Ernährungstherapie der dyslipoproteinämien

Dyslipoproteinaemias are common and are associated with an enhanced risk of coronary heart disease. Generally, with only rare exceptions, their course may be influenced by nutritional therapy. Hence, any treatment of dyslipoproteinaemias must, first of all, lower LDL cholesterol levels by reducing and modifying fat in the diet. Lower HDL cholesterol levels are achieved by reducing the body weight and via enhanced physical activity. Hyperchylomicroaemias are treated by means of medium-chain triglycerides and enhanced VLDL triglycerides by weight reduction and a moderate intake of sweets and alcohol. Various fatty acids do not only influence lipoproteins in the blood plasma; they also act on other factors that are of importance in atherogenesis, such as viscosity of the blood, thrombocyte aggregation, blood pressure and even the gene expression of cytokines. Fatal infarctions can be prevented and life expectancy increased by enhanced supply of n-3 fatty acids. Other nutritional factors are also coronary protectors, such as antioxidative vitamins, secondary plant constituents and dietary fibres. The plasma lipoproteins should not be the only targets in the treatment of dyslipoproteinaemia; it is essential to fully utilise the preventive potentials of whole-food nutrition prominently featuring food from the plant kingdom and of a single-minded pursuit of a diet with moderate and modified fats, combined at the same time with adequate physical activity.