Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece.
Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Maturitas. 2018 Feb;108:45-52. doi: 10.1016/j.maturitas.2017.11.011. Epub 2017 Nov 14.
Specific dietary strategies are the mainstay of management in most cases of dyslipidaemia, prior to or simultaneously with the initiation of a lipid-lowering agent. The exact approach differs according to the type of dyslipidaemia. In particular, a reduction in carbohydrates (mainly foods with a high glycaemic index) and their substitution with mono- and polyunsaturated fatty acids is the main strategy in patients with high levels of triglycerides (Tg) and/or low levels of high-density lipoprotein cholesterol (HDL-c). A reduction in saturated and trans fatty acids, combined with an increased intake of specific dietary components, such as plant sterols, soy protein and red yeast rice, constitutes the more efficacious dietary approach in cases where levels of total cholesterol and low-density lipoprotein cholesterol (LDL-c) are elevated. A reduction in excessive body weight is beneficial in every type of dyslipidaemia, whereas increased physical activity is mostly effective in cases with low HDL-c and high Tg levels. With respect to the potential cardiovascular benefit of these dietary interventions, there is currently evidence for the Mediterranean diet. Potential benefit may derive also from single dietary components of that diet, such as legumes, fruits, vegetables, nuts and omega-3 fatty acids, although to a lesser extent than with that general dietary pattern. The purpose of this review is to outline current knowledge regarding the recommended specific dietary pattern according to the type of dyslipidaemia and the evidence for the potential cardiovascular benefits of such approaches.
在大多数血脂异常情况下，特定的饮食策略是管理的主要方法，可在开始使用降脂药物之前或同时进行。具体方法因血脂异常的类型而异。特别是，降低碳水化合物（主要是高血糖指数的食物）并将其替代为单不饱和和多不饱和脂肪酸，是高甘油三酯（Tg）和/或低高密度脂蛋白胆固醇（HDL-c）水平患者的主要策略。减少饱和脂肪和反式脂肪，同时增加特定膳食成分的摄入，如植物固醇、大豆蛋白和红曲米，是治疗总胆固醇和低密度脂蛋白胆固醇（LDL-c）升高的更有效的饮食方法。减轻超重对每种类型的血脂异常都有益，而增加身体活动主要对 HDL-c 水平低和 Tg 水平高的情况有效。关于这些饮食干预的潜在心血管益处，目前有证据表明地中海饮食有益。这种饮食模式的单一膳食成分，如豆类、水果、蔬菜、坚果和欧米伽-3 脂肪酸，也可能具有潜在益处，但程度低于这种一般饮食模式。本文旨在概述根据血脂异常类型推荐的特定饮食模式的现有知识，以及这些方法对潜在心血管益处的证据。
