DAIRY PRODUCTS.

All dairy products must be non-fat or contain no more than 1 gram of saturated fat per serving. The recommended daily amount is two (2) servings. (1 cup = 1 serving) The following foods are permissible in any amount: Non-fat milk or skimmed milk Evaporated skimmed milk Powdered skimmed milk Non-fat buttermilk (without butter bits added) Non-fat or dry curd cottage cheese Fat-free cheese Non-fat sour cream Non-fat yogurt Non-fat ice cream Butter Buds Molly McButter Cooking sprays

Products to be avoided are as follows: Margarine Butter Shortening Lard Cocoa butter Coconut oil Palm oil Hydrogenated oil

Imitation dairy products

EGGS. The white of the egg contains no fat. The yolk contains 5 grams of mostly saturated fat. You are allowed three eggs per week, but no more than one per serving. One complete egg = 5 grams of saturated fat. It is not necessary to count the small amount of fat or oil found in the grains, cereals, rice and pastas in your diet. The recommended daily amount is four (4) servings. GRAINS & CEREALS. You are encouraged to use whole-grain products as much as possible. Refined, un-enriched products provide very little, if any, vitamin source. All bread products are permissible. This includes white bread, whole wheat bread, sourdough bread, English muffins, bagels and all the other grain breads available. The natural grains provide bulk in the diet and aid in elimination. Although these products may contain a small amount of saturated fat, it has been accounted for in the body of the diet. Avoid items such as muffins containing an undesirable oil, pastry, cakes, pies or any other product made with hydrogenated palm or coconut oil, lard, butter, margarine, shortening or vegetable oil that is not defined. Cold and hot cereals are permissible on the diet. The most economical are usually the ones with the least amount of saturated fat. Cheerios, shredded wheat, Wheaties, puffed rice and Grape Nuts are almost fat-free and less expensive. Watch granola; it is usually high in fat. All hot cereals are permissible, e.g., Cream of Wheat, Cream of Rice, oatmeal, cornmeal and any other rich grain used for cereal. PASTA & RICE. Refined pastas and rice are permissible in any amount, but whole grain pastas are preferred.

CRACKERS. Snack crackers containing no shortening, butter, margarine or processed oils are permissible. Rye-Krisp, melba toast, matzo bread, non-fat saltines, fat-free graham crackers and non-fat tortilla chips are acceptable snacks. Avoid all commercially prepared chips and fancy crackers. PASTRY. Commercially-prepared pastry usually contains shortening, butter, margarine and/or processed oil. Therefore, you should avoid these foods. Angel food cake does not contain egg yolks or shortening and can be used as an acceptable dessert. COMMERCIALLY PREPARED FOOD. Any boxed or canned food containing processed oil (hydrogenated), shortening or butter and exceeding 1 gram of saturated fat per serving is to be avoided. Some acceptable products are available. Read labels and be sure to check serving size.

CONDIMENTS. With the exception of mayonnaise, condiments such as mustard, catsup, relish, barbeque sauces, taco sauces, sweet & sour sauces, herbs and spices are permissible in any amount. Mayonnaise contains unsaturated fatty acids (oil) and must be counted in your daily oil allotment. 2 tsp. mayonnaise or salad dressing, commercial = 1 tsp. oil 1 tsp. mayonnaise, homemade = 1 tsp. oil 1 Tbsp. "fat-free" mayonnaise = 1 tsp. oil Fat-free salad dressings = zero (0) fat and oil BEVERAGES. Caffeine. Caffeine-containing products increase nervousness and insomnia, as well as frequency and urgency to urinate. Therefore, it is necessary to limit these beverages to a maximum of 3 cups daily (can be combined). If an increase in symptoms occurs, do not consume caffeine. Example: 1 cup coffee + 1 cup tea + 1 cup cola = 3 cups daily total. 3 cups coffee or 3 cups tea or 3 cups cola = 3 cups daily total.

In whatever way you decide to combine your caffeine, the daily amount must not exceed 3 cups. Alcohol. Most patients tend to be sensitive to alcoholic beverages. A glass of wine or a cocktail with the evening meal is permissible. NUTS AND SEEDS. Nuts and seeds are good sources of natural oils as well as essential fatty acids. Commercial nut butters that are not hydrogenated or that you grind yourself at the health food store, also contain good sources of oil. Daily snacks of these foods help to maintain a good energy level. The following list is to be used to count your daily intake of oil: 2 tsp. peanut butter or other nut butters (old-fashioned, non-hydrogenated) = 1 tsp. oil 1/2 oz. (about 10) peanuts, almonds or cashews = 1 tsp. oil 1/3 oz. (about 10) any other kind of nuts (walnut and pecan halves, filberts, hazelnuts) = 1 tsp. oil 3 tsp. sunflower seeds = 1 tsp. oil 3 tsp. pumpkin kernels = 1 tsp. oil 1/3 oz. Energy Snack Mix = 1 tsp. oil (mix together almonds, walnuts, hazelnuts, pumpkin seeds, sunflower seeds and sesame seeds)

FRUITS. Recommended amount is two (2) fruits daily. All fruits are permissible in any amount. Fresh fruits are preferred since they contain the most nutrients, followed by frozen and then canned fruits. The following fruits contain unsaturated fatty acids and must be counted in the daily oil allotment: Avocados. 1/8 = 1 tsp. of unsaturated fat (oil) = 5 grams Olives. 3 medium black = 1 tsp. of unsaturated fat (oil) = 5 grams Olives. 6 medium green = 1 tsp. of unsaturated fat (oil) = 5 grams

VEGETABLES. Recommended amount is 2 cups daily. 1 cup = 1 serving. Vegetables provide the body with vitamins and minerals and are rich in essential fatty acids. You are encouraged to include a variety of vegetables in your daily diet.

POULTRY. The average serving is four (4) ounces. Skinned, trimmed white chicken or turkey meat is permissible. Avoid processed meat products such as ground turkey and chicken, which may contain dark meat, skin and fat; luncheon meats made from pressed turkey and chicken; and canned turkey and chicken products. For ground turkey and chicken breast, grind it yourself or ask your butcher to prepare and grind it for you when the grinder is clean. This may cost a bit more. FISH. All white fish is permissible in any amount: Cod, abalone, halibut, snapper, smelt, flounder, sole, sturgeon, tuna canned in water, shark, mahi mahi, haddock, perch, pollack, etc. All shellfish is permissible in any amount: Clams, crab, lobster, oysters, scallops, shrimp. (For those patients with elevated cholesterol levels, shellfish should be eaten infrequently.) Fatty fish contains unsaturated fatty acids and must be counted in your daily oil allowance. You are allowed 50 grams (10 tsp.) per day. Tuna, canned in oil -- 2 oz. = 1 tsp. oil (5 grams) Tuna, canned in oil, rinsed & drained -- 3 oz. = 1 tsp. oil (5 grams) Salmon, Chinook -- 1 oz. = 1 tsp. oil (5 grams)

Salmon, Coho -- 2 oz. = 1 tsp. oil (5 grams) Trout -- 2 oz. = 1 tsp. oil (5 grams) Sardines, canned in oil -- 1 oz. = 1 tsp. oil (5 grams) Herring -- 1 oz. = 1 tsp. oil (5 grams)

RED MEATS. During the first year on the diet, red meat is not allowed, including pork. Of the following low-fat meats, 3 oz. = 1 tsp. saturated fat. You are allowed 3 ounces (weighed after cooking) following the first year. Low-Fat Meats Lamb (leg) Liver (chicken, turkey, beef, calf, pork) Kidney (pork, veal, lamb) Heart (calf, beef - lean portion only) Tongue (calf only) Rabbit Venison Elk Gizzard (chicken)

2 ounces of the following medium-fat meats = 1 tsp. saturated fat. You are allowed 3 ounces following the first year. Medium-Fat Meats Beef (lean only) Ham (lean only) Lamb (rib, loin, shoulder) Pork (lean only) Veal

Chicken (dark meat, no skin) Turkey (dark meat, no skin) Pheasant (no skin) Squab (no skin) Heart (lamb, chicken, turkey) Kidney (beef) Tongue (beef) Gizzard (turkey)

VITAMIN SUPPLEMENTS The following vitamin supplements are recommended: 1 tsp. cod liver oil or 4 capsules (equals 5 grams oil to be counted in your daily allotment). Cod liver oil contains highly unsaturated fatty acids and will give you more energy. It also aids in reducing the number of colds and flu you may have. Cod liver oil is high in vitamins A and D. Additional A and D should be restricted to only one therapeutic multiple vitamin and mineral capsule per day (not mega doses). 1 multiple vitamin with minerals (see #1 above). 1,000 mg. vitamin C 400 IU vitamin E

FATS. The main energy-providing components of food are protein, fat, carbohydrate and alcohol. Of these, weight for weight, fats provide the most energy at 9 calories per gram, compared to 4 calories per gram in carbohydrates and proteins. There are two types of fats: saturated and unsaturated (fats and oils). Fats are broken down in the body to form three kinds of fatty acids as follows: saturated fatty acids monounsaturated fatty acids polyunsaturated fatty acids.

SATURATED FATTY ACIDS. Saturated fats are those lipids containing mainly saturated fatty acids found in animal fat, processed (hydrogenated) vegetable oils, coconut and palm oils. Saturated or animal fats are solid or hard at room or refrigerator temperatures.

POLYUNSATURATED FATTY ACIDS. Both vegetable and animal products contain polyunsaturated fatty acids. Abundant sources are sunflower, safflower, rapeseed (canola), corn and soybean oils. Salmon and trout are meat sources. MONO-UNSATURATED FATTY ACIDS. These are found mainly in vegetable oils and nuts. Olive oil is an excellent source of this fatty acid. HYDROGENATION. When reading labels you will become familiar with this term. Polyunsaturated fats do not resist spoilage. When exposed to the air they begin to oxidize and become rancid. Chemically, unsaturated fats contain many double bonds. The process of hydrogenation adds hydrogen to reduce the number of double bonds, thereby making the oil saturated (solid) and more resistant to oxidation. This extends the shelf life of the product. "Non-fat" products may contain as much as 5 grams of saturated fat! When eating socalled non-fat products, count each serving as 1 gram of saturated fat. Your diet will consist of no more than 3 teaspoons (15 grams) of saturated fat per day. Your diet should contain a minimum of 4 teaspoons (20 grams) unsaturated fat (oil) and must not exceed 10 teaspoons (50 grams) daily. (5 grams = 1 tsp.) FATS AND OILS. Essential fatty acids are necessary nutrients in the diet. Because of the reduced consumption of saturated fat, it is suggested that you increase the consumption of unsaturated fats (oils). Essential fatty acids are necessary for the function of the nervous system. The body is able to synthesize most of the fatty acids needed for growth but must rely on necessary food sources for small amounts of polyunsaturated fatty acids known as Essential Fatty Acids. Fats and oils are a concentrated source of energy; each gram of fat or oil (9 calories per gram) supplies twice as much energy as protein or carbohydrate (4 calories per gram). On a low-fat diet, you may notice drying of your skin and hair, and easy fatigability, if your intake of unsaturated fat (oil) per day is limited. Your lifestyle will dictate the amount of unsaturated fatty acids necessary in your diet. If you are working and exercising, you may need to increase your oil. If you are sedentary, 4 teaspoons (20 grams) per day will usually be sufficient. The following oils may be used in your diet: sunflower seed olive

safflower sesame seed rapeseed (canola) cottonseed linseed soybean peanut flax seed

RULES FOR OIL. Do not reuse oil when cooking. Always refrigerate oil after opening to avoid rancidity (except olive oil). Keep olive oil in a cool, dark place (do not refrigerate). Do not heat oil to the smoking point. Count oil used in cooking in your daily oil allowance. Three (3) teaspoons of oil = one (1) tablespoon. Sixteen (16) tablespoons of oil = one (1) cup. If an oil clouds or hardens at refrigerator temperature, do not use. (Olive oil is the exception to this rule.)