Managing Cardiometabolic Risk
Managing Cardiometabolic Risk in Abdominally Obese Patients
Nutrition
- 1Key Points (1 page)
- 2Managing abdominally obese patients at increased cardiometabolic risk: the nutritional perspective (1 page)
- 3Targeting excess body weight (1 page)
- 4CVD and its nutritional components (2 pages)
- 5Reducing blood pressure (1 page)
- 6Moderate alcohol consumption (1 page)
- 7The Mediterranean diet (1 page)
- 8Other dietary measures to lower CVD risk and cholesterol levels (2 pages)
- 9References (1 page)
CVD and its nutritional components
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Figure: 
Figure: Dietary components known to directly influence LDL cholesterol—which is the major cholesterol-carrying lipoprotein particle in plasma—and promote atherogenesis and thrombogenesis are saturated fats, cholesterol, and trans-fatty acids. Lowering saturated fat intake is crucial in the presence of hypertension and high plasma lipids. To reduce LDL cholesterol, saturated fat intake should be limited to <7% of total energy intake, cholesterol intake to less than 300 mg/day, and <1% of total energy should come from trans-fatty acids (9). These targets can be reached by limiting intake of foods high in saturated fat, cholesterol, and/or trans-fatty acids, such as tropical oils, fatty meats, egg yolk, shellfish, high-fat dairy products, and packaged foods containing partially hydrogenated vegetable oils. Saturated fat should also be replaced with monounsaturated fat, polyunsaturated fat, and complex carbohydrates (e.g., over 10% of total calories from polyunsaturated fat, over 15% of total calories from monounsaturated fat, and 55 to 65% or more of total calories from complex carbohydrates) (5, 7).
The AHA has set out guidelines for reducing the risk of CVD through overall healthy practices (5, 9, 12). These guidelines stress the need to achieve and maintain energy balance by matching energy expenditure to energy intake, which can help patients attain a healthy body weight, a normal lipid profile, and normal blood pressure (BP) (9). Patients should also consume a variety of fruits, vegetables, whole grains and high-fibre foods, fat-free or low-fat (<1% fat) dairy products, low in saturated fat and lean meats, and fish (at least twice a week) to ensure a sufficient supply of essential nutrients (5, 9). Portion size and frequency must be monitored, and the consumption of high-calorie foods containing refined sugars and having little nutritional value should be limited (9). Your hands can be very useful in estimating portion size. Use the portion sizes shown in the Figure as a guide.
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