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SlideSourceLipidsOnlinewww.lipidsonline.orgLifestyleInterventions:LifestyleInterventions:DietaryTherapy,PhysicalActivity,DietaryTherapy,PhysicalActivity,WeightControlWeightControlNeilJ.Stone,M.D.NeilJ.Stone,M.D.SlideSourceLipidsOnlinewww.lipidsonline.org0%20%40%60%80%20102010NowNowPrimaryPrevention:PrimaryPrevention:StatusandGoalsStatusandGoalsin2010in2010NCEP.AdultTreatmentPanelIIIReport.2001.ModerateModeratephysicalactivityphysicalactivityVegetableintakeVegetableintakeof>3servingsof>3servingsSaturatedfatSaturatedfat<10%ofcalories<10%ofcaloriesSlideSourceLipidsOnlinewww.lipidsonline.org0%20%40%60%80%PrimaryPrevention:PrimaryPrevention:StatusandGoalsStatusandGoalsin2010in2010Fruit>2servings/dFruit>2servings/dSmokingcessationSmokingcessationHealthyweightHealthyweight20102010NowNowNCEP.AdultTreatmentPanelIIIReport.2001.SlideSourceLipidsOnlinewww.lipidsonline.org-60%-40%-20%0%PrimaryPrevention:PrimaryPrevention:CrucialOpportunitytoCrucialOpportunitytoReducetheBurdenofCHDReducetheBurdenofCHDLawMRetal.BMJ1994;308:367-372.Age70Age70Reductioninriskinmenwith10%reductionReductioninriskinmenwith10%reductionintotalcholesterol(10cohortstudies)intotalcholesterol(10cohortstudies)Age50Age50Age40Age40SlideSourceLipidsOnlinewww.lipidsonline.orgPrimaryPrevention:PrimaryPrevention:AdverseLifeHabitAdverseLifeHabitChangesChangesAtherogenicdietSedentarylifestyleObesityExpertPanel.JAMA2001;285:2486-2497.SlideSourceLipidsOnlinewww.lipidsonline.orgPrimaryPrevention—Rx:PrimaryPrevention—Rx:TherapeuticTherapeuticLifestyleChanges(TLC)LifestyleChanges(TLC)TherapeuticdiettolowerLDL-CPhysicallyactiveonadailybasisWeightcontrolExpertPanel.JAMA2001;285:2486-2497.SlideSourceLipidsOnlinewww.lipidsonline.orgPrimaryPrevention—Rx:PrimaryPrevention—Rx:TLCMeasurestoTLCMeasurestoLowerLDL-CLowerLDL-CSaturatedfats(<7%totalcalories)andcholesterol(<200mg/d)Alsotherapeuticoptions:—Plantstanols/sterols(2g/d)—Increasedviscousfiber(10–25g/d)ExpertPanel.JAMA2001;285:2486-2497.SlideSourceLipidsOnlinewww.lipidsonline.orgTotalFat...Whyarange?TotalFat...Whyarange?PrimaryemphasisistoreducesaturatedfatsTotalfatshouldrange25–30%formostcasesThosewithmetabolicsyndromeAvoidveryhighfatintakesAvoidverylowfatintake(lowHDL-C,highTG)Totalfatintakecanrangefrom30–35%ifextrafatisunsaturatedMayreducesomelipidandnonlipidriskfactorsClinicaljudgmentrequired.SlideSourceLipidsOnlinewww.lipidsonline.orgTherapeuticLifestyleChanges:TherapeuticLifestyleChanges:NutrientCompositionofTLCDietNutrientCompositionofTLCDietNutrientNutrientRecommendedIntakeRecommendedIntakeSaturatedfat*Saturatedfat*Lessthan7%oftotalcaloriesLessthan7%oftotalcaloriesPolyunsaturatedfatPolyunsaturatedfatUpto10%oftotalcaloriesUpto10%oftotalcaloriesMonounsaturatedfatMonounsaturatedfatUpto20%oftotalcaloriesUpto20%oftotalcaloriesTotalfatTotalfat25–35%oftotalcalories25–35%oftotalcaloriesCarbohydrate**Carbohydrate**50–60%oftotalcalories50–60%oftotalcaloriesFiberFiber20–30gramsperday20–30gramsperdayProteinProteinApproximately15%oftotalcaloriesApproximately15%oftotalcaloriesCholesterolCholesterolLessthan200mg/dayLessthan200mg/dayTotalcalories(energy)Totalcalories(energy)BalanceenergyintakeandoutputtoBalanceenergyintakeandoutputtomaintainexpendituremaintainexpenditurehealthybodyhealthybodyweight/preventweightgainweight/preventweightgain*Lo...