Flashcards in Nutrition and Cardiovascular Disease Deck (27)
What are the major changeable risk factors for CVD?
High blood cholesterol, smoking, hypertension
What are the other risk factors for CVD?
2. Male -> although females have higher rate after menopause
6. Low HDL, High TG
8. Personality, including stress and coping tendencies
How do CVD risk factors work together?
Which apoproteins are considered atherogenic and what are they found on?
Apo B-100: LDL, IDL, VLDL
Apo E: IDL, VLDL only
Which apoproteins are associated with lower risk for CVD and what are they found in?
A-1, A-4 = Chylomicrons
A-1, A-2 = HDL
What are the two subclasses of LDL particles and which one is considered more atherogenic? Why?
Phenotype A: Lower risk -> large
Phenotype B: Higher risk -> smaller
Smaller particles more easily infiltrate the endothelium
What diseases does high wait circumference increase risk for?
CVD, Type 2 diabetes, gall bladder disease
What are the best sources of MUFA's (good)?
Olive oil > Canola oil > Peanut oil
What are the best sources of PUFA's (good)?
Safflower oil, sunflower oil, corn oil, soybean oil, all n-6, although fish n-3 is the best
What are the best sources of SF's (bad)?
Coconut oil, palm kernel oil, butter, animal fats
Which oil is thought to be beneficial even though it is high in saturated fat and why?
Palm oil - probably because it is high in vitamin E. It has a positive effect on blood cholesterol levels.
What are the positive effects of MUFA's?
1. Lower LDL while not lowering HDL
2. Improve resistance to LDL oxidation
3. Reduce macrophage uptake of o-LDL as compared to saturated fatty acids or carbohydrates
What is the effect of trans fat?
Atherogenic, raises level of small, dense LDL cholesterol + systemic inflamation
What is the significance of conjugated linoleic acid?
It is an n-6 PUFA which is a naturally-occurring trans-fat, actually has anticarcinogenic activity
What is alpha-Linolenic acid (ALA) and what is the current recommendation?
It is an n-3 PUFA which comes from walnuts, canola oil, flaxseed oil, and is converted to EPA and DHA (two important eicosanoids), very gud for you
Why are fish n-3 PUFA's better than plant n-3 PUFA's?
Fish n-3's are already EPA and DHA, plant n-3's like ALA must be converted in the body into EPA and DHA. This is done much more readily in females
What are the positive effects of n-3 PUFA?
Reduce thromboxanes, which aggregate platelets
Lower arachidonic acid synthesis as well as enzymes which convert it to inflammatory leukotrienes.
improving hemodynamics by reducing blood viscosity, blood pressure, and TAG levels.
Reduce number of small size LDL particles, and counteract vessel proliferation and atherogenic lesion site.
What is the primary n3 eicosanoid and its effect?
Prostacyclin - vessel dilation, lower platelet aggregation
What is primary n6 eicosanoid and its effect?
Thromboxane - platelet aggregation and vasoconstriction
Are saturated fats bad? What's most important?
Likely neutral. What's most important is what those calories are replaced by -> low quality carbohydrates are worse. Carbohydrates increase CVD risk by lowering HDL and increasing TAGs
What is the order of the best fatty acids for protecting against CVD?
Fish n3 > plant n3 > plant n6 > MUFA > saturated fats
What are the 9 risk variables for CVD risk assessment?
4. Smoker (yes/no)
5. Total cholesterol
6. HDL cholesterol
7. Systolic blood pressure
8. Treatment for hypertension (yes/no)
9. Diabetes (yes/no)
What are the components of the DASH diet?
Dietary Approaches to Stop Hypertension
1. High fruits / vegetables
2. High in diary
3. High in K, Ca, Mg as a result
4. Low in sodium reduces blood pressure
Who is the DASH diet best for?
What are the typical nutritional problems that arise after a stroke?
1. Dysphagia - difficulty swallowing. May include choking / dehydration and lead to temporary or permanent weight loss
2. Physical disability - unable to feed oneself, but also lack of physical activity can cause weight gain
What percentage of cardiovascular accident (CVA) / stroke patients have malnutrition, and what is the recommendation for these patients?
Up to 50%. Ischemic CVA who are nutritionally compromised on admission are more likely to become malnourished and have worse outcomes.
Recommendation: Give 240 additional calories + 11g of protein, gives much better outcomes