FAT-CONTROLLED DIET
(50 Grams)

Description
Omitting and/or limiting fat-containing foods restricts the total amount of fat in the diet. The type of fat is not considered.

Indications
A fat-controlled diet is indicated for individuals who are unable to properly digest, metabolize, and absorb fat. Common diseases of the hepatobiliary tract, pancreas, intestinal mucosa, and lymphatic system impair fat digestion, metabolism, and absorption (1-5). A low fat-diet may also be useful in the treatment of patients with gastroesophageal reflux (4,6).

Contraindications
In pancreatic insufficiency, enzyme preparations remain the primary treatment for steatorrhea. As normal a diet as possible is encouraged to increase the likelihood that a nutritionally adequate diet will be consumed (5,7,8). The diet should restrict fat only to the individual’s tolerance level.

The treatment of choice for gallstones at the present time, where indicated, is surgery. There is no reason in the postoperative period to restrict or modify fat intake in any way.

Nutritional Adequacy
The Fat-Controlled Diet can be planned to meet the Dietary Reference Intakes (DRIs) for all nutrients as outlined in the Statement on Nutritional Adequacy. Vitamin E intake will be lower than in a regular diet. However, the requirement for vitamin E is proportional to the intake of polyunsaturated fatty acids, which will also be reduced in a Fat-Controlled Diet.

Ordering the Diet

Order as “Low-Fat Diet” or “50-Gram-Fat Diet” can be ordered (this is sufficiently restricted for many indications).
Other levels of fat restriction can be specified, eg, 25 to 35 g fat diet.
If a cholesterol restriction is desired, the diet ordered should be “Therapeutic Lifestyle Changes Diet” in Medical Nutrition Therapy for Disorders of Lipid Metabolism.

FOOD GUIDE – FAT-CONTROLLED DIET
FOOD GROUP	FOODS ALLOWED	FOODS EXCLUDED
Beverages and Milk	Coffee, tea, carbonated drinks, fat-free milk or buttermilk, evaporated skim, nonfat dry milk, skim or low-fat yogurt	Whole, reduced-fat, evaporated, condensed, or chocolate milk, yogurt made from whole milk, cocoa mixes
Breads, Cereals and Grains	Whole-grain or enriched breads, dinner rolls, cereals and grains, pasta, plain crackers	Quick breads such as muffins, biscuits, rich or sweet rolls, doughnuts, pancakes, waffles, party crackers, potato chips, granola unless calculated into diet
Meat, Fish, Poultry, Cheese, Eggs (average 3 to 5 g fat/oz) (limit intake to 5 oz/day)	Lean meat (trimmed of visible fat), fish, and fowl (without skin). The following are equal to 1 oz meat: 1 egg, ¼ cup tuna, salmon (water-packed), or cottage cheese. The following low-fat cheeses are allowed (one serving per day): 1oz low fat or fat free milk cheeses (sapsago, mozzarella, farmer’s) or ¼ cup 1% cottage or ricotta cheese	Fried or fatty meats, such as luncheon meats, cured and processed meats, other cheeses

Vegetables	Any prepared without fat.	Vegetables in cream sauces or gravies, fried vegetables including potatoes
Fruits and Juices	All	None
Fats (limit intake to 5 tsp/day; use no more than 2 servings/meal) (Average: 1 tsp fat = 5 g fat)	Butter, margarine, vegetable oil, crisp bacon (1 strip = 1 tsp fat)	Cream, avocado, nuts, coconut, olives, peanut butter
Soup	Any soups made with fat free milk or fat free broth	Commercially canned soups, cream soups, soups containing fat or whole milk
Desserts	Fruit, sherbet, sorbet, fat-free frozen desserts, gelatin, angel food/sponge cake, low fat cookies (gingersnaps, vanilla wafers), fat-free cakes, puddings made with fat free milk, meringues	Ice milk, ice cream, pie, cake, cookies, pastries, any desserts made with shortening, chocolate, cream, nuts, or fat
Sweets	Sugar, jelly, honey, syrups with no fats, molasses, plain marshmallows, hard candy	Any containing chocolate, nuts, cream, coconut, butter-flavored or fudge syrup
Miscellaneous	Vinegar, low-calorie or fat-free dressings, cocoa or carob powder, herbs and spices, salt, pepper, Butter Buds®	Chocolate, coconut, gravy

SAMPLE MENU
Breakfast	Noon	Evening
Orange juice Cream of wheat Scrambled egg Wheat toast Margarine Jelly Fat free milk Coffee Sugar	Honey glazed chicken (skinless) Baked potato/margarine Steamed broccoli Fruited gelatin Dinner roll Margarine Sherbet Iced Tea Sugar	Lean beef tips and noodles Seasoned green beans Sliced tomato salad Fat-free French dressing Peach halves Dinner roll Margarine Fat free milk Iced tea Sugar

References

Gastrointestinal Disease/Gallbladder. In: American Dietetic Association Nutrition Care Manual. Chicago: Ill: American Dietetic Association; 2007. Available at: nutritioncaremanual.org. Accessed January 6, 2007.
Burch JM. Acute pancreatitis. In: Rakel RE, ed. Conn’s Current Therapy. Philadelphia: WB Saunders Co; 1993:502-506.
Chak A, Banwell JG. Malabsorption syndromes. In: Rakel RE, ed. Conn’s Current Therapy. Philadelphia: WB Saunders Co; 1993:496-502.
Dwyer JT, Roy J. Diet therapy. In: Isselbacher KJ, Braunwald E, et al, eds. Harrison’s Principles of Internal Medicine. 12th ed. New York, NY: McGraw-Hill, Inc; 1991:420-427.
Marotta RB, Floch MH. Dietary therapy of steatorrhea. Gastroenterol Clin N Am. 1989; 18:485-512.
Goyal RK. Diseases of the esophagus. In: Isselbacher KJ, Braunwald E, et al, eds. Harrison’s Principles of Internal Medicine. 13th ed. New York, NY: McGraw-Hill, Inc; 1992:1503-1515.
Brady MS, Rickard K, Yu PL, Eigen H. Effectiveness of enteric coated pancreatic enzymes given before meals in reducing steatorrhea in children with cystic fibrosis. J Am Diet Assoc. 1992;92:813-817.
Bone R. Cystic fibrosis. In: Wyngaarden JB, Smith LH, Bennett JC, eds. Cecil Textbook of Medicine. 19th ed. Philadelphia: WB Saunders Co; 1992;418-421.

Ordering the Diet

FOOD GUIDE – FAT-CONTROLLED DIET

FOODS ALLOWED

FOODS EXCLUDED

Beverages and Milk

SAMPLE MENU