Avaliação de uma intervenção nutricional sobre o consumo alimentar de indivíduos hiperlipidêmicos coronarianos / Evaluation of a dietary treatment on food intake of hyperlipidemic patients with cardiovascular disease

This study aimed to evaluate the changes on the dietary intake of patients with coronary heart disease, after a nutritional intervention based on the Scoring System for Control of Serum Lipids and Cholesterol Levels. An intervention study was carried out on hyper lipidemic patients with cardiovascular disease. This protocol accompanied the following groups: three patients with coronary heart disease advised to follow their usual diet and with a total cholesterol > 200mg/dL (DHCA); eight patients with coronary heart disease advised to follow their usual diet and with a total cholesterol < 200mg/dL (DHCB); three patients with coronary heart disease advised to follow the diet proposed by the Scoring System and with a total cholesterol > 200mg/dL (DPCA); eight patients with coronary heart disease advised to follow the diet proposed by the Scoring System and with a total cholesterol < 200mg/dL (DPCB). Changes in dietary intake variables were compared between the groups by analysis of variance for repeated measures using the general linear model. It was observed that the DPCB group presented a significantly lower intake of fats, saturated fatty acids, trans fatty acids and cholesterol when compared with the DHCB group(p<0.050). The DPCA group presented a significantly lower intake of saturated fatty acids and an increased intake of dietary fiber, vitamin C and vitamin E when compared to the DHCA group (p<0.050). From the results of the present study, it is possible to conclude that patients who adopted the guidelines proposed by the Scoring System changed their food intake, especially regarding the consumption of lipids.

Este estudio tuvo por objetivo evaluar los cambios en la ingestión de alimentos de pacientes hiperlipidémicos con enfermedad coronaria, después de una intervención nutricion albasada en el Sistema de Puntos para el Control del Colesterol y de la Grasa en la Sangre. Se realizó un estudio de intervención con pacientes hiperlipidémicos con enfermedad coronaria. Este protocolo de investigación acompañó los siguientes grupos: tres pacientes coronarios aconsejados a seguir su dieta habitual y con colesterol total >200mg/dL (DHCA); ocho individuos coronarios aconsejados a seguir su dieta habitual y con colesterol total<200mg/dL (DHCB); tres pacientes coronarios aconsejados a seguir la dieta propuesta por el Sistema de Puntos y con colesterol total>200mg /dL (DPCA), y ocho pacientes coronarios aconsejados a seguir la dieta de los puntos con colesterol total <200mg / dL (DPCB). Los cambios en las variables de consumo de alimentos fueron comparados entre los grupos de estudio mediante análisis de varianza para medidas repetidas utilizando el Modelo Lineal General. Se observó que los pacientes del grupo DPCB consumieron cantidades significativamente más bajas de grasa, grasas saturadas, grasas trans y colesterol en comparación con el grupo DHCB (p <0,050). El grupo DPCA mostró un menor consumo de ácidos grasos saturados yun mayor consumo de fibra y vitaminas C y Eque el grupo DHCA (p <0,050). Los resultados obtenidos por este estudio permiten concluir que los pacientes que adoptaron las directrices propuestas por el Sistema de Puntos modificaron su consumo de alimentos, especialmente con relación a la ingesta de lípidos.

Este estudo teve como objetivo avaliar as modificações no consumo alimentar de indivíduos hiperlipidêmicos coronarianos, após uma intervenção nutricional baseada no Sistema de Pontos para Controle de Colesterol e Gordura no Sangue. Foi realizado um estudo de intervenção, com pacientes hiperlipidêmicos com doença coronariana. Este protocolo de pesquisa acompanhou os seguintes grupos: três pacientes coronarianos orientados a seguir sua dieta habitual e com colesterol total >200mg/dL (DHCA); oitoi ndivíduos coronarianos orientados a seguir sua dieta habitual e com colesterol total<200mg/dL (DHCB); três pacientes coronarianos orientados a seguir a dieta proposta pelo Sistemade Pontos e com colesterol total >200mg/dL(DPCA); oito pacientes coronarianos orientados a seguir a dieta de pontos e com colesterol total <200mg/dL (DPCB). Alterações sobre as variáveis de consumo alimentar foram comparadas entre os grupos de estudo utilizando a análise de variância para medidas repetidas por meio do modelo linear generalizado. Pôde-se observar que os pacientes do grupo DPCB consumiram quantidades significantemente menores de lipídios, ácidos graxos saturados, trans e colesterol quando comparados aos do grupo DHCB (p<0,050).O grupo DPCA apresentou menor consumo de ácidos graxos saturados e maior ingestão de fibras e vitaminas C e E que o DHCA(p<0,050). Os resultados obtidos pelo presente estudo permitem concluir que os pacientes que adotaram as orientações propostas pelo Sistema de Pontos alteraram seu consumo alimentar, principalmente em relação ao consumo de lipídios.

Aspectos clínicos e socioeconômicos das dislipidemias em portadores de doenças cardiovasculares / Clinical and socioeconomic aspects of dyslipidemia in patients with cardiovascular diseases

O presente artigo aborda os aspectos clínicos e socioeconômicos decorrentes da presença de dislipidemias em portadores de doenças cardiovasculares (DCV). Existem inúmeros estudos relacionados às DCV, uso de hipolipemiantes orais como as estatinas, e os aspectos econômicos envolvidos com impacto na área da saúde. Além de evidenciar a importância do tratamento das dislipidemias, o artigo busca demonstrar o ponto de vista farmacoeconômico, ou seja, dos custos gerados com o tratamento farmacológico desta patologia versus os custos decorrentes dos eventos cardiovasculares acometidos e suas consequências. Existe, portanto, relevante relação entre os impactos sociais decorrentes de incapacidade física e laborativa, aposentadorias precoces, entre outros custos importantes que poderiam ser evitados com uma análise econômica abrangente e eficiente realizada nos serviços de saúde do Brasil. Neste contexto, é enfatizada a importância da análise conjunta dos aspectos clínicos e socioeconômicos das dislipidemias que poderiam influenciar nas decisões das autoridades de saúde no momento da elaboração de protocolos clínicos de tratamentos farmacológicos a serem implementados no SUS.

This paper discusses the clinical and socioeconomic factors arising from the presence of dyslipidemia in patients with cardiovascular disease (CVD). There are numerous studies related to CVD, oral use of statins as statins, and the economics aspects involved with an impact on health. In addition to demonstrating the importance of the treatment of dyslipidemia, the paper shows the pharmacoeconomic viewpoint, i.e. costs generated by the pharmacological treatment of this disease versus the costs of cardiovascular events and their consequences. There is therefore relevant relationship between the social impacts arising from physical disability and work, early retirements, among other important costs that could be avoided with a comprehensive economic analysis and efficient health services in Brazil. In this context, we emphasize the importance of joint analysis of the clinical and socioeconomic aspects of dyslipidemia that could influence the decisions of health authorities at the time of preparation of clinical protocols of pharmacological treatments to be implemented within the SUS.

[Effect of ground black seed [nigella sativa l.] on serum lipid profile, body weight and food intake in hyperlipidemic rabbits]

Black seed [Nigella sativa L.] is one of the most revered medicinal plants which has been used to treat many diseases including hypercholesterolemia in some folk medicines. The aim of this study was to examine the effect of dietary supplementation with crushed black seed on serum lipid profile, body weight and food intake in hyperlipidemic rabbits. Twenty-four New Zealand male rabbits after 2 weeks of adaptation received a hypercholesterolemic diet with 0.5% cholesterol for 1 month. Then the rabbits were randomly assigned into two groups, the control group was continued on the 0.5% cholesterol diet and the black seed group received 7.5 g/kg bw/day crushed black seed along with the 0.5% cholesterol diet, for 2 months. The diets were isocaloric and isonitrogenous. Fasting blood sampling and measurement of body weight was carried out at baseline, after hyperlipidemia, 1 month and 2 months of treatment and the levels of serum lipid profile were determined. Daily food intake also was measured by subtracting the given food from its residues. The concentrations of serum TC, TG, LDL-C, TC/HDL-C and LDL.C/ HDL-C were significantly lower in black seed group as compared to the control group during the 2 months of treatment, but there was no significant difference in body weight and food intake between the two groups. According to these findings, dietary black seed favorably decreased serum lipid profile in hyperlipidemic rabbits; therefore, black seed may be used as a useful therapy for hyperlipidemia

[ effects of soy bean on serum homocysteine, Lp[a] and lipoproteins in hyperlipidemic postmenopausal women]

Because of undesirable serum lipoprotein profiles, postmenopausal women are at risk of cardiovascular disease. Soy protein may help protect against these risk factors although its effect on homocysteine and Lp [a] is not clear; however, the effects of soy bean in hyperlipidemic postmenopausal women has not been assessed independently yet. The aim of this study was to determine the effects of soy bean on serum concentration of homocysteine, Lp[a] and lipoproteins in hyperlipidemic postmenopausal women. In a randomised clinical trial with parallel design, 34 hyperlipidemic postmenopausal women were randomly assigned to group 1 and given 130 g soy bean containing 50 g/d soy protein and 159/9mg isoflavones, while group 2 continued their usual diet for 10 weeks [controls]. Serum lipoproteins, homocysteine and Lp [a] were measured at baseline and after the 10[th] week. There were significant decreases in Lp [a] LDL-c, TC, LDL-c/HDL-c, TG/HDL-c, TC/HDL-c in group 1, as compared to group 2, after ten weeks of study [p<0.05, p<0.001, p<0.01, p<0.01, p<0.05 and p<0.05 respectively] at the end of the study. Similarly, Lp[a], homocysteine, LDL-c, TC, LDL-c/HDL-c, TG/HDL-c, TC/HDL were significantly decreased [p<0.01, p<0.05 p<0.01, p<0.01, p<0.01, p<0.05, p<0.01] at the end of the study, compared with initial values of the soy group. We can conclude that Soy protein reduces CVD risk in postmenopausal women because of both modest reductions in serum lipoproteins and Lp[a] in hyperlipidemic postmenopausal women

Influência de uma intervenção nutricional baseada no Sistema de Pontos para Controle de Colesterol e Gordura no Sangue em indivíduos hiperlipidêmicos coronarianos usuários de sinvastatina / Effects of a dietary treatment based on the Points System to Control serum lipids and cholesterol in patients with coronary heart disease making use of sinvastatin

Introdução: O tratamento das dislipidemias consiste em mudanças no estilo de vida( introdução de dieta e atividade física) e uso de hipolipemiantes. As estatinas diminuem a mortalidade em pacientes com doença cardiovascular e em indivíduos em risco de desenvolverem cardiopatias. No entanto, poucas informações existem sobre a interação destes medicamentos com o tratamento dietético. Objetivo: Avaliar o efeito de uma dieta com baixo índice de colesterol e gordura saturada baseada no Sistema de Pontos para Controle de Colesterol e Gordura no Sangue, sobre marcadores bioquímicos e antropométricos em indivíduos dislipidêmicos coronarianos sob o uso de estatinas. Metodologia: Foi realizado um ensaio clínico randomizado controlado, com pacientes hiperlipidêmicos portadores de doença coronariana, em uso de sinvastatina. Este protocolo de pesquisa acompanhou os seguintes grupos de pacientes: coronarianos fazendo uso de sinvastatina, orientados a seguir sua dieta habitual e com colesterol total > 200mg/dL (DHCA); indivíduos coronarianos fazendo uso de sinvastatina, orientados a seguir sua dieta habitual e com colesterol total < 200 mg/dL (DHCB); pacientes coronarianos fazendo uso de sinvastatina, orientados a seguir a dieta proposta pelo Sistema de Pontos e com colesterol total > 200 mg/dL (DPCA); pacientes coronarianos fazendo uso de sinvastatina, orientados a seguir a dieta de pontos e com colesterol total < 200 mg/dL (DPCB). Alterações sobre as variáveis antropométricas, perfil lipídico, proteína C reativa e auto-anticorpos anti-LDL-ox foram comparadas entre os grupos de estudo utilizando a análise de variância para medidas repetidas por meio de modelo linear generalizado (GLM). Resultados: Em relação ao consumo alimentar pôde-se observar que os pacientes do grupo DPCB consumiram quantidades significativamente menores de lipídios, ácidos graxos saturados, trans e colesterol quando comparados aos do grupo DHCB (p<0,050). O grupo DPCA apresentou menor consumo de ácid...

Influence of dietary mustard and fennel seeds on hypercholesterolemic, hyperlipidemic rats

This work has been planned to study the effect of dietary mustard [Brassica campestris] and Fennel [Foenicum vulgare Mill] seeds on hypercholesterolemic rats. The male Albino rats with average weight [113 +/- 19.1 g] divided into six groups, group [1] as control [healthy] group; group [2] as high fat cholesterol; groups [3, 4] which rats fed on high fat cholesterol plus 5 or 10% mustard seeds; groups [5. 6] which rats fed on high fat cholesterol plus 5 or 10% fennel seeds respectively. Results obtained revealed that there were highly significant decrease in the mean values of total lipids, total cholesterol, triacylglycerols, VLDL-C, HDL-C, LDL-C and risk ratio. There was highly significant increase in concentration of glutathione [GSH] and superoxide dismutase [SOD] activity while highly significant decrease in malondialdehyde [MDA] as lipid peroxidation. Also results showed highly significant decrease in activities of ALT, AST and ALP and concentration of albumin and creatinine in serum as compared with group [2] fed on high fat cholesterol diet alone [P < 0.01]. It could be concluded that the administration of mustard or fennel seeds at levels of 5 and 10% in high fat cholesterol diet can be able to reduce the lipid profile and lipid peroxidation and maintain kidney and liver in rats

Beneficial effects of Zingiber officinale Roscoe on fructose induced hyperlipidemia and hyperinsulinemia in rats.

Fructose supplementation produced cardinal features of Syndrome-X including significant elevations in seum cholesterol, triglyceride, glucose and insulin and also in body weight. While treatment with methanolic extract of dried rhizomes of Zingiber officinale produced a significant reduction in fructose induced elevation in lipid levels, bodyweight, hyperglycemia and hyperinsulinemia, treatment with ethyl acetate extract of Z officinale did not poduce any significant change in either of the last two parameters. However, it produced a significant reduction in elevated lipid levels and body weight The concentration of 6-gingerol was found to be higher in methanolic extract and less in ethyl acetate extract. The results suggest that the methanolic extract of Z officinale produces better effects as compared to ethyl acetate extract in fructose induced hyperlipidemia associated with insulin resistance. The extent of activity appears to be dependent on the concentration of 6-gingerol present in the extracts.

Use of rice bran oil in patients with hyperlipidaemia.

BACKGROUND: The quantity and type of dietary fat is known to affect plasma lipid concentration and hence the choice of cooking oil is important to lower the risk of coronary heart disease. Rice bran oil, which was not popular worldwide, is slowly being recognized as a 'healthy' oil in India. We assessed if rice bran oil had hypolipidaemic effects in subjects with elevated lipid levels. METHODS: The study had a cross-over design with subjects (n = 14) randomly assigned to consume either rice bran oil or refined sunflower oil in their homes, for a period of 3 months (period 1). After a washout period of 3 weeks, they were crossed over to the other oil (period 2). The serum lipid values were estimated at the beginning, on day 45 and day 90 of each phase. Additional parameters assessed included anthropometry, dietary and physical activity patterns. RESULTS: The use of rice bran oil significantly reduced plasma total cholesterol and triglyceride levels compared with sunflower oil. The reduction in plasma LDL-cholesterol with rice bran oil was just short of statistical significance (p = 0.06). HDL-cholesterol levels were unchanged. CONCLUSION: The use of rice bran oil as the main cooking oil significantly reduced serum cholesterol and triglyceride levels. The use of rice bran oil together with dietary and lifestyle modifications may have implications for reducing the risk of cardiovascular disease.

Effects of soy protein isoflavones on serum lipids, lipoprotein profile and serum glucose of hypercholesterolemic rabbits

The main objective of this research was to determine the effects of soy protein isoflavones on serum lipids, lipoproteins and fasting blood sugar levels in hypercholesterolemic rabbits. Twenty-four male New Zealand rabbits received the basic pellet diet for two weeks and were then placed on a hypercholesterolemic diet [pellets plus 1% cholesterol] for three weeks. After elevation of total cholesterol, the rabbits were randomly allocated into four experimental groups. Groups 1 to 3 received 100g soy protein containing 200mg [SPI+], 100mg [SPI50%] soy protein diet and without isoflavones [SPI-], respectively, for six weeks. The fourth group was kept on the hypercholesterolemic diet [HC]. Findings showed that cholesterol rich diet produced significant increase in total, LDLand HDL-cholesterol concentrations. In SPI+ group these parameters remained unchanged, compared with SPI- and SPI50% groups [P<0.0001]. HDL-cholesterol was significantly elevated after administration of HC diet and remained high [almost three fold] in all soy diets relative to baseline. However, its level was significantly lower in SPI50% compared with SPI-group [p<0.01]. Triglycerides and VLDL concentrations were significantly increased in SPI50% compared with baseline and HC groups [P<0.03]. Fasting blood sugar levels were not changed in all soy treatment groups. These results suggest that intact soy protein isoflavones ameliorate the lipid profile in spite of high-cholesterol intake, but has no obvious effect on blood sugar levels and can therefore be useful in hyperlipidemias especially when cholesterol intake is simultaneously decreased. Moreover, there is no direct doseresponse relationship between soy isoflavone content and its lipid-lowering effect

Effect of Fiber bread on the management of diabetes mellitus

To evaluate the effects of soluble fiber rich bread on lowering blood glucose, blood pressure and blood lipid levels. An interventional study. The study was undertaken at Medical Unit III, Jinnah Postgraduate Medical Centre, Karachi. Duration of the project was one year [1997-1998]. Twenty stable diabetics of both genders were included in this study. They were provided with this bread [test diet] to replace their usual breakfast bread and chapati for lunch and dinner. The intakes of other foods as well as medications were unchanged. Anthropometric measurements, fasting and 2 hours postprandial blood sugar, fasting serum cholesterol and triglyceride levels were recorded before and after 4 weeks of intervention. Blood sugar and blood pressure were checked every week. Quality of life was assessed subjectively with the help of questionnaire, which were asked before and after the end of the intervention. Glycemic control, both fasting and postprandial, improved significantly during intervention. Satisfactory reduction of blood pressure as well as serum cholesterol and triglyceride level was also observed in these cases. The medicines reduced significantly and quality of life improved in all subjects. None of these subjects complained any gastrointestinal discomfort during their consumption of this bread for 4 weeks. The use of soluble fiber rich bread helps to control blood sugar, the hyperlipidemia, and blood pressure which are elevated in poorly controlled diabetics. Thus, integrated improvement will improve the quality of life, reduce the cost of drugs as well as help to avoid harmful effect of drugs

Non-pharmacological therapy of hyperlipidaemia.

Hyperlipidaemia is one of the major contributors to atherosclerosis and Coronary Heart Disease (CHD) in our society. Numerous clinical and epidemiological studies have shown repeatedly that an elevated blood cholesterol level is one of the major modifiable risk factors associated with the development of CHD. In particular, these studies have demonstrated that low- density lipoprotein (LDL) cholesterol is the primary lipoprotein mediating atherosclerosis. Non-pharmacological therapy especially dietary therapy and exercise remains the first line of treatment in hyperlipidaemia, with pharmacotherapy reserved for use in patients at high risk of coronary heart disease or patients who do not respond to non-pharmacological therapy.

Terapêutica das hiperlipemias: como e por quê? / Therapeutic of hyperlipidemias: how and why?

O tratamento das hiperlipemias envolve dois tipos de abordagem, a dietoterapia e a farmacoterapia. A dietoterapia tem suas bases de aplicaçäo bastante conhecidas e estabelecidas dentro de sólidos princípios científicos. A reduçäo da ingestäo de açúcares simples, álcool e energia tem efeito importante na reduçäo da trigliceridemia. A reduçäo na ingestäo de colesterol e gordura saturada ativa os receptores de LDL, aumentando o catabolismo dessas lipoproteínas. As drogas usadas para a reduçäo da lipemia podem ser divididas em dois grandes grupos: aquelas com efeito mais significativo na reduçäo da trigliceridemia e aquelas com efeito mais significativo sobre a colesterolemia. As estatinas säo as drogas mais efetivas para a reduçäo da colesterolemia. Essas drogas podem atuar também na prevençäo da formaçäo de placas, na reduçäo da progressäo e na estabilizaçäo das mesmas. Algumas delas modificam a biologia da placa pela reduçäo da agregaçäo de plaquetas e pela alteraçäo da contratilidade da artéria.

Efecto de bezafibrato en la dieta de hipertensos con dislipidemia e hiperfibrinogenemia / Effects of bezafibrate in the diet of hypertensive patients with dyslipidemia and hyperfibrinogenemia

Objetivo. Evaluar la respuesta a bezafibrato en la dieta de sujetos con hipertensión arterial, hiperinsulinemia, hiperlipidemia mixta e hiperfibrinogenemia. Métodos. Se usó un diseño comparativo, doble ciego de placebo (N = 13) ó 400 mg/día de bezafibrato (N = 15) añadidos a una dieta hipolipémica pobre en azúcares refinados durante 90 días de tratamiento. Al inicio y al final del tratamiento se midieron fibrinógeno, lípidos, insulina y péotido C y se hizo una curva de tolerancia a la glucosa. Resultados. Los grupos fueron similares en edad, presión arterial e IMC. Al final de tratamiento hubo disminución de fibrinógeno, colesterol, triglicéridos y LDL-C en ambos grupos, pero sólo en el grupo de bezafibrato hubo: a) una disminución significativa de triglicéridos (64 mg/dL, p 0.01); y b) cambios marginales en fibrinógeno (disminuyó 35 mg/dL, p = 0.09), colesterol (disminuyó 26 mg/dL, p= 0.10) y en la relación glucosa/insulina (aumentó de 4.4 a 5.2, p= 0.09). El bezafibrato disminuyó ligeramente los niveles de insulina pero no afectó al péptido C. La correlación de los cambios de nivel de fibrinógeno versus la insulina de 60 min de la curva de tolerancia fue mayor en el grupo de bezafibrato (r = 0.61) que en el de placebo (r = 0.23). Conclusiones. En pacientes resistentes a insulina y con riesgo cardiovascular elevado, el bezafibrato y el placebo añadidos a una dieta hipolipémica disminuyeron el fibrinógeno plasmático. El bezafibrato bajó significativamente los niveles de triglicéridos en estos pacientes

Terapia nutricional en el control de las dislipidemias / Nutritional therapy in dyslipidemia control

Se estudió la eficacia de la terapia nutricional exclusiva sobre el perfil lipídico en pacientes dislipidémicos. A 43 individuos con dislipidemia mixta y a 29 con hipercolesterolemia aislada, se les indicó la fase 2 de la recomendación del National Cholesterol Education Program: 30 por ciento de las calorías como lípidos (<75 por ciento como grasas saturadas, 10 por ciento de poliinsaturadas y 13 por ciento de monoinsaturadas); ingesta de colesterol (200 mg/día). Al control (2 a 4 meses) se observó una disminución significativa del colesterol y triglicéridos; en un 20 por ciento se logró la normalización de estos parámetros. El 25 por ciento de los pacientes aumentó el colesterol y los triglicéridos (NS). Tanto los hombres como las mujeres con HDL en cifras de riesgo elevaron sus niveles (p < 0.01); las LDL disminuyeron significativamente en los hombres con dislipidemia mixta y en las mujeres con hipercolesterolemia aislada. Las tasas de riesgo colesterol/HDL y LDL/HDL no se modificaron. En un 35 por ciento de los sujetos los menores niveles de colesterol se asociaron a una reducción de las HDL, pero sin alcanzar tasas de riesgo. La dieta disminuyó la correlación negativa entre triglicéridos y HDL que presentaban los pacientes al ingreso. La terapia nutricional exclusiva es efectiva en modificar el perfil lipídico de los dislipidémicos; sin embargo, es necesario agregar otras medidas no farmacológicas (ejercicio, supresión del tabaco) y farmacológicos para obtener una real disminución de las tasas de riesgo cardiovascular

Intervención nutricional y farmacológica en pacientes dislipidémicos / Nutritional intervention and pharmacological in dyslipidemic patients

El efecto de la intervención nutricional y farmacológica sobre el perfil lipídico fue evaluado en 38 pacientes dislipidémicos (M=15,F=23, edad 50.0+- 1.5 años) durante seis meses tenían hipercolesterolemia y 10 dislipidemia mixta. Mediante intervención nutricional, la dieta redujo el colestrol (344,0+-14,0 a 309,0+-17.0 mg/dl) y el colesterol LDL descendió un 18 por ciento. En pacientes dislipidémicos con predominio de triglicéridos,el colesterol bajó de 263,2+-13,0 a 249,0+-20.0 mg/dl (-5 por ciento), pero el colesterol LDL no varió; los triglicéridos descendieron de 379,0+- 45,0 a 359,6+-27,0 mg/dl. La dislipidemia persistió a pesar de dieta por lo que los pacientes hipercolesterolémicos recibiron lobastatina y aquellos con hipertrigliceridemia, gemfibrozil. En los primeros el colesterol se redujo (309.0+-16.7 a 257.0+-16.0 mg/dl); el colesterol LDL bajó un 28 por ciento (p>0.001) y el colesterol HDL subió (47,0+-2,6 vs 55,0 +-3,4 mg/dl, p<0,05). Pacientes con gemfibrozil redujeron el colesterol (244,0+-17,0 a 223,0+-17,0 mg/dl) y los triglicéridos (391,0+-73,0 a 26,0 273,0+-26,0 mg/dl, p<0,06, el colesterol HDL varió (39,5+-4,1 a 37,5+5,5 mg/dl. Después de la interveción nutricional, la relación colesterol/colesterol HDL fue 6,57 en hipercolesterolémicos y 6,11 en hipertrigliceridémicos. Esta relación bajó a 4,67 y a 5,36 en los tratados con lovastatina y gemfibrozil, respectivamente. Este reporte muestra el efecto de tratamientos hipolipemiantes para reducir el riesgo de las complicaciones para alcanzar las metas deseadas en el perfil lipídico.

Modificaciones en el perfil de lípidos inducidas al agregar nueces a la dieta del paciente hipercolesterolémico / Modifications in lipids profile when nuts are added to the diet of the hypercholesterolemic patients

En un estudio prospectivo, longitudinal y abierto se evaluó la modificación en el perfil de lípidos de pacientes hepercolesterolémicos. Se incluyeron 22 individuos (7 H y 15 M) dislipidémicos (colesterol mayor de 6.20 mmoles), se agregaron 100 gramos de nuez cáscara de papel cada tercer día y se siguieron con determinaciones de colesterol cada mes durante tres meses; no se dio otro tipo de dieta que la habitual del paciente, para evitar confusiones sobre la causa de la modificación del perfil de lípidos (42 por ciento del peso de este tipo de nuez es grasa monoinsaturada y 18 por ciento grasa poliinsaturada). La prueba estadística empleada fue la t de Student. Los 22 pacientes tuvieron una respuesta satisfactoria tanto en la reducción de colesterol -inicial 7.39 mmoles, final 7.03 mmoles (32 por ciento)- como en la de triglicéridos -inicial 2.05 mmoles, final 1-62 mmoles- p < 0.05. Siete pacientes eran además hipertensos y cinco diabéticos; sin embargo, no hubo diferencia significativa en su respuesta. Nuestros resultados muetran un claro efecto benéfico del uso de este tipo de alimentos sobre el perfil de lípidos del paciente con dislipidemia, reforzando el que su manejo se base en modificaciones en la dieta más que en el uso de fármacos hipocolesterolemiantes. Una ventaja adicional de esta variedad de nuez es su alto contenido en L-arginina, aminoácido precursor del óxido nítrico, el cual ha demostrado en animales hipercolesterolémicos un marcado efecto antiaterogénico