Step I & Step II Diet

This diet consists of 500-1000 Kcal/day reduction from usual intake. Please note every gram of carbohydrate or protein produces 4 Kilocalories and each gram of fat makes up 9 Kilocalories.  The daily intake of different nutrient is as follows:

Step I:

Total Fat: 30% or less of the total calories
Saturated fat: 8-10% of the total calories
Monounsaturated fat: Up to 15% of the total calories
Polyunsaturated fat : Up to 10% of the total calories
Cholesterol: < 300 mg a day
Protein: 15% of the total calories
Carbohydrates: 55% of the total calories
Sodium: no more than 2.4 grams( equals to maximum of 6 grams of table salt)
Calcium: 1000-1500 mg total
Fiber: 20-30 grams a day
Multivitamin: once a day

Step II:

Total Fat: 25% or less of the total calories
Saturated fat: <7% of the total calories
Monounsaturated fat: Up to 15% of the total calories
Polyunsaturated fat : Up to 10% of the total calories
Cholesterol: <200 mg a day
Protein: 15% of the total calories
Carbohydrates: 55% of the total calories
Sodium: no more than 2.4 grams( equals to maximum of 6 grams of table salt)
Calcium: 1000-1500 mg total
Fiber: 20-30 grams a day
Multivitamin: once a day

In this diet regular alcohol consumption has been associated with failure to lose weight. It may be consumed but the calories have to be calculated and subtracted from total number of calorie intake. Each gram of alcohol produces 7 kilocalories. Proteins should be derived from either plants or lean sources of animal proteins. Most carbohydrates should be complex carbohydrates (vegetables, fruits and whole grains). Sources of fiber include: oat bran, legumes, barley). Water intake should be adequate. Portion sizes should be small.
Total number of calories shall not exceed 1600 kcal for women and 2250 kcals for men under any circumstances. No meals is allowed after 8pm. Average intake for women should be 1200 and for men 1600.

Exercise should be tailored to individuals. Everyone who wants to lose weight must exercise to help maintain the weight lost. A typical exercise is walking 2 miles or 30 minutes a day five days a week. If not possible it should start slow and gradually advance as tolerated. Another way to exercise is to wear a pedometer. At the end of the day, if the number of the steps is less that 10000 further steps shall be taken to reach the goal. If not possible its should start at the goal of 5000 steps a day and then to be increases by 500 steps a week to achieve 10000 steps a day at least 5 days a week.
Special Considerations

  1. Limit sugar and alcohol. They provide few nutrients but many calories. Therefore, they contribute to high cholesterol by increasing body weight. An overweight body contains excess fat that is saturated.
  2. Fish should be eaten often, 3 or more times per week. Research indicates that certain deep-sea fish: mackerel, salmon, herring, albacore tuna, and lake trout, contain oil called Omega-3 fatty acid. This oil may help to lower blood cholesterol. Fish oil supplements, however, are not recommended because they add too many calories.
  3. Avoid high sodium content in foods. Some patients with high cholesterol also have high blood pressure. Reducing sodium can help to keep blood pressure within normal limits. Table salt is about 1/2 sodium. Sodium is also an ingredient in many commercially processed foods. Common medications such as antacids, laxatives, and cough remedies can contain large amounts of sodium. Read product labels and use products with no more than 300 mg of sodium per serving. Herbs and spices can be used in place of salt to add flavor and variety to meals. Do not use a salt substitute unless the physician has approved it.
  4. Increase complex carbohydrates, (pasta, whole grains, and potatoes) in the diet. Like fats, they are an excellent source of energy without the harmful effects fats can have on the body. But, read labels of commercially prepared baked goods, cookies, and crackers. These products are notorious for using highly saturated fats such as coconut or palm oils and hydrogenated fats.
  5. Eat 20 to 30 grams of dietary fiber every day. Foods such as legumes, oats, barley, brown rice, apples, strawberries, and carrots are good to eat because they contain soluble fiber. Research indicates that soluble fiber helps to lower blood cholesterol levels. Supplements such as psyllium mucilloid (trade names: Konsyl, Metamucil) can lower cholesterol up to 15% when used daily. Oat bran is another soluble fiber that has the same benefit.
  6. Choose meats carefully. Grading of meats (Prime, Choice, or Good) refers to fat content, with Prime grades having the most fat. Marbling refers to the threads of white fat running through a cut of meat -- the greater the marbling, the more fat. Read labels and avoid any meat product with more than 3 grams of fat per ounce.

Eating out can be a challenge. Avoid fast food restaurants; their foods are usually high in fats and sodium. However, many restaurants now understand the need to provide items for clients on fat or cholesterol-restricted diets. Their menus often contain words like "heart healthy" or have items marked with the symbol™. Ask about ingredients and how foods are prepared. Choose foods wisely and ask for smaller portions