Blood lipids can be simply understood as fat in the blood, part of which we eat through food, and some of which are synthesized by the body itself, and the components of blood lipids mainly include neutral fats, that is, triglycerides (TG), cholesterol, and lipids, which include many substances, such as phospholipids, glycolipids, steroids, etc.
Since all lipids are bound to proteins to form lipoproteins, we often detect the lipid content in the blood by detecting various lipoproteins, which are the indicators shown by our usual blood tests, according to the density from low to high, divided into: chylomicron CM, very low density lipoprotein VLDL, low density lipoprotein LDL, high density lipoprotein HDL.
Our dietary strategies also vary relatively differently from these indicators in the blood, but the general principles of the general diet remain unchanged.
1. What are the general principles of diet for dyslipidemia?
1, food is diverse, grain-based
Coarse and fine combination, coarse grains to increase the appropriate amount of corn, noodles, oats, etc., less refined sugar, sweets and drinks.
Since sucrose, fructose, etc. are more easily converted into triglycerides than starch, sweets and sugary drinks should be consumed less. If stomach function is normal, whole grains should account for 1/2 of the staple food.
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2. Eat more vegetables, fruits and potatoes
This type of food is rich in dietary fiber, dietary fiber has the effect of regulating blood lipids, soluble dietary fiber is stronger than insoluble dietary fiber, the former is mainly present in barley, oats, beans, fruits.
The proportion of dark or leafy greens should account for half of vegetables; garlic and onions have the effect of lowering serum total cholesterol and raising HDL cholesterol, which may be related to their sulfide content and can often be used as a side dish.
Shiitake mushrooms and fungus contain polysaccharides that also have the effect of lowering total cholesterol (TC) and preventing atherosclerosis.
3. Appropriate amount of fish, poultry, eggs and lean meat
Steaming, boiling, mixing and other cooking methods with less oil should be the mainstay. Broth should remove the upper layer of fat after cooling. Do not eat fatty meat, remove chicken skin. Use less animal fat and control edible vegetable oils.
Eat more aquatic products, especially deep-sea fish, 2 times a week or more, marine fish are rich in EPA and DHA, which can significantly reduce blood triglycerides, reduce plasma cholesterol and antiplatelet aggregation.
4, the appropriate amount of soy products and dairy products
Skim milk or legumes are a good natural source of calcium to supply adequate amounts of calcium and are highly utilized. Dietary fiber in plant foods can affect the body's absorption of cholesterol, thereby lowering cholesterol levels.
5, light and less salt
Salt intake is less than 6 grams per day, and salt should be limited in patients with hypertension.
6, drink less alcohol, drink more tea
Alcohol will promote the liver to synthesize more endogenous triglycerides and low-density lipoprotein cholesterol (LDL-C), so it is better to drink less, and if you really need to drink alcohol, you should also drink low alcohol.
Tea contains tea polyphenols and other components, which have the effect of reducing the deposition of cholesterol in the arterial wall, inhibiting platelet aggregation, promoting plasmin activity, antithrombosis, etc., so it is recommended to drink more tea.
7. Active exercise and weight control
Total energy intake should be based on height and weight, with weight control within the ideal body mass index (BMI) in squares of weight/height.
Adults: 18.5 to 23.9 kg/m2; 60-70 years: >20-23.9 kg/m2; >70 years old: >22 to 23.9 kg/m2.
2. What are the classifications of dyslipidemia?
Type I dyslipidemia (hypermyel microparticleemia) is manifested by elevated plasma chylomicrons (CM), resulting in elevated triglycerides and a normal or mild increase in total cholesterol.
Dietary principles: Strict limits on fat (20% <), including cooking oils and fats contained in foods. Due to fat restriction, the intake of essential fatty acids and fat-soluble vitamins is reduced, and supplementation should be taken during treatment.
Dyslipidemia type II.a (hypercholesterolemia) is manifested by elevated total cholesterol alone, elevated LDL cholesterol, and normal triglycerides.
Dietary principles: appropriate restriction of saturated fatty acids, increase of polyunsaturated fatty acids, strict restriction of cholesterol (< 300 mg / day).
Type II.b and III dyslipidemia (mixed hyperlipidemia: i.e., high cholesterol and high triglycerides) present with elevated very low-density lipoprotein cholesterol (VLDL-C) and LDL cholesterol, and elevated total cholesterol and triglycerides.
Dietary principles: limit the amount of total energy, lose weight, and keep the BMI within the normal range. On a high-protein diet, protein accounts for 20% of total energy. Strictly limit carbohydrates (50% to 60%). Severe cholesterol restrictions (< 300 mg/day).
1. Example of recipes for patients with type I. to type III dyslipidemia
Patient, female, 52 years, height 155 cm, weight 60 kg, BMI =25 kg/m2, overweight. Energy 1200 to 1250 kcal (kcal), cholesterol < 300 mg, fat < 20%, protein 20% to 25%, carbohydrate 50% to 60%, suitable for patients with type I to III. dyslipidemia.
Due to limited fat intake, reduced intake of essential fatty acids and fat-soluble vitamins, additional vitamins A, D and E supplementation is required. The following recipes are recommended for the patient's situation.
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Type IV dyslipidemia (hypertriglyceridemia) is manifested by elevated very low-density lipoprotein cholesterol and triglycerides, and total cholesterol is normal or high.
Dietary principles: limit the amount of total energy, lose weight, and keep the BMI within the normal range. Severe restrictions on carbohydrates (<50%). Limit cholesterol (< 300 to 500 mg/day).
2. Example of recipes for patients with type IV dyslipidemia
Patient, female, 52 years, height 155 cm, weight 60 kg, BMI = 25 kg/m2, overweight.
Energy 1200 to 1250 kcal, cholesterol 300 to 500 mg/day, carbohydrate < 50%, suitable for patients with type IV dyslipidemia. The following recipes are recommended for the patient's situation.
Type V dyslipidemia (hypertriglyceridemia and hyperceliac granulemia) Plasma chylomicron and very low-density lipoprotein cholesterol levels are elevated, triglycerides and total cholesterol are elevated, but predominantly elevated triglycerides.
Dietary principles: limit the amount of total energy, lose weight, and keep the BMI within the normal range. On a high-protein diet, protein accounts for 20% to 25% of total energy. Limit fat (< 20%). Strictly limit carbohydrates (50% to 60%).
Cholesterol is severely restricted (< 300 to 500 mg/day).
3. Example of recipes for patients with type V. dyslipidemia
Patient, female, 52 years, height 155 cm, weight 60 kg, BMI =25 kg/m2, overweight. Energy 1200~1250 kcal, protein accounts for 20%~25% of total energy. Fat < 20%. Carbohydrates 50% to 60%.
Cholesterol 300 to 500 mg/day. Suitable for patients with dyslipidemia type V. The following recipes are recommended for the patient's situation.
bibliography:
[1] Catapano AL，Graham I，De Backer G.2016 ESC/EAS Guidelines for the Management of Dyslipidaemias.Kardiol Pol. 2016;74(11):1234-1318.
Chinese Nutrition Society. Dietary Guidelines for Chinese Residents (2016). Beijing:People's Medical Publishing House.]
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