Page 96 - Nutrition Essentials for Nursing Practice

84 U N I T 1 Principles of Nutrition

Box 4.5 STRATEGIES FOR REDUCING SOLID FATS AND
INCREASING OILS (continued)

Increase Oils
■ Use oils instead of butter or shortening for cooking and baking.
■ Eat fatty fish twice a week.
■ Eat nuts and nut butters that are rich in monounsaturated fats: walnuts, almonds,

hazelnuts, pecans, pistachios, and pine nuts. Walnuts also contain alpha-linolenic
acid. Cashews and macadamia nuts are higher in saturated fats.
■ Sprinkle flaxseed (1–2 tbsp/day) over cereal or yogurt or use as a fat substitute in
many recipes: 3 tbsp of ground flaxseed can replace 1 tbsp of fat or oil.
■ Read the Nutrition Facts label to identify oils with the highest unsaturated fat
content.

Methyl Mercury: supplements may be considered in consult with a physician. Likewise, the American
mercury is a heavy Diabetes Association recommends two or more servings of fish per week, with the excep-
metal that occurs natu- tion of commercially fried fish filets (Bantle et al., 2008). The health risks associated
rally in the environment with eating fish contaminated with methyl mercury are outweighed by the benefits of
and is released into the consuming 8 oz of fish per week, even for women who are or may become pregnant, lac-
air through industrial tating women, and young children (USDA, USDHHS, 2010). However, these groups
pollution. It changes to are advised to avoid shark, swordfish, king mackerel, and tilefish to minimize exposure
methyl mercury when to methyl mercury. Likewise, state and local advisories should be adhered to for locally
it falls from the air into caught fish. Table 4.2 lists the amount of n-3 fatty acids and mercury in various types
the water. Almost all of seafood.
fish contain minute
amounts of methyl mer- Despite widespread recommendations to eat more fatty fish, the role of n-3 in prevent-
cury that are not harm- ing chronic disease is far from certain. Interest in n-3 fatty acids began back in the early
ful to humans. Pregnant 1970s when researchers observed that populations with a high intake of fish, such as Eski-
and lactating women mos and Japanese, have lower rates of cardiovascular disease than populations who eat less.
and children younger Omega-3 fatty acids, in particular EPA and DHA, were credited with protecting against
than age 8 years are cardiovascular disease, fatal heart attacks, and arrhythmia through their anti-inflammatory
vulnerable to the toxic and anticoagulant effects (IFICF, 2011). However, promising observations are not the
effects of mercury be- same as clinical trials. A recent meta-analysis of 20 randomized clinical trials found that n-3
cause it can damage supplementation was not associated with a lower risk of all-cause mortality, cardiac death,
the developing brain sudden death, myocardial infarction, or stroke (Rizos, Ntzani, Bika, Kostapanos, and Elisaf,
and spinal cord. 2012). A study by Quinn et al. (2010) found that compared with a placebo, supplementa-
tion with DHA did not slow the rate of cognitive and functional decline in patients with
mild to moderate Alzheimer disease.

A large randomized clinical trial, the VITAL (VITamin D and OmegA-3 TriaL)
Study, is currently under way to determine whether taking daily dietary supplements of
vitamin D or n-3 fatty acids reduces the risk for developing cancer, heart disease, and
stroke in people who do not have a prior history of these illnesses (Liebman, 2009).
Ancillary studies will also be conducted to determine whether either of these supplements
provides other benefits, such as lowering the risk for diabetes, hypertension, memory
loss or cognitive decline, autoimmune diseases, infections, asthma, depression, macular
degeneration, and others. The controversy over the role of n-3 fatty acids in maintaining
health is likely to continue.