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Nutrition Management in

HYPERTRIGLYCERIDEMIA
Inge Permadhi
Departemen Ilmu Gizi FKUI-RSCM

Lipid Family
Triglyceride FAT
Phospholipid
Sterol

GLYCEROL

Saturated Fatty Acids (SFA)


SFA are solid at temperature room except coconut oil, palm
oil ect.
Saturated fats are most resistant to oxidation, least likely to
become rancid
SFA composition:

Lauric acids (12 C), Myristic acids (14 C) and Palmitic acids (16
C) LDL cholesterol and cardiovascular disease
Stearic acids (C-18) does not seem to raise blood cholesterol
Medium chain triglyceride (6 12C) caproic acid (C6), caprylic
acid (C8), capric acid (C10), and lauric acid (C12).

PUFA
Omega 3
Omega 3 sources: fish, flaxseed
EPA and DHA sources: fish and fish oil (especially deep
sea fish salmon, mackarel, halibut, tuna)

Omega 6
Source: vegetable oil

Balance intake omega 6 : omega 3 = 2 - 3 : 1

MUFA

Hydrogenated Fatty Acids or Trans Fatty Acids


Hydrogenation

Making PUFA more saturated


protect unsaturated fat against oxidation
Alters the texture of liquid vegetable oil more solid

Sources: margarine and natural foods as milk and meat


product

Effect of the different fatty acid classes


of the lipid profile

Ros E and Mataix J. Fatty acid composition of nuts implications for cardiovascular health. J Am Coll
Nutr, 2012; 89:1643S8S.

Fat Requirements
25 - 30% total calorie/day
Composition of fat
SFA < 10%
PUFA < 10%
MUFA < 15%
Cholesterol < 300 mg

Jacobs B, et al. J Nutr, 2004; 134: 1400 - 1405

Subject: 14 nonobese hypertriglyceridemic men


Method:
Randomized crossover design
3 weeks a low fat diet (29% energy)
2 weeks washout period
3 weeks high fat diet (40% energy)
Diet
Isocaloric, MUFA and omega 3

Jacobs B, et al. J Nutr, 2004; 134: 1400 - 1405


High vs low fat 40%
: 29% energy

Nydahl MC, et al. Am J Clin Nutr; 59: 115 - 122

Subject: hypercholesterolemia with or without concomitant


hypertriglyceridemia
Method: 2 x 3.5 weeks, cross over design

Nydahl MC, et al. Am J Clin Nutr; 59: 115 - 122

Carbohydrate Requirement
55 60% Total calorie
5% total calorie as simple sugar

Schwarz JM, et al, Am J Clin Nutr 2003; 77: 43 - 50

Fat 40% and CHO 45%

Fat 17% and CHO 68%

Schwarz JM, et al, Am J Clin Nutr 2003; 77: 43 - 50


Fat 40% and CHO 45%

Fat 17% and CHO 68%

Volek, JS, et al. Am Coll Nutr, 2000; 19: 383 - 391


Subject: 10 men free of metabolic and endocrine disorders
Method: 8 weeks with dietary intervention

Volek, JS, et al. Am Coll Nutr, 2000; 19: 383 - 391

Pieke B, et al. Int J Obese. 2000: 24: 1286 - 1296

Subject: 19 non obese hypertrigliseridemia


outpatients
Method: 2 x 3 weeks with 2 type of diets

Pieke B, et al. Int J Obese. 2000: 24: 1286 - 1296

CONCLUSION
CARBOHYDRATE
<5% simple carbohydrate

Protein
15%
Carbohydrate
>55%

Fat
<30%

FAT
<7% Saturated FAs
<10% Polyunsaturated FAs
<15% Monounsaturated FAs

Cholesterol: <300 mg/d


Fiber: 20-30 g/d
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in
Adults The Evidence Report. Obes Res. 1998;6 (suppl 2).