Trans fats are a type of fatty acid found in the foods we eat. Fatty acids are a source of energy for your body. Some types of fatty acids are healthy. Moderate amounts of polyunsaturated fats and monounsaturated fats benefit your diet. This includes seeds, nuts, animal fats, and fruit, vegetable, and fish oils. However, trans and saturated fats are bad types of fatty acid. Trans fats are made from turning liquid oils into solid fats. They are cheap and have a long shelf life. Most processed foods and commercial baked goods have trans fats.

Path to improved health

Trans fats increase your levels of “bad” cholesterol (called low-density lipoprotein, or LDL). They decrease your levels of “good” cholesterol (called high-density lipoprotein, or HDL). Eating trans fats can make you gain weight. It also raises your risk of coronary heart disease, type 2 diabetes, and other health issues.

Ideally, you should get 0 grams of trans fat per day. The American Heart Association recommends that less than 25% to 30% of your daily calories come from fats. Of these, less than 1% should come from trans fats. An average 2,000-calorie daily diet should include less than 2 grams of trans fats.

Trans fats occur naturally in foods, such as milk, butter, and animal meat. These trans fats are less harmful to your health. The worst kinds occur in fast food, fried foods, and snack foods. You also should avoid trans fats found in commercial baked goods. Bad trans fats are found in the following:

• Margarine
• Shortening
• Crackers
• Cookies
• Chips
• Cake, pies, and doughnuts
• Salad dressing
• Frozen foods

Things to consider

Plan your diet to avoid bad trans fats. To start, check all nutrition fact labels for trans fats. The U.S. Food and Drug Administration (FDA) requires that companies list it. However, a listing of 0 grams per serving still may contain trans fat. A company can list 0 grams if the product contains less than .5 grams per serving. Keep this in mind. You also can look for packaging to say “trans fat free.” The words “hydrogenated oil” or “partially hydrogenated oil” are also used to represent trans fats.

When you’re eating out, ask about trans fats before you order. Make an effort to eat more fruits and vegetables instead of processed or packaged foods. Fruits and vegetables are whole foods that are naturally free of trans fats. Replace whole-fat dairy products with nonfat or low-fat products.

You also can eat small amounts of foods with healthy fatty acids. Monounsaturated fats occur in many liquid oils. This includes vegetable, olive, canola, peanut, sunflower, and sesame oils. You can eat avocados, peanut butter, nuts, and seeds in moderation. Polyunsaturated fats occur in other types of liquid oils. This includes soybean, corn, and safflower oils. You can eat fatty fishes, such as salmon, mackerel, herring, and trout.

Questions to ask your doctor

• Are products labeled “trans fat free” healthy to eat?
• What are the best substitutes for trans fats?

Resources

American Heart Association: Trans Fats

National Institutes of Health, MedlinePlus: Facts About Trans Fats

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What are plant sterols and stanols?

Plant sterols and stanols are substances naturally found in fruits, vegetables, whole grains, legumes, nuts, and seeds.

How do plant sterols and stanols affect my body?

Research has shown that plant sterols and stanols help lower cholesterol. Cholesterol is a waxy substance your body uses to protect nerves, make cell tissues, and produce certain hormones. Your liver makes all the cholesterol your body needs. Your body also gets cholesterol directly from the food you eat (such as eggs, meats, and dairy products).

There are 2 types of cholesterol:

• Low-density lipoprotein (LDL), or “bad” cholesterol
• High-density lipoprotein (HDL), or “good” cholesterol

High levels of LDL cholesterol may narrow your arteries and cause heart disease or stroke. A high level of HDL cholesterol, on the other hand, is usually a good sign. It may actually help protect your arteries and prevent fatty deposits that can clog arteries.

Path to Improved Health

Regardless of your cholesterol levels, eating plant sterols and stanols can help lower your LDL (unhealthy) cholesterol. It does this while keeping your HDL cholesterol at the same level. Normally, your body’s small intestine absorbs cholesterol from the foods you eat. To your body, plant sterols and stanols look a lot like cholesterol. They can prevent your body from absorbing LDL cholesterol. Over time, this lowers the level of LDL cholesterol in your blood.

How much do I need to help lower my cholesterol?

If you need to lower your cholesterol, the National Cholesterol Education Program recommends that you take in 2 to 3 grams of plant sterols and stanols each day. But plant sterols and stanols alone will not help you reach your cholesterol goals. To improve your cholesterol levels, you will also need to make lifestyle changes. These include eating a heart-healthy diet, exercising, and quitting smoking.

What foods contain plant sterols and stanols?

Plant sterols and stanols are naturally found in some foods. But these amounts have only a small effect on cholesterol levels. To use sterols and stanols to reduce your LDL cholesterol level, you will need more than these foods can provide.

Some foods are now fortified with plant sterols and stanols. These include fortified margarines, cheese, orange juice, milk, and bread. Dietary supplements are also available. Ask your doctor if you should get your sterols and stanols from a fortified food or if a dietary supplement is right for you.

If you do use these products, keep in mind that the amount of plant sterols/stanols varies from product to product. For example, a 2- to 4-tablespoon serving of margarine fortified with plant sterols provides the recommended 2 grams. Two 8-oz. servings of fortified orange juice also provide the recommended amount. Read label information carefully to find out the appropriate daily dosage or serving size of these products. Also, remember that more isn’t always better. You still need to eat a wide variety of foods and be aware of how many calories you are eating.

Do plant sterols and stanols interact with any foods or medicines?

No, plant sterols and stanols have not been shown to interact with any foods or medicines.

Things to Consider

It is important to take your medicine just as your doctor prescribed. You should not use plant sterols and stanols as a substitute for your cholesterol-lowering medicine.

Questions to Ask Your Doctor

• Should I add plant sterols and stanols to my diet?
• Should I begin taking dietary supplements that include plant sterols and stanols?
• If I’m already taking cholesterol-reducing medicine, do I need to worry about adding plant sterols and stanols to my diet?
• Do plant sterols and stanols cause any bad side effects?
• Will taking plant sterols and stanols be enough to reduce my cholesterol to a safe level?

Resources

National Lipid Association: Plant Sterols and Stanols in Foods and Supplements

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High cholesterol can begin in childhood. High cholesterol levels are likely to continue to rise as a child grows into a teen and adult. This increases your child’s risk for cholesterol-related health problems.

What are the risks of high cholesterol levels?

Your child’s body needs some cholesterol to protect nerves, make cell tissues, and produce certain hormones. But too much cholesterol damages blood vessels. It builds up along blood vessel walls. This forms sticky, fatty deposits called plaque. Studies show that plaque can begin to form in childhood. It is more likely to form when a child’s cholesterol levels are high.

High cholesterol levels increase your child’s risk of heart disease and stroke when he or she gets older. Heart disease is the leading cause of death in the United States. The risk is higher in people who:

• Have a family history of heart disease or strokes
• Have diabetes
• Are overweight or have obesity
• Have unhealthy eating habits
• Are not physically active
• Smoke or are exposed to second-hand smoke

Where does cholesterol come from?

The liver makes all the cholesterol your child’s body needs. He or she also gets cholesterol from food, including animal products such as eggs, meats, and dairy products.

What is the difference between “good” cholesterol and “bad” cholesterol?

Low-density lipoproteins (LDL) are often called “bad” cholesterol. They deliver cholesterol to the body. Some people’s bodies make too much LDL cholesterol. LDL levels also are increased by eating foods high in saturated fat, trans fats, and dietary cholesterol.

High-density lipoproteins (HDL) are often called “good” cholesterol. They remove cholesterol from the blood. A healthy level of HDL may help protect against heart disease. Exercise can increase the amount of HDL cholesterol the body produces. Avoiding trans fats and following a healthy diet also can increase HDL levels.

Sometimes cholesterol levels are high because of a high LDL level. This increases the risk for heart disease or stroke. Other times, cholesterol levels are high because of a high HDL  level. This does not increase the risk for heart disease or stroke.

Should my child be tested for high cholesterol levels?

The American Academy of Pediatrics recommends all children be tested for hyperlipidemia (fat levels in the blood) between the ages of 9 and 11. Your child should have a cholesterol test if there is a family history of high cholesterol. Your doctor will also recommend testing if your child or teen has diabetes.

What causes high cholesterol levels in children?

The following are factors that can cause high cholesterol levels in children:

• Family history of high cholesterol levels (for example, a parent who has high cholesterol levels)
• Lack of physical activity
• Obesity

Path to improved well being

You can help your child maintain a healthy weight by making healthy choices. Teach him or her to make healthy food choices and be physically active. Here are a few tips:

• Offer your child at least 5 servings of fruits and vegetables each day. For example, have healthy snacks such as apples, bananas, carrots, and celery readily available.
• Include plenty of low-fat proteins, vegetables, and whole grains in the meals you make.
• Avoid saturated fat and trans fats. Saturated fats are usually found in animal products (for example, fried or fatty meats). You can also find them in dairy products (for example, cheese and butter). Many snack foods (for example, cookies and chips) are high in saturated fat. Trans fats are usually found in processed foods (for example, doughnuts and crackers). They are also in fried foods (for example, French fries and onion rings).
• Avoid fast-food dining. If you do eat at a fast-food or sit-down restaurant, choose the healthiest options available. Try a salad with a grilled or broiled piece of meat and a fruit cup.
• Limit your child’s screen time (TV, computer, cell phone, or game station) to no more than 1 to 2 hours a day. Set a good example by limiting your own screen time, too.
• Encourage your child to find physical activities he or she enjoys and get active. Aim for at least 1 hour of active play every day.
• Make physical activity part of your whole family’s lifestyle. Take a walk, go for a bike ride, or do chores together. Plan active family outings.

Things to consider

Healthy eating and physical activity are the first choice to lower a child or teen’s high cholesterol levels. If these don’t help, your family doctor may consider prescribing a cholesterol-lowering medicine. This type of medicine may be needed if your child has diabetes or is overweight or obese.

Not all medicines are safe for use in children. Do not give your child a cholesterol-lowering medicine that isn’t specifically prescribed to him or her.

Questions to ask your doctor

• Should I have my child’s cholesterol level tested?
• If my child’s cholesterol level is high now, will it always be high?
• How often should my child’s cholesterol level be tested?
• Does my child need to see a specialist?
• Do you recommend any other diagnostic tests?
• What are our options for cholesterol treatment?
• What are the benefits, risks, or side effects of these treatments?

Resources

Centers for Disease Control and Prevention: Abnormal Cholesterol Among Children and Adolescents

National Institutes of Health, MedlinePlus: Cholesterol

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