Fat Phobia, Why You Need Fat Into Your Diet,
Eating Too Little Fat Can Lead To Serious Health Problems
Fighting Fat Phobia: Help clients reintroduce moderate amounts of fat into their diets.
By Susan Kundrat, MS, RD
Here’s an all-too familiar scenario: A client is venting her frustration about not being able to lose weight, and you’re uncertain how to advise her. You know she’s been working hard, dedicated to her workouts and extremely aware of her diet. She’s eating what appear to be all the right foods–plenty of fruits and vegetables, whole-grain products, skim milk and the occasional grilled chicken breast. Still, she just can’t seem to make any noticeable progress. What could be the problem?
You may be surprised to learn this client may be too concerned about her diet, especially her fat intake. That’s right…Fat. Viewed as “bad” and to be avoided at all cost, fat has become the pariah of the food pyramid in the last several years. The myth abounds that eating fat will directly and immediately result in fat deposits on the hips and thighs and around the middle. Eating fat has even taken on a moral value as many people have begun to equate the amount of fat they consume each day with how little willpower they have. What has been lost in the equation, however, is that eating too little fat can cause serious health problems and lead to an unhealthy obsession with food.
Why We Need Fat
Fat is as critical a component of the diet as carbohydrate, protein or water. Fat supplies our bodies with essential fatty acids that can be found only in food. These essential fatty acids help manufacture hormones and nerve cells and are important for carrying and absorbing fat-soluble vitamins A, D, E and K. Fat also helps maintain healthy skin and hair; two of the telltale signs of a lack of fat in the diet are dry, brittle hair and scaly skin.
Fat intake can also affect the rate at which the body absorbs nutrients. Consuming a moderate amount of fat will cause food to be absorbed more slowly, allowing energy to be released into the muscles gradually and consistently. For example, eating a bowl of nonfat cereal with skim milk for breakfast can leave you hungry within an hour or two. Yet simply adding a slice of toast spread with a little peanut butter (which adds fat as well as other important nutrients) can delay the food’s absorption, helping you feel full longer.
Fat also provides texture and flavor to food, making mealtime far more enjoyable. When fat is severely limited in the diet, eating loses some of its pleasure. Some clients compensate for this loss of enjoyment by eating greater amounts of fat-free, carbohydrate rich foods. Increasing carbohydrate consumption causes hunger to return more quickly, leading to a diet that, while higher in overall energy, is much less nutritionally balanced (Allred 1995).
According to several recent studies, restricting fat intake may also be associated with binge eating (Neumerk-Sztainer et al. 1995). Ronda Bokram, MS, RD, a nutritionist at Michigan State University who works with competitive athletes, cautions that severely limiting fat often leads to eating more frequently to compensate. “Food is always on the client’s mind, and [the client will] often feel guilty for being hungry and needing to eat so often,” she adds.
Perhaps the most insidious outcome of a severely limited fat intake is the domino effect it has as other nutrients are eliminated from the diet. Clients on an overly restrictive diet typically suffer deficits in several important dietary components, such as calcium and iron. The body needs calcium to maintain strong bones, carry nerve signals, keep the heart functioning, contract muscles and clot blood. Iron is essential for supplying oxygen to red blood cells and maintaining energy levels. While red meat is one of the best sources of iron, it is often shunned by those on a restrictive diet because it is mistakenly assumed to be too high in fat.
In fact, because fat contains nine calories per gram, it provides considerably more energy than protein or carbohydrate, each of which yields only four calories per gram. This means our bodies get more than twice the energy from fat as they do from protein or carbohydrate. When total energy intake is low, which can easily occur with a very low fat or nonfat diet, individuals may simply lack the fuel necessary to build muscle mass and repair tissue.
This lack of energy is of special concern for those who exercise regularly. Despite frequent meals, these clients may never feel full or satisfied and often lack sufficient energy to work out. “Without a doubt, one of the biggest problems we have in our strength and conditioning room is young women and men who do not get proper nutrition and then try to exercise,” says Carol Kennedy, MS, program director for fitness and wellness at Indiana University’s Division of Recreational Sports. The reason is that clients struggling to control their diet frequently don’t get enough fuel, of which fat is a primary source. “It is so common that we tell our exercise consultants to inquire about what clients have eaten that day if they are having trouble getting through workouts,” Kennedy said.
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How Much Fat Is Enough?
So if eating too little fat can be a problem and eating too much fat increases the risk of heart disease and other health related problems, what’s a good middle ground for fat intake? Cindy Conroy, MA, RD, coordinator of the Iowa Heart Center’ s Lipid Clinic in Des Moines, recommends that the average person obtain 30 percent of total daily calories from fat, cautioning that 20 to 25 percent is more appropriate for individuals with elevated cholesterol levels. For most people who exercise regularly, 20 to 25 percent is reasonable and would provide enough fuel for the energy expended in workouts. This percentage (which includes added fats and fats already present in food) would equate to 45 to 70 grams of fat for active people consuming 2,000 to 2,500 calories daily.
More important than focusing on the number of fat grams in the diet, however, is determining whether a client’ s diet is balanced and the client is comfortable eating an appropriate amount of fat. If someone is eating virtually no added fat, gradually adding small amounts would be more appropriate than trying to immediately increase fat intake to 20 percent. In fact, rapidly adding large amounts of fat to the diet could result in physical symptoms such as cramping, bloating and diarrhea, so gradual increases are crucial. One way to slowly reintroduce fat is to replace nonfat foods with low-fat varieties. Another way is to add highly nutritious foods containing some fat to items already in the diet. For more specific suggestions, see “Ways to Reintroduce Fat Into Meals.”
Sometimes the psychological factors underlying a restricted fat diet are just as compelling as the physical ones. Clients may cling to the notion that “fat free is best” and may need time to get used to adding fat to their diets. To facilitate this adjustment, Bokram often encourages clients to think back to childhood, when foods weren’t selected based on their nutritional value but rather on what tasted good and was satisfying. “Kids are usually such innately healthy eaters,” she says. If this is not effective, consider a referral to a registered dietitian. (See “Additional Resources” for more information.)
A Second Look at Food Labels
The misguided practice of monitoring fat content while ignoring all other nutrients is a big stumbling block for many clients. For example, focusing solely on the fat grams listed on the nutrition facts labels makes it easy to ignore the protein requirements essential for health and strength. “Because pretzels are fat free, clients may eat a whole bag of them instead of a meal, taking in excess calories but not enough protein and other nutrients,” according to Conroy. “We need to encourage healthy eating as opposed to simply fat-free eating.”
Clients often eliminate a particular food from their diets after trying the fat-free version and finding it lacking in taste compared to the “real thing.” For instance, many people have banished cheese altogether because they consider the fat-free alternatives devoid of flavor and texture. Other people cut out high-protein foods, such as eggs, meat or nuts, because of their higher fat content. The danger of this selective elimination is that essential nutrients get ignored in the process.
To ensure that their diets are balanced, clients should be taught to look at entire food labels as opposed to simply counting fat grams. Encourage clients to first check an item’s protein and calcium content and then review the fat content. Stress the importance of fiber content as well, since fiber is an essential part of the diet that is often overlooked. When reading food labels, clients should also consider sodium content, especially if they suffer from high blood pressure.
Helping Clients Make Gradual Changes
The transition away from a severely limited fat intake will be easier for clients if they take small, gradual steps to balance their diets. There is no right or wrong way to make these changes as long as the clients understand the importance of fat in the diet and are willing to try different things. The following are practical ways clients can gradually add fat back into the diet: Replace nonfat milk products with the low-fat varieties, such as low-fat yogurt, low-fat cheese and 1 percent milk. Don’t be afraid to eat moderate amounts of meat. Start with sandwiches made of lean roast beef (high in protein, iron and zinc) or lean ham and low-fat cheese on a whole-wheat bagel. Gradually add a small amount of fat to each meal to avoid negative reactions from too much too soon.
Spread peanut butter on an English muffin for breakfast, add half a cup of low-fat cottage cheese to your lunch, or broil a chicken breast for dinner. Focus less on fat and more on balance. Imagine a plate divided into fourths with one part protein (lean meat or 1% milk), one part grain (pasta, rice or bread), one part vegetable and one part fruit. Looking at the big picture makes it easier to balance one’s diet. For more tips on helping individuals gradually incorporate fat into their diets, see “Working With Fat-Phobic Clients.”
Just Desserts
Refocusing on total nutrition takes time, energy and patience. Work with your clients to help them stay in tune with changes in their energy levels, performance and overall well-being as they adjust to a life with fewer food restrictions. Maintaining a moderate amount of fat in the diet can make a world of difference to one’s self-image and the pleasure derived from eating. It can also form a solid foundation on which to build a healthy and balanced fitness program.
Susan Kundrat, MS, RD, is the sports nutritionist at the University of Illinois SportWell Center in Champaign-Urbana and a nutrition consultant to the university’s athletic teams. She is a member of the American Dietetic Association (ADA) and the ADA ‘s Sports, Cardiovascular and Wellness Nutritionists (SCAN) practice group.
Ways to Reintroduce Fat Into Meals
Your client can gradually reintroduce fat into their diets by adding foods loaded with nutrients-and just a little fat. Here are some suggestions:
Spread peanut butter on toast or bagels.
Top pancakes with nuts and seeds.
Grate a little low-fat cheese over a green salad.
Add a slice or two of lean roast beef or ham to sandwich.
Slice a chicken breast and serve it over pasta.
Add diced pork loin to vegetable stir-fry.
Bake high-fiber muffins with sunflower seeds.
Top dark, leafy greens with a small scoop of tuna salad.
Sprinkle some granola over a bowl of low-fat frozen yogurt.
Add a fatty fish, such a salmon, to a green salad.
Working With Fat-Phobic Clients
Educate clients about the important role fat plays in the diet. Dispel the myth that fat is simply too many added calories. Emphasize how fat provides the additional fuel necessary for hard workouts. Discourage guilt-ridden notions about “good” and “bad” foods. Stress that dietary changes should be gradual and feel comfortable. Explain that while diet is an important consideration, it need not become an obsession. Track the client’s progress during workouts as additional nutrient-dense, low-fat foods are added to the diet. Stress the dangers of compensating for overeating by overexercising. Encourage clients to derive pleasure from meals and exercise. Teach clients to strive for total balance in their workouts and diets.
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