Ms. Liu recently participated in a physical examination and was found to have "hyperlipidemia" and "fatty liver". Among them, the lipid profile showed that low-density lipoprotein cholesterol (LDL-C) was 4.06 mmol/L (normal reference value should be less than 3.40), total cholesterol was 6.15 mmol/L (normal reference value should be less than 5.18), triglyceride (TG) was 1.12 mmol/L (normal reference value should be less than 1.70, this item is normal), and high-density lipoprotein cholesterol (HDL-C) was 1.62 mmol/L (normal reference value should be between 1.04-1.55). In addition, abdominal ultrasound suggests fatty liver. Ms. Liu's case reminds us that regular check-ups and timely health interventions are indispensable. So, how does Ms. Liu adjust her diet and arrange three meals a day? "Public Health News" interviewed experts to lead an in-depth understanding of how Ms. Liu successfully improved her physical condition through scientific and personalized dietary nutrition adjustment with the help of the nutrition clinic.
Experts interviewed
Tang Hanfen, attending physician, Department of Nutrition, Second Xiangya Hospital, Central South University
Understand your condition and develop a personalized diet plan
First, let's briefly review Ms. Liu's health record. She is a 63-year-old woman with a height of 152 cm, a weight of 59.4 kg and a body mass index of 25.8 kg/(m)2, which is in the overweight range. At the same time, laboratory tests found that the levels of total cholesterol and LDL cholesterol (commonly known as "bad" cholesterol) were higher than the normal range. In order to achieve the blood lipid standard, Ms. Liu came to the nutrition clinic. Here, the first person to receive her is a nutritionist. In order to have an in-depth understanding of Ms. Liu's eating habits, most of the dietitians used the 24-hour dietary survey method or the food frequency method to conduct dietary surveys. The 24-hour dietary survey is like taking a "family photo" of Ms. Liu's diet, detailing in detail the food and drinks she has consumed in the past 24 hours. The Food Frequency Questionnaire is more like a long-term "food diary", asking how often she usually eats a certain food and how much she eats each time.
After completing the dietary survey, Ms. Liu brought the dietary survey results to the nutrition clinic. Here, the dietitian not only understands the purpose of the nutrition clinic, but also asks and understands her past medical history, smoking, drinking, exercise, menstruation, and family history. In addition, the doctor will perform a series of physical examinations for her height, weight, waist circumference, hip circumference, blood pressure, etc., and check her hair and skin for abnormalities. In order to assess Ms. Liu's health condition more thoroughly, the doctor also recommended that she undergo further examinations, such as nutritional metabolic function testing, body composition analysis, 25-hydroxyvitamin D and electrocardiogram. When all the test results came out, the doctor formulated a set of scientific and personalized diet and nutrition guidance plans for Ms. Liu according to her specific condition. This program is designed to help her adjust her diet to achieve healthy blood lipid levels while enjoying delicious food.
Develop and implement scientific and individualized dietary nutrition intervention programs
After a detailed dietary survey, physical examination and laboratory tests, we found that there were some problems in her eating habits, such as picky eating, picky eating, heavy oil and salt, and a special love for eating melon seeds and peanuts. In addition, in her lifestyle, playing mahjong for long periods of time leads to excessive sitting time. Laboratory tests showed that her total cholesterol and LDL cholesterol were high, but her liver and kidney function were normal. Body composition analysis revealed that she had a body fat percentage of 38.3%, a visceral fat area of 121 square centimeters, and insufficient skeletal muscle. Based on this information, our nutrition experts developed a scientific and personalized dietary nutrition intervention plan for her. The goal is to lower her total cholesterol and LDL cholesterol levels, raise HDL cholesterol, and control her weight and waist circumference to reduce the risk of cardiovascular and cerebrovascular diseases.
In view of the specific conditions of overweight and fatty liver disease, in order to achieve these goals, our dietary principles are low-salt, low-fat and energy-restricted balanced diets. Specific dietary guidance includes the following three points:
(1) Daily food types and intake: Ensure adequate intake of protein, dietary fiber, vitamins and minerals, while limiting the intake of saturated fat, trans fat and sugar.
(2) Daily food examples: Provide some healthy food choices, such as whole grains, lean meats, fish, legumes, vegetables and fruits. Examples of daily recipes are detailed in Table 1.
(3) Dietary precautions: It is recommended to use a diary to record the daily diet and exercise, so as to better monitor the progress and adjust the plan.
Other lifestyle adjustments
In addition to her diet, Ms. Liu also needs to pay attention to the following three points to improve her health:
(1) Increase physical activity: Sitting still for a long time is not good for health. Following the principle of step-by-step, under the premise of ensuring safety, it is recommended that Ms. Liu do 30 minutes of aerobic exercise at least 3~5 times a week, such as brisk walking, swimming or cycling. In addition, in order to gain muscle, she also needs to perform some resistance exercises such as lifting dumbbells, pulling elastic bands/bungee cords, supine leg presses or planks, etc.
(2) Quit smoking and limit alcohol: Both tobacco and alcohol will cause a burden on the liver, and it is recommended that Ms. Liu should avoid it as much as possible.
(3) Ensure adequate sleep: Ensure 7~8 hours of high-quality sleep every night to help the body recover.
Track your progress and adjust your diet plan in a timely manner
To ensure that Ms. Liu strictly followed the doctor's instructions, she returned to the nutrition clinic for a follow-up in the second month. This follow-up includes a test of blood lipid levels and a body composition analysis. Based on the results, our dietitian will adjust the diet plan in a timely manner. It is worth mentioning that Ms. Liu has become proficient in using a diary to record her daily diet and exercise, which helps her better understand and analyze her eating habits and make adjustments accordingly.
Improve your health and witness the results of your conditioning
After 3~4 months of hard work, Ms. Liu's total cholesterol and LDL cholesterol levels dropped to 4.98 mmol/L and 3.38 mmol/L, respectively, both reaching the normal range. More encouragingly, the body composition of the re-examination showed a decrease in body fat percentage to 30.2% and a reduction in visceral fat area to 108 square centimeters. All this is due to the professional guidance of the nutrition clinic and Ms. Liu's insistence on implementation.
Through Ms. Liu's story, we deeply realized that we are the first person responsible for health, and health requires long-term investment and maintenance. With the help of the nutrition clinic, through scientific diet and lifestyle adjustments, everyone is able to take control of their own health. Remember, health is a marathon, let's work together for health!