Weight Articles

Introduction

Weight loss advice is built upon the important basis that in order to lose weight you need to use up more energy (measured in kilocalories or kilojoules) than your body takes in from food and drink.

Eating a healthy diet with fewer calories, combined with more physical activity, achieves the best results. A weight loss of ½-2lb per week is generally considered safe and enables your body to adjust to your new size and eating habits and helps to safeguard against regaining the weight once you stop dieting. 

Energy savings usually come from eating a diet that is lower in fat, alcohol and simple carbohydrates such as sugars. As fat and alcohol contain more calories it is especially important to limit these.   The emphasis is also on removing foods from the diet which contribute energy but few vitamins and minerals.  This includes foods such as sugary drinks, confectionary, alcoholic beverages, as well as rich cakes; biscuits and puddings.   

It helps to know how much energy each of the 4 major nutrients provide. 

1 gram of fat = 9 calories

1 gram of carbohydrate = 4 calories

1 gram of protein = 4 calories

1 gram of alcohol = 7 calories

Trying to lose weight does not mean starving yourself.  You should still enjoy and eat a variety of foods.   In particular it is important to fill up on hart healthy foods that are low in calories yet still satisfying:

• About a third of your food should be carbohydrate rich foods such as bread, potatoes, chapattis, pasta, rice and other cereals.  These foods do not contain too many calories unless you add fat to them.  Most us eat too little fibre so where possible try to choose wholemeal or wholegrain varieties.  They also contain higher levels of nutrients and are more satisfying than refined carbohydrates like sugars and white bread. 
• Eat plenty of vegetables, salads and fruit.  At mealtimes try to cover half of your plate with vegetables.  Fresh, canned, frozen and dried fruit and vegetables all count but if choosing canned fruit go for those in natural juices rather than syrup.
• Try increasing your intake of pulses, beans, peas and lentils.  These are all low in calories but high in fibre so are excellent choices.

For successful weight loss it is particularly important to lower your fat intake.  But not all fats are equal.   Fats are can be divided into saturated and unsaturated fats.  Whilst both are high in energy, saturated fats are less heart healthy than unsaturated fat.  This is because saturated fat can increase the levels of cholesterol in your blood.  So when cutting energy from fat it is best to concentrate on reducing the amount of saturated fat.

What is cholesterol?

Cholesterol is a white waxy substance, vital for good health as it helps form cell membranes, various hormones, bile salts and vitamin D. It only becomes a problem if you have too much of it, as too much increases your risk of heart disease.

There are two main types of cholesterol, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. LDL cholesterol is thought of as the ‘bad’ cholesterol as it is the main carrier of harmful cholesterol to your arteries where it builds up and causes narrowing. The HDL is the ‘good’ cholesterol as it picks up excess cholesterol and takes it away from the arteries.

The ideal situation is to have a low LDL and a high HDL.

What should my cholesterol level be?

Cholesterol is measured in millimoles per litre (mmol/L).

The average cholesterol in middle aged men and women in the UK is between 5.0 and 6.0mmol/L. Cholesterol experts agree that a total cholesterol of 5mmol/L or less, a non HDL cholesterol of 4mmol/L or less and an LDL cholesterol of 3mmol/L or less, are considered healthy for most people. A fasting triglyceride should be 2mmol/L or less (less than 4mmol/L if non-fasting).

If you have existing heart disease, or are at higher risk of developing heart disease, it is likely that your doctor will advise you to reduce your cholesterol further. It is best to discuss this with your doctor when he or she reviews your treatment. Any target cholesterol levels your doctor suggests will depend on the cause of your high cholesterol, your age and any other risk factors you have.

Why is cholesterol important?

A number of risk factors contribute to developing heart disease. However a raised LDL (bad) cholesterol in the blood is the single greatest modifiable risk factor for heart disease and contributes to almost half of all deaths from coronary heart disease (CHD). In the UK:

• It’s also a major risk factor in stroke and a big problem for diabetic and South Asian groups.
• Approximately six in every ten adults have a cholesterol level over 5mmol/L.
• CHD is the most common cause of premature death.

If I lose weight will this lower my cholesterol level?

Blood cholesterol levels are influenced by many things.  Being overweight, obese or diabetic can increase your cholesterol levels especially if you carry a lot of weight around your waist.  Weight around the waist is sometimes referred to as abdominal obesity or being “apple shaped”.  Cholesterol levels are also influenced by the amount of activity you do and the kind of foods you eat.

People who are apple shaped often have a particular pattern of raised blood fats (cholesterol and triglycerides).   This is because their body handles blood fats somewhat differently to slimmer people. Typically they have increased levels of triglycerides, small denser particles of LDL-cholesterol and a decrease in the protective HDL-cholesterol.  These changes result in a greater risk of cardiovascular disease especially if accompanied by other risk factors such as high blood pressure or smoking.

The INTERHEART case-control study estimated that 63% of heart attacks in Western Europe and 28% of heart attacks in Central and Eastern Europe were due to abdominal obesity.  Those with abdominal obesity were over twice at risk of a heart attack compared to those without.

Reducing body weight by 5-10% and reducing saturated fat in the diet can bring about modest reductions in LDL (bad) cholesterol of around 10% and a significant reduction in cardiovascular risk.  

So where do I find the different types of fats?

Most foods contain some fat and this is usually a mixture of saturated and unsaturated fat.  However generally animal fat is mainly saturated and vegetable fat is mainly unsaturated. 

Below is a summary explaining which foods contribute most saturated and unsaturated fat to the diet.

Saturated fat:           

Usually solid at room temperature and generally of animal origin

Foods rich in saturated fats include:

Butter, ghee, lard, hard margarines and in foods made from these (cakes, biscuits, puddings, pies, pastries and pasties)

Diary fats (full cream milk, cheese, full fat yoghurt, crème fraiche and cream)

Fatty meats and meat products (sausages, burgers, salami)

Palm and coconut oils

Unsaturated fat:

There are two types of unsaturated fats.  The difference lies in the degree of saturation. Monounsaturated fats, as their name suggests, have one double (unsaturated) bond and polyunsaturated fats have two or more double (unsaturated) bonds.   Both are heart healthy. 

Monounsaturated fats:

Usually liquid at room temperature and vegetable origin

Foods rich in mono unsaturated fats include

Olive oil, rapeseed oil and spreads based on these  

Avocado

Nuts, flaxseed

Polyunsaturated fats:

Usually liquid at room temperature and vegetable origin

Foods rich in polyunsaturated fats include

Corn, safflower and sunflower oil and spreads based on these

Oily fish such as salmon, trout, herring and mackerel

Sunflower and other edible seeds

How much saturated fat can I eat?

Ideally no more than a third of the fat in your diet should be saturated fat, this means less than 20g of saturated fat a day for most adults.

It is all too easy to eat more saturated fat than you think.  Here are some examples of what 10g of saturated fat might look like.  Notice that for some foods e.g. many vegetable oils, low fat milks and Quorn, the quantities are generous because they are so low in saturated fats.   But beware this does not mean they are low in calories.  At 9 calories per gram all fats contain more than twice the amount of energy as can be found in the same quantity of protein or carbohydrates (sugars and starchy foods). 

Fats and oils (10g saturated fat)

• 4 teaspoons butter (20g)
• 5 teaspoons hard margarine (25g)
• 3 teaspoons ghee (15g)
• 5 teaspoons lard (25g)
• 4 teaspoons suet (20g)
• 16 teaspoons standard low fat spread (83g)
• 21 teaspoons very low fat spread  (107g)
• 4½ tablespoons corn oil (70g)
• 4 tablespoons soya oil  (64g)
• 7 tablespoons walnut oil (109g)
• 5½ tablespoons sunflower oil (83g)
• 10 tablespoons rapeseed oil (151g)

Meat/Meat products (10g saturated fat)

• 1½ medium sausage rolls (90g)
• 3 sausages (125g)
• 1 medium Cornish pasty ( 170g)
• 1 quarter pounder beef burger (90g)
• 2/3 small donna kebab
• 1 average lamb chop/cutlet (80g)
• 5 rashers back bacon (125g)
• Small portion beef casserole (150g)
• Just more than 1 whole pack Quorn pieces (4 portions) (380g)

Bread/Cereals/Confectionary (10g saturated fat)

• 5 slices Garlic bread (100g)
• 10 papadums (125g)
• 1 2/3 medium slices fried bread (80g)
• 1 2/3 plain croissants (100g)
• 3 chocolate biscuits (75g)
• 14 toffees
• 1 choc ice

Milk and Dairy (10g saturated fat)

• 2/3 pint whole milk (400ml)
• 1½ pints semi skimmed milk (900ml)
• ½ small carton single cream (80g)
• 2 tablespoons double cream (before whipping) (30g)
• 2½ tablespoons crème fraiche
• 1½ matchbox sized pieces cheddar
• 1 small slice cheesecake (100g)

Typical Meal Plan – low in saturated but containing heart healthy fats

Breakfast: 

Wholegrain cereal with skimmed milk

Small glass of fruit juice or piece of fruit 

 

Lunch:

Sandwich made from wholegrain bread

Sunflower or olive oil based spread

Lean meat, fish or vegetarian filling

Salad with oil based dressing if desired

Fruit portion

Evening Meal:

Modest portion of lean meat, oily fish, white fish, shellfish*, eggs*, vegetarian option (e.g. quorn, tofu, pulses, lentils, nuts)

Generous portion of vegetables and or salad (dress salad with modest amounts low fat or olive oil based salad dressings)

Portion of starchy food such as rice, pasta, potatoes, yam, chapatti, noodles, preferably wholegrain varieties

This meal should be steamed, boiled, poached, grilled, baked, casseroled, micro-waved or stir fried – using modest amounts of unsaturated cooking oils

 

Snacks:           

Fresh and dried fruit, unsalted nuts, malt loaf, low fat yoghurts or rice puddings, breakfast and cereal bars, oatcakes and vegetable soups       

* Shellfish and eggs contain dietary cholesterol but are low in fat and a potential source of omega 3 fatty acids.  For most eating moderate amounts of these foods will not raise cholesterol levels. However people with FH should consult their doctor or dietitian for advice.

For more information on saturated fat, reducing cholesterol or heart disease contact the HEART UK Cholesterol Helpline on 0345 450 5988 or email ask@heartuk.org.uk or visit www.heartuk.org.uk