Synonyms in the wisest sense
nutrition therapy:
- Hyperlipoproteinemias
- Hypercholesterolemia
- Hypertriglyceridemia
Hyperlipoproteinaemia, also called hyperlipidaemia, is accompanied by a pathological increase in blood lipid levels. These values refer to cholesterol and (or) 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 fat metabolism can be influenced by numerous nutritional factors in very different ways. In addition to an excessive calorie intake and the resulting overweight, the quantity and composition of dietary fat, the cholesterol supplied with the food, the quality of the carbohydrates and the fibre intake are of particular importance.
Existing overweight often leads to an increase in triglycerides and hypercholesterolemia. The so-called HDL cholesterol (high density lipoproteins) is lowered. It is also called “good cholesterol” because these proteins transport the cholesterol that is not water-soluble in the blood and are able to reabsorb cholesterol that has already been deposited.
Therefore, the HDL level in the blood should be as high as possible. The LDL cholesterol values (low density lipoproteins) are usually elevated and the risk of vascular calcification increases. In overweight individuals with a strain-specific obesity (apple type), hyperlipoproteinaemia is often associated with a decreasing effect of insulin, followed by increased secretion. This is often accompanied by high blood pressure and a tendency to thrombosis. This concatenation of symptoms is also known as a metabolic syndrome.
Causes of hyperlipoproteinaemia
Dietary fat and fat-accompanying substances
- Saturated fatty acids (contained mainly in animal fats from meat, sausage, fatty dairy products) have undisputedly the highest cholesterol-increasing effect.
- Simply insatiated fatty acids from vegetable fats such as rape oil, olive oil lower the total and the LDL Cholesterol
- Polyunsaturated fatty acids
- Omega 6-Fettsäuren from vegetable oils such as sunflower or wheat germ oil lower the Gesamtcholesterin less strongly than simply insatiated fatty acids.
- Omega-3 fatty acids from cold-water fish (mackerel, herring, salmon) lower triglycerides in hypertriglyceridemia.
- Trans-fatty acids, which originate predominantly from chemically hardened fats, increase total and LDL cholesterol and lower HDL cholesterol. The effect on blood lipid values is unfavorable.
Food cholesterolIf cholesterol is taken in with food (from animal foods such as eggs, offal), the cholesterol content of the blood is hardly negatively affected. However, there are few people who, due to their genetic disposition, develop a significant increase in blood cholesterol levels when they eat more cholesterol with their food CarbohydratesIn conjunction with a reduction in the intake of saturated fats, the increase in carbohydrate intake has a positive effect on blood fat levels.
Total and LDL cholesterol levels drop sharply. Triglycerides often increase. FibresThey have a positive effect on the blood fat values.
If the fibre content of the daily diet is increased, the supply of other nutrients is usually reduced. In most cases, there is a reduction in fat and sugar intake. The starch content of the food is increased and all these factors together are the cause of the positive effect on blood fat values.
If elevated cholesterol levels also result in increased body weight (see BMI), weight reduction is the first step in therapy. Otherwise, the following basic rules apply to a blood lipid-lowering diet: With a daily calorie consumption of 2000 calories, this would be approximately 65 g of fat in total. This fat is composed of spreadable fat, cooking fat and hidden fat.
Above all, the animal saturated fats from meat, sausage, milk and dairy products should be reduced. These fats usually occur in hidden form. Saturated fatty acids from vegetable fats such as coconut fat and palm kernel fat are also unsuitable.
Saturated fatty acids should not account for more than 7-10% of the energy intake and it is necessary to select only low-fat products (meat, sausage, dairy products) to achieve this goal.Among the animal fats, fats from cold-water fish (salmon, mackerel, herring) are an exception. They contain omega-3 fatty acids which have a positive influence on the cholesterol level. The admission of chemically hardened fats and thus in it contained Transfettsäuren is to be avoided.
These chemically hardened fats are primarily contained in ready meals, deep-frying fats and cheap margarines. They always appear on the list of ingredients 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.
Thereby 10 – 15% of the energy is to come from simply insatiated fatty acids and only 7 – 8% from several times insatiated fatty acids. In former times one had to lower the Cholesterinspiegel for a long time the several times insatiated fatty acids as best suitably regarded. These fatty acids are found for example in Distelöl, sunflower oil, Sojaöl and wheat germ oil.
In the meantime one recommends to take up more simply insatiated fatty acids (from olive oil, rapeseed oil, peanut oil) than several times insatiated fatty acids. These fats should also be used sparingly. Oils with a high portion of simply insatiated fatty acids are not so long durable and less suitable for heating than oils with a high portion of several times insatiated fatty acids.
50% of the daily calorie intake should come from carbohydrates. Especially suitable are the so-called “complex carbohydrates” from whole grain products, potatoes, legumes, vegetables and fruit. If this recommendation is followed, the amount of dietary fiber in the daily diet will inevitably also increase.
Ideally, this should be around 25 g per day. In order to benefit from the cholesterol-lowering effect (even if only slightly) of soluble fiber, oat products, pulses and pectin-rich fruits (apples, pears, soft fruits) should be regular components of the diet. The blood value can only be influenced to a very small extent by simply reducing the proportion of cholesterol in food.
It is more important to follow a low-fat diet according to the principles described above. Since cholesterol is only present as a fat-accompanying substance in animal fats and mainly in those with a high fat content, the reduction of the total fat intake from animal fats and the reduction of the cholesterol content automatically run parallel. Only the consumption of particularly cholesterol-rich foods such as offal, eggs, crustaceans and shellfish should be restricted.
- Reduction of the total fat intake to 30% of the nutritional energy.
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