A HEALTH PROFESSIONAL’S GUIDE TO IMPROVING CONSUMER CONFIDENCE IN DIETARY FAT

GOODFATSWORKBOOK

THE

While it’s common knowledge for health experts to understand the differences in the types of dietary fats and the varying roles each plays in a healthy diet, lines become blurred when you take a closer look from the consumer point of view. Between contradicting headlines, “good” vs. “bad” designations and technical jargon that doesn’t match up to dietary recommendations, it’s understandably hard to keep it all straight. Consumers need help from trusted and knowledgeable health professionals.

In fact, when it comes to seeking advice on foods consumers should be eating, two out of three trust nutrition information from a registered dietitian.1 This workbook is designed to help you, the health professional, best guide your clients through the good and bad myths and facts about dietary fat and give clients the confidence and knowledge to make healthier food choices. Take a peek, walk through the guide with a client or share with a colleague and keep up the hard work in connecting the dots on dietary fats.

HELP YOUR CLIENTS NAVIGATE

THE FACTS ON FATS

1.IFIC2017FoodandHealthSurvey.

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WHERE DO CONSUMERS STAND?Consumers understand some, but not all, of the science-supported facts on dietary fat.2, 3

Saturated fats are, more or less, understood: Although 9% of consumers think saturated fats are healthy, more than 60% are trying to cut back on foods higher in saturated fat.

Time and again, unsaturated fats are confusing: In 2017, about 40% view unsaturated fats as healthy, and this stat is even lower for Millennials (33%). Data from 2016 also shows a barrier to consumption, with roughly one in four reporting they don’t know how to prepare foods with unsaturated fats.

Consumers are clear on omega-3: Over 71% of consumers rate omega-3 fatty acids as healthy.

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CONSUMER AWARENESS, PERCEPTIONS, ATTITUDES AND BELIEFS

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2.IFIC2017FoodandHealthSurvey.

3.IFIC2016FoodandHealthSurvey.

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AS HEALTHY

ONLY 40%OF CONSUMERSVIEW UNSATURATED FATS

40%60%

EXPERT TOOLBOX (Ask your clients)

DISCUSS DIFFERENCES BETWEEN EACH TYPE:

Polyunsaturated fat: found in plant and animal foods, such as salmon, vegetable oils and some nuts and seeds. Polyunsaturated fats include omega-3 and omega-6 fats. Strong and consistent evidence shows that replacing saturated fats with unsaturated fats, especially polyunsaturated fats, is associated with reduced blood levels of total cholesterol and of low-density lipoprotein-cholesterol (LDL-cholesterol).

Monounsaturated fat: found in plant foods, such as nuts, avocados and vegetable oils. Some evidence has shown that replacing saturated fats with plant sources of monounsaturated fats may be associated with a reduced risk of cardiovascular disease (CVD).

Saturated fat: found in the greatest amounts in coconut, palm and palm kernel oils, and in animal fats and animal-derived products. These fats are often solid at room temperature. Evidence shows that replacing saturated fats with unsaturated fats is associated with better heart-health outcomes.

Trans fat: found in some margarines, snack foods and prepared desserts. Individuals should limit intake of trans fats as much as possible by limiting foods that contain synthetic sources. A number of studies have observed an association between increased intake of trans fats and increased risk of CVD due, in part, to its LDL-cholesterol-raising effect.

WHAT WORDS OR FEELINGS COME TO MIND WHEN YOU HEAR “DIETARY FATS”?

CAN YOU NAME THE DIFFERENT TYPES OF DIETARY FATS?

WHICH FOODS DO YOU ASSOCIATE WITH EACH TYPE OF FAT?

WHICH TYPES OF FAT DO YOU CONSIDER “HEALTHY”?

HOW MUCH FAT ARE YOU CURRENTLY CONSUMING? ARE YOU TRYING TO INCREASE OR DECREASE YOUR CONSUMPTION OF ANY SPECIFIC TYPES?

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As trusted health advisors, you can help set the record straight for your clients by using an evidence-based approach. Scientific research continues to investigate the effects of foods that contain predominantly unsaturated fats, like avocados, nuts, olive oil and fish, on heart health, weight management, nutrient absorption and more. This growing body of evidence is helping us understand the role of dietary fats as part of a healthy diet.

We’ve summarized some of this research, including studies funded by the Hass Avocado Board, to help uncover the nutritional benefits of good fats for human health, particularly as it relates to fresh avocados.

STUDY: THE EFFECT OF A MODERATE-FAT DIET WITH AND WITHOUT AVOCADOS ON LIPOPROTEIN PARTICLE NUMBER, SIZE AND SUBCLASSES IN OVERWEIGHT AND OBESE ADULTS—A RANDOMIZED, CONTROLLED TRIAL.4

4.Wang,L.,Bordi,P.L.,Fleming,J.A.,Hill,A.M.,&Kris-Etherton,P.M.(2015).EffectofaModerateFatDietWithandWithoutAvocadosonLipoproteinParticleNumber,SizeandSubclassesinOverweightandObeseAdults:ARandomized,ControlledTrial.Journal of the American Heart Association, 4(1).doi:10.1161/jaha.114.001355.

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TRANSLATING THE CURRENT SCIENTIFIC EVIDENCE ON DIETARY FATS

Key takeaway: A moderate-fat diet that includes avocado may help reduce LDL cholesterol levels.

STUDY DETAILS:Who were the researchers? Pennsylvania State University (PSU).

Who were the participants? 45 healthy overweight and obese men and women.

What did they do? Researchers investigated how including one fresh avocado in a moderate-fat diet (AV) would affect cholesterol levels compared to a calorie-matched moderate-fat (MF) or low-fat (LF) diet without avocado.

What did they find? AV diet: The AV diet (compared to MF/LF diet) significantly reduced total cholesterol and LDL “bad” cholesterol levels.

LF diet: The LF diet (compared to MF/AV diets) increased triglycerides considerably and decreased HDL “good” cholesterol levels significantly more than the other diets.

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5.Wang,D.D.,Li,Y.,Chiuve,S.E.,Stampfer,M.J.,Manson,J.E.,Rimm,E.B.,Hu,F.B.,etal.(2016).AssociationofSpecificDietaryFatswithTotalandCause-SpecificMortality.JAMA Internal Medicine, 176(8),1134.doi:10.1001/jamainternmed.2016.2417.

STUDY DETAILS:Who were the researchers? Harvard University.

Who were the participants? 126,233 healthy adults (83,349 women; 42,884 men).

What did they do? Researchers investigated dietary fat intake compared with mortality rates among participants of the Nurse’s Health Study and the Health Professionals Follow-Up Study.

What did they find? Participants with the highest intakes of saturated fats and trans fats were associated with increased risk of mortality, 8% and 13%, respectively.

Participants with the highest intakes of polyunsaturated and monounsaturated fats were associated with reduced risk of mortality, 19% and 11%, respectively.

Replacing 5% of energy from saturated fats with equivalent energy from polyunsaturated and monounsaturated fats was associated with risk reductions in total mortality of 27% and 13%, respectively.

What should I keep in mind? Changes in health may result in changes in diet (reverse causation), and errors can occur with self-reported food and nutrient intake. As with all observational studies, causality cannot be established.

Where can I find more information? Read more about the science on dietary fats and consumer perception: LoveOneToday.com/DietaryFatResearch.

Download related resource: LoveOneToday.com/AvocadoADay.

Practical application: Encourage clients to swap fats in their diets to emphasize more of the unsaturated variety. Fresh avocado can be used as a sandwich spread, salad dressing substitution or a delightful dip. See links on pages 9 and 10 for recipes.

TRANSLATING THE CURRENT SCIENTIFIC EVIDENCE ON DIETARY FATS, CONT. What should I keep in mind? The MF and AV diets were matched for calories and macronutrients, but not for fiber (26 grams MF versus 35 grams AV), phytosterols, carotenoids or other bioactives. Additionally, the AV diet included a whole avocado, more than a one-third serving.

Where can I find more information? Download the scientific summary: LoveOneToday.com/PSUStudy. Download related resources: LoveOneToday.com/AvocadoADay.

Practical application: Walk through an example of a “fat swap,” where you replace some of the saturated fats found in a meal with unsaturated fats. For example, using a fresh avocado salsa on top of fresh seafood or meat instead of a butter or cream sauce. See links on pages 9 and 10 for recipes.

STUDY: ASSOCIATION OF SPECIFIC DIETARY FATS WITH TOTAL AND CAUSE-SPECIFIC MORTALITY5

Key takeaway: Replacing saturated fat and trans fat with unsaturated fat may help reduce risk of mortality.

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STUDY DETAILS:Who were the researchers? PREDIMED Trial, a multicenter trial in Spain.

Who were the participants? 7,447 men and women, aged 55–80, with a high risk for CVD. From this group, 1588 were excluded from the analysis because of irregularities in the randomization procedures.

What did they do? Researchers investigated the impact of three different diets on heart-health outcomes: a Mediterranean Diet supplemented with extra virgin olive oil (MedDiet EVOO), a Mediterranean Diet supplemented with mixed nuts (MedDiet Nuts) and a low-fat control diet (Control), which participants followed for nearly five years.

What did they find? The incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.

6.Estruch,R.(2018).PrimaryPreventionofCardiovascularDiseasewithaMediterraneanDietSupplementedwithExtra-VirginOliveOilorNuts.New England Journal of Medicine,378(25).doi:10.1056/nejmoa1800389.

TRANSLATING THE CURRENT SCIENTIFIC EVIDENCE ON DIETARY FATS, CONT. STUDY: PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE WITH A MEDITERRANEAN DIET6

Key takeaway: Dietary patterns that are high in monounsaturated fat, like the Mediterranean Diet, can be associated with positive cardiovascular health outcomes.

What should I keep in mind? These findings cannot be generalized to a healthy U.S. population (those with lower cardiac risk), but they do provide strong support for the heart-health benefits of diets emphasizing monounsaturated fats, like the Mediterranean Diet.

Where can I find more information? Download the related resource at LoveOneToday.com/MediterraneanDiet.

Practical application: Although they are not native to Mediterranean countries, fresh avocados fit right in with a healthy Mediterranean-style eating pattern. Help your clients identify ways they can make their diets more Mediterranean, whether that means shifting to more plant-based proteins, adding avocado in place of saturated-fat-laden dips or spreads or choosing to cook with olive oil. See links on pages 9 and 10 for recipes.

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Key messages for clients:

• Not all fats are “bad.” There are “good” monounsaturated and polyunsaturated fats that have been shown to support healthy cholesterol levels and reduce the risk of cardiovascular disease. The Dietary Guidelines for Americans (DGA) and the American Heart Association (AHA) recommend replacing “bad” saturated fats with “good” mono- and polyunsaturated varieties. Sources of good fat include extra virgin olive oil, nuts, fatty fish and avocados.

• Avocados are one of the only fresh fruits that provide “good” unsaturated fats to the diet. And as part of their unique package, they also provide a good source of fiber per one-third serving, which can help you feel fuller longer.

ASK YOUR CLIENT: DID YOU KNOW SOME FAT-CONTAINING FOODS ARE HEART HEALTHY?_________________________________________________________________________________________________________________________

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REASSURE YOUR CLIENT: JUST BECAUSE A FOOD CONTAINS FAT DOES NOT NECESSARILY MEAN IT WILL CAUSE WEIGHT GAIN. ILLUSTRATE WITH EXAMPLES FROM RESEARCH._________________________________________________________________________________________________________________________

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EMPOWER YOUR CLIENT: THERE ARE MANY SIMPLE, DELICIOUS AND NUTRITIOUS “GOOD” FAT FOOD OPTIONS THAT YOU CAN INCORPORATE INTO YOUR DIET. PROVIDE SPECIFIC FOOD EXAMPLES AND INGREDIENT SWAP IDEAS._________________________________________________________________________________________________________________________

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EXPERT TOOLBOX (Summarize the research and ask your clients)

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MAKING SMART SHIFTS FOR HEALTHIER DIETARY PATTERNS

Savory Turkey Torta with Spicy Avocado Salsa LoveOneToday.com/HC-Turkey-Torta

Oven Roasted Salmon with Citrus Salsa LoveOneToday.com/HC-Citrus-Salmon

Kale Avocado Salad with Roasted Carrots LoveOneToday.com/HC-Kale-Salad

Avocado and Mango Kick-Starter Smoothie LoveOneToday.com/HC-Mango-Smoothie

LoveOneToday.com/HealthyUSDiet LoveOneToday.com/MediterraneanDietLoveOneToday.com/VegetarianDiet

Add avocados for a breakfast double bonus: you’ll get fresh fiber from the fruit to help you stay full + powerful protein from eggs.

BREAKFASTAvocado Shakshuka+ 1 slice whole-wheat toast with blueberries

A dish full of textures: creamy, crunchy and chewy. Blend avocados with Greek yogurt for bright color and heart-smart monounsaturated fats.

LUNCHGrilled Chicken Flatbread with Avocado Yogurt + sweet potato fries and apple

A Mediterranean medley: fresh avocado, salmon and citrus. Need we say more? This dish packs a nutritious punch with monounsaturated fat, omega-3s, lean protein and potassium!

DINNEROven-Roasted Salmonwith Avocado Citrus Salsa + corn, brown rice and snap peas

One of three healthy eating patterns to meet

nutrient Dietary Guidelines for Americans

(DGA) standards, the Healthy Mediterranean-

Style is reflective of the eating patterns

associated with positive health outcomes in

scientific studies and emphasizes fruits and

vegetables, whole grains and good fats from

nuts, fish and olive oil, with small amounts of

meat and dairy. The diet also recommends

seasoning foods with herbs and spices,

rather than salt, and savoring small amounts

of polyphenol-containing treats like dark

chocolate and red wine.

Although they are not native to Mediterranean

countries, fresh avocados fit right in with a

Healthy Mediterranean-Style Eating Pattern.

One serving of avocado, one-third of the fresh

fruit, contains 5 grams of monounsaturated

fatty acids (MUFA), a hallmark nutrient of

Mediterranean eating that can help the body

absorb fat-soluble nutrients such as vitamins

A, D, K and E.

Here are four easy ways to make your plate more Mediterranean with avocados.

Swap mayo in a traditional tuna salad for fresh avocado to help reduce your intake of saturated fat, calories and cholesterol. Grapes + dark chocolate welcome polyphenols for an antioxidant boost in this PM snack.

SNACKMayo-Free AvocadoTuna Salad + grapes and dark chocolate

PER SERVING(1/3 OF A MEDIUM AVOCADO)

FRESH AVOCADOSCONTRIBUTE SIX GRAMS OF

NATURALLY GOOD FATS, A GOOD SOURCE

OF FIBERESSENTIALVITAMINS + MINERALSTO THE DIET, MAKING THEM AHEALTHY, NUTRIENT-RICH & VERSATILE FOOD CHOICE TO INCLUDE IN THE HEALTHY MEDITERRANEAN-STYLE EATING PATTERN.

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These are some of the key dietary recommendations outlined by the DGA; the Physical Activity Guidelines for Americans should also be met in order to achieve an overall healthy lifestyle.

Is this meal plan on track with the DGA? When included in a 2,000-calorie diet, the meal plan above meets DGA recommendations of:

< 10% saturated fat< 10% added sugars

< 2,300 mg sodiumFiber DV (28g)

Protein DV (50g)Majority of fat is good fat.

Add good fat and fiber to your breakfast bowl. Fresh avocado makes this plant-packed breakfast shine and gives you the staying power you need to conquer the day.

BREAKFASTSmoky Avocado QuinoaBreakfast Bowl+ 1 egg and 1 apple

No need for creamy dressings when you have satisfying avocado. This salad covers all nutrition bases: good fats, veggies and protein. Sprinkle with a dash of Parmesan cheese because you deserve it.

LUNCHKale Avocado Saladwith Roasted Carrots + whole-wheat pita, hummus and sliced pineapple

Veggies take center stage tonight, and adding avocado makes it all come together with that creamy, refreshing bite. Plus, good fats (like those in avocados) can help your body absorb the fat-soluble nutrients found in fresh fruits and veggies.

DINNERAvocado Bibimbap+ egg and brown rice

One of three healthy eating patterns

recognized to meet nutrient and Dietary

Guidelines for Americans (DGA) standards,

the Healthy Vegetarian-Style is adapted

from the Healthy U.S.-Style Plan, modifying

amounts recommended from some food

groups to meet the nutritional needs of

vegetarians. The plan is typically higher in

fiber and incorporates more plant-based

proteins and whole grains, while eliminating

meat, poultry and seafood.

A typical day includes a variety of fresh

fruits and vegetables, whole grains, fat-free

or low-fat dairy, eggs and a variety of

plant-based proteins, including soy products,

legumes, nuts and seeds.

Fresh avocados are a vegetarian-friendly

food choice to include in this healthy eating

pattern. According to the DGA, eating a

variety of fruits and vegetables, like healthy

avocados, is associated with a reduced risk

of many chronic diseases, including heart

disease, and may be protective against

certain types of cancers.

Here are four easy ways to add avocados to your plant-based plate.

Oh my pudding! Fresh avocado comes in for the smart swap to make your sweet treat a nutritious one, too. Swapping in avocados may help reduce your intake of extra calories, saturated fat and cholesterol!

SNACKVegan AvocadoChocolate Chia Pudding + banana and chopped pistachiosPER SERVING

(1/3 OF A MEDIUM AVOCADO)

FRESH AVOCADOSCONTRIBUTE SIX GRAMS OF

NATURALLY GOOD FATS, A GOOD SOURCE

OF FIBERESSENTIALVITAMINS + MINERALSTO THE DIET, MAKING THEM AHEALTHY, NUTRIENT-RICH & VERSATILE FOOD CHOICE TO INCLUDE IN THE HEALTHY VEGETARIAN-STYLE EATING PATTERN.

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These are some of the key dietary recommendations outlined by the DGA; the Physical Activity Guidelines for Americans should also be met in order to achieve an overall healthy lifestyle.

Is this meal plan on track with the DGA? When included in a 2,000-calorie diet, the meal plan above meets DGA recommendations of:

< 10% saturated fat< 10% added sugars

< 2,300 mg sodiumFiber DV (28g)

Protein DV (50g)Majority of fat is good fat.

Add creaminess and fiber to your morning smoothie with avocados! One-third of an avocado provides a good source of fiber. Fiber can help you stay fuller longer.

BREAKFASTThe Ultimate HassAvocado Smoothie+ 2 slices of whole-wheat toast

Swap mayo and other saturated fat-laden spreads for creamy fresh avocado. Spread on this tasty sandwich for a combo of lean protein, fresh veggies and delicious satisfaction.

LUNCHSavory Turkey Torta with Spicy Avocado Salsa + baked sweet potato fries

Think before you dip: Good fats, like the kind found in fresh avocados, can help the absorption of vitamins found in other fresh fruits and veggies.

SNACKSmoky Avocado Spread+ bell pepper, carrot and pita chips

Leaner sources of protein = shrimp + beans. Adding avocado ensures a creamy, refreshing bite with good fats and fiber.

DINNERAvocado Shrimp Tacos+ strawberries

These are some of the key dietary recommendations outlined by the DGA; the Physical Activity Guidelines for Americans should also be met in order to achieve an overall healthy lifestyle.

One of three healthy eating patterns

recognized to meet nutrient and Dietary

Guidelines for Americans (DGA) standards,

the Healthy U.S.-Style is based on a

traditional American diet, but focuses on

the selection of more nutrient-dense food

options in proper amounts. It is designed

to help fill the nutrient gaps where most

Americans fall short while also limiting

nutrients that are often overconsumed.

A typical day includes a variety of fruits

and veggies, whole grains, fat-free or

low-fat dairy, a variety of protein foods,

including seafood, lean meats and poultry,

eggs, nuts and seeds, and oils. A healthy

eating pattern also limits saturated fats,

added sugars and sodium.

Here are four easy ways to add avocados to your everyday favorites.

PER SERVING(1/3 OF A MEDIUM AVOCADO)

FRESH AVOCADOSCONTRIBUTE SIX GRAMS OF

NATURALLY GOOD FATS, A GOOD SOURCE

OF FIBERESSENTIALVITAMINS + MINERALSTO THE DIET, MAKING THEM A

HEALTHY, NUTRIENT-RICH & VERSATILE FOOD CHOICE TO INCLUDE IN THE HEALTHY U.S.-STYLE EATING PATTERN.

AND NEARLY TWENTY

Is this meal plan on track with the DGA? When included in a 2,000-calorie diet, the meal plan above meets DGA recommendations of:

< 10% saturated fat< 10% added sugars

< 2,300 mg sodiumFiber DV (28g)

Protein DV (50g)Majority of fat is good fat.

Dietary fat plays a vital role in the diet. We’ve outlined only a small subset of the body of evidence exploring the impact of unsaturated fats in the diet and the potential benefits to be gained from including fresh avocados as part of a healthy eating plan. However, special attention must be given to the type and quantity of dietary fat consumed, and consumer confusion in this area represents an opportunity for health professionals to close the knowledge gap.

ENGAGE: Ask your client to list 10 foods containing fats. Then take it a step further and ask which foods in the list are known for their “good” unsaturated fats and how they would use them in place of saturated fats.

If your client needs help, use the list below to get the conversation going:

Nuts or nut butter: predominantly unsaturated fats; use as a dip or spread.

Fresh avocados: predominantly unsaturated fats; use as a dip or spread, smoothie ingredient or baking substitute.

Olive oil: predominantly unsaturated fats; use to sauté vegetables or dress salads.

Homemade cookies or cakes: predominantly saturated fats; substitute the butter 1:1 for avocado to reduce the saturated fat and boost the unsaturated fat.

ENJOY: Prepare our easy-to-follow Heart-Check certified recipes.

EDUCATE: Share client-ready resources like the Hass Avocado Board’s Healthy Meal Patterns handouts and the American Heart Association’s “Four Ways to Get Good Fats” infographic.

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RECIPE INSPIRATIONCook up something delicious at LoveOneToday.com/recipes.

NUTRITION INSPIRATIONBrowse common client questions about fat, nutrition and weight management at LoveOneToday.com/Nutrition.

NUTRITION MATERIALS TOOLKITDownload and print free educational handouts for you and your clients at LoveOneToday.com/HPResources.

AVOCADO GOODNESS COMMUNITYGet helpful tips from our Avocado Goodness experts, and sign up for our health professional e-newsletter for even more avocado goodness delivered straight to your inbox at LoveOneToday.com/Avocado-Goodness.

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RESOURCES

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naturally good fats cholesterol free

Patient Education Tips and Recipes

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©2017 Hass Avocado Board. All rights reserved.

Color & Texture

Not Ripe Days to Ripe: 4–5

Almost Ripe Days to Ripe: 1–2

Ready to Eat Days to Ripe: 0

Past Ripe

Place the avocado in the palm of your hand and squeeze lightly to avoid bruising. If the avocado yields to gentle pressure, you know it’s ripe and ready-to-eat. If not, then the avocado will be ripe in 2–3 days. If the avocado feels mushy, it may be overripe.

Color alone doesn't determine ripeness, but darker avocados may be riper than ones with lighter skin. Large indentations are signs that the fruit has been bruised and shouldn't be purchased.

Firmness

FIRM BREAKING RIPE OVERRIPE

How to pick the best fresh avocado

Unripe, firm or green fruit can take 4–5 days to ripen at room temperature. To speed up the ripening process, place avocados in a brown paper bag with an apple or banana.

To slow down the avocado ripening process, place ripe and ready to eat avocados uncut in the refrigerator. They will last 2–3 days.

Sprinkle cut, mashed or sliced avocados with lemon or lime juice. Store in the refrigerator in an air-tight container or tightly covered with plastic wrap.

Add lemon juice, lime juice or vinegar to help prevent browning. Place guacamole in an air-tight container, then press clear plastic wrap directly on the surface and cover with a lid. Store in the refrigerator.

TIP: If refrigerated guacamole or cut avocados turn brown during storage, discard the top oxidized layer and enjoy the rest.

Unripe Avocados Whole Ripe Avocados Cut Avocados Guacamole

How to store fresh avocados

Avocado 101How to pick, store and prepare fresh avocados.

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