ITEMS IN AFP WITH MESH TERM:
Management of Dyslipidemia in Adults - Article
ABSTRACT: The importance of treating dyslipidemias based on cardiovascular risk factors is highlighted by the National Cholesterol Education Program guidelines. The first step in evaluation is to exclude secondary causes of hyperlipidemia. Assessment of the patient's risk for coronary heart disease helps determine which treatment should be initiated and how often lipid analysis should be performed. For primary prevention of coronary heart disease, the treatment goal is to achieve a low-density lipoprotein (LDL) cholesterol level of less than 160 mg per dL (4.15 mmol per L) in patients with only one risk factor. The target LDL level in patients with two or more risk factors is 130 mg per dL (3.35 mmol per L) or less. For patients with documented coronary heart disease, the LDL cholesterol level should be reduced to less than 100 mg per dL (2.60 mmol per L). A step II diet, in which the total fat content is less than 30 percent of total calories and saturated fat is 8 to 10 percent of total calories, may help reduce LDL cholesterol levels to the target range in some patients. A high-fiber diet is also therapeutic. The most commonly used options for pharmacologic treatment of dyslipidemia include bile acid-binding resins, HMG-CoA reductase inhibitors, nicotinic acid and fibric acid derivatives. Other possibilities in selected cases are estrogen replacement therapy, plasmapheresis and even surgery in severe, refractory cases.
ABSTRACT: The association between nutrition and health has been clearly documented. Primary care physicians are expected to address nutrition and dietary behavior issues with their patients in the context of a brief clinical encounter. This article proposes the use of a short interview form, with specific suggestions for behavior changes that family physicians can use to help their patients meet currently accepted dietary guidelines. Answers to the questions on the interview form provide the physician with an overall sense of the patient's daily eating habits and help to identify major sources of saturated fat in the patient's diet. The patient is asked about the number of meals and snacks eaten in a 24-hour period, dining-out habits and frequency of consumption of fruits, vegetables, meats, poultry, fish, dairy products and desserts. Documentation of dietary changes can be accomplished using the suggested nutrition history form, and improvements in nutritional status can be measured using weight, blood pressure and laboratory test data.
Dietary Fatty Acids - Article
ABSTRACT: Fatty acids can be divided into four general categories: saturated, monounsaturated, polyunsaturated, and trans fats. Saturated fatty acids and trans fats are associated with an increased risk of coronary heart disease. Monounsaturated fatty acids and polyunsaturated fatty acids are associated with a decreased risk of coronary heart disease, although these associations are not uniformly supported in the literature. Omega-3 fatty acids, which are a type of polyunsaturated fatty acid, have been studied as potential therapy for a variety of medical conditions because of their suspected anti-inflammatory properties. Omega-3 fatty acids have also been shown to provide some benefit to patients with cystic fibrosis, and may have a protective effect against dementia. Physicians should counsel patients about the importance of avoiding hydrogenated oils and foods containing trans fats because of their association with coronary heart disease in observational studies.
Dietary Fat: Quantity and Quality - Editorials
Dietary Fat Modification and the Risk of Future Cardiovascular Events and Mortality - Cochrane for Clinicians