Doctor’s Tip: Are plant-based diets healthy for kids? Part 3, Fats

This is the third weekly column in a series from the book “Nourish, The Definitive Plant-Based Nutrition Guide for Families,” by Stanford University-affiliated pediatrician Reshma Shah, MD, MPH, and dietitian Brenda Davis. Two weeks ago’s article was about carbs, last week’s article was about protein, and today’s article was about the third and final macronutrient, fat. Carbohydrates and proteins contain 4 calories per gram and fats 9, so it is the most caloric of the three.

Fats are needed at all ages for human health. However, there are healthy fats and unhealthy fats, and most Americans eat too many of them, contributing to many of the chronic diseases we suffer from and die from.

SATURATED FAT is found in all animal products – meat, including chicken, dairy products, eggs and, to a lesser extent, seafood. It is also present in tropical oils (palm and coconut) ; and in vegetable oils (canola oil contains 7% saturated fat, olive oil 15% and coconut oil more than 90%). Saturated fats raise LDL (bad) cholesterol and are linked to inflammation, diabetes, fatty liver disease, heart disease and several cancers. Current guidelines for children specify a saturated fat intake of less than 10% of total calories. For example, an average 6-year-old child consuming 1,400 calories should eat no more than 15 grams of saturated fat per day (a cup of whole milk or an ounce of cheddar cheese would provide 5 grams, two slices of pepperoni pizza 12 grams ) .



MONOUNSATURATED FATS has a neutral to slightly beneficial effect on health. Current guidelines for children state that monounsaturated fats should make up 50% of daily fat intake. Examples are olives, avocados, almonds, peanuts and seeds.

TRANS FATS (PARTIALLY HYDRODENATED) were developed to replace animal fats such as butter and lard in processed foods, but were recently banned in several countries, including the United States, after they were shown to increase disease risk heart disease, sudden death and diabetes. However, products may contain up to 0.5 mg of trans fat per serving and still declare on the food label that they are trans fat free. Many animal products also contain small amounts of natural trans fats. The National Academy of Sciences has concluded that the only safe intake of trans fat is zero.



CHOLESTEROL is a waxy fat found in cell walls and is also a building block of certain vitamins and hormones. It is found in all animal products, including seafood. Our bodies produce everything we need, and excess dietary cholesterol can raise blood cholesterol to dangerous levels.

POLYUNSATURATED FATS are healthy fats. ALA (alpha-linolenic acid) is an omega-3 fatty acid that our body converts into health-promoting EPA and DHA. Our body converts omega-6 linolenic acid into arachidonic acid, too much of which causes inflammation. The healthiest ratio of omega-6 to omega-3 is 1:1 or at most 2:1. Unfortunately, the average American, who eats a diet high in animal products and added oil, has an unhealthy ratio of 10:1 to 30:1 (too much 6, not enough 3). The building blocks for omega-3s, and therefore EPA and DHA, are green vegetables, beans (especially soy), fruits, and especially nuts and seeds (chia, hemp, ground flaxseeds) .

ENSURE HEALTHY FATS FOR CHILDREN, SHAH AND DAVIS RECOMMENDATIONS

• Breast milk is ideal for at least the first 12 months, and preferably for two years and beyond. If using formula, use a commercial formula for at least the first 12 months, then consider high-fat soy or pea milk. For dairy eaters, cow’s milk is not recommended for the first 12 months, but whole cow’s milk can be considered from 12 to 24 months, after which low-fat options are recommended.

• Eat a variety of whole, high-fat plant foods every day, such as seeds (pumpkin, sunflower, chia, hemp, flax), nuts (especially walnuts) and nut butters.

•Serve tofu, tempeh, edamame and other soy products regularly.

• Spread avocado on toast or healthy crackers; use in dips such as guacamole; add to salads, bowls and sandwiches.

• Fish is a good source of omega-3s, but contaminants like heavy metals and PCBs are a concern. Adequate amounts of omega-3s can be obtained from plant sources.

IMPORTANT TIPS: 1) Fats are damaged (oxidized) by heat, light and oxygen, resulting in a rancid taste. Especially if nuts and seeds lose their protective shell – for example ground flax seeds or shelled walnuts – they should be stored in the freezer. 2) If fats are heated above their smoking point, they become carcinogenic. 3) Shah and Davis note that “fat intakes below 20% of total calories, while effective in treating and reversing chronic disease, are generally not considered appropriate for children or adolescents”, nor to pregnant or breastfeeding women. 4) If you are concerned that your child is not getting enough EPA and DHA, consider a vegan omega-3 supplement derived from seaweed – capsules are sold at most grocery stores and a liquid option is available from the Dr. Joel Fuhrman at DrFuhrman.com. 5) Inexpensive blood tests are available to check omega-3 and omega-6 levels and ratios.

Dr. Feinsinger is a retired family physician with a special interest in the prevention and reversal of disease through nutrition. Free services offered by the Center for Prevention and the People’s Clinic include: one-hour consultations, shopping with a doctor at the Carbondale City Market, and cooking classes. Call 970-379-5718 for an appointment or email [email protected].

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