Lifestyle advice in FH (familial hypercholesterolaemia)

• Diet: Physical activity: Smoking advice:
  • people with FH should be offered individualised nutritional advice from a healthcare professional with specific expertise in nutrition
    • should be advised to consume a diet in which:
      • total fat intake is 30% or less of total energy intake
      • saturated fats are 10% or less of total energy intake
      • intake of dietary cholesterol is less than 300 mg/day
      • saturated fats are replaced by increasing the intake of monounsaturated and polyunsaturated fats
    • advise to eat at least five portions of fruit and vegetables a day, in line with national guidance for the general population. Examples of what constitutes a portion can be found at www.eatwell.gov.uk/healthydiet
    • advise people with FH to consume at least two portions of fish a week (one of which should be oily fish). Pregnant women with FH should be advised to limit their oily fish to two portions a week
    • advise people with FH that if they wish to consume food products containing stanols and sterols these need to be taken consistently to be effective
    • people with FH should not routinely be recommended to take omega-3 fatty acid supplements
      
      
  • people with FH to take at least 30 minutes of physical activity a day, of at least moderate intensity, at least 5 days a week
  • encourage people with FH who are unable to perform moderate-intensity physical activity at least 5 days a week because of comorbidity, disability, medical conditions or personal circumstances to exercise at their maximum safe capacity
    
    
  • people with FH, especially children, who do not smoke should be strongly discouraged from starting because of their already greatly increased risk of coronary heart diseas
  • people with FH who smoke should be advised that, because of their already greatly increased risk of coronary heart disease, they should stop

Notes:

• recommended types of physical activity include those that can be incorporated into everyday life, such as brisk walking, using stairs and cycling
• bouts of physical activity of 10 minutes or more accumulated throughout the day are as effective as longer sessions

Reference:

• (1) NICE (August 2008). Identification and management of familial hypercholesterolaemia