Chapter 5 Lipids

The Functions of Lipids in the Body

Regulating and Signaling

TriacylglycerolsThe most common of the three basic classes of lipids and the main form fat takes in both diet and the human body. A triacylglycerol is made up of three molecules of fatty acids and one molecule of glycerol. control the body’s internal climate, maintaining constant temperature. Those who don’t have enough fat in their bodies tend to feel cold sooner, are often fatigued, and have pressure sores on their skin from fatty acid deficiency. Triacylglycerols also help the body produce and regulate hormones. For example, adipose tissue secretes the hormone leptin, which regulates appetite. In the reproductive system, fatty acids are required for proper reproductive health; women who lack proper amounts may stop menstruating and become infertile. Omega-3 and omega-6 essential fatty acids help regulate cholesterol and blood clotting and control inflammation in the joints, tissues, and bloodstream. Fats also play important functional roles in sustaining nerve impulse transmission, memory storage, and tissue structure. More specifically in the brain, lipids are focal to brain activity in structure and in function. They help form nerve cell membranes, insulate neurons, and facilitate the signaling of electrical impulses throughout the brain.

Lipids serve as signaling molecules; they are catalysts of electrical impulse activity within the brain.

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Aiding Digestion and Increasing Bioavailability

The dietary fats in the foods we eat break down in our digestive systems and begin the transport of precious micronutrients. By carrying fat-soluble nutrients through the digestive process, intestinal absorption is improved. This improved absorption is also known as increased bioavailabilityRefers to the proportion of nutrients that are absorbed or become available in the bloodstream.. Fat-soluble nutrients are especially important for good health and exhibit a variety of functions. Vitamins A, D, E, and K—the fat-soluble vitamins—are mainly found in foods containing fat. Some fat-soluble vitamins (such as vitamin A) are also found in naturally fat-free foods such as green leafy vegetables, carrots, and broccoli. These vitamins are best absorbed when combined with foods containing fat. Fats also increase the bioavailability of compounds known as phytochemicalsNonessential plant compounds considered to have a beneficial impact on human health., which are plant constituents such as lycopene (found in tomatoes) and beta-carotene (found in carrots). Phytochemicals are believed to promote health and well-being. As a result, eating tomatoes with olive oil or salad dressing will facilitate lycopene absorption. Other essential nutrients, such as essential fatty acids, are constituents of the fats themselves and serve as building blocks of a cell.

Figure 5.2 Food Sources for Fat Soluble Vitamins

Note that removing the lipid elements from food also takes away the food’s fat-soluble vitamin content. When products such as grain and dairy are processed, these essential nutrients are lost. Manufacturers replace these nutrients through a process called enrichment.

Tools for Change

Remember, fat-soluble nutrients require fat for effective absorption. For your next snack, look for foods that contain vitamins A, D, E, and K. Do these foods also contain fat that will help you absorb them? If not, think of ways to add a bit of healthy fat to aid in their absorption. (For more details on healthy fat, refer to Section 5.4 "Understanding Blood Cholesterol" of this chapter.)

The Role of Lipids in Food

High Energy Source

Athletes have high-energy requirements.

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Fat-rich foods naturally have a high caloric density. Foods that are high in fat contain more calories than foods high in protein or carbohydrates. As a result, high-fat foods are a convenient source of energy. For example, 1 gram of fat or oil provides 9 kilocalories of energy, compared with 4 kilocalories found in 1 gram of carbohydrate or protein. Depending on the level of physical activity and on nutritional needs, fat requirements vary greatly from person to person. When energy needs are high, the body welcomes the high-caloric density of fats. For instance, infants and growing children require proper amounts of fat to support normal growth and development. If an infant or child is given a low-fat diet for an extended period, growth and development will not progress normally. Other individuals with high-energy needs are athletes, people who have physically demanding jobs, and those recuperating from illness.

When the body has used all of its calories from carbohydrates (this can occur after just twenty minutes of exercise), it initiates fat usage. A professional swimmer must consume large amounts of food energy to meet the demands of swimming long distances, so eating fat-rich foods makes sense. In contrast, if a person who leads a sedentary lifestyle eats the same high-density fat foods, they will intake more fat calories than their body requires within just a few bites. Use caution—consumption of calories over and beyond energy requirements is a contributing factor to obesity.

Triacylglycerols Structure and Functions

Triacylglycerols are the main form of lipid found in the body and in the diet. Fatty acids and glycerol are the building blocks of triacylglycerols. Glycerol is a thick, smooth, syrupy compound that is often used in the food industry. To form a triacylglycerol, a glycerol molecule is joined by three fatty acid chains. Triacylglycerols contain varying mixtures of fatty acids.

Fatty Acids

Fatty acids determine if the compound is solid or liquid at room temperature. Fatty acidsAn organic compound that contains a carboxylic acid (−COOH) group at one end and a methyl group at the other (−CH3). consist of a carboxylic acid (−OOH) group on one end of a carbon chain and a methyl group (−CH₃) on the other end. Fatty acids can differ from one another in two important ways—carbon chain length and degree of saturation.

It’s All in the Chain

Fatty acids have different chain lengths and different compositions. Foods have fatty acids with chain lengths between four and twenty-four carbons and most of them contain an even number of carbon atoms. When the carbon chain length is shorter, the melting point of the fatty acid becomes lower—and the fatty acid becomes more liquid.

Figure 5.3 Structures of a Saturated, Monounsaturated, and Polyunsaturated Fat

Cis or Trans Fatty Acids?

The introduction of a carbon double bond in a carbon chain, as in an unsaturated fatty acid, can result in different structures for the same fatty acid composition. When the hydrogen atoms are bonded to the same side of the carbon chain, it is called a cis fatty acidA fatty acid with the hydrogen atoms bonded to the same side of the carbon chain.. Because the hydrogen atoms are on the same side, the carbon chain has a bent structure. Naturally occurring fatty acids usually have a cis configuration.

In a trans fatty acidA fatty acid that has hydrogens attached on opposite sides of the carbon chain., the hydrogen atoms are attached on opposite sides of the carbon chain. Unlike cis fatty acids, most trans fatty acids are not found naturally in foods, but are a result of a process called hydrogenation. Hydrogenation is the process of adding hydrogen to the carbon double bonds, thus making the fatty acid saturated (or less unsaturated, in the case of partial hydrogenation). This is how vegetable oils are converted into semisolid fats for use in the manufacturing process.

According to the ongoing Harvard Nurses Health Study, trans fatty acids have been associated with increased risk for coronary heart disease because of the way they negatively impact blood cholesterol levels.Harvard School of Public Health. “It’s Time to End the Low-Fat Myth.” Introduction to “Fats and Cholesterol: Out with the Bad, In with the Good” in The Nutrition Source. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-full-story/#references.

Interestingly, some naturally occurring trans fats do not pose the same health risks as their artificially engineered counterparts. These trans fats are found in ruminant animals such as cows, sheep, and goats, resulting in trans fatty acids being present in our meat, milk, and other dairy product supply. Reports from the US Department of Agriculture (USDA) indicate that these trans fats comprise 15 to 20 percent of the total trans-fat intake in our diet. While we know that trans fats are not exactly harmless, it seems that any negative effect naturally occurring trans fats have are counteracted by the presence of other fatty acid molecules in these animal products, which work to promote human health.

Nonessential and Essential Fatty Acids

Fatty acids are vital for the normal operation of all body systems. The circulatory system, respiratory system, integumentary system, immune system, brain, and other organs require fatty acids for proper function. The body is capable of synthesizing most of the fatty acids it needs from food. These fatty acids are known as nonessential fatty acidsA fatty acid that can be synthesized by the body.. However, there are some fatty acids that the body cannot synthesize and these are called essential fatty acidsA fatty acid that the body cannot synthesize and must be supplied through the diet.. It is important to note that nonessential fatty acids doesn’t mean unimportant; the classification is based solely on the ability of the body to synthesize the fatty acid.

Essential fatty acids must be obtained from food. They fall into two categories—omega-3 and omega-6. The 3 and 6 refer to the position of the first carbon double bond and the omega refers to the methyl end of the chain. Omega-3 and omega-6 fatty acids are precursors to important compounds called eicosanoidsCompounds derived from polyunsaturated fatty acids that control several body functions.. Eicosanoids are powerful hormones that control many other hormones and important body functions, such as the central nervous system and the immune system. Eicosanoids derived from omega-6 fatty acids are known to increase blood pressure, immune response, and inflammation. In contrast, eicosanoids derived from omega-3 fatty acids are known to have heart-healthy effects. Given the contrasting effects of the omega-3 and omega-6 fatty acids, a proper dietary balance between the two must be achieved to ensure optimal health benefits.

Essential fatty acids play an important role in the life and death of cardiac cells, immune system function, and blood pressure regulation. Docosahexaenoic acid (DHA)An omega-3 fatty acid that is especially important for brain growth and development in infants. is an omega-3 essential fatty acid shown to play important roles in synaptic transmission in the brain during fetal development.

Some excellent sources of omega-3 and omega-6 essential fatty acids are fish, flaxseed oil, hemp, walnuts, and leafy vegetables. Because these essential fatty acids are easily accessible, essential fatty acid deficiency is extremely rare.

Tools for Change

There are many sources of omega-3 foods.

It is important to strike a proper balance between omega-3 and omega-6 fats in your diet. Research suggests that a diet that is too high in omega-6 fats distorts the balance of proinflammatory agents, promoting chronic inflammation and causing the potential for health problems such as asthma, arthritis, allergies, or diabetes. Omega-6 fats compete with omega-3 fats for enzymes and will actually replace omega-3 fats. The typical western diet is characterized by an excessive consumption of foods high in omega-6 fatty acids. To gain proper balance between the two, increase your omega-3 fat intake by eating more fatty fish or other sources of omega-3 fatty acids at least two times per week.

Fatty-Acid Composition in the Diet and in the Body

The fatty-acid profile of the diet directly correlates to the tissue lipid profile of the body. It may not solely be the quantity of dietary fat that matters. More directly, the type of dietary fat ingested has been shown to affect body weight, composition, and metabolism. The fatty acids consumed are often incorporated into the triacylglycerols within the body. Evidence confirms that saturated fatty acids are linked to higher rates of weight retention when compared to other types of fatty acids. Alternatively, the fatty acids found in fish oil are proven to reduce the rate of weight gain as compared to other fatty acids.Mori, T. “Dietary fish oil upregulates intestinal lipid metabolism and reduces body weight gain in C57BL/6J mice.” J Nutr. 2007 Dec;137(12):2629-34. http://www.ncbi.nlm.nih.gov/pubmed/18029475

Phospholipids

Like triacylglycerols, phospholipids have a glycerol backbone. But unlike triacylglycerols, phospholipids are diglycerides (two fatty-acid molecules attached to the glycerol backbone) while their third fatty-acid chain has a phosphate group coupled with a nitrogen-containing group. This unique structure makes phospholipids water soluble. Phospholipids are what we call amphiphilicA compound that has both water-loving and fat-loving properties.—the fatty-acid sides are hydrophobic (dislike water) and the phosphate group is hydrophilic (likes water).

In the body phospholipids bind together to form cell membranes. The amphiphilic nature of phospholipids governs their function as components of cell membranes. The phospholipids form a double layer in cell membranes, thus effectively protecting the inside of the cell from the outside environment while at the same time allowing for transport of fat and water through the membrane.

Phospholipids are ideal emulsifiersCompound that allow two immiscible liquids to combine so that no separation occurs. that can keep oil and water mixed. Emulsions are mixtures of two liquids that do not mix. Without emulsifiers, the fat and water content would be somewhat separate within food. Lecithin (phosphatidylcholine), found in egg yolk, honey, and mustard, is a popular food emulsifier. Mayonnaise demonstrates lecithin’s ability to blend vinegar and oil to create the stable, spreadable condiment that so many enjoy. Food emulsifiers play an important role in making the appearance of food appetizing. Adding emulsifiers to sauces and creams not only enhances their appearance but also increases their freshness.

Lecithin’s crucial role within the body is clear, because it is present in every cell throughout the body; 28 percent of brain matter is composed of lecithin and 66 percent of the fat in the liver is lecithin. Many people attribute health-promoting properties to lecithin, such as its ability to lower blood cholesterol and aid with weight loss. There are several lecithin supplements on the market broadcasting these claims. However, as the body can make most phospholipids, it is not necessary to consume them in a pill. The body makes all of the lecithin that it needs.

Sterols

Sterols have a very different structure from triacylglycerols and phospholipids. Most sterols do not contain any fatty acids but rather multiring structures. They are complex molecules that contain interlinking rings of carbon atoms, with side chains of carbon, hydrogen, and oxygen attached. Cholesterol is the best-known sterol because of its role in heart disease. It forms a large part of the plaque that narrows the arteries in atherosclerosis. In stark contrast, cholesterol does have specific beneficial functions to perform in the body. Like phospholipids, cholesterol is present in all body cells as it is an important substance in cell membrane structure. Approximately 25 percent of cholesterol in the body is localized in brain tissue. Cholesterol is used in the body to make a number of important things, including vitamin D, glucocorticoids, and the sex hormones, progesterone, testosterone, and estrogens. Notably, the sterols found in plants resemble cholesterol in structure. However, plant sterols inhibit cholesterol absorption in the human body, which can contribute to lower cholesterol levels.

Although cholesterol is preceded by its infamous reputation, it is clearly a vital substance in the body that poses a concern only when there is excess accumulation of it in the blood. Like lecithin, the body can synthesize cholesterol.

From the Mouth to the Stomach

The first step in the digestion of triacylglycerols and phospholipids begins in the mouth as lipids encounter saliva. Next, the physical action of chewing coupled with the action of emulsifiers enables the digestive enzymes to do their tasks. The enzyme lingual lipaseAn enzyme responsible for the breakdown of triacylglycerols and phospholipids., along with a small amount of phospholipid as an emulsifier, initiates the process of digestion. These actions cause the fats to become more accessible to the digestive enzymes. As a result, the fats become tiny droplets and separate from the watery components.

Figure 5.4 Lipid Digestion

In the stomach, gastric lipase starts to break down triacylglycerols into diglyceridesA product of lipid digestion, consisting of a glycerol molecule that has two fatty acids attached. and fatty acids. Within two to four hours after eating a meal, roughly 30 percent of the triacylglycerols are converted to diglycerides and fatty acids. The stomach’s churning and contractions help to disperse the fat molecules, while the diglycerides derived in this process act as further emulsifiers. However, even amid all of this activity, very little fat digestion occurs in the stomach.

Going to the Bloodstream

As stomach contents enter the small intestine, the digestive system sets out to manage a small hurdle, namely, to combine the separated fats with its own watery fluids. The solution to this hurdle is bileA substance secreted by the liver that aids in the absorption and digestion of fats.. Bile contains bile salts, lecithin, and substances derived from cholesterol so it acts as an emulsifier. It attracts and holds on to fat while it is simultaneously attracted to and held on to by water. Emulsification increases the surface area of lipids over a thousand-fold, making them more accessible to the digestive enzymes.

Once the stomach contents have been emulsified, fat-breaking enzymes work on the triacylglycerols and diglycerides to sever fatty acids from their glycerol foundations. As pancreatic lipase enters the small intestine, it breaks down the fats into free fatty acids and monoglyceridesA product of lipid digestion, consisting of a glycerol molecule with one fatty acid attached.. Yet again, another hurdle presents itself. How will the fats pass through the watery layer of mucous that coats the absorptive lining of the digestive tract? As before, the answer is bile. Bile salts envelop the fatty acids and monoglycerides to form micelles. Micelles have a fatty acid core with a water-soluble exterior. This allows efficient transportation to the intestinal microvillus. Here, the fat components are released and disseminated into the cells of the digestive tract lining.

Fats can travel through the watery environment of the body due to the process of emulsion.

Just as lipids require special handling in the digestive tract to move within a water-based environment, they require similar handling to travel in the bloodstream. Inside the intestinal cells, the monoglycerides and fatty acids reassemble themselves into triacylglycerols. Triacylglycerols, cholesterol, and phospholipids form lipoproteinsProteins that contains a lipid which serves to transport fat through blood and lymph. when joined with a protein carrier. Lipoproteins have an inner core that is primarily made up of triacylglycerols and cholesterol esters (a cholesterol ester is a cholesterol linked to a fatty acid). The outer envelope is made of phospholipids interspersed with proteins and cholesterol. Together they form a chylomicronChylomicron clusters form when lipids are combined with carrier proteins in the cells of the intestinal lining. Chylomicron is a vehicle of transport for fats throughout the watery environment of the body to the liver and other tissues., which is a large lipoprotein that now enters the lymphatic system and will soon be released into the bloodstream via the jugular vein in the neck. Chylomicrons transport food fats perfectly through the body’s water-based environment to specific destinations such as the liver and other body tissues.

Cholesterols are poorly absorbed when compared to phospholipids and triacylglycerols. Cholesterol absorption is aided by an increase in dietary fat components and is hindered by high fiber content. This is the reason that a high intake of fiber is recommended to decrease blood cholesterol. Foods high in fiber such as fresh fruits, vegetables, and oats can bind bile salts and cholesterol, preventing their absorption and carrying them out of the colon.

If fats are not absorbed properly as is seen in some medical conditions, a person’s stool will contain high amounts of fat. If fat malabsorption persists the condition is known as steatorrhea. Steatorrhea can result from diseases that affect absorption, such as Crohn’s disease and cystic fibrosis.

The Truth about Storing and Using Body Fat

Before the prepackaged food industry, fitness centers, and weight-loss programs, our ancestors worked hard to even locate a meal. They made plans, not for losing those last ten pounds to fit into a bathing suit for vacation, but rather for finding food. Today, this is why we can go long periods without eating, whether we are sick with a vanished appetite, our physical activity level has increased, or there is simply no food available. Our bodies reserve fuel for a rainy day.

One way the body stores fat was previously touched upon in Chapter 4 "Carbohydrates". The body transforms carbohydrates into glycogen that is in turn stored in the muscles for energy. When the muscles reach their capacity for glycogen storage, the excess is returned to the liver, where it is converted into triacylglycerols and then stored as fat.

In a similar manner, much of the triacylglycerols the body receives from food is transported to fat storehouses within the body if not used for producing energy. The chylomicrons are responsible for shuttling the triacylglycerols to various locations such as the muscles, breasts, external layers under the skin, and internal fat layers of the abdomen, thighs, and buttocks where they are stored by the body in adipose tissue for future use. How is this accomplished? Recall that chylomicrons are large lipoproteins that contain a triacylglycerol and fatty-acid core. Capillary walls contain an enzyme called lipoprotein-lipase that dismantles the triacylglycerols in the lipoproteins into fatty acids and glycerol, thus enabling these to enter into the adipose cells. Once inside the adipose cells, the fatty acids and glycerol are reassembled into triacylglycerols and stored for later use. Muscle cells may also take up the fatty acids and use them for muscular work and generating energy. When a person’s energy requirements exceed the amount of available fuel presented from a recent meal or extended physical activity has exhausted glycogen energy reserves, fat reserves are retrieved for energy utilization.

As the body calls for additional energy, the adipose tissue responds by dismantling its triacylglycerols and dispensing glycerol and fatty acids directly into the blood. Upon receipt of these substances the energy-hungry cells break them down further into tiny fragments. These fragments go through a series of chemical reactions that yield energy, carbon dioxide, and water.

Major Lipoproteins

Recall that chylomicrons are transporters of fats throughout the watery environment within the body. After about ten hours of circulating throughout the body, chylomicrons gradually release their triacylglycerols until all that is left of their composition is cholesterol-rich remnants. These remnants are used as raw materials by the liver to formulate specific lipoproteins. Following is a list of the various lipoproteins and their functions:

• VLDLsVery low-density lipoproteins formed in the liver from the remains of the chylomicron.. Very low-density lipoproteins are made in the liver from remnants of chylomicrons and transport triacylglycerols from the liver to various tissues in the body. As the VLDLs travel through the circulatory system, the lipoprotein lipase strips the VLDL of triacylglycerols. As triacylglycerol removal persists, the VLDLs become intermediate-density lipoproteins.
• IDLsIntermediate-density lipoproteins transport a variety of fats and cholesterol in the bloodstream and are a little under half triacylglycerol in composition.. Intermediate-density lipoproteins transport a variety of fats and cholesterol in the bloodstream and are a little under half triacylglycerol in composition. While travelling in the bloodstream, cholesterol is gained from other lipoproteins while circulating enzymes strip its phospholipid component. When IDLs return to the liver, they are transformed into low-density lipoprotein.
• LDLsLow-density lipoproteins are also known as “bad cholesterol.” It contains higher concentrations of triacylglycerols and lower concentrations of protein and is responsible for delivering cholesterol to the body’s tissues.. As low-density lipoproteins are commonly known as the “bad cholesterol” it is imperative that we understand their function in the body so as to make healthy dietary and lifestyle choices. LDLs carry cholesterol and other lipids from the liver to tissue throughout the body. LDLs are comprised of very small amounts of triacylglycerols, and house over 50 percent cholesterol and cholesterol esters. How does the body receive the lipids contained therein? As the LDLs deliver cholesterol and other lipids to the cells, each cell’s surface has receptor systems specifically designed to bind with LDLs. Circulating LDLs in the bloodstream bind to these LDL receptors and are consumed. Once inside the cell, the LDL is taken apart and its cholesterol is released. In liver cells these receptor systems aid in controlling blood cholesterol levels as they bind the LDLs. A deficiency of these LDL binding mechanisms will leave a high quantity of cholesterol traveling in the bloodstream, which can lead to heart disease or atherosclerosis. Diets rich in saturated fats will prohibit the LDL receptors. Thus, LDL receptors are critical for regulating cholesterol levels.
• HDLsHigh-density lipoproteins are also known as “good cholesterol.” It contains the maximum percentage of protein and a lower percentage of cholesterol and collects and transports excess cholesterol, returning it to the liver for reuse or excretion.. High-density lipoproteins are responsible for carrying cholesterol out of the bloodstream and into the liver, where it is either reused or removed from the body with bile. HDLs have a very large protein composition coupled with low cholesterol content (20 to 30 percent) compared to the other lipoproteins. Hence, these high-density lipoproteins are commonly called “good cholesterol.”

Blood Cholesterol Recommendations

For healthy total blood cholesterol, the desired range you would want to maintain is under 200 mg/dL. More specifically, when looking at individual lipid profiles, a low amount of LDL and a high amount of HDL prevents excess buildup of cholesterol in the arteries and wards off potential health hazards. An LDL level of less than 100 milligrams per deciliter is ideal while an LDL level above 160 milligrams per deciliter would be considered high. In contrast, a low value of HDL is a telltale sign that a person is living with major risks for disease. Values of less than 40 milligrams per deciliter for men and 50 milligrams per deciliter for women mark a risk factor for developing heart disease. In short, elevated LDL blood lipid profiles indicate an increased risk of heart attack, while elevated HDL blood lipid profiles indicate a reduced risk.

The University of Maryland Medical Center reports that omega-3 fatty acids promote lower total cholesterol and lower triacylglycerols in people with high cholesterol.University of Maryland Medical Center. “Omega-3 fatty acids.” http://www.umm.edu/altmed/articles/omega-3-000316.htm It is suggested that people consume omega-3 fatty acids such as alpha-linolenic acid in their diets regularly. Polyunsaturated fatty acids are especially beneficial to consume because they both lower LDL and elevate HDL, thus contributing to healthy blood cholesterol levels. The study also reveals that saturated and trans fatty acids serve as catalysts for the increase of LDL cholesterol. Additionally, trans fatty acids raise HDL levels, which can impact negatively on total blood cholesterol.

Testing Your Lipid Profile

The danger of consuming foods rich in cholesterol and saturated and trans fats cannot be overemphasized. Regular testing can provide the foreknowledge necessary to take action to help prevent any life-threatening events.

Current guidelines recommend testing for anyone over age twenty. If there is family history of high cholesterol, your healthcare provider may suggest a test sooner than this. Testing calls for a blood sample to be drawn after nine to twelve hours of fasting for an accurate reading. (By this time, most of the fats ingested from the previous meal have circulated through the body and the concentration of lipoproteins in the blood will have stabilized.)

According to the National Institutes of Health (NIH), the following total cholesterol values are used to target treatment:National Heart, Lung, and Blood Institute, National Institutes of Health. “High Blood Cholesterol: What You Need to Know.” NIH Publication No. 05-3290. (Revised June 2005). Section 2.01. http://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm.

• Desirable. Under 200 milligrams per deciliter
• Borderline high. 200–239 milligrams per deciliter
• High risk. 240 milligrams per deciliter and up

According to the NIH, the following desired values are used to measure an overall lipid profile:

• LDL. Less than 160 milligrams per deciliter (if you have heart disease or diabetes, less than 100 milligrams per deciliter)
• HDL. Greater than 40–60 milligrams per deciliter
• Triacylglycerols. 10–150 milligrams per deciliter
• VLDL. 2–38 milligrams per deciliter

Recommended Fat Intake

The acceptable macronutrient distribution range (AMDR) from the Dietary Reference Intake Committee for adult fat consumption is as follows:Institute of Medicine. “Dietary Reference Intakes: Macronutrients.” Accessed October 5, 2012. http://www.iom.edu/~/media/Files/Activity%20Files/Nutrition/DRIs/DRI _Macronutrients.pdf

• Fat calories should be limited to 20–35 percent of total calories with most fats coming from polyunsaturated and monounsaturated fats, such as those found in fish, nuts, and vegetable oils.
• Consume fewer than 10 percent of calories from saturated fats. Some studies suggest that lowering the saturated fat content to less than 7 percent can further reduce the risk of heart disease.
• Keep the consumption of trans fats (any food label that reads hydrogenated or partially hydrogenated oil) to a minimum, less than 1 percent of calories.
• Think lean and low-fat when selecting meat, poultry, milk, and milk products.

The current AMDR for child and adolescent fat consumption (for children over four) are as follows:

• For children between ages four and eighteen years, between 25 and 35 percent of caloric intake should be from fat.
• For all age groups, most fats should come from polyunsaturated and monounsaturated fats such as fish, nuts, and vegetable oils.

Identifying Sources of Fat

Population-based studies of American diets have shown that intake of saturated fat is more excessive than intake of trans fat and cholesterol. Saturated fat is a prominent source of fat for most people as it is so easily found in animal fats, tropical oils such as coconut and palm oil, and full-fat dairy products. Oftentimes the fat in the diet of an average young person comes from foods such as cheese, pizza, cookies, chips, desserts, and animal meats such as chicken, burgers, sausages, and hot dogs. To aim for healthier dietary choices, the American Heart Association (AHA) recommends choosing lean meats and vegetable alternatives, choosing dairy products with low fat content, and minimizing the intake of trans fats. The AHA guidelines also recommend consuming fish, especially oily fish, at least twice per week.American Heart Association. “Frequently Asked Questions About Fish.” http://www.heart.org/HEARTORG/General/Frequently-Asked-Questions-About-Fish _UCM_306451_Article.jsp. These more appropriate dietary choices will allow for enjoyment of a wide variety of foods while providing the body with the recommended levels of fat from healthier sources. Evaluate the following sources of fat in your overall dietary pattern:

Enjoy a delicious vegetable burger with carrot sticks as an alternative to a traditional beef hamburger with French fries.

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• Monounsaturated fat. This type of fat is found in plant oils. Common sources are nuts (almonds, cashews, pecans, peanuts, and walnuts) and nut products, avocados, extra virgin olive oil, sesame oil, high oleic safflower oil, sunflower oil, and canola oil.
• Polyunsaturated fat. This type of fat is found mainly in plant-based foods, oils, and fish. Common sources are nuts (walnuts, hazel nuts, pecans, almonds, and peanuts), soybean oil, corn oil, safflower oil, flaxseed oil, canola oil, and fish (trout, herring, and salmon).
• Saturated fat. This fat is found in animal products, dairy products, palm and coconut oils, and cocoa butter. Limit these products to less than 10 percent of your overall dietary fat consumption.
• Trans fatty acids. Stick margarines, fast foods, commercial baked goods, and some snack foods contain trans fats. Limit your consumption of these products to keep trans fats to less than 1 percent of your fat consumption.
• Omega-3 fatty acids (linolenic acid). Good sources of these are canola oil, flaxseed oil, soybean oil, olive oil, nuts, seeds, whole grains, legumes, and green leafy vegetables.
• DHA and EPA. Good sources of these are cod liver oil and fish such as tuna, herring, mackerel, salmon, and trout.
• Omega-6 fatty acids (linoleic acid). Eggs, poultry, most vegetable oils, wheat germ oil, whole grains, baked goods, and cereals contain these fatty acids. Omega-6 fatty acids are present abundantly in nuts and seeds such as flaxseeds, sunflower seeds, sesame seeds, and watermelon seeds.

Omega-3 and Omega-6 Fatty Acids

Recall that the body requires fatty acids and is adept at synthesizing the majority of these from fat, protein, and carbohydrate. However, when we say essential fatty acid we are referring to the two fatty acids that the body cannot create on its own, namely, linolenic acidAn omega-3 fatty acid that is essential for human health. and linoleic acidAn omega-6 fatty acid that is essential for human health..

• Omega-3 Fatty Acids. At the helm of the omega-3 fatty acid family is linolenic acid. From this fatty acid, the body can make eicosapentaenoic acid (EPA)An omega-3 fatty acid made from linolenic acid, found in fish. and docosahexaenoic acid (DHA)An omega-3 fatty acid that is especially important for brain growth and development in infants.. Linolenic acid is found in nuts, seeds, whole grains, legumes, and vegetable oil such as soybean, canola, and flaxseed. EPA and DHA are found abundantly in fatty fish.
• Omega-6 Fatty Acids. At the helm of the omega-6 fatty acid family is linoleic acid. Like linolenic acid, the body uses linoleic acid to make other important substances such as arachidonic acid (ARA)An omega-6 essential fatty acid that is a precursor to the synthesis of eicosanoids. that is used to make eicosanoids. Recall that eicosanoids perform critical roles in the body as they affect a broad spectrum of functions. The word eicosanoid originates from the Greek word eicosa, meaning twenty, because this hormone is derived from ARA that is twenty carbon atoms in length. Eicosanoids affect the synthesis of all other body hormones and control all body systems, such as the central nervous system and the immune system. Among the many functions eicosanoids serve in the body, their primary function is to regulate inflammation. Without these hormones the body would not be able to heal wounds, fight infections, or fight off illness each time a foreign germ presented itself. Eicosanoids work together with the body’s immune and inflammation processes to play a major role in several important body functions, such as circulation, respiration, and muscle movement.

Hydrogenation: The Good Gone Bad?

Food manufacturers are aware that fatty acids are susceptible to attack by oxygen molecules because their points of unsaturation render them vulnerable in this regard. When oxygen molecules attack these points of unsaturation the modified fatty acid becomes oxidized. The oxidation of fatty acids makes the oil rancid and gives the food prepared with it an unappetizing taste. Because oils can undergo oxidation when stored in open containers, they must be stored in airtight containers and possibly be refrigerated to minimize damage from oxidation. Hydrogenation poses a solution that food manufacturers prefer.

When lipids are subjected to hydrogenation, the molecular structure of the fat is altered. Hydrogenation is the process of adding hydrogen to unsaturated fatty-acid chains, so that the hydrogen atoms are connected to the points of saturation and results in a more saturated fatty acid. Liquid oils that once contained more unsaturated fatty acids become semisolid or solid (upon complete hydrogenation) and behave like saturated fats. Oils initially contain polyunsaturated fatty acids. When the process of hydrogenation is not complete, for example, not all carbon double bonds have been saturated the end result is a partially hydrogenated oil. The resulting oil is not fully solid. Total hydrogenation makes the oil very hard and virtually unusable. Some newer products are now using fully hydrogenated oil combined with nonhydrogenated vegetable oils to create a usable fat.

Manufacturers favor hydrogenation as a way to prevent oxidation of oils and ensure longer shelf life. Partially hydrogenated vegetable oils are used in the fast food and processed food industries because they impart the desired texture and crispness to baked and fried foods. Partially hydrogenated vegetable oils are more resistant to breakdown from extremely hot cooking temperatures. Because hydrogenated oils have a high smoking pointThe temperature at which fat gives off a pungent blue gas. they are very well suited for frying. In addition, processed vegetable oils are cheaper than fats obtained from animal sources, making them a popular choice for the food industry.

Trans fatty acids occur in small amounts in nature, mostly in dairy products. However, the trans fats that are used by the food industry are produced from the hydrogenation process. Trans fats are a result of the partial hydrogenation of unsaturated fatty acids, which cause them to have a trans configuration, rather than the naturally occurring cis configuration.

Health Implications of Trans Fats

No trans fats! Zero trans fats! We see these advertisements on a regular basis. So widespread is the concern over the issue that restaurants, food manufacturers, and even fast-food establishments proudly tout either the absence or the reduction of these fats within their products. Amid the growing awareness that trans fats may not be good for you, let’s get right to the heart of the matter. Why are trans fats so bad?

Processing naturally occurring fats to modify their texture from liquid to semisolid and solid forms results in the development of trans fats, which have been linked to an increased risk for heart disease. Trans fats are used in many processed foods such as cookies, cakes, chips, doughnuts, and snack foods to give them their crispy texture and increased shelf life. However, because trans fats can behave like saturated fats, the body processes them as if they were saturated fats. Consuming large amounts of trans fats has been associated with tissue inflammation throughout the body, insulin resistance in some people, weight gain, and digestive troubles. In addition, the hydrogenation process robs the person of the benefits of consuming the original oil because hydrogenation destroys omega-3 and omega-6 fatty acids. The AHA states that, like saturated fats, trans fats raise LDL “bad cholesterol,” but unlike saturated fats, trans fats lower HDL “good cholesterol.” The AHA advises limiting trans-fat consumption to less than 1 percent.

How can you benefit from this information? When selecting your foods, steer clear of anything that says “hydrogenated,” “fractionally hydrogenated,” or “partially hydrogenated,” and read food labels in the following categories carefully:

• cookies, crackers, cakes, muffins, pie crusts, pizza dough, and breads
• stick margarines and vegetable shortening
• premixed cake mixes, pancake mixes, and drink mixes
• fried foods and hard taco shells
• snack foods (such as chips), candy, and frozen dinners

Choose brands that don’t use trans fats and that are low in saturated fats.

Watch Out for Saturated Fat and Cholesterol

In proper amounts, cholesterol is a compound used by the body to sustain many important body functions. In excess, cholesterol is harmful if it accumulates in the structures of the body’s vast network of blood vessels. High blood LDL and low blood HDL are major indicators of blood cholesterol risk. The largest influence on blood cholesterol levels rests in the mix of saturated fat and trans fat in the diet. According to the Harvard School of Public Health, for every extra 2 percent of calories from trans fat consumed per day—about the amount found in a midsize order of French fries at a fast-food establishment—the risk of coronary heart disease increases by 23 percent.Harvard School of Public Health. “Fats and Cholesterol: Out with the Bad, In with the Good.” Section 2.02. http://www.hsph.harvard.edu/nutritionsource/what-should-you -eat/fats-full-story/. A buildup of cholesterol in the blood can lead to brittle blood vessels and a blockage of blood flow to the affected area.

How saturated is the fat in your diet? Is it really necessary to eat saturated fat when the body makes all the saturated fat that it needs? Saturated fats should fall into the “bad” category—the body does not demand this kind of fat and it is proven to be a forerunner of cardiovascular disease. In the United States and other developed countries, populations acquire their saturated fat content mostly from meat, seafood, poultry (with skin consumed), and whole-milk dairy products (cheese, milk, and ice cream). Some plant foods are also high in saturated fats, including coconut oil, palm oil, and palm kernel oil.

A Guide to Making Sense of Dietary Fat

On your next trip to the grocery store prepare yourself to read all food labels carefully and to seriously consider everything that goes into your shopping cart. Create a shopping list and divide your list into columns for “Best,” “Better,” “Good,” “Least Desirable,” and “Infrequent Foods.” As you refine your sense of dietary fat, here are key points to bear in mind:

• Shopping for groceries. Don’t be bombarded with gratuitous grams of saturated fats and empty grams of trans fats. Read and decipher food labels carefully so that you know exactly what types of fat a food item contains and how much fat it will contribute to your overall fat intake. For snacks and daily eating, gravitate toward foods that are lowest in or absent of harmful trans fats. Restrict other foods to occasional usage based upon their fat content. For example, if selecting prepared foods, choose the ones without high-fat sauces in favor of adding your own flavorings. If selecting precooked meats, avoid those that are fried, coated, or prepared in high-fat sauces. A popular and healthy precooked meat food choice is the rotisserie chicken that most supermarkets carry. When selecting meats be aware of the need to compare different cuts—notice their fat content, color, and marbling. Higher-fat meats tend to have whiter fat marbled throughout. Choose lean cuts and white meat as these are lower in saturated fat. Always choose plenty of fresh fruits, vegetables, nuts, and seeds, as their phytosterols are a good competitor for cholesterol. Keep a collection of nuts in your freezer that can be added to your salads, stir-fry, one-dish foods, soups, desserts, and yogurts.
• Appearance. Saturated and trans fats are not good for you and must be placed in your “Least Desirable” column because they increase cholesterol levels and put you at risk for heart disease. Monounsaturated and polyunsaturated fats are better choices to replace these undesirable fats. The key in identifying the “Best” or “Better” fats from the “Least Desirable” fats while you shop is based upon appearance. When choosing fats remember that saturated fats and trans fats are solid at room temperature; think of butter. Monounsaturated and polyunsaturated fats are liquid at room temperature; think of vegetable oil.
• Stay away from trans fats. There is no amount of trans fats that are good for human health. Try to eliminate as much of these fats as possible from your food selections. Avoid commercially baked goods and fast foods. Make these your “Infrequent Foods.”
• Choose unsaturated fats. Fatty fish, walnuts, flaxseeds, flaxseed oil, and canola oil all have good health benefits and should be on the “Best,” “Better,” and “Good” fat lists. They each provide essential omega-3 fatty acids necessary for overall body health. To derive the most benefit from including these foods, do not add them to an existing diet full of fat. Use these to replace the “Least Desirable” fats that are being removed from the diet. Be careful of exposing fats and oils to heat, light, and oxygen as they can be easily damaged. Exercise caution when heating oils. Polyunsaturated fats are the most fragile and lose beneficial properties when exposed to heat. For proper storage and freshness, place your oils in opaque containers and keep refrigerated. Do not use any oil if it has a bitter smell or taste.
• Limit saturated fat intake. Reduce red meat consumption, processed meats, and whole-fat dairy products. A good replacement for red meat could be beans (black beans are very high in protein), nuts, poultry, and fish whenever possible. To reduce full-fat dairy items try their low-fat or nonfat counterparts such as mozzarella cheese.
• Low fat does not equal healthy. Remember, a fat-free label does not provide you with a license to consume all the calories you desire. There will be consequences to your weight and your overall health. Common replacements for fat in many fat-free foods are refined carbohydrates, sugar, and calories. Too much of these ingredients can also cause health problems. Choose and consume wisely.

Helpful Suggestions

Keep the following in mind as you strive toward a healthier diet:

• A “better-fat” diet will successfully support weight loss. With the obesity rates in the United States more than tripling since 1980, it is interesting to note that this figure has presented itself and increased at a time when “low fat” advertising runs rampant throughout the food supply. While cutting “Least Desirable” fat calories are vital to weight loss, remember that “Better” fats are filling and just a handful of nuts can curb an appetite to prevent overeating.
• Consume omega-3 fats each day. For optimal health and disease prevention include a moderate serving of fish, walnuts, ground flaxseeds, flaxseed oil, or soybean oil in your diet every day.
• Limit cholesterol-rich foods. The following foods should be limited from the diet in order to reduce blood cholesterol: chicken livers, beef, pork, fast foods, pastries, butter, cheese, and ice cream.
• How much saturated fat is too much? Your goal is to keep your intake of saturated fat to no more than 10 percent of your total dietary calories on a daily basis. Thus, it is important to learn to reduce the intake of foods high in saturated fat. High-fat foods can be consumed but they must fall within the overall goal for a person’s fat allowance for the day.
• Home cooking. Limit the use of saturated fats in home preparation of meals. Instead of butter try spreads made from unsaturated oils such as canola or olive oils and the use of cooking sprays. Couple this with the use of herbs and spices to add flavor. Avoid using high-fat meat gravies, cheese, and cream sauces. Limit adding extras to foods such as butter on a baked potato. Use nonfat sour cream instead. Grill, bake, stir-fry, roast, or bake your foods. Never fry in solid fats such as butter or shortening. Marinate foods to be grilled in fruit juices and herbs. Instead of relying upon commercial salad dressings, learn to make your own top-quality dressing from cold-pressed olive oil, flaxseed oil, or sesame oil.
• Make sure the fat is flavorful. Adding flavor to food is what makes the eating experience enjoyable. Why not choose unsaturated fats and oils that have strong flavors? In this way you will add good flavor to your meals but use less fat in the process. Some examples are sesame oil, peanut oil, and peanut butter. Replace less flavorful cheeses with small amounts of strongly flavored cheeses such as romano, parmesan, and asiago.

Now that you have gained a wealth of information and food for thought to enable you to make changes to your dietary pattern we hope that your desire to pursue a healthier lifestyle has been solidified. While we realize that making grand strides in this direction may be awkward at first, even the smallest of accomplishments can produce noticeable results that will spur you on and perhaps spark the interest of friends and family to join you in this health crusade.

Becoming aware of the need to limit your total fat intake will facilitate your ability to make better choices. In turn, making better dietary choices requires gaining knowledge. As you understand that your food choices not only impact your personal physical health but also the delicate balance of our ecosystem, we are confident that you will successfully adapt to the dynamics of the ever-changing global food supply. Remember, the food choices you make today will benefit you tomorrow and into the years to come.