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Flashcards in Overnutrition and Cardiovascular Disease Deck (39)
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Obesity increases mortality in men and women across all age strata from 35 to 89. Increased mortality is due to what specific causes?

Ischemic heart disease, stroke, diabetes, cancer and live disease


Obesity shortens lifespan. Therefore how much weight loss can increase lifespan via lower mortality and blood pressure, decreasing risk of DM and improving lipid profile?



Cardiovascular disease is responsible for what percent of male and female deaths?

32% of male deaths
23% of female deaths


If your relative risk is greater than 3 then what disease outcomes are you at risk for?

Type 2 diabetes
Insulin resistance
Sleep Apnea


If your relative risk about 2-3 then what disease outcomes are you at risk for?

Coronary heart disease/heart failure
Osteoarthritis (knees)
Hyperuricaemia and gout
Gall Bladder disease


If your relative risk is about 1-2 then what disease outcomes are you at risk for?

Pregnancy complications
Cancer (breast and endometrium)
Impaired fertility/polcystic ovary


In terms of mortality what are the benefits of 10kg of weight loss?

20-25% fall in total mortality
30-40% fall in diabetes-related death
40-50% fall in obesity-related cancer deaths


In terms of blood pressure what are the benefits of 10kg of weight loss?

Fall of 10mm Hg in systolic and diastolic


In terms of diabetes what are the benefits of 10kg of weight loss?

Risk of developing diabetes reduced by less then 50%
Fall in 30-50% in fasting blood glucose
Fall of 15% in HbA1c


In terms of lipids what are the benefits of 10kg of weight loss?

Fall of 10% in total cholesterol
Fall of 15% in low density lipoprotein
Fall in 30% in triglycerides
Increase of 8% in high density lipoprotein (HDL)


How does cardiovascular disease develop?

Atherosclerosis ---- unstable plaque ---- rupture---- thrombosis ---- ischemia ----arrhythmia ---morbidity and mortality


What are the factors that help contribute to the development of atherosclerosis?

Blood pressure


What two factors are directly related to obesity?

blood pressure and inflammation


What is the role of cholesterol?

Higher cholesterol is associated with increased mortality from CHD when comparing countries
---there are big differences between populations, but it is a poor discriminator when comparing CHD risk within a country


_________ is a better indicator of CHD risk/

(have to measure when fasting)


Increased TAGs are associated with what things?

Decreased HDL and increased LDL
Intolerance to dietary fat
Pro inflammation and Pro thrombosis


A major part of the risk for CVD is modifiable by what?

Diet and lifestyle
--66% of the risk is modifiable by diet


What are the main risks in the diet associated with CVD?

1. Too much salt -- coming from processing of foods, not added at the dinner table and processing of foods replaces K with Na
2. Too much and the wrong type of fats and carbs
3. Not enough fiber, fruits, veggies and nuts


Fruits and Veggies give us what?

High potassium with low sodium
--processed foods will always have more sodium and less potassium


How does diet affect blood pressure?

1. Excess salt and low potassium increase risk of HTN
2. Fruits and veggies reduce the risk


Which dietary fats are good and bad for our diets?

Saturated and trans fat are bad
----dyslipidemia caused by marked elevation of triglycerides and cholesterol.
--cholesterol only has an effect on serum cholesterol and not triglycerides


MUFA have no effect on clotting or inflammation but does help to decrease what?



N-6 PUFA and N-3 PUFA have what effects on cholesterol and triglycerides?

N-6: decreases cholesterol, but are pro-inflammatory and thrombotic
N-3: decreases triglycerides and are anti-inflammatory and anti-thrombotic
--there needs to be a good balance.


What is the current advice about dietary fat?

1. If obesity is target: reduce total fat
2. Heart disease: fat quality
---atherogenesis: reduce SFA/trans fat and increased PUFA and MUFA n-3 with oily fish
-clotting/inflammation: increase n-3 with oily fish (to improve eicosanoid balance)


Fish oil is urged as a supplement for what kind of patients?

Heart attack patients


In summary explain the effects of n-3, n-6, mono--unsaturated, saturated/trans/cholesterol on CVD

n-3: decreased clotting, inflammation and triglycerides
n-6: increases clotting, decreases cholesterol and increased inflammation
mono-unsaturated: decreases cholesterol
Saturated/Trans: increases triglycerides and increased cholesterol
Cholesterol: increases cholesterol


How do carbs affect CVD?

1. Eating too much of the wrong type --- high glycemic index (GI)
--which is related to how quickly the blood glucose falls and rises after consumption
2. Low glycemic index
3. Not enough fiber (non starch polysaccharides)


Low glycemic index diets improve what?

Improve blood lipids, esp triglycerides


What is the equation for glycemic load?

Glycemia index x Amount of carbs


Which fibers are shown to lower cholesterol?

Soluble fibers


Combining a low GI diet with high fiber will improve what?

Both cholesterol and triglycerides
--reducing the risk of dyslipidemia and atherosclerosis


High Gi and low fiber diet leads to what?

High cholesterol and high triglycerides
--including rice/short grain white rice and hot potatoes


Low GI and high fiber diet leads to what?

Low cholesterol and high fibers
--red lentils/beans/spaghetti/yellow split peas


Hypertension is associated with what foods that increase the CVD risk?

Excess Na (in processed foods)
Low K (fruits, veggies, and unprocessed foods)


Dyslipidemia is associated with what foods that increase the CVD risk?

Excess SFA/trans fat/dietary cholesterol
Low PUFA, MUFA, and VLC n-3 PUFA (oily fish)
High GI/GL carbs, excess fructose
Low antioxidants in fruits and vegetables, nuts


Increased clotting and inflammation is associated with what dietary factors that increase the CVD risk?

Excess n-6 PUFA
low n-3, esp oily fish


Fruits and veggies provide a good source of what?

Anti-oxidants and potassium
--remember the more antioxidants the less oxidants


Do dietary and lifestyle interventions actually work?

---health behaviors may be additive in their effect (not smoking, exercise, decrease ETOH use, five fruits and veggies)


Patients who exhibited all 4 health behaviors in interventions, had what results?

75% reduction in total mortality and 80% reduction in CVD mortality with 14 years of extra life.