Diet and cholesterol

• Introduction:

Synonyms in the broadest sense

Nutritional therapy for:

• Hyperlipoproteinemia
• Hypercholesterolemia
• Hypertriglyceridemia

1. Nutritional therapy for hyperlipoproteinemia

Introduction:

Hyperlipoproteinemias, too Hyperlipidemias called, go hand in hand with a pathological increase in blood lipid levels. These values ​​refer to that cholesterol and (or) the triglycerides.
The causes for this can be genetic. In the majority of cases, however, the cause is a combination of hereditary and nutritional Factors.

The very complicated one Fat metabolism can be influenced in very different ways by numerous nutritional factors.
In addition to an excessive intake of calories and the resulting Obesity are above all the amount and composition of dietary fat, the cholesterol in the diet and the quality of the carbohydrates and fiber intake is important.

If you are overweight, there is often an increase in triglycerides and a Hypercholesterolemia. The so-called HDL Cholesterol (High density lipoproteins, high density lipoproteins) is humiliated. It is also called "good cholesterol" because of this Proteins transport the insoluble cholesterol in the blood and are able to absorb cholesterol that has already been deposited. Therefore, the HDL level in the blood should be as high as possible.

You can find out more about the topic here: Lipid metabolism disorder and HDL - "high density lipoprotein"

The LDL- cholesterol levels (low density lipoproteins, low density lipoproteins) are usually increased and the risk of vascular calcification increases.
If you are overweight with obesity with a pronounced trunk (apple type), hyperlipoproteinemia is often associated with a decrease in the effectiveness of insulin and, as a result, an increased release. In addition, there is often high blood pressure and a tendency to thrombosis.
This chain of symptoms is also known as metabolic syndrome.

Causes of hyperlipoproteinemia

Dietary fat and accompanying fat

• Saturated fat (mainly contained in animal fats from meat, sausage, fatty dairy products) undisputedly have the highest cholesterol-increasing effect.

• Monounsaturated fatty acids from vegetable fats such as rapeseed oil and olive oil lower total and LDL cholesterol

• Polyunsaturated fatty acids

• Omega-6 fatty acids from vegetable oils such as sunflower or wheat germ oil lower total cholesterol less than monounsaturated fatty acids.

• Omega-3 fatty acids from cold water fish (mackerel, herring, salmon) lower the triglycerides in hypertriglyceridemia.

• Trans fatty acids the majority of which are made from chemically hydrogenated fats, increase total and LDL cholesterol and lower HDL cholesterol. The effect on blood lipid levels is unfavorable.

Dietary cholesterol
With an increased intake of cholesterol the cholesterol content of the blood is hardly influenced negatively with food (from animal foods such as eggs, offal). However, there are few people who, due to their genetic predisposition, also develop a significant increase in blood levels when they eat high cholesterol

carbohydrates
Coupled with a reduction in the intake of saturated fats, the increase in carbohydrate intake has a positive effect on blood lipid levels. Total and LDL cholesterol drop sharply. The triglycerides often go up.

Fiber
They have a positive effect on blood lipid levels. When the fiber content of the daily food is increased, the supply of other nutrients is usually reduced. Most often there is a decrease in fat and sugar intake. The starch content of the food is increased and all these factors together are the cause of the beneficial effect on blood lipid levels.

2. Nutritional therapy for hypercholesterolemia

If there is an increased body weight (see BMI) with high cholesterol levels, weight reduction is the first step in therapy.
Otherwise, the following basic rules apply to a blood lipid-lowering diet:

1. Reduction of total fat intake to 30% of food energy.

With a daily calorie consumption of 2000 calories, that would be around 65 g total fat. This fat is made up of spread fat, cooking fat and hidden fat.
Above all, saturated animal fats from meat, sausage, milk and milk products should be reduced. These fats mostly come in hidden form. Saturated fatty acids from vegetable fats such as coconut oil and palm kernel oil are also unsuitable. Saturated fatty acids should not make up more than 7-10% of the energy intake and it is only necessary to select low-fat products (meat, sausage, dairy products) in order to achieve this goal.
Among the animal fats, the fats from cold water fish (salmon, mackerel, herring) are an exception. They contain omega-3 fatty acids which have a beneficial effect on the cholesterol level.
The intake of chemically hydrogenated fats and the trans fatty acids they contain should be avoided. These chemically hardened fats are found primarily in ready meals, deep-frying fats and cheap margarines. On the list of ingredients they always appear under the designation: vegetable oils, hardened or partially hardened.
Fat-saving cooking methods such as grilling, steaming in foil and cooking in coated pans also make it easier to save visible fats.

2. Increase in the proportion of mono- and polyunsaturated fatty acids

10-15% of the energy should come from monounsaturated fatty acids and only 7-8% from polyunsaturated fatty acids.
In the past, polyunsaturated fatty acids were considered to be the most suitable for lowering cholesterol levels. These fatty acids are found in safflower oil, sunflower oil, soybean oil and wheat germ oil, for example.
It is now recommended to consume more monounsaturated fatty acids (from olive oil, rapeseed oil, peanut oil) than polyunsaturated fatty acids. These fats should also be used sparingly. Oils with a high proportion of monounsaturated fatty acids do not last as long and are less suitable for heating than oils with a high proportion of polyunsaturated fatty acids.

3. More complex carbohydrates and fiber

50% of the daily calorie intake should come from carbohydrates. The so-called “complex carbohydrates” from whole grain products, potatoes, pulses, vegetables and fruits are particularly suitable.
If this recommendation is followed, the amount of fiber in the daily diet will inevitably increase. This should ideally be 25 g per day. In order to use the cholesterol-lowering effect (even if only slightly) of soluble fiber, oat products, legumes and pectin-rich fruits (apples, pears, berries) should be regular food components.

4. The daily cholesterol intake should be below 300 mg

The blood value can only be influenced very little by simply lowering the dietary cholesterol content. It is more important to stick to a low-fat diet according to the principles described above. Since cholesterol is only found in animal fats as an accompanying substance, and mainly in those with a high fat content, the reduction in total fat intake from animal fats and the reduction in the cholesterol content automatically run in parallel. Only the consumption of foods that are particularly rich in cholesterol, such as offal, eggs, crustaceans and shellfish, should be restricted.

You might also be interested in this topic: Cholestyramine

3. Nutritional therapy for hypertriglyceridemia

This increase in blood lipids is very often associated with being overweight, diabetes and high alcohol intake. If these causes are treated successfully, the triglyceride concentration in the serum will also decrease in most cases.

Obesity should follow the principles of a low-fat, balanced mixed diet. The same nutritional principles apply to nutrition with high triglyceride levels as for high cholesterol levels. However, the following features must be taken into account:

1. If possible, alcohol should be avoided completely.
2. Sugar and sugary foods such as sweets, baked goods and sugared drinks should be very limited. Sugar substitutes (sorbitol, xylitol, fructose) are also unsuitable. Sweeteners (saccharine, aspartame, cyclamate) have no negative influence on the level of blood lipids and are suitable in small amounts.
3. Whole grain products with a high fiber content are preferred.
4. Prefer omega-3 fatty acids. Regular consumption of mackerel, tuna, salmon and herring.