Dietary Intervention and Recommendations in the Prevention of Obesity and Heart Disease. Nathan D. Wong, Ph.D., F.A.C.C. Professor and Director Heart Disease Prevention Program, University of California, Irvine. Dietary Effects on Lipids.
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Nathan D. Wong, Ph.D., F.A.C.C.
Professor and Director
Heart Disease Prevention Program, University of California, Irvine
All dairy products 0.619
Meat and poultry 0.561
Sugar and syrup 0.676
Grains, fruits, and starchy -0.633
and nonstarchy vegetables
*1973 data, all subjects. From Stamler J: Population studies. In Levy R: Nutrition, Lipids, and CHD. New York, Raven, 1979.
†All coefficients are significant at the P<0.05 level.
Japan Hawaii California
Age (years) 57 54 52
Weight (kg) 55 63 66
Serum cholesterol (mg/dL) 181 218 228
Dietary fat (% of calories) 15 33 38
Dietary protein (%) 14 17 16
Dietary carbohydrate (%) 63 46 44
Alcohol (%) 9 4 3
5-yr CHD mortality rate 1.3 2.2 3.7
*Data from Kato et al. Am J Epidemiol 1973;97:372. CHD, coronary heart disease.
*Results from Seven Countries, 18 countries, 20 countries, 40 countries,
and Ni-Hon-San Studies
Leren et al. Acta Med. Scand 1966; 466:1.
Dayton et al. Circulation 1969; 40:1.
de Lorgeril et al. Circulation 1999; 99:779-785.
McCully KS. Am J Pathol. 1969;56:111-128.
McCully KS. JAMA. 1998;279:392-393.
Rimm EB et al. JAMA. 1998;279:359-364.
Visit 3 Goals at 2000 Calories
If LDL goal notachieved, consideradding drug Tx
If LDL goal notachieved, intensifyLDL-Lowering Tx
Begin LifestyleTherapiesA Model of Steps in Therapeutic Lifestyle Changes (TLC)
Q 4-6 mo
Fat SFA MUFA PUFA Cholesterol
Canola oil† 6 62 31 0
Corn oil 13 25 62 0
Olive oil 14 77 9 0
Palm oil 51 39 10 0
Safflower oil 9 12 78 0
Soybean oil† 15 24 61 0
Sunflower oil 11 20 69 0
*Values for SFA, MUFA, and PUFA represent percentage of total fat calories, whereas those for cholesterol
are expressed as mg per tablespoon. SFA is the sum of lauric, myristic, palmitic, and stearic acids.
†Contain a considerable amount (>5%) of alpha-linolenic acid.
‡Some are high in trans fatty acids: vegetable shortening>margarine fat>animal fat shortening>butter fat.
SFA, saturated fatty acids; MUFA, monounsaturated fatty acids; PUFA, polyunsaturated fatty acids.
I. 6- 11 servings of bread, cereal, rice or pasta
1 serving is 1 slice of bread, 1 ounce of ready to eat cereal,
or a ½ cup of cereal, rice, or pasta.
II.3-5 servings of vegetables
1 serving is 1 cup of leafy vegetables, a ½ cup
of other vegetables (cooked or chopped), or 3/4 cup of vegetable juice.
III. 2-4 servings of fruit
1 serving is 1 apple, banana, or orange, a ½ cup of chopped,
cooked, or canned fruit, or 3/4 cup of fruit juice.
IV. 2-3 servings of milk, yogurt, or cheese
1 serving is 1 cup of low fat or skimmed milk or yogurt,
1½ ounces of natural cheese, or 2 ounces of processed cheese.
V. 2-3 servings of meat, poultry, fish, dried beans, or nuts
1 serving is 2-3 ounces of lean meat,
poultry (white meat without skin), or fish, or 1 cup of beans or nuts.
VI.Use fats, oils, and sugars (including syrup) sparingly