[Medical nutrition prevention and medical nutrition therapy of lipid metabolism disorder].

High energetic density of nutrition, insufficient physical activity and smoking are the most common causes of obesity and lipid metabolism disorders (hyperlipoproteinemia and dyslipoproteinemia). Hyperlipoproteinemia and dislipoproteinemia are mass noncommunicable diseases and at the same time they are main causes of atherosclerotic cardiovascular diseases and cerebrovascular diseases, metabolic syndrome, hepatic diseases and some localization of malignant diseases. Cardiovascular diseases and malignant diseases are the leading causes of mortality in the world. Global Strategy on Diet, Physical Activity and Health Nutrition and The Second European Action Plan for Food and Nutrition Policy represent the World Health Organisation approach in prevention of risks of development, and treatment of mass noncommunicable diseases, first of all for hyperlipoproteinemia, cardiovascular diseases and cerebrovascular diseases. According to the previously mentioned health programmes, medical nutrition therapy of hyperlipoproteinemia and dislipoproteinemia should be applied on whole population and individual level as well. Medical nutrition therapy is managed on individual level. Eminent international organizations, such as the European Society of Atherosclerosis and the American Heart Association, give priority to medical nutrition prevention and medical nutrition therapy in their guides for prevention and therapy of hyperlipoproteinemia, cardiovascular diseases and cerebrovascular diseases.

[The influence of diet with including amaranth oil on lipid metabolism in patients with ischemic heart disease and hyperlipoproteidemia].

It was investigated the influence of a diet supplemented with amaranth oil on dynamic of lipid profile and composition of fatty acids of erythrocytes in patients with ischemic heart disease and hyperlipoproteidemia. The efficacy of diet with different contents of squalene (100, 200, 400 and 600 mg per day) was compared. It was shown that antiatherosclerotic diet with including 600 mg squalene has promoted the most positive changes of the serum cholesterol and triglycerides level and fatty acid composition of erythrocytes membranes as well.

[The influence of a diet with including amaranth oil on antioxidant and immune status in patients with ischemic heart disease and hyperlipoproteidemia].

It was investigated the influence of a diet supplemented with amaranth oil on dynamic of antioxidant and immune status in 125 patients with ischemic heart disease and hyper-lipoproteidemia. The efficacy of diets with different contents of squalene (100, 200, 400, 600 mg per day) was compared. It was shown that antiatherosclerotic diet with inclusion 600 mg squalene has promoted the most positive changes of immune status. The consumption of 200-400 mg of squalene per day produced the more significant antioxidant effect.

Rice bran oil and gamma-oryzanol in the treatment of hyperlipoproteinaemias and other conditions.

Diet is the first (and sometimes the only) therapeutic approach to hyperlipoproteinaemias. Rice bran oil and its main components (unsaturated fatty acids, triterpene alcohols, phytosterols, tocotrienols, alpha-tocopherol) have demonstrated an ability to improve the plasma lipid pattern of rodents, rabbits, non-human primates and humans, reducing total plasma cholesterol and triglyceride concentration and increasing the high density lipoprotein cholesterol level. Other potential properties of rice bran oil and gamma-oryzanol, studied both in vitro and in animal models, include modulation of pituitary secretion, inhibition of gastric acid secretion, antioxidant action and inhibition of platelet aggregation. This paper reviews the available data on the pharmacology and toxicology of rice bran oil and its main components with particular attention to those studies relating to plasma lipid altering effects.

[Clinical-metabolic evaluation of the effectiveness of the olive oil use in patients with cardiovascular diseases]. / Kliniko-metabolicheskaia otsenka éffektivnosti primeneniia olivkovogo masla v dietoterapii bol'nykh s serdechno-sosudistymi zabolevaniiami.

Investigation of influence of diet with olive oil on clinical, metabolic and immune indices in patients with ischemic heart disease and hypertension was conducted. As a result of the diet modified by the lipid component positive effect on the course of the diseases and lipid spectrum of blood, pronounced action on some indices of cell immunity, intensity of processes of lipid peroxidation were observed.

[Effect of anti-atherosclerotic diet with polyunsaturated fatty acids omega-3 from linseed oil on dynamics of natural antibodies to bradykinin and angiotensin II in blood serum of patients with cardiovascular diseases]. / Vliianie protivoateroskleroticheskoi diety s PNZhK omega-3 l'nianogo masla na dinamiku estestvennykh antitel k bradikininu i angiotensinu II v syvorotke krovi bol'nykh serdechno-sosudistymi zabolevaniiami.

The dynamic of natural antibodies against bradykinin and angiotensin II in blood serum was studied in 124 patients with ischemic heart disease, hyperlipidemia and hypertension against a background of usage of basic and modified antiatherosclerotic diet during 4 weeks. Besides favorable influence to a clinical picture of the disease universal normalizing influence of antiatherosclerotic diet with addition of linseed oil, consisting in increase of lowered levels of natural antibodies against bradykinin and angiotensin II and decrease of their contents in blood serum under primary increased concentrations.

[Effect of diet including omega-3 polyunsaturated fatty acids on the status of T-cell immunity in patients with ischemic heart disease and hyperproteinemia]. / Vliianie diety s vkliucheniem polinenasyshchennykh zhirnykh kislot omega-3 na sostoianie T-kletochnogo immuniteta u bol'nykh ishemicheskoi bolezn'iu serdtsa i giperlipoproteidemiiami.

Use of antisclerotic diet in patients with ischemic heart disease and hyperlipidemia promoted positive changes of clinical symptoms of diseases, some parameters of lipid metabolism and T-cellular immunity. Including in diet polyunsaturated fatty acids promoted increasing of its hypolipidemic effect.

[Effect of antiatherosclerotic diet, containing polyunsaturated fatty acids of the omega-3 family from flax oil, on fatty acid composition of cell membranes of patients with ischemic heart disease. Hypertensive disease and hyperlipoproteinemia]. / Vliianie protivoateroskleroticheskoi diety, soderzhashchei polinenasyshchennye zhirnye kisloty semeistva omega-3 l'nianogo masla, bol'nykh ishemischekoi bolezn'iu i giperlipoproteidemiiami.

Use flax oil as a vegetative source of PUFA omega-3 in diet of patients with ischemic heart disease, hyperlipidemia and high blood pressure resulted in positive dynamic of clinical manifestation, blood lipids and coagulograms of the patient. Pronounced influence on membrane lipids of erythrocytes was revealed: significantly increased a quota an linolenic, eicosapentaenic and docosahexaenic PUFA against a background of reducing a level of linoleic acid.

[Clinico-biochemical validation of the use of PUFA omega-3 in patients with ischemic heart disease, familial hyperlipoproteinemias and hypertension]. / Kliniko-biokhimicheskoe obosnovanie primeneniia PNZhK omega-3 u bol'nykh ishemicheskoi bolezn'iu serdtsa, semeinymi giperlipoproteidemiiami i gipertonicheskoi bolezn'iu.

The effectivity of diet AI, containing 20 g of fish oil eiconol, for patients suffering with ischemic heart disease, family hyperlipidemia and hypertension were checked. It was concluded that treatment with eiconol is recommended during 4 weeks 2-3 times per year in dose of 3-6 capsules 3 times a day depending on degree of lipids metabolism and hemocoagulation disturbances.

Similar effects of rapeseed oil (canola oil) and olive oil in a lipid-lowering diet for patients with hyperlipoproteinemia.

OBJECTIVE: To compare the metabolic effects of a lipid-lowering diet containing either low erucic rapeseed (canola) oil or olive oil. METHODS: Twenty-two hyperlipidemic patients participated in a cross-over study comprising two consecutive 3.5-week treatment periods. The participants were free-living throughout the study period, visiting the metabolic clinic initially and at the end of each treatment period for weighing and blood sampling. All food was prepared daily and weighed out for each individual appropriate to his/her energy requirement. RESULTS: Total serum cholesterol, low-density lipoprotein and the ratio between low-density and high-density lipoprotein cholesterol decreased to the same extent on the two diets tested, as did the apolipoproteins B, A-I and Lp(a). After adjustment for body weight changes, most of the reported effects remained virtually unaltered. However, there was a slightly greater decrease in low-density lipoprotein cholesterol with the diet containing rapeseed oil (-17%, p < 0.001) than with the olive oil diet (-13%, p < 0.01) with p < 0.04 for the difference between diets. Also, the intravenous glucose tolerance improved to a similar extent on both diets. CONCLUSIONS: The results indicate that lipid-lowering diets containing either rapeseed oil or olive oil have similar effects on serum lipoprotein concentration and glucose tolerance in hyperlipidemic subjects.

A diet rich in monounsaturated rapeseed oil reduces the lipoprotein cholesterol concentration and increases the relative content of n-3 fatty acids in serum in hyperlipidemic subjects.

The effects of 3 wk on a diet rich in monounsaturated rapeseed oil were compared with those of a diet containing sunflower oil within a lipid-lowering diet. Ninety-five subjects with moderate hyperlipoproteinemia were randomly assigned to one of the two well-controlled diets prepared at the hospital kitchen. Total serum, low-density- and high-density-lipoprotein cholesterol concentrations decreased by 15%, 16%, and 11% (P < 0.001), respectively, on the rapeseed oil diet and by 16%, 14%, and 13% (P < 0.001) on the sunflower oil diet. Serum triglycerides decreased more markedly (by 29%, P < 0.001) on the sunflower oil than on the rapeseed oil diet (14%, P < 0.01). The n-3 fatty acids (20:5 and 22:5) in the serum phospholipids increased significantly on the rapeseed oil diet but decreased on the sunflower oil diet. There was an increase in the alpha-tocopherol concentrations after both diets. The findings indicate that low erucic acid rapeseed oil can replace oils and fats rich in polyunsaturated fatty acids in a lipid-lowering diet.

[Dietary effects of PUFA omega-3 on lipid peroxidation and antioxidant system in patients with IHD, hyperlipoproteinemia and hypertension]. / Vliianie diety s PNZK omega-3 na pokazateli POL i antioksidantnoi sistemy u bol'nykh IBS, giperlipoproteidemiei i gipertonicheskoi bolezn'iu.

Dietary effects of polyunsaturated fatty acids (PUFA) omega-3 on lipid peroxidation (LPO) and antioxidant system were studied in 73 patients with ischemic heart disease, hyperlipoproteinemia (HLPE) type IIa, IIb, IV and essential hypertension. Eiconol-enriched antiatherosclerotic diet has more potent hypolipidemic, hypotensive and thrombolytic action in association with inhibition of LPO, enhances SOD activity, keeps red cell catalase within normal. Vitamin E concentrations were not changed. It is suggested that eiconol addition to antiatherosclerotic diet causes no LPO induction and is pathognomonic for HLPE, hypertension and IHD patients.

[Modern diet for patients with hyperlipoproteinemia]. / A hyperlipoproteinaemiák korszerü diétája.

Diet is fundamental in the treatment of primary hyperlipoproteinaemias. The author outlines nutritional factors affecting serum lipoproteins. In the treatment of hypercholesterolaemia the most effective is the reduction of the intake of saturated fatty acids, it being twice as effective as the reduction of dietary cholesterol, which is necessary as well. The proportion of the saturated, poly- and monounsaturated fatty acids is recommended to be 10-10-10 percent of the overall calorie intake. Such a composition of diet has no disadvantageous effect on the level of HDL cholesterol. Of carbohydrates the consumption of sugar and alcohol should be limited in the presence of hypertriglyceridaemia and/or obesity. Water soluble dietary fibres may have a cholesterol-lowering effect. The reduction of overall calorie intake is indispensable in hyperlipoproteinaemias with obesity. As a result of the diet a 10-20 percent decrease in the level of cholesterol and--in some cases--the normalization of hypertriglyceridaemia can be expected.

[Effect of linseed oil on fatty acid composition of low- and very low density lipoproteins, cholesterol and its fractions in the blood serum of albino rats]. / Vliianie l'nianogo masla na zhirnokislotnyi sostav lipo- proteidov nizkoi i ochen' nizkoi plotnostei, urovnii kholesterina i ego fraktsii v plazme krovi belykh krys.

The authors studied the influence of linseed oil, and mixtures of linseed and sunflower oils, in varying ratios, on the levels of cholesterol, low- and very low-density lipoproteins, high-density cholesterol, free and esterified cholesterol, and on the fatty-acid composition of low- and very low-density lipoproteins. In experiments on Wistar white rats linseed oil decreased cholesterol concentration, and the levels of low- and very low-density lipoproteins, as well as affected the fatty-acid composition of lipoproteins.

A possible contribution of decrease in free fatty acids to low serum triglyceride levels after diets supplemented with n-6 and n-3 polyunsaturated fatty acids.

Intraindividual comparisons of diets supplemented with sunflowerseed oil (rich in linoleic acid, LA, C18:2n-6), linseed oil (enriched with alpha-linolenic acid, LNA, C18:3n-3) and canned mackerel (rich in eicosapentaenoic acid, EPA, C20:5n-3 and docosahexaenoic acid, DHA, C22:6n-3) were made in 30 patients with primary hyperlipoproteinemia (HLP) of phenotypes IIa (n = 9), IIb (n = 7), IV (n = 7) and V (n = 7). The lipid- and blood pressure-lowering effects of polyunsaturated fatty acids (PUFA), particularly those of the EPA- and DHA-rich diet, were confirmed irrespective of the type of HLP. Apolipoproteins A-I and B remained unchanged. The most remarkable finding was a substantial depression of free fatty acids (FFA) within a standardized glucose tolerance test (GTT) associated with the fall of serum triglycerides after diets enriched with n-6 and especially after those supplemented with n-3 PUFA. It was suggested that the decrease of FFA indicates reduced peripheral lipolysis, which might be a hitherto ignored factor involved in the triglyceride-lowering action of n-6 and, more pronounced, of n-3 PUFA.

[Dietary treatment of hyperlipoproteinemia]. / Diätetische Behandlung der Hyperlipoproteinämien.

Hyperlipoproteinemias are most common metabolic disorders, both in clinic and in practice. Primarily, these metabolic disorders are caused by exogenous factors (nutrition etc.), secondly by genetic factors (LDL-receptor defects, apoprotein variants, etc.). Although a number of efficient lipid lowering drugs is now available, basically any lipid lowering therapy should start with the change of nutritional habits. Beside the reduction of eventually increased body weight, special attention should be paid to fat modification, fat restriction and the decrease of cholesterol intake. With regard to fat restriction, mainly the intake of saturated fatty acids has to be decreased, an increase of polyunsaturated fatty acids to not more than approximately 10% of total energy intake should be considered. Recently, the beneficial effect of monounsaturated fatty acids has been discussed, particularly due to the fact that these fats do not reduce HDL cholesterol. For excessive hypertriglyceridemia the use of omega-3 fatty acids from fish oil should be considered, general recommendations for the long-term treatment with fish oil for prevention of cardiovascular diseases cannot be made.

Serum lipids and cholesterol metabolism during guar gum, plantago ovata and high fibre treatments.

Short-term viscous dietary fibres, plantago ovata and guar gum preparations, decreased serum cholesterol, mainly LDL cholesterol, as compared to low fibre or nonviscous high fibre periods, through enhancing cholesterol elimination as fecal bile acids. These changes were associated with significant increases in serum levels of cholesterol precursors, both in methylsterols and demethylated precursor sterols, while that of cholestanol (saturated cholesterol derivative) was decreased. In addition, cholesterol precursor contents were positively related, cholestanol negatively, to fecal cholesterol elimination both on and off viscous fibres. These findings indicate increased cholesterol synthesis, also seen by sterol balance data. As compared to low fibre diet, nonviscous high fibre diet conserved bile acids and decreased cholesterol absorption. Thus, it had no effect on cholesterol synthesis as indicated by fecal total steroids or serum levels of cholesterol precursors.