INYANG and OKPAKO Fat Related Diseases

8/6/2019 INYANG and OKPAKO Fat Related Diseases

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Journal of Education in Developing Areas (JED A) Vol. 19, No. 1.

FATS AND RELATED DISEASES: IMPLICATIONS FOR HEALTH EDUCATION

AND PROMOTION

By

Dr. Mfrekemfon P. Inyang PhD.

Dept. of Human Kinetics and Health EducationFaculty of Education

University of Port-HarcourtPort-Harcourt.

Phone No:+234 803 756 4011E-mail:[email protected]

&

Dr. J. E. F. Okpako PhD

Dept. of Human Kinetics and Health EducationFaculty of Education

University of Port-HarcourtPort-Harcourt.

ABSTRACT

Fat is one of the nutrients found in food. It is necessary for proper functioning of the

body. This notwithstanding, the quantity of fat consumed by an individual should not

exceed the necessary amount required for normal functioning of the body. Excessive

intake of fat predisposes to life threatening health problems. Such health problems

include obesity, fatty liver disease, different types of cancers, cardiovascular

diseases, high blood pressure, stroke, diabetes, gallstones, rheumatoid arthritis,

multiple sclerosis and skin problems amongst others. There is need for a review on

this because of the recent craze on fat laden foods. Excessive intake of fatty foods is

capable of reducing longevity. Moderate intake of the right type of fats at the otherhand can help in reversing existing health problems and increase longevity. The

paper aims at educating and promoting health through a detailed review on fat

related diseases. Excessive intake of fats impact negatively on almost all the organs

of the body. Benefiting from the good aspects of fat requires moderate consumption.

Key words:Fats, Fat related diseases, Implications for Health Education, Review


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March , 2011 JOURNAL OF EDUCATION IN DEVELOPING AREAS (JEDA) VOL.19 (1).

w w w . j e d a - u n i p o r t . c o m Page 2

Introduction

Research has established a strong linkage between diet and diseases. Consequently

diseases can also be reversed by eating the right and good type of diet. Good healthis an outcome of proper dietary pattern. This is a diet void of saturated fats,

cholesterol and hydrogenated vegetable oils. A diet full of saturated fats with excess

cholesterol seems to thicken the blood because of their sticky nature. The outcome

of this is a sluggish system which does not promote good health.

Studies have established that diets are capable of causing different types of

diseases especially with increase in age. For instance, researchers have linked

dietary intake to cancer (Levi, Pasche, La Vecchia, Lucchini & Franceschi, 1999).

Diseases that are related to diet are important and serious health problems. Thereis need to educate and create awareness on this because it involves all humans. Fat

is one of the nutrients necessary for proper functioning of the body. Incidentally it

is only safe when taken in moderation. According to Tsang (2004), we all need fats

because of the associated good functions such as nerve transmission and

absorption of nutrients.

However, she further stated that fats consumed in large quantities are not

without serious adverse effects which can be life threatening or result in outright

death. It is long known that high fat diet can cause fat-related heart disease and

certain types of cancer. The normal functioning of the heart can be disrupted by

accumulation of fat in heart cells. Excessive intake of fatty foods that are not

properly metabolised by the body can give rise to fat related heart disease (Lim,

Wang, Wessells, Ocorr & Bodmer, 2011).Some fats promote health while some

increase the risk of disease(Tsang, 2004).A relationship therefore exists between

indiscriminate consumption of fat and health problems.

The number of overweight individuals has alarmingly increased in recent

past. The number of fat and overweight people seems to suggest that being fat is

normal and does not carry any health risk along with it. Mere observations revealthat the number of overweight parents alongside with their children is alarmingly

high. Accumulation of fat and a corresponding increase in weight might not only be

due to the direct consumption of fatty foods. Fat can also accumulate in the body

from indirect sources. This fact calls for proper education which is the central

purpose of this paper. In most cases, in attempting to reduce the direct intake of

fat, the consumption of carbohydrate will be stepped up. Unfortunately, this does

not solve the intended problem. The carbohydrate intake stimulates the body to

produce more insulin. Increased level of insulin due to increased intake of

carbohydrate in order to play down on the intake of fat leads to the storage ofenergy in the body in the form of fat (National Health Service, Dept. of Human

Health and Human Services, USA, National Institute of Health, USA and American


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Heart Association).year?

Scientific papers are published each year on adverse effects associated with

excessive intake of fatty foods. Promising findings are emerging each year on fat

related diseases published in different types of journals. It has become necessary to

critically assess, analyze and synthesize the ideas other investigators in the field

have generated on fat related diseases. The sole aim of this paper is to acquaint

readers with the current scientific information on fats and related diseases for

informed dietary decisions. This review discusses fats, different types of fats,

advantages, disadvantages, sources, different types of diseases associated with

excessive intake and the implications of the findings to health education and

promotion.

MEDLINE electronic database for English-Language articles was searched by

using the key word, fat related diseases. Manual searches for relevant literatures onfat related diseases were also carried out. Studies were selected for inclusion

according to their relevance to the topic of review and the recency of the study.

Review included articles that addressed the outcome of excessive intake of fats. It

also included trials that modified or reduced dietary fat intake and trials that

replaced saturated fat with polyunsaturated fat.

Fats

Fat is a nutrient. It is necessary for the normal functioning of the body and

survival. Excess calories are stored by fat in a safe way for usage at times ofhunger. Fats also help in releasing hormones that control metabolism. It supplies

energy and enhances the functions of other nutrients. These functions

notwithstanding, it is necessary to consume fat with knowledge. A detailed

knowledge of the different types of fats is also important. This aligns with the

position of Sears (2002) that stressed that knowing the types of fats are important.

Fats are soluble in organic solvents but insoluble in water. Fat in its liquid form is

known as oil. In its solid form, it is called fats. The solid and liquid form of fat

together is referred to as Lipid. There are two major categories of fat which are

animal and vegetable fats (Nordqvist 2002). Examples of animal fats include butter,

Lard, cream, fat-in and fat-on meats. Vegetable fats include olive oil, peanut oil,

flax seed oil and corn oil (Nordqvist 2002).

Hydrogenation of Fats

This is the process of adding hydrogen to liquid fat. When added to vegetable oil it

makes it semi solid with a corresponding increase in the shelf life and maintenance

of flavour as with margarine. In most cases hydrogenation is not complete. In this

case trans fat are produced which are harmful and capable of raising cholesterol

level (Nordqvist 2002).

Cholesterol


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Cholesterol is a waxy steroid of fat found in all the cells of the body. It is necessary

for the building of healthy cells and vital hormones. Liver and other cells make

about 75% of blood cholesterol (NHS, 2011).The body makes approximately

1000mg cholesterol required for proper functioning of the body (Freeman & Junge,

2005). When blood cholesterol level is high, it is referred to ashypercholesterolemia. With this fatty deposits are formed in the blood vessels thus

affecting the free and smooth flow of blood. This might affect the heart by depriving

it of sufficient oxygen-rich blood supply resulting in heart attack. If it is the brain

that is not receiving sufficient blood supply then a stroke might set in. Any other

organ affected in the process loses its functioning ability because of insufficient

supply of oxygen rich blood.

High density lipoprotein (HDL) is the good type of cholesterol and low density

Lipoprotein (LDL) is the bad type of cholesterol. Triglycerides are fats that are

carried in the blood stream. When total cholesterol level is higher than 240, the

individual has double risk of having heart disease. In this case the HDL cholesterol

(good) will be low(Less than 40) and the LDL cholesterol (Bad) will be above 160.

Triglycerides will be higher than 200.

Saturated fats raise the blood cholesterol level. Total fat intake, especially

saturated fat and trans fat play a larger role in blood cholesterol than intake of

cholesterol itself (Ostlund, Racette &Stenson, 2003). The amount of the bad

cholesterol (LDL) in the blood stream is related to the amount of saturated fat and

cholesterol consumed. A reduced fat diet can therefore decrease LDL (Freeman andJunge2005).Polyunsaturated and monounsaturated fats help in reducing it. Higher

levels of cholesterol in the blood build up as plaques on the arterial walls thereby

limiting a free flow of blood to the respective organs. According to studies the type

and amount of fats and cholesterol consumed increases a persons risk of dying

prematurely from coronary heart disease. There is evidence that arteriosclerosis

(thickening and hardening of the arteries) can be reversed with reduced

consumption of saturated fat and cholesterol.In general, the lower your LDL and

the higher your HDL, the better your chances of preventing heart disease and other

chronic conditions.

Plant sources of cholesterol are lower than animal sources (Jensen, Hagerty

& McMahon, 1978). Plant sources of cholesterol contain phytosterols which help in

lowering serum cholesterol (Behrman & Gopalan2005).

Sources: All foods containing animal fat. Major sources include cheese, egg yolk,

beef, pork, shrimp, poultry, full cream milk, fish and lobster.

Classification of Fats

Saturated Fats

Each molecule of fat is covered in hydrogen atoms. Nutritionists opine that


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consuming excessive amount of saturated fat for a long period of time poses health

risks. At the long run a high consumption of saturated fat raises the total

cholesterol level. It raises the low density lipoprotein (LDL), the bad type of

cholesterol which causes cardiovascular disease and even stroke and also raises

the good cholesterol (HDL) (Nordqvist 2002). There is no need consuming saturatedfats since the body can produce all that is required. However Unsaturated fat is

preferred because it lowers the bad cholesterol (LDL) and raises the good (HDL)

cholesterol. It is advisable to reduce the intake of saturated fats to the barest

minimum because they are part of many foods even vegetable oils that are mainly

unsaturated fats. Reduction can be achieved through cutting down on red meat

and dairy fats which are the main sources of dietary saturated fats.

Sources of saturated fats include fatty cuts of meat as seen in ground beef,

sausage, processed meats as in hot dogs, meat products, skin of poultry, dairy

products such as high-fat milk and milk products like whole-milk cheeses, whole

milk, butter and ice cream, processed foods such as cakes, biscuits, pastries,

crisps, coconut oil, lard, palm kernel and palm oils.

Monounsaturated Fat

The fat molecules here are unsaturated with hydrogen atom. Each fat molecule

has space for only one hydrogen atom. Health experts submit that

monounsaturated fat has a neutral effect on health. This implies that they are

neither good nor bad. According to health professionals, monounsaturated fatreduces the risk of cardiovascular disease (Mensink, Zock , Kester & Katan, 2003).

This is because they do not raise the level of the Low density Lipoprotein (LDL)

being the bad type of cholesterol. Unsaturated fats are called good fats because

they can improve blood cholesterol levels, ease inflammation, stabilize heart

rhythms, and play a number of other beneficial roles (Appel, Sacks & Carey, 2005).

They are liquids at room temperature. Sources of monounsaturated fat include

olives, canola oil, groundnut oil and avocadoes.

Polyunsaturated Fats

Each polyunsaturated fat has several spaces surrounding it. They are void of

hydrogen atoms. Nutritionists recommend poly-unsaturated fat for good health

because they do not raise the level of the bad type of cholesterol LDL) (Mozaffarian,

Katan, Ascherio, Stampfer & Willett, 2006). Omega-3polyunsaturated fatty acids

from fish lower blood cholesterol level thereby preventing heart disease

(Mozaffarian, Katan, Ascherio, Stampfer & Willett, 2006). According to healthcare

professionals, consuming omega-3 polyunsaturated fatty acids may help in

reducing symptoms of arthritis, joint problems and skin diseases. Dutch

researchers conducted an analysis of 60 trials that examined the effects of

carbohydrates and various fats on blood lipid levels. In trials in which


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polyunsaturated and monounsaturated fats were eaten in place of carbohydrates,

these good fats decreased levels of harmful LDL and increased protective HDL

(Mensink, Zock , Kester & Katan, 2003). Also a randomized trial known as the

Optimal Macronutrient Intake Trial for Heart Health (OmniHeart) showed that

replacing a carbohydrate-rich diet with one rich in unsaturated fat, mostlymonounsaturated fats, lowers blood pressure, improves lipid levels, and reduces

the estimated cardiovascular risk (Appel, Sacks & Carey, 2005).Sources include oily

fish (Sardines, mackerel, trout, salmon and herring), safflower oil, corn oil, sesame

oil, soy, cottonseed oils, grape seed oil and sunflower oil.

Trans Fats

Trans fats are very bad fats. It is produced synthetically through an industrial

process that adds hydrogen to oils (Tsang 2004).Hydrogenation makes the oil more

solid. They are also referred to as hydrogenated oils.Trans fat is not saturated but

either monounsaturated or polyunsaturated. Trans-isomer fatty acids are added.

They contain less hydrogen atoms than saturated fats. It is worth noting that they

do not promote good health.Some scientists believe they raise cholesterol levels

more than saturated fats (Mozaffarian, Katan, Ascherio, Stampfer & Willett,

2006). When trans fat is taken, the bad type of cholesterol is raised (LDL). This in

turn brings down the level of the good cholesterol (HDL). Altogether this increases

the risk of coronary heart disease and stroke. According to experts taking in trans

fat affect human health more negatively than naturally occuring oils (Tsang 2004).

Food companies patronise trans fats because of the added benefits they

enjoy. These benefits include easy usage and cheap production. They last longer

than others and also give food a better taste. It is worth noting that fast food outlets

and restaurants patronise it since it can be used repeatedly in their commercial

fryers. This is of immense concern with the alarming craze for fast food

consumption. Trans fat is considered worse than saturated fat in the risk of

vascular diseases.

As of January 2006, the FDA required trans fat to be listed on the nutrition

label (Mozaffarian, Katan, Ascherio, Stampfer & Willett, 2006). Many fast foods

contain high levels of trans fatty acids (TFA) There are no labeling regulations for

fast food, and it can even be advertised as cholesterol-free and cooked in vegetable

oil. Eating one doughnut at breakfast (3.2 g of TFA) and a large order of French

fries at lunch (6.8 g of TFA) add 10 grams of TFA to one's diet (Tsang, 2004).

While the consumption of trans fat is reducing in developed countries it is

unfortunately becoming a class issue in developing countries such as Nigeria. The

current inclination to trans-rich partially hydrogenated oils even in homes is

responsible for the progressive incidence of cardiovascular disease epidemic indeveloping countries (Mozaffarian, Pischon, and Hankinson, 2004).Trans fat raises

the bad (LDL) cholesterol level and lowers the good cholesterol level. According to


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Mozaffarian, Pischon, and Hankinson (2004) trans fat enhance inflammatory

processes, hyperactivity of immune system implicated in heart disease, stroke,

diabetes and other chronic diseases. Even small amounts of trans fat in the diet

have harmful health effects. For instance, for every extra 2 percent of calories from

trans fat daily, about the amount in a medium order of fast-food French friesincreases the risk of coronary heart disease by 23 percent (Mozaffarian, Katan,

Ascherio, Stampfer & Willett, 2006).

Trans-fat is found in foods prepared partially from hydrogenated vegetable

oils as seen in hard margarines and shortening. They also include baked products,

fast foods and snacks foods such as crackers, cookies, doughnuts and breads.

French fries and chicken fried in hydrogenated shortenings are also sources of

trans-fats.

NOTE: One gram of fat is equal to 9calories.

Source: American Dietary Guidelines 2005

A Sample of a Healthy Diet

According to United States department of Agriculture (n.d.), a healthy diet is the

one that consists of the following components:

1. At least two servings of fruit per day.

2. At least three servings of vegetables per day.

3. Thirty percent (30%) or less of calories from total fats.

4. Less than ten percent (10%) of calories from saturated fat.

5. Three hundred or fewer milligrams of dietary cholesterol per day (Belizan, Villar,

Pineda, Gonzalez, Sainz , Garrera & Sibrian1983; Johnson, Smith & Freudenheim,

1985)

NOTE: A serving size can be likened to a small fist, baseball, hockey puck or a

computer mouse.

Diseases Associated With Excessive Intake of Fat

QUANTITY OF FAT TO BE TAKEN

Age(Yrs) Total Calorie Intake of Total Fat (%)

2-3 30-35

4-18 25-35

19andAbove 20-35


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The normal amount of body fat (expressed as a percentage of body weight) is

between 25%-30% in women and 18%-23% in men. Women with over 30% body fat

and men with over 23% body fat are considered obese (Dietary guidelines for

Americans,2005).When the total body fat is in excess, it results in obesity which is

associated with overweight (Boyles,2008). Increase in male hormones is found inobese women with subsequent increasing risk of heart disease. These hormones

give rise to balding as in men and profuse facial hair acne. Overweight is also

associated with sleep disorders such as sleep apnea which is risky. Victim of sleep

apnea experiences intermittent cessation of breathing several times during the

night. This negatively affects the level of oxygen. Low level of oxygen affects the

normal functioning of the heart. Consequently the risk of diabetes, stroke and heart

attack is on the increase. Accumulation of fat on the abdomen is of a greater

consequence than around the hip or thigh (Kern, 2008).It enhances resistance to

insulin thereby increasing the risk of diabetes. It raises the blood fat level

increasing the risk of heart disease and stroke. Abdominal fat gives the body an

apple shape. Individual with a fat abdomen has a higher tendency to heart disease

and other diseases. The bigger your waist, the higher your risk of developing heart

failure, a condition where the heart is not pumping enough blood out and fluid

leaks into the lungs, feet and legs(Kern,2008) Other specific fat related diseases are

discussed below.

Cancer

There is an established relationship between diet and disease. Cancer is linked tothe pattern of dietary intake (Willet & Trichopoulos 1996; Block, Patterson & Subar

1992; Levi, Pasche, Vecchia, Lucchini & Franceschi,1999; Hercherg, Galan,

Preziosi, Alfarez &Vazquez, 1998). Shaw (2007) opined that a lifestyle choice which

includes dietary pattern is capable of reducing the risk of cancer. Accumulation of

excessive bad fat leads to cancer according to research (Meclelland, 2011).Increased

weight gain due to excessive intake of saturated fats leads to obesity which is

implicated in different types of cancer such as breast, endometrial, colon and

kidney cancers. When American Institute for Cancer Research (AICR's) expert

international panel(2007) reviewed all the scientific findings relating to fat andcancer, they found a pattern suggesting that diets high in animal fat and or

saturated fat possibly increase the risk of lung, colorectal, breast, uterine and

prostate cancers. Research has shown that most Japanese eat little fat of any kind

and this explains why cases of breast and colon cancers are very rare among

them(Willet & Trichopoulos 1996; Block, Patterson & Subar 1992).Studies have

also revealed that intestinal bacteria break down fatty and cholesterol laden diet

into substances that can cause cancer or enhance the action of other cancer

causing substances. These are the type of diet with less fibre and are not bulky

enough to stimulate peristalsis. When this happens constipation ensues and stool

remains longer in the colon exposing it to carcinogens.

High consumption of red meat (beef, pork, and lamb) and processed meat (hot


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dogs, bacon, and deli meats) does increase the risk of colon cancer (American

Institute for Cancer Research, 2007). Diet high in animal and saturated fat is also

implicated in the risk of prostate and breast cancer (American Institute for Cancer

Research, 2007).A study of premenopausal women who ate diets high in animal fat

had a 40 to 50 percent higher risk of breast cancer, compared to women who atethe least animal fat (Cho, Spiegelman & Hunter 2003). Since vegetable fat was not

related to risk of breast cancer, these findings suggest that red meat and high-fat

dairy products may contain other factors, such as hormones, that increase risk of

breast cancer.Some European studies have reported suggestive findings of lower

breast cancer risk among women with a high intake of monounsaturated fats

mainly in the form of olive oil (Sieri, Krogh & Pala 2004; Kushi & Giovannucci,

2002 ).

Heart Diseases

There are several types of heart diseases. When fat accumulates in the cells of the

heart, the normal functioning of the heart is interfered leading to lipotoxic

cardiomyopathy (Lim, Wang, Ocon, Bodmer, & Sanford-Burnham 2011; Medical

Research Institute- Genes and development).When an excess fatty foods are taken,

the body cannot metabolise it and this leads to obesity. Obesity in turn results in

lipotoxic cardiomyopathy (weakening of the heart muscle). Hui-ying Lim study

(2011) revealed that an imbalance in the fats that make up the basic structure of

the body cells result in obesity and associated heart problem. Fat around the waist

instead of the hips to the extent of increasing the waist size to more than 35inchesin women and 40inches in men increases the risk of coronary heart disease.

Obesity and high-fat especially saturated fat diets are major risk factors for

lipotoxic cardiomyopathy ( Anonymous, Science Daily Jan. 18, 2011).

When cholesterol, fatty deposits and other substances accumulate on the

walls of arteries arteriosclerosis ensues. Higher concentrations of LDL (bad

cholesterol) and lower concentrations of functional HDL (good cholesterol) are

strongly associated with cardiovascular disease because they promote the

development of atherosclerosis (Schwarz & Leweling, 2005). This disease processleads to myocardial infarction (heart attack), stroke, and peripheral vascular

disease (Schwarz &Leweling, 2005).

The buildup continues to narrow the arteries until they become so clogged

that blood cannot flow through. This causes damage to some part of the heart

muscle because of insufficient blood supply and a heart attack or death may

happen. Dietary pattern plays a major role in heart disease. Recent evidence shows

that arteriosclerosis begins in childhood. Other studies also show that plaque can

build up slowly and can progress into coronary heart disease in adulthood. This

shows that consumption of saturated fats excessively also have adverse effects in

children in their adulthood. Study reveals that when saturated fats are replaced

with polyunsaturated fats then the rate of attacks and cardiac deaths will be


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reduced (Boston, 2010). Replacing saturated fats with trans fat or a high

consumption of refined carbohydrate is detrimental to health.

According to Mozaffarian (2010) the specific replacement for saturated fat is

very important. He further stated that the findings suggest that polyunsaturatedfats are a preferred replacement for saturated fats for better heart health. The

impact of high cholesterol on health is still larger in older people (Sacks, Bray &

Carey, 2009).

OBESITY

Obesity is when there is an excessive amount of fat in the body. Extra weight from

the muscle, bone, fat or water amount to overweight. The best way of measuring

over weight and obesity is by the body mass index (BMI). This measure is based on

height and weight. Body mass index is a ratio of weight in kilograms to the squareof height in meters. The normal range is 18.5-24.9 while 25-29.9 suggests

overweight (Harvard Womens Health Watch, 2006).It is useful for estimating the

weight of adults, teens and children. Accumulation of body fat increases weight.

Obesity and being overweight puts one at the risk of different types of health

problems. Such health problems include coronary heart disease, high blood

pressure, type 2 diabetes, gallstones, breathing problems and certain cancers.

Many factors account for weight gain. The one worth mentioning within the

context of this paper is lifestyle habits. Lack of following a healthy eating plan.

Taking more than is required for activity will lead to overweight and obesity. The

gravity of health risks associated with obesity and overweight necessitates efforts at

maintaining a healthy weight. More than two hours of regular television viewing

leads to overweight and obesity.

Energy imbalance produces overweight and obesity. When the energy IN

exceeds the energy OUT obesity is the outcome. Foods and drinks are the sources

of energy IN. Energy expended on breathing, digestion and physical activity is the

energy OUT. More intake of energy more than output overtime leads to weight

gain. Less intake of energy and more output lead to weight loss. Weight gain alsoresults from unburnt calories from foods and drinks due to inactivity. This further

increases the risk of coronary heart disease, high blood pressure, diabetes, colon

cancer and other health problems. Oversized food portions give rise to too much

energy IN. This causes weight gain overtime especially where it is not balanced

with physical activity.

Health risks associated with overweight and obesity include coronary heart

disease. The coronary arteries are coated with plaques. Fats, cholesterol, calcium

and other substances found in the blood make up the plaques. The presence of

plaques narrow or blocks the lumen of the coronary arteries. With this, oxygenated

enriched blood flow to the heart muscle is reduced. This leads to pains in the chest

referred to as angina. Increase in the body mass index (BMI) increases the risk of


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getting coronary heart disease and a heart attack. Obesity can also cause

congestive heart failure. When this happens the heart muscle weakens and is no

longer able to pump enough blood to meet the demands of the body.

Diabetes

Research links dietary intake to diabetes (Swinburn, Metcall & Lev, 2001).When fat

is taken in excess it accumulates in the system thus giving rise to excessive weight

gain. Overweight in turn predisposes to diabetes (McClelland 2011) because of

increase resistance to insulin. Accumulation of fat around the waist instead of the

hips increases the risk of type2 diabetes. A study conducted by Singh (n.d.)

established that high levels of fat in the blood inhibit effective functioning of

insulin. He placed eighty (80) diabetic patients on low fat diet without sugar. Six

weeks after it was established that 60% of the participants did not need insulin

again. The study established that reduction of saturated fats enhances theeffectiveness of insulin.

Hypertension

Research also links dietary intake to hypertension (Taubes 1997; Jones & Brown,

1979).High intake of fat leads to obesity and this is a risk factor for high blood

pressure.People who are overweight are more likely to develop high blood pressure,

high levels of triglycerides (blood fats) and LDL cholesterol (a fat-like substance

often called bad cholesterol), and low levels of HDL cholesterol (good

cholesterol). These are all risk factors for high blood pressure and stroke. Excessbody fat especially abdominal fat may produce substances that cause inflammation

of the blood vessels. Replacing a carbohydrate-rich diet with one rich in

unsaturated fat, predominantly monounsaturated fats, lowers blood pressure,

improves lipid levels, and reduces the estimated cardiovascular risk (Appel, Sacks

& Carey 2005).

Implications for Health Education and Promotion

Evidence available from reviewed literature has established that reducing the intake

of saturated and trans fat while emphasizing on unsaturated and mostly

polyunsaturated fats will reduce the risks of fat related diseases. Large intake of

saturated fats increases the level of blood cholesterol and increases the risk of

cardiovascular diseases and stroke. Partially hydrogenated oils are used in

processed foods because they are cheap, available and sustain the flavour of food.

However this is known to increase cholesterol level with corresponding risk of heart

disease. This makes necessary a reduction on the consumption of processed foods.

Reducing the intake of fat and increasing carbohydrates, end up increasing the

accumulation of fat. This happens because increase intake of fat increases the

production of insulin leading to the storage of energy as fat. This implies that

reducing the intake of fats does not connote a step up on other nutrients such as

carbohydrate. Review has revealed a solid evidence that replacing saturated fats


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with unsaturated will help in preventing heart disease and not replacing saturated

fats with carbohydrates which is a common practice probably due to ignorance.

There is little scientific evidence to show that only reduction in the

consumption of saturated fats reduces the risk of coronary heart disease

(Anonymous, Science Daily, 2010). A new study from Harvard School of Public

Health (HSPH), (2010) reveals first conclusive evidence of reduction of the risk of

heart disease by 19% in people that will replace saturated fat with polyunsaturated

fat. Another finding revealed that increasing the intake of polyunsaturated fats as a

replacement for saturated fats could significantly reduce the rate of heart attacks

and cardiac deaths (HSPH Mar 2010).

A good understanding of the functions of each type of fat is necessary for the

achievement of good results. For example when saturated fats were replaced with

trans fat in a clinical trial, the outcome was detrimental (Mozaffarican & Wallace2010). Replacement of saturated fats with increased refined carbohydrate and

grains still yields detrimental results (Mozaffarican & Wallace 2010). Replacing

saturated fat with the right nutrient is critical in promoting heart health. The

findings of HSPH showed that polyunsaturated fat is the recommended nutrient in

place of saturated fats (Mozaffarican & Wallace 2010).

It can be deduced from the aforegoing that reducing the risk of heart disease

is possible with replacing saturated fats with polyunsaturated fats. Consumption of

polyunsaturated fats from vegetable oils in place of saturated fats promotes heart

health. This serves as an important guideline for food manufacturers and

restaurant operators. Products from polyunsaturated fats should be preferred to

those from saturated fats.

The bottom line is that the crucial factor in the consumption of fat lies in

consuming the right type of fat. The amount of fat consumed whether high or low is

not linked with disease but consuming the bad type of fats. The bad fats are the

saturated and trans fats which increase the risk of diseases. The good fats are the

monounsaturated and polyunsaturated fats which lower the risk of diseases.

Another study revealed that reduction or modification of intake of dietary fat

is capable of reducing the incidence of cardiovascular events by sixteen (16%)

percent and cardiovascular deaths by nine (9%) percent. A high intake of fats

responsible for building up the basic structures of the body leads to obesity. This is

the type of obesity that predisposes to heart problems (Hui-Ying Lim, 2011).

Obesity predisposes to many serious types of illness beginning from cancer,

arthritis, gall bladder disease, hypertension, heart disease, type2 diabetes amongst

others. Obesity should be avoided

The "bad" fats which are saturated and trans fats increase the risk for certaindiseases. The "good" fats, monounsaturated and polyunsaturated fats lower the risk

of diseases. Although it is still important to limit the amount of cholesterol


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consumed especially if one has diabetes. Cholesterol in the bloodstream is what is

most important. And the biggest influence on blood cholesterol level is the mix of

fats in the diet and not the amount of cholesterol eaten from food. The watch word

is to choose unsaturated fats over saturated whenever possible.

Health education and promotion should be tailored towards the creation of

awareness on the different types of nutrients, their sources, the advantages of

eating right and the disadvantages of not eating right. There is need to inculcate

into people the consciousness of the effect of whatever is eaten on the body.

Nutrition education has to be both planned and incidental. The programme has to

be age appropriate and planned for the understanding of both the educated and

uneducated in order to achieve the desired results.

CONCLUSION

Review has revealed that just reducing the intake of saturated fats will not prevent

heart disease and other diseases. Preventing fat related diseases requires a sound

knowledge of different types of fats capable of distinguishing the good from the bad

fats. The key to a healthy diet and preventing fat related diseases is in substituting

the good fats for bad fat and avoiding trans fats. Specifically saturated fats (bad

fats) should be replaced with monounsaturated and polyunsaturated fats. Review

has also disclosed that avoiding saturated fats in favour of increase consumption of

carbohydrates will still end with increase storage of fat in the body. The emphasis is

in moderate consumption of the right type of fat. The American Institute for Cancer

Research (2007) has posited that an inclination towards a plant-based diet rich in

variety of vegetables, fruits, whole grains and beans in disfavour of a high-fat

animal and processed foods will promote health and longevity.

RECOMMENDATIONS

In order to avert the numerous health problems (almost all of them do not have a

medical solution) associated with indiscriminate consumption of fats revealed by

the review. The following recommendations geared towards health promotion are

made:

1. Awareness should be created on different types of fats. Trans fats andsaturated fats are laden with the risk of heart disease and this requires

limiting their intake. Polyunsaturated fat is the best of all fats and should be

consumed for its good health properties. Monounsaturated fat should bepreferred to saturated fats. Measures should be adopted to improve the

knowledge of the relationship between diet and health. This will influence the


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choice of foods.

2. Consumer education is encouraged. They should be taught to check labels offood to ensure that they are free from partially hydrogenated oils. Fast food

outlets and restaurants should be checked by appropriate authorities to rule

out the use of trans-fat in their preparations. A healthy eating plan should beadopted. This has to do with eating foods that are low in saturated fat, trans

fat, cholesterol, sodium and added sugar.

3. Education should be given on different types of fats including the harmfulones and their food sources. There should be limited consumption of fatty

foods of animal origin. The use of commercially packaged foods which are

high in trans fats should be minimised. Food labels should be read always to

look for trans-fat free alternatives. The amount of trans-fat does not appear

on Nutrition Facts food labels, so watch out for "partially-hydrogenated oils"

in package ingredient lists. A new labeling law that forces food companies to

list trans fats on the label should be put in place to help curb the

consumption of these harmful fats.

4. Consumption of animal products should be reduced because they containsaturated fats. Lower-fat version dairy such as 1% or skim milk instead of

whole milk should be used. Visible fats and skins from meat products should

be trimmed off. The consumption of commercially fried foods and baked

goods made with shortening or partially hydrogenated vegetable oils should

be limited. French fries, doughnuts, cookies, crackers, muffins, pies and

cakes are examples of foods that are high in trans fat. Do not eat them

often. Not only are these foods very high in fat, but that fat is also likely to be

very hydrogenated.

5. A diet high in natural oils, fats, seeds, grains, sprouts and an abundance offresh fruits and vegetables will increase the bodys ability to remove health-

destroying factors. Eat at least one good source of omega-3 fats each day.

Fatty fish, walnuts, and canola oil all provide omega-3 fatty acids.

6. Eat avocados, almonds, peanuts and other nuts (monounsaturated fats) inmoderation as they will help to reduce the risk of heart disease and cancer.

Saturated fats, trans-fatty acids and dietary cholesterol raise blood

cholesterol. Monounsaturated and polyunsaturated fats do not raise the bad

(LDL) cholesterol but rather helps in lowering it.

7. Overindulge in any fat should be avoided. A diet high in total (saturated andunsaturated) fat possibly increases the risk of lung, colorectal, breast and

prostate cancers and is linked to a higher risk of heart disease and stroke.

Diets high in fat are usually higher in calories, which can lead to obesity. In

this way, fat is an indirect risk factor for diseases linked with excessive

weight, including cancer, heart disease, high blood pressure, stroke and

diabetes. All fat should not be eliminated from the diet but consumption

should be moderate.

REFERENCES


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INYANG and OKPAKO Fat Related Diseases