Expert advice, Excellent results Online Nutrition Training Course Module 23: Dyslipidaemia www.diet-specialist.co.uk Notice of Rights All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form, or by any means, electronic, mechanical, photocopying, recording or otherwise without prior written permission from Diet Specialist. P a g e 1
Dietetics and disease DYSLIPIDAEMIA Aims of the Dyslipidaemia section: 1) The definition and sub-groups of the disease 2) Understanding the difference between good and bad cholesterol 3) Understand the role of hyperglyceridemia including symptoms 4) How is it discovered and treated including dietary management 5) Practical tips and guidance on how to treat the disease 6) The role of fibre and whole grains and practical methods to increase consumption 7) Other specific tips to reduce the risk. Remember This module will give you a general understanding of dyslipidaemia, however you should not apply this advice to specific individuals, instead the refer the individual to their GP. Dyslipidaemia Previously known as hyperlipidaemia, this is where there is an excess of fatty substances called lipids, largely cholesterol, in the blood also called hyperlipoproteinemia because the substances travel in the blood attached to proteins. This is the only way they can remain dissolved whilst in circulation. What is the description of dyslipidaemia? The fat complexes in the blood are called lipoproteins. The best known are low density lipoproteins (LDL) and high density lipoproteins (HDL). Excess LDL leads to the blockage of arteries eventually resulting in a heart attack; the higher the level of LDL the greater the risk of CHD. This is true in men and women in different ratios for ethnic groups and all adult age groups hence LDL is labelled the bad cholesterol. The lower the level of HDL the greater the risk of CHD, therefore it is commonly referred to as the good cholesterol. Low levels of HDL are accompanied by an increase in blood triglyceride levels. Studies have shown that high triglyceride levels are associated with a high risk of CHD Symptoms of dyslipidaemiathere are no noticeable symptoms and it tends to be discovered during routine examinations for atherosclerotic cardiovascular disease. Deposits of cholesterol form underneath the skin for those with high cholesterol in the blood. Those with hypertriglyceridemia may develop numerous pimple like lesions across their body and extremely high levels of triglyceride may also result in pancreatitis; severe inflammation of the pancreas that may be life threatening. Dyslipidaemia typically diagnosed based on medical history, physical examination and blood tests, to determine the levels of LDL, HDL and triglycerides. P a g e 2
Practical tips on how to manage blood cholesterol The following dietary changes should be considered: 1. Read food labels and choose foods with low cholesterol and low saturated fat levels. 2. Limit the intake of red meat and eggs to reduce intake of saturated fat and cholesterol. 3. Choose semi skimmed or skimmed milk, as well as low fat and fat-free dairy products. 4. Limit fried food, and use healthy oils in cooking, such as vegetable oil. 5. Reduce total fat intake as well as saturated and trans fat intake. The remaining fat should come from monounsaturated and polyunsaturated fats such as unsalted nuts and seeds, oily fish including salmon, trout and herring at least twice per week, and vegetable oils. 6. Limit cholesterol intake to less than 300mg per day and for CHD cholesterol intake should be less than 200mg per day. 7. Increase the consumption of fibre as this can help lower cholesterol levels by as much as 10 percent. 8. Increase intake of grains including wheat, oats and rice. Some foods made from these grains use only the inside of the grain such as white rice and white pasta whereas whole-grain foods include the outside and the entire grain. What makes whole grains so great? Wholegrain foods are healthy because they contain fibre. A diet high in fibre can help reduce the risk of heart disease and diabetes. High fibre foods stay in your stomach for longer, so you feel fuller and your blood sugar doesn t go up as quickly after you eat. Whole grains, such as whole-wheat flour and brown rice, also have more fibre than refined white flour and white rice. Whole grains and other high-fibre foods are helpful for the following reasons: Control blood sugar and blood cholesterol Making you feel fuller for longer resulting in eating less Preventing constipation, or hard bowel movements How to eat more fibre To increase fibre intake consider the following suggestions: Instead of... Try... White bread or wheat bread Whole-wheat bread or rye bread White rice Brown rice or wild rice Regular pasta Whole-wheat or whole-grain pasta Macaroni Bulgur wheat Corn flakes Bran flakes or other bran cereal Crispy rice cereals Whole-grain cereals Cream of wheat Oatmeal Flour tortillas Whole-grain or corn tortillas (made without lard) Maintain a healthy weight Weight loss of 10% can reduce the risk of risk of dyslipidaemia. To promote weight loss it is necessary to burn more calories than consumed; every good weight loss plan has the same two parts, food and physical activity. Helpful food choices and increased physical activity can result P a g e 3
in fewer calories consumed and burning off some of the calories consumed resulting in maintaining a healthy weight. Keep portions smaller than your fist It s easy to overeat when you have too much food on your plate therefore smaller portions help prevent overeating. Overeating can make health problems worse, especially with dietary related diseases like diabetes and a helpful way to control overeating is to reduce portion sizes. For most foods, a reasonable portion is ½ to 1 cup, approximately the size of a woman s fist. Even if the individual s fist is larger than that it is still a useful measuring tool. The two most common exceptions for these portion sizes are: Meat, chicken and fish. For these foods, keep portions the size of a deck of cards, which is about half the size of your fist. Plain vegetables, including salads without dressing. You can have as much as you want because these foods are filling and low in calories. Control your hunger with filling foods that are low in calories. Foods such as soup, salad, fruit and vegetables digest slower and as a result satisfy hunger and help weight loss due to a fuller feeling on a smaller amount of food. Keep track of what you eat Studies have shown that keeping a track of what is consumed on a daily basis will result in being more likely to maintain dietary and lifestyle changes and, if necessary, promoting weight loss. Enjoy more physical activity Regular physical activity is important for keeping a healthy heart. By increasing physical activity this may help weight loss as well as strengthening the heart muscle at the same time. Helpful tips to maintain a healthy weight: Instead of... Try... Counting every calorie and fat Keeping a food diary. Once you know what you are eating gram you may be able to reduce the amount without having to Eating dessert after dinner count every calorie. Try eating ½ portions. If you want a dessert, try only eating it after lunch, and choose a low-calorie dessert like fruit. The earlier in the day you eat high-calorie foods, the more time you have during the day to burn off those extra calories. Skipping meals to lose weight Eating 4-5 smaller meals during the day. Eating every 3-4 hours helps control hunger. Just make sure that your smaller meals do not exceed your daily total calorie goals. Leaving long gaps between meals Tasting food while you cook Stopping at the supermarket on the way home Weighing yourself every day Planning ahead and bringing healthy snacks with you wherever you go so you won t be tempted to pick up an unhelpful choice instead. Drink a tall glass of water to get you through a craving. Resisting eating the food you are making until you are sitting at the table with a plate an appropriate portion size in front of you. Shopping after you eat. Aim to avoid food shopping whilst hungry and if you have to go to the shops before eating a meal make sure you have a healthy snack to eat before. This will help to curb the appetite and reduce the likelihood of binge-buying. Weighing yourself once a week allows you to see more accurate weight loss rather than daily fluctuations and prevents an unhealthy obsession with the scales; a P a g e 4
change in your body shape or meeting a dietary and lifestyle goal is just as successful as weight loss. P a g e 5