Dietary recommendations in disorders of the lipid metabolism

Part 1: Pathogenesis and influence of nutritional factors

A. Wächtershäuser, J. Stein, Frankfurt

Disorders of the lipid metabolism are devided into hypercholesterolemia, hypertriglyceridemia and combined hyperlipidemia. They are the cause of various cardiovascular diseases and are greatly influenced by exogenous factors such as nutrition and lifestyle.

It has been shown that an increased consumption of dietary fat in general, and a high intake of saturated fat in particular contribute to increased serum LDL cholesterol levels. A reduction of fat intake and fat modification (mono- and polyunsaturated instead of saturated fatty acids), replacement, to some extent, of fats by complex carbohydrates and use of soluble dietary fibre (pectin, psyllium or guar) and plant sterols which inhibit cholesterol absorption are appropriate means of  reducing LDL cholesterol.

Physical activity has a beneficial influence on HDL cholesterol. Although humans respond differently to reduced dietary cholesterol intake, high-cholesterol food (offal, eggs, shellfish and crustaceans) should be avoided and total intake of animal food be reduced.

Replacement, to some extent, of animal protein by soy protein may further reduce LDL cholesterol. Consumption of products made of chemically hydrated fat (chocolate cream, confectionery, French fries) should be reduced because of  their high content of trans-fatty acids. Few data are available about the use of phytochemicals. Substances with antioxidative properties (vitamins C and E, beta-carotene) protect against coronary heart disease. A nutritional therapy of patients with hypertriglyceridemia comprises a reduction of mono- and disaccharides, total abstinence from alcohol and use of omega-3 fatty acids.

In general, a consequent change in lifestyle associated with a low-fat vegetarian or Mediterranean diet, normalization of weight, no smoking, stress management and physical activity should be recommended. In case of hyperlipidemia, pertaining recommendations should be combined. EU03/04

Keywords: Lipid metabolism / hypercholesterolemia / hypertriglyceridemia / pathogenesis / nutritional factors

Sie finden den Artikel in deutscher Sprache in Ernährungs-Umschau 01/04 ab Seite 95.

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