Nutrition in Dyslipidemia

Yenni ZuhairiniNutrition Department

DYSLIPIDEMIALipid metabolism disorders marked by an increase or decrease in plasma lipid fractions

Risk for CHD incidenceBlood lipid profile

– High total cholesterol– High LDL cholesterol– High triglyceride– With or without low

HDL

CHOLESTEROL

Principles of nutritional therapy for lowering cholesterol• Reduce consumption of dietary

cholesterol• Inhibit the production of cholesterol in

the body• Inhibits absorption and increase

excretion of cholesterol by the intestine

Reduce consumption of dietary cholesterol • By avoiding high

cholesterol foods, such as:– Brain, marrow, organ

meats– Egg yolk (wheat)– Cheese, butter (wheat)– Animal skin (kikil, krecek)– Shrimp (shrimp paste,

terasi)

The Content of Cholesterol per 100 g of Food

Food stuff Cholesterol (mg)Brain 2200Egg yolk 1600Egg 548Kidney 370Liver 300Pancreas 250Tripe, animal stomach 150

Food stuff Cholesterol (mg)Lobster 150Shrimp 150Lard 95Cheese 79Butter 219Whole milk 14Vegetable cooking oil 0

The Content of Cholesterol per 100 g of Food

Reduce Consumption Of Dietary Cholesterol• Cholesterol intake <300 mg / day can

be achieved with the menu without high cholesterol foods

• Cholesterol intake <200 mg / day can be achieved with the menu without animal foods, except lean meat or fish weighing 200 g / day

Exogenous PathwayFood particles

Intestines

Free Fatty Acids

Breakdown of Triglyceride

Chylomicrons

Bloodstream

Liver

Chylomicron Remnants

Bile Acids

Endogenous Pathway

Free Fatty Acids

Breakdown of Triglyceride

Bloodstream

Liver

IDLVLDL

LDL

Body Tissues

HDL

Inhibit the manufacture of cholesterol in the bodyAvoid excess of energy in bodyLose weight for people with excess

body fat

Classification BMI (kg/m2) Comorbidities

Underweight < 18.5 Low (but risk of other clinical problems increased)

Normal range 18.5 – 22.9 Average

Overweight > 23.0At Risk 23.0 – 24.9 IncreasedObese class I 25.0 – 29.9 ModerateObese class II > 30.0 Severe

BMI=(Body weight in kg) /(Body height in cm)2

Classification of weight status according to BMIin Asian Adults

Source: WHO/IASO/IOTF (2000)

Increase the consumption of fiber, especially water-soluble (pectin, guar gum, gum) which are abundant in :

– Apple, orange, guava, pear

– Passion fruit, papaya, dll– Red bean, soy, tofu,

tempe, etc.

Increase excretion and inhibiting the absorption of cholesterol

Food Menu for lowering LDL cholesterol level

• Low cholesterol <200 mg / day• Low fat (+ 30% of calories)• lipid composition

– SFA <7% of total calories– PUFA to 10% of total calories– MUFA and 20% of total calories– Avoid trans fat

Raising HDL cholesterol

Research shows that:• Weight loss in obese people

• Stop smoking in smokers• More active in the less active

will lower LDL levels and increase plasma HDL levels

Normal HDL cholesterol Regular exercise or eat enough fiber

TRIGLYCERIDE

Terapi nutrisi untuk menurunkan trigliserida• Mengurangi konsumsi trigliserida

(lemak)• Mengurangi pembuatan trigliserida oleh

tubuh• Menambah pengunaan trigliserida oleh

tubuh

Reduce consumption of triglyceride

• Avoid fatty meats: satay, gule, oxtail soup, stew legs, pig, etc.

• Fried thin shape food, such as dendeng, crackers, chips, etc.

Reducing triglyceride synthesis by the body• By creating energy deficit, that are:

– Reduce consumption of foods– Raising energy use– Reduce consumption of foods for only the

excessive food

reduce simple carbohydrates (starch and sugar) so that fiber is not reduced

If excess carbohydrates,

When excess fat, reduce animal fats so that the ratio of polyunsaturated / saturated fatty acid increases and dietary cholesterol intake decreases

Increasing use of triglycerides

• Changing inactivity

becomes more active

• Doing aerobic exercise of

moderate intensity and long duration such as

walking

TERIMA KASIH