When It Comes to Changes in Diet, Experts Say Take It Easy, Slow

For people who are not in cholesterol trouble now, the issues are not whether to eat that steak or cheeseburger, but how much of it to eat and how to balance out the rest of the day by eating less fatty foods.

National nutrition experts are not advocating that Americans try specifically to lower their cholesterol levels if they already are below the “borderline high-risk” level of 200 mg. of cholesterol per deciliter of blood. In fact, a healthy body needs cholesterol, an essential component for building cell walls and a precursor to various hormones. Fat also provides the body with its source of long-term energy.

But the same experts are pushing for all Americans to eat a diet containing no more than 30% fat--only a third of that from saturated fats--a development that could be expected to lower cholesterol levels even in low-risk individuals.

Less Restrictive Approach

This long-term approach would be less restrictive than the menu someone with a skyrocketing cholesterol level must follow. And it leaves room for minor forays into the traditional fat-laced fare of the past.

For instance, you don’t always have to order chicken or fish when you eat out. But you do need to approach the local steakhouse’s fare differently: Why not eat just 3 ounces of the steak you’re served and doggie-bag the rest for later? asks Dr. Edward N. Brandt, executive dean of the University of Oklahoma College of Medicine.

Or, if a person chooses to eat all 6 ounces of steak, it would be wise to carefully limit consumption of saturated and other fats the rest of the day--no margarine or, especially, butter on toast, only diet dressing on salad, nonfat instead of 2% milk, no ice cream for dessert.

Diet Changes Would Help

A 30% fat diet low in saturated fats would lower the risk not only of heart disease but also of certain cancers and obesity, says the National Research Council’s Committee on Diet and Health.

In a report in last week’s issue of the Journal of the American Medical Assn., doctors at the U.S. Centers for Disease Control estimated that 60 million U.S. adults ages 20 to 74 have cholesterol levels high enough to require medical advice and intervention. But dietary changes would lower the levels sufficiently for at least two-thirds of them, the scientists concluded.

Addressing heart disease as well as other food-related health problems in a March report, the panel recommended that American adults:

* Cut the amount of calories they consume as fat from the current 36.5% to just 30% a day. No more than 10% of total calories should be from saturated fats, which are largely in meat and dairy products. However, saturated fats also are “hidden” in convenience foods that use palm and coconut oils.

* Reduce their consumption of cholesterol to less than 300 mg. a day, approximately the amount in one egg yolk.

* Reduce their consumption of cooked protein to a level that would amount to less than 16 ounces per day for a 160-pound person or 12 ounces per day for a 120-pound person.

However, half that much cooked protein is considered both nutritionally adequate and desirable for cutting blood cholesterol levels. This would be two meat or fish portions a day, each about the size of a deck of cards.

* Increase the amount of complex carbohydrates they eat (bread, cereal, beans and peas) to at least 55% of calories.

* Eat at least five servings of fruit and vegetables daily.

* Avoid overeating, and drink no more than one ounce of pure alcohol (two beers, two small glasses of wine or two cocktails) a day. Although some studies have shown moderate amounts of alcohol lower the risk of heart disease, drinking poses other health risks, the panel said.

Quiet Revolution

If health experts succeed in inspiring this kind of quiet, day-to-day revolution in American eating habits, it could cut heart disease by 20%, the National Research Council estimates.

Already, the National Heart, Lung and Blood Institute’s National Cholesterol Education Program has seen an 800% increase since 1982 in the number of visits by Americans to doctors for treatment of high cholesterol levels.