Najeeb Fizza, Azhar Natalia, Khan Madeeha, Khan Rezzan, Bibi Zainab, Khan Mohammad Iqbal, Sadiq Fouzia
Faculty of Health Sciences, Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad, Pakistan.
Faculty of Health Sciences, King Edward Medical University, Lahore, Pakistan.
Oman Med J. 2024 May 30;39(3):e645. doi: 10.5001/omj.2024.81. eCollection 2024 May.
Dyslipidemia and atherosclerotic cardiovascular events are highly prevalent in Pakistan, which could be attributed to a lack of education, poverty, unhealthy dietary habits, and the absence of local guidelines. Our main goal was to develop a comprehensive comparison of the existing international dyslipidemia guidelines, highlighting the different nutritional recommendations proposed by each. A secondary objective was to establish local food sources beneficial for dyslipidemia coexistent with other morbidities.
We conducted a systematic review of three databases Pubmed, Scopus, and International Guidelines Library to acquire guidelines for the management of dyslipidemia. The guidelines fulfilling the criteria of the Clinical Practice Guidelines developed by the Institute of Medicine in 2011 were selected for data extraction and their quality was assessed by the Mini-Checklist (MiChe) tool. Using the Harvard Healthy Eating Plate, a modified MyPlate describing portion of each macronutrient was established. Dietary recommendations for dyslipidemia and other comorbidity conditions were developed based on the review of guidelines and data from randomized control trials.
A total of 23 guidelines were selected based on our inclusion criteria. Final guidelines presented dietary patterns beneficial for the management of dyslipidemia, which differed due to the availability and cost-effectiveness of nutritional sources in Pakistan. After developing a modified MyPlate better suited to the dietary intakes of the population of Pakistan, nutritional recommendations for dyslipidemia with other comorbids were developed using local sources suggested by practicing dietitians.
Dietary modification is the cornerstone of managing dyslipidemia. Due to Pakistan's unique dietary patterns and the economic condition, a multidisciplinary approach with physicians and dietitians is required to develop easily applicable dietary regimes for dyslipidemia.
血脂异常和动脉粥样硬化性心血管事件在巴基斯坦极为普遍，这可能归因于缺乏教育、贫困、不健康的饮食习惯以及缺乏当地指南。我们的主要目标是对现有的国际血脂异常指南进行全面比较，突出各指南提出的不同营养建议。次要目标是确定与其他疾病共存时对血脂异常有益的当地食物来源。
我们对三个数据库（PubMed、Scopus和国际指南图书馆）进行了系统综述，以获取血脂异常管理指南。选择符合2011年医学研究所制定的临床实践指南标准的指南进行数据提取，并通过迷你清单（MiChe）工具评估其质量。使用哈佛健康饮食盘，建立了一个描述每种宏量营养素比例的改良版我的餐盘。基于对指南的综述和随机对照试验的数据，制定了血脂异常和其他合并症的饮食建议。
根据我们的纳入标准，共选择了23份指南。最终指南提出了对血脂异常管理有益的饮食模式，由于巴基斯坦营养来源的可用性和成本效益不同，这些模式也有所不同。在开发出更适合巴基斯坦人群饮食摄入量的改良版我的餐盘后，利用执业营养师建议的当地食物来源，制定了针对伴有其他合并症的血脂异常的营养建议。
饮食调整是管理血脂异常的基石。由于巴基斯坦独特的饮食模式和经济状况，需要医生和营养师采取多学科方法，为血脂异常制定易于应用的饮食方案。
