77: Influence of Nutrition on Cardiovascular Disease Flashcards
…… is a group of diseases that include the heart and blood vessels. It is also known as artherosclerotic cardiovascular diseases (ASCVD).
Cardiovascular Diseases (CVD)
…….is the single largest cause of death in Western societies and is also named coronary artery disease (CAD).
Coronary Heart Disease (CHD)
Plaque builds up in ………..and can lead to atherosclerosis and myocardial infarction.
Coronary Arteries
Preventable risk factors Cardiovascular Disease:
– Diet high in trans fat, saturated fats, salt and refined sugar.
– Smoking (cigarette, cigar, pipe).
– Physical inactivity and sedentary life style.
– Excessive alcohol intake
Individual risk factors Cardiovascular Disease:
– Genetic predisposition, family history.
– Age: men > 45 years old and women > 55 years old.
Clinical conditions that are risk factors:
– Dyslipidemia • High LDL, high VLDL and low HDL
– Hypertension • BP > 140/90 mm Hg
– Obesity • BMI > 30 – Diabetes • Blood glucose > 126 mg/dL
– Metabolic Syndrome • All of the above
Primary Dyslipidemia is caused by:
Genetic Disorders
Secondary Dyslipidemia related to:
Diet:
– Diet high in saturated fats or trans fats.
– Diet high in cholesterol.
– Excessive alcohol intake.
Levels of Total Cholesterol, LDL-Cholesterol, TAG, HDL-C of patients with Dyslipidemia
High total cholesterol > 200 mg/dL
High LDL-cholesterol >160 mg/dL
High TAG > 200 mg/dL
Low HDL-C < 40 mg/dL
The …….. diet lowers serum total cholesterol, LDL-C and TAG.
Mediterranean
Mediterranean diet has more ………..and less ………….
Oleic acid 18:1
Saturated fatty acids
……….. increase LDL and decrease HDL and shouldn’t be ingested.
Trans-fatty acids
Saturated fatty acids especially palmitate (16:0) and a high palmitate/oleate ratio increase …….
LDL
To reduce risk of CHD, substitute saturated fatty acids for:
- Monounsaturated: Oleic acid (18:1)
- Polyunsaturated fatty acids (w6): Linoleic acid (18:2) dietary essential Arachidonic acid (20:4)
- Polyunsaturated fatty acids (w3): a-linolenic acid (18:3) dietary essential Eicosapentaenoic acid (EPA 20:5) Docosahexaenoic acid (DHA 22:6)
Food rich in w3 fatty acids:
Fish Oil/Fish
Dietary EPA and DHA- Found in Fish oil
a-linolenic acid- FOund in Flax seeds, walnuts, and soybeans
Dietary doses of DHA and EPA reduce:
- Arrhythmia
- Heart rate
- Blood pressure
A diet rich in ………….leads to less formation of blood clots
EPA
…………is reduced by prostacyclin (PGI) and stimulated by thromboxane (TXA).
Blood Clotting
EPA leads to TXA3 that has a …………potency than TXA2
Weaker
It is recommended that there should be no intake of ……… and reduced intake of ……..
Trans fat
Palmitate
It is recommended that you should ……… w3 fat intake as they lead to less potent inflammatory mediators than w6 fatty acids. DHA and EPA are ……….
Increase
Cardioprotective
Dietary fatty acid that increases LDL levels and risk of coronary heart disease (may increase risk of prostate, colon cancer)
Saturated fatty acid
……… and ………. fatty acids decease LDL levels and incidence of coronary heart disease.
Monounsaturated fatty acid (Maintains/Increase HDL)
Polyunsaturated fatty acids Omega-6 (Decrease HDL)
……….. fatty acids have little to no effect on LDL or HDL , decrease incidence of coronary heart disease and risk of sudden cardiac death.
Polyunsaturated fatty acids w-3
- Suppress cardiac arrhythmias, reduce serum TAGS, decerase thrombosis and blood pressure
…………is correlated to the BMI and obesity (BMI>30)
Dyslipidemia
………. body shape indicates high amount of visceral fat.
Apple body shape
Fatty acids from ………..are released into the portal vein and can lead to increased ………….formation leading to dyslipidemia.
Visceral fat depots
Hepatic VLDL
………….increases the risk of ……….., the development of diabetes and features of Metabolic syndrome.
Central Obesity
CHD
Obesity is a risk factor for chronic diseases:
- Heart disease
- Dyslipidemia
- Type-2 Diabetes
- Hypertension
Health benefits of weight loss in obese individuals:
- Decreased blood glucose levels
- Decreased blood pressure
- Decreased serum TAGs and increased HDL
Prolonged over-nutrition and weight gain causes:
Increase in adipocyte size and number (hyperplasia)
……….release leptin which acts on the hypothalamus and decreases appetite
Adipocytes
A peptide hormone secreted in proportion depending on the size of fat stores
Leptin
Why is it hard for obese individuals to maintain their achieved lower weight for a longer period?
Due to weight loss and smaller size of adipocytes: Less leptin is released after a meal even though the threshold for leptin action is still the same. The amount of released leptin is not sufficient to lead to satiety in obese individuals who have lost weight.
Refined sugar and foods with a high glycemic index raise fast the blood glucose levels resulting in a high production of ………….
Insulin
Stimulates hepatic fatty acid synthesis and VLDL are released. This can lead to obesity and dyslipidemia.
Insulin
- Reduces the glycemic index in food and is generally beneficial for health.
- Absorbs water in the intestine increasing bowel motility.
Fiber
Functions of water-insoluble fiber:
a. Adds to bulk of stool.
b. Helps food pass more quickly
c. Stool softener.
Functions of water-soluble fiber:
a. Turns into a gel, delays gastric emptying, feeling of satiety.
b. Is fermented by intestinal bacteria.
c. Lowers LDL-C by interfering with bile acid reabsorption.
Moderate consumption of alcohol ……… the risk of CHD as it can lead to a ……… in LDL
Decrease
……….is rich in B-vitamins which are protective against high blood homocysteine levels
Beer
………cardioprotective as it contains resveratol (phenolic compound) which reduces formation of oxLDL.
Red Wine
This antioxidant action reduces formation of foam cells and plaque accumulation.
HIgh ……blood level is considered a risk factor for CHD It is found in individuals with a genetic enzyme deficiency. These patients have premature vascular disease with a high death rate from thrombotic complications.
Homocysteine
Individuals with ……….. deficiency show high homocysteine levels which can be reduced by supplementation with folate, B6 and B12 .
Vitamin B defieciency
High ……… intake increases blood pressure and raises the risk of CHD and stroke
Ssalt intake (table or sea salt)
Trace minerals (zinc, copper, manganese, iron.), Vitamin C and E and Radical Scavengers are ……… that protect against CHD
Micronutrients
DASH diet Dietary Approaches to Stop Hypertension:
- Low in sodium, reduced intake of processed foods.
- Cooked without added table salt.
- Low in saturated fats and no trans fats.
- Rich in potassium, calcium, magnesium, fiber and protein.
