CHD Diet

Question 1

LDL Levels

Answer 1

190 = very high

Question 2

CHD Risk Equivalents

Answer 2

• Symptomatic CAD
• PAD
• AAA
• DM
• > 20% risk factors
• Renal insufficiency (creatinine > 1.5)

Question 3

Major Cardiac Risk Factors

Answer 3

• Cigarettes
• HTN (BP > 140/90 or on antihypertensives)
• Low HDL (< 55-males, < 65-females)
• Age (>45-males, >55-females)

Question 4

Hyperlipidemia (LDL) Assessment

Answer 4

• 0-1 risk factors: start TLC @ > 160, drugs @ >190, tx goal = < 160
• 2+ risk factors: start TLC @ > 130, drugs @ > 130 or 10-yr. risk of 10-20%, tx goal = < 130
• 10 yr. risk > 20%: TLC @ >100, drugs @ > 130 (preferably 100-129), tx goal = < 100

Question 5

TG Goals

Answer 5

• Goal: < 150 mg/dL
  
  • Borderline high: 150-199 mg/dL
  • High: 200-499 mg/dL
  • Very high: > or equal to 500 mg/dL

Question 6

TG Risk Factors

Answer 6

• Overweight
• Excess Alcohol
• Diet high in carbs/sugars

Question 7

Heart Healthy Diet

Answer 7

• Decrease saturated fats to <200 mg/day
• Ideally increase soluble fiber to 10-25 g/day
• Increase plant stanols/sterols-add 2g/day to diet
• 25-35% of daily calories should be from fat (mainly unsaturated)
• At least 30 minutes of moderate intensity physical activity on most, preferably all days of the week

Question 8

Saturated Fat

Answer 8

• Solid at room temperature
• Raises cholesterol more than anything else!
• Highest in animal fats
• Also in palm/coconut vegetable oil

Question 9

Unsaturated Fats

Answer 9

• Liquid at room temperature
• Mainly in vegetable oils, nuts, olives, avocados, fatty fish (omega-3 FAs)
• 2 types: monounsaturated, polyunsaturated
• Both can help lower LDL and elevate HDL

Question 10

Trans Fat

Answer 10

• Raises cholesterol
• Found in foods made with hydrogenated vegetable oils (i.e., stick margarines, shortenings) & baked goods (i.e., cookies, fried foods)
• Also found in some animal fats

Question 11

Total Fat

Answer 11

Total Fat = Saturated + Trans + Monounsaturated + Polyunsaturated

Question 12

Dietary Cholesterol

Answer 12

• Body makes all it needs!
• Travels in lipoproteins (esp. VLDL) in the blood
• Excess amounts get trapped in arteries
• Leads to atherosclerosis
• Main source = animal products (meats, egg yolks, shrimp, whole milk, butter, cream)

Question 13

Soluble Fiber

Answer 13

• Dissolves into a gel-like substance & helps block cholesterol/fats from being absorbed
• Found in plants
• Helps reduce the risk of CHD (unlike insoluble fiber)
• Beneficial for digestion & weight loss

Question 14

Insoluble Fiber

Answer 14

• “roughage”
• Undigested
• Ex. whole grains, fruits (with skin), vegetables, & legumes

Question 15

Plant Stanols & Sterols

Answer 15

• Found naturally in plants (soybean)
• Combine w/ canola oil & margarines
• Helps block absorption of cholesterol
• Aids in decreasing LDL
• NOT calorie free

Question 16

Omega-3 Fatty Acids

Answer 16

• Found in fatty fish, walnuts, canola/soybean/olive oil, & flaxseed
• Contains DHA & EPA (some have ALA)
• Benefits: prevent clots, protect arteries from inflammation, reduce arrhythmias, reduce TGs, raise HDL, slow atherosclerosis, reduce BP slightly
• Do not affect LDL levels

Question 17

Sodium

Answer 17

• Intake should be < 2,300 mg/day (~1 tsp)
• Fresh fruits/vegetables have little sodium
• Na+ traps water, causing increased BP

Question 18

Alcohol

Answer 18

• Small amount can decrease plaque buildup & prevent CHD
• < or equal to 1/day-women
• < or equal to 2/day-men
• Very high in calories

Question 19

BMI

Answer 19

• Normal: 18.5-24.9
• Overweight: 25-29.9
• Obese: 30+
• Morbidly Obese: 40+

Question 20

Weight Loss Tips

Answer 20

Should lose 1-2 lbs/week

• Eat less
• Increase physical activity
• Slow eating
• Smaller plates
• Drink 8 oz. water before meals
• Beware of triggers (ex. boredom)
• Don’t skip meals
• Set goals & reward yourself
• Be consistent
• Find a support system