After a two-year, 24,000-mile voyage aboard a 71-foot sailboat, Graham Kerr
was stunned by a mutiny in his own kitchen.
Kerr, who gained fame as television's "Galloping Gourmet" in the 1960s, his wife, Treena, and their three children had willingly forsaken his delectable but high-fat meals after they discovered that rich foods aggravated seasickness. But they revolted against the famed chef's improvised low-fat cuisine as soon as they docked for the final time in 1974.
So while Kerr clung to his newly found low-fat lifestyle, his family eagerly returned to typical high-fat favorites like cheese, eggs, and sausages. The result? Seven years later, Treena suffered a stroke and a heart attack.
"When the family rebelled, I think if I had said, 'Look, we'll recreate the table so that we eat healthy food but get it in a way that you'll like it,' what happened to Treena wouldn't necessarily have occurred," says Kerr, now in his sixties and the author of Graham Kerr's Best.
Although she fully recovered, Treena was still at high risk for recurrent strokes and heart attacks because she was overweight and her total cholesterol hovered near 350 milligrams per deciliter (mg/dl). So in 1982, she agreed to change her diet. Since then, the couple has stuck to a low-fat lifestyle that consists mainly of fruits, vegetables, and grains. Treena eats no more than 2 ounces of fish, poultry, or red meat daily. Graham's diet allows him to have slightly more, but never more than 6 ounces. By 1995, when she was in her early sixties, Treena had lost 15 pounds; dropped her total cholesterol to 220 mg/dl raised her high-density lipoproteins (HDLs), the so-called good cholesterol; and slashed her low-density lipoproteins (LDLs), the "bad cholesterol."
"She's done very well," Kerr says. "I think there is no question that you can do wonderful things if you adopt low-fat eating."
In fact, more and more doctors are convinced that eating excessive amounts of fat is second only to smoking as a health threat. A growing arsenal of powerful evidence is also proving that cutting way back on dietary fat at any age can prevent or reverse heart disease, short-circuit strokes, and stifle the growth of many cancers, says Michael Klaper, M.D., director of the Institute of Nutrition Education and Research in Manhattan Beach, California.
How Bad Can Fat Be?
Americans love fat. So much that we eat the fat equivalent of six sticks of butter each week. But doing that month after month, year after year, takes its toll.
Of the estimated 13.5 million Americans alive today with a history of heart attack, angina, or both, about 50 percent are age 60 and older. Overall, heart disease and strokes annually kill more than 40 percent of all people who die in the United States. Of the eight controllable risk factors for those two diseases, five—elevated cholesterol and triglycerides, high blood pressure, diabetes, and excessive weight—have been linked to high-fat eating, says Hans Diehl, Dr.H.Sc., director of the Coronary Health Improvement Project, a lifestyle intervention program based in Loma Linda, California, that has helped more than 15,000 people worldwide reduce their risk of heart disease.
Eighty-three percent of the people who die of heart attack, which can be attributed in part to diet, are age 65 or older.
Heart disease, particularly due to atherosclerosis—hardening of the arteries caused by fatty buildups in the circulatory system—can at least double your risk of stroke, says Ralph L. Sacco, M.D., director of the North Manhattan Stroke Study at Columbia-Presbyterian Medical Center, an ongoing project examining stroke incidence among 260,000 people living in racially diverse neighborhoods in New York City.
The risk of ischemic stroke, the most common type caused by blood clots that block arteries supplying blood to the brain, may be even higher if you also have heart disease. French researchers who examined 250 men and women in their sixties and seventies found that those who had deposits of fatty plaque narrowing their aortic arches, the main artery leading out of the heart, were up to nine times more likely to have ischemic strokes than those who didn't have such buildups.
"If you have plaque there, more than likely you're going to have it in the arteries leading to or inside the brain, too," Dr. Sacco says.
. . . And Then There's Cancer
Dietary fat also may have a role in up to 40 percent of cancers in men and 60 percent of those that affect women, says Moshe Shike, M.D., director of clinical nutrition at Memorial Sloan-Kettering Cancer Center in New York City and co-author of Cancer Free.
Research shows that men in their sixties and seventies who continue to eat lots of red meat are at 2 to 3 times greater risk for colon cancer. They also are more likely to develop rectal cancer and 2.6 times more likely to have prostate cancer than men who limit dietary animal fats. Women older than age 60 who load up on red meat are 2.5 times more likely to develop colon cancer.
Scientists also are learning more about the role of fat in the development of breast cancer. Researchers at the University of Hawaii, for instance, compared the eating habits of 272 postmenopausal women who were being treated for breast cancer with 296 women who lived in the same area but who were cancer-free. They found that overweight women who ate a lot of foods high in saturated fat like sausage, processed cold cuts, beef, lamb, and whole-milk dairy food were at greater risk for breast cancer.
"We know that saturated fats have an impact on hormone levels in the body, and we think that has a role in promoting breast cancer," says Cheryl Ritenbaugh, Ph.D., head of nutrition research at the Arizona Cancer Center in Tucson.
Eating fat also might increase your risk of lung cancer even if you don't smoke, says Michael Alavanja, Ph.D., senior scientist at the National Cancer Institute in Rockville, Maryland. In his study of 429 female nonsmokers ranging up to age 84, Dr. Alavanja concluded that those who ate the most saturated fat were six times more likely to have lung cancer than those who consumed the least amount of that fat.
"At least seven studies worldwide have shown an effect of saturated fat on lung cancer," Dr. Alavanja says. "It's not conclusive, but the evidence is pointing toward the fact that fat increases the risk of lung cancer among smokers and nonsmokers."
But the truth is that none of these things need to happen to you. You could help prevent and possibly subdue almost every one of these diseases if you did just one thing: Slash the fat.
"It's very clear that our diet is totally devastating us," Dr. Diehl says. "We know that if we cut the fat content and ate a more plant food-centered diet, we could drastically cut our risk for most cancers, heart disease, and stroke."
So Why Do We Still Eat It?
A surprising number of people—particularly among those of us over age 60—haven't gotten the word yet.
In fact, one-third of 4,480 people who cook household meals told University of Nebraska researchers that they had never heard that fat was a problem.
"I was very surprised by that finding. The information about fat has been around for a long time. You'd think that by the 1990s everyone would be aware of it, especially the people who are taking care of food preparation for an entire household," says Nancy Betts, R.D., Ph.D., associate professor of nutritional science at the university in Lincoln, who conducted the survey.
Why are we so perplexed?
Well, you probably can guess that fat exists for a reason. Eating it provides us with essential fatty acids that we need to regulate body temperature, maintain healthy skin and hair, and insulate and protect nerves and vital organs like the heart and kidneys.
The problem is that all fats are not created equal. Monounsaturated fats like olive and canola oils and polyunsaturated fats, like corn and safflower oils are considered healthier than saturated fats, which are found mainly in meats, eggs, and dairy products. Trans-fatty acids, another type of harmful fat, are unsaturated fats that have been artificially solidified by food manufacturers to make products like margarines and vegetable shortenings.
Unfortunately, many foods aren't purely unsaturated or saturated. So when you eat a typical American meal, you're likely consuming a mixture of these good and bad fats. Therefore, it is possible to unwittingly load up on bad fats even if you chop obvious fats like butter out of your life.
Why Cut Back Now?
The average American eats about 34 percent of calories from fat—down from 43 percent just a few years ago. But many people in their sixties, seventies, and eighties continue to consume 40 to 50 percent of their calories from fat, says Cheryl Pingleton, R.D., a dietitian at the Grand Court Lifestyles, a retirement community in Phoenix.
"Many of the people I see are eating a lot of fried foods, creamy salad dressings, and rich desserts," Pingleton says. "They feel as if they've worked their whole lives and now literally want to enjoy the fat of the land."
But as we have seen, enjoying fat too much can lead to serious health problems. If, however, you switch to a low-fat lifestyle, you may quickly feel rejuvenated, particularly if you have a chronic ailment.
"You can lose weight, feel more energetic, have fewer digestive problems, and just feel better about yourself," Pingleton says. "No matter what your age or medical condition—diabetes, gout, high cholesterol, heart disease—low-fat eating is the way to go."
The American Heart Association (AHA) and the National Cancer Institute recommend that no more than 30 percent of total calories come from fat. The AHA says that less than 10 percent of calories should come from saturated fat. Many researchers believe that fat should have an even smaller role on our dinner plates—down to 20 percent or possibly as low as 10 percent of total calories.
"Cutting back on fat will help, and the more drastically you can cut back, the better off you'll be, with the lower limit being around 7 percent of calories from fat for nutritional adequacy. If you have angina, you'll certainly have less angina. You'll also have less risk of stroke, heart attack, and cancer. And every study that I've ever looked at says it's never too late to make these important changes in your diet," says Lee Lipsenthal, M.D., medical director of Preventive Medicine Research Institute in Sausalito, California, where Dean Ornish, M.D., is conducting his pioneering research on reversing heart disease.
In fact, according to Dr. Diehl, switching to a low-fat lifestyle even in your later years can help quash the big three killers—heart disease, stroke, and cancer. Here's a look at how dietary fat does its harm and how you can stop or even reverse some of this damage.
The Heart of the Matter
Within five hours of eating a fatty meal like a slice of pepperoni pizza or a bologna sandwich, which are loaded with saturated fat, radical and dangerous changes occur in your body's chemistry, Dr. Klaper says.
First, a tide of fat oozes into the bloodstream and coats red blood cells with a sticky film. "Under normal conditions, blood serum is clear. But after you eat a fatty meal, it is thick, white, and greasy. It looks like household glue," Dr. Klaper says.
Because they're more sticky, these cells begin to clump together. It is this clumping that eventually forms the blood clots in the arteries, which lead to stroke or heart attack. At the same time, saturated fat raises the harmful LDL cholesterol levels in the blood by suppressing the production of enzymes in the liver that would normally help destroy these compounds. Adding to your woes, as the body processes the fat, it produces free radicals, the same oxidizing molecules that cause metal to rust and food to spoil. Inside your body, these free radicals cause cholesterol to cling to artery walls and clog them up. Years of eating like that virtually guarantees that a person age 60-plus will have at least some atherosclerosis, the underlying disease that can lead to stroke and heart attack.
In addition, this arterial rust makes it more difficult to deliver oxygenated blood, says Dr. Diehl. This starves the tissues and leads to degenerative changes that can cause impotence, hearing loss, degenerative disk disease, memory loss, and vision problems, Dr. Diehl says.
But remember, it doesn't have to happen.
"Atherosclerosis is totally unnecessary. But it is reversible, even after age 60. All you have to do is take better care of yourself, particularly how you eat. The simpler your diet, the better your chances of reversing these narrowed arteries and increasing blood flow to more adequate levels once again," Dr. Diehl says. "In as little as three weeks, most people can eat themselves out of angina symptoms just by switching to a simpler diet that includes very low fat foods."
Going into Reverse
Several exciting studies have shown that eating a very low fat and low cholesterol diet in conjunction with other lifestyle changes like exercise, smoking cessation, and stress reduction can, as Dr. Diehl says, actually reverse heart disease.
"Our experience has shown that within days of starting a low-fat diet, patients with angina can show an immediate and dramatic decrease in their symptoms," says Monroe Rosenthal, M.D., medical director of the Pritikin Longevity Center in Santa Monica, California. In addition, studies have shown that coronary artery blockages can actually be reversed over a one- to two-year period, he says.
Pritikin researchers, for example, studied a group of 4,587 men and women that included people in their eighties and nineties. After three weeks, those who ate a diet that was less than 10 percent of calories from fat and consisted mostly of fruits, vegetables, and whole grains lowered their total cholesterol levels by 23 percent. This reduction sliced their heart attack risk in half.
"There was little difference in drop in cholesterol levels between the young people and the older people. This is clear proof that it's never too late to change your lifestyle and improve your health," says R. James Barnard, Ph.D., author of the study and professor of physiology in the Department of Physiological Science at the University of California, Los Angeles.
The Ornish Way Works
Even more dramatic results come from Dr. Ornish's landmark work. Dr. Ornish divided 43 men and 5 women—many in their fifties, sixties and seventies who had severe atherosclerosis—into two groups. The "treatment" group was instructed to go on a strict vegetarian diet deriving fewer than 10 percent of calories from fat. No meat, poultry, fish, or cheese. No nuts or seeds. No chocolate, no coffee, no cooking oils. In addition, they walked for at least 1 hour, three times a week; practiced meditation and yoga daily; and if they smoked, they quit.
Meanwhile, the other group was advised to follow the standard American Heart Association lifestyle program. That is, reduce their fat intake to less than 30 percent of calories, stop smoking, and exercise moderately.
After one year, 82 percent of those in the treatment group had shown reversal of coronary blockage. The average amount of reduction was about 5 percent. But even that modest regression can mean a 100 percent improvement in blood flow, says Dr. Lipsenthal. Those on the AHA diet didn't experience these striking results. At best, their disease appeared to progress at a slower rate.
"It's a world of difference. I'm doing things that I never imagined I could do again," says Victor Karpenko, in his seventies and a retired nuclear engineer in Danville, California. When he began the Ornish program in 1987, he had one artery almost completely blocked, had suffered from persistent angina, and could walk less than a block.
Since then, his total cholesterol has dropped from 290 to 150 milligrams per deciliter, he has lost 30 pounds, his angina is gone, and he regularly hikes in the hills surrounding his home. He also climbs the equivalent of 130 floors on his stair-climber in a half-hour and backpacked in the High Sierras at 8,000 feet with 40 pounds on his back.
"The diet is really the foundation of the whole program," Karpenko says. "I feel so much better now physically and mentally because of it. And it's a diet that really isn't hard to stick to when you consider the benefits."
Fat-Busting Starts Here
Before you can break away from high-fat living, you need some information about your dietary needs. First, you need to roughly calculate how many calories you should eat daily based on your age, says Moshe Shike, M.D., director of clinical nutrition at Memorial Sloan-Kettering Cancer Center in New York City and co-author of Cancer Free.
To do that, multiply your body weight by 13. (The average person needs to eat 13 calories per pound to do normal daily activities.) Next, subtract 2 percent of that total for each decade after age 30.
So if you are 70 years old and weigh 160 pounds, for example, multiply 160 by 13. That's 2,080 calories. Now deduct 10 percent to account for your age—that leaves you with 1,872 calories. That's your basic caloric need. Now you can use the following chart to figure out the maximum number of fat grams you want to eat per day based on 30, 25, 20, 15, or 10 percent of calories from fat. Tallying your fat grams each day will help you make better decisions when you're reading food labels and preparing meals.
If You Eat (in Calories)
Little Trims Add Up, Too
But even if you can't see yourself curbing your fat consumption as much as Dr. Ornish suggests, just shaving a modest amount of fat from the obvious sources might have some positive effects.
In the St. Thomas' Atherosclerosis Regression Study in London, for instance, 26 men up to age 66 were put on a diet that limited fat intake to 27 percent of calories and lowered saturated fat to 8 percent of calories. In a similar group, 24 men were allowed to eat their usual English diets, which typically consist of about 40 percent of calories from fat. Three years later, researchers found that 10 men in the dietary group (compared to 1 man in the usual-care group) had small regressions of artery blockages. As a result, the dietary group reported better control of angina and had three times fewer deaths and coronary surgeries and two times fewer heart attacks.
"Anything that you can do to lower your fat is better than doing nothing at all," Dr. Barnard says. "It's like a game of Russian roulette. It just depends on how many bullets you want to stick in that revolver. If it holds six bullets and you eat the typical American diet, then you have five bullets in it. If you want to eat 20 percent, you're down to four. If you go to 15 percent, you're down to three. And if you can manage to get down to less than 10 percent, you may only have one bullet in that pistol, and your risk of these diseases is dramatically reduced."
The Cancer Link: Another Reason to Lower Fat Now
Fat doesn't directly cause cancer. Instead, it promotes it—much like ice on a porch step increases the chances that you'll slip and fall, Dr. Klaper says. Although researchers aren't certain how this happens, they do have plenty of theories. Some suspect that free radicals, produced as the body metabolizes fat, damage a cell's genetic codes and spark cancers. Others believe that fat may interfere with the body's ability to shut down cell growth or that it disrupts the immune system, which may have a protective role against cancer.
High-fat meals also may stimulate production of sexual hormones like estrogen and testosterone that can promote cancer, particularly in the breast and prostate, Dr. Klaper says.
But whatever the reason, it is becoming increasingly clear that the longer you stick to a high-fat lifestyle, the less likely it is that you will remain cancer-free in what should be the best years of your life.
"Eating high-fat foods is like throwing gasoline on a fire," Dr. Klaper says. "You're just fanning the flames of the cancer and helping it spread."
But as with heart disease and stroke, this doesn't have to be your future. In fact, slashing dietary fat might help many of us in our sixties, seventies, and eighties halt the progression of certain tumors before they become cancerous and prevent recurrences, Dr. Ritenbaugh says.
It may be too late, for instance, for dietary changes to stop a tumor from developing in the next couple of years, but "tumors that would have gotten you 4, 5, or 10 years from now, you can still do something about," Dr. Ritenbaugh says.
Cutting back to 20 percent of calories from fat, for example, may reduce your risk of precancerous skin growths and prevent skin cancer in your sixties and beyond, according to researchers at Baylor College of Medicine in Houston. In their study, researchers found that people who continued eating the typical American diet developed three times more precancerous skin lesions, called actinic keratosis, than those who ate a low-fat diet.
Men over the age of 60 who have been cancer-free all of their lives run a 21 percent risk of being diagnosed with prostate cancer, the second leading lethal cancer among American men. But switching to low-fat eating may help stop the growth of microscopic prostate cancers before they have a chance to cause major problems, says William R. Fair, M.D., chief of urologic surgery and chairman of urologic oncology at Memorial Sloan-Kettering Cancer Center in New York City. In his animal studies, Dr. Fair is finding that dipping fat consumption below 20 percent of calories can halt the progression of these tiny tumors.
"I really don't think a low-fat diet could cure a sizable tumor, but if it can halt the progression of a microscopic tumor, then that would be tantamount to a cure," Dr. Fair says.
Cutting back on fat may also stave off colon cancer, according to Harvard
University researchers who followed nearly 52,000 male health professionals for
two years. Those who ate the least amount of animal fat—about 24 percent of
calories—were half as likely to develop precancerous colon polyps as the men who
consumed more fat.
"These studies suggest that eating a healthy diet that includes lower amounts of animal fat and higher amounts of fruits and vegetables that have lots of fiber and micronutrients is an important part of what we can do to prevent colon cancer," says Eric Rimm, Sc.D., assistant professor of epidemiology and nutrition at the Harvard School of Public Health.
Women can dramatically reduce their risk of other common types of cancer—particularly breast cancer—if they significantly ease up on fat, Dr. Klaper says.
Researchers put 13 postmenopausal women at the Pritikin Longevity Center in Santa Monica, California, on an eating plan that included less than 10 percent of calories from fat. In three weeks, their blood levels of estradiol, a form of the hormone estrogen linked to breast cancer, fell nearly 50 percent. As a result, the women were far less likely to develop breast cancer at the end of the study, Dr. Barnard estimates.
Even if a woman age 60 or older does get breast cancer, reducing fats may be a good move. Women who have breast cancer might substantially improve their chances of surviving if they are on low-fat diets, according to researchers at the University of Minnesota in Minneapolis who polled 42,000 women between the ages of 55 and 69 on their eating habits. Of the 698 women who developed breast cancer in the next five years, those who reported eating 56 grams of fat a day (almost 2 ounces) had twice the risk of death as women who ate less fat, says Aaron Folsom, M.D., professor of epidemiology at the university and co-author of the study.
"I'm not surprised that lower-fat diets are effective in the prevention of breast cancer as well as its treatment," Dr. Klaper says. "High-fat diets raise the levels of sex hormones like estrogen in the bloodstream, and many breast cancers depend on estrogen to grow."
Cutting down on fat also may help women slash their risk of ovarian cancer, a disease that becomes more common as women reach their early sixties, says Harvey A. Risch, M.D., Ph.D., associate professor of epidemiology and public health at Yale University School of Medicine.
Dr. Risch and his colleagues evaluated the eating habits of 450 women up to age 79 with ovarian cancer and 564 without the disease. They concluded that cutting 10 grams of saturated fat a day (about the same amount as in one cheeseburger with all the fixings) could trim the risk of ovarian cancer by 20 percent. And adding 10 grams of vegetable fiber a day—what you would get in about 1 cup of cooked lentils—may take the risk down by another 37 percent.
"It appears possible to cut your risk of ovarian cancer in half by assertive modification of the diet," Dr. Risch says.
How to Start Now
Really cutting back on total fat and sorting out the best low-fat foods from the worst high-fat offenders takes some adjustments, but these changes don't have to be time-consuming or costly or sap flavor from your favorite meals.
"Changing a lifetime of eating habits, particularly for people age 60-plus, can be challenging. But I don't think it's as hard to do as many people perceive. It doesn't have to be all or nothing. Over time, even small changes in your eating habits can improve your health," says Sheah Rarback, R.D., an American Dietetic Association spokesperson in Miami.
Here are some basics to get you started.
Keep score. For the next couple of days, jot down on a piece of paper or handy 3-by-5-inch cards all the foods and beverages that you eat and drink. Note the amount and type of fat listed on the nutrition labels. If you're eating in a restaurant, estimate your intake of food, Dr. Shike suggests. This will give you an idea about how much fat you're eating now and how much you'll need to cut back. Every three months or so, do this all over again so that you can see your progress.
Set a goal. Give yourself something to strive for, but make it practical, Pingleton says. Making over a lifetime of eating habits in a week probably isn't realistic. But getting your total fat intake under 25 percent of calories in the next six months is a reasonable goal.
Be bold. Most doctors and dietitians recommend that no more than 30 percent of your calories come from fat. But it seems that the more you slash the fat you eat, the more dramatic the impact on your health. So be adventurous, Dr. Klaper suggests. Experiment with lower levels of fat in your meals. To begin, pick a day of the week and on that day, make a bean dish, pasta, or salad the centerpiece of your meals. If you dine out, try low-fat ethnic foods or vegetarian dishes. Then gradually, over a month or two, increase the number of days of the week you eat like that. All of this will help your taste buds adapt to eating less fat and help you become comfortable with a new lower-fat lifestyle.
Count the grams. Figuring the percentage of fat in a meal can be tricky.
An easier way to control fat consumption is to count grams, because that's how fats are measured on nutrition labels, says William Castelli, M.D., epidemiologist, medical director of the Framingham Cardiovascular Institute and former director of the Framingham Heart Study in Massachusetts. So if you eat 2,000 calories a day and want to keep your fat intake below 20 percent, multiply 2,000 by 20 percent. That's 400 calories. Now divide 400 by 9—which is the number of fat calories in 1 gram. You get 45, the number of grams of fat you're allowing from all the foods that you eat in one day. How much is that? A beef bologna sandwich made with two pieces of meat and a 1-ounce slice of regular Cheddar cheese has about 36 grams of fat—nearly an entire day's fat allowance in one meal. So use those fat grams thoughtfully, Dr. Castelli says.
Take 20. Try to keep your consumption of saturated fat—the really bad fat—under 20 grams a day (10 grams if you have suffered a heart attack), Dr. Castelli says. Again, read the food labels carefully. What can you eat and stay under 20 grams? A lot more than wheat germ.
"You could have rolled oats, fruit, and low-fat yogurt for breakfast; a chicken, tuna, or turkey sandwich for lunch; and shrimp cocktail, a 3-ounce filet mignon, vegetables, salad, and fat-free dressing for dinner—and you'd still be under 20 grams of saturated fat for the day," Dr. Castelli says. "Now does that sound like such a miserable experience?"
Make the switch gradually. Cravings for fat won't disappear immediately, but you can retrain your taste buds, says John Foreyt, Ph.D., director of the Nutrition Research Clinic at Baylor College of Medicine in Houston.
"You can retrain yourself at any age by making shifts gradually away from high-fat foods," he says.
Make one gradual change a week. If you use whole milk in your coffee or on cereal, for example, try a 50/50 mixture of whole milk and 2 percent milk for a week. Then switch to 2 percent for seven days. Then use a mixture that is half 2 percent and half 1 percent, and so on until you are using skim milk. If skim milk alone doesn't satisfy your taste buds, you can stir in some nonfat powdered milk to improve its texture and flavor, Dr. Foreyt says. You can use the same strategy to wean yourself off cheeses, shortenings and oils, ice cream, and other high-fat traditions.
Reinvent your favorites. The worst thing that you can do is give up your favorite dishes, because you'll feel deprived and may develop cravings that make it harder to stick to a low-fat lifestyle, Dr. Foreyt says. Instead, experiment with low-fat ingredients.
"Take your 10 favorite recipes and go into the supermarket and buy all the low-fat substitutes for the ingredients that you would normally use," says Dr. Castelli.
If you prefer not to modify your recipes, then serve the original versions less often—on holidays and special occasions, for instance—and take only half of the portion that you would normally eat, Dr. Foreyt suggests.
Eat with friends. Make your transition to low-fat living a social celebration, Rarback says. Ask a few friends to join a lunch or dinner club. On a rotating basis, one of you makes a low-fat main entrée while the others bring the bread, salad, fruit, or dessert.
"It will help all of you experiment with new low-fat recipes, and it is fun to eat together," she says.
Splurge now and then . . . Make high-fat foods like country fried steak a once-a-month treat rather than daily fare, says Michele Tuttle, R.D., director of consumer affairs for the Food Marketing Institute in Washington, D.C.
"I've never met anybody who can eat perfectly. In fact, that's probably the best recipe for failure because the thought that you can never have chocolate fudge double cake again in your life will drive you crazy," Tuttle says. "So go ahead and have a little bit with some friends. One dessert split four ways is not a big deal."
. . . But make up for it later. Any one food or any one meal can have some extra fat as long as you compensate for it, Dr. Foreyt says.
"Over a week you want your fat consumption to be certainly less than 30 percent of calories and closer to 20 percent of calories if you can get there," Dr. Foreyt says. "So if you eat a hamburger or cheesecake on a Monday, that's fine. But you should adjust your eating plans so that you eat less fat during the rest of the week."
With these essentials in mind, here are some ideas for stocking your pantry, shopping for groceries, eating at home, and dining out that will help you become a savvy low-fat role model for your grandchildren.
The Pantry: Low-Fat Living Starts Here
Filling your pantry with high-fat foods is like asking a compulsive gambler to live next door to a casino.
It's too much of a temptation.
"If you don't have the right things in your pantry, you're going to prepare the foods you do have in the same old way, or you're going to be tempted to say 'the heck with it' and go out to eat at a high-fat restaurant," Tuttle says. "So it only makes sense to stock your pantry well."
For low-fat living, here is what should be readily at hand in the kitchen of anyone who is age 60 and over.
Remember the 75/25 rule. "Whenever you open the refrigerator, a kitchen cabinet, or the bread box, 75 percent of what you see should be plant-derived foods—pastas, breads, beans, cereals, grains, and fresh, frozen, or canned fruits and vegetables. Then the remaining 25 percent can be made up of small amounts of lean meats and low-fat dairy products like milk and cheese. If the bulk of your pantry is like that, then your plate will probably look that way, too," says Elizabeth Somer, R.D., author of Nutrition for Women.
Consider the pastabilities. Pastas like spaghetti, linguine, and fettucine have earned a bizarre reputation for being fattening. But in reality, these grain foods are almost devoid of fat and are a great source of complex carbohydrates—your body's best fuel.
"If you fill up on pasta, you'll be more inclined to eat less meat, and that will mean that you're eating even less fat," Rarback says. So keep several boxes of your favorite pastas within reach.
Be wary of what you put on pasta. What fattens up most pastas is what we put on it, says Rarback. A typical white sauce, for instance, is 71 percent calories from fat. And most bottled spaghetti sauces have up to 9 grams of fat in a ½-cup serving.
Instead of those, always keep in your refrigerator a jar of spaghetti sauce that has 5 grams of fat or less to pour over pasta, spread on pizza crust or even on baked potatoes, says Elaine Moquette-Magee, R.D., author of the book series Fight Fat and Win: How to Eat a Low-Fat Diet without Changing Your Life.
Count on beans and rice. Dried beans like pinto, navy, lima, and black beans, and grains like brown rice are virtually fat-free and are terrific sources of protein that can reduce or eliminate the need for fat-laden meats in stews, chili, salads, and other traditional dishes, Rarback says. Instead of using 10 ounces of beef in a stew, for example, use 5 ounces and round out the dish with lentils.
Be aware that beans can cause gas. To prevent it, soak your beans overnight in a bowl of water and then use new water for cooking them, suggests Rarback. Or try over-the-counter products containing enzymes such as alpha-galactosidase (Beano) that can prevent gas by breaking down sugars in the digestive system.
Get cracking. Unlike packaged bread crumbs, which have some fat, cracker meal is fat-free, Moquette-Magee says. Cracker meal can be used for coating oven-roasted chicken or fish, as a topping for low-fat fruit crisps and casseroles, or as a filler for meat loaf.
Stock up on low-fat cream soups. Be sure to have in your pantry plenty of low-fat condensed cream soups, like 99 percent fat-free cream of broccoli or cream of chicken, says Evelyn Tribole, R.D., author of Healthy Homestyle Cooking. They're great in casseroles and as sauces on meats, poultry, and fish.
Stay away from solids. If you use cooking oils, stock up on liquid olive or canola oils that are loaded with monounsaturated fat. These oils and tub margarines are better for you than solid oils and fats like shortenings that contain lots of saturated fat, says Edith Howard Hogan, R.D., a spokesperson for the American Dietetic Association in Washington, D.C. Better yet, coat your cookware with a vegetable oil cooking spray.
Brown it in broth. Keep defatted chicken broth in your cupboard instead of vegetable oil, Moquette-Magee says.
"I use chicken broth all the time to sauté vegetables, pan-simmer meats or boil and flavor rice. All it does is keep the food moist and transfer heat. Those are the same things the oil would be doing, except the broth doesn't have all that fat," she says.
Slash fat with a splash from the vine. Alcohol is another good fat substitute to have on hand, Moquette-Magee says. You can use beer and wine to stir-fry meats and simmer mushrooms, green peppers, onions, and other vegetables.
Juice up your meals. White grape, apple, orange, and pineapple juices are all light-flavored alternatives to oil in homemade salad dressings or marinades, Tribole says.
Bring on the prunes. Pureed prunes are one of the best fat substitutes in baked chocolate favorites like brownies and cakes, Tribole says. They're chewy and contribute a naturally sweet flavor to the dessert. A ½-cup can save you more than 800 calories and almost 100 grams of fat compared to a ½-cup of butter. For convenience, Tribole suggests buying jars of baby- food prunes that have already been pureed.
Peel away calories with applesauce. "Applesauce is another great substitute," Tribole says. "You can use it in place of cooking oils or butter in brownies, muffins, and cakes. For every ½ cup of applesauce you use, you'll save about 109 grams of fat and 900 calories."
Cocoa satisfies taste buds. If you bake, keep your pantry well-stocked with unsweetened cocoa powder. It provides rich chocolate taste without the fat of unsweetened baking chocolate, Tribole says. For each ounce of unsweetened chocolate called for in a recipe, substitute 3 tablespoons of unsweetened cocoa powder, she advises.
Keep the cow in the cupboard. Cartons of skim milk that can be stored without refrigeration until opened have no fat and are convenient and cost-effective because they reduce spoilage, Hogan says. The milk contains no preservatives, but is safe because it is pasteurized at a higher temperature than other milk products. You can store it for up to five months in your pantry, she says. These products are available on most grocery shelves. Look for "UHT" (ultra-high temperature) on the label.
Make that fat evaporate. Evaporated skim milk is terrific for sauces and soups because it has the texture and flavor of cream but without the fat, Tribole says. Each cup contains 80 grams less fat and 600 fewer calories than heavy cream.
Expand yogurt's horizons. Plain nonfat or low-fat yogurt is a versatile addition to any refrigerator, Moquette-Magee says. It can be used to replace sour cream and make salad dressings, and it is a good, quick add-on to breakfast cereals and desserts.
Take a chance on butter substitutes. Butter-flavored sprinkles like Molly McButter or Butter Buds add taste to foods without the fat or calories, Rarback says.
Teach old spices new tricks. Low-fat foods may seems less flavorful when you first try them. There are a couple of reasons for that. First, fat adds flavor to some foods, and it's a taste that you're used to. Second, as we age, our taste buds become less acute. So keep plenty of herbs and spices like basil, garlic, ginger, onion powder, tarragon, and oregano in your pantry to add zip to low-fat meals, Rarback says.
"By using some different spices and herbs in your food, you're going to bring back flavor and zest to the meal and make it more enjoyable while still eliminating fat," she says. Tinker with low-fat foods and spices until you find combinations that you like.
Invigorate with vinegar. "Using a flavorful vinegar like raspberry, tarragon, or rice wine vinegar will allow you to decrease the amount of oil in homemade salad dressings. So I'd encourage you to have them in your kitchen and experiment with them," Rarback says.
Do a mayo makeover. Regular mayonnaise is 98 percent fat. "It's just egg yolks and oil," Moquette-Magee says. "I can't think of anything worse for you."
Try one of the light, low-fat or fat-free varieties. If you don't like how they taste on sandwiches, opt for mustard, cranberry sauce, barbecue sauce, or plain yogurt, says Moquette-Magee. You also might want to try creating your own mayo. Either mix ½ cup of light or low-fat mayonnaise with ½ cup of plain yogurt, or whip ½ cup of low-fat cottage cheese in a food processor or blender.
Have a "biteables" box. Put a variety of low-fat snacks like grapes, dates, celery, rice cakes, and other crunchy, chewy things into a container in your kitchen so that you can quickly satisfy yourself without being tempted to dash out for higher fat goodies between meals, Graham Kerr suggests.
Shopping: Surviving the High-Fat Maze
"If you're the cook in the family, your first line of defense against high-fat living is at the grocery store," Pingleton says.
But while most supermarkets have a tremendous variety of nonfat and low-fat options, they are also filled with prominently displayed, high-fat enticements.
Here are some ways to get through the grocery store without loading up on fat.
Make a list. This may seem like obvious advice, but some people in their sixties, seventies, and eighties still don't do it, Somer says.
Before you go to the store, sit down and plan out what you would like to eat that week. In the long run, a list will save time and reduce the risk that you'll impulsively throw a high-fat food into your cart, Somer says.
Don't shop on an empty stomach. "You want your mind working, not your stomach, as you stroll the grocery store aisles," Somer says. "If you're hungry, you're going to be reaching for all the high-fat stuff that you shouldn't be eating." Go grocery shopping after a meal or a snack like low-fat cheese and crackers, she says.
Shop outside in. Generally, the fresher, lower-fat foods like fruits and vegetables are on the perimeter of the store. So shop on the outside aisles first. That way, you'll load your cart with healthier foods and be less tempted to fill it with the more processed, higher-fat products on the inner aisles, says Jayne Newmark, R.D., a nutrition consultant in Phoenix.
Read those labels . . . Nutrition Facts labels can be your best weapon in your war against high-fat eating. Among other things, each label is now required by law to list the amount of total calories, total fat, saturated fat, and sodium per listed serving size.
When reading the Nutrition Facts label, says Kathy Pompliano, R.D., manager of the M-Fit Supermarket Program at the University of Michigan in Ann Arbor, remember the following rules of thumb: If an item contains 5 percent or less of the Daily Value for a particular nutrient, it is considered "low." On the other hand, if an item contains 20 percent or more of the Daily Value for a particular nutrient, it is considered "high." Look for foods that are low in total fat, saturated fat, and sodium and foods that are high in fiber, vitamin A, vitamin C, and calcium. Read the ingredients list, too, she suggests. Compare products and choose the one with fewer fat sources listed. Common fat sources included vegetable oil, meat fat, whole milk, butter, cream, and eggs. Check breads and cereals for fiber-rich whole grains, such as whole or rolled oats, whole wheat, cracked wheat or stone-ground.
. . . But take a few at a time. Of course, reading every label on every food every time you shop would be tedious and time-consuming. Instead, each time you shop pick out a couple of foods and read those labels very carefully, recommends Mona Sutnick, R.D., Ed.D., a nutrition consultant in Philadelphia and a spokesperson for the American Dietetic Association.
"Today, for example, you could read salad dressing labels and pick one that has little or no fat," she says. "If you like it, you don't have to read salad dressing labels anymore, because you've found one that suits you. That approach will work for virtually every food in the store."
Give hydrogenated foods the heave-ho. Avoid foods like baked goods or
margarines that list hydrogenated or partially hydrogenated oils as ingredients.
This means hydrogen has been added to unsaturated liquid oils to make them
solidify. But adding hydrogen does two things. First, it transforms unsaturated
fat into saturated fat, says George Seperich, Ph.D., a food scientist and
associate professor of agribusiness at Arizona State University in Tempe.
Second, it creates trans-fatty acids, molecules that raise LDL cholesterol as
much as saturated fat does.
"When I'm shopping and I see the word 'hydrogenated' on the label, that food goes right back on the shelf because I know it is loaded with things that I don't want in my body," Dr. Klaper says.
Water it down or whip it up. Pick a margarine that lists water as its first ingredient. It will almost certainly be low-fat, Dr. Castelli says.
Whipped margarines also are a good choice because they have more air, and that reduces the fat content, says Gerry Bates, R.D., nutritional program manager for the Florida Department of Elder Affairs in Tallahassee.
Keep veggies on ice. "For many people in this age group who live alone, buying fresh fruits and vegetables is often a problem because they rot before they're eaten," Rarback says. "Frozen vegetables packed without sauces are a very good alternative. Then a person living alone or a couple doesn't have to worry about spoilage, and they have a fresh-tasting vegetable readily available that they can take out of the freezer and microwave quickly, or use as a base in soups or stews."
Become a cereal fan. "There didn't used to be a lot of low-fat, low-sodium breakfast cereals, but now there is a multitude of very good ones," says Jeanne Jones, cookbook author and "Cook It Light" syndicated columnist in La Jolla, California. In particular, look for shredded wheat, oatmeal, and puffed rice, corn, or wheat.
Smile when you say low-fat cheese. Most regular cheeses have about 9 grams of fat per ounce. Instead look for low-fat cheeses that have about 6 grams of fat or less per ounce or part-skim varieties of ricotta and mozzarella that have about 5 grams or less, according to Moquette-Magee.
Nonfat cheeses taste fine in sandwiches but don't cook well, Kerr says.
Reach for nonfat cream cheese. Regular varieties of cream cheese are very high in fat and saturated fat. Look for the nonfat or low-fat varieties to accompany a breakfast bagel, says Pompliano.
Pass on the processing. Make foods that are naturally low-fat your first choice, says Dr. Seperich. That's because many nonfat products—particularly nonfat sweets like cakes and cookies—are highly processed, Dr. Klaper says. Instead of fat, they're packed with gums and sugars that cause the formation of free radicals and drive up triglycerides, a type of fat that increases your risk of heart disease.
People also tend to eat larger amounts of nonfat foods because they don't give the feeling of fullness that fat does. Dutch researchers also have found that fat substitutes can reduce your body's ability to absorb vitamin E and health-promoting antioxidants like carotenoids.
Some nonfat products such as fat-free sour cream, cream cheese, yogurt, and mayonnaise are fine if they are used sparingly on sandwiches or to make other foods like vegetable dips and salad dressings, Dr. Seperich says.
Find a fresh path. Instead of heading straight to the meat department, purchase a new fruit, vegetable, grain, bean, or pasta that you've never tried before, like kiwifruit, bok choy, couscous, Anasazi beans, or ziti, Pingleton says. It will awaken your taste buds and give you another way to experiment with low-fat living.
Gobble up ground turkey breast. Ground turkey or chicken breast are among the leanest meats you can buy, Pingleton says. Be wary, though, if the label doesn't indicate that it is 100 percent breast meat, because the package may include skin and other poultry fat.
If ground turkey or chicken breast isn't available, consider 15 percent- fat ground beef. It is leaner than plain ground turkey, Pingleton says.
Select the "select" meats. The more marbling a meat has, the more tender and tasty it will be. But that marbling is pure fat. Look for the U.S. Department of Agriculture grade on the package. Choose "select" grade meats, which have the least amount of marbling and may be cheaper than other meats, Tuttle says. If that isn't available, get "choice," the next highest grade. "Prime" grades have the most marbling, so save these for special occasions.
Look for loin. Leaner cuts of beef contain the words "round" or "loin," as in "top round" or "sirloin." Lean cuts of pork usually are loins or legs. For ham, choose lower-fat varieties or Canadian bacon, Pingleton says.
As always, go fish. Researchers are backing away from claims that eating five or six servings of fish a week—fish like salmon and tuna, which are rich in a polyunsaturated fat called omega-3 fatty acids—is any more beneficial to your heart than eating one or two servings a week. But those one or two servings will clearly protect your heart better than none at all.
"Fish isn't a magic bullet, but it is a fine choice in the grocery store. It's a healthy food, and from all we know, it is better for you than red meat," says Walter Willett, M.D., Dr.P.H., professor of epidemiology and nutrition and chairman of the Department of Nutrition at the Harvard School of Public Health and author of several classic fish-consumption studies.
Try eating fish like salmon, trout, or tuna once or twice a week in place of red meats like beef, Dr. Willett suggests.
Be a deli detective. While it is true that many deli meats and salads are loaded with fat and sodium, there are healthier varieties at supermarkets today, says Pompliano. Look for chicken breast, turkey breast, or other lean and extra-lean meats for a low-fat and low-saturated protein source. To reduce the amount of sodium on these meats, rinse the meat gently under cool water and pat dry before making a sandwich, suggests Pompliano.
If traditional deli items are too hard to resist, ask the deli clerk about lower-fat options. Some delis have fat-free or low-fat macaroni salads and potato salads, says Pompliano.
To really slash the fat that you carry away from the deli, ask the clerk to slice the meat as thin as possible, and instead of ordering it by the quarter- to half-pound, ask for only the number of slices that you think you'll eat that week, Tuttle says. That also may prevent overindulging or wasting food.
Send the oil packing. Tuna and other seafoods packed in oil just add unwanted fat to your meal. Pick water-packed tuna or seafood like clams canned in their own juices, Jones says.
Dump doughnuts, muzzle the muffins. Because half of the calories in a doughnut comes from fat and a third of the calories in a muffin comes from fat, a bagel is your best choice—it's nearly fat-free.
"A bagel is a great breakfast food. It is fast, convenient and readily available in most areas," Pompliano says.
Eat a few, but don't go nuts. Eating nuts, which are good sources of monounsaturated and polyunsaturated fats, may protect you from heart disease, according to researchers at Loma Linda University in California. These researchers, who studied the eating habits of 31,000 Seventh-Day Adventists in their fifties, sixties, and seventies, found that those who ate nuts four or more times a week had half the risk of fatal heart attacks than people who munched on them less than once a week.
But keep in mind that the fats in nuts still count toward your daily fat total, and most nuts are chock-full of calories. A cup of peanuts, for example, has about 800 calories.
"For the average person nuts can be dangerous because they're like potato chips. It's hard to just have one," Newmark says. If you're going to eat them, avoid doing it by the handful. Instead just use five or six nuts to add flavor or texture to foods like salads or frozen desserts, she says.
Eating at Home: Give Low-Fat a Personal Touch
By age 70, the average person who cooks for a family has made about 49,000 meals. Unfortunately, most household cooks also have a limited repertoire of about 14 entrée dishes, so they're feeding their families the same high-fat meals day after day, says Kerr. For a low-fat entrée to replace one of those 14—particularly after decades of cooking the same way—you need to personalize the effort.
"Go to some degree of trouble to find out what works well for you," Kerr says. "If you readdress how you prepare food and spice it the way you like it, then it is possible to make the change to low-fat living."
Stick with no-stick. No-stick cookware is worth the modest investment because it has a special coating that allows you to cook or bake without greasing it with fat, Rarback says.
"I know a woman in her sixties who has been using the same cooking pots and pans since her wedding years ago, and there have been a few innovations since then," Rarback says.
Don't drown the pans. If you normally use oil or butter to grease your pans, try dabbing a small spot—about the size of a quarter—onto a paper towel and swabbing it into the pan, Hogan says. That should cut back on the amount you use during cooking. Better yet, use fruit juice or defatted chicken broth instead.
Throw out the frying pan . . . Bake, roast, grill, microwave, or sauté foods that you would normally fry, Dr. Foreyt says. These cooking methods allow fats to run off the meats and be discarded.
. . . But not the chicken. Instead of frying chicken, remove the skin, coat it with a dusting of flour and egg white, dip it in bread or cornflake crumbs, and bake it. "It comes out remarkably well," Tribole says. "That keeps it moist and reduces the amount of fat you're eating significantly."
Be a poacher. Poaching fish in white wine, rather than frying it, trims fat and helps keep the fish flavorful and moist, Rarback says.
Bake those fries. If you crave french-fried potatoes, try this simple low-fat alternative: Cut four medium potatoes into strips, coat them with 1 tablespoon of oil by stirring in a bowl, and bake on a baking sheet in a 450°F oven for 30 to 40 minutes, turning frequently. Sprinkle with paprika or lightly with salt or salt substitute, Dr. Foreyt says.
Honey, I shrunk the meat . . . "Many people of this generation, especially men in their sixties and seventies, are used to eating 16-ounce steaks. But the real serving size that they should be eating is about 3 ounces, which is about the size of a man's palm," Somer says. "So if you eat a 16-ounce steak, you're eating more than three days' worth of meat in one serving."
Use a small amount of meat—2 to 3 ounces after cooking—to complement low-fat meals instead of letting it crowd fruits and vegetables off the plate, Pingleton says. In any case, try to limit your meat consumption to no more than 6 ounces a day, Tuttle says.
. . . And blew up the vegetables. For every bite of meat, take four bites of fruits, vegetables, beans, and grains, Somer says. It will help keep you on track for a low-fat lifestyle.
Freeze out TV dinners. Many frozen meals are loaded with fat and sodium, and in some cases take just as much time to prepare as fresh foods, Jones says. In the same 10 minutes that it takes to make fat-laden boil-in-the-bag Swedish meatballs, for instance, you could brown ground turkey breast in a skillet, add some low-fat spaghetti sauce, and pour it over pasta.
Do a macaroni makeover. To lower the fat content of packaged macaroni and cheese, add vegetables like broccoli, carrots, or cauliflower, and use low-fat or skim milk and half as much butter or margarine, Moquette-Magee says.
"Try using 1½ tablespoons of margarine or butter and 2 tablespoons of light sour cream instead of the 4 tablespoons of butter called for. It's wonderful and you won't notice the difference," she says.
Lighten up puddings. Evaporated skim milk adds body and richness to puddings, but unlike whole milk, it doesn't have any fat, Tribole says.
Ditch the yokes. If your recipe calls for whole eggs, use fat-free egg substitute instead (¼ cup substitute equals 1 whole egg). Since fat content of the substitutes varies, check the label before buying. For baking, however, using two egg whites in place of each whole egg is a better choice, because it reduces the fat yet maintains the flavor and texture of the original recipe, Rarback says.
Soak it in yogurt. Instead of oil-based marinades, try pleasant-tasting plain nonfat yogurt, Rarback says. Allow meat or skinless poultry to soak for several hours or overnight. Marinate fish for only an hour or so because of its delicate texture.
Lose 100,000 fat calories in 25 seconds. "Butter has gone the way of all flesh in our household," Kerr says. "In its place, I've been making fresh cheese from nonfat yogurt. That has actually saved me 100,000 calories a year in fat."
It takes about 25 seconds to prepare, Kerr says. Put a cheesecloth into a hand sieve and scoop in a tub of plain nonfat yogurt. Put a plate on top of the sieve and set it over a bowl in the refrigerator so that the whey can drip out.
After 12 hours it should look like thick, creamy, loosely packed cream cheese. If it tastes too sour, add a few drops of maple syrup to sweeten it, Kerr says.
Shred that cheese. Instead of putting a full slice of cheese on a sandwich, grate it or shred it. You'll use less cheese, yet get the same flavor and cut the fat in half, Rarback says.
Cook now, eat later. Once or twice a month make large quantities of low-fat soups, stews, waffles, and other favorites. Then divide them into one- or two-serving packets and store them in the freezer, Pingleton says. Then when you don't feel like cooking, you'll have a ready-made low-fat meal that you can reheat in minutes.
Kick the grease bucket. "A lot of people in this age group like to save the grease from bacon and other fatty foods in a bucket for use in cooking later. Get rid of it," Pingleton urges. That fat is mainly saturated and causes the most havoc in your body.
If you insist on using it, discard the oils that harden on top and use the liquid oil underneath, because it is less saturated, Pingleton says.
Squeeze the fat out of gravy. "People over 60 absolutely love their gravies," Pingleton says. "If you're going to make it, put the drippings in the freezer and let the saturated fat harden on top, then discard it. Use the broth underneath. It has very little fat and delivers all of the flavor you want in a gravy. Be sure to use skim or low-fat milk, too."
For quick low-fat gravy or sauce, take a can of condensed low-fat cream soup such as cream of chicken or mushroom out of your pantry and mix it with a half-can of water. Then pour the mixture over cooked meat, fish, or poultry and let it simmer for 5 to 10 minutes, Pingleton says.
Turn vinaigrette upside down. Traditional vinaigrette is made with two parts oil to one part vinegar. Flop that around: Double the vinegar and halve the oil, and you've created an exciting lower-fat salad dressing and marinade, Kerr says. Try this formula with a balsamic or Japanese rice wine vinegar and a tasty olive oil. Throw in a crushed garlic clove and dash of dry mustard and brown sugar for flavor. Whip in a blender and keep it in your refrigerator.
Back away from butter. "It's hard for a 60-plus person to get away from butter for some reason, probably because they were raised eating lots of it," Pingleton says. If you use butter, don't use it in cooking, but add a small amount—about the size of a postage stamp—after the dish is done for flavoring only. On bread or toast, spread it thinly, so that you can still see the bread fiber. If you're making a sandwich, only butter one slice of bread. Better yet, use an all-fruit spread, low-fat mayonnaise, or margarine instead, Pingleton says.
"A lot of foods will surprise you by how good they taste without butter," Tribole says. "You really won't miss it in most cases."
Dining Out: Dodging the High-Fat Temptations
"The same rules you use for eating at home apply when you eat out. You just have to be more vigilant, and you can't assume anything," Somer says. "You still want to minimize the amount of meat that you eat and focus on fruits, vegetables, and grains."
Call first. Most high-quality restaurants will accommodate you if you give them sufficient notice, Dr. Lipsenthal says. Call a day or so beforehand, explain that you're eating low-fat foods, and ask if they can fulfill some specific requests.
Take a menu with you. If you eat at a restaurant frequently, ask for a copy of the menu to take home with you, Dr. Shike suggests. That way you can study your food choices without feeling pressured to order.
At fast-food restaurants—where many foods are 40 to 55 percent fat—try salads, plain hamburgers, or grilled chicken or ask for a copy of their nutritional information so that you can make wise selections, Dr. Shike says.
Ask for it any way but fried. If a fried entrée is offered on the menu, ask if the chef can bake it, broil it, grill it, or steam it to cut down on the fat, Dr. Shike says.
Ease back on the appetizers. Many appetizers, like buffalo wings, fried zucchini, and creamed soups, are high in fat. If you want something to munch on while you wait for your entrée, ask for bread sticks, grain breads, crackers, pretzels, or fresh vegetables like carrots and celery with honey-mustard dressing (not ranch), and salads with dressings on the side, Pingleton says.
Get feisty. Ask the waiter lots of questions and don't stop until you're satisfied, Somer says. How is the fish grilled? If it is in butter, ask for it dry.
"It's your meal, you're paying for it, and within reason you should be able to get it the way you want it," Somer says. "If they say they can do something and they don't, send it back. You need to hold them to their promise."
Create a take-home portion. Ask your server to bring a doggie bag when your meal is served. That way you can cut the meal in half and put it in the bag for take-home before you take your first bite, Somer says. You'll not only have a meal for the next day, you'll slash the amount of fat and calories in each serving.
"Don't start eating until you do that, because once you start eating you'll be likely to finish it," Somer says.
Carry a restaurant survival kit. In a small sandwich bag, carry packets of low-fat dressings, herbal teas, spices, hot-pepper sauce, and other essentials that may not be readily available at the restaurant, Newmark says.
Split a meal with a friend. Order soup or salad à la carte with one entrée. It will save you money and reduce the fat in each meal, Somer says.
Get dressings on the side. Many restaurants put more than 3 tablespoons of dressing on their salads, which can add more than 16 grams of fat to those veggies, Somer says.
Always order salad dressings on the side so that you can control the portion and try to stick with oil and vinegar. It spreads more evenly than cream dressings, so you'll use less of it, she says.
Let go of the extras. Cheese, bacon, olives, eggs, and croutons add unnecessary fat to a salad. Ask your server not to add them, Bates says.
Cut back on the rich sauces. The sauce for fettuccine Alfredo is often referred to as "heart attack on a plate," Dr. Foreyt says. Avoid rich sauces on pasta, meats, or fish or ask for the sauce on the side.
Satisfy the kid within. If you want dessert, ask if you can get a child's portion, Somer says. That will cut some of the fat and still satisfy your sweet tooth.
Say ciao to meat toppings. Choose a pizza parlor that has a salad bar so that you can fill up on fresh fruits and vegetables while you're waiting for your pizza to cook, Somer says. Steer clear of pies that have lots of fatty meats like sausage or pepperoni. Try a vegetarian pizza—ask for extra veggies and skimp on the cheese—and limit yourself to two to three pieces.
Hold the mayo. Many delis use regular mayonnaise on their sandwiches. Ask if they have a low-fat substitute. If not, ask them to leave it off. If mayo is a must, ask the clerk to just wet the bread with it rather than slathering it on, Moquette-Magee suggests.
Sail clear of tartar sauce. Tartar sauce, which is served with many fish entrées, gets 96 percent of its calories from fat, Moquette-Magee says. So use it sparingly, if at all.
"If you order a fish fillet sandwich at a fast-food restaurant and scrape the tartar sauce off the bun, or ask that it not be put on in the first place, you're cutting the fat in that sandwich by 50 percent," she says.
Take a no-thank-you portion. "Years ago, if a child told his mother that he didn't want a particular food, she'd put a little on his plate anyway. It was called a no-thank-you helping. You can do the same thing now. If you are tempted by a high-fat food, ask for a no-thank-you helping—a tablespoon of it—so that you still get a taste and don't feel deprived," Hogan says.
Wash that veggie sauce away. In restaurants, ask for your vegetables steamed without added oils, butter, margarine, or creamed sauces. If the waiter tells you that the vegetables are already prepared with one of those ingredients, ask if your portion can be put in a colander and rinsed with boiling water to wash away the unwanted add-ons, says Francine Grabowski, R.D., at Cooper Hospital in Camden, New Jersey, and co-author of Low-Fat Living for Real People.
Make bacon a special treat. "People who are age 60 and up just love bacon. But just one slice of cooked bacon has approximately 3 to 5 grams of fat, and it's about 80 percent calories from fat. I tell people not to even buy it or keep it at home," Pingleton says. "If you must have it, get it at a restaurant where you're only going to be served 1 to 2 slices instead of the 10 that you would be tempted to eat at home."
Prescription for Prevention
Regularly eating foods loaded with fat can clog arteries and lead to heart disease and stroke. Excessive dietary fat also can promote the growth of cancers. Lowering the amount of fat you eat, even after age 60, can prevent or even reverse these diseases.
* Count grams. Take the average number of calories that you eat each day and multiply that by 20 percent. Then divide the resulting number by 9 (the number of fat calories in a gram). The result is the maximum number of fat calories you should eat daily.
* Read labels. Almost all foods list fat grams per serving. Study these labels carefully before buying.
* Make a grocery list. It will discourage you from impulsively buying high-fat foods.
* Leave foods that contain hydrogenated or partially hydrogenated oils on the grocery shelf.
* Buy ground turkey or chicken breast that has been processed without the skin. These are among the leanest meats that you can get.
* Fill your pantry and refrigerator with plant foods—pastas, breads, beans, cereals, grains, and fresh, frozen, or canned fruits and vegetables. Only one in four items should be a lean meat or low-fat dairy product.
* Keep low-fat snacks like grapes, dates, celery, and rice cakes handy.
* Experiment with low-fat ingredients in your favorite recipes.
* Use solid oils like shortening for cooking. Instead, reach for liquid canola or olive oils.
* Shop on an empty stomach.
* Automatically reach for nonfat foods. They may contain substances that drive up triglycerides, a type of fat that increases your risk of heart disease. A low-fat alternative may be a better choice.
* Grease your cooking pans. Use fruit juice or defatted chicken broth instead.
* Eat fried foods. They're loaded with fat. Grill, bake, broil, or steam food instead.
* Order appetizers in restaurants. Many are high in fat.