Eating to Lower Your High Blood Cholesterol

              U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
                         Public Health Service
                     National Institutes of Health

                           [Graphic Omitted]

                 National Cholesterol Education Program
               National Heart, Lung, and Blood Institute

              For sale by the Superintendent of Documents,
                    U.S. Government Printing Office
                         Washington, D.C. 20402

                      NIH Publication No. 92-2920
                          Reprinted April 1992


Table of Contents


Eating to Lower Your High Blood Cholesterol

What You Need to Know About High Blood Cholesterol

Why Should You Know Your Blood Cholesterol Level?
How High Is Your Blood Cholesterol Level?
What Should Your Blood Cholesterol Goal Be?
How Does Your Blood Cholesterol Become High?

The Recommended Treatment: A Blood Cholesterol-Lowering Diet

What Changes Should You Make in Your Diet?
     Eat Less High-Fat Food
     Eat Less Saturated Fat
     Substitute Unsaturated Fat for Saturated Fat
     Eat Less High-Cholesterol Food
     Substitute Complex Carbohydrates for Saturated Fat
     Maintain a Desirable Weight

How Should You Change Your Daily Menu?

What Kind of Success Can You Expect?

How to Change Your Eating Patterns

Shop for Foods That Are Low in Saturated Fat and Cholesterol
Read the Labels
Low-Fat Cooking Tips
Where Can You Go For Help?

Glossary


List of Appendices


Appendix 1:  Desirable Weights for Men and Women

Appendix 2:  Meats

Appendix 3:  Poultry

Appendix 4:  Fish and Shellfish

Appendix 5:  Dairy Products

Appendix 6:  Frozen Desserts

Appendix 7:  Fats and Oils

Appendix 8:  Nuts and Seeds

Appendix 9:  Breads, Cereals, Pasta, Rice, and Dried Peas and
             Beans

Appendix 10: Sweets and Snacks

Appendix 11: Miscellaneous

A Guide to Choosing Low-Saturated Fat, Low-Cholesterol Foods


Eating to Lower Your High Blood Cholesterol

[Graphic Omitted]

High blood cholesterol is a serious problem. Along with high blood
pressure and cigarette smoking, it is one of the three major modifiable
risk factors for coronary head disease. Approximately 25 percent of the
adult population 20 years of age and older has "high" blood cholesterol
levels--levels that are high enough to need intensive medical attention.
More than half of all adult Americans have a blood cholesterol level
that is higher than "desirable."

Because high blood cholesterol is a risk to your health, you need to
take steps to lower your blood cholesterol level. The best way to do
this is to make sure you eat foods that are low in saturated fat and
cholesterol. The purpose of this brochure is to help you learn how to
choose these foods. This brochure will also introduce you to key
concepts about blood cholesterol and its relationship to your diet. For
example, it includes basic (but very important) information about
saturated fat-the dietary component most responsible for raising blood
cholesterol--and about dietary cholesterol-the cholesterol contained in
food.

This brochure is divided into three parts. The first part of the
brochure gives background information about high blood cholesterol and
its relationship to head disease. The second part introduces key points
on diet changes and better food choices to lower blood cholesterol
levels.

Finally, in the third pad more specific instructions are given for
modifying eating patterns to lower your blood cholesterol, choosing
low-saturated fat and low-cholesterol foods, and preparing low-fat
dishes.

The "glossary" provides easy definitions of new or unfamiliar terms. The
"appendices" that follow the glossary list the saturated fat and
cholesterol content of a variety of foods.


What You Need to Know About High Blood Cholesterol


Why Should You Know Your Blood Cholesterol Level?


There are important reasons for you to be concerned about your blood
cholesterol level. Over time, cholesterol, fat, and other substances can
build up in the walls of your arteries (a process called
atherosclerosis) and can slow or block the flow of blood to your heart.
Among many things, blood carries a constant supply of oxygen to the
heart. Without oxygen, heart muscle weakens, resulting in chest pain,
heart attacks, or even death. However, for many people there are no
warning symptoms or signs until late the disease process.

[Graphic Omitted]

Head disease is the leading cause of death in this country. Scientists
have known for a long time that high blood cholesterol, high blood
pressure, and smoking all increase the risk of heart disease.

Research now shows that the risk of developing atherosclerosis or
coronary heart disease also increases the blood cholesterol level
increases. And it has now been proven that lowering high blood
cholesterol, like controlling high blood pressure and avoiding smoking,
will reduce risk.


How High Is Your Blood Cholesterol Level?


The medical community recently set guidelines for classifying blood
cholesterol levels. They advise that a total cholesterol level less than
200 mg/dl is "desirable" for adults--above 200 mg/dl the risk of
coronary head steadily increases. The classifications of total blood
cholesterol in the following chart are related to the risk of developing
heart disease.


Does Your Total Blood Cholesterol Level Increase Your Risk For
Developing Coronary Heart Disease?


Desirable            Borderline-High          High
Blood Cholesterol    Blood Cholesterol        Blood Cholesterol

Less than 200        200-239 mg/dl            240 mg/dl and
mg/dl                                         above


If your total cholesterol level is in the range of 200-239 mg/dl, you
are classified as having "borderline-high" blood cholesterol and are at
increased risk for coronary heart disease compared to those with lower
levels. However, if you have no other factors that increase your risk
for coronary heart disease,* you should not need intensive medical
attention. But you should make dietary changes to lower your level and
thus reduce your risk of coronary heart disease.

On the other hand, if you have borderline-high blood cholesterol and
have coronary head disease or two other risk factors for coronary heart
disease, you need special medical attention. In fact, you should be
treated in the same way as people with "high" blood cholesterol- 240
mg/dl or greater--who could be at high risk for developing coronary head
disease and warrant more detailed evaluation and medical treatment.

Additional evaluation helps your physician determine more accurately
your risk of coronary head disease and make decisions about your
treatment. Specifically, your doctor will probably want to measure your
low density lipoprotein (LDL)cholesterol level--since LDL-cholesterol
more accurately reflects your risk for coronary head disease than a
total cholesterol level alone. LDL-cholesterol levels of 130 mg/dl or
greater increase your risk for developing coronary heart disease. After
evaluating your LDL-cholesterol level and other risk factors for
coronary head disease, your physician will determine your treatment
program.

Remember: As your cholesterol level rises, your risk of developing
coronary heart disease increases.

   * Risk factors for coronary head disease include high blood pressure,
     cigarette smoking, family history of coronary head disease before
     the age of 55, diabetes, vascular disease, obesity, and being male.


What Should Your Blood Cholesterol Goal Be?


If you have high blood cholesterol or need intensive treatment because
of other risk factors, your physician will probably set an
LDL-cholesterol goal for you. This goal will vary depending on your
overall risk and what may be a realistic goal for you. Remember, a total
cholesterol level below 200 mg/dl and an LDL-cholesterol level below 130
mg/dl are desirable. Even though achieving your LDL-cholesterol goal is
more important than your total cholesterol goal, your physician may
choose to check your progress by measuring your total cholesterol level
because it is a good deal simpler and you do not have to fast before its
measurement. When you reach your total cholesterol goal, your physician
will probably measure your LDL-cholesterol to confirm that you also
reached your LDL-cholesterol goal.


How Does Your Blood Cholesterol Level Become High?


What you eat can raise or lower your blood cholesterol level. The
average American diet of high-saturated fat, high cholesterol foods like
fatty meats, many dairy products, fried foods, cookies, cakes, and eggs
contributes to high blood cholesterol.

In some countries like Japan, for example, people eat diets rich in
rice, fruits, vegetables, and fish. The Japanese have lower blood
cholesterol levels and lower rates of coronary head disease than
Americans. This is in part because these foods are low in fat,
particularly saturated fat, which is the greatest dietary contributor to
high blood cholesterol.

While diet plays an important role in raising or lowering your blood
cholesterol level, inherited tendencies also influence your level. A
small percentage of people can eat diet that is high in saturated fat
and cholesterol and still maintain a low blood cholesterol level. On the
other hand, there is a small percentage of people who may not be able to
lower their blood cholesterol even with a low-saturated fat,
low-cholesterol diet. However, both of these groups constitute a
minority of the population of the United States. Most people can control
their blood cholesterol levels by following a diet that is low in
saturated fat and cholesterol.


The Recommended Treatment:


A Blood Cholesterol-Lowering Diet


Whatever the reasons may be for your high blood cholesterol level--diet,
heredity, or both--the treatment your doctor will prescribe first is a
diet. If your blood cholesterol level has not decreased sufficiently
after carefully following the diet for 6 months, your doctor may
consider adding cholesterol-lowering medication to your dietary
treatment. Remember, diet is a very essential step in the treatment of
high blood cholesterol. Cholesterol-lowering medications are more
effective when combined with diet. Thus they are meant to supplement,
not replace, a low-saturated fat, low-cholesterol diet.


What Changes Should You Make in Your diet?


The following chart illustrates some guidelines for dietary changes to
help you lower your blood cholesterol level. Your new diet is low in
saturated fat and low in cholesterol and is adequate in all nutrients,
including protein, carbohydrate, fat, vitamins, and minerals.

[Graphic Omitted]

Guidelines for Lowering High Blood Cholesterol
Levels Basic Trends


Eat less high-fat food (especially those high in saturated fat).

Replace part of the saturated fat in your diet with unsaturated fat.

Eat less high-cholesterol food.

Choose foods high in complex carbohydrates (starch and fiber).

Reduce your weight, if you are overweight.


Eat Less High-Fat Foods


There are two major types of dietary fat--saturated and unsaturated.
Unsaturated fats are further classified as either polyunsaturated or
monounsaturated fats. Together, saturated and unsaturated fats equal
total fat. All foods containing fat contain a mixture of these fats.

One of the goals in your blood cholesterol-lowering diet is to eat less
total fat, because this is an effective way to eat less saturated fat.
Because fat is the richest source of calories, this will also help
reduce the number of calories you eat every day. If you are overweight,
weight loss is another important step in lowering blood cholesterol
levels (as discussed later in this brochure). If you are not overweight,
be sure to replace the fat calories by eating more food high in complex
carbohydrates.

Remember: When you decrease the amount of total fat you eat, you are
likely to reduce the saturated fat and calories in your diet.

[Graphic Omitted]

Eat Less Saturated Fat


Saturated fat raises your blood cholesterol level than anything else in
your diet. The best way to your blood cholesterol level is to reduce the
amount of saturated fat that you eat.

[Graphic Omitted]

Animal products as a group are a major source of saturated fat in the
average American diet. Butter, cheese whole milk, ice cream, and cream
all contain high of saturated fat. Saturated fat is also concentrated in
the that surrounds meat and in the white streaks of fat in the muscle of
meat (marbling). Poultry, fish, and shellfish also contain saturated
fat, although generally less than meat.

A few vegetable fats--coconut oil, cocoa butter (found chocolate), palm
kernel oil, and palm oil--are high in saturated fat. These vegetable
fats are found in many murkily baked goods, such as cookies and
crackers, in nondairy substitutes, such as whipped toppings, creamers,
cake mixes, and even frozen dinners. They can be found in some snack
foods like chips, candy and buttered popcorn. Because these vegetable
fats are not visible in these foods (unlike the fat in meats) it is
important for you to read food labels. The label may tell you how much
saturated fat a food contains, which will help you choose foods lowest
in saturated fats.

Remember: Saturated fats are found primarily in animal products. But a
few vegetable fats and many commercially processed foods also contain
saturated fat. Read labels carefully. Choose foods wisely.


Substitute Unsaturated Fat for Saturated Fat


Unsaturated fat actually helps to lower cholesterol levels when it is
substituted for saturated fat. Therefore, health professionals recommend
that, when you do eat fats, unsaturated fats (polyunsaturated and
monounsaturated fats) be substituted for part of the saturated fat
whenever possible.

Polyunsaturated fats are found primarily in safflower, corn, soybean,
cottonseed, sesame, and sunflower oils, which are common cooking oils.
Polyunsaturated fats are also contained in most salad dressings. But be
cautious. Commercially prepared salad dressing also may be high in
saturated fats, and therefore careful inspection of labels is important.
The word "hydrogenated" on a label means that some of the
polyunsaturated fat has been converted to saturated fat.

Another type of polyunsaturated fat is found in the oils of fish and
shellfish (often referred to as fish oils, or omega-3 fatty acids). This
type of polyunsaturated fat is found in greatest amounts in such fatty
fish as herring, salmon, and mackerel. There is little evidence that
omega-3 fatty acids are useful for reducing LDL-cholesterol levels.
However, fish is a good food choice for this diet plan anyway because it
is low in saturated fat. The use of fish oil supplements are not
recommended for the treatment of high blood cholesterol because it is
not known whether longterm ingestion of omega-3 fatty acids will lead to
undesirable side effects.

Olive and canola oil (rapeseed oil) are examples of oils that are high
in monounsaturated fats. Like other vegetable oils, these oils are used
in cooking as well as in salads. Recently, research has shown that
substituting monounsaturated fat, like substituting polyunsaturated fat,
for saturated fat reduces blood cholesterol levels.

Remember: unsaturated fats when substituted for saturated fats help
lower blood cholesterol levels.

[Graphic Omitted]

Eat Less High-Cholesterol Food


Dietary cholesterol is a waxy, fat-like substance found in foods that
come from animals. Although it is not the same as saturated fat, dietary
cholesterol also can raise your blood cholesterol level. Therefore, it
is important to eat less food that is high in cholesterol. While
cholesterol is needed for normal body function, your liver makes enough
for your body's needs so that you don't need to eat any cholesterol at
all.

Cholesterol is found in eggs, dairy products, meat, poultry, fish, and
shellfish. Egg yolks and organ meats (liver, kidney, sweetbread, brain)
are particularly rich sources of cholesterol. High-fat dairy products,
meat, and poultry all have similar amounts of cholesterol. Fish
generally has less cholesterol, but shellfish varies in cholesterol
content. Foods of plant origin, like fruits, vegetables, grains,
cereals, nuts, and seeds, contain no cholesterol.

Since cholesterol is not a fat, you can find it in both high-fat and
low-fat animal foods. In other words, even if a is low in fat, it may be
high in cholesterol. For instance, organ meats, like liver, are low in
fat, but are high in cholesterol.

Because many foods such as dairy products and some meats are high in
both saturated fat and cholesterol, it is important to limit the amount
of these high-fat foods that you eat, choosing lean meats and low-fat
dairy products whenever possible.

Remember: Organ meats and egg yolks are high in cholesterol. High-fat
dairy products, meats, and poultry have similar amounts of cholesterol.
Some fish has less. Foods of plant origin like fruits, vegetables,
vegetable oils, grains, cereals,nuts, and seeds contain no cholesterol.


Substitute Complex Carbohydrates for Saturated Fat

[Graphic Omitted]

Breads, pasta, rice, cereals, dried peas and beans, fruits, and
vegetables are good sources of complex carbohydrates (starch and fiber).
They are excellent substitutes foods that are high in saturated fat and
cholesterol. The type of fiber found in foods such as oat and barley
bran, some fruits like apples and oranges, and in some dried beans may
even help reduce blood cholesterol levels.

Contrary to popular belief, high-carbohydrate foods (like pasta, rice,
potatoes) are lower in calories than foods high in fat. In addition,
they are good sources of vitamins and minerals. What adds calories to
these the addition of butter, rich sauces, whole milk, or cream, which
are high in fat, especially saturated fat. It is important not to add
these to the high-carbohydrate foods you are substituting for foods high
in fat.

Remember: Foods that are high in complex carbohydrates, if eaten plain,
are low in saturated fat and cholesterol as well as being good sources
of vitamins, minerals, and fiber.


Maintain a Desirable Weight


People who are overweight frequently have higher blood cholesterol
levels than people of desirable weight. You can reduce your weight by
eating fewer calories and by increasing your physical activity on a
regular basis. By reducing the amount of fat in your diet, you will be
cutting down on the richest source of calories. Substituting foods that
are high in complex carbohydrates for high-fat foods will also help you
lose weight, because many high carbohydrate foods contain little fat and
thus fewer calories.

Fat has more than twice the calories as the same amount of protein or
carbohydrate. Protein and carbohydrate both have about 4 calories in
each gram, but all fat saturated, polyunsaturated or monounsaturated
fat--has 9 calories in each gram. Thus, foods that are high in fat are
high in calories. And all calories count. So, to maintain a desirable
weight, it is important to eat no more calories than your body needs.
(To find your desirable weight, see appendix 1.)

[Graphic Omitted]

Remember: To achieve or maintain a desirable weight, your caloric intake
must not exceed the number of calories your body burns.


How Should You Change Your Daily Menu?


So far we have discussed the basic dietary trends for reducing your
blood cholesterol level. Now, we will focus on how to make specific
changes in the foods you choose to eat. The following chart describes
these dietary changes in terms of percentages of daily calories. (This
concept is explained in the footnote.)

Since fat, carbohydrate, and protein are the three major sources of
calories, the amounts that you eat of each of them makes up your daily
calorie intake. For example, as shown below, the average diet of an
adult American provides about 35-40 percent of calories from fat, and
about 47 percent from carbohydrate and 16 percent from protein. On a
cholesterol-lowering diet, the percentage of calories from total fat
decreases, while the percentage of calories from carbohydrate increases
and protein may stay the same.


Guidelines for Lowering Your High Blood Cholesterol Level


Specific Changes


Eat less than 30% of your total daily calories from fat.* Less than 10%
of your calories should come from saturated fat

No more than 10% of your calories should come from polyunsaturated fat.

10-15% of your calories should come from monounsaturated fat.

Eat less than 300 mg of cholesterol each day.

Eat 50-60% of your daily calories from carbohydrates.

Adjust your caloric intake to achieve or maintain a desirable weight.

   * You can calculate the percent of your total daily calories from fat
     with the following equations:

   * You can calculate the percent of your total daily calories from fat
     with the following equations (use the numbers from the appendices
     at the end of this brochure or from food labels): % calories from
     fat = (total fat calories/total calories) x 1 00. Total fat
     calories = total fat (grams) x 9. In other words, if your daily
     calorie need is 2,000 calories, 30% of your total daily calories
     from fat would equal 600 calories, or 67 grams of fat.

Remember, when you are using these equations, that not everything you
eat must have fewer than 30% calories from fat, but that you should
balance foods with a slightly higher fat content with foods that have a
much lower fat content.

[Graphic Omitted]

The differences between these two diets are subtle and appear to be
small, but they are very important for lowering your blood cholesterol
level. All of these small changes add up to big improvements in your
blood cholesterol level. Take a look at the sample menus. Although the
new low-fat diet has the same number of calories as the average

American diet, it has much less fat. And, the sample menus show that
because the fat you were eating was so calorie-rich, the new diet
actually allows you to eat more food!


Sample Menus


Average American Diet (37% fat)


Breakfast


1 fried egg
2 slices white toast with 1 teaspoon butter 
1 cup orange juice 
black coffee or tea


Snack


1 doughnut


Lunch


1 grilled cheese (2 ounces) sandwich on white bread
2 oatmeal cookies 
black coffee or tea


Snack


20 cheese cracker squares


Dinner


3 ounces fried hamburger with ketchup 
1 baked potato with sour cream 
3/4 cup steamed broccoli with 1 teaspoon butter 
1 cup whole milk
1 piece frosted marble cake


Nutrient Analysis

Calories                                     2,000     
Total fat (percent of calories)                 37
Saturated fat (percent of calories)             19
Cholesterol                                 505 mg


A New Low-Fat Diet
(37% fat)


Breakfast


1 cup corn flakes with blueberries 
1 cup 1% milk
1 slice rye toast with 1 teaspoon margarine 
1 cup orange juice
black coffee or tea


Snack


1 toasted pumpernickel bagel with 1 teaspoon margarine


Lunch


1 tuna salad (3 ounces) sandwich on whole wheat bread with
  lettuce and tomato 
1 graham cracker 
tea with lemon

[Graphic Omitted]

Snack


1 crisp apple


Dinner


3 ounces broiled lean ground beef with ketchup 
1 baked potato with low-fat plain yogurt and chives 
3/4 cup steamed broccoli with 1 teaspoon margarine
tossed garden salad with 1 tablespoon oil and vinegar dressing
1 cup 1% milk
1 small piece homemade gingerbread* with a maraschino cherry
  and sprig of mint


Nutrient Analysis

Calories                                     2,000
Total fat (percent of calories)                 30
Saturated fat (percent of calories)             10
Cholesterol                                 186 mg


A New Low-Fat Diet
(30%)


Breakfast


1 cup shredded wheat with peach slices 
1 cup 1% milk
1 slice whole wheat toast with 1 teaspoon margarine 
1 cup pink grapefruit juice 
black coffee


Snack


1 toasted English muffin with 1 teaspoon margarine


Lunch


3 ounces turkey salad on lettuce with tomato wedges
1 thick slice of French bread
10 animal crackers
tea with lemon


Snack


1 banana


Dinner


3 ounces broiled halibut with lemon and herb seasoning 
1/2 cup brown rice with mushrooms 
1 dinner roll with 1 teaspoon margarine 
3/4 cup carrot strips with 1 teaspoon margarine 
spinach salad with 1 tablespoon oil and vinegar dressing 
1 cup 1% milk
1 small piece homemade yellow cake*


Nutrient Analysis

Calories                                     2,000
Total fat (percent of calories)                 30
Saturated fat (percent of calories)             10
Cholesterol                                 172 mg

   * Homemade desserts should be made with unsaturated fats instead of
     saturated fats. Two egg whites may be substituted for one egg yolk.


What Kind of Success Can You Expect?


Generally your blood cholesterol level should begin to drop 2 to 3 weeks
after you stay on a cholesterol-lowering diet.  Over time, you may
reduce your level 30-55 mg/dl. The reduction in your blood cholesterol
level depends on several factors:

   * The amount of saturated fat in your diet -- If your diet is very
     high in saturated fats, you will probably see a greater reduction
     in your cholesterol level once you start to change your eating
     pattern than if your initial diet was only moderately high in
     saturated fat.

   * Your blood cholesterol level prior to starting your new diet -- In
     general, the higher your blood cholesterol level is, the greater
     reduction you can expect from your new diet. If your level is very
     high, you might be able to lower your cholesterol level even more
     than 55 mg/dl.

   * How responsive your body is to your new diet -- Genetic factors
     play a role in determining your blood cholesterol level and, to
     some extent, can determine your ability to lower your level by
     diet.


How to Change Your Eating Patterns


Look at your overall eating pattern and begin to plan. If you are eating
few foods high in saturated fat, an occasional high-saturated fat food
won't raise your blood cholesterol level. If you anticipate a
high-saturated fat, high-cholesterol day, eat an especially
low-saturated fat, low-cholesterol the day before and the day after.
With a little planning, you can change your eating patterns and reduce
your high blood cholesterol level.

Remember, the goal is to limit the saturated fat and cholesterol in your
diet each day. You don't have to cut all the high-saturated fat and
high-cholesterol foods in diet. Try to substitute one or two
low-saturated fat or low-cholesterol foods each day, and soon you will
reach your goal of a low-saturated fat, low-cholesterol diet.

Changing your eating patterns takes time. In fact, it take you 6 months
or longer to incorporate all the changes you'll want to make in your
diet. Most likely you will be shopping for some different foods,
preparing some food differently, even modifying your choices at
restaurants parties.

Remember: eat foods high in unsaturated fats and high in complex
carbohydrates in place of foods high in saturated fat and cholesterol.
Make substitutions gradually and plan your meals ahead to adjust your
diet and reduce your blood cholesterol level.

[Graphic Omitted]

Shop for Foods That Are Low in Saturated Fat and Cholesterol


If you stock your kitchen shelves with foods that are saturated fat and
cholesterol, it will be much easier to adjust your eating habits. With a
little direction you can learn to shop for these foods.

This part of the brochure is divided into categories will be helpful
when you make out your grocery lists. categories, or food groups, are
listed in the chart


Food Groups


You must eat a variety of foods each day to get the nutrients you need.
One way to do this is to choose from different food groups, which are
categorized by nutrients they provide. The number and size of should be
adjusted to reach and maintain your desired weight. Use the information
in the following sections identify specific foods in each of the food
groups that low in saturated fat and cholesterol.


Food Group


Meat, Poultry, Fish, and Shellfish (up to 6 ounces a day)

[Graphic Omitted]

Dairy Products
(2 servings a day; 3 servings for women who are pregnant or
breastfeeding)

[Graphic Omitted]

Eggs
(no more than 3 yolks a week)

[Graphic Omitted]

Fats and Oils
(up to 6-8 teaspoons a day)

[Graphic Omitted]

Breads, Cereals, Pasta, Rice, and Dried Peas and Beans 
(6 or more servings a day)

[Graphic Omitted]

Fruits and Vegetables
(2-4 servings of fruit, 3-5 servings of vegetables a day)

[Graphic Omitted]

Sweets and Snacks (avoid too many sweets)

[Graphic Omitted]

Meat, Poultry, Fish, and Shellfish


Meat, poultry, fish, and shellfish are important sources of protein and
other nutrients in your diet. However, they also contain saturated fat
and cholesterol. The following chad shows the differences between lean
and fatty examples of each. As you can see, lean beef is lower in
saturated fat than beef short ribs. Chicken without skin has less
saturated fat than chicken with skin. Haddock has less saturated fat and
cholesterol than either chicken or meat. And, of course, foods with less
fat contain fewer calories as well.

[Graphic Omitted]

To lower your blood cholesterol level, choose the meats and poultry,
fish, and shellfish. Remember, all of foods contain some saturated fat
and cholesterol. Therefore the amount you eat is also important. The
recommended amount of meat, poultry, fish, or shellfish is up to ounces
each day. For variety, consider dried beans or legumes as a main dish.
If larger, more filling main dishes are desired, extend meat with pasta
or vegetables for hearty dishes. Eating a diet that includes a variety
of foods is important because a food lowest in fat may not have the same
vitamins and minerals as one a little higher in fat.

Meat. Some people think well-marbled meat (meat with white fat running
through it) tastes better than less well-marbled meat. However, the
tasty cuts are not all high in fat. For example, well-trimmed cuts from
the "round" of the animal are tender if prepared appropriately and are
lower in saturated fat than well-marbled meat. The below gives you other
examples of trimmed, lean meats.


Lean Cuts of Meat

Beef            Veal             Pork              Lamb
Round           All trimmed      Tenderloin        Leg
Sirloin         cuts except      Leg (fresh)       Arm
Chuck           commercially     Shoulder (arm     Loin
Loin            ground           or picnic)


Beef, veal, and lamb can be graded as "prime," "choice," or "good." The
grade is determined by the amount of marbling (fat) in the meat.
"Prime," which is the top grade, has the most fat, while "choice" has
less marbling. Even though the difference in marbling between "good" and
"choice" is small, "good" grades of meat are lower in fat. Keep in mind
that it is not necessary to completely remove red meat from your diet.
Lean meat is high in protein and iron. Women in particular should avoid
severe reductions in lean meat that would increase their risk of
iron-deficiency anemia.

Some producers now are using "lean" and "lite" and other similar labels
to designate beef, lamb, and pork that have been produced with less
trimmable fat (fat surrounding the meat) and, in some instances, less
marbling. These labels frequently appear on processed meat products but
may appear on fresh meats as well. "Light," "lite," "leaner," and "lower
fat" generally refer to foods containing less fat. They can be, but are
not necessarily low in fat. Read the label for information on grams of
fat per serving.

High-fat processed meats should be eaten infrequently because 60-80
percent of their calories come from fat much of which is saturated. Some
examples of these processed meats are bacon, bologna, salami, hot dogs,
and sausage.

Organ meats, like liver, sweetbreads, and kidneys are relatively low in
fat. However, these meats are high in cholesterol.

A more extensive list of meats is provided in appendix 2. Poultry. In
general, poultry is low in saturated fat, especially when the skin is
removed. Poultry is, therefore, an excellent choice for your new diet.
When choosing poultry, keep these points in mind:

   * Eat chicken and turkey pieces without skin to reduce the saturated
     fat.

   * Limit goose, duck, and many processed poultry products like bologna
     and hot dogs, which are very high in saturated fat.

     For a more complete listing see appendix 3.

Fish and Shellfish. Most fish is lower in saturated fat and cholesterol
than meat and poultry. Therefore, usually a good substitute for meats
and poultry.

Shellfish varies in cholesterol content -- some is relatively high and
some is low -- but all has less fat than meat, poultry, and most fish.

A more complete listing of seafood appears in appendix 4.


Dairy Products


Although many people believe that meats have the highest cholesterol and
saturated fat content, dairy products that contain fat are also high in
saturated fat and cholesterol. Since dairy products are often added to
foods like casseroles, cakes, or pies, you might eat a significant
amount of them without knowing it.

Milk. Milk provides many essential nutrients. And both 1% and skim milk
provide the same nutrients as whole milk (3.3%) or 2% milk, while
providing much less saturated fat and cholesterol and fewer calories.

Ease Your Way From Whole Milk to Skim Milk. Make the change gradually.
Drink 2% milk for a few weeks, then 15, and finally skim. With each
step, you will decrease your intake of saturated fat, cholesterol, and
calories.

[Graphic Omitted]

Cheese. Often, when people cut back on meat, they replace it with
cheese, thinking they are cutting back on their saturated fat and
dietary cholesterol. They couldn't more wrong. Because they are prepared
from whole milk or cream, most cheeses, while high in calcium, are high
in saturated fat and cholesterol. Ounce for meat, poultry, and most
cheeses have about the same amount of cholesterol. But cheeses for the
most part have much more saturated fat. Also, cheese is not as good a
source of some vitamins and minerals, especially iron, as meats. The
following chart compares the saturated fat and cholesterol content in
chicken, a relatively lean cut of and some cheeses.


Poultry, Meat, and Cheese: A Comparison

Product          Saturated Fat    Dietary         Total Fat
(3 ounce         (grams)          Cholesterol     (grams)
serving)                          (Milligrams)

Beef, top                    2              84            6
round, lean
only, broiled

Chicken, broiler/            1              85            5
fryer, without
skin, light meat
roasted

Low-fat cottage              1               4            1
cheese

Part-skim                    9              48           14
mozzarella

Mozzarella                  11              66           18

American Processed          17              81           26

Natural cheddar             18              90           28

Cream cheese                19              93           30


Determining which cheeses are high and low in saturated fat and
cholesterol can be confusing because there are so many different kinds
on the market: part-skim-milk, low-fat, imitation, processed, natural,
hard, and soft. Imitation cheeses made with vegetable oil,
part-skim-milk cheeses, and cheeses advertised as "low-fat" are usually
lower in saturated fat and cholesterol than are natural and processed
cheeses, which are made with whole milk. However, even part-skim-milk
cheeses and "low-fat" cheeses are not necessarily lower in fat than many
meats. Remember it this way:

   * Natural and processed hard cheeses are highest in saturated fat.

   * Low-fat and imitation cheeses may have less saturated fat.

   * Meats have less saturated fat than many of these cheeses.

Therefore, substitute low-fat and imitation cheeses whenever possible
for natural, processed, and hard cheeses. Read the label and choose
low-fat cheeses that have between 2 and 6 grams of fat per ounce. When
you get the urge for cheese, the following should be eaten instead of
hard cheese, or low-fat imitation cheese:

   * Cottage cheese (low-fat)

   * Farmer cheese (made with skim milk)

   * Pot cheese

[Graphic Omitted]

     The list in appendix 5 compares the saturated fat and cholesterol
content in a wide variety of dairy products.

[Graphic Omitted]

Ice Cream. Americans love ice cream. But, ice cream is made from whole
milk and cream and therefore contains a considerable amount of saturated
fat and dietary cholesterol. You do not need to eliminate ice cream, but
do eat it in small amounts and less often. Try frozen desserts like ice
milk, yogurt, sorbets, and popsicles which are low in saturated fat.
Appendix 6 compares the saturated fat and cholesterol content of several
frozen desserts.


Eggs


Egg yolks are high in cholesterol: each contains about 270 mg. Eat no
more than three egg yolks a week including those in processed foods and
many baked goods. Egg whites contain no cholesterol and can be
substituted for whole eggs in recipes. For cakes or cookies, this
substitution will be acceptable for 1-2 eggs in most recipes and up to
3-4 whole eggs in some.


Fats and Oils


     In your cooking, limit the amounts you use of these saturated fats:

   * Butter

   * Lard

   * Fatback

   * Solid Shortenings

Instead of using butter as a spread or in recipes, substitute margarine.
Choose liquid vegetable oils that are highest in unsaturated fats like
safflower, sunflower, corn, olive, sesame, and soybean oils for your
cooking and in your salad dressings. Peanut oil and peanut butter may be
eaten in small amounts. Choose margarines and oils that have more
polyunsaturated fat than saturated fat.

Saturated fats often are found in commercially prepared products.
Remember, some vegetable oils (like coconut, palm, and palm kernel oil)
are saturated, and other vegetable oils can become saturated by
hydrogenation - a process that solidifies them. They are called
hydrogenated vegetable oils. Read the labels before deciding which
products to buy.

[Graphic Omitted]

Appendix 7 ranks solid fats and oils from low to high in terms of
saturated fat. You will reduce your intake of saturated fat by not
choosing those fats at the bottom of the list. And using less will
decrease your total fat intake.

Since avocados, olives, nuts, and seeds are high in fat, they are often
grouped with fats and oils. Although the fat in nuts and seeds is mostly
unsaturated fat, they are very high in calories. See appendix 8 to
compare fat and calorie content of nuts and seeds.


Fruits and Vegetables


Fruits and vegetables contain no cholesterol and are very low in fat and
low in calories (except for avocados and olives, which are high in fat
and calories). By eating fruits as a snack or dessert and vegetables as
snacks and side dishes, you can increase your intake of vitamins,
minerals, and fiber and lower your intake of saturated fat and dietary
cholesterol.


Breads, Cereals, Pasta, Rice, and Dried Peas and Beans


Breads, cereals, pasta, rice, and dried peas and beans are all high in
complex carbohydrates and low in saturated fat. By substituting more
foods from this group for high-saturated fat foods, you will:

   * Decrease your saturated fat, dietary cholesterol, and calorie
     intake and


   * Increase your complex carbohydrate consumption.

Try pasta, rice, and dried peas and beans (like split peas, lentils,
kidney beans, and navy beans) as main dishes, casseroles, soups, or
other one-dish meals without high-fat sauces. Also, try recipes that use
small quantities of meat, poultry, fish, or shellfish as flavoring or
seasoning in casseroles rather than as the main ingredient.

Cereal products, both cooked and dry, are usually low in saturated
fat--with the exception of those that contain coconut or coconut oil,
like many types of granola. (Most granolas are high in fat.)

Breads and most rolls also are low in fat (for more fiber, choose the
whole-grain types). However, many other types of commercially baked
goods are made with large amounts of saturated fats. Read the labels on
these products to determine their fat content. The ones listed below (as
well as many others) are high in saturated fat:

   * Croissants          * Biscuits            * Doughnuts
   * Muffins             * Butter rolls

Remember, you can make your own muffins and quick breads using
unsaturated vegetable oils and egg whites. Two egg whites may be
substituted for one egg yolk.

Appendix 9 lists many common foods from this group. Use it to choose
those that are lowest in saturated fat and dietary cholesterol.


Sweets and Snacks


Sweets and snacks often are high in saturated fat, cholesterol, and
calories. Examples of these foods are commercial cakes, pies, cookies,
cheese crackers, and some types of chips. Once again, the key is to read
labels carefully since some of these products may contain unsaturated
fats and be low in total fat and calories.

If you are accustomed to eating commercially prepared pies, cakes, or
cookies, there are some very tasty alternatives to these high-saturated
fat and high-cholesterol items. A few examples of commercially prepared
desserts that are acceptable include angel food cake, fig bars, and
ginger snaps. Keep in mind that most desserts can be made at home
substituting polyunsaturated oil or margarine for butter and lard, skim
milk for whole milk, and egg whites for egg yolks (see "Low-Fat Cooking
Tips"). Although this reduces their saturated fat and cholesterol
content, these baked products remain a rich source of fat (and therefore
calories) and should be eaten only occasionally if you are trying to
lose weight. As an alternative, try fruit for dessert. And for your next
snack, try a piece of fruit, some vegetables, or a low-fat snack like
unbuttered popcorn or breadsticks.

See appendix 6 for more information on frozen desserts and appendix 10
for information on sweets and snacks.


Read the Labels


When you are shopping, compare labels. Some premixed, frozen, or
prepared foods have a lower saturated fat or cholesterol content than
others. Now that many products list their fat and cholesterol content,
shopping for low-saturated fat, low-cholesterol foods is much easier.
With a little guidance, you can learn how to use these labels when you
shop.


Look at the Ingredients


All food labels list the product's ingredients in order by weight. The
ingredient in the greatest amount is listed first. The ingredient in the
least amount is listed last. To avoid too much total or saturated fat,
limit your use of products that list a fat or oil first or that list
many fat and oil ingredients. The checklist below helps you identify the
names of common saturated fat and cholesterol sources in foods.


Sources of Saturated Fat and Cholesterol

Animal Fat
Bacon Fat
Beef Fat 
Butter 
Chicken Fat
Cocoa Butter
Coconut
Coconut Oil
Cream
Egg and Egg-Yolk solids
Ham Fat
Hardened Fat or Oil
Hydrogenated Vegetable Oil
Lamb Fat
Lard
Meat Fat
Palm Kernel Oil
Palm Oil
Pork Fat
Turkey Fat
Vegetable Oil*
Vegetable Shortening
Whole-Milk Solids

   * Could be coconut or palm oil.


Read the Nutrition Information


Look for the amount of fat, polyunsaturated, and saturated fats and
cholesterol. The following samples show you how to identify products
with lower saturated fat and cholesterol. The labels give the amount of
fat in grams (g) and cholesterol in milligrams (mg) per serving. You can
see that skim milk has less fat and cholesterol than whole milk. Tub
margarine has less saturated fat and cholesterol than butter.

Nutrition Information      Whole Milk   2% Milk   Skim Milk
Per Serving 

Serving Size                    1 cup     1 cup       1 cup     
                                        
Calories                          150       121          86
Protein                           8 g       8 g         8 g 
Carbohydrates                    11 g      12 g        12 g 
Fat                               8 g       5 g        less     
                                                       than
                                                        1 g
     Polyunsaturates             less      less         0 g
                                 than      than 
                                  1 g       1 g                 
     Saturates                    5 g       3 g        less
                                                       than
                                                        1 g
Cholesterol                     33 mg     18 mg        4 mg
 

Nutrition Information Per Serving

                         Butter, Stick   Margarine, Tub  
Serving Size                        1T               1T
Calories                           101              101
Protein                          0.1 g            0.1 g
Carbohydrates                    0.1 g             01 g
Fat (100% calories from fat)    11.4 g           11.4 g
     Polyunsaturates             0.4 g            3.9 g
     Saturates                   7.1 g            1.8 g
Cholesterol                      31 mg             0 mg

Note: The amount of monounsaturated fat is not listed.

Low-Fat Cooking Tips


Your kitchen is now stocked with great tasting, low-saturated fat,
low-cholesterol foods. But you may still be faced with the temptation to
fix your favorite higher fat meats, rich soups, and baked breads and
cookies. The suggestions below will help you to reduce the amount of
total and saturated fats in these foods.


New Ways To Prepare Meat, Poultry, Fish, and Shellfish


When you prepare meats, poultry, and fish, remove as much saturated fat
as possible. Trim the visible fat from meat. Remove the skin and fat
from the chicken, turkey, and other poultry. And, if you buy tuna or
other fish that is packed in oil, rinse it in a strainer before making
tuna salad or a casserole, or buy it packed in water.

Changes in your cooking style can also help you remove fat. Rather than
frying meats, poultry, fish, and shellfish, try broiling, roasting,
poaching, or baking. Broiling browns meats without adding fat. When you
roast, place the meat on a rack so that the fat can drip away.

Finally, if you baste your roast, use fat-free ingredients such as wine,
tomato juice, or lemon juice instead of the fatty drippings. If you
baste turkeys and chickens with fat use vegetable oil or margarine
instead of the traditional butter or lard. Self-basting turkeys can be
high in saturated fat--read the label!


New Ways To Make Sauces and Soups


Sauces, including gravies and homemade pasta sauces, and many soups
often can be prepared with much less fat. Before thickening a sauce or
serving soup, let the stock or liquid cool- preferably in the
refrigerator. The fat will rise to the top and it can easily be skimmed
off. Treat canned broth-type soups the same way.

For sauces that call for sour cream, substitute plain low-fat yogurt. To
prevent the yogurt from separating, mix 1 tablespoon of cornstarch with
1 tablespoon of yogurt and mix that into the rest of the yogurt. Stir
over medium heat just until the yogurt thickens. Serve immediately.
Also, whenever you make creamed soup or white sauces, use skim or 1%
milk instead of 2% or whole milk.


New Ways To Use Old Recipes


There are dozens of cookbooks and recipe booklets that will help you
with low-fat cooking. But there is no reason to stop using your own
favorite cookbook. The following list summarizes many of the tips. Using
them, you can change tried and true recipes to low-saturated fat,
low-cholesterol recipes. In some cases, especially with baked products,
the quality or texture may change. For example, using vegetable oil
instead of shortening in cakes that require creaming will affect the
result. Use margarine instead; oil is best used only in recipes calling
for melted butter. Substituting yogurt for sour cream sometimes affects
the taste of the product. Experiment! Find the recipes that work best
with these substitutions.

[Graphic Omitted]

Instead of                Use
1 tablespoon butter       1 tablespoon margarine or 3/4
                          tablespoons oil

1 cup shortening          2/3 cup vegetable oil

1 whole egg               2 egg whites

1 cup sour cream          1 cup yogurt (plus 1 tablespoon
                          cornstarch for some recipes)

1 cup whole milk          1 cup skim milk


Where Can You Go for Help?


If you want additional help in planning an approach to low-saturated
fat, low-cholesterol eating, make an appointment with a registered
dietitian or qualified nutritionist. They can help you design an eating
plan particular to your own needs and preferences. Dietitians may be
identified through a local hospital as well as through state and
district affiliates of the American Dietetic Association. The American
Dietetic Association maintains a roster of registered dietitians. By
calling the Division of Practice [(312) 899-0040] you can request names
of qualified dietitians in your area. Others can be found in public
health departments, health maintenance organizations, cooperative
extension services, and colleges.

[Graphic Omitted]

These health professionals can assist you in making dietary changes by
providing additional advice on shopping and preparing foods, eating away
from home, and changing your eating behaviors to help you maintain your
new eating pattern. Their expertise will help you set short term goals
for dietary change so that you can successfully lower your high blood
cholesterol levels without drastically changing your eating pattern or
overall lifestyle.

If you would like more information to help you start your new approach
to healthy eating, contact the National Cholesterol Education Program
(NCEP) of the National Heart, Lung, and Blood Institute. NCEP has
developed a Community Guide to Cholesterol Resources, which includes the
names and addresses of other organizations that can provide additional
information. So You Have High Blood Cholesterol provides more specific
information on the significance of high blood cholesterol and how it
affects your health. To request additional information, write:

National Cholesterol Education Program
National Heart, Lung, and Blood Institute
National Institutes of Health
C-200
Bethesda, M D 20892

[Graphic Omitted]

Glossary


  1. Atherosclerosis -- A type of "hardening of the arteries" in which
     cholesterol, fat, and other blood components build up on the inner
     lining of arteries. As atherosclerosis progresses, the arteries to
     the heart may narrow so that oxygen-rich blood and nutrients have
     difficulty reaching the heart.

  2. Carbohydrate -- One of the three nutrients that supply calories
     (energy) to the body. Carbohydrate provides 4 calories per
     gram--the same number of calories as pure protein and less than
     half the calories of fat. Carbohydrate is essential for normal body
     function. There are two basic kinds of carbohydrate--simple
     carbohydrate (or sugars) and complex carbohydrate (starches and
     fiber). In nature, both the simple sugars and the complex starches
     come packaged in foods like oranges, apples, corn, wheat, and milk.
     Refined or processed carbohydrates are found in cookies, cakes, and
     pies.

   * Complex carbohydrate -- Starch and fiber. Complex carbohydrate
     comes from plants. When complex carbohydrate is substituted for
     saturated fat, the saturated fat reduction helps lower blood
     cholesterol. Foods high in starch include breads, cereals, pasta,
     rice, dried beans and peas, corn, and lima beans.

   * Fiber -- A nondigestible type of complex carbohydrate. High-fiber
     foods are usually low in calories. Foods high in fiber include
     whole grain breads and cereals, whole fruits, and dried beans. The
     type of fiber found in foods such as oat and barley bran, some
     fruits like apples and oranges, and some dried beans may help
     reduce blood cholesterol.

  3. Cholesterol -- A soft, waxy substance. It is made in sufficient
     quantity by the body for normal body function, including the
     manufacture of hormones, bile acid, and vitamin D. It is Present in
     all pads of the body, including the nervous system muscle, skin,
     liver, intestines, head, etc.

   * Blood cholesterol -- Cholesterol that is manufactured in the liver
     and absorbed from the food you eat and is carried in the blood for
     use by all pads of the body. A high level of blood cholesterol
     leads to atherosclerosis and coronary head disease.

   * Dietary cholesterol -- Cholesterol that is in the food you eat. It
     is present only in foods of animal origin, not in foods of plant
     origin. Dietary cholesterol, like saturated fat, tends to raise
     blood cholesterol, which increases the risk for heart disease.

  4. Coronary heart disease -- Heart ailment caused by narrowing of the
     coronary arteries (arteries that supply oxygen and nutrients
     directly to the heart muscle). Coronary heart disease is caused by
     atherosclerosis, which decreases the blood supply to the heart
     muscle. The inadequate supply of oxygen-rich blood and nutrients
     may damage the heart muscle and can lead to chest pain, heart
     attack, and death.

  5. Fat -- One of the three nutrients that supply calories to the body.
     Fat provides 9 calories per gram, more than twice the number
     provided by carbohydrate or protein. In addition to providing
     calories, fat helps in the absorption of certain vitamins. Small
     amounts of fat are necessary for normal body function.

   * Total fat -- The sum of the saturated, monounsaturated, and
     polyunsaturated fats present in food. A mixture of all three in
     varying amounts is found in most foods.

   * Saturated fat -- A type of fat found in greatest amounts in foods
     from animals such as meat, poultry, and whole-milk dairy products
     like cream, milk, ice cream, and cheese. Other examples of
     saturated fat include butter, the marbling and fat along the edges
     of meat, butter, and lard. And the saturated fat content is high in
     some vegetable oils--like coconut, palm kernel, and palm oils.
     Saturated fat raises blood cholesterol more than anything else in
     the diet.

   * Unsaturated fat -- A type of fat that is usually liquid at
     refrigerator temperature. Monounsaturated fat and polyunsaturated
     fat are two kinds of unsaturated fat.

     Monounsaturated fat -- A slightly unsaturated fat that is found in
     greatest amounts in foods from plants, including olive and canola
     (rapeseed) oil. When substituted for saturated fat, monounsaturated
     fat helps reduce blood cholesterol.

     Omega-3 fatty acid (fish oil) - A type of polyunsaturated fat found
     in seafood and found in greatest amounts in fatty fish. Seafood is
     lower in saturated fat than meat.

     Polyunsaturated fat -- A highly unsaturated fat that is found in
     greatest amounts in foods from plants, including safflower,
     sunflower, corn, and soybean oils. When substituted for saturated
     fat, polyunsaturated fat helps reduce blood cholesterol.

  6. Gram (g) -- A unit of weight. There are about 28 g in 1 ounce.
     Dietary fat, protein, and carbohydrate are measured in grams.

  7. Hydrogenation -- A chemical process that changes liquid vegetable
     oils (unsaturated fat)into a more solid saturated fat. This process
     improves the shelf life of the product- but also increases the
     saturated fat content. Many commercial food products contain
     hydrogenated vegetable oil. Selection should be made based on
     information found on the label.

  8. Lipoproteins -- Protein-coated packages that carry fat and
     cholesterol through the blood. Lipoproteins are classified
     according to their density.

   * High density lipoproteins (HDL) -- Lipoproteins that contain a
     small amount of cholesterol and carry cholesterol away from body
     cells and tissues to the liver for excretion from the body. Low
     levels of HDL are associated with an increased risk of coronary
     head disease. Therefore the higher the HDL level, the better.

   * Low density lipoproteins (LDL) -- Lipoproteins that contain the
     largest amount of cholesterol in the blood. LDL is responsible for
     depositing cholesterol in the artery walls. High levels of LDL are
     associated with an increased risk of coronary head disease.

  9. Milligram (mg) -- A unit of weight equal to onethousandth of a
     gram. There are about 28,350 mg in 1 ounce. Dietary cholesterol is
     measured in milligrams.

 10. Milligrams/deciliter (mg/dl) -- A way of expressing concentration:
     in blood cholesterol measurements, the weight of cholesterol (in
     milligrams)in a deciliter of blood. A deciliter is about one-tenth
     of a quart.

 11. Protein -- One of the three nutrients that supply calories to the
     body. Protein provides 4 calories per gram, which is less than half
     the calories of fat. Protein an essential nutrient that becomes a
     component of many parts of the body, including muscle, bone, skin,
     and blood.


Appendix 1: Desirable Weights 1 for Men and Women (Ages 25 and Over)

     Height 2      Small Frame     Medium Frame     Large Frame
     Feet Inches

Men    5   2           112-120          118-129         126-141
       5   3           115-123          121-133         129-144
       5   4           118-126          124-136         132-148
       5   5           121-129          127-139         135-152
       5   6           124-133          130-143         138-156
       5   7           128-137          134-147         142-161
       5   8           132-141          138-152         147-166
       5   9           136-145          142-156         151-170
       5   10          140-150          146-160         155-174 
       5   11          144-154          150-165         159-179
       6   0           148-158          154-170         164-184
       6   1           152-162          158-175         168-189
       6   2           156-167          162-180         173-194
       6   3           160-171          167-185         178-199
       6   4           164-175          172-190         182-204


Women
       4 10            92-98            96-107          104-119
       4 11            94-101           98-110          106-122
       5 0             96-104           101-113         109-125
       5 1             99-107           104-116         112-128
       5 2             102-110          107-119         115-131
       5 3             105-113          110-122         118-134
       5 4             108-116          113-126         121-138
       5 5             111-119          116-130         125-142
       5 6             114-123          120-135         129-146
       5 7             118-127          124-139         133-150
       5 8             122-131          128-143         137-154
       5 9             126-135          132-147         141-158
       5 10            130-140          136-151         145-163
       5 11            134-144          140-155         149-168
       6 0             138-148          144-159         153-173

1 Weight in pounds according to frame (indoor clothing).

2 With 1-inch heel shoes on for men and 2-inch heel shoes on for women.

Appendix 2: Meats


Fat and Cholesterol Comparison Chart


When following a cholesterol-lowering diet, select the meats that are
lowest in saturated fat (i.e. saturated fatty acids) and cholesterol.
The information on total fat, percent calories from fat, and calories
should be helpful if you are trying to lose weight.

The following foods within each category (veal, lamb, beef, pork) are
ranked from low to high saturated fat. To reduce the saturated fat in
your diet, select the leaner cuts from the upper portion of each
category. Trimming the visible fat will reduce the fat content even
more. Since meats contribute a significant amount of saturated fat and
cholesterol to your diet, you should eat smaller portions (no more than
6 ounces a day).

[Graphic Omitted]

Appendix 3: Poultry


Fat and Cholesterol Comparison Chart


When following a cholesterol-lowering diet, select poultry low in
saturated fat (i.e. saturated fatty acids) and cholesterol. Choosing
poultry lower in total fat, calories, and percent calories from fat will
also help you lose weight.

This table ranks poultry from low to high saturated fat. Select the
lower fat poultry from the upper portion of the table. In general,
poultry, especially poultry with the skin removed, is lower in saturated
fat than most cuts of meat. To reduce the saturated fat in your diet
even more, eat smaller servings (no more than 6 ounces a day).

[Graphic Omitted]

Appendix 4: Fish and Shellfish


Fat and Cholesterol Comparison Chart


When following a cholesterol-lowering diet, you may want to eat more
fish and shellfish, which in general have a lot less saturated fat (i.e.
saturated fatty acids) and cholesterol than meat and poultry. However,
some shellfish is relatively high in cholesterol and should be eaten
less often. Fish and shellfish also contain less total fat and calories
than meat and poultry. Use the information on total fat, percent
calories from fat, and calories to help you lose weight.

This table ranks fish and shellfish within each category (finfish,
crustaceans, mollusks) from low to high saturated fat. You will want to
select the lower fat and cholesterol fish and shellfish from the upper
portion of the table. To reduce the amount of saturated fat in your diet
even more, eat smaller portions (no more than 6 ounces a day).

Omega-3 fatty acid (fish oil) is a type of polyunsaturated fat found in
the greatest amounts in fattier fish. Evidence is mounting that omega-3
fatty acids in the diet may help lower high blood cholesterol. Since
their potential benefit is not fully understood, the use of fish oil
supplements is not recommended. However, eating fish is beneficial
because it not only contains omega-3 fatty acids but, more importantly,
it is low in saturated fat.

[Graphic Omitted]


Appendix 5: Dairy and Egg Products


Fat and Cholesterol Comparison Chart

When following a cholesterol-lowering diet, select dairy products low in
saturated fat (i.e. saturated fatty acids) and cholesterol. Whole milk
dairy products are relatively high in both when compared ounce for ounce
with meat, poultry, and seafood. If you are trying to lose weight on
your cholesterol-lowering diet, choose dairy products low in total fat,
calories, and percent calories from fat.

The following foods within each category (milk, yogurt, cheese) are
ranked from low to high saturated fat. In general, the hard cheeses are
much higher in saturated fat and cholesterol than yogurt and most soft
cheeses. You will want to select foods from the upper portion of each
category.

[Graphic Omitted]

Appendix 6: Frozen Desserts


Fat and Cholesterol Comparison Chart


When following a cholesterol-lowering diet, select frozen desserts low
in saturated fat (i.e. saturated fatty acids) and cholesterol. This
table ranks frozen desserts from low to high saturated fat. Select the
lower fat desserts from the upper portion of the list. If you are also
trying to lose weight on your cholesterol-lowering diet, the calories
will be of special interest to you. Although some frozen desserts are
lower in fat than others, they may be just as high in calories as the
higher fat products because of their sugar content. You will want to
select those desserts not only low in fat but also low in calories.

[Graphic Omitted]

Appendix 7:


Fats and Oils Comparison Chart


This table compares the fat content of selected fats and oils, going
from those with a low saturated fat (i.e. saturated fatty acids) content
to those with a high saturated fat content. When following a
cholesterol-lowering diet, you will limit the amount of fat and oil in
your diet and when necessary use those fats which are lower in saturated
fat, in the upper portion of the table. All fats and oils are high i
calories, 115-120 calories per tablespoon.

[Graphic Omitted]

Appendix 8: Nuts and Seeds


Fat Comparison Chart


When following a cholesterol-lowering diet, you will be selecting foods
low in saturated fat (i.e. saturated fatty acids) and cholesterol. This
table ranks nuts and seeds from low to high saturated fat. Choose those
from the upper portion of the list. Most nuts and seeds would appear to
be appropriate foods to eat because they contain little saturated fat.
However, except for chestnuts, they are all high in total fat and
consequently high in calories. Thus if you are also trying to lose
weight, you should limit the use of nuts and seeds in your diet.

[Graphic Omitted]

Appendix 9: Breads, Cereals, Pasta, Rice, and Dried Peas and Beans


Fat and Cholesterol Comparison Chart


When following a cholesterol-lowering diet, you will be selecting foods
low in saturated fat (i.e. saturated fatty acids) and cholesterol. To
lose weight on your cholesterol-lowering diet, choose foods that are
lower in total fat, percent calories from fat, and calories.

Each of the following categories (breads, cereals, pasta, rice, and
dried peas and beans) is ranked from low to high saturated fat. To
reduce the saturated fat in your diet, select the products from the
upper portion of each category.

[Graphic Omitted]

Appendix 10: Sweets and Snacks


Fat and Cholesterol Comparison Chart


When following a cholesterol-lowering diet, select foods low in
saturated fat (i.e. saturated fatty acids) and cholesterol. To lose
weight on your cholesterol-lowering diet, see the information on total
fat, percent of calories from fat, and calories. Since the foods in this
table may be sweet even if they are low in fat, they could be high in
calories. Fruits, vegetables, and breads provide tasty, low-fat,
low-calorie alternatives.

The following foods within each category (beverages, candy, cookies,
cakes and pies, snacks, and pudding) are ranked from low to high
saturated fat. To reduce the saturated fat in your diet, select the
products from the upper portion of each category.

[Graphic Omitted]

Appendix 11: Miscellaneous


Fat and Cholesterol Comparison Chart

[Graphic Omitted]

The First Step in Eating Right is Buying Right


A Guide to Choosing Low-Saturated Fat, Low-Cholesterol Foods

[Graphic Omitted]

Limited quantities of this brochure are available free of
charge.

National Cholesterol Education Program
National Heart, Lung, and Blood Institute
C-200 Bethesda, Maryland 20892


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