Doctor’s Tip: Are plant-based diets healthy for kids? Part 3, Fats
This the third weekly column in a series taken from the book “Nourish, The Definitive Plant-Based Nutrition Guide for Families,” by Stanford University-affiliated pediatrician Reshma Shah, M.D., MPH, and registered dietitian Brenda Davis. The column two weeks ago discussed carbohydrates, last week’s column discussed protein, and today’s column is about the third and final macronutrient, fats. Carbs and protein have 4 calories per gram, and fat has 9, so it’s the most calorie-dense of the three.
Fats are necessary at all ages for human health. However, there are healthy fats and unhealthy fats, and most Americans eat too much of the latter, contributing to many of the chronic diseases we suffer and die from.
SATURATED FAT is found in all animal products — meat including chicken, dairy, eggs, and, to a lesser extent, seafood. It is also present in tropical oils (palm and coconut); and in vegetable oils (canola oil is 7% saturated fat, olive oil 15% and coconut oil over 90%). Saturated fat increases LDL (bad) cholesterol, and is linked to inflammation, diabetes, fatty liver, heart disease and several cancers. Current guidelines for children specify a saturated fat intake of less than 10% of total calories. For example, the average 6-year-old eating 1,400 calories should not eat more than 15 grams of saturated fat a day (a cup of whole milk or an ounce of cheddar cheese would deliver 5 grams, two slices of pepperoni pizza 12 grams).
MONOUNSATURATED FAT has a neutral to slightly beneficial effect on health. Current guidelines for children say that monounsaturated fat should comprise 50% of daily fat intake. Examples are olives, avocados, almonds, peanuts and seeds.
TRANS (PARTIALLY HYDRODENAGED) FATS were developed to replace animal fat such as butter and lard in processed food but were recently banned in several countries including the U.S. after they were proven to increase the risk of heart disease, sudden death and diabetes. However, products can have up to 0.5 mg of trans fat per serving and still claim on the food label to be trans fat-free. Many animal products contain small amounts of natural trans fat as well. The National Academy of Sciences concluded that the only safe intake of trans fats is zero.
CHOLESTEROL is a waxy fat present in cell walls and is also a building block for certain vitamins and hormones. It is found in all animal products, including seafood. Our bodies make all we need, and excess dietary cholesterol can raise blood cholesterol to harmful levels.
POLYUNSATURATED FATS are healthy fats. ALA (alpha-linolenic acid) is an omega-3 fat that our bodies convert to health-promoting EPA and DHA. Our bodies convert the omega-6 linolenic acid to arachidonic acid, too much of which causes inflammation. The healthiest ratio of omega-6 to omega-3 is 1:1 or at most 2:1. Unfortunately, the average American, who eats a diet rich in animal products and added oil, has an unhealthy ratio of 10:1 to 30:1 (too much 6, not enough 3). Building blocks for omega-3, and therefore EPA and DHA, are green vegetables, beans (especially soybeans), fruit and especially walnuts and seeds (chia, hemp, ground flaxseeds).
ENSURING HEALTHY FATS FOR KIDS, RECOMMENDATIONS BY SHAH AND DAVIS
• Breast milk is ideal for at least the first 12 months, and preferably two years and beyond. If you use formula, use a commercial infant formula for at least the first 12 months, and after that consider full-fat fortified soy or pea milk. For dairy consumers, cow’s milk is not recommended for the first 12 months, but whole cow’s milk can be considered from 12 to 24 months, after which low fat options are recommended.
• Include a variety of high fat, whole plant foods daily, such as seeds (pumpkin, sunflower, chia, hemp, flax), nuts (especially walnuts) and nut butters.
•Serve tofu, tempeh, edamame and other soy products regularly.
• Spread avocado on toast or healthy crackers; use in dipping sauces such as guacamole; add to salads, bowls and sandwiches.
• Fish is a good source for omega-3, but contaminants such as heavy metals and PCBs are a concern. Adequate omega-3 can be obtained through plant sources.
IMPORTANT TIPS: 1) Fats are damaged (oxidized) by heat, light and oxygen, resulting in a rancid taste. Especially if nuts and seeds lose their protective shells — e.g. ground flaxseeds or shelled nuts — they should be kept in the freezer. 2) If fats are heated above their smoke point, they become carcinogens. 3) Shah and Davis note that “fat intakes below 20% of total calories, while effective in the treatment and reversal of chronic disease, are not generally considered suitable for children or adolescents,” or for pregnant or lactating women. 4) If you have any concern that your child is not getting enough EPA and DHA, consider a vegan, algae-derived omega-3 supplement—capsules are sold at most grocery stores, and a liquid option is available from Dr. Joel Fuhrman at DrFuhrman.com. 5) Inexpensive blood tests are available to check omega-3 and omega-6 levels and ratio.
Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email firstname.lastname@example.org.
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