Cardio dz

Question 1

Obesity

Answer 1

increases total mortality in both men and women in all age strata from 35-89 years, CVD increases, most cancers increase and some decrease (cancer of lung, mouth, pharynx, larynx or esophagus)

Question 2

Relative risk > 3 if obese

Answer 2

type II diabetes, HTN, breathlessness, gall bladder disease, insulin resistance, dyslipidemia, sleep apnea

Question 3

Weight loss linked to

Answer 3

significant reduction in mortality, BP, risk of diabetes, risk of cancer deaths, decrease of body lipids

Question 4

CVD

Answer 4

biggest killer of males (1/3 of male deaths) -> mostly CHD, also stroke and other diseases; risk is lower in females (1/4 of deaths)

Question 5

CVD Mech

Answer 5

Atherosclerosis -> unstable plaque -> plaque rupture -> thrombosis -> ischemia and arrhythmia -> cell death and heart failure; influenced by clotting, BP, dyslipidemia, inflammation, vascular endothelial dysfunction

Question 6

BMI

Answer 6

increases both diastolic and systolic as this increases; increases LDL and decreases HDL

Question 7

Cholesterol

Answer 7

total plasma levels predict mortality -> increases mortality for CHD and overall mortality -> give statins -> marked difference between populations for CVD risk, poor discriminator of CHD risk within countries/populations

Question 8

TAG

Answer 8

better indicator of CHD risk -> raised level = pro-inflammatory, pro-thrombotic state, reduced HDL, increased LDL (begins plaque) and causes intolerance to dietary fat -> measurements must be done in fasting state

Question 9

Diet

Answer 9

66% of CVD is modifiable by this; this can modify clotting, BP, dyslipidemia, inflammation and vascular endothelial dysfunction

Question 10

CVD and diet

Answer 10

main factors -> too much salt, too little potassium, amount and type of fat is inappropriate, inappropriate amount and quality of carbohydrates, too little dietary fiber, not enough fruit/veggies/nuts/oils (antioxidants)

Question 11

Excess salt/low potassium

Answer 11

increases risk of hypertension -> fruit and veggies reduce risk (low salt, high potassium)

Question 12

Olive oil and canola oil

Answer 12

have lots of MUFAs

Question 13

Soy bean oil and corn oil

Answer 13

have primarily n-6 PUFAs (linoleic 18:2)

Question 14

N-3 VLC PUFAs

Answer 14

decrease clotting, TGs, inflammation

Question 15

N-6 PUFAs

Answer 15

increase clotting and inflammation but decrease cholesterol

Question 16

MUFAs

Answer 16

decreases cholesterol (not as much as PUFAs)

Question 17

Saturated FA and Trans FA

Answer 17

increase TGs and cholesterol

Question 18

Atherogenesis (high LDL cholesterol) tx

Answer 18

reduce SFA/trans FA, increase PUFA/SFA ratios, increase MUFA/PUFA ratios

Question 19

Atherogenesis (high TGs/postprandial lipidemia) tx

Answer 19

increase n-3 with oily fish

Question 20

Decrease clotting and inflammation (eicosanoids balance: EPA/AA ratio)

Answer 20

increase n-3 with oily fish

Question 21

CVD and carbohydrates

Answer 21

Keep glycemic index low, keep non-starch polysaccharides (NSP -> fiber) high

Question 22

Glycemic index

Answer 22

incremental area under blood glucose response curve for the test food containing 50g of CHO / corresponding area after equal carbohydrate portion of white bread/glucose solution x 100 -> ripe bananas are high, whole wheat is low

Question 23

Glycemic load

Answer 23

Glycemic index x amount of carbohydrates

Question 24

Low glycemic index diets

Answer 24

improve blood lipids -> especially TGs

Question 25

Viscous fiber

Answer 25

can help reduce LDL

Question 26

High glycemic index, low fiber

Answer 26

glutinous rice, short grain white rice, fresh mashed potatoes -> increases cholesterol and triglycerides (dyslipidemia)

Question 27

Low glycemic index, high fiber

Answer 27

red lentils, pinto beans, spaghetti, yellow split peas -> decrease cholesterol and triglycerides (reduce dyslipidemia)

Question 28

Antioxidants (nuts and oils -> vitamin E is lipid soluble; fruits and vegetables)

Answer 28

protect against LDL oxidation -> can prevent atherosclerosis

Question 29

HTN

Answer 29

excess NA (in processed foods), low K+ (not enough fruit, vegetables and unprocessed foods)

Question 30

Dyslipidemia

Answer 30

excess SFA, Trans fat and dietary cholesterol (not a major player - except with people with ApoE4 genotype = bad; ApoE2 is resistant), low PUFA, MUFA and VLC n-3 PUFA, high glycemic index carbohydrates, low NSP, low antioxidants

Question 31

Increased clotting and inflammation

Answer 31

excess n-6 PUFA, low n3 especially oily fish (same effect as aspirin but better)