FAT REPLACERS

FAT REPLACERS

            Dietary fat intake can be reduced by lowering the amount of high fat foods in the diet or by providing lower fat or fat free versions of food and beverages or by using ft replacers (ingredients that mimic the properties of fat but with significantly fewer calories) in food formulation. The FDA provides assurance that current fat replacers/ substitutes are safe to use in foods.

            Regular use of foods with fat replacers may help to reduce dietary fat intake (including saturated fat and cholesterol), but may not reduce total energy intake or weight.

            The primary dietary fat goal in persons with diabetes is to limit saturated fat and dietary cholesterol intake. Saturated fat is the principal dietary determinant of plasma LDL cholesterol. In nondiabetic persons, low saturated fat and cholesterol diets decrease plasma total cholesterol, LDL cholesterol and tryglycerides with mixed effects on HDL cholesterol.

            Adding exercise results in greater decrease in plasma total and LDL cholesterol and triglycerides and prevents the decrease in HDL cholesterol associated with low fat diets.

            In metabolic study diets, in which energy intake and weight are held constant, diets low in saturated fat and high in carbohydrates or enriched with cis-monosaturated fattyacids (MUFA), lower plasma LDL cholesterol equivalently. Low saturated fat (i.e. 10% of energy) high carbohydrate diets increase postprandial levels of plasma glucose, insulin and triglycerides and decrease plasma HDL cholesterol.

            Polyunsaturated fats appear to lower plasma total and LDL cholesterol, but not as well as monounsaturated fats.

            N-3 polyunsaturated fattyacids supplements lower plasma triglycerides levels in persons with type II diabetes. N-3 supplements may be most beneficial in the treatment of severe hypertriglyceridemia. Foods containing N-3 fattyacids have cardioprotective effects. To or three servings of fish per week provide dietary N-3 polyunsaturated fat and can be recommended.

            The effect of trans-unsaturated fattyacids (formed when vegetable oils are processed and made more solid (hydrogenation) is similar to saturated fats in raising plasma LDL cholesterol. In addition, trans-fattyacids lower plasma HDL cholesterol. Therefore, intake of transfattyacids should be limted.

            Plant sterols and stanol esters block the intestinal absorption of dietary and biliary cholesterol, plant sterols/stanols in amounts of approximate 2g/day to lower total and LDL cholesterol.

            Low fat high carbohydrate diets are associated with a transient decrease in energy intake and modest weight loss to a new equilibrium body weight with this modest weight loss, a decrease in plasma total cholesterol and triglycerides and increase in HDL cholesterol occurs.

CONCLUSION:

1. Less than 10% of energy intake should be derived from saturated fats. Some individuals (i.e. persons with LDL cholesterol ³ 100mg/dl) may benefit from lowering saturated fat intake to <7% of energy intake.
2. Dietary cholesterol intake should be <300mg/day some individuals (i.e. persons with LDL cholesterol ³ 100mg/dl) may benefit from lowering dietary cholesterol to <200mg/dl.
3. To lower LDL cholesterol, energy derived from saturated fats can be reduced if weight loss is desirable or replaced with either carbohydrate or MUFA when weight loss is not a goal.
4. Intake of trans-unsaturated fattyacids should be minimized.
5. Reduced fat diets when maintained long terms contribute to modest loss of weight and improvement in dyslipidemia.
6. Polyunsaturated fat intake should be ~10% of energy intake.

Reference:

            Clinical practice recommendations ADA

         RSSDI Text Book of DM