Food Substitutions

Kids and Heart Disease: The Heart of the Matter

What Should I Eat?

Planning for your family’s healthy future starts with the building blocks of good nutrition, physical activity, and a healthy lifestyle. By encouraging the right eating and exercise patterns for your family, you can help reduce risk factors for chronic diseases, such as heart disease, that have been linked to poor lifestyle choices.

Foods to Choose More Often and Less Often
Eating a diet with the right amount of calories and that is low in total fat, saturated fat, and cholesterol is a balancing act. One way to assure a varied, healthy diet is to wisely choose foods every day as indicated by this chart:

Foods Choose More Often Choose Less Often
Meat, Poultry, Fish and ShellfishMeat, Poultry,
Fish and Shellfish
Lean cuts of meat with fat trimmed; poultry without skin; fish and shellfish; lean luncheon meat (e.g., turkey) Fatty cuts of meat; bacon and sausage; organ meats; fried chicken, fried fish and shellfish; high-fat luncheon meat (e.g., salami)
Eggs and DairyEggs and Dairy Egg whites; egg substitutes; skim or 1% milk; low-fat or nonfat cheeses; low-fat or non-fat yogurt Egg yolks; whole milk or 2% milk; whole milk products (example: cheese, yogurt)
Fats and OilsFats and Oils Margarine spreads (made from unsaturated oils, especially no trans fat, reduced-fat, non-fat varieties); reduced-fat or non-fat salad dressings (including mayonnaise); liquid cooking oils; seeds and nuts. Butter, tropical oils; lard; bacon fat; shortening; full-fat salad dressings; coconut or spreads containing partially hydrogenated vegetable oils
Breads, Cereals, Pasta, RiceBreads, Cereals,
Pasta, Rice
Breads, cereals, pastas and rice made from whole grains White and egg breads; granola-type cereals; refined pastas, rice
beanDry Peas, Beans
and Soy Products
Dry peas; beans; baked goods made with unsaturated oil or margarine spreads Dry peas or beans made with bacon, fat back, cream, butter or cheese sauce
Fruits & VegetablesFruits & Vegetables Fresh, frozen, or canned prepared plain or with lemon juice, broth or small amounts of unsaturated oils or margarine spreads; fresh, frozen, canned or dried fruit; 100% fruit juice Vegetables prepared with butter, cheese or cream sauce; fried fruit or fruit served with butter or cream sauce

Did You Know...

  • By eating a buttery spread (soft or tub margarine) instead of butter, the average person will save a minimum of 1196 grams of saturated fat per year.
  • Losing as little as 7-10 pounds can significantly lower blood pressure and reduce the risk of developing diabetes and heart disease.
  • Whole grains derived from wheat, rice, corn or oats can reduce the risk of heart disease, help to manage weight, and reduce the risk of certain cancers or diabetes.
  • A whole stick of butter has almost as much animal fat and cholesterol and double the amount of saturated fat as three popular quarter-pound burgers with cheese.
  • Healthy adults should consume two servings of fatty fish per week to reduce their risk of heart disease. Individuals with known heart disease are encouraged to get at least one daily serving of fatty fish or take a fish oil (omega 3 fatty acid) supplement.
  • Lifestyle management of exercise and diet can lead to an approximate 20% reduction in cholesterol levels
  • Walnuts were the first whole food to receive a health claim from the FDA.
  • Don't drink your calories - drinking liquids with sugar can lead to weight gain and can increase triglyceride levels. This is true of ice-cream, as well.

Simple Substitutions

Recent research confirms that making simple changes in the diet can make a significant difference in terms of lowering cholesterol levels and one's risk of heart disease. In fact, a simple substitution like using buttery spreads (soft margarine spreads) instead of butter over a week's time can cut an entire day's worth of saturated fat.

Simple SubstitutionsSoft, liquid and spray margarine products are now in sync with the recommendations included in the 2005 Dietary Guidelines for Americans and the MyPyramid food guidance system. Soft margarine products were elevated in their importance in that they "help meet essential fatty acid needs and also contribute toward Vitamin E needs" according to the 2005 Dietary Guidelines Advisory Committee Report.

Ten scientific studies have directly evaluated the health benefits of margarine versus butter, and all have confirmed that a buttery spread (soft margarine spread) is the healthier tablespread. One groundbreaking study, published in The Journal of the American Medical Association, involving 46 biological families (226 individuals, 134 children, some as young as six), was conducted by Dr. Margo Denke, M.D., an associate professor of medicine at the University of Texas, and showed that making the simple switch from butter to soft margarine lowered levels of LDL cholesterol by nine percent in children and eleven percent in adults.

Heart Healthy Eating FAQ’s

Why are buttery spreads a sensible alternative to butter?

Buttery spreads are a wise alternative for consumers who want a versatile tablespread that offers nutritional advantages over butter. These spreads contain no cholesterol and 0-2 grams of saturated fat (compared to the 7 grams found in butter), and most varieties today are labeled “zero grams trans fat.” Not only are buttery spreads a good source of vitamin A, they contain mono- and poly-unsaturated fats as well as essential fatty acids.

What is the difference between "margarine" and a "buttery spread"?

Even before "margarine" first became a staple in the American diet in the 1950s, federal regulations (called standards of identity) required that both margarine and butter contain 80 percent fat. Today, many products found alongside margarine and butter in the store have less than 80 percent fat; they are called vegetable oil spreads (or referred to as buttery spreads on this Website). These spreads are the most popular products today and are consistent with health professionals’ recommendations to choose foods low in saturated fat, trans fat and cholesterol.

Why all of the focus on saturated fat and trans fat? What about unsaturated fat?

Elevated cholesterol levels are a known risk factor for heart disease. Both trans fat and saturated fat can raise cholesterol levels and their intake should be kept as low as possible. Health professionals recommend minimizing the amount of trans fats in the diet while maintaining a nutritionally sensible diet. When shopping for a soft spread margarine, for example, look for those that are labeled “zero grams trans fat” and no cholesterol.

Unsaturated fats (such as the monounsaturated and polyunsaturated fat found in buttery spreads) can help maintain healthy cholesterol levels when included in a diet low in saturated fat and cholesterol. They are also a source of essential fatty acids, which are needed for healthy growth and development. However, saturated fat and trans fat can raise levels of LDL ("bad") cholesterol. Trans fats also have been shown to lower levels of HDL “good” cholesterol. This is why choosing a food low in both saturated fat and trans fat can be part of a heart-healthy diet.

Besides fatty fish, are there other dietary sources, of omega 3 fatty acids?

Walnuts, flax seed meal/oil, soybeans, canola oil and dark leafy green vegetables are plant sources of omega 3 fatty acids. The simplest ways to incorporate these foods into your diet is to add them to foods eaten regularly such as breakfast cereal, yogurt, sandwiches, salads, salad dressing, pasta and rice. Walnuts are also a good snack, but because they are calorie dense, keep portion size to no more than a palmful.

Does it really matter if food contains cholesterol?

The government's latest Dietary Guidelines report continues to stress that dietary cholesterol intake should be limited to less than 300 milligrams per day, advice which is pertinent to children beginning at the age of two.

How do you know if a food product is made from whole grains?

Look for the word "whole grain", or "whole wheat" for example as one of the first ingredients on a food label. The 2005 Dietary Guidelines use the American Association of Cereal Chemists' definition of wholegrain: "foods made from the entire grain seed, usually called the kernel, which consists of the bran, germ,and endosperm". The U.S. Food and Drug Administration uses the definition of 51% or more by weight as its criterion for the whole grain health claim. Understanding the definition of whole grain is important because the health benefits of whole grains come from the entire grain kernel and not just individual components. Whole grains supply fiber, vitamins, minerals, and hundreds of phytonutrients. This "nutrient package" from whole grains offers protection against chronic diseases like heart disease and cancer.

What is recommended by the leading health organizations?

Consumers should listen to the advice of leading health authorities such as the American Heart Association, the National Institutes of Health and its National Cholesterol Education Program as well as the newest Dietary Guidelines for Americans – all of these stress the need to reduce total fat, saturated fat, trans fat and cholesterol in the diet, starting at age two. For heart health, these authorities recommend choosing buttery spreads -- soft and liquid soft spread margarines -- with no trans fat instead of butter. Even the Food and Drug Administration advises consumers to "Choose vegetable oils (except coconut and palm kernel oils) and soft margarines (liquid, tub, or spray) more often because the amounts of saturated fat, trans fat, and cholesterol are lower than the amounts in solid shortenings, hard margarines, and animal fats, including butter."

Five Tips for a Heart-Healthy Refrigerator

Once a month pull everything out and take stock of what's inside.

Store away any indulgent foods in the crisper, so they're out of sight, out of mind.

Keep perishable foods such as fresh fruits and vegetables front-and-center on the refrigerator shelf, where you can see them.

Replace high-fat foods with lower fat ones. Some examples include: nonfat or 1% milk for whole milk; lean meat or poultry for fattier cuts; a buttery spread (soft spread margarine product) for butter. A simple substitution like a soft spread margarine (tub margarine) for butter over a week's time can save you an entire day's worth of saturated fat.

Prepare leftovers as a meal for the next day. Put the entree with the vegetables and other side items on a plate and cover for the next day's lunch or dinner to create a do-it-yourself balanced "TV dinner."

Rinse and chop produce when you come home from grocery shopping. Cut up vegetables and fruits and store them in containers so they'll be ready for the next meal or when you come looking for a ready-to-eat snack.