Diet And Cardiovascular Disease Flashcards
Atherosclerosis
Focal chronic inflammatory disease of large and medium arteries induced by lipid products and characterised by intima thickening and lipid deposition
Thrombosis
Formation of a solid mass from the constituents of the blood within the circulation which can impede blood flow
Which type of cholesterol is ‘good’ and which is ‘bad’
HDL good
LDL bad
How does obesity affect hypertension risk
Increase
Metabolic syndrome
Insulin resistance/T2 diabetes + abdominal obesity + hypertension
Which ethnicity has increased effects from obesity and increased T2 diabetes risk
South asian
What does fatty acid transporter CD36 do
Transports excess fatty acids from blood lipids into cells causing accumulation and insulin receptor signalling blockage and metabolism to toxic products
How does hypertriglyceridaemia cause T2 diabetes
Fatty acids accumulate in cells and are metabolised to toxic products which block the insulin receptor signalling activating GLUT4
What is the most important dietary factor on CV disease
Total calorie intake, followed by sat fat
Which types of sugar are beneficial and harmful for CVD
Starch as whole grains - beneficial
Refined sugar - harmful
Which acid is incorporated into membrane phospholipids
Arachidonic acid
Does dietary cholesterol have a significant impact on serum cholesterol or CVD risk
No
Which diet is beneficial for CVD risk
Mediterranean diet
Are flavonoids beneficial or harmful in MI and stroke risk
Beneficial
Soucres of flavonoids
Fruit
Veg
Tea
Cocoa/chocolate
Wine
Olive oil
How can alcohol protect against CVD
Improving insulin sensitivity
Increases HDL
How does folate or vit B12 deficiency increase CVD risk
Increases blood homocysteine level which can be converted to thiolactone which damages endothelium
How does exercise decrease CVD and atherosclerosis risk
Stimulates blood flow increasing NO production
How does exercise decrease hypertension
Increased NO causes vessel dilation and reduces peripheral resistance
What are characteristics of a stable atherosclerotic plaque
Much fibrous plaque
Little lipid
What are characteristics of an unstable atherosclerotic plaque
Much lipid
Small fibrous cap
Inflammation
What molecule drives leukocyte migration into the artery wall in atherosclerosis
Oxidised LDL
Why does inflamed endothelium increase atherosclerosis and thrombosis
Endothelium marked adhesion molecules and chemoattractants
Pro inflammatory risk factors for endothelium
Hyperlipidaemia
LDL
Smoking
Hyperglycaemia
Diabetes
Hypertension
Angiotensin II
Anti inflammatory factors on endothelium
HDL
Increased blood flow
Exercise
Nitrites
NO
flavonoids
Anti inflammatory mediators
Statins
How do nitrites reduce CVD risk
Used in NO production
Is low or high birthweight associated with CVD and diabetes in later life
Low
Why does low birthweight increase CVD and diabetes risk in later life
Foetal programming due to restricted foetal growth from inadequate nutrition
Foetal programming
Reprogramming of neurohormonal regulation probably by epigenetic mechanisms
What does increased refined carbohydrates in diet lead to
Obesity
Metabolic syndrome
T2 diabetes
Hypertriglyceridaemia
Incr VLDL
What does increased salt intake lead to
Hypertension
How does smoking increase CVD and atherosclerosis risk
Tobacco smoke contains substances toxic to endothelial cells
NHS recommendations for reducing CVD risk
Balanced diet
Controlled calories
Low fat
High fibre
Low sat fat
Starchy foods
5 fruit and veg
Salt <6g/day
Avoid excess sugar
How much salt should be eaten to decrease CVD risk
Less than 6g/day
