On the one hand, nonpharmacologic treatment in patients with FH is less important than it is in, for example, patients with metabolic syndrome. As a result, it is sometimes underestimated. On the other hand, it is necessary to use some approaches in FH patients that do not usually play a primary role in HLP patients. Generally speaking, nonpharmacologic treatment leads to a 5-10% reduction in LDL-C.
A standard diet with restriction of animal fats is recommended for FH patients. For more details, we refer to available literature and patient brochures.
Of course, an increase in physical activity is recommended for FH patients (or a continuance thereof, if the patient is already active). To address the issue of what types of activities are preferred, we refer to some of the R3i initiative recommendations.
Given that we generally try to reduce the CV risk in the whole population (and, of course, all patients at high CV risk) through measures that result in smoking cessation, it is imperative that FH patients do not smoke. Smoking cessation should be achieved “at any cost.” We attempt this through use of standard guidelines and, if they fail, refer patients to specialized facilities that deal with treatment for tobacco dependence. One exceptionally serious recommendation is that children should be advised never to start smoking!