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Omega-3: Fish versus Flax                                                                                Most people eating a Western diet need to limit the amount of
A major review published in the British Medical Journal (Hooper et                                       omega-6 essential fats in their diet and increase the amount of
al., 2006) supports the view that pollutants in fish, such as                                            omega-3. This can be achieved by reducing the use of omega-6
mercury, dioxins and polychlorinated biphenyls, may cancel out                                           rich sunflower, safflower and corn oils and increasing the use of
the beneficial effects of the ‘good’ omega-3 fats they contain.                                          omega-3 rich flaxseed and rapeseed oils.

The good news is there are perfectly safe plant sources of omega-3                                       Cutting down on dietary cholesterol (avoiding eggs, meat and
that can benefit health. Many studies, including a joint report by                                       dairy products), avoiding or cutting down on processed foods, and
the World Health Organisation and Food and Agriculture                                                   avoiding foods containing hydrogenated vegetable oils (listed on
Organisation show that ALA has a protective effect against heart                                         the packaging) will help your body make best use of the omega-3
disease. This benefits the environment as well; flax is a sustainable                                    from plant foods.
crop whereas fish are not. (For more information, see the VVF’s
Fishing for Facts fact sheet.)                                                                           Also avoid or reduce fried foods, alcohol, caffeine, sugar, smoking
                                                                                                         and stress. Make sure that you get all the minerals you require
Recent studies suggest that the ratio of omega-6 to omega-3 fatty                                        including zinc – found in pulses, wholegrains (eg brown rice,
acids is more important than the amounts of individual fatty acids                                       wholemeal bread etc), nuts and seeds – and chromium, found in
consumed. Recent changes in the diet, as we have moved away                                              nuts, wholegrains and brewer’s yeast.
from whole foods towards refined foods rich in processed
vegetable oils, have increased our intake of omega-6 fats. This has                                      One teaspoon of flaxseed oil or one-and-a-half tablespoons of
increased the ratio of omega-6 to omega-3 fats in the diet, which                                        ground flaxseed should provide most people with sufficient
may have a detrimental effect on the rate of conversion of ALA to                                        omega-3 fats (see Table 5). These fats are easily damaged by light
EPA and DHA.                                                                                             or heat so try and keep these foods refrigerated and use them cold,
                                                                                                         for example on cold vegetable/rice/pasta salads and so on.




Summary
•      Reduce your intake of saturated fat, dietary cholesterol, and                                     •   Pollutants in fish may cancel out the beneficial effects of the
       trans-unsaturated fatty acids                                                                         ‘good’ omega-3 fats they contain
•      Avoid products containing hydrogenated fats or oils (listed on                                    •   ALA (from plant foods) can be converted into EPA and DHA,
       the packaging)                                                                                        and has a protective effect against heart disease
•      Avoid butter, cream, whole milk and tropical oils as they are                                     •   Cutting down on dietary cholesterol (eggs, meat and dairy
       especially rich in cholesterol-raising saturated fats                                                 products), processed foods, and hydrogenated vegetable oils
•      If you are genetically prone to hypercholesterolaemia then it is                                      will help your body to make best use of the omega-3 from
       particularly important for you to restrict dietary cholesterol,                                       plant foods
       which is found in all animal products                                                             •   Also avoid or reduce fried foods, alcohol, caffeine, sugar,
•      Improve the balance of omega-6 to omega-3 in your diet by                                             smoking and stress
       reducing omega-6 oils (sunflower, corn oil) and increasing                                        •   Increase the consumption of foods rich in fibre, including
       omega-3s (flax, rapeseed)                                                                             wholegrains, fruit and vegetables


References

1. AHA, 2008. Cholesterol AHA Scientific Position [online]. AHA. Available                               omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review.
from: http://www.americanheart.org/presenter.jhtml?identifier=4488 [Accessed                             BMJ. 332 (7544), 752-60.
17 January 2008].                                                                                        11. Katan M.B., Zock P and Mensink R.P 1995. Dietary oils, serum
                                                                                                                               .L.             .,
2. British Nutrition Foundation, 2000. BNF Nutrition Papers. n-3 Fatty Acids                             lipoproteins, and coronary heart disease. Am J Clin Nutr. 61 (Suppl),
and Health [online]. BNF. Available from:                                                                1368S–1373S.
http://www.nutrition.org.uk/home.asp?siteId=43&sectionId=686&subSectionId                                12. Kris-Etherton P.M. and Yu S, 1997. Individual fatty acid effects on plasma
=341&parentSection=303&which=6#1171 [Accessed 20 October 2008].                                          lipids and lipoproteins: human studies. Am J Clin Nutr. 65 (suppl), 1628S-44S.
3. Department of Health, 1991. Dietary Reference Values for Food Energy and                              13. Mensink R.P.M. and Katan MB, 1990. Effect of dietary trans fatty acids on
Nutrients for the United Kingdom. Report of the Panel on Dietary Reference                               health. Ann Nutr Metab. 48 (2), 61-6.
Values of the Committee on Medical Aspects of Food Policy. London: HMSO.                                 14. Murray S., 2005. Chewing the fat on trans fats. CMAJ. 173 (10), 1158-1159.
4. Enas A., Senthilkumar A., Chennikkara H. and Bjurlin M.A., 2003. Prudent                              15. Pereira C., Li D. and Sinclair A.J., 2001. The alpha-linolenic acid content of
diet and preventive nutrition from pediatrics to geriatrics: current knowledge and                       green vegetables commonly available in Australia. Int J Vitamin Nutr Res. 71 (4),
practical recommendations. Indian Heart J. 55 (4), 310–338.                                              223-228.
5. Food Standards Agency, 2002. McCance and Widdowson’s The Composition of                               16. Prior I.A., Davidson F., Salmond C.E. and Czochanska Z., 1981. Cholesterol,
Foods, Sixth Summary Edition. Cambridge: Royal Society of Chemistry.                                     coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and
6. Food Standards Agency/Department of Health, 2003. The National Diet &                                 Tokelau Island studies. Am J Clin Nutr. 34 (8), 1552-61.
Nutrition Survey: Adults aged 19 to 64 years. London: TSO.                                               17. Renaud S. and Delorgel M., 1989. Dietary lipids and their relation to ischemic
7. German J.B. and Dillard C.J., 2004. Saturated fats: what dietary intake. Am J                         heart disease from epidemiology to prevention. J Int Med. 225 (Suppl), 39–46.
Clin Nutr. 80 (3), 550-9.                                                                                18. Stender S. and Dyenberg J., 2004. Influence of trans fatty acids on health.
8. Grundy S.M., 1986. Comparison of monounsaturated fatty acids and                                      Ann Nutr Metab. 48 (2), 61-6.
carbohydrates for lowering plasma cholesterol. N Engl J Med. 314 (12), 745–748.                          19. Trinidad T.P Loyola A.S., Mallillin A.C., Valdez D.H., Askali F.C., Castillo
                                                                                                                         .,
9. Grundy S.M. and Denke M.A, 1990. Dietary influences on serum lipids and                               J.C., Resaba R.L. and Masa D.B., 2004. The cholesterol-lowering effect of
lipoproteins. J Lipid Res. 31 (7), 1149-1172.                                                            coconut flakes in humans with moderately raised serum cholesterol. J Med Food.
10. Hooper L., Thompson R.L., Harrison R.A., Summerbell C.D., Ness A.R.,                                 7 (2), 136-40.
Moore H.J., Worthington H.V Durrington P
                           .,           .N., Higgins J.P Capps N.E.,
                                                        .,
Riemersma R.A., Ebrahim S.B. and Davey Smith G., 2006. Risks and benefits of
                                                                                                                                             VVF - Feeding you the Facts
T h i s i s o n e i n a s e r i e s o f V V F f a c t s h e e t s . Fo r d e t a i l s c o n t a c t :
VVF, Top Suite, 8 Yor k Co urt, W i l d e r S t r e et , B r i s t o l B S2 8QH. Tel: 0117 970 5190. Email: info@vegetarian.org.uk Web: www.vegetarian. org. uk
Chewing the Fat
                                                                                         How a plant-based diet provides all the
                                                                                         essential fats you need – and why animal fats
                               by Amanda Woodvine, BSc Nutrition                         are particularly detrimental to health
                               VVF Senior Nutritionist, with additional
                               research from Dr Justine Butler,
                               VVF Senior Health Campaigner                                                                    Table 2: The Main Sources of Fat in the Human Diet

                               W h a t i s F a t a n d W h y D o We N e e d I t ?                                              Source of Fat Examples                          Type of Fat
                               Of the four main classes of food, fat is the most energy dense. It                              Milk fat      Milk, yoghurt,                    Almost inevitably highly
                               contains more than twice as many calories (kilocalories) weight-                                              cream, butter                     saturated (typically 50 to 65
                               for-weight as protein or carbohydrate (see Table 1). It is a good                                             and cheese                        per cent saturated)
                               source of energy, both for immediate use and for laying down a
                               storage depot (adipose tissue) for use when food intake is reduced.                             Meat fat             Meat (poultry and          Tends to be highly saturated
                                                                                                                                                    red meat), meat            (typically 27 to 44 per cent
                                Table 1: The Energy Content of the Main Classes of                                                                  products (such as          of fat is saturated)
                                Food (Macronutrients)                                                                                               sausages and
                                                                                                                                                    burgers), cooking
                                                     Energy per gram in kilocalories                                                                fats of animal
                                Fat                  8.8                                                                                            origin such as lard
                                Protein              4.06
                                Carbohydrate         3.8                                                                       Fatty fish           Mackerel, herring, Relatively low in
                                Alcohol              7.1                                                                                            trout and salmon    saturated fats
                                                                                                                                                    (typically 17 to 25
                                                                                                                                                    per cent of fat is
                               Fat in the diet helps the body to absorb fat-soluble vitamins (A, D,                                                 saturated)
                               E and K). It is a source of the essential fatty acids that the body
                               cannot make itself. Fat also provides insulation, protects the body’s                           Seeds                Seeds, nuts,               Relatively low in ‘bad’
                               vital organs and acts as a shock absorber.                                                                           vegetable and nut          saturated fats and high
                                                                                                                                                    oils and soft              in ‘good’ polyunsaturated
                               Fat’s more technical name is ‘lipid’ – a term that includes both fats                                                margarines                 fats (except tropical oils
                               and oils. Nominally, fats are solid at room temperature, oils are                                                                               such as coconut and palm
                               liquid, and dense brittle fats are called waxes.                                                                                                oil). Typically eight to 25
                                                                                                                                                                               per cent of fat is saturated
                               Lipids in the diet can come from both plants and animals. Plants
                               most often store their oils in seeds, such as nuts, sunflower seeds,
                               soya beans and corn; and sometimes in fruits, eg avocados, olives                             Table 2 summarises the main sources of fat in the human diet. Any
                               and coconuts. Animals most commonly store fat within their                                    food that contains any of these products as an ingredient will also
                               muscles (commonly called marbling fat), between their muscles,                                contain fat.
                               under their skin and around their gut area.
                                                                                                                             Dietary Cholesterol
                               Lipids in the diet are largely made up of molecules called fatty                              Cholesterol is a soft, waxy substance found in the bloodstream and
                               acids, attached to the molecule glycerol. Three fatty acids                                   in all the body's cells. It is used to form cell membranes and some
                               combine with one molecule of glycerol to form ‘triglycerides’.                                hormones. However, a high level of cholesterol in the blood
                               The fatty acids can be of three major types – saturated,                                      (hypercholesterolaemia) is a major risk factor for heart disease.
                               monounsaturated and polyunsaturated, depending on how many
                               double bonds they contain.                                                                    Cholesterol and other fats have to be transported to and from the
                                                                                                                             cells by special carriers called lipoproteins. Two of particular note are
                               A certain type of unsaturated fatty acid – trans-unsaturated, or                              low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
                               ‘trans fatty acids’ – is often considered separately because of its ill
                               effects on health, and because it is largely created by the                                   LDL is the major cholesterol carrier in the blood. Too much LDL
                               manufacturing process.                                                                        cholesterol in the blood can lead to the build up of fatty deposits
                                                                                                                             (plaques) on the inside walls of the arteries. Plaques can clog the
                               The human body cannot function without some fat, but it is eating                             arteries feeding the heart and brain (atherosclerosis); hence LDL is
                               the right kind of fat that is vital in terms of our overall health.                           termed ‘bad’ cholesterol. Lower levels of LDL cholesterol reflect a
                               According to the Committee on Medical Aspects of Food Policy,                                 lower risk of heart disease.
                               most people should aim to get no more than 10 per cent (and
                               preferably less than seven per cent) of their total calorie intake                            HDL, on the other hand, tends to carry cholesterol away from the
Chari ty numb er : 1 037 486




                               from saturated fat. Less than 10 per cent of calories should come                             arteries and back to the liver, where it is eliminated from the body.
                               from polyunsaturated fat. The 10 per cent figure for                                          A high HDL level seems to protect against heart disease, hence
                               polyunsaturates includes one to two per cent of calories from                                 HDL cholesterol is termed ‘good’ cholesterol.
                               omega-3 fats (Department of Health, 1991). Less than one per
                               cent of calories – and preferably none – should come from trans                               Cholesterol comes from two main sources. The body produces
                               fatty acids.                                                                                  approximately 1,000 milligrams per day. Animal products also


                               VVF, Top Suite, 8 York Cou rt, W i l d e r S t r ee t , B r i s t o l B S2 8QH. Tel: 0117 970 5190. Email: info@vegetarian.org.uk Web: www.vegetarian.org. uk            FS11
contain cholesterol, especially egg yolks, meat, poultry, shellfish         Table 3: Where Saturated Fat Comes From
and whole- and reduced-fat milk and dairy. One small grilled
skinless chicken breast contains 94 milligrams of cholesterol (FSA,         Source of Saturated Fat                     % Contribution
2002), whereas foods from all plants (every type of fruit and                                                           to Saturated
vegetable, pulses, (peas, beans and lentils) wholegrains, nuts and                                                      Fat Intake
seeds) are cholesterol-free.                                                Milk and milk products of which             24
                                                                            Whole milk                                  4
Humans have no need for dietary cholesterol as the body can                 Semi-skimmed milk                           5
manufacture all that it requires. The American Heart Association            Cheese (including cottage cheese)           10
recommends that people limit their average daily cholesterol intake         Meat and meat products of which             22
to no more than 300 milligrams (AHA, 2008).                                 Bacon and ham                               2
                                                                            Beef, veal and dishes                       4
High intakes of dietary cholesterol increase harmful LDL                    Lamb and dishes                             1
cholesterol (Grundy and Denke, 1990) which can increase the risk            Pork and dishes                             1
of heart disease. If you are genetically prone to                           Coated turkey and chicken                   1
hypercholesterolaemia then it is especially important to restrict           Chicken, turkey and dishes                  3
dietary cholesterol, which is found in all animal products. High-           Burgers and kebabs                          2
quality proteins from vegetable sources such as pulses are good             Sausages                                    3
substitutes for animal sources of protein. For more information,            Meat pies and pastries                      4
see the VVF guide, Have a Heart.                                            Other                                       1
                                                                            Cereals and cereal products of which        18
S a t u r a t e d Fa t t y A c i d s                                        Pizza                                       2
We have no nutritional need for saturated and monounsaturated               White bread                                 1
fats as the body can make them. Diets high in saturated fat and             Biscuits                                    4
calories raise blood cholesterol levels and contribute to                   Buns, cakes and pastries                    4
cardiovascular disease, diabetes and some cancers. Saturated fat has        Fat spreads of which                        11
10 times the cholesterol-raising power of dietary cholesterol (Enas         Butter                                      6
et al., 2003). Furthermore, foods high in saturated fat generally           Margarines                                  1
contain substantial amounts of dietary cholesterol. Reducing total          Polunsaturated reduced fat spreads (60-80%) 1
and saturated fat intakes could also lower the risk of breast cancer        Reduced fat spreads (60-80% fat)            2
(see VVF report, One in Nine).                                              Low-fat spreads (40% fat or less)           1
                                                                            Potatoes and savoury snacks of which        7
Table 3 illustrates the major sources of saturated fats in the UK           Chips                                       3
national diet.                                                              Other fried or roast potatoes               1
                                                                            Savoury snacks                              3
Not all saturated fatty acids have the same effects. Those which            Chocolate confectionery                     5
raise cholesterol the most are lauric acid, myristic acid, and
palmitic acid, which are found in meat, dairy products, eggs and
tropical oils. These three fatty acids account for 60 to 70 per cent       expected, Tokelauans have higher blood cholesterol levels.
of the saturated fat in Western diets.                                     However, cardiovascular disease – the build up of lipids and other
                                                                           cells on the artery wall – is still surprisingly rare in both
Myristic acid is the most powerful cholesterol-raising saturated fatty     populations (Prior et al., 1981).
acid (Kris-Etherton et al., 1997). The major dietary sources of myristic
acid are butter, cream, whole milk and tropical oils. Milk fat (from       This apparent paradox might be explained by coconut’s fibre
dairy cows) contains eight to 14 per cent myristic acid. Coconut and       content. Coconut is a good source of soluble and insoluble dietary
palm oils contain up to 18 per cent (German et al., 2004).                 fibre which have cholesterol-lowering powers. Coconut flakes
                                                                           (rather than coconut oil) have been found to lower harmful (LDL)
Palmitic acid is the most common fatty acid in the human diet. It is       cholesterol levels (Trinidad et al., 2004). Of course, processing
the main saturated fatty acid in animal fats (including red meats,         coconut in order to produce coconut oil does strip away the
poultry and eggs) and in palm oil.                                         protective fibre.

Lauric acid is the least harmful of these three saturated fats, with       Conversely, the leading sources of harmful saturated fats in the
around one-third less cholesterol-raising power than palmitic acid.        British national diet – namely dairy products and meat – contain
It is the main saturated fatty acid in coconut and palm kernel oils        no protective, cholesterol-lowering fibre (FSA, 2002;
(they contain around 48 per cent) (Grundy, 1986; Renaud and                FSA/Department of Health, 2003). As perhaps would be expected,
Delorgel, 1989; Katan et al., 1995).                                       cardiovascular disease is a common finding in people who
                                                                           consume the modern Western diet. For more information, see VVF
As tropical oils such as coconut and palm do not feature heavily in        fact sheet, Plant-based Diets and Cardiovascular Disease.
our typical national diet, they do not contribute significantly to
average national saturated fat intake (FSA/Department of Health,           Tr a n s- u ns a tu r a te d Fa t t y A c i d s
2003). However, coconut is the main source of energy for certain           Trans fatty acids have also been shown to increase the risk of heart
Polynesian populations. The habitual diets of the toll dwellers from       disease by raising harmful (LDL) cholesterol levels and lowering
both Pukapuka and Tokelau are high in saturated fat (primarily             protective (HDL) cholesterol levels. Their combined effect on LDL
from coconut) but low in dietary cholesterol (found only in animal         and HDL cholesterol is twice that of saturated fatty acids (Mensink
products) and sucrose (sugar).                                             and Katan, 1990).

Tokelauans take in many more calories from coconut than the                Gram for gram, trans fats are even more strongly linked to heart
Pukapukans (63 per cent compared with 34 per cent) and                     disease than saturated fats. A review of trans fats’ effects on health
therefore have higher intakes of saturated fat. As might be                found them to be associated with a two-and-a-half to tenfold
higher risk of heart disease than saturated fats (Stender and          E s s e n t i a l Fa t t y A c i d s
Dyerberg, 2004). No safe limits of trans fat consumption have          The fats which are essential to the diet are linoleic acid (from the
been identified (Murray, 2005).                                        omega-6 family of fatty acids) and alpha-linolenic acid (omega-3
                                                                       family). Dietary sources of these essential fatty acids, or EFAs, are
Trans fatty acids are often found in processed foods. An industrial    listed in Table 4. Seed oils such as flax (linseed), rapeseed (canola)
process known as hydrogenation is often used to convert liquid         and walnut oil are rich sources of EFAs as are seeds and nuts
vegetable oils to solid or semi-solid fats, such as those present in   themselves (Buttriss, 1999). Green leafy vegetables are also a
margarine. The final product of this process is called hydrogenated    source (Pereira et al., 2001).
vegetable oil, or hydrogenated fat. It is used in some biscuits,
cakes, pastry, margarine and many processed foods. Foods that          Polyunsaturated fatty acids have many important functions in the
contain hydrogenated vegetable oil (which is always declared in        body. They have a structural function in cell membranes; can aid
the ingredients list) are likely to contain trans fats. By avoiding    the retina and other organs, including the brain and skin; are
products containing hydrogenated fats or oils the trans fat content    involved in regulating the transport, breakdown and excretion of
of a plant-based diet can be kept desirably low.                       cholesterol; and are precursors of prostaglandins, thromboxane
                                                                       and leukotrienes, which regulate many body processes including
Low levels of trans fatty acids are also found naturally in dairy      inflammation and blood clotting.
products, lamb and beef fat. This is because small amounts of trans
fats are produced in the gastrointestinal tract of ruminant animals    There are at least three important fatty acids in the omega-3
(Murray, 2005).                                                        family: ALA, EPA and DHA. ALA can be obtained from flaxseed
                                                                       (linseed) oil, walnuts, rapeseed, soya beans and green leafy
                                                                       vegetables (although the latter do not contain much as they are
                                                                       generally very low in fat) (see Table 4). EPA and DHA – which are
                                                                       required for brain function – can only be obtained from marine
                                                                       sources, namely oily fish and some species of algae. However,
                                                                       ALA can be converted into EPA and DHA in the body.

                                                                       Likewise, LA, found in sunflower, corn, walnut and soya oils, can
                                                                       be converted into other important polyunsaturated fatty acids in
                                                                       the omega-6 family, such as arachidonic acid.

                                                                        Table 5: Recommended Daily Intake of Omega-3 Fats for Adults
                                                                        Omega-3 fatty acids         1 daily portion is…

                                                                        Flaxseed (linseed) oil                1 teaspoon
                                                                        Ground flaxseed (linseed)             11⁄2 tablespoons
 Table 4: Plant Sources of EFA s                                        Hempseed oil                          1 tablespoon
 Adapted from VVF scientific report, Fishing for Facts                  Rapeseed oil                          11⁄2 tablespoons
                                                                        Walnuts                               8 halves/28g/1oz
 Food (serving size)                  Omega-3 (g) Omega-6 (g)           Hempseed                              5 tablespoons
                                      (ALA)       ( L A)
 Oils
 Flaxseed (linseed) oil, 1 tbsp       8.0            2.2
 Rapeseed (canola) oil, 1 tbsp        1.3            2.8
 Walnut oil, 1 tbsp                   1.4            7.2
 Soya oil, 1 tbsp                     0.9            6.9
 Wheat germ oil                       0.9            7.5

 Nuts and seeds
 Flaxseeds (linseeds), ground, 2 tbsp 3.2            0.8
 Walnuts, 2 tbsp                      1.0            5.4

 Vegetables, fruits and pulses
 Soya beans, cooked, 1 cup            1.1            7.8
 Tofu, firm, 1⁄2 cup                  0.7            5.0
 Tofu, medium, 1⁄2 cup                0.4            2.9
 Soya milk, 1 cup                     0.4            2.9
 Berries, 1 cup                       0.2            0.2
 Peas, 1⁄2 cup                        0.2            0.2
 Legumes, 1⁄2 cup                     0.05           0.05

 Green leafy vegetables (broccoli, kale, Brussels sprouts,
 leeks, spinach, Chinese greens, salad greens) 1 cup raw or
 1
  ⁄2 cup cooked                       0.1             0.03

 Grains
 Oat germ, 2 tbsp                     0.2            1.6
 Wheat germ, 2 tbsp                   0.1            0.8

 Note: 1 cup = 112g

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Fat Factsheet

  • 1. Omega-3: Fish versus Flax Most people eating a Western diet need to limit the amount of A major review published in the British Medical Journal (Hooper et omega-6 essential fats in their diet and increase the amount of al., 2006) supports the view that pollutants in fish, such as omega-3. This can be achieved by reducing the use of omega-6 mercury, dioxins and polychlorinated biphenyls, may cancel out rich sunflower, safflower and corn oils and increasing the use of the beneficial effects of the ‘good’ omega-3 fats they contain. omega-3 rich flaxseed and rapeseed oils. The good news is there are perfectly safe plant sources of omega-3 Cutting down on dietary cholesterol (avoiding eggs, meat and that can benefit health. Many studies, including a joint report by dairy products), avoiding or cutting down on processed foods, and the World Health Organisation and Food and Agriculture avoiding foods containing hydrogenated vegetable oils (listed on Organisation show that ALA has a protective effect against heart the packaging) will help your body make best use of the omega-3 disease. This benefits the environment as well; flax is a sustainable from plant foods. crop whereas fish are not. (For more information, see the VVF’s Fishing for Facts fact sheet.) Also avoid or reduce fried foods, alcohol, caffeine, sugar, smoking and stress. Make sure that you get all the minerals you require Recent studies suggest that the ratio of omega-6 to omega-3 fatty including zinc – found in pulses, wholegrains (eg brown rice, acids is more important than the amounts of individual fatty acids wholemeal bread etc), nuts and seeds – and chromium, found in consumed. Recent changes in the diet, as we have moved away nuts, wholegrains and brewer’s yeast. from whole foods towards refined foods rich in processed vegetable oils, have increased our intake of omega-6 fats. This has One teaspoon of flaxseed oil or one-and-a-half tablespoons of increased the ratio of omega-6 to omega-3 fats in the diet, which ground flaxseed should provide most people with sufficient may have a detrimental effect on the rate of conversion of ALA to omega-3 fats (see Table 5). These fats are easily damaged by light EPA and DHA. or heat so try and keep these foods refrigerated and use them cold, for example on cold vegetable/rice/pasta salads and so on. Summary • Reduce your intake of saturated fat, dietary cholesterol, and • Pollutants in fish may cancel out the beneficial effects of the trans-unsaturated fatty acids ‘good’ omega-3 fats they contain • Avoid products containing hydrogenated fats or oils (listed on • ALA (from plant foods) can be converted into EPA and DHA, the packaging) and has a protective effect against heart disease • Avoid butter, cream, whole milk and tropical oils as they are • Cutting down on dietary cholesterol (eggs, meat and dairy especially rich in cholesterol-raising saturated fats products), processed foods, and hydrogenated vegetable oils • If you are genetically prone to hypercholesterolaemia then it is will help your body to make best use of the omega-3 from particularly important for you to restrict dietary cholesterol, plant foods which is found in all animal products • Also avoid or reduce fried foods, alcohol, caffeine, sugar, • Improve the balance of omega-6 to omega-3 in your diet by smoking and stress reducing omega-6 oils (sunflower, corn oil) and increasing • Increase the consumption of foods rich in fibre, including omega-3s (flax, rapeseed) wholegrains, fruit and vegetables References 1. AHA, 2008. Cholesterol AHA Scientific Position [online]. AHA. Available omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. from: http://www.americanheart.org/presenter.jhtml?identifier=4488 [Accessed BMJ. 332 (7544), 752-60. 17 January 2008]. 11. Katan M.B., Zock P and Mensink R.P 1995. Dietary oils, serum .L. ., 2. British Nutrition Foundation, 2000. BNF Nutrition Papers. n-3 Fatty Acids lipoproteins, and coronary heart disease. Am J Clin Nutr. 61 (Suppl), and Health [online]. BNF. Available from: 1368S–1373S. http://www.nutrition.org.uk/home.asp?siteId=43&sectionId=686&subSectionId 12. Kris-Etherton P.M. and Yu S, 1997. Individual fatty acid effects on plasma =341&parentSection=303&which=6#1171 [Accessed 20 October 2008]. lipids and lipoproteins: human studies. Am J Clin Nutr. 65 (suppl), 1628S-44S. 3. Department of Health, 1991. Dietary Reference Values for Food Energy and 13. Mensink R.P.M. and Katan MB, 1990. Effect of dietary trans fatty acids on Nutrients for the United Kingdom. Report of the Panel on Dietary Reference health. Ann Nutr Metab. 48 (2), 61-6. Values of the Committee on Medical Aspects of Food Policy. London: HMSO. 14. Murray S., 2005. Chewing the fat on trans fats. CMAJ. 173 (10), 1158-1159. 4. Enas A., Senthilkumar A., Chennikkara H. and Bjurlin M.A., 2003. Prudent 15. Pereira C., Li D. and Sinclair A.J., 2001. The alpha-linolenic acid content of diet and preventive nutrition from pediatrics to geriatrics: current knowledge and green vegetables commonly available in Australia. Int J Vitamin Nutr Res. 71 (4), practical recommendations. Indian Heart J. 55 (4), 310–338. 223-228. 5. Food Standards Agency, 2002. McCance and Widdowson’s The Composition of 16. Prior I.A., Davidson F., Salmond C.E. and Czochanska Z., 1981. Cholesterol, Foods, Sixth Summary Edition. Cambridge: Royal Society of Chemistry. coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and 6. Food Standards Agency/Department of Health, 2003. The National Diet & Tokelau Island studies. Am J Clin Nutr. 34 (8), 1552-61. Nutrition Survey: Adults aged 19 to 64 years. London: TSO. 17. Renaud S. and Delorgel M., 1989. Dietary lipids and their relation to ischemic 7. German J.B. and Dillard C.J., 2004. Saturated fats: what dietary intake. Am J heart disease from epidemiology to prevention. J Int Med. 225 (Suppl), 39–46. Clin Nutr. 80 (3), 550-9. 18. Stender S. and Dyenberg J., 2004. Influence of trans fatty acids on health. 8. Grundy S.M., 1986. Comparison of monounsaturated fatty acids and Ann Nutr Metab. 48 (2), 61-6. carbohydrates for lowering plasma cholesterol. N Engl J Med. 314 (12), 745–748. 19. Trinidad T.P Loyola A.S., Mallillin A.C., Valdez D.H., Askali F.C., Castillo ., 9. Grundy S.M. and Denke M.A, 1990. Dietary influences on serum lipids and J.C., Resaba R.L. and Masa D.B., 2004. The cholesterol-lowering effect of lipoproteins. J Lipid Res. 31 (7), 1149-1172. coconut flakes in humans with moderately raised serum cholesterol. J Med Food. 10. Hooper L., Thompson R.L., Harrison R.A., Summerbell C.D., Ness A.R., 7 (2), 136-40. Moore H.J., Worthington H.V Durrington P ., .N., Higgins J.P Capps N.E., ., Riemersma R.A., Ebrahim S.B. and Davey Smith G., 2006. Risks and benefits of VVF - Feeding you the Facts T h i s i s o n e i n a s e r i e s o f V V F f a c t s h e e t s . Fo r d e t a i l s c o n t a c t : VVF, Top Suite, 8 Yor k Co urt, W i l d e r S t r e et , B r i s t o l B S2 8QH. Tel: 0117 970 5190. Email: info@vegetarian.org.uk Web: www.vegetarian. org. uk
  • 2. Chewing the Fat How a plant-based diet provides all the essential fats you need – and why animal fats by Amanda Woodvine, BSc Nutrition are particularly detrimental to health VVF Senior Nutritionist, with additional research from Dr Justine Butler, VVF Senior Health Campaigner Table 2: The Main Sources of Fat in the Human Diet W h a t i s F a t a n d W h y D o We N e e d I t ? Source of Fat Examples Type of Fat Of the four main classes of food, fat is the most energy dense. It Milk fat Milk, yoghurt, Almost inevitably highly contains more than twice as many calories (kilocalories) weight- cream, butter saturated (typically 50 to 65 for-weight as protein or carbohydrate (see Table 1). It is a good and cheese per cent saturated) source of energy, both for immediate use and for laying down a storage depot (adipose tissue) for use when food intake is reduced. Meat fat Meat (poultry and Tends to be highly saturated red meat), meat (typically 27 to 44 per cent Table 1: The Energy Content of the Main Classes of products (such as of fat is saturated) Food (Macronutrients) sausages and burgers), cooking Energy per gram in kilocalories fats of animal Fat 8.8 origin such as lard Protein 4.06 Carbohydrate 3.8 Fatty fish Mackerel, herring, Relatively low in Alcohol 7.1 trout and salmon saturated fats (typically 17 to 25 per cent of fat is Fat in the diet helps the body to absorb fat-soluble vitamins (A, D, saturated) E and K). It is a source of the essential fatty acids that the body cannot make itself. Fat also provides insulation, protects the body’s Seeds Seeds, nuts, Relatively low in ‘bad’ vital organs and acts as a shock absorber. vegetable and nut saturated fats and high oils and soft in ‘good’ polyunsaturated Fat’s more technical name is ‘lipid’ – a term that includes both fats margarines fats (except tropical oils and oils. Nominally, fats are solid at room temperature, oils are such as coconut and palm liquid, and dense brittle fats are called waxes. oil). Typically eight to 25 per cent of fat is saturated Lipids in the diet can come from both plants and animals. Plants most often store their oils in seeds, such as nuts, sunflower seeds, soya beans and corn; and sometimes in fruits, eg avocados, olives Table 2 summarises the main sources of fat in the human diet. Any and coconuts. Animals most commonly store fat within their food that contains any of these products as an ingredient will also muscles (commonly called marbling fat), between their muscles, contain fat. under their skin and around their gut area. Dietary Cholesterol Lipids in the diet are largely made up of molecules called fatty Cholesterol is a soft, waxy substance found in the bloodstream and acids, attached to the molecule glycerol. Three fatty acids in all the body's cells. It is used to form cell membranes and some combine with one molecule of glycerol to form ‘triglycerides’. hormones. However, a high level of cholesterol in the blood The fatty acids can be of three major types – saturated, (hypercholesterolaemia) is a major risk factor for heart disease. monounsaturated and polyunsaturated, depending on how many double bonds they contain. Cholesterol and other fats have to be transported to and from the cells by special carriers called lipoproteins. Two of particular note are A certain type of unsaturated fatty acid – trans-unsaturated, or low-density lipoprotein (LDL) and high-density lipoprotein (HDL). ‘trans fatty acids’ – is often considered separately because of its ill effects on health, and because it is largely created by the LDL is the major cholesterol carrier in the blood. Too much LDL manufacturing process. cholesterol in the blood can lead to the build up of fatty deposits (plaques) on the inside walls of the arteries. Plaques can clog the The human body cannot function without some fat, but it is eating arteries feeding the heart and brain (atherosclerosis); hence LDL is the right kind of fat that is vital in terms of our overall health. termed ‘bad’ cholesterol. Lower levels of LDL cholesterol reflect a According to the Committee on Medical Aspects of Food Policy, lower risk of heart disease. most people should aim to get no more than 10 per cent (and preferably less than seven per cent) of their total calorie intake HDL, on the other hand, tends to carry cholesterol away from the Chari ty numb er : 1 037 486 from saturated fat. Less than 10 per cent of calories should come arteries and back to the liver, where it is eliminated from the body. from polyunsaturated fat. The 10 per cent figure for A high HDL level seems to protect against heart disease, hence polyunsaturates includes one to two per cent of calories from HDL cholesterol is termed ‘good’ cholesterol. omega-3 fats (Department of Health, 1991). Less than one per cent of calories – and preferably none – should come from trans Cholesterol comes from two main sources. The body produces fatty acids. approximately 1,000 milligrams per day. Animal products also VVF, Top Suite, 8 York Cou rt, W i l d e r S t r ee t , B r i s t o l B S2 8QH. Tel: 0117 970 5190. Email: info@vegetarian.org.uk Web: www.vegetarian.org. uk FS11
  • 3. contain cholesterol, especially egg yolks, meat, poultry, shellfish Table 3: Where Saturated Fat Comes From and whole- and reduced-fat milk and dairy. One small grilled skinless chicken breast contains 94 milligrams of cholesterol (FSA, Source of Saturated Fat % Contribution 2002), whereas foods from all plants (every type of fruit and to Saturated vegetable, pulses, (peas, beans and lentils) wholegrains, nuts and Fat Intake seeds) are cholesterol-free. Milk and milk products of which 24 Whole milk 4 Humans have no need for dietary cholesterol as the body can Semi-skimmed milk 5 manufacture all that it requires. The American Heart Association Cheese (including cottage cheese) 10 recommends that people limit their average daily cholesterol intake Meat and meat products of which 22 to no more than 300 milligrams (AHA, 2008). Bacon and ham 2 Beef, veal and dishes 4 High intakes of dietary cholesterol increase harmful LDL Lamb and dishes 1 cholesterol (Grundy and Denke, 1990) which can increase the risk Pork and dishes 1 of heart disease. If you are genetically prone to Coated turkey and chicken 1 hypercholesterolaemia then it is especially important to restrict Chicken, turkey and dishes 3 dietary cholesterol, which is found in all animal products. High- Burgers and kebabs 2 quality proteins from vegetable sources such as pulses are good Sausages 3 substitutes for animal sources of protein. For more information, Meat pies and pastries 4 see the VVF guide, Have a Heart. Other 1 Cereals and cereal products of which 18 S a t u r a t e d Fa t t y A c i d s Pizza 2 We have no nutritional need for saturated and monounsaturated White bread 1 fats as the body can make them. Diets high in saturated fat and Biscuits 4 calories raise blood cholesterol levels and contribute to Buns, cakes and pastries 4 cardiovascular disease, diabetes and some cancers. Saturated fat has Fat spreads of which 11 10 times the cholesterol-raising power of dietary cholesterol (Enas Butter 6 et al., 2003). Furthermore, foods high in saturated fat generally Margarines 1 contain substantial amounts of dietary cholesterol. Reducing total Polunsaturated reduced fat spreads (60-80%) 1 and saturated fat intakes could also lower the risk of breast cancer Reduced fat spreads (60-80% fat) 2 (see VVF report, One in Nine). Low-fat spreads (40% fat or less) 1 Potatoes and savoury snacks of which 7 Table 3 illustrates the major sources of saturated fats in the UK Chips 3 national diet. Other fried or roast potatoes 1 Savoury snacks 3 Not all saturated fatty acids have the same effects. Those which Chocolate confectionery 5 raise cholesterol the most are lauric acid, myristic acid, and palmitic acid, which are found in meat, dairy products, eggs and tropical oils. These three fatty acids account for 60 to 70 per cent expected, Tokelauans have higher blood cholesterol levels. of the saturated fat in Western diets. However, cardiovascular disease – the build up of lipids and other cells on the artery wall – is still surprisingly rare in both Myristic acid is the most powerful cholesterol-raising saturated fatty populations (Prior et al., 1981). acid (Kris-Etherton et al., 1997). The major dietary sources of myristic acid are butter, cream, whole milk and tropical oils. Milk fat (from This apparent paradox might be explained by coconut’s fibre dairy cows) contains eight to 14 per cent myristic acid. Coconut and content. Coconut is a good source of soluble and insoluble dietary palm oils contain up to 18 per cent (German et al., 2004). fibre which have cholesterol-lowering powers. Coconut flakes (rather than coconut oil) have been found to lower harmful (LDL) Palmitic acid is the most common fatty acid in the human diet. It is cholesterol levels (Trinidad et al., 2004). Of course, processing the main saturated fatty acid in animal fats (including red meats, coconut in order to produce coconut oil does strip away the poultry and eggs) and in palm oil. protective fibre. Lauric acid is the least harmful of these three saturated fats, with Conversely, the leading sources of harmful saturated fats in the around one-third less cholesterol-raising power than palmitic acid. British national diet – namely dairy products and meat – contain It is the main saturated fatty acid in coconut and palm kernel oils no protective, cholesterol-lowering fibre (FSA, 2002; (they contain around 48 per cent) (Grundy, 1986; Renaud and FSA/Department of Health, 2003). As perhaps would be expected, Delorgel, 1989; Katan et al., 1995). cardiovascular disease is a common finding in people who consume the modern Western diet. For more information, see VVF As tropical oils such as coconut and palm do not feature heavily in fact sheet, Plant-based Diets and Cardiovascular Disease. our typical national diet, they do not contribute significantly to average national saturated fat intake (FSA/Department of Health, Tr a n s- u ns a tu r a te d Fa t t y A c i d s 2003). However, coconut is the main source of energy for certain Trans fatty acids have also been shown to increase the risk of heart Polynesian populations. The habitual diets of the toll dwellers from disease by raising harmful (LDL) cholesterol levels and lowering both Pukapuka and Tokelau are high in saturated fat (primarily protective (HDL) cholesterol levels. Their combined effect on LDL from coconut) but low in dietary cholesterol (found only in animal and HDL cholesterol is twice that of saturated fatty acids (Mensink products) and sucrose (sugar). and Katan, 1990). Tokelauans take in many more calories from coconut than the Gram for gram, trans fats are even more strongly linked to heart Pukapukans (63 per cent compared with 34 per cent) and disease than saturated fats. A review of trans fats’ effects on health therefore have higher intakes of saturated fat. As might be found them to be associated with a two-and-a-half to tenfold
  • 4. higher risk of heart disease than saturated fats (Stender and E s s e n t i a l Fa t t y A c i d s Dyerberg, 2004). No safe limits of trans fat consumption have The fats which are essential to the diet are linoleic acid (from the been identified (Murray, 2005). omega-6 family of fatty acids) and alpha-linolenic acid (omega-3 family). Dietary sources of these essential fatty acids, or EFAs, are Trans fatty acids are often found in processed foods. An industrial listed in Table 4. Seed oils such as flax (linseed), rapeseed (canola) process known as hydrogenation is often used to convert liquid and walnut oil are rich sources of EFAs as are seeds and nuts vegetable oils to solid or semi-solid fats, such as those present in themselves (Buttriss, 1999). Green leafy vegetables are also a margarine. The final product of this process is called hydrogenated source (Pereira et al., 2001). vegetable oil, or hydrogenated fat. It is used in some biscuits, cakes, pastry, margarine and many processed foods. Foods that Polyunsaturated fatty acids have many important functions in the contain hydrogenated vegetable oil (which is always declared in body. They have a structural function in cell membranes; can aid the ingredients list) are likely to contain trans fats. By avoiding the retina and other organs, including the brain and skin; are products containing hydrogenated fats or oils the trans fat content involved in regulating the transport, breakdown and excretion of of a plant-based diet can be kept desirably low. cholesterol; and are precursors of prostaglandins, thromboxane and leukotrienes, which regulate many body processes including Low levels of trans fatty acids are also found naturally in dairy inflammation and blood clotting. products, lamb and beef fat. This is because small amounts of trans fats are produced in the gastrointestinal tract of ruminant animals There are at least three important fatty acids in the omega-3 (Murray, 2005). family: ALA, EPA and DHA. ALA can be obtained from flaxseed (linseed) oil, walnuts, rapeseed, soya beans and green leafy vegetables (although the latter do not contain much as they are generally very low in fat) (see Table 4). EPA and DHA – which are required for brain function – can only be obtained from marine sources, namely oily fish and some species of algae. However, ALA can be converted into EPA and DHA in the body. Likewise, LA, found in sunflower, corn, walnut and soya oils, can be converted into other important polyunsaturated fatty acids in the omega-6 family, such as arachidonic acid. Table 5: Recommended Daily Intake of Omega-3 Fats for Adults Omega-3 fatty acids 1 daily portion is… Flaxseed (linseed) oil 1 teaspoon Ground flaxseed (linseed) 11⁄2 tablespoons Table 4: Plant Sources of EFA s Hempseed oil 1 tablespoon Adapted from VVF scientific report, Fishing for Facts Rapeseed oil 11⁄2 tablespoons Walnuts 8 halves/28g/1oz Food (serving size) Omega-3 (g) Omega-6 (g) Hempseed 5 tablespoons (ALA) ( L A) Oils Flaxseed (linseed) oil, 1 tbsp 8.0 2.2 Rapeseed (canola) oil, 1 tbsp 1.3 2.8 Walnut oil, 1 tbsp 1.4 7.2 Soya oil, 1 tbsp 0.9 6.9 Wheat germ oil 0.9 7.5 Nuts and seeds Flaxseeds (linseeds), ground, 2 tbsp 3.2 0.8 Walnuts, 2 tbsp 1.0 5.4 Vegetables, fruits and pulses Soya beans, cooked, 1 cup 1.1 7.8 Tofu, firm, 1⁄2 cup 0.7 5.0 Tofu, medium, 1⁄2 cup 0.4 2.9 Soya milk, 1 cup 0.4 2.9 Berries, 1 cup 0.2 0.2 Peas, 1⁄2 cup 0.2 0.2 Legumes, 1⁄2 cup 0.05 0.05 Green leafy vegetables (broccoli, kale, Brussels sprouts, leeks, spinach, Chinese greens, salad greens) 1 cup raw or 1 ⁄2 cup cooked 0.1 0.03 Grains Oat germ, 2 tbsp 0.2 1.6 Wheat germ, 2 tbsp 0.1 0.8 Note: 1 cup = 112g