Limit trans fats, boost heart health

What has been the effect from the ban on trans fats in New York City restaurants?

Restrictions on the use of partially hydrogenated vegetable oils at restaurants in New York City appear to have slashed the amount of trans fat that their patrons consume.

First, some background: Both saturated fat and trans fat increase blood cholesterol levels. High cholesterol increases the risk of heart disease, so health officials have long looked for ways to reduce such fats in the diet.

Trans fat has a far more negative effect than saturated fat. It’s estimated that an increase of just 2 percent of total calorie intake from trans fat — the equivalent of 40 calories in a 2,000-calorie-a-day diet, or 4.5 grams of trans fat — increases the risk of heart disease by as much as 23 percent.

Some of the trans fat we consume comes from milk, meat and other natural sources, but most of it is from partially hydrogenated oils — widely used because they improve the texture, shelf-life and flavor stability of processed foods.

When the Food and Drug Administration mandated in 2006 that trans fat amounts be listed on Nutrition Facts labels, many products were reformulated to reduce or eliminate trans fat. But meals from restaurants and other food-service establishments make up about one-third of the American diet. That’s why New York City and some other localities decided to put restrictions in place.

A study of lunches purchased at New York fast-food restaurants before and after the ban took effect found trans fat consumption decreased considerably, from almost 3 grams per meal to about a half-gram.

Interestingly, other research has found that Americans’ blood cholesterol levels have dropped from an average of 206 in 1988-94 to 196 in 2007-2010, and levels of LDL (the “bad”) cholesterol have dropped from 129 to 116. While no one can be certain what is causing the decline, researchers believe the decreased consumption of trans fat certainly has played a role.

To reduce trans fat in your diet:

  • Read labels. Foods with less than 0.5 grams of trans fat per serving will say “0” trans fat on Nutrition Facts labels. Also look at ingredient listings. Foods with “partially hydrogenated” oils contain at least some trans fat.
  • When eating out or buying foods at bakeries or other places that might not provide a label, inquire about use of partially hydrogenated oils. And, before going to a chain restaurant, visithttp://www.calorieking.com or a similar website to look up nutrition information on menu items.
  • Even better: Set a weekly goal to eat out less, and prepare food at home with healthy ingredients.

Understanding HDLs can be complex

I have always been proud of my high HDL level, but I heard recently that it might not be very important in terms of heart disease after all. What happened?

Well, not so fast.

You probably heard about a study that the medical journal The Lancetpublished online in May 2012. It received a lot of publicity because its findings were rather startling: After years of advising people to do what they can to raise their levels of HDLs — high-density lipoproteins, or what we’ve called the “good” cholesterol — researchers found that the 15 HDL-raising genetic variants they tested are not, in fact, linked to a reduced risk of heart attack.

However (and this is important): The scientists also emphasized that low HDL levels remain a good predictor, or what they call a “biomarker,” that a person has a higher risk of heart disease. This study revealed that low HDL levels themselves aren’t actually the bad guys — it appears that they’re just somehow associated with some as-yet-undetermined factor that increases the risk of heart disease.

So, for people who have a low HDL level, increasing it — by changing the diet or taking supplements, for example — won’t lower the risk of heart disease in and of itself. Raising a low HDL level simply won’t change the underlying factors that signal an increased risk.

At the same time, eating a healthy, balanced diet has many benefits. If it increases your HDLs at the same time, there’s certainly no harm in that.

It’s also important to realize that this finding does not affect recommendations regarding LDLs, or low-density lipoproteins. And, while genetic factors play a strong role in determining LDL levels, there’s a lot you can do to keep them as low as possible, including avoiding trans fats; keeping saturated fats low (less than 7 percent of your total calories); limiting total fat to 25 to 35 percent of total calories; keeping cholesterol intake to less than 200 milligrams a day; consuming 2 grams of plant stanols or sterols a day; increasing soluble fiber to 10 to 25 grams a day; and maintaining a healthy weight.

In addition, get at least 30 minutes of moderately intense exercise most days of the week, if not every day. And, when necessary, take prescribed medication, such as statins, to lower LDLs.

For more information, the National Institutes of Health offers a free, comprehensive, easy-to-read guide to “Lowering Your Cholesterol with TLC: Therapeutic Lifestyle Changes.” To download a copy, go tohttp://bit.ly/chol_TLC.