Hyperlipoproteinemias are 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.
Nutritional causes
- 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
- Several times insatiated 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) reduce triglycerides in hypertriglyceridemia.
- Trans-fatty acids: which come predominantly from chemically hardened fats increase total and LDL cholesterol and lower HDL cholesterol. The effect on the blood fat values is unfavorable.
- Food cholesterol: With an increased intake of cholesterol 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 consume more cholesterol with food
Coupled with a reduction in the intake of saturated fats, the increase in carbohydrate intake has a positive effect on blood fat values.
Total and LDL cholesterol are strongly reduced. Triglycerides often increase. They have a positive effect on blood lipid values.
When the fibre content of the daily diet increases, 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 reason for the positive effect on blood fat values.
If elevated cholesterol levels also result in increased body weight, weight reduction is the first step in therapy. Otherwise, the following basic rules apply to a blood fat-lowering diet:With a daily calorie consumption of 2000 calories, this would be approximately 65g 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 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, hydrogenated or partially hydrogenated. 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.
This increase in blood fats is very often accompanied by overweight, diabetes and high alcohol intake. If these causes are successfully treated, in most cases the triglyceride concentration in the serum also decreases. Overweight should be treated according to the principles of a low-fat, balanced mixed diet.
The same nutritional principles apply to a diet with elevated triglyceride levels as to elevated cholesterol levels. However, the following special features must be taken into account:
- Alcohol should be avoided as much as possible.
- Sugar and sugary foods such as sweets, bakery products, sugared beverages should be very restricted. Sugar substitutes (sorbitol, xylitol, fructose) are also unsuitable.
Sweeteners (saccharin, aspartame, cyclamate) have no negative influence on the level of blood lipids and are suitable in small amounts.
- Whole grain products with a high dietary fiber content are preferred.
- Preference of omega-3 fatty acids. Regular consumption of mackerel, tuna, salmon and herring.
They should be main components of the daily diet. They are low in fat and cholesterol or free of cholesterol and (or) high in fiber.
Listed fatty fish and edible oils contain a favorable fatty acid composition. However it applies to limit the consumption quantity also here. Edible oils: Fish: Milk and dairy products: Eggs: Grain products: Vegetables Potatoes Fruit Beverages Other products
- Rapeseed oil, olive oil
- Meat, poultry, sausages:
- All lean meats, poultry without skin, corned beef, turkey breast fillet
- All lean fish species (pollack, cod, redfish, trout).
Also herring, mackerel, salmon and tuna.
- Low-fat milk (1.5%), buttermilk, skimmed curd cheese, cottage cheese, hand cheese.
- Protein
- All products made from whole grain. Bread, cereal flakes, oat products from whole grain, corn, green spelt, buckwheat, millet, whole grain rice
- All vegetables (fresh or frozen) as raw or cooked, low-fat, legumes
- Jacket potatoes (early potatoes with skin), boiled potatoes
- All types of fruit fresh or frozen. Unsweetened fruit compote, fruit ice cream made from unsweetened, pure fruit juice or fruit sorbet
- Mineral water, tap water, herbal and fruit tea unsugared, black tea and coffee in moderation, juice spritzer, unsugared fruit juice, vegetable juice.
- Fresh and dried herbs, spices, mustard, vinegar
Products from this group should not be consumed every day or in large quantities.
Edible fats Meat and meat products Fish Milk and dairy products Eggs Grain products Potatoes Fruit and nuts Confectionery Beverages Spices
- Sunflower oil, maize germ oil, wheat germ oil, nut oil, safflower oil, margarine with a high content of unsaturated fatty acids
- Lean beef or pork without visible fat. Cut off fat edges! Lean cooked ham, salmon ham, turkey sausage and all other low-fat sausage types.
(In any case, lean cheese is preferable as a topping for bread! )
- Canned fish with sauce, shellfish and crustaceans, breaded fish.
- Low-fat cheeses up to 30% fat in dry matter, edible quark with 20% fat, cream cheese cream stage
- Two to three eggs per week (this includes hidden eggs, for example in pancakes)
- Light flour (type 405), light breads, sweetened breakfast cereals and muesli mixes with added sugar, white peeled rice, light noodles.
- Potato dishes prepared with suitable fats such as fried potatoes (use little oil!) or French fries from the oven.
- Avocado, canned fruit with sugar, dried fruit, all kinds of nuts
- Sweetener, household sugar, dextrose, fructose, jam and jelly, honey.
- Candies, liquorice, fruit gums, fruit ice cream
- Cocoa drinks, lemonades and Coca Cola, fruit nectars, malt beer, alcoholic beverages
- Ketchup, salt, herbal salt.
Products from this group are rich in fat and saturated fatty acids.
Also the Cholesteringehalt is too high in most products. Therefore the consumption avoid or drastically limit. Edible fats Meat Fish Milk and dairy products Eggs Grain products Potatoes Confectionery Beverages Spices and sauces
- Butter, clarified butter, lard, coconut fat, palm kernel fat, fats with chemically hardened oils like some margarines and frying fats.
- Generally fat meat, goose, duck.
Bacon, minced meat, offal, all kinds of high-fat sausages (spreadable sausage, meat sausage, black pudding, etc. )
- Eel, caviar and all high-fat fish except the cold water fish herring, salmon, mackerel and tuna.
- All fatty dairy products like whole milk, cream, crème fraiche. Sour cream, cream quark, cream yoghurt and all types of cheese with a fat content of more than 30% in dry matter.
- No more than 3 eggs per week
- Fatty breads (some toasts and baguettes), croissants, pasta with egg.
- All commercially available baked goods such as cakes, coffee pieces with white flour, high fat content and lots of sugar.
Cookies, salty and cheese cookies.
- All potato preparations with unsuitable fats (butter, clarified butter) and high fat content such as French fries from the deep fryer or potato chips.
- Chocolate and all chocolate products, nut nougat cream, cream ice cream and milk ice cream, marzipan, confectionery
- Unfiltered coffee and drinking chocolate with cream
- Mayonnaise, Remoulade
All products that are marked in the list as suitable in moderation and contain sugar should also be omitted here. Such as sugary muesli, breakfast cereals, white rice, white noodles, all sugars and confectionery and sugary soft drinks. It is also recommended to eat cold-water fish regularly (normal weight approx.
100 g per day). In mixed hyperlipidemia, the pattern of blood lipid increases is very different and subject to fluctuations. Accordingly, different priorities must be set in nutritional therapy.
If the total and LDL cholesterol is elevated, the rules of a cholesterol-lowering diet apply first and foremost. With increased Cholesterinwerten (LDL highly, HDL low) and simultaneous increase of the triglycerides it is recommended to increase the portion of simply insatiated fatty acids (olive oil, rapeseed oil, nut oil) to reduce saturated fatty acids from animal products. In addition, it is recommended to eat cold-water fish regularly, to increase the dietary fiber content of the daily food and not to drink alcohol.
In this very rare metabolic disease, the chylomicrons in the blood are greatly increased and triglyceride concentrations of more than 1000 mg/dl are often present.An extremely low-fat diet is recommended in the beginning (maximum 20 to 25 g daily total fat intake. Vegetable food and renouncement of edible fats and oils. Slowly increase the daily fat intake.
Initially only medium-chain fats (MKT fats = Ceres margarine and Ceres oil) as a substitute for the usual spreadable fats and oils. Gradually add 5 to 10 g of an oil rich in linoleic acid such as sunflower oil or safflower oil. Very carbohydrate-rich diet.
Avoid household sugar, dextrose and sugary foods such as sweets, honey, jam) Remove easily digestible carbohydrates such as white flour and white flour products (cakes, pastries, white bread) from the daily diet. Give preference to wholemeal products with high fiber content. Avoid high cholesterol foods such as offal, eggs, shellfish and crustaceans.
Preference should be given to all vegetables, pulses, potatoes, fresh fruit, vegetable juices. Fatty meat and fatty fish are unsuitable. Choose the low-fat varieties here.
Prefer low-fat milk and dairy products. 5 smaller meals spread over the day are recommended. If you are overweight, you should try to lose weight with the aim of achieving normal weight. With, on this food form not responding forms of the illness, an interval chamfering (for example 1 day per week) can lead to success.
