Fats: Fact and Fiction

1. Fats: Fact and Fiction Gretchen Gruender MS, RD, CD Seattle Cancer Care Alliance

2. Pouring over the fats • Dietary fat and cancer • Role of fats in our body • Types of fat • Sources of fat in food • Cooking with fat

3. Cancer Survivors Increased risk for lingering effects: • Body composition changes • Weight gain, weight loss, changes in body composition • Accelerated bone loss / Osteoporosis • Diabetes • Congestive heart failure • Changes in bowel function • Taste and smell changes • Hot flashes • Neuropathies • Hyperlipidemia Where can the quantity and quality of fat make a difference?

4. Women’s Intervention Nutrition Study (WINS): Study Results Does a low fat diet prevent breast cancer (BC) recurrence? • 2437 women with early stage resected BC • 48 to 79 years old • Randomized to one of two groups: • Low fat diet (~15% total calories) - ~33 gm total fat • 8 individual counseling sessions with Registered Dietitian (RD), then every 3 month contact with RD, monthly and quarterly group classes • Control – ~51 gm total fat • 1 individual counseling session, then every 3 month contact with RD • Median follow-up of 5 years Chlebowski, J Nat’l Cancer Inst 98, 2006

5. Women’s Intervention Nutrition Study (WINS): Study Results 24% reduction in breast cancer recurrence in the low fat diet group compared to the control group

6. Nutrition and Lifestyle Studies Prostate cancer intensive nutrition & lifestyle change study: • almost vegan diet • very low meat intake • high fruit and vegetable intake • reduced fat • lifestyle interventions: yoga, exercise, meditation and support groups After one year, participants had no need for conventional therapies • lower PSA’s • greater quality of life • less in vitro prostate cancer cell growth Dean Ornish, 2005

7. FAT is a nutrient is a source of energy adds taste and texture to foods makes us feel full longer helps absorb fat-soluble vitamins (A, D, E, K) Regulates immune function, inflammation and cell membrane integrity Role of Fat in our Body

8. Polyunsaturated fats (PUFA) Monounsaturated fats (MUFA) Saturated fats Trans fats Types of Fat

9. Foods Have a Mixture of Fats

10. Types of Fat Polyunsaturated fats • Essential because our bodies need but cannot make • Polyunsaturated fatty acids: 2 types • Omega-6: linoleic acid (LA) • AA (Arachadonic acid)- eicosanoids • Omega-3: alpha-linolenic acid (ALA) • DHA/EPA (docosapentaenoic acid/eicosapentaenoic acid)

11. Essential Fatty Acids The ratio of omega-6 to omega-3 is more important than the absolute amount of omega-3. Was 1:1 or 2:1 Now 15:1 or 20:1

12. Essential Fatty Acids Role of omega-3 fatty acids in chronic disease • Cancer • Cardiovascular disease • Rheumatoid arthritis • Diabetes • More…

13. Fats in Food Omega-3 • ALA: flaxseed oils, walnuts, hemp and chia seeds, legumes, green leafy vegetables, canola, soybean,black current seed oil, algae • EPA and DHA: oily cold-water fish such as herring, tuna, sardines, anchovies and salmon, grass-fed meats/poultry and eggs • ALA has to be converted in our bodies to EPA/DHA

14. Fats in Food Conversion of ALA to DHA and EPA is inefficient and is reduced with: • High intake of omega 6 fatty acids • Alcohol • Trans fat It is estimated that only 2-5% of ALA is converted to EPA/DHA.

15. Fats in Food Omega-6 • LA: corn, soy, sunflower and safflower oils, processed foods and grains • AA: beef, pork and poultry

16. Fats in Food Monounsaturated Fats Examples: Olive oil canola oil Peanuts Almonds Cashews Hazelnuts pecans

17. Fats in Food Saturated Fats Examples: butter, cakes and pastries, chocolate bars, coconut, coffee creamer, meat, poultry, dairy products, coconut oil

18. Trans Fats Made by hydrogenating vegetable oils More dangerous than saturated fats in the body Increases inflammation Inhibits the conversion of ALA to DHA Makes membranes more rigid Interferes with intercellular communication Increases LDL cholesterol Increases insulin resistance Fats in Food

19. Fats in Food Trans Fats • Most found in processed foods • French fries, potato chips, donuts, cookies, crackers, cereals, shortening, muffins, pizza crusts, buns, cakes, fish sticks Read labels!!!!! A product can say trans-fat free and still have hydrogenated oils.

20. Fats in Food What’s next? • Fully hydrogenated fat • Inter-esterified fats • Genetically modified seed oils • Tropical oils • Partially hydrogenated with low Trans Fats

21. How do we damage fats? Refine, oxidize, heat Refining grains, nuts and seed oils • Creates a colorless, flavorless oil • Destroys/removes micronutrients • >180 degrees C – fatty acids are oxidized • >240 degrees C – trans fat is formed

22. Preparation of oils How are oils extracted from the nut/seed? • Cold pressing: mechanical process - maximum temperature of 172 degrees • Heat pressing: mechanical process – temperatures between 208-280 degrees. Oil from this method will be treated with a solvent, and may go through degumming, refining, neutralizing, bleaching, hydrogenating, or deodorizing.

23. If possible, choose oils that have not been refined, expeller pressed or extracted with solvents Best options: unrefined and/or cold pressed Avoid exposing oils to heat, light and air Cooking with Fats

24. Cooking with Fats • Do not exceed the smoke point of an oil • PUFA’s are not tolerant of high temperatures • Better choices for cooking at high heat include peanut, sunflower and canola oil • Avoid cooking with cold pressed oils and reserve for vinaigrettes

25. Cooking with Fats • Purchase nuts and seeds raw and in a shell if possible • Store in a cool, dark place Best choices for fish: • Wild salmon, cod, sardines, small tuna or halibut

26. How much is enough? 20 – 35% of total Calories from fat 2000-Calorie diet = 44 – 78 grams of fat or 11 – 19 ½ teaspoons 1500-Calorie diet = 33 – 58 grams of fat or 8 ¼ – 14 ½ teaspoons

27. Ways to decrease your overall fat intake: • Use higher fat foods as “condiments” • Grate cheese on vegetables • Add a handful of granola to fruit • Add a small handful of nuts to a salad • Most fruits, vegetables, grains and legumes have very small amounts of fat – enjoy an abundance of these foods. • Decrease the amount of meat that you eat • Take the skin off chicken and turkey

28. Ways to decrease your overall fat intake: continued… • Before sautéing, warm your pan slightly before adding vegetable oil – the oil will disperse in the pan quicker if it is warm which may result in using less oil • Minimize eating processed foods such as crackers, cakes and microwavable meals as they are generally higher in fat than whole foods. • Eat real cheese but eat it in small amounts, not at every meal, not daily

29. Ways to decrease your overall fat intake: continued… • Use low fat or nonfat dairy, or eat smaller amounts of whole fat dairy • If you buy large quantities of nuts or vegetables oils (like olive oil), put a small amount in a separate container to use daily. Studies show we serve 22% more volume of food when we dispense food from a larger container. • Practice mindful eating – don’t buy a bid bag of nuts and eat them in the car while you are driving to work, talking on the phone, etc.

30. Cooking with Fats Recipe: Triple A Salad Smell and Taste Questions?