Q2 for October
Q2. Based on the modality of action of phytosterols, would it be important to know the reason for the patient’s hypercholesterolemia? Why?
posted by Nisa M. @ 1:32 PM
7 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
7 Comments:
I think that phytosterols can be benefical in reducing TC and LDL-C in all patients regarless of the reason for the patient's hypercholesterolemia. However, I do think that it is helpful to know the reason for the patient's hypercholesterolemia in order to recommend a specfic diet for them. I think that phytosterols are especially helpful in patients who have elevated levels of LDL-C.
The only thing I can think of is that persons who have high cholesterol from "genetics" even though they follow a heart healthy diet and are at a normal weight may not have the lowering effect of phytosterols.
Additionally knowing about a person's diet is important to tailor a cholesterol lowering diet with phytoserols to their own practices. So that phytosterols can be used as a subsitute for fats they have in their diet.
Lisa, I agree that phytosterols are good for reducing cholesterol and that is beneficial to know the reason for the patient's hypercholesterolemia.
Mary Ellen, the genetic predisposition of certain persons to hypercholesterolemia is very important to consider. This trait, Familial hypercholesterolemia (FH), may not see as drastic of results from a heart healthy diet.
Yes, it is beneficial to determine the form of hypercholesterolemia- namely familial or polygenic. Familial hypercholesterolemia is associated with mutations in the gene for the LDL receptor. Stanols would combat the condition by increasing the hepatic expression of the LDL receptors, but the effect may not be as great as someone with no mutations of the LDL receptors. Polygenic hypercholesterolemia is associated with overproduction and reduced catabolism of LDL. Possibly stanols would have a greater effect at cholesterol lowering on this population.
Yes, it is important to know the reasoning behind a pts hypercholestemia. This particular type of pt may be on cholesterol lowering drug. During dietary counseling it would be more effecient to know this in order to avoid wasting effort providing a treatment that is far less effective than drugs. Although, I would not ignore this possible treatment entirely, I would not make it a priority when suggesting how pts can make better lifestyle changes.
Exactly, it is best to take into account that each person is different. One dietary suggestion or therapy may not be as effective in another person. It is definitely best to look at the pt's hx and dx in order to make the best decisions for their dietary recommendations and not focus attention to something that may not be effective.
Yes it is important to know the reason why a patient has high choleterol. If is just based on diet then it would be easy to suggest that the patient changes their diet. On the other hand if a person has a family history of high cholesterol then a diet may not have a huge impact. In any case trying the sterols is worth a chance to see if it has any impact. Also encouraging the use of a heart healhty diet would still be beneficial to anyone.
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