Nutrition in Dyslipidemia
Yenni Zuhairini
Nutrition Department
Lipid metabolism disorders marked by an increase or decrease in
plasma lipid fractions
DYSLIPIDEMIA
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
Brain
Egg yolk
Egg
Kidney
Liver
Pancreas
Tripe, animal stomach
Cholesterol (mg)
2200
1600
548
370
300
250
150
The Content of Cholesterol per
100 g of Food
Food stuff
Cholesterol (mg)
Lobster
150
Shrimp
150
Lard
95
Cheese
79
Butter
219
Whole milk
14
Vegetable cooking oil
0
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
Bile Acids
Liver
Intestines
Chylomicrons
Chylomicro
n Remnants
Bloodstream
Breakdown of
Triglyceride
Free Fatty Acids
Endogenous Pathway
LDL
HDL
Liver
Body Tissues
Bloodstream
VLDL
Breakdown of
Triglyceride
Free Fatty Acids
IDL
Inhibit the manufacture of
cholesterol in the body
Avoid excess of energy in body
 Lose weight for people with excess
body fat
Classification of weight status according to BMI
in Asian Adults
Classification
BMI (kg/m2)
Comorbidities
Underweight
< 18.5
Normal range
18.5 – 22.9
Low (but risk of
other clinical
problems increased)
Average
Overweight
At Risk
> 23.0
23.0 – 24.9
Increased
Obese class I
25.0 – 29.9
Obese class II
> 30.0
Moderate
Severe
Source: WHO/IASO/IOTF (2000)
BMI=(Body weight in kg) /(Body height in cm)2
Increase the
consumption of fiber,
especially water-soluble
(pectin, guar gum, gum)
which are abundant in :
Increase
excretion and
inhibiting the
absorption of
cholesterol
– Apple, orange, guava,
pear
– Passion fruit, papaya, dll
– Red bean, soy, tofu,
tempe, etc.
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
If excess carbohydrates,
reduce simple carbohydrates (starch and
sugar) so that fiber is not reduced
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