Question 1
Question 1: How would you explain to the average person your recommendations for consuming an optimal balance between dietary alpha-linolenic acid and linoleic acid to prevent atherosclerosis?
posted by Breine @ 6:04 PM
55 comments
55 Comments:
I would explain that there are benefits from both fats and that many oils contain both alpha- linolenic (ALA) and linoleic but having a greater ratio of ALA to linolice may lower risk of CHD. Foods high in ALA include walnuts, flaxseed, canola oil and soybean oil.
Although the article points out that there may be a benefit to having a ratio of ALA to linoleic acid greater than 0.10, it states later that the ratio is only weakly related to CHD risk. This is attributed to the CHD risk lowering of both ALA and linoleic. The typical American diet may be lacking in both of these important fats as trans fats and saturated fats are widely consumed. I agree with recommendations to replace animal and hydrogentated fats with natural liquid vegetable oils containing both mono- and polyunsaturated fats. I might also emphasize consumption of fish, nuts, and flaxseed as methods to increase the ALA to linoleic ratio.
I would explain to the patient that an inappropriate balance of these essential fatty acids contributes to the development of disease (heart disease, high cholesterol, etc), while a proper balance helps maintain and even improve health. Also important in such a consultation is to put it into terms that the patient can relate to and implament into thier lifstyle. For instance, I would recommend cooking with vegetable oils (canola, soybean, flaxseed/linseed, olive), and consuming fish two to three times a week in order in increase the patients comsumption of ALA.
I would explain that research has found that a healthy diet should consist of roughly one to four times more omega-6 fatty acids than omega-3 fatty acids. The typical American diet tends to contain 11 to 30 times more omega-6 fatty acids than omega-3 fatty acids and many researchers believe this imbalance is a significant factor in the rising rate of inflammatory disorders in the United States. So in order to help bring this ratio back down people shoud try to consume more flaxseeds or flaxseed oil, canola oil, soybean oil and walnuts.
Explaining fat consumption to patients can often be very confusing. First, I would make sure to list some of the health-related issues that can be associated with a high fat intake, such as heart disease, high cholesterol levels, and weight gain. Next, I would also explain some of the benefits of a healthy fat intake level. Fat is absolutely essential to normal functioning, and the patient should also know this side of the issue. Then, after the patient understands the basics about fat, you could go into more detail about the different types of fats, and which ones are potentially beneficial or harmful if eaten in excess. This would be when you could bring up the balance of certain fats. Increasing the use of vegetable oils rather than hydrogenated oils, as well as increasing the consumption of foods such as fish and nuts can help to balance the intake of saturated fats which are largely found in dairy and other animal products. Balancing the unsaturated and saturated fats can help to maintain heart health; once the patient understands this, you could move into actually balancing the omega-6 and omega-3 intakes by simply changing a few small dietary habits.
The previous posts mentioned replacing trans and saturated fats with soybean, flaxseed, olive, or canola oil. Are all of these oils created equal in terms of omega 3 to omega 6 fatty acid ratio? Do you know of any specific brands that are more reliable compared to others?
I would also start off with explaining the role of at in the diet. It's necessity and it's contribution to disease. I would then more specifically try to explain how to read labels and see what foods contain higher portions of saturated or trans fats versus mono and polyunsaturated fats. I would also recommend good sources of ALA and linoleic fats like have been mentioned in previous posts including vegetable oils, fish, and nuts. I would be less concerned trying to explain specifics with a client on ratios as it may be confusing. Instead I would help them make dietary changes over time.
I would explain that there are different types of fats some have benefical effects for the heart while other have negative effects on the heart. I would not go into detail but, recommend that the patient or client restrict animal fats and hydrogentaed fats and replace with natural liquid vegetable oils such as canola and soybean. I would also mention that fish is a source of good fats and should be consumed twice a week and flaxseed as previously mentioned. However, I would not go to the trouble of explaining that a higher ratio of n-3 to n-6 fatty acids may be more benefical, etc. because I think this may be too much for the average patient to comprehend.
I would explain that ALA is important in preventing atherosclerosis and since the recommended intake may mean nothing to the average person, I would instead put it into perspective by offering likely dietary suggestions, such as fish 2x/week and either eggs supplemented with Omega-3 FA, flaxseed, walnuts, or canola oil on days they do not have fish—the latter three being great sources for those who do not like fish. As for LA, I would explain their needs are most likely met from a normal diet as they can be found in sources like whole grains, vegetable oils, eggs, as well as many other sources including those providing alpha-linolenic acid.
I think Karlie suggests a great approach of offering a visual aide to help the client put the various fats and their associated risks/benefits into perspective. I also agree it is important to educate the pt on how they should not suddenly switch to a very low fat diet and that fat is actually essential in our diets. Emphasizing balance is definitely key when explaining the importance of various dietary elements (such as fat) for a healthy lifestyle.
I would begin by explaining in simple terms how each contributes to the development of atherosclerosis. I would stress the importance of a balanced diet with variety and moderation. I would suggest limiting animal and hydrogenated fats and instead use vegetable oils like canola or olive. I would not go into detail with ratios or the science background because too much information would certainly confuse the patient.
I would explain that ALA is a member of the group of essential fatty acids called omega-3 fatty acids, which are an essential dietary requirement. ALA is related to lowering the risk of cardiovascular disease. One can get ALA from seed oils including: canola, soybeans, walnuts and flaxseed. I would explain that fish is a good source of omega-3 fatty acids and they should try to incorporate fish into his/her diet. Dietary resources of Omega-6 fatty acids include: cereals, whole grains, vegetable oils and eggs. I would explain that it is important to have balance and variety in a diet and with incorporating those healthy fats into ones diet to may help to prevent atherosclerosis.
Annie,
I agree with you that explaining the ratios may be rather confusing to a patient. I think that the patient is probably already overwhelmed with the fact that there are actually fats that are good for you and us explaining how and why is probably already going to be hard for them to understand and throwing in ratios and explanations about that would be a waste of time and effort. Instead, sticking to the dietary changes and having ideas and exchanges for their typical diet would be the way to go and easier to explain!
First, I would explain the importance of a well-rounded, healthy diet for optimal health and disease prevention. Secondly, I would explain how omega 3 & omega 6 fatty acids play a key role in his/her health. It can be made easy to consume these fatty acids in his/her diet by consuming small amounts of canola oil, soybean oil, walnuts, and flaxseed, by way of cooking or eating raw. If this is unachievable or undesirable, supplements are another route. Overall, these fatty acids keep the blood thinner, reduce arterial plague buildup, and may very well reduce future heart complications, keeping him/her out of the hospital (which is never a joyful experience).
Everyone has pretty much said similar things to how I would educate my patients/clients. First, I would explain that eating fish at least 2-3 times per week in addition to adding nuts as snacks provide healthy fats that protect our heart. (The simpler, the better.) Then, I would recommend, to those who are very dedicated, to try cooking with canola oil. If they eat out a lot, I would recommend trying fish dishes rather than a steak, or even get a combo plate that has both fish and steak. If we can at least get Americans to try the foods, it is a start and is better than nothing!
I would first start by explaining what atherosclerosis is. Atherosclerosis is when the arteries become clogged by the buildup of cholesterol, which eventually reduces the flow of blood to the tissues. People who have atherosclerosis have a higher risk for developing coronary artery disease and stroke. So in order for a person to prevent atherosclerosis from occurring they need to consume alpha-linolenic acid (omega-3) and linoleic acid (omega-6). Omega -3 fatty acids are linked to improvements in cardiovascular health by reducing the amount of cholesterol buildup. Some examples of omege-3 food sources are canola oil, soybean oil, walnuts, flaw seeds, and fatty fish (i.e. tuna, salmon). Omega-6 fatty acids help to increase blood clotting and are found in plant oils. Once I had explained to them what alpha-linolenic acid and linoleic acid were I would discuss with them ways to incorporate both sources into their diet.
Karlie-
I agree that it is very important to explain to the patient that fats are an essential part of life and that they should not try to completely eliminate them from their diet. Too may people think that if they eliminate fats from their diets that they will be healthy, what they do not realize is that there are certain health benefits that come from consuming healthy fats.
I would start off explaining that there is a difference in the types of fat that a person can consume. Fats such as saturated and trans are associated with CHD, while fats such as ALA have been proven to help prevent CHD. Consuming foods that contain high amounts of ALA are fish (salmon, mackerel, herring, and anchovies), flaxseed, and walnuts. Also, oils that are high in ALA are canola, soybean, and flaxseed. Eating and cooking with these products should be part of their daily routine in order to keep a good ratio of LA to ALA. Researchers believe the ideal omega-6 intake should be no more than 4-5 times that of our omega-3 intake. The typical American diet consumes a ratio of 10:1 to 30:1 of omega-6(LA) to omega-3(ALA). Studies have shown that a high intake of LA to ALA can result in a build up of plaque in the arteries.
jme,
I think that explaining the importance of a well-rounded, healthy diet for optimal health is important. After all, a heart healthy diet is similply a well-rounded healthy diet, we should all be eating this way not just patients or clients who are have or are at risk for heart disease.
I would explain that it is good to have a balance of these fats. Alpha-linolenic has been known to lower coronary heart disease, so it would be good to have more of that than the linoleic. The studies that have been done on these fats are inconclusive as to if the alpha-linolenic will actually reduce CHD, but since having a healthy balance does not produce any adverse affects, it would not hurt to have a greater ratio of the ALA.
steph
I think its a good idea to explain things so a pt can understand them. Also it is important to not patronize them and talk down to them. I agree with you and I think it is important to figure out a pts level of comprehension before preceding to education.
Dietary alpha-linolenic acid, also known as omega-3 fatty acid, and linoleic acid (omega-6) are essential fatty acids. Thus, our bodies cannot produce these on their own and we must consume them through our diet. These fatty acids are very important for vital body functions such as blood pressure, blood clotting, immune response, inflammation etc. Omega-3's work both to stimulate blood clotting and also inhibit blood clotting (blood thinner),whereas omega-6's are a powerful stimulator of blood clotting. Thus, having a balance between the two will promote healthier arteries by shifting towards a less amount of blood clotting. If someone gets too much omega-6 and not enough of the blood thinning type of omega-3 they are more likely to develop blood clots or atherosclerosis. Eating omega-3 from fatty fish has been shown to reduce the risk for heart attacks so we figure this particular omega-3 in the fatty fish is acting to reduce blood clotting knowing that blood clots are part of the heart attack process. Therefore, it is a great idea to incorporate at least two servings of fatty fish such as salmon, trout, tuna, sardines, herring, mackerel or non-fish sources such as soybean or canola oils, walnuts, and flaxseed into the diet per week. Too much omega-3 fatty acid intake can allow uncontrolled bleeding and may cause hemorrhagic stroke. So we see that a balance of the omega-3 and omega-6 fatty acids will keep a healthy flow of blood.
When counseling a patient on the proper balance of ALA and linoleic acid, I would start out by explaining the benefits of each. ALA is an Omega-3 fatty acid that is linked to improvements in cardiovascular health, and 2 servings of fish per week is a great way to start. As for linoleic acid, it is classified as an Omega-6 fatty acid and is found in plant oils. I would then inform the patient that both of these fats are essential; that one needs to consume them in his/her diet, and that research has pointed out that consuming ALA and linoleic acids in a ratio of 1:4 provides further health benefits in preventing some cardiovascular diseases. Furthermore, I would mention to the patient that it is important to reduce intake of trans and saturated fats and increase mono and polyunsaturated fats, and then explain benefits and provide food choice examples.
I agree that explaining the whole fat ratio to a new patient would be very overwhelming. I would keep my message simple by encouraging healthier choices when consuming fats by naming foods like fish, walnuts and flax and using liquid cooking oils like canola. I also would stress limiting trans fats and fried foods in general. I think people will remember the food items more than teaching them about the difference btwn ALA and linoleic acids or what a trans fat is and that way they will more likely implement your suggestions for healthier living.
I would keep all of my explanations in as simple of terms as possible for most people. Explain the difference between alpha-linolenic and linoleic acid and what types of food go with each. Then I would state that foods high in each of these are healthier for a person. I would emphasize the use of vegetable oils and eating fish into a normal diet.
Jodee,
I agree with your method of first getting back to the basics and explaining exactly what atherosclerosis is before getting into anything about food. The patient needs to know exactly what is going on in their bodies before they can or want to change. If they are aware of, in this case, the horrible facts of atherosclerosis, they will probably become a little scared and then want to change their food habits. I'm saying "scared" here in a good way; simply letting the patient know they they need to change now or adverse outcomes are a strong possibility.
Alpha-linolenic acid and linoleic acid are also referred to as omega-3 fatty acid and omega-6 fatty acid respectively. Both of these are considered to be essential fatty acids. These fatty acids are essential in that they are needed to maintain health, but not synthesized by the human body. This means these nutrients must be consumed through the diet. It is important to maintain a balance between the two fatty acids because they work together to promote health. For example, omega-3 fatty acids help reduce inflammation, whereas most omega-6 fatty acids promote inflammation. When consuming these fatty acids at an imbalanced level, one is more prone to developing disease. A proper balance with maintain and possible improve health.
I agree with Karlie that patients first need to be told about how fats are necessary for everyday life because many people do not necessarily know that we need GOOD fats in our diet. Then,I would make sure to provide the patient with lists of sources of both ALA and linoleic acid before they left the consultation. From observations I have completed through the undergraduate professional practice requirement, I have found it is important to outline what foods are good and bad. I have also noticed that if a person realizes what exactly their choices will do for them they are more likely to make good choices. I believe, people respond to this type of learning better.
I would first explain to the individual the necessity for alpha-linolenic acid and linoleic acid in one’s diet. I would explain how they are essential fatty acids that must be consumed in one’s diet because the body is unable to synthesize such fatty acids. I would then explain the role these two fatty acids play in body functions. I would make the individual aware of eicosanoids and their role as localizing hormones in the body. I would specifically focus on the role eicosanoids play with regards to platelet aggregation and relate it to CHD. After the individual understands the role of eicosanoids in the body, I would tell them that alpha-linolenic and linoleic acids are necessary components of these eicosanoids. Lastly I would introduce the individual to good sources of both fatty acids. With regards to linolenic acid, I would recommend the individual try to incorporate a lot of vegetable oils as his or her sources of fat in the diet. I would also educate the individual to try to incorporate a couple rich sources of alpha-linolenic acid into the diet through consumption of walnuts, ground flax seed, or fatty fish including salmon and mackerel. If possible, I would reevaluate the individual in a few weeks and see if the ratio of alpha-linolenic acid to linoleic acid is appropriate.
Karlie,
I agree that explaining fat consumption to patients can be confusing. I also like how you explained that fat is essential for the body. Sometimes people think that it is the enemy and to stay away from it. Informing them about the benefits is a great idea.
I would explain it to an average person the same way it was explained to me in my basic nutrition class. I would simply explain that alpha-linolenic acid is an omega-3 fatty acid that is found to lower te risk of cardiovascular disease. The dietary sources containing ALA are canola oil, soybeans, walnuts, and flaxseed. I think we should stay away from using all the scientific terms in order to avoid confusion and just stick to the basics of telling them which fats are healthy, where they can be found in dietary sources, and their role in the body.
Jodee,
I agree with you that by first explaining to the patient what atherosclerosis is would be very helpful. Once they understand exactly what it is that they have they may be more interested in listening to the types of foods they should eat and why. I feel they would be more likely to want to change if they more thoroughly understood what was going on in their body. Then giving them sources of each of the fatty acids and helping them incorporate them into their diet and lifestyle would be a great approach.
I would explain what causes atherosclerosis (in layman terms) and the benefits of consuming more omega-3 and omega-6 would do for their body. I would attempt to educate the person to understand that they not only will prevent atherosclerosis but will help with pain sensation (decrease inflammation), immune function, blood clotting, and short term memory. Also, I have found (along with Lauren) that being very specific, such a list of foods that have omega-3 and omega-6, and having easy ways a person can incorporate the FA into their diet, increases the likelihood the person will do it.
I would first explain the benefits of consuming both alpha-Iinolenic and linoleic acids. I would recommend consuming a variety of foods that contain those fatty acids, such has Flaxseed, several types of fish, soybean oil and canola oil for ALA and vegetable oils and whole grains for LA. I would also explain that saturated fats and trans fats should be avoided with this type of condition. An overall explaination of the role it plays in the diet would be helpful as well.
Vanessa-
You presented a great idea. I agree that the recommendations may not have any significance to a person and by breaking it down further for the patient (like you said:fish 2x/week and either eggs supplemented with Omega-3 FA, flaxseed, walnuts, or canola oil on days they do not have fish) would make it easier for a patient to accomplish in their diet.
Well I would first give examples of saturated fats and the diseases they cause. Next I would explain what omega-3's and omega-6's are and fill them in on the research that has been done on how beneficial these fatty acids are. Then I would explain how saturated fat is involved in plaque and can lead to Atherosclerosis which could ultimately turn into CHD. And so an optimal balence is neccessary with with these omega's as with all food.
dmf,
I absolutely agree that when ever you can keep it simple and easy for people to understand the information that your throwing at them you will achieve the best feedback. Most people have heard of omega 3&6 in those terms, but saying ALA or linoleic acid is going to confuse them. Just make sure to remind them which omega goes with what such as omega 3 being flaxseed.
I believe that the topic of just explaining alpha linolenic acid and linoleic acid would be very confusing at first. In order for a client to better understand fat intake I would first explain the basic types of fat and explain that fat should not be eliminated in the diet, but consumed in healthful, conscientious amounts. I would then explain that unsaturated fat is preferred to saturated fat and trans fat because both of those fats are correlated with CHD, atherosclerosis, and other chronic diseases. After a client knows the difference between saturated, trans, and unsaturated (even the break down of mono and poly), I would them teach them the importance of the ratio between omega 3 (alpha linolenic acid) and omega 6 (linoleic acid), letting them know that foods are more likely to have a higher amount of omega 6, so omega 6 will always be easier to obtain, the prime reason that the ratio of omega 6:omega 3 will be greater for omega 6. Both are polyunsaturated fatty acids that are considered essential in the human diet. I would tell them that good sources of both alpha linolenic and linoleic fats can be found in fatty fish such as salmon and tuna, vegetables oils such as olive, flax seed, soybean oils, and nuts such as walnuts. Also, to try and use hydrogenated oils as little as possible and cooking methods that do not involve deep frying as this will add to the saturated and trans fat nutrient content!
Samantha McCoy,
I think your explanation of omega-3 and omega-6 fatty acids are very clear. It seems like the average person would have no problem understanding your descriptions and suggestions. You do a great job of explaining what these fatty acids are, why they are important, and how to get them through the diet.
I totally agree with Suzie that “the simpler the better” when it comes to educating patients on fat intake. I definitely feel that the best advice you can give them is concrete choices, such as choosing fish rather than red meats. Of course there are going to be exceptions to the rule, and if you have a patient that understands these concepts and wants to know more, teach them everything they can handle! However, for the average patient, specific ratios of types of fats is going to completely confuse and cloud your ultimate point.
I would start by explaining to the patient what atherosclerosis is. I would then explain how ALA is important in preventing this disease. I would then describe to them in very simple and understandable terms of what they can do to prevent this. I would start by giving them a list of foods they can consume to help with this. Fish is a very good source of omega 3 fatty acids and incorporating fish into ones diet would help contribute to the daily dietary needs one should be consuming. Also by adding other non fish sources such as nuts, seeds, and oils one can balance their fats which leads to an overall healthy diet. The patient must know the difference between good and bad fats and educating them on these topics is definitely the key.
Nisa,
I do agree with you on trying to keep things simple for the clients. By explaining certian foods to eat instead of getting technical with the terms would probably be more beneficial to the client. Maybe as sessions go on as an RD we can include more information as they pick up on what was already discussed.
Breine- I don't know if anyone answered your question on which fats have a better ration of Omega 3:6. These are good sources of high ratio oils (in decreasing order): Flax, canola, walnut, and soybean. They have have much higher ratios than some other oils like butter and safflower oils. I don't know about brands though, they should be pretty consistent.
I also agree with Karlie and Lauren (and who ever else commented) that it is importrant to emphasize the importance of fat in a diet. In rotations I met a woman who cut out most of the fat from her diet and was able to tell us exactly how much fat (in grams) she was having at every meal. The thing she didn't realize was that if she ate a little more fat then she wouldn't have been so hungry and miserable all the time. As we know there a lot of major risks involved with lowering the amount of essential fatty acids in the body. Let's face it we need that extra padding (or at least our intestines need it)
I would explain that these are the “good” fats that they may have heard about. They are essential to the body. I think more people have heard about omega-3 and omega 6 fatty acids than alpha-linolenic acid and linoleic acid. So, I would explain that alpha-linolenic acid is a omega-3 fatty acid and linoleic acid is a omega-6 fatty acid. I would inform them that whole grain breads, cereals, and most vegetable oils are a good source of omega-6; and fatty fish, flax seed, and canola oil are good sources of omega-3. In regards to the prevention of atherosclerosis, omega-3s can help prevent blood platelets from being sticky and prevent blood clot formation. They also may help blood flow. Atherosclerosis is characterized by plaque deposits on the artery wall. This can be preventing by reducing your LDL aka “bad cholesterol” and increasing your HDL aka “good cholesterol”. Consuming alpha-linolenic acid and linoleic acid can help reduce you LDL intake.
Karlie,
You bring up a very good point by saying the client should have a solid understanding of saturated and unsaturated fats before you move into teaching them the ratio of omega 3 and 6. I believe that clients may fall off track and become confused easily if a dietitian does not start the explanation process slowly. R.D.'s should think of counseling as building a house. If your house has a sturdy foundation, you may just have to "update" every so often, but if you frame a house on a flimsy foundation, it will eventually begin to crack. The same goes with how you present nutritional knowledge to a client. If you build a strong foundation, the client will be able to understand concepts more easily, but if you try to teach little concepts before broad one, they may get frustrated, confused, and give up easily!
Blradwan,
I agree with your approach of how to educate the individual to incorporate polyunsaturated fatty acids into his or her diet. By giving the individual some relevant background information on what the typical American diet consists of with regards to the amounts of linoleic versus alpha linolenic fatty acids can help the individual understand the challenges involved in incorporating a healthier ratio of linoleic to alpha linolenic fatty acids in one’s diet. This piece of information along with some good food sources for these polyunsaturated fats is definitely a good starting point when aiding an individual with his or her diet.
Samantha...
I agree that your explanation is very clear and would be a great way to explain fatty acids to a client. I would also maybe go more into what they are actually used for in the body and the benefits of them.
Beth – In general, I think it’s a great idea to explain the concept of fats being healthy in the diet before explaining alpha linoleic and linoleic acid. Fat always seems to be deemed as ‘bad,’ but educating individuals about the critical role(s) fat plays in the body’s functions is a great idea. Education on the types of fat to consume and the daily amounts are very important.
Beth c.
I agree that explaining what healthy fats are is a way to show to some people that all fats are not unhealthy. I also agree that showing a person how balancing alpha linoleic and linoleic acid is essential for a healthy heart and lowering ones cholesterol.
I agree with everyone who has said that we should stress to the patient the good effects just as much as the bad effects of fat. People tend to take things to the extreme and many will hear fat is bad and completely cut it out of their diet which can potentially be just as bad as consuming too much. I think the best way to deal with this situation is to highlight the good fats vs the bad fats and create an easy to read list that the client/patient can then refer back to when attempting to make the better choice.
Lisa,
I agree with you in your approach to first break down the scientific terms. Most people do not know what omega-3 fatty acids are. It is important to break down all aspects so that your patients fully understand everything.
Lisa,
I agree with you in your approach to first break down the scientific terms. Most people do not know what omega-3 fatty acids are. It is important to break down all aspects so that your patients fully understand everything.
Jme,
I agree that a well balanced, healthy diet is ideal for healthy life style. Just focusing on one aspect of nutrition, like fatty acids, will not fix everything. However, I also agree that it is important to educate on how these fatty acids keep the blood thinner, reduce arterial plague buildup, and overall keeping your heart happy.
Suzie
I agree that trying to get the average American to even try a new dish is a success. However, we also have to caution them when eating out to not just pick fish over steak but to pick a broiled, grilled option and not the alternative: fish that has been deep fried and has beer batter crusted to it. It is tricky not to overload the client with information. Best option is to steer them in the right direction and hope they understand what their healthy choices are and that they take it.
Melissa,
I agree with you when you talked about informing the patient about what types of food are considered good and bad fats. By listing out some options for them they are more willing to take the advice and actually follow it. It is also important to describe the types of characterizes that are associated with atherosclerosis. It is once again very important for your patient to know what is going on in their body and the ways they can treat it and what they can do to improve upon it.
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