8
Weight loss of 5-10% body weight is generally recommended
for overweight or obese individuals to lower atherogenic
lipoprotein lipids and improve other ASCVD risk factors. A
variety of dietary approaches can be implemented for weight
loss. Any dietary approach will result in weight loss if energ y
intake is reduced. An energ y-reduced healthy dietary pattern
that meets nutrient needs is recommended for patients who
are overweight or obese.
Several healthy dietary patterns, such as the Mediterranean-
style, DASH, USDA, and vegetarian diets, can be tailored
to personal and cultural food preferences and appropriate
calorie needs for weight control.
A Moderate
Eating patterns that contain a moderate quantity of
carbohydrate, lower glycemic index and load, and higher
protein, have been associated with modest benefits for weight
loss and maintenance.
C Low
Plant sterols and stanols (~2 g/day) are recommended for
cholesterol lowering, as well as viscous fibers (5–10 g/day or
even greater, if acceptable to the patient), as adjuncts to other
lifestyle changes. However, individuals with phytosterolemia
(sitosterolemia) should avoid foods that are fortified with
stanols and sterols.
B Moderate
For patients with TG levels ≥150 mg/dL, lifestyle therapy
is indicated, including weight loss if overweight or obese,
physical activity, and restriction of alcohol, sugars and
refined starches. Partial replacement of sugars and refined
starches with a combination of unsaturated fats, proteins, and
high-fiber foods may help to reduce TG and non-HDL- C
concentrations.
A Moderate
For patients with TG levels ≥1000 mg/dL (and selected
patients with TG 500–999 mg/dL), a low-fat diet (<15%
of energ y) and alcohol abstinence are recommended
initially to minimize chylomicronemia. In patients with
hypertriglyceridemia and diabetes, dietary carbohydrate
should not be substantially increased to avoid worsening
glycemia when reducing fat intake. Medium chain TG
oil may be used as a source of energ y that will not induce
chylomicron production. For patients without lipoprotein
lipase deficiency, dietary fat may be liberalized with
monitoring of the TG response once the TG concentration
is <500 mg/dL.
B Moderate
Chart 1. Nutritional Recommendations (cont'd)
Recommendations
Strength Quality
Lifestyle
