Nutrition interventions for adults with dyslipidemia: A Clinical Perspective from the National Lipid Association
- PMID: 37271600
- DOI: 10.1016/j.jacl.2023.05.099
Nutrition interventions for adults with dyslipidemia: A Clinical Perspective from the National Lipid Association
Abstract
Lifestyle habits can have a profound impact on atherosclerotic cardiovascular disease (ASCVD) risk. The National Lipid Association previously published recommendations for lifestyle therapies to manage dyslipidemia. This Clinical Perspective provides an update with a focus on nutrition interventions for the three most common dyslipidemias in adults: 1) low-density lipoprotein cholesterol (LDL-C) elevation; 2) triglyceride (TG) elevation, including severe hypertriglyceridemia with chylomicronemia; and 3) combined dyslipidemia, with elevations in both LDL-C and TG levels. Lowering LDL-C and non-high-density lipoprotein cholesterol are the primary objectives for reducing ASCVD risk. With severe TG elevation (≥500 mg/dL), the primary objective is to prevent pancreatitis and ASCVD risk reduction is secondary. Nutrition interventions that lower LDL-C levels include reducing cholesterol-raising fatty acids and dietary cholesterol, as well as increasing intakes of unsaturated fatty acids, plant proteins, viscous fibers, and reducing adiposity for patients with overweight or obesity. Selected dietary supplements may be employed as dietary adjuncts. Nutrition interventions for all patients with elevated TG levels include restricting intakes of alcohol, added sugars, and refined starches. Additional lifestyle factors that reduce TG levels are participating in daily physical activity and reducing adiposity in patients with overweight or obesity. For patients with severe hypertriglyceridemia, an individualized approach is essential. Nutrition interventions for addressing concurrent elevations in LDL-C and TG include a combination of the strategies described for lowering LDL-C and TG. A multidisciplinary approach is recommended to facilitate success in making and sustaining dietary changes and the assistance of a registered dietitian nutritionist is highly recommended.
Keywords: ASCVD; Dyslipidemia; Lifestyle habits; Low-density lipoprotein cholesterol; Nutrition interventions; Obesity; Triglyceride elevation.
Copyright © 2023. Published by Elsevier Inc.
Conflict of interest statement
Declaration of Competing Interest CFK is an employee of Midwest Biomedical Research and has no additional conflicts of interest to report beyond those disclosed for KCM. During the past 24 months, CAMA received honoraria for Science Advisory Board from Weight Watchers and McCormick Science. During the past 24 months, KEA received honoraria for principal investigator for Amgen, Esperion, Novartis, and Ionis. During the past 24 months, PMKE received research grants for American Pecan Council, American Pistachio Growers, Hass Avocado Board, McCormick Science Institute, Ocean Spray Cranberries, NIH – Byambaa, NIH – Paul, NIH – Al-Shaar and served on Advisory Boards for HumanN, Seafood Nutrition Partnership, and Heali. During the past 24 months, KCM received research grants for 89Bio, Acasti Pharma, Beren Therapeutics, Bragg Live Products, Campbell’s, Cargill, Eli Lilly, General Mills, Greenyn Biotechnology, Hass Avocado Board, Indiana University Foundation, Medifast, National Cattlemen’s Beef Association, Matinas Biopharma, National Dairy Council, Naturmega, NeuroEnergy Ventures, New Amsterdam Pharma, Pepsico, Pharmavite, and Seed, Inc. GS, KSP, and JPB have nothing to disclose.
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