Guest Post by Sally Marchini – Dietitian
In today’s blog we’ll focus on which fats we should include in our diets, why this is so, and how much we should be having. Last week in the introduction to fats and d-health blog we talked about how it’s important for us, especially as people with or at risk of diabetes, to understand about the different types of fats, or fatty acids, and choosing the right fats in the right amounts can benefit our wellbeing in many ways. We explored what the different types of fats are and where they’re found, as well as how much the Australian Dietary Guidelines recommends for people with diabetes.
I need to keep this explanation relatively simple as fats and their pathways is actually quite a complex topic that, even with in depth study is tricky to explain in a short blog. I recommend that if you would like more detailed information that you go see your Accredited Practising Dietitian for personalised advice and further explanation. I also encourage you to remember that the Australian Dietary Guidelines Foundation Diet provides an excellent balance of nutrients for our wellbeing so is an excellent point of reference to know what we should be consuming for our wellbeing.
Off we go!
The Mediterranean Diet
The Mediterranean diet is currently being discussed as a very healthy way of eating, and research continues to back this up. If we just look at the fat types within that diet you’ll see a focus on monounsaturated fatty acids (being the predominant fatty acids in olive oil, canola oil, avocado and nuts) and the long chain omega-3 polyunsaturated acids (as found in deep sea fish and some plants). The research in this area is ongoing but at this stage it mostly indicates that diets higher in these types of fats help with weight maintenance as well as improving the quality of blood fats and longer term studies also showing reduced all cause mortality including cardiovascular disease.
There is also emerging evidence that demonstrates the importance of the ratio of saturated fats to anti-inflammatory fats that, being out of balance, is potentially a big cause for our Australian population’s high risk of cardiovascular disease.
Why is this important?
Recently released data through Australia’s Health 2014 that looks at the whole population and indicated that cardiovascular disease costs $7.7 billion or 10% of total expenditure and was also the leading cause of death. We also know that people with diabetes are 3 to 4 times more likely to develop cardiovascular disease (including heart attack and stroke) than those who do not have diabetes. In addition, around 75% of all people with diabetes die from cardiovascular disease, including heart attack and stroke, and people with diabetes are up to six times more likely to suffer from atherosclerosis than people without diabetes.
The National Diabetes Services Scheme website also reminds us that “People with type 2 diabetes often have ‘abnormal’ levels of blood fats (cholesterol and triglycerides). Not only are the blood fat levels different to those of a person without diabetes, the cholesterol also tends to ‘behave’ differently.” All the more reason to heed the advice provided by the Australian Heart Foundation and backed up by the Dietitians Association of Australia to avoid those saturated and trans fats.
Although I have type 1 diabetes, I’m not willing to take chances of developing heart conditions (as the rest of our healthy population should consider too) so choose foods higher in monounsaturated fats and omega 3 polyunsaturated fats whenever I can, along with the low-GI carbs which are also known to help reduce blood fats compared with high-GI carbs.
Why those particular fats?
When we look at the reason (without going into miniscule detail) that we’re advised to choose monounsaturated and omega-3 polyunsaturated fats wherever possible, it is because monounsaturated fats are shown to follow non-inflammatory pathways and omega-3s (particular from deep-sea fish) promote anti-inflammatory reactions in our bodies. Compare that with saturated fats which are recognised as being pro-inflammatory (they cause inflammation, which causes detriment to our health in several ways).
There is also some evidence that the other main type of polyunsaturated fats, omega-6s, may be seen to take the inflammatory route and compete with the omega-3s. The jury is still out on this, and the potential inflammatory effect of omega 6 can be seen as merely an “interesting theory” at this stage. Accredited Practising Dietitian Sonia Navidi recently wrote about this issue in her blog (Nourish Me Simply), and it seems at this point in time to be a sensible view towards omega-6 fatty acids. Sonia writes:
“Interesting theory, but does it play out?
Actually, no, at least as far as the latest evidence is concerned. A Science Advisory from the American Heart Association, published in the prestigious journal Circulation in 2009, gives an excellent review of the evidence. They note that while Omega-6 acts as a precursor to compounds that promote inflammation in the body, it actually also acts as a precursor to compounds that are either anti-inflammatory, or help our arteries in other ways. They note that, while the theory of Omega-6 being pro-inflammatory has been around for a while, there is no solid evidence to support it.
They also state that:
“On the basis of the intakes of omega-6 [polyunsaturated fatty acids] used in the randomized trials, metabolic studies, and nonhuman primate studies discussed below, reductions in [coronary heart disease] risk might be expected with omega-6 [polyunsaturated fatty acid] intakes of 10% to 21% of energy compared with lower intakes, with no clinical evidence for adverse events.”
* Brackets inserted where the original source gave an acronym.”
So at this point in time the main fats to avoid are saturated and trans fats found in animal products as well as palm and coconut fats. Also, trying to ensure that we have plenty of omega 3s and monounsaturated fats in our diets.
If you’re interested in reading more about coconut oil being in this ‘avoidance’ group when it seems to be claimed as healthy by some on the internet, please read this explanation by the Dietitians Association of Australia.
Let’s finish up today’s blog with some recipes containing healthy fats, remembering that the quality of the carbohydrate is also important.
Atlantic salmon has the highest amount of naturally occurring omega 3s of our Australian fish. This Salmon and White Bean Mash recipe will give you the omega 3s along with the nutritious and low-GI carbs of the white beans, and only 2 carb exchanges per serve.
As a vegetarian option how about these Cashew and Brazil Nut Burgers? You can read more about nuts in my blog, but generally speaking nuts are high in monounsaturated fats. You could swap the cous cous for quinoa to make it gluten free if you need to, and of course hummous is made on olive oil – also high in monounsaturated. This one has 2.5 carb exchanges per serve of nutritious low-GI carbs.
This Avocado and Four Bean pasta recipe looks and sounds delicious with only 1.5 carbohydrate exchanges per serve. The monounsaturated fats in the avocado will help to ensure a low glycemic index and will keep your hunger satisfied for longer too.
And there are lots more where these came from. To find these ones I went to some of my favourite recipe sites including Taste.com.au, Nuts for Life and Australian Healthy Food Guide and searched terms such as ‘salmon’, ‘healthy fats’, olive oil and then looked for ones with the qualities of good fats and low-GI nutritious carbs that are so important to us with diabetes.
The take-home message is that we should be choosing more monounsaturated fats (good sources include olive and canola oil, avocadoes and nuts) and omega-3 polyunsaturated fats (good sources include deep sea fish, walnuts, linseeds and soy products), while reducing our intake of saturated fats (from animal based products, coconut and palm oil) and trans fats (found in many processed foods).
Please share any questions you have about this blog, let me know if there’s anything else you’d like to know about fats, and of course we’d love you to share your favourite recipes that you enjoy for good health.
Sally is owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too.