Fat simple – A nursing tool for client education

Abstract
Recent debate about “good fats” and “bad fats” has created uncertainty for nurses and clients as they struggle to make sense of the often contradictory statements in the media. This article summarises the current level of knowledge regarding dietary effects on serum cholesterol and presents the information in an eye catching table that can be used as an educational resource in heart disease prevention education. Information from a literature review was used to design a table that identifies how changes in diet and activity can alter components of a person’s lipid profile. Nurses can use the resulting table as a simple tool to give clients targeted education based on their individual cholesterol results. This tool illustrates that not all dietary recommendations to the public are beneficial to serum cholesterol levels and it also explains why popular diets such as the Atkins, Mediterranean, and glycaemic index/ load can produce more cardio-protective profiles than the traditional low fat diet. It should provide a way forward in an increasingly contentious area of practice.

Keywords
Cholesterol, coronary heart disease, diet – fat restricted, dietary education

Introduction
Much of the recent research into dietary control of serum cholesterol has suggested that the traditional low fat diet is less cardio-protective than “popular” diets, for example glycaemic load/index (Ludwig, 2002; Willett & Stampfer, 2003), Mediterranean (de Lorgeril et al., 1999; Trichopoulou & Trichopoulos, 2005) and low carbohydrate diets such as “Atkins” (Arora & McFarlane, 2005; Willett, 2004). Articles in the scientific (Taubes, 2001; Willett & Stampfer) and lay media (Burne, 2005; O’Hare, 2003a, 2003b) disseminate this message to the general public, with the result that clients are often sceptical when advised to adopt a low cholesterol diet for the management of coronary heart disease (CHD). Nurses should be able to enter into an informed discussion with clients wanting to try such “popular” diets, rather than simply dismissing the regimes as unhealthy. This article presents and demonstrates an educational tool developed from a review of research findings regarding the effects of different foods on serum lipids. The tool displays information in a simple format, so that nurses can use it to give targeted information to their clients. The tool is used to guide a brief critique of a number of popular diets and other dietary recommendations. It is hoped that readers will adopt the tool in their workplace and report their experiences and recommendations to the author.