This video has been provided as a service of Sandoz Pharmaceuticals Corporation and
Marion Merrill Dow to aid you in your efforts to control cholesterol.
Although your health care provider has prescribed a cholesterol lowering drug, it's still important
for you to follow a diet low in saturated fat and cholesterol.
This video will help you do that by giving you tips on appropriate food selection.
Your health care provider has prescribed Lescol, a brand of fluvastatin sodium, to help control
your high cholesterol.
Lescol belongs to a class of drugs known as HMG-CoA reductase inhibitors, which bring
down cholesterol when diet and exercise are just not enough.
You should be concerned about high cholesterol levels because the consequences can be very
serious.
Over time, cholesterol and fat can build up in the walls of your arteries and slow or
even block the flow of blood to your heart, possibly leading to chest pain or heart attack.
Several research has shown that high blood cholesterol levels increase the risk of clogged
arteries and coronary heart disease.
If you have other risk factors for coronary heart disease, such as high blood pressure,
smoking, or a family history of heart disease, it's even more important that you keep your
cholesterol level low.
Once you start taking Lescol, this doesn't mean that you can eat whatever you want and
stop exercising.
It's extremely important that you continue your low-fat diet and keep up your exercise
program in order to get the most out of your therapy.
It's also important that you take Lescol as directed.
You can't feel the beneficial effects of your therapy, so you may be tempted to skip your
medication or forget to take it.
Don't.
Medical studies have proven that lowering your blood cholesterol will significantly
reduce your risk of heart disease.
Keep up your diet and exercise regimen, and keep taking your medication to keep yourself
in good health.
This program is intended to provide general nutrition information only and is not intended
to be a substitute for medical treatment.
The opinions given here are based on information provided by the manufacturer's labels at the
time this program was videotaped, information provided directly by the manufacturers, the
United States Department of Agriculture, some information of which is provisional, or current
health information available to the general public.
No endorsements of products are intended or implied.
References to and calculations concerning grams of saturated fat have been rounded to
the nearest half-gram.
According to current regulations, labels are supposed to give rounded-off numbers based
on serving size listed.
Please remember also that manufacturers constantly change formulations on various products, thus
labels shown here may vary from the labels on similarly named products from time to time.
Also, some products shown may not be available nationwide at this time.
This tape is not designed to diagnose or prescribe.
The producers and their representatives assume no responsibility or liability if you use
it in such a manner.
Always contact a qualified medical specialist before beginning any nutrition program.
In addition, children, especially those under 2 years of age, have different nutrition needs.
Always consult your physician before beginning any nutrition program for them.
Viewers, please note that throughout this tape, you will see products on green and
yellow blocks.
Each block represents 1 gram of saturated fat.
The number in front of each stack of blocks is the total number of grams of saturated
fat in a typical serving.
Products on the green blocks fall within current guidelines for a cholesterol-lowering diet
as recommended by the American Heart Association and the National Cholesterol Education Program.
It is suggested that products on the yellow blocks be used only occasionally and in small
amounts.
Ask your individual nutrition counselor for details.
Lanie Reed is a registered dietitian and a nationally recognized speaker and seminar
leader.
She's the author of the Supermarket Savvy Tour video and one of the authors of the American
Heart Association Low Fat, Low Cholesterol Cookbook.
She's also the founder of Supermarket Savvy, a nutrition and education consulting firm
that works with health professionals and industry.
Hi, I'm Lanie Reed.
If you're watching this tape, it's probably because your doctor told you to follow a diet
to help lower your blood cholesterol.
One that's much like these diets, the Step 1 and 2 diets of the National Cholesterol
Education Program.
Both of these diets cut back on fat, especially saturated fat, cut back on cholesterol, and
aim to promote weight loss in people who are overweight by eliminating excess calories.
But what does all this really mean to you, our viewer?
You want to know what foods you can have and what foods you can't, and how much.
This tape will introduce you to lots of new foods and give you scores of practical strategies
for shopping, cooking, and dining out.
But even more importantly, it will show you how to evaluate foods on the basis of saturated
fat and cholesterol so that no matter what foods are in your supermarket, you will be
able to decide for yourself if they're best for you.
Now sit back, relax, and enjoy yourself as I talk with Connie, someone who like many
of you wants to lower her cholesterol and her husband's too, and keep it there.
All oils are made of three fats, saturated fat, monounsaturated, and polyunsaturated
fat, which I may refer to as saturated, mono, and poly.
Now saturated fat raises blood cholesterol, and mono and poly lower it when substituted
for saturated fat.
Now here's an important point.
Saturated fat raises blood cholesterol twice as much as mono or poly lower it.
So the best oils for you to choose are those with the least amount of saturated fat.
I've already arranged these oils according to the saturated fat in one tablespoon.
Here we have oils with only one gram of saturated fat.
Actually, this oil, canola oil, has the least amount of saturated fat, and this has slightly
more, but labels are supposed to give rounded off numbers.
So both say one gram, but for our purposes that's fine.
Here we have oils with two grams saturated fat, and over here we have the oils with the
most saturated fat, 11 and 12 grams per tablespoon.
What we have here is palm kernel oil and coconut oil loaded with saturated fat.
In between we have these oils, cottonseed and palm.
Now for a cholesterol lowering diet, you want to choose oils with no more than one or two
grams saturated fat.
But not all these oils are the same.
Some of these oils are low in saturated fat, but high in poly, while others are low in
saturated fat, but high in mono.
And for different reasons, both of those kinds of fat are important for a heart healthy diet.
Let's first look at the mono and saturated fats.
Let's look at olive oil for example.
Olive oil is very high in mono and saturated fat as we can see here.
There's more mono than anything else in olive oil.
So this is an oil low in saturated fat and high in mono.
Now let's talk about canola oil.
Lainey, what is canola oil?
Canola oil is the oil extracted from the canola plant.
It's bland tasting like corn oil, and it's high in mono and saturated fat.
Another oil that's fairly good for a source of mono is peanut oil.
But peanut oil is not as high in mono as these other oils.
Now for a cholesterol lowering diet, you want to choose oils that have no more than two
grams of saturated fat in a tablespoon.
So any of these oils would be fine.
But these oils are not all the same.
Some are low in saturated fat and high in mono, these in particular.
And some are low in saturated fat and high in poly, all of these.
The safflower, the soybean, the sunflower, and the corn.
And I suggest for you to use at home, choose one of these and one of these.
How much oil can I have in a day?
That depends on how many calories you can have.
So it's a good question to ask your nutrition counselor.
And I can tell you this, that a cup of oil has about 2,000 calories, and just one tablespoon
has about 120.
So I'm quite sure your counselor will tell you not to have very much.
In baking, you can get a fine mist of oil on your pan if you use a vegetable oil spray
like this one that contains corn oil.
Canola oil and olive oil are high in mono unsaturated fat or polyunsaturated fat.
The answer is mono unsaturated fat.
Connie, salad dressings are low in saturated fat, like the oils from which they're made.
But if you use lots of them, you can get lots of saturated fat.
Now a typical salad dressing like Thousand Island, Italian, French, or ranch, a regular
salad dressing, not a diet one, has about one gram of saturated fat per tablespoon.
And if at a salad bar you use a regular salad dressing and use just two ladles on your salad,
you'll get about as much saturated fat and about as many calories as you would in a McDonald's
small hamburger.
What about diet dressing?
Diet dressings are fine.
Diet dressings have more water, and regular salad dressings have more fat.
Let me show you how you can discover that on a label.
Now here's a diet dressing.
The first ingredient listed is water.
So there's more water than anything else, because ingredients are listed in descending
order by weight.
Now let's look at a regular salad dressing.
This one, the first ingredient is olive oil.
Just as you would expect, there's a lot of fat in a regular dressing and a lot of water
in a diet dressing.
So to cut the saturated fat from salad dressings, use diet ones or use less of the regular.
When you eat out, you can always have a diet dressing if you take a product like this with
you.
And here's another tip.
Mix equal amounts of a regular and a diet dressing for about half the saturated fat
of the regular kind.
And here's an idea I think you'll really like.
Marinate cooked or canned beans in store-bought or homemade salad dressing, then sprinkle
the zesty marinated beans on your salad instead of using plain salad dressing.
And while we're talking about salads, here's a terrific tip.
Instead of topping your salad with ready-made croutons, use stuffing mix cubes instead.
They have no added fat and therefore no saturated fat, while croutons are loaded with fat.
Now let's check out mayonnaise.
Light and diet mayonnaise have less saturated fat than the regular ones.
That's because light and diet mayonnaise have more water.
For a cholesterol-lowering diet, choose a mayonnaise with no more than 1 gram of saturated
fat per tablespoon like this one.
And by the way, don't make the common mistake of choosing a mayonnaise just because it has
no cholesterol in it.
You see, almost any mayonnaise that contains cholesterol has very little cholesterol, only
about 5 milligrams or so per serving.
And that's not nearly enough to get concerned about.
Also and most importantly, it's saturated fat that raises blood cholesterol more than
anything else in the diet, and therefore it's saturated fat that we should focus on.
If you're in a rush for supper, you don't have to pass up the Deli's Chicken Salad,
even if it looks like a mayonnaise salad.
Just ask for a small portion and stretch it into a large one by adding lots of low-fat
ingredients like chopped celery, cooked brown rice, and beans.
In what order are ingredients listed on a label?
Increasing by weight or decreasing by weight?
The answer is decreasing by weight.
This tape is divided into separate programs.
Because so much information is covered in each unit, we suggest you watch only one at
a time.
My husband and I have been told we need to lower our cholesterol.
Can we eat any red meat?
The fat and cholesterol in meat, fish, and poultry have a tremendous impact on a cholesterol
lowering diet.
To talk about these foods, let's take a trip to the meat counter of our local supermarket
where our butcher, Ed, will show us how to select the best foods for you.
Many people think that on a cholesterol lowering diet, they can have practically no meat.
But if you follow the guidelines we're going to give you, you can have reasonable amounts
of meat.
Now, let's talk about beef first.
The leanest cuts of beef all have the words loin or round in them.
Ed, would you show us the six leanest cuts of beef, please?
Eye of round, top round, round tip, top loin, tenderloin, and sirloin.
And what about flank steak?
Some flank steaks are lean and others aren't.
As you can see here, we trim a lot of the fat off, but this is going to be a little
bit, we trim more off of this than we have off of this one.
Notice that the meat we have here is almost surgically trimmed of fat.
You won't find meat already trimmed like this in your supermarket, but you can ask
your butcher to trim it for you or trim it yourself at home.
In a four ounce cooked portion of any one of these well trimmed cuts of very lean beef,
there's no more than four grams of saturated fat.
By comparison, in four ounces of cheddar cheese, there are 24 grams of saturated fat.
A four ounce portion isn't very big though.
Most of us are used to eating five or six ounces.
Here's what a four ounce, a five ounce, and a six ounce steak look like.
Quite a difference, isn't there?
Generally, five ounces raw, if it's meat and no bone, hooks down to about four ounces.
Ed, now for comparison, can we see some really fatty cuts of meat?
The prime rib eye and the prime strip are examples.
You can see the marbling throughout the meat and also the fat, extra fat around the outside
of the meat.
Yes, this is what's called prime meat.
It's very high in fat because it's the highest fat grade.
There are three grades of meat.
In order from the lowest fat to the highest fat, it's select, choice, and prime.
For a cholesterol lowering diet, buy select or choice meat, choose lean cuts, trim the
visible fat before cooking, and keep portion sizes on the small side.
Your nutrition counselor will tell you what portion sizes are right for you.
Now let's talk about ground meat.
Here we have regular ground hamburger, and as you can see, it's high in fat.
Here we have a ground lean meat, and it too has more fat than you need to get in ground
meat.
Here's how to get the leanest ground beef.
Start with any of the six leanest cuts that we just saw.
What I do is I buy whatever's on sale, and then ask your butcher to trim all the visible
fat from around the meat, and then grind it specially for you.
That's no problem.
A lot of our customers ask us to grind top brown and top sirloin for them.
We also have ground chicken and ground turkey.
And those of course are very lean too.
But if the butcher that ground these meats removed the skin and fat before he ground
them.
If he did, then you really don't get much saturated fat at all.
In fact, you only get one to one and a half grams of saturated fat in four cooked ounces
of chicken or turkey light meat.
And in the dark meat, you would get about three grams of saturated fat.
That's still not very much.
And now let's talk about pork and lamb.
What about the lean cuts of pork?
The pork tenderloin is the leanest, and then the pork loin chop.
Yes, the pork tenderloin is very lean.
In fact, in four cooked ounces, you only get two grams of saturated fat.
The pork loin chop has more fat, even though it's still on the lean side.
In four cooked ounces, without the fat and without the bone, you get five and a half grams
of saturated fat.
Now what about some really high fat cuts of pork?
The pork rib chop and of course the spare ribs.
Yes, spare ribs.
In a small portion, you get 10 grams of saturated fat.
What about a lean cut of lamb?
Are there any?
Lamb loin chop.
The lamb loin chop is quite lean.
In four cooked ounces, without the bone and without the fat, you get only three grams
of saturated fat.
Many fish have very little saturated fat.
In fact, no more than one gram of saturated fat in four cooked ounces.
And even a fatty fish like salmon has no more than two grams of saturated fat in four cooked
ounces.
Ed, would you tell us the names of these fish that are very low in saturated fat?
Perch, cod, pollock, flounder, haddock, halibut, snapper, and trout.
And by the way, a significant portion of the fat in fish is a special kind of polyunsaturated
fat called omega-3 fatty acids.
It's now thought that the omega-3s help to prevent blood clots from forming and thus
reduce the risk of heart disease and stroke.
Tofu, a product made from soybeans, is a good vegetarian substitute for meat and fish.
In a four ounce serving of firm tofu, there's only about one and a half grams of saturated
fat.
As you can see, for a cholesterol lowering diet, you have plenty of choices.
So you don't have to grow feathers and scales to lower your cholesterol.
Bake, broil, or roast meat on a rack so that the meat stays above the drippings and some
of the fat can drip out.
To get rid of excess fat, blot cooked burgers with white paper towel before serving.
To make a little meat go a long way, stretch it with vegetables and plain grains.
Combine a small amount of stir-fried lean meat with a bag of frozen seasoned vegetables
from your store's frozen food section.
Eating a cholesterol lowering diet means eating practically no meat, true or false?
The answer is false.
Your nutrition counselor can show you how you can include reasonable amounts of lean
meats in your diet.
Which of the two following words indicate lean meat?
Loin, prime, or round?
The answer is loin and round.
When most people think of cholesterol, they think of eggs.
According to new data, a large egg has about 210 milligrams of cholesterol, less than we
used to think.
It's the yolk that has all the cholesterol.
The white has none.
Egg yolks also have saturated fat, about one and a half grams per egg yolk.
If you want to eat eggs and avoid the cholesterol, use egg whites or egg substitutes made from
egg whites like these.
These have no cholesterol and zero to one gram saturated fat, depending on the product.
In many baking recipes, you can use two egg whites in place of one whole egg.
For example, when making pancakes or waffles, or when baking muffins, quick breads, cookies,
and cakes.
When you make scrambled eggs, you can still have some of the flavor and color of the yolk.
Try mixing one whole egg with about eight egg whites and a squirt of fresh lemon juice.
This makes light and tasty scrambled eggs for four people.
And now I'd like you to have the opportunity to spend a few minutes with someone who's
an internationally respected physician and researcher in the field of nutrition and heart
disease, Dr. Scott Grundy, Director of the Center for Human Nutrition at the University
of Texas Southwestern Medical Center.
And by the way, if you think nothing ever stays the same in nutrition, Dr. Grundy's
research is certainly one of the reasons why we know a lot more today than we used to.
When I see a patient who's found to have a high cholesterol, the first thing I do is
to make a second measurement just to make sure the cholesterol is high.
If it continues to be high before proceeding any further than that, I actually would like
to have the patient have their family members tested because other family members may also
have a high cholesterol and that needs to be found out.
Also, I check for other risk factors.
Is the patient a smoker?
Does the patient have high blood pressure or diabetes or a low level of HDL or the good
cholesterol?
So I try to assess the patient's overall risk status.
Now once that's done, then I can make a judgment about how that patient should be treated.
Now certainly the first step of treatment is diet.
I don't think about drugs at first.
I emphasize diet and I urge that patient to modify diet, to lose weight down to a desirable
range and to look at what's being eaten to reduce the intake of saturated fat and cholesterol.
So we work with diet for several months and in many cases we're able to get the cholesterol
level down to a desirable range.
Lunch meats like these are low in saturated fat, low enough for cholesterol lowering diet.
Your best choices are lunch meats with no more than one gram saturated fat per ounce
like lean ham or turkey breast, but be cautious with bologna.
They tend to be high in saturated fat.
And do remember that if you put two slices on your sandwich of a product like this or
this, you'll be getting twice as much saturated fat.
I've arranged these according to the saturated fat in one ounce.
As you can see, bacon has the most saturated fat.
In fact, four slices of bacon has about as much saturated fat as ten slices or ten ounces
of lean ham.
Which is high in saturated fat too, so your best choices are Canadian bacon and lean ham
like this one that's 97% fat free.
Regular hot dogs like these beef and beef and pork have about four times more saturated
fat than the leanest cuts of beef or pork.
But not all hot dogs are so high in saturated fat.
Like these, these turkey hot dogs, they have about three grams of saturated fat in each
hot dog.
But if you eat two, you get six grams of saturated fat.
If you're trying to eat healthier, here's some good news, and it's on almost every
box, bag, carton, can, and jar of the foods you buy, the new food label.
It may be hard to believe, but the new label must tell it like it is.
No more misleading claims like light for an oil that's just lighter in color or low cholesterol
for a non-dairy creamer that's loaded with saturated fat.
Now, such terms are strictly defined by the government and cannot be used where they would
be misleading.
To benefit from the new label, you have to know how to read and interpret it.
Let's take a few minutes to go over what you need to know about the new label.
Of course, when you're actually in the supermarket with coupons in hand and maybe even kids in
tow, you're lucky if you have a few seconds to look at a label.
Don't worry.
At the end of this tape, I'll give you our split-second method for label reading.
Now let's take a look at this label.
The heading says Nutrition Facts, and you'll find this heading on all of the new labels.
Now let's look at serving size information.
The new label has standardized serving sizes.
This makes it easy to compare similar products because you'll be comparing like with like.
For example, these two cereals.
Of course, if the amount you generally eat is not the same as the serving size, you will
get more or less of the nutrients listed.
Also, remember that the serving size is not a recommended amount.
It's a reference amount to help you make comparisons.
Now let's look at the bottom of the label.
It tells you what's recommended for good health so you can compare what's in a particular
food with what you should get in a day.
You'll find the same information on all food labels that have space to include it.
As you can see, there are two sets of recommended intakes called Daily Values, and they apply
to people ages four and older.
One set is for people who need 2,000 calories a day, and the other is for people who need
2,500 calories a day.
Who needs about 2,000 calories a day?
Most women, young children, older people, and sedentary individuals.
Many men and very active women need at least 2,500 calories a day.
But everyone is different, and as the label says, your daily values may be higher or lower
depending on your calorie needs.
And also, one should add, depending on your medical needs.
If you're on a step two diet, which we discussed earlier, you should get less saturated fat
and less cholesterol than is stated on the label.
The label's recommendations apply to the general public and also to people on a step one diet.
If you're on a step two diet, consult with your doctor or dietician for their recommendations.
Now let's take the 2,000 calorie a day diet, since that's the one the government chose
as a standard.
As it says right here, the percent daily values are based on a 2,000 calorie diet.
Ideally, what should a 2,000 calorie a day diet be like?
The label tells us it should have less than 65 grams of total fat and less than 20 grams
of saturated fat a day.
It should also have less than 300 milligrams of cholesterol and less than 2,400 milligrams
of sodium a day.
In other words, these are the upper limits for total fat, saturated fat, cholesterol,
and sodium.
But for other nutrients, total carbohydrate and dietary fiber, no upper limits are given.
The label recommends 300 grams of total carbohydrate and 25 grams of fiber, which is more than
most people generally get.
Good sources of fiber include fruits, vegetables, whole grain foods, and all kinds of beans.
Now let's look at the top half of the label again.
Here we find the percent daily value information, and here's how to make use of this information.
For example, if the percent daily value for saturated fat is 5 percent, then one serving
contributes 5 percent of the maximum amount of saturated fat that one should have in a
day, if one's calorie needs are 2,000 a day.
There's still more useful information in the new label.
It gives the grams of sugar and the grams of protein in a food, too.
In the United States, most people already get more protein than they need.
Remember, protein-rich animal foods come with fat and cholesterol, too.
Eat smaller servings of lean meat, fish, and poultry.
Use skim milk and low-fat milk, preferably 1 percent, and skim milk, yogurt, and cheese.
Include more vegetable protein foods such as dry beans, split peas, and lentils.
Not only do these foods give you more protein, but they also boost your total carbohydrate
and fiber intakes, which is what most people need.
Now let's look at the vitamin and mineral information.
These nutrients, vitamin A, vitamin C, calcium, and iron, are often low in the American diet,
so look for foods that are good sources or provide at least 10 percent of any one of
these nutrients.
Now let's go on to the calorie information.
Many of us are concerned about calories, and often that's all that we look at on a label.
But if you focus on fat instead, the calories will take care of themselves.
Keeping your total fat intake low automatically keeps your calorie intake in line.
That's because, as the label states, fat has a lot of calories, 9 calories a gram.
By comparison, carbohydrate and protein have only 4 calories a gram.
There's still a bit more information about calories on the new label.
It's the calories from fat.
As you can see in our example, there are 35 calories from fat in a serving of this food.
But wait a minute, we know there are 9 calories in a gram of fat, and that there are 4 grams
of fat in this product.
So there should be 36 calories from fat, not 35.
The only reason the label says 35 is that the numbers on the label are rounded off according
to rules that make comparing products easier.
So that's a story behind the label you see in front of you.
Fortunately, you don't need to know every last detail to make smart decisions in the
store.
Now, here's the split-second approach to label reading.
First, check the serving size.
Next, proceed to look at the numbers for total fat and saturated fat.
Can you live with these numbers, or do you get 50% of your daily value for saturated
fat from just one serving of this product?
Then, look at sodium.
If it's high in sodium, can you balance this food off with other foods low in sodium?
Lastly, check for nutrients you want to get plenty of.
Total carbohydrate, dietary fiber, vitamin A, vitamin C, calcium, and iron.
Is it a good source of at least one of these?
And to double-check, flip over to the ingredients statement, because it tells you exactly what's
in the product.
As you can see, the new label makes shopping for healthier foods much easier than it used
to be.
Now, the only problem is how to avoid the candy aisle if you're shopping with kids.
Is lowering cholesterol a personal issue, or a family issue?
We want cholesterol to control to be a family issue, not just the individual.
It's better if one person in the family doesn't have to eat a special diet, but if everyone
in the family can eat the same diet.
This gets into the public health approach to controlling cholesterol levels.
It's particularly important if several members of the family also have high cholesterol.
So a family diet should be really that, a diet that all the members of the family eat.
This can extend to children, particularly kids above age two.
A cholesterol-lowering diet is fine as long as it stays within good nutrition.
So it is important that we make cholesterol-lowering a family issue, and not just a personal issue.
Thank you.