[Current aspects on nutrition in hypercholesterolemia]

New European and American guidelines for nutrition in hypercholesterolemia coincided with a lowered target value for LDL(Low density lipoprotein)-cholesterol.

Guidelines, their development and supporting meta-analyses were searched in Medline/PubMed and Cochrane database and analyzed for the influence of fat, carbohydrates and protein on reduction of LDL-cholesterol as well as the differences between European and American guidelines.

In contrast to European guidelines, American guidelines increasingly refrain from controlling fat in nutrition, based on studies on the influence of nutrition on LDL-cholesterol and saturated fat; instead, monosaccharides and disaccharides are to be reduced from 15% to 10% of total calories for avoidance of high LDL-cholesterol and a non-alcoholic fatty liver. In predisposed persons the ratio of triglycerides to HDL-cholesterol should be checked when controlling LDL-cholesterol, an early indicator of type 2 diabetes mellitus and non-alcoholic fatty liver disease. Substituting animal fat with plant fat hardly influences LDL-cholesterol. Whole fat milk should be consumed as a source of protein. The nutritional pattern is more important than single components.

Fat content in nutrition is increasingly less important in hypercholesterolemia but the reduction of monosaccharides and disaccharides gains importance.