B4.063 Prework 2: Nutrition and Cardiovascular Disease

Question 1

what are key points about fitness vs weight

Answer 1

1. diet quality may have a more lasting health impact than wright loss alone
2. fit overweight individuals have similar mortality risks as normal weight fit individuals
3. your fitness now and as you age can lower your risk for CVD and mortality

Question 2

list food groups from benefit to harm from a cardioprotective standpoint

Answer 2

benefit
fruit, nuts, fish
vegetable, vegetable oils
whole grains, beans, yogurt
cheese
eggs, poultry, milk
butter
unprocessed red meats
refined grains, starches, sugar
processed meats, higher sodium foods
industrial trans fat
harm

Question 3

effect of fruits and vegetables on cardio health

Answer 3

fruit and veggie consumption decreased CVD risk by 15%
inversely related to the risk of CHD and stroke
risk reduction begins at >3 servings/day, plateaus at 5-6 servings/day
lowest risk associated with cruciferous vegetables, green leafy, citrus

Question 4

direct links of fruits and veggies to CVD health

Answer 4

lowers glycemic index
decreases BP
decreased inflammation
reduced LDL oxidation
decreases lipid peroxidation of membrane PUFAs

Question 5

effect of whole grains on cardio health

Answer 5

whole grains decrease CVD by 21%
each 10g increase in intake of fiber is associated with a 14% risk reduction decrease for all coronary events
each whole grain serving/day decreases heart failure risk by 7%

Question 6

direct links of whole grains to CVD health

Answer 6

lower glycemic index
decreases LDL
decreases homocysteine
decrease inflammation

Question 7

what are eicosanoids

Answer 7

EPA
DHA
omega 3 eicosanoids

Question 8

what do eicosanoids do?

Answer 8

reduce CHD and sudden CHD death

decreases blood clotting

Question 9

mechanism of eicosanoids

Answer 9

altered cell membrane fluidity
lowers serum triglycerides by 25-30%
raises HDL 3%
lowers BP
lowers resting HR
reduced inflammation

Question 10

recommended intake of fisk

Answer 10

> 2 servings per week

Question 11

what kinds of fish have the highest concentration of EPA and DHA

Answer 11

anchovy
salmon
sardines

Question 12

what kinds of fish have the lowest concentration of EPA and DHA

Answer 12

cod
catfish
tuna

Question 13

general dietary fat recommendations

Answer 13

weak evidence that a high fat diet is harmful
type of fat/fatty acid is more important
-replace sat fat with PUFA or MUFA
-don’t replace sat fat with carbs

Question 14

how are trans fats made

Answer 14

hydrogenation
used to solidify oils
addition of H to C=C double bonds

Question 15

effects of dietary trans fats

Answer 15

increases risk for heart disease
raises LDL
lowers HDL
increases inflammation

Question 16

major sources of trans fats

Answer 16

cake, cookies, crackers, pies, bread
margarine
fried food

Question 17

2013 AHA/ACC recommendations on dietary fats

Answer 17

reduce % of cals from sat fats (5-6%)
reduce % of cals from trans fats
insufficient evidence that lowering dietary cholesterol reduced LDL

Question 18

avg salt intake

Answer 18

3400 mg/day

Question 19

who has the best effects of salt intake reduction

Answer 19

black people
older adults
chronic kidney disease
hypertensive whites
young adults

Question 20

direct links of salt reduction to CVD health

Answer 20

lower CVD
decrease blood pressure
LVH

Question 21

mechanism of salt reduction benefits

Answer 21

incompletely understood
Na/Cl handling lead to volume changes
less pronounced activation of the renin aldosterone mechanism

Question 22

2013 AHA/ACC recommendations on salts

Answer 22

lower sodium intake
no more than 2400 mg/day
reduction to 1500 mg/day leads to greater reductions in BP
reducing by at least 1000 mg/day lowers BP
combine with DASH diet for best BP control

Question 23

how much alcohol provides a cardio benefit

Answer 23

1/2 drink per day
older adults have a greater benefit
young to middle aged adults may experience more harm than benefit

Question 24

mechanisms of cardio protective effects of alcohol

Answer 24

increase HDL 10%
decrease blood pressure
increase adiponectin
enhanced insulin sensitivity
reduced inflammation
antithrombotic effects

Question 25

level of alcohol consumption associated with increased mortality

Answer 25

> 2 drinks/day for women

>3 drinks/day for men

Question 26

link between BMI and CHD

Answer 26

each 5 unit increase in BMI associated with 29% increase in CHD
25-30 is low risk
30-35 is moderate
35-40 high risk
>40 very high risk

Question 27

reason for issues with high BMI

Answer 27

coexist with hypertension, dyslipidemia, abnormal, glucose metabolism
facilitating causal agent likely interacting with other risk factors to varying degrees in each individual

Question 28

benefits of exercise

Answer 28

strong inverse correlation between physical activity and CVD in primary prevention
increases HDL
lower BP
decreases insulin resistance
reduce inflammation