Ms Teo Kiok Seng, Nutritionist

Fat- The good, bad and ugly

Fats are essential……..…..• Every cell of our body is made of fats. • It is a rich source of energy. Acts as

reserve during starvation.• It provides satiety.• Helps to absorb fat-soluble vitamins.• It keeps us warm.• It gives flavour and texture to food. • We need essential fatty acids from food as

our body cannot make them.

Fats can harm also…………… When fat is taken in excess, it results in

•ObesityWhich in turn

• raises the risk of developing many diseases

• Makes a person lethargic• Cause breathlessness & difficulty in

movement• Stresses the joints and cause

problem

What is cholesterol? ……Some facts………. Cholesterol is a waxy fat-like material found in all

parts of our body. Our liver produce 85% of the cholesterol in our

body.We get the rest (15%) from food.Only animal foods contain cholesterol

Cholesterol – Magic PotionCholesterol is essential

To form & maintain cell membranes- helps cells to resist changes in temperature- protects nerve fibers

To form sex hormones and bile to digest fat To get converted into vitamin D in the skin

under sunlight.

“I may be fat, but

I am essential”

How does fat affects our cholesterol level?Choosing the right types of fat can help

us have healthy level of cholesterol

HOW?Monounsaturated fat tends to keep our

good cholesterol (HDL) high. Polyunsaturated fat tends to lower both

good and bad cholesterol (HDL & LDL).

That’s why we need to watch what we eat?• High cholesterol & high saturated fats in diet

can increase our blood cholesterol

• Excess cholesterol gets deposited in the blood vessels forming plaques.

• Plaques can narrow or block blood vessels leading to Heart attack Stroke

Plaque -blocking the artery

Haemorrhage in artery due to plaque

Cholesterol – The Poison

How do plaques form?Cholesterol circulates in blood

Gradually gets deposited on the walls of arteries

More & more accumulates narrowing arteries

How do Singaporeans fare?• Singaporeans have high rate of heart disease

comparable to those from the western countries.

• Many Singaporeans have high fat intake. • Chinese men and Malay women are more likely

to have high fat intake.• Malays consume more saturated fats • Chinese have a higher fat intake from food

eaten outside • Indians have a higher fat intake from home

cooked food

Other factors that make my cholesterol level go up?…………• High cholesterol & high saturated fat

diet• Heredity• Age & Gender• Smoking• High blood pressure• Overweight or obesity• Excessive alcohol intake• Stress

How high is HIGH?………….

• Total cholesterol levels of more than 5.0 mmol/L or 200 mg/dl is considered as high.

• There is also the good cholesterol (HDL) and the bad cholesterol (LDL).

What is cholesterol and triglyceride ?HDL-Cholesterol Triglyceride

LDL-Cholesterol

The Good The Bad The Ugly

What is desirable cholesterol and triglyceride level ?

• Total Cholesterol <200mg/dl or <5.2mmol/l

• Triglyceride <150mg/dl or <1.7mmol/l

• Ratio of chol/HDL <4.5

• LDL (bad chol) <130mg/dl or <3.4 mmol/l

• HDL (good chol) >40mg/dl or >1.0 mmol/l

Good Cholesterol……………… Bad Cholesterol…………………

Good cholesterol (HDL) takes the bad cholesterol out of your blood and prevents plaque from building up in your arteries.

Bad cholesterol (LDL) deposits cholesterol on the walls of your arteries and increases your chances of getting heart disease.

So, how to increase my good cholesterol (HDL) and decrease my bad cholesterol

(LDL) ?

Recommendation for cholesterol intake

• Limit cholesterol intake to less than 300mg per day for healthy adults.

Cut down on cholesterol rich foods like fatty meat, organ meats, eggs etc. Seafood (except squid /sotong /cuttlefish) can be taken in moderation.

Include monounsaturated fat like olive and canola oil to keep your good cholesterol (HDL) high.

Avoid saturated fat like ghee, butter, lard which tends to increase your bad cholesterol (LDL).

Diet and lifestyle habits to lower cholesterol level

COUNT YOUR CHOLESTEROLLOW < 100mg cholesterol

MEDIUM 100-199mg cholesterol

HIGH 200mg & > cholesterol

Egg white Low cholesterol eggs Whole egg/egg yolk

Full cream milk Tongue(all kinds), heart(all kinds)

Brains(all kinds)

Natural yoghurt Pig stomach/intestine

Kidney(all kinds)

Low fat cottage cheese

Lobster Liver(all kinds)

All fresh fish/clams/mussels/cr

ab

Prawns/shrimps Cuttle fish, fish roe,

Lean beef, lean chicken, lean lamb

Abalone, sardines in oil

Sotong

If you ever wonder…

““Cholesterol-Free”Cholesterol-Free”• Not necessarily fat free. Plant food do

not have cholesterol but may be high in saturated fat.

Vegetable-blended oilsVegetable-blended oils• Usually contain higher amounts of

saturated fat as it comprises mainly palm oil.

Saturated fat- Increase our cholesterol level

• Mainly from animal sources.• Butter, lard, ghee and dairy products • Plant sources: coconut milk, palm oil,

vegetable shortening and hydrogenated oil

Trans-fat, how bad is it?• Hydrogenation produces trans-fat to provide longer

shelf-life in baked products.• Partially hydrogenated oils are used in processed

foods, like cakes, cookies, pastries and other baked goods.

• Trans fats lower level of good cholesterol and increase level of bad cholesterol.

• Trans fat also makes the arteries more rigid; causes major clogging of arteries.

• It may even increase the risk of getting type 2 diabetes.

Deep frying• Polyunsaturated &

monounsaturate oil go through changes under high temperature when deep-frying and carcinogenic substances are formed.

• Saturated oil like palm oil (blended vegetable oil) is more suitable for deep frying.

Butter and margarine controversy• On hydrogenation, liquid plant oil is

converted into margarine. • Trans-fatty acids are formed during

this process. • Hard margarine has a high amount of

trans-fat.• Soft margarine (poly or

monounsaturated) is still preferable for heart health.

• Some may choose butter because it has no trans-fatty acid.

““Margarine has fewer calories than Margarine has fewer calories than butter”butter”

• False. Both contain the same calories weight for weight.

““Eggs are bad for me, so I should Eggs are bad for me, so I should avoid them totally”avoid them totally”

• Not necessary. You can have 1-2 eggs per week. Only egg yolk has cholesterol, not egg whites.

Myths

Polyunsaturated fat- lowers our cholesterol level

• They are mostly from plants• Examples of this are corn, soy, sunflower,

cottonseed & polyunsaturated soft margarine.

• Some fish are high in omega-3 fatty acid, which is good for the heart. Examples of this are oily fish like salmon, tuna, mackerel.

Monounsaturated fat- Keeps our good cholesterol high• Olive oil, canola oil, peanut oil are

common types used for home cooking.

• Other sources are monounsaturated soft margarine, peanut butter, sesame oil, avocado, certain nuts and seeds etc.

• Save French fries and other fried foods and high-fat desserts for special occasions; have a small serving; share with a friend.

• Use nonfat or lower fat spreads or salad dressing.

• Choose low-fat or non-fat dairy products like milk, cheese, yoghurt.

• Replace coconut milk with low-fat milk or evaporated milk.

Cut it out: Tips to cut down fatsCut it out: Tips to cut down fats

• Choose small portions of lean meat, fish, and poultry

• Use low-fat cooking methods (baking, poaching, broiling); trim off all fat from meat and remove skin from poultry

• Choose turkey or chicken breast, lean ham, lean sliced beef.

Tips to cut down fatsTips to cut down fats

Tantalizing recipes

Chicken curry cooked with low-fat milk or yoghurt

Die die must try

Steamed fish with light soy sauce Die die must try

Salad with low fat dressing

ExcellentFruits dipped in low fat chocolate/chocolate sauce

Excellent

Diet and lifestyle habits to lower cholesterol level (cont’d) Increase the intake of fruit and vegetables for

water-soluble fibre, as it helps to lower cholesterol level.

Sources of water-soluble fibre are beans, oats, papaya, apples etc.

Try vegetarian diet for drastic reduction in cholesterol level.

Achieve healthy weight. Exercise regularly to increase HDL levels.

Foods that lowers cholesterol level• Oat• Beans• Garlic• Fish high in omega-3 fatty acid• Onion• Olive oil• Apples & carrots• Grapefruits• Almonds• shellfish

Lose weight if you are overweight

• Consume few hundred kcal less from usual diet

• Recommended weight loss is 0.5 to 1 kg per week

Learning about healthy eating

• It takes time to adjust to healthy eating. • Find a good balance between healthy

eating and regular exercise.• Start to enjoy a new way of eating and

exercising. You can reap a life time of benefit.