Lifestyle Modification & Nutrition Counseling Flashcards

A patient with severe hypertriglyceridemia (TG 1,200 mg/dL) is counseled on diet. Which restriction is most critical?

Answer: Severely restricting total dietary fat to below 15% of calories

In severe hypertriglyceridemia, markedly reducing total fat intake (to <15% of calories) is critical to prevent chylomicronemia and pancreatitis by limiting exogenous TG delivery.

Which counseling approach is most appropriate for a patient who expresses readiness to change their diet but lacks confidence in their ability to do so?

Answer: Focus on building self-efficacy through small achievable goals and positive reinforcement

Self-efficacy is a key predictor of behavior change; setting small, achievable goals and celebrating successes builds confidence and sustains long-term dietary adherence.

The DASH diet was originally designed to lower blood pressure, but it also improves lipid profiles. Which component most directly contributes to LDL reduction?

Answer: Emphasis on fruits, vegetables, whole grains, and low-fat dairy with limited saturated fat

The DASH diet's emphasis on fiber-rich foods and replacement of saturated fat with unsaturated fat directly reduces LDL-C while also improving blood pressure.

A patient reports eating salmon twice weekly. Which additional dietary fish recommendation would best increase omega-3 intake while minimizing mercury exposure?

Answer: Including sardines, herring, or mackerel (Atlantic) as additional low-mercury fatty fish options

Sardines, herring, and Atlantic mackerel are small fatty fish rich in EPA+DHA with low bioaccumulation of methylmercury, making them ideal additions to a heart-healthy diet.

Which statement about the relationship between dietary carbohydrate quality and lipid levels is most accurate?

Answer: Replacing refined carbohydrates with high-fiber, low-glycemic options reduces triglycerides and improves HDL

Replacing refined, high-glycemic carbohydrates with fiber-rich low-glycemic alternatives reduces postprandial lipemia, lowers VLDL production, and modestly raises HDL-C.

A 60-year-old patient has a BMI of 32 and low HDL-C of 36 mg/dL. Which lifestyle intervention has the greatest evidence for raising HDL-C?

Answer: Regular aerobic exercise combined with modest weight loss

Regular aerobic exercise and weight loss are the most effective lifestyle interventions for raising HDL-C, working by increasing lipoprotein lipase activity and apoA-I synthesis.

When counseling a patient about the Portfolio Diet for LDL reduction, which four food components are central to this dietary pattern?

Answer: Plant sterols, soluble fiber, soy protein, and nuts

The Portfolio Diet, developed by Jenkins et al., combines plant sterols, viscous fiber, soy protein, and nuts, achieving LDL reductions comparable to low-dose statin therapy.