3.0.0.0 LIPID MAN­AGE­MENT

3.1.0.0 Lifestyle In­ter­ven­tion

Rec­om­men­da­tions

10.15 Lifestyle modification fo­cus­ing on weight loss (if in­di­cated); ap­pli­ca­tion of a Mediter­ranean diet or Di­etary Ap­proach­es to Stop Hy­per­ten­sion (DASH) di­etary pat­tern; re­duc­tion of sat­u­rat­ed fat and trans fat; in­crease of di­etary n-3 fatty acids, vis­cous fiber, and plant stanols/‍ sterols in­take; and in­creased phys­i­cal ac­tiv­i­ty should be rec­om­mend­ed to im­prove the lipid profile and re­duce the risk of de­vel­op­ing atheroscle­rot­ic car­dio­vas­cu­lar dis­ease in pa­tients with di­a­betes. A

10.16 In­ten­si­fy lifestyle ther­a­py and op­ti­mize glycemic con­trol for pa­tients with el­e­vat­ed triglyc­eride lev­els (≥150 mg/dL [1.7 mmol/‍L]) and/‍or low HDL choles­terol (<40 mg/dL [1.0 mmol/‍L] for men, <50 mg/dL [1.3 mmol/‍L] for women). C

Lifestyle in­ter­ven­tion, in­clud­ing weight loss (72), in­creased phys­i­cal ac­tiv­i­ty, and med­i­cal nu­tri­tion ther­a­py, al­lows some pa­tients to re­duce ASCVD risk fac­tors. Nu­tri­tion in­ter­ven­tion should be tai­lored ac­cord­ing to each pa­tient’s age, di­a­betes type, phar­ma­co­log­ic treat­ment, lipid lev­els, and med­i­cal con­di­tions.

Rec­om­men­da­tions should focus on ap­pli­ca­tion of a Mediter­ranean diet (73) or Di­etary Ap­proach­es to Stop Hy­per­ten­sion (DASH) di­etary pat­tern, re­duc­ing sat­u­rat­ed and trans fat in­take and in­creas­ing plant stanols/‍ sterols, n-3 fatty acids, and vis­cous fiber (such as in oats, legumes, and cit­rus) in­take (74). Glycemic con­trol may also beneficial­ly mod­i­fy plas­ma lipid lev­els, par­tic­u­lar­ly in pa­tients with very high triglyc­erides and poor glycemic con­trol. See Sec­tion 5 “Lifestyle Man­age­ment” for ad­di­tional nu­tri­tion in­for­ma­tion.