Chapter Review

BRING IT HOME

CHAPTER 7 BRING IT HOME

Fast-food facts

The term “fast food” brings to mind high-calorie, high-fat, and low-nutrition menu items. However, for many, particularly young to middle-aged Americans, eating out is not only considered necessary, but it provides a significant source of their overall nutrition. In a 2013 Gallup poll, 8 in 10 Americans reported eating at fast-food restaurants at least monthly; almost half said they eat fast food at least weekly. Only 4% said they never eat at fast-food restaurants.

Is it possible to find healthful menu items at chain restaurants? Although greater variety and control of ingredients and preparation methods can usually be achieved by preparing food at home, with a bit of planning and awareness, you can still make positive choices when eating out.

Explore and consider

Visit the corporate website for a major fast-food chain (e.g., www.mcdonalds.com; www.wendys.com; www.subway.com; www.in-n-out.com; or many others) and find the nutrition information or facts. Using the chart provided, compare a typical meal you or a friend might order (for example, cheeseburger, large fries, and large cola) with another meal that has a better overall nutrient profile and a more positive—or, at least, less negative—potential impact on blood lipid profile (total, LDL, and HDL cholesterol levels). Nutrition information and suggestions can also be found at http://www.fastfoodnutrition.org/.

Typical restaurant meal at

Food Item or Beverage Serving Size Calories Fat (g) Percent Calories from Fat* (for meal only) Saturated Fat (g) Trans Fat (g), If Available Fiber (g) Sodium (mg)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTALS

 

 

 

 

 

 

 

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Healthier alternative at same restaurant

Food Item or Beverage Serving Size Calories Fat (g) Percent Calories from Fat* (for meal only) Saturated Fat (g) Trans Fat (g), If Available Fiber (g) Sodium (mg)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTALS

 

 

 

 

 

 

 

 

DIFFERENCES (+/−)

 

 

 

 

 

 

 

*To calculate percentage calories from fat, multiply grams of fat by 9 and then divide by the total calories times 100.

Consider

  1. As you reviewed the nutrition facts information for the restaurant you chose, did calorie or fat content of menu items surprise you? Why or why not?

  2. Briefly comment on the differences between the typical and healthier meals you chose.

  3. With regard to total fat, saturated fat, and trans fat, discuss the potential impact of the meals you chose on blood lipid levels and heart disease risk.

  4. Do you feel it is possible to find a reasonably healthy meal at a fast-food restaurant? Why or why not?

  5. Do you feel the posting of calorie information on menu boards will make a difference in what customers order? Do you think requiring calorie information has the potential of lowering risk of heart disease and obesity in the United States? Why or why not?

  6. What might you propose on a food industry, policy, or consumer level to encourage not only healthier options, but improved individual food choice behavior at fast-food restaurants?

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KEY IDEAS

KEY IDEAS

  • Atherosclerosis, a thickening and hardening of the arteries along with plaque development along blood vessel walls, is a major cause of heart attack and stroke.

  • Atherosclerosis is a form of cardiovascular disease (CVD) that often begins when an injury to a vessel wall triggers inflammation and low-density-lipoprotein (LDL) cholesterol infiltration, which results in plaque accumulation.

  • CVD risk factors increase the risk of vessel injury, as well as increase the rate and extent of the progression of plaque buildup and arterial blockage.

  • The presence of risk factors increases the risk of developing and promoting CVD. Some risk factors cannot be modified, like race, age, and a family history of heart disease, but certain lifestyle choices can significantly affect the risk of CVD.

  • Modifiable risk factors for CVD include smoking; a diet high in saturated and trans fats, cholesterol, sodium, and added sugar; a sedentary lifestyle; obesity; diabetes; elevated lipid levels in the blood (cholesterol, LDL, and triglycerides); excessive alcohol consumption; and high blood pressure.

  • The concentrations of various lipids in the blood correlate with the risk of atherosclerosis and CVD. A high level of total blood cholesterol is a major risk factor, particularly when accompanied by high levels of LDL cholesterol and low levels of high-density lipoprotein (HDL) cholesterol.

  • Metabolic syndrome is a cluster of risk factors associated with the development of CVD and type 2 diabetes. Diagnosis involves the presence of at least three of the following abnormalities: excessive abdominal fat, high blood pressure, elevated levels of triglycerides in the blood, low levels of HDL, and elevated blood glucose levels.

  • Diet, including the intake of fatty acids and cholesterol, plays a critical role in the development or prevention of CVD.

  • Available evidence suggests that replacing saturated fats with monounsaturated and polyunsaturated fatty acids may be beneficial.

  • The Therapeutic Lifestyle Changes (TLC) program was created by the National Institutes of Health’s National Cholesterol Education Program and is also endorsed by the American Heart Association as a heart-healthy regimen that can lower blood cholesterol and reduce the risk of CVD.

  • The dietary component of the TLC program focuses on lowering saturated fat and dietary cholesterol levels along with other heart-healthy strategies, such as eating foods that contain plant sterols and stanols and sufficient soluble fiber.

  • Additional dietary strategies to improve blood lipid profiles and reduce the risk of CVD include minimizing intake of trans fatty acids and lowering the ratio of omega-6 fatty acids to omega-3 fatty acids.

  • The science behind the biological and health effects of dietary fat and fatty acids is complex and continually evolving.

160

NEED TO KNOW

NEED TO KNOW

Review Questions

Question 7.9

1. Atherosclerosis is theorized to begin with:

  1. a heart attack.

  2. injury to the lining of the artery.

  3. excessive sugar intake over time.

  4. blood clot formation.

  5. a stroke.

1. b

Question 7.10

2. All of the following are true with regard to inflammation of blood vessel walls, EXCEPT that it:

  1. can be triggered by damage or injury to the blood vessel wall.

  2. occurs when white blood cells move to vessel walls in response to LDLs in the blood.

  3. causes further damage to blood vessel walls.

  4. makes blood vessels more prone to accumulation of plaque.

  5. helps keep vessel walls flexible and protects against heart attack.

2. e

Question 7.11

3. Modifiable risk factors do NOT include:

  1. diets that are high in trans fat, sodium, and added sugar.

  2. smoking, sedentary lifestyle, obesity, and high blood pressure.

  3. consumption of excessive amounts of alcohol.

  4. risk factors like family history, increasing age, and race.

3. d

Question 7.12

4. For adults, a healthy blood cholesterol level is considered to be less than:

  1. 100 mg/dl.

  2. 120 mg/dl.

  3. 160 mg/dl.

  4. 200 mg/dl.

  5. 240 mg/dl.

4. d

Question 7.13

5. A higher risk of CVD is associated with higher levels of:

  1. linolenic acid.

  2. chylomicrons.

  3. red blood cells.

  4. LDLs.

  5. HDLs.

5. d

Question 7.14

6. A primary function of HDLs is to:

  1. aid in the digestion of lipids in the small intestine.

  2. transport cholesterol to all cells of the body.

  3. transport cholesterol from tissues to the liver.

  4. transport triglycerides to adipose tissue.

  5. link amino acids to form proteins.

6. c

Question 7.15

7. All of the following are among the cluster of conditions that characterize metabolic syndrome, EXCEPT:

  1. excessive abdominal fat.

  2. high blood pressure.

  3. prediabetes or type 2 diabetes.

  4. low levels of LDL cholesterol in the blood.

  5. elevated levels of triglycerides in the blood.

7. d

Question 7.16

8. Current evidence indicates that reducing saturated fats in the diet is most effective in reducing the risk of CVD when:

  1. saturated fats are replaced by unsaturated fats.

  2. all dietary cholesterol is eliminated.

  3. saturated fats are replaced by carbohydrate-rich foods.

  4. saturated fats are replaced by low-fat breads and cereals.

  5. total fat intake is kept under 20% of calories from fat.

8. a

Question 7.17

9. The Therapeutic Lifestyle Changes (TLC) dietary component for individuals with increased risk of CVD focuses on all of the following, EXCEPT:

  1. foods that contain plant sterols and stanols.

  2. sufficient soluble fiber intake.

  3. lowering intake of monounsaturated fats.

  4. lowering intake of dietary cholesterol.

  5. lowering saturated fat to less than 7% of total calories.

9. c

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Question 7.18

10. Trans fatty acids:

  1. are recommended to make up at least 5% of daily calories from fat.

  2. shorten the shelf life of food products.

  3. are currently not required to be listed on the Nutrition Facts panel of food labels.

  4. are found only in processed foods, not found naturally in any other foods.

  5. can raise LDLs and lower HDLs.

10. e

Take It Further

Contrast two 45-year-old men, one with a low risk of CVD and one with an elevated risk of CVD. List five ways in which diet, exercise, and other lifestyle choices might have increased the risk of CVD for one of these men more than the other.

Dietary Analysis Using SuperTracker

Dietary Analysis Using SuperTracker

Focus on fats for heart health

The lipid content of our diet is a key component of any healthy diet, but it’s important to know if you’re getting too little or too much. In this exercise, you will evaluate your lipid intake, break down the various types of fats you consume on an average day, and compare them with heart-healthy dietary recommendations. You will also be evaluating your diet for CVD risk and will identify appropriate changes to reduce these risks.

Question 7.19

1. Log onto the United States Department of Agriculture (USDA) website at www.supertracker.usda.gov. Click this link. If you have not done so already, you will need to create a profile to get a personalized diet plan. This profile will allow you to save your information and diet intake for future reference. Do not use the general plan.

Question 7.20

2. Click the Track Food and Activity option.

Question 7.21

3. Record your food and beverage intake for one day that most reflects your typical eating patterns. Enter each food and beverage you consume into the food tracker. Note that there may not always be an exact match to the food or beverage that you consumed, so select the best match available.

Question 7.22

4. Once you have entered all of your food and beverage choices into the food tracker, on the right side of the page under the bar graph you will see Related Links: View by Meal and Nutrient Intake Report. Print these reports and use them to answer the following questions. You may use the analysis and reports you generated for the Supertracker activity in Chapter 6 to help you complete this activity.

  1. What percent of your total calories came from dietary fat? How does this compare with the 25% to 35% recommended by the American Heart Association (AHA)?

  2. What percent of your total calorie intake came from saturated fat? Does this exceed the AHA’s limit of 7% of total calories? If so, what foods contributed the most saturated fat to your diet?

  3. What percent of your total calorie intake came from monounsaturated fat? Is this greater than your intake of saturated fat?

  4. What percent of your total calorie intake came from polyunsaturated fat? Is this greater than your intake of saturated fat?

  5. Did you meet the recommended target for omega-3 fatty acids? Identify at least three food sources of omega-3 fatty acids.

  6. How much dietary cholesterol did you consume on this day? Does this exceed the limit of 300 mg? If so, what foods contributed the most cholesterol to your diet?

  7. Health experts recommend that we minimize our intake of trans fats. What information can you look for on food labels to indicate whether a food product contains trans fat?

  8. Did you meet the target for dietary fiber for this day? Sufficient fiber intake, particularly soluble fiber, is an important part of a heart-healthy diet. Identify at least three foods that provide an excellent source of soluble fiber.