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Living Well : Nutrition

All About Fat

Understanding different types of fat can mean the difference between healthy weight loss and the risk of serious disease

WHY DO WE NEED FAT?

Fat is an important part of the foods you eat. But, too much fat can lead to heart disease or cancer, which has given fat a bad name. Your body needs some fat, however. The key is to eat just the right amount.

Fat provides essential fatty acids that carry key vitamins (A, D, E, and K) throughout the body. One semi-essential fatty acid helps prevent growth deficiencies and builds cell wall membranes! Fat also gives flavor to many foods.

Body fat protects vital organs and keeps your body from losing too much heat. It also stores energy for you, releasing energy when you need it. Unlike the quick energy from carbohydrates, the energy from fat is very good for endurance activities. But, remember, too much body fat can lead to health problems.

Your body turns carbohydrate and protein into fatty acids; however, there are some fatty acids your body can’t make. You need to get these fatty acids from the food you eat.

DIFFERENT KINDS OF FAT

Fats in foods can be grouped into 3 basic types: saturated fat, monounsaturated fat, and polyunsaturated fat. The difference between saturated and unsaturated fat is important for your health. Eating too much saturated fat may cause heart disease and raise your risk of colon and breast cancers.

Most saturated fats are solid at room temperature and tend to come from meat, egg yolks, and dairy products. There are some exceptions, however: coconut oil, palm oil, and palm kernel oil also contain saturated fat. As a rule, saturated fats are harder and more stable—butter, margarine, lard, and the fat in meats and cheeses are good examples.

Monounsaturated fats are found mainly in olive, peanut, and canola oils; they tend to be liquid at room temperature. Polyunsaturated fats can be either liquid or soft at room temperature. They are found mainly in safflower, sunflower, corn, soybean, and cottonseed oils and some fish. Omega-3 and omega-6 polyunsaturated fats are especially good for you; omega-3 fatty acids, found in fatty fish and vegetable oils, and omega-6 fatty acids, found in vegetable oils, have been shown to be good for your heart.

Unsaturated fats are generally healthier than saturated fats, thus many people choose to eat less high-fat meats, like beef. They may also cook more with vegetable oils. The best unsaturated oils are corn, safflower, soy, and sunflower; safflower oil is the most highly unsaturated oil.

Trans fats get a lot of attention because they are linked to heart disease. There are small amounts of these fats in some meats and dairy products. Some food companies make synthetic trans fats through a process called hydrogenation. This process turns liquid vegetable oils into solid, spreadable fat—trans fats. Hydrogenation increases the shelf life and is used to make food stay fresh longer and improve texture. Foods with these oils must list “partially hydrogenated vegetable oil” in the ingredients label. These oils are used in cakes, cookies, fried foods, salad dressings, and some snack foods.

Most health experts now suggest limiting the trans fats you eat. Trans fats raise levels of LDL (low-density lipoprotein, or “bad”) cholesterol, increasing the risk of heart disease. Because of this, food companies must now list trans fat on the label (they can be found directly under saturated fat and on some Nutrition Facts panels). Some restaurant chains and food makers have cut back on use of trans fats.

TRY TO EAT A DIET LOW IN FAT

Remember 3 things about fat. First, fat stores a lot of energy, which can be bad news when you want to lose weight. Fat contains double the amount of calories (9 calories per gram vs. 4 calories per gram) found in either protein or carbohydrate. If your diet plan includes foods that are high in fat, try to eat smaller portions. The fat on a steak has more calories than the same amount of pure sugar.

Second, too much fat is linked with serious diseases. The average American gets close to 40% of his or her calories from fat, though the United States Department of Agriculture (USDA) recommends a total fat intake of 20% to 35% of total calories. Try to opt for unsaturated fats—these come from fish, nuts, and vegetable oils. It is recommended that saturated fat makes up less than 10% of the calories you eat, and cholesterol intake should be less than 300 mg per day. Finally, fat calories are easier to convert to body fat.

For all these reasons, cutting down the fat you eat can help with weight loss and general health.

SOURCES OF FAT

We tend not to realize how much fat we eat because about 60% of the fat you eat can’t be seen. This is the fat in food, such as meat, cheese, nuts, breads, etc. We call this hidden fat. Visible fat is the fat you can see—butter on bread, for example. When you record the fat in your diet, be sure to count both visible and hidden fat.

The fat in some foods adds up quickly. Fat contains more than twice the calories of protein or carbohydrate—more specifically, 1 gram of fat has 9 calories, while 1 gram of carbohydrate or protein has only 4 calories. This means that 1 teaspoon (1 pat) of butter or margarine has 4 grams of fat, or 36 calories.

It is important to watch out for extras with high amounts of fat. For example, a bologna and cheese sandwich made with 2 slices (2 oz) of bologna, 2 slices (2 oz) of cheese, and 2 teaspoons of mayonnaise has 36 grams of fat. That’s 324 calories just from fat! A sandwich made with lean beef, lettuce, tomato, and low-fat mayonnaise, and served with a cup of nonfat milk instead of cheese, has only 6 grams of fat, or about 54 calories.

REDUCING THE FAT IN YOUR DIET

Read the food label on the package to find out how much fat is inside. Snacks and desserts are often high in fat; therefore, when you need a snack, try to choose fresh fruits and vegetables, which are low in fat. If you want something salty or crunchy, try low-fat or unflavored popcorn popped in the microwave or air popper instead of chips.

Pastries, doughnuts, cookies, and frosted cakes are high in fat; try to eat them sparingly. You may want to opt for sorbet and frozen fruit bars as tasty low-fat desserts; baked fruit desserts, such as baked apples or fruit crumbles made with low-fat toppings, can be other healthful options. Remember to check the food label on packaged foods for both fat and total calorie counts.

If you are cooking, there are many steps you can take to reduce the fat in your diet. You may want to try the following tips:

  • Choose recipes with little added butter, margarine, or oil
  • Trim visible fat from meat before cooking
  • Remove skin and fat from chicken and turkey before cooking
  • Use nonstick pans and sprays for cooking
  • Substitute low-fat or nonfat plain yogurt for sour cream or mayonnaise in sauces, salads, and soups
  • Broil or bake meats instead of frying

WORD TO THE WISE ABOUT REDUCED-FAT FOODS

At the grocery store you see many “reduced fat” or "low-fat" foods. These can help you cut fat from your diet; however, remember that low-fat does not always mean low calories. In fact, some low-fat cookies have nearly as many calories as regular cookies.

Studies have shown that when people think a food is "healthy," they often end up eating more at that meal, even when the food they chose is quite high in calories. Similarly, if food is labeled “low-fat,” people will eat more of it. So, if you encounter cookies, crackers, or other foods that are low in fat, make sure to check the calories.

Remember, it’s not fat that makes you gain weight, it’s the total number of calories consumed. It is easy to eat a diet that is low in fat but high in calories—this is why counting total calories is important for weight management.

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INDICATION

Qsymia® should be used together with a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m2 or greater (obese) or
  • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol

Limitations of Use:

  • It is not known if Qsymia changes your risk of heart problems or stroke or of death due to heart problems or stroke
  • It is not known if Qsymia is safe and effective when taken with other prescription, over-the-counter, or herbal weight loss products

It is not known if Qsymia is safe and effective in children under 18 years old

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

Qsymia can cause serious side effects, including:

Birth defects (cleft lip/cleft palate). If you take Qsymia during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. Women who are pregnant must not take Qsymia. Women who can become pregnant should have a negative pregnancy test before taking Qsymia and every month while taking Qsymia and use effective birth control (contraception) consistently while taking Qsymia. Talk to your healthcare provider about how to prevent pregnancy. If you become pregnant while taking Qsymia, stop taking Qsymia immediately, and tell your healthcare provider right away. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and the Qsymia Pregnancy Surveillance Program at 1-888-998-4887.

Increases in heart rate. Qsymia can increase your heart rate at rest. Your healthcare provider should check your heart rate while you take Qsymia. Tell your healthcare provider if you experience, while at rest, a racing or pounding feeling in your chest lasting several minutes when taking Qsymia.

Suicidal thoughts or actions. Topiramate, an ingredient in Qsymia, may cause you to have suicidal thoughts or actions. Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity or talking (mania); other unusual changes in behavior or mood.

Serious eye problems, which include any sudden decrease in vision, with or without eye pain and redness or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These problems can lead to permanent vision loss if not treated. Tell your healthcare provider right away if you have any new eye symptoms.

Possible side effects of Qsymia include:

Mood changes and trouble sleeping. Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur.

Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with concentration, attention, memory or speech. Tell your healthcare provider if symptoms occur.

Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia.

Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus. Weight loss can cause low blood sugar in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus (such as insulin or sulfonylureas). You should check your blood sugar before you start taking Qsymia and while you take Qsymia.

High blood pressure medicines. If you are taking medicines for your blood pressure, your doctor may need to adjust these medicines while taking Qsymia.

Central Nervous System (CNS) side effects. The use of prescription sleep aids, anxiety medicines, or drinking alcohol with Qsymia may cause an increase in CNS symptoms such as dizziness and light-headedness. Do not drink alcohol with Qsymia.

Possible seizures if you stop taking Qsymia too fast. Seizures may happen in people who may or may not have had seizures in the past if you stop Qsymia too fast. Your healthcare provider will tell you how to stop taking Qsymia slowly.

Kidney stones. Drink plenty of fluids when taking Qsymia to help decrease your chances of getting kidney stones. If you get severe side or back pain, and/or blood in your urine, call your healthcare provider.

Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition.

Common side effects of Qsymia include:

Numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of Qsymia. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to VIVUS, Inc. at 1-888-998-4887 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please read the Qsymia Medication Guide and Full Prescribing Information.

The Q and Me Patient Resources and Education site is based on the LEARN® Program provided under copyright license (September 15, 2010). All rights reserved.

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

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