products containing oils described as hydrogenated or partially hydrogenated. This is a process used in commercial food preparation to make liquid fats into solids. Often products with these oils will be labeled as "low cholesterol." While this is technically true, hydrogenated oils, known as trans-fatty acids, raise blood cholesterol and aren’t really any better for you than saturated fats. Don’t be tricked! Count hydrogenated or partially hydrogenated oils as part of your allotment of bad fat. You probably won’t find these oils listed on the nutrition label, so you may have to read the food’s ingredient list. The closer they are to the beginning of the list, the more that was used! Also beware: harder and more stick-like margarines contain more trans fatty acids. Pick those that come in tub or liquid form and have liquid vegetable oil as their first ingredient. They should contain less than two grams of saturated fat per tablespoon.

Increase the amount of fiber you eat: What has fiber got to do with fat? Not only are fiber-rich foods typically low in saturated fat and cholesterol, but soluble fiber also helps lower blood cholesterol. Foods containing oats have the most soluble fiber. Beans, peas, rice, bran, barley, citrus fruits, strawberries and apple pulp are also pretty good. It will be hard to eat too much fiber – the average American gets only half of the recommended 25-30 grams of fiber daily.

Making Choices
Here are just a few things you can do to both lower your fat intake and to increase the proportion of good fats:

  • When cooking, replace lard and butter with olive oil, a polyunsaturated oil, or nonfat cooking spray.
  • Fry less. Try baking, barbecuing, or broiling instead. If you need to fry, try using water, the food’s own juices, or a low-fat chicken or vegetable broth.
  • Pick healthier dairy products: skim or 1% milk instead of whole milk; white instead of yellow cheeses.
  • Replace red meat with some baked or grilled salmon; remove the skin from your chicken and turkey; and, with all meats, eat smaller portions – an amount about the size of a deck of playing cards is a full serving.

Remember: Think big picture. You can’t replace every food with one that’s nonfat. You can’t take all the fun out of eating. Just keep in mind that even small cutbacks help.

Additional Resources

  • The American Heart Association’s Internet site at www.americanheart.org
  • A Practical Guide to Health Promotion after Spinal Cord Injury, by Indira S. Lanig. Aspen Publications, 1996.
  • Dietary Guidelines for Americans. US Department of Agriculture & US Department of Health and Human Services. Nutrition and Your Health: Home and Garden Bulletin No. 232. Washington DC . 1990.
  • SCI, Aging & Cholesterol. A brochure also available from Craig Hospital (see address in box to left)

This is part of a library of educational brochures developed by Craig Hospital with a federal grant titled, "Marketing Health Promotion, Wellness, and Risk Information for Spinal Cord Injury Survivors in the Community. The opinions expressed here are not necessarily those of the funding agency, the National Institute on Disability and Rehabilitation Research of the US Department of Education.

For a hard copy of this brochure, click on your selection above and hit the "print" button on your browser. If you'd like to ask for one directly from Craig Hospital, you can contact us by telephone at 303-789-8202, or you can e-mail us at HealthResources@craighospital.org.