CHAPTER 4 LIPIDS

A client asks why lowering saturated fat intake is necessary for lowering serum cholesterol levels. Which of the following is the nurse's best response? a. "Saturated fats raise the 'bad' cholesterol levels more than any other fat in the diet." b. "Sources of saturated fat also provide monounsaturated fat, and both should be limited to control blood cholesterol levels." c. "Saturated fat is high in calories, and excess calories from any source increase the risk of high blood cholesterol levels." d. "Saturated fats make blood more likely to clot, increasing the risk of heart attack."

A

Which of the following are the best sources of omega-3 fatty acids? a. Salmon and trout b. Flaxseed and walnuts c. Olive and canola oils d. Cod fish and haddock

A

The client asks if the cholesterol in shrimp is the "good" or "bad" type. Which of the following would be the nurse's best response? a. "All cholesterol is bad cholesterol." b. "Bad and good refer to how cholesterol is packaged for transport through the blood. The cholesterol in food is unpackaged and neither bad nor good." c. "Good cholesterol is found in plants; bad cholesterol is found in animal sources." d. "Shrimp has good cholesterol because it is low in saturated fat; foods high in cholesterol and saturated fat are a bad source of cholesterol."

B

The nurse knows that instructions have been effective when the client verbalizes that the sources of synthetic trans fats are a. Red meat and full-fat dairy products b. Commercial baked goods and stick margarine c. Pretzels and nuts d. Butter and lard

B

What is the primary function of fat? a. To facilitate protein metabolism b. To provide energy c. To promote the absorption of fat-soluble vitamins d. To facilitate carbohydrate metabolism

B

What should the nurse tell a client who likes fish but refuses to eat it because of fear of mercury poisoning? a. "You are justified to be concerned. To be safe, use fish oil supplements instead." b. "You can eat as much fish as you want because most fish are not contaminated with even small amounts of mercury." c. "The benefits of eating 8 oz/week of a variety of fish outweigh any potential risks from mercury." d. "As a compromise, eat 4 oz of fish per week instead of 8 oz."

C

When developing a teaching plan for a client who needs to limit saturated fat, which of the following foods would the nurse suggest the client limit? a. Seafood and poultry b. Nuts and seeds c. Olive oil and canola oil d. Red meat and full-fat dairy products

D

Which statement indicates the client understands about choosing low-fat foods from MyPlate? a. "All items within a food group have approximately the same amount of fat." b. "You don't have to consciously select low-fat items because the empty calorie allowance will account for higher fat choices." c. "It is best to eliminate as much fat from the diet as possible." d. "Within each food group, the foods lowest in fat should be chosen most often."

D

All fats are bad fats

FALSE "Good" fats—namely, polyunsaturated and monounsaturated fats—may help to lower LDL cholesterol when used in place of saturated fat. Omega-3 fish oils are also "good": they lower triglyceride levels; decrease platelet aggregation; and may decrease inflammation in rheumatoid arthritis, Crohn disease, and ulcerative colitis.

The most effective dietary strategy for lowering serum cholesterol is to limit cholesterol intake

FALSE Eating less saturated fat has a greater impact on lowering serum cholesterol than does simply limiting cholesterol intake.

Butter is healthier than margarine.

FALSE Even though some margarines contain more trans fats than butter, the combined amount of "bad" fat (saturated fat plus trans fat) is higher in butter than in margarine, even stick margarine. In addition, butter contains cholesterol; margarine generally does not.

"Fish oils" are essential in the diet.

FALSE Fish oils are not essential in the diet because the body can convert alpha- linolenic acid to EPA and DHA, although only in limited quantities. Vegetarians do not appear to suffer adverse effects from eliminating fish from their diets.

Saturated fatty acids are found only in animal products.

FALSE Saturated fatty acids are found in varying proportions in all sources of fat. A fat labeled as "saturated" has saturated fatty acids providing the biggest percentage of fat in that item. Animal products (meat and full-fat dairy items) and coconut, palm kernel, and palm oils are considered saturated fats.

In a "healthy" diet, no foods derive more than 30% of their calories from fat.

FALSE The 30% guideline refers to the total diet, not individual foods. Over the course of the day, high-fat items (e.g., canola oil, peanut butter) are balanced by low-fat and fat-free items (nonfat milk, grains, vegetables, and fruit).

Menu items described as being "cooked in vegetable oil" are trans fat free.

FALSE Vegetable oils are still vegetable oils, even when they are lightly or partially hydrogenated; therefore, the term "vegetable oil" is not synonymous with trans fat free.

Fat provides more than double the amount of calories as an equivalent amount of carbohydrate or protein.

TRUE All fats, whether saturated or unsaturated, provide 9 cal/g compared to 4 cal/g from carbohydrates and protein.

All sources of fat are a blend of saturated and unsaturated fatty acids.

TRUE All food fats are a blend of saturated, polyunsaturated, and monounsaturated fatty acids. The description of a fat as "saturated" means that there are more saturated fatty acids than polyunsaturated or monounsaturated fatty acids in that source, not that saturated fatty acids are the only fatty acids present.

The body makes two to three times more cholesterol than the typical American consumes.

TRUE Endogenous cholesterol synthesis is generally two to three times higher than the average cholesterol intake in the United States.