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Nutrition in Dyslipidemia
Yenni Zuhairini
Nutrition Department
DYSLIPIDEMIA
Lipid metabolism disorders marked by an increase or decrease in plasma lipid fractions
Risk for CHD incidence
Blood 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 150
Shrimp 150
Lard 95
Cheese 79
Butter 219
Whole milk 14
Vegetable 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 Pathway
Food 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
IDL
VLDL
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 Moderate
Obese 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