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diet and chd Flashcards

1
Q

what is atherosclerosis?

A

Focal chronic inflammatory disease of large and medium arteries. Induced by lipid products

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2
Q

what is atherosclerosis characterised by?

A

thickening of the intima + lipid deposition

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3
Q

what are major modifiable risk factors for athersclerosis?

A
  • Hyperlipoproteinaemia – hypercholesterolaemia
  • Hypertension
  • Smoking
  • Diabetes
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4
Q

what is LDL?

A

bad cholesterol

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5
Q

what is HDL?

A

good cholesterol

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6
Q

what are other modifiable risk factors?

A
  • Obesity –
  • Dietary pattern
  • Physical inactivity
  • Alcohol intake
  • Psychosocial
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7
Q

how do you measure obesity?

A

measure by waist/hip ratio or BMI

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8
Q

what are non-modifiable risk factors for atherosclerosis?

A
  • Increasing age
  • Male gender (females before menopause are protected)
  • Family history/genetics
  • Ethnicity
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9
Q

which ethnicity has an increased risk of atherosclerosis?

A

South Asians have an increased risk

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10
Q

what conditions does obesity predispose you to?

A

T2D, MI and hypertension

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11
Q

what is metabolic syndrome?

A

• A syndrome including an increased risk of CVD consisting of;
o Insulin resistance/T2D
o Abdominal obesity
o Dyslipidaemia (particularly hypertriglyceridaemia)
o Hypertension

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12
Q

what is metabolic syndrome a consequence of?

A

excess food intake of poor quality

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13
Q

what induces insulin resistance?

A

• Hypertriglyceridaemia/increased intracellular fatty acids

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14
Q

explain the mechanism of insulin resistance?

A
  • Hypertriglyceridaemia/increased intracellular fatty acids induce insulin resistance/T2D
  • In a typical muscle cell, fatty acid transporter CD36 transports excess fatty acids from blood lipids
  • Normally, fatty acids are metabolised in the mitochondria
  • Excess fatty acid accumulates that isn’t burnt in the mitochondria
  • Saturated fatty acids are metabolised to toxic products e.g. ceramide
  • Toxic products cause signalling from the insulin receptor to become blocked
  • Insulin on the receptor normally activates GLUT4, but GLUT4 becomes blocked so cells can’t take up glucose
  • Insulin resistance occurs
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15
Q

what foods raise blood cholesterol?

A

saturated fat and dietary cholesterol

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16
Q

what type of carbohydrate is good and which is bad?

A

o BUT polysaccharide carbohydrate (starch) as whole grains is beneficial rather than harmful as with refined sugar

17
Q

what are saturated fatty acids? give examples

A

no double bonds between the carbon atoms in the chain e.g. stearic acid, palmitic acid etc. Aren’t v reactive

18
Q

what are monounsaturated fatty acids? give examples?

A

single carbon-carbon double bone.

E.g. oleic acid, palmitoleic acid, erucic

19
Q

what are polyunsaturated fatty acids?

A

first double bond exists as the third carbon-carbon double bond from the terminal methyl end of the carbon chain

20
Q

what type of double bonds are made artificially?

A

trans double bonds

21
Q

what is arachidonic acid?

A

omega 6 fatty acid

22
Q

what fatty acids can and cant be metabolised into arachidonic acid?

A

Linoleic acid can be metabolised to arachidonic acid, omega 3s cannot

23
Q

what happens to omega 6 and omega 3 fatty acids on inflammation?

A
  • On inflammation, omega 6 arachidonic acid is released from membrane phospholipids by phospholipase A2 enzyme
  • Initially inflammatory mediators, eicosanoids e.g. prostaglandins and leukotrienes are synthesised from it
  • Omega3 FAs are metabolised to anti-inflammatory eicosanoids
24
Q

what effects do omega 3 FAs have on inflammation and atherosclerosis?

A

anti-inflammatory and anti-atherogenic

25
Q

what is trans a common name for?

A

common name for unsaturated fat with trans-isomer fatty acids

26
Q

what effect do trans-unsaturated fatty acids have on LDL and HDL?

A

Increase LDL (bad) and reduce HDL (good)

27
Q

what are flavonoids? what are they found in?

A

pigmented polyphenol plant compounds involved in photosynthesis
Found in fruit, veg, tea, chocolate, wine, olive oil

28
Q

why are nitrates important in the diet?

A

nitric oxide production

29
Q

what is the mediterranean diet?

A

fish, pasta, salads with olive oils, pulses, fresh fruit, nuts etc

30
Q

which diet has major effects on preventing CVD?

A

mediterranean

31
Q

what effect does exercise have on CVD and how?

A
  • Exercise stimulates blood flow through the arteries  increases NO production  dilation and anti-atherosclerotic
  • Reduces hypertension through dilation and reduction of peripheral resistance
32
Q

explain the main stages of atherosclerosis?

A
  • macrophages appear from monocytes
  • endothelial lining cells have become inflamed
  • sticky adhesion molecules allow monocytes to bind and enter tissue to become macrophages
  • macrophages take up oxidised LDL
  • recognised by scavenger receptors to become foam cells
  • Macrophages die and eventually release cholesterol
    •LDL carries cholesterol into the wall and HDL takes it out
33
Q

what factors are pro-atherosclerosis?

A
  • Hyperlipidaemia and LDL
  • Smoking
  • Hyperglycaemia
  • Diabetes
34
Q

what factors are anti-inflammatory/anti-atherosclerosis?

A
  • HDL
  • Increased blood flow from exercise
  • Nitrites from nitrates
  • Flavonoids in fruit, veg and wine
  • Statins
35
Q

how do statins protect against atherosclerosis?

A

inhibit cholesterol formation in the liver bc they’re HMG-CoA reductase inhibitors

36
Q

what complications does low birth weight lead to?

A

increased CHD, T2D, stoke and hypertension risk

increased LDL and fibrinogen levels and increased blood pressure

37
Q

what dietary and lifestyle factors have an effect on hypertension?

A
  • Obesity
  • Excess sodium – raises BP bc of genetic disposition. Mild effect on CVD
  • High alcohol intake increases BP
  • Potassium (high in fruit/ vegetables), magnesium, calcium and dietary fibre may be protective factors.
  • Exercise lowers BP
  • Smoking >15/day elevates BP, less smoking tends to decrease it
38
Q

what are the nhs dietary recommendations for hypertension?

A
  • Eat a balanced diet, not to excess.
  • Plenty of potatoes, bread, rice, pasta or other starchy foods (polysaccharides with a low glycaemic index)
  • Plenty of fruit & vegetables:- 5 portions (of 80g) a day
  • Moderate amounts of low fat milk and dairy foods
  • Moderate amounts of meat, fish, eggs & beans (sources of protein)
  • Restrict food & drink with a high fat, sugar or salt content (e.g.chips, fizzy drinks, crisps)

m2 (24 decks)

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