Exam #1: Nutrition and Cardiovascular Disease

Question 1

What are the causative factors of vascular disease?

Answer 1

• HTN
• Vascular effects of DM
• Platelet aggregation
• Hypercoaguable states from obesity and high dietary fat
• Smoking
• Insufficient regular exercise
• DIET

Question 2

What fats have a deleterious effect on the heart?

Answer 2

1) Saturated fat

2) Cholesterol

Question 3

What are elements of diet that can be cardioprotective?

Answer 3

• High fiber
• Folate
• Anti-oxidants
• Vitamin K
• Low Na+
• High K+ and Mg++
• Omega 3

Question 4

Where do most fatty acids in the blood come from?

Answer 4

Diet

Question 5

What are fatty acids used for in the body?

Answer 5

• Important membrane components
• Precursors for hormones and other complex lipids
• Precursor for eicosanoids

Question 6

How are lipids transported in the blood?

Answer 6

As lipoproteins

Question 7

List the lipoprotein classes.

Answer 7

• Chylomicrons & remnants
• Low Density Lipoproteins
• High Density Liporotein
• Very Low Density Lipoproteins

Question 8

What are the athrogenic lipoproteins?

Answer 8

• Chylomicron remnants
• LDL
• VLDL remnants

Question 9

What are the non-athrogenic lipoproteins?

Answer 9

• Chylomicrons
• HDL
• VLDL

Question 10

What is a triglyceride?

Answer 10

Ester w/

• 3x fatty acids
• Glycerol

Question 11

What is the carbon chain length for the FAs that compose TGs?

Answer 11

Even numbers:

16, 18, and 20

Question 12

What is the function of a chylomicron?

Answer 12

Transport fat-soluble molecules from intestine to other organs

E.g.

• Fat-soluble vitamins
• TGs
• Cholesterol

Question 13

What enzyme cleaves chylomicrons to release fat-soluble molecules?

Answer 13

Lipoprotein lipase

Question 14

What is the function of VLDL?

Answer 14

Transport lipids from liver to muscles and other organs

Question 15

What happens to VLDL remnants?

Answer 15

Re-circulation to the liver to make LDL cholesterol

Question 16

What is LDL cholesterol derived from?

Answer 16

VLDL

Question 17

How is LDL cholesterol taken up by the liver?

Answer 17

Receptors on hepatocytes

Question 18

What happens to LDL receptors in a high cholesterol diet? Low cholesterol diet?

Answer 18

High= fewer receptors expressed–>more circulating LDL

Low= more receptors expressed–>less circulating LDL

Question 19

How does HDL cholesterol structurally differ from the other lipoproteins?

Answer 19

• More protein
• More phospholipids
• Contains LCAT enzyme
• Contains apoE

Question 20

What are the major functions of HDL cholesterol?

Answer 20

1) Transfer ApoC-II and apoE to chylomyicrons and VLDL
2) Take up cholesterole from LDL, VLDL, and phospholipids from VLDL
3) REVERSE TRANSPORT of CHOLESTEROL

Question 21

What are the bad dietary fats?

Answer 21

Saturated fats:

• Myristic (14:0)
• Palmitic (16:0)
• Stearic (18:0)

Question 22

What are the major sources of “bad” fat?

Answer 22

Butter 
Milk 
Meat 
Coconut 
Shortening 
Beef fat 
Chocolate

Question 23

What are the cholesterol lowering fats?

Answer 23

• Linoleic acid (18:2)
• a-loinolenic acid (18:3)
• EPA (20:5)
• DHA (22:6)

Question 24

What are the harmful effects of Trans-fats?

Answer 24

• Dyslipidemia i.e. high LDL, low HDL, and high TG
• Abdominal fat deposition
• Systemic inflammation
• Endothelial dysfunction
• DM
• Membrane effects (ROS)

Question 25

What is a Mono-unsaturated fat?

Answer 25

Single double bond *****Also called "MUFAs" and liquid at room temp. b/c of higher melting point

Question 26

What are the mono-unsaturated fatty acids?

Answer 26

``` Palmitoleic acid (16:1) Oleic acid (18:1) ``` *****Note that the most common source is olive oil

Question 27

What is a PUFA?

Answer 27

Fat with multiple double bonds

Question 28

What are Eicosanoids?

Answer 28

- Signaling molecules - Made from oxidation of 20C FA ****Include prostacyclin, thromboxane, lipoxins, and leukotrienes

Question 29

What is the difference between Eicosanoids derived from FA with N6 or N3 oils?

Answer 29

``` N6= pro-inflammatory N3= less inflammatory ```

Question 30

Outline the pathogenesis of Athersclerosis.

Answer 30

1) Free radicals attack PUFAs and apoB generating fragments 2) LDL is not recognized by hepatocyte receptor 3) Scavenger receptors on macrophages bind LDL fragments and makes "foam cells" 4) Dead and dying foam cells deposit cholesterol creating atherosclerosis ****Note that oxidized lipids also stimulate the inflammatory response*****

Question 31

What are free radicals?

Answer 31

Unstable atoms with unpaired electrons

Question 32

What are the defense mechanisms against free radicals?

Answer 32

- Protective cellular enzymes - Fat-soluble anti-oxidants - Proteins and metabolites that protect the aqueous environment of cells

Question 33

What are the protective cellular enzymes that inactive free radicals?

Answer 33

Superoxide dismutase | Catalase

Question 34

What are the cardioprotective fat-soluble anti-oxidants?

Answer 34

Alpha-tocopherol | Carotenoids

Question 35

What proteins and metabolites protect the liquid environment of cells?

Answer 35

Albumin Uric acid Ascorbid acid

Question 36

Is there a difference in the efficacy of different sources of anti-oxidants?

Answer 36

Generally, fruits, veggies, seeds, and nuts are better than corresponding supplements

Question 37

How many servings of cold water fish per week have been shown to be cardioprotective?

Answer 37

2