Cardiac Nutrition and Wellness (Exam 2) Flashcards by Brian Bradway

Diagnosis of obesity

BMI >30 is obese, 25-29 is overweight. Waist circumference of > 40 in. for men and >35 in. for women. Waist-to-hip ratio >1 in men and > .08 in women. (waist measurement/hips measurement at widest point)

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How is obesity associated with Increased risk of CVD?

^LDL and triglycerides
Low HDL
metabolic syndrome
DM
HTN

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How do you prevent CVD in diabetes patients?

good glycemic control and attention to diet.

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How is diabetes associated with increased risk of CVD?

obesity, hyperglycemia, insulin resistance, defects in carb and lipid metabolism, macrovascular disease, HTN

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Distinguish between stage 1 and stage 2 HTN

stage 1: systolic 140-159 or diastolic 90-99

stage 2: systolic > or = to 160 or diastolic > or = to 100

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Describe sodium and potassium in relation to increased risk of CVD.

Sodium intake is directly proportional to incidence of HTN and potassium deficiency is moderately linked to CVD risk

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Metabolic syndrome diagnosis criteria

waist circumference of over 40 in. in men or over 35 in women.
serum triglycerides greater than 150 mg/dL
bp greater than 130/85
HDL lower than 40 in men or lower than 50 in women.
fasting serum glucose over 110 mg/dL

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name some sources of dietary cholesterol

AKA the face group: meat, fish, poultry, egg yolks, butter, lard, cheese, dairy, products made from whole milk or reduced fat milk.

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name sources of saturated fat.

foods from animals (dairy, meet, butter etc), foods and oils from tropical plants (coconut, palm, palm-kernel oils, cocoa butter)

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what is the impact of saturated fats in relation to CVD?

they reaise blood lipid levels. LDL cholesterol can lead to endotheilial dysfunction. saturated fatty acids can increase risk of insulin resistance.

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how to read a label

start at top where serving size is listed. Check calories. check guide to % daily value. limit total fat (if saturated fat is higher than unsaturated fat content it is not considered heart healthy). limit cholesterol, sodium, carbs, and get enough of vitamins, calcium, iron.

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Name some sources of hydrogenated fats.

margarine, solid vegetable shortening, fried foods, processed foods, home prepared and commercial baked products.

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How does hydrogentated fat increase your risk of CVD?

they behave like saturated fats and increase LDL

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Name some sources of trans fatty acids (TFA)

they are produced when polyunsaturated oils are hydrogenated to solidify them into stick margarine or shortening. found in commerical baked goods like cookies, crackers and muffins. found in chips as well.

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How does TFA contribute to increased risk of CVD?

increase serum cholesterol and LDL; lowers HDL
increases triglycerides
increases Lp(a) (inflammatory marker)
increases insulin resistance in type 2 dm
increases endothelial damage
decreases conversion of ALA to EPA and DHA
may contribute to cancers

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Types of omega-3 fatty acids

ALA (alpha linolenic acid)
DHA (decosoheaenoic acid)
EPA (eicosopentaenoic acid)

Sources of ALA

Vegetable oils (canola, flaxseed, olive) and nuts (soy beans, punmpkin seeds, hemp seeds, chia seeds, almonds, walnuts)

Sources of DHA and EPA

fish or fish oil supplements (tuna, salmon, mackerel, herring, trout, sardines, cod)

What are health benefits of omega-3 fatty acids?

lowers: cholesterol, tryiglycerides, VLDL, platelet aggregation, clotting thrombosis and plaque formation, inflammation, BP (promotes arterial relaxation), CHD mortality.
Increases: Insulin sensitivity

Sources of monounsaturted fats (MFA)

canola oil, olive oil, nuts (peanuts, cashews, almonds, other tree nuts.) avocados

what are health benefits of MFA in relation to reduction of CVD?

lowers cholesterol and LDL

preserves or raises HDL

sources of plant sterol/stanol esters

freely present in corn, soy, wheat, wood oils.
commercially extracted and synthesized found in fortified table spreads, juices, salad dressings, yogurt, and supplements

What are some health benefits of plant sterol/stanol esters in relation to CVD risk reduction?

lowers: absorption of dietary cholesterol and bile acids in GI tract, cholesterol by 4-11%, LDL
adding these to diet of patients on statins appears to be somewhat more effective than doubling the statin dose

sources of fiber

soluble fibers: apples, pears, citrus, okra, eggplant, fruits, veg, whole grains, psyllium, prunes, pectin
greates impact: oats, oat bran, barley

What are the health benefits of fiber in relation to reduction of CVD risk?

decreases the absorption of dietary cholesterol; bind bile acids in GI tract increasing this excretory route of cholesterol lowers: cholesterol, LDL promotes satiety leading to weight loss and improves glycemic control

Health benefits of fruits and vegetables in relation to reduction of CVD risk

naturally low in sodium and high in potassium and magnesium. protective for BP regulation. more than 3 servings compared to 1 serving or less: decrease in stroke, stroke death, ischemia deaths, CVD

Potential health benefits of alcohol with regard to CVD

may increase HDL levels and decrease risk of CVD. 2/day decreases inflammatory markers antioxidant effects of flavonoids and polyphenols may be protective.

Health benefits of folic acid with regard to CVD

elevated homocysteine levels have been cited as an independent risk factor for vascular disease, particularly stroke.

antioxidant sources

found in small quantites in plant foods: leafy greens, fruits, veg, tea, wine, nuts, seeds, dark chocolate, and herbs/spices

Health benefits of antioxidants

decreased risk of CVD, CHD, Stoke, all causes of death

Health benefits of policosanol

cholesterol lowering effects as much as 10% with doses up to 80 mg/day

Health benefits of nicotinic acid

inhibits synthesis of VLDL; fallout effect of decreasing LDLs

What are the key features of dietary guidelines for americans 2010?

designed for primary prevention. | target all americans regardless of risk.

What are the key features of NCEP-TLC?

Making "therapeutic" recommendations for secondary and teritary prevention of hyperlipidemia and CVD. other aspects of NCEP in public health and school setting have objectives targeting primary prevention

What are the key features of the DASH diet?

Prevention and management of HTN. | selected beneficial minerals: 1500 or less mg sodium, 4700 mg potassium, 1250 mg calcium, 500 mg magnesium.

What are the ACSM/AHA recommendations for physical activity?

moderate-intensity aerobic (endurance) physical activity to a minimum of 30 minutes for 5 days/week OR vigorous activity for a minimum of 20 minutes 3 days/week. resistance exercise that maintains increases muscle strength and endurance shoul be done at least 2 day/week

Key pritority areas based on Hypertension?

sodium, weight reduction if overweight or obese, DASH, exercise-10 lb weight loss may be most efective treatment outcome

what is the key priority areas based on high LDL, or high TC/HDL ratio?

limit cholesterol, saturated fat, trans fat, and hydrogentated fat. add the good fats. weight reduction if obese. exercise. dont forget the fiber!

what is the key priority areas based on hypertriglyceridemia?

limit chlesterol, saturated fat, trans fat, and hydrogenated fat. add the good fats avoid simple surgars and high glycemic index foods avoid alcohol weight reduction if overweight or obese