生活方式和饮食控制对HDL-C的影响课件.ppt

HDL and Coronary Heart Disease Lifestyle Changes Weight loss Smoking cessation Exercise Weight and HDL-C Inverse correlation between body weight and HDL-C is consistently observed in both men and women. For every 3 kg (7 lb) of weight loss, HDL-C levels increase 1 mg/dL. Weight Loss Increases HDL-C Level 131 overweight sedentary men were randomized to 1-year intervention of exercise, diet, or no instructions. Lipids were tracked. Subjects Wt change LDL-C HDL-C (kg) (mg/dL) (mg/dL) Control (n = 42) + 0.2 144 40 Exercise (n = 47) - 4.0 138 44* Diet (n = 42) - 7.2 137 47* Smoking Cessation Increases HDL-C Level In study by Moffatt, smokers had HDL-C levels 15–20% lower than nonsmokers (P 0.05).1 PROCAM showed less of an effect of smoking on HDL-C (7% lower than nonsmokers).2 HDL-C levels returned to normal within 30–60 days after smoking cessation.1 In eight women who smoked 1 packs per day for 5 years, HDL-C levels increased from 51 to 64 mg/dL after quitting for 60 days.1 Effects of Chronic Exercise on HDL-C Level Regular exercise increases HDL-C level. Kokkinos et al reported a clear dose-response relationship between aerobic exercise (running) and HDL-C levels in healthy men: HDL-C (mg/dL) Nonrunner 5 mi/wk 9 mi/wk 12 mi/wk 17 mi/wk 31 mi/wk (n = 685) (n = 335) (n = 512) (n = 376) (n = 602) (n = 396) 47.3 48.7 50.6* 52.5*? 53.0*? 56.3*? Dietary Influences Total fat intake, independent of type Trans–fatty acids Alcohol Caloric restriction Total Fat Intake HDL-C levels were significantly associated with dietary fat intake in prepubertal lean boys from several countries. Low-Fat Diets and HDL-C Low-fat diets with equivalent saturated-fat content lower HDL-C levels (mg/dL) without significantly lowering LDL-C. Diet (% energy from fat) Mean LDL-C Mean HDL-C Safflower oil (n = 11) 9% 128 37 20% 128 41 30% 124 46 Olive oil (n = 11) 9% 129 43 20% 136 46 30% 128 48 Very-Low-Fat Diets: