Diet and exercise in the management of lipids

Question 1

What do dietary guidelines focus on?

Answer 1

Dietary guidelines focus on fats, fruits and vegetables and more recently carbohydrate intakes alongside physical activity.

Question 2

Which nutrients are important to be considered in CHD patients?

Answer 2

Dietary Fat
Triacylglycerol
Cholesterol
Dietary carbohydrate
Simple sugars 
Polysaccharides
Non starch polysaccharides
Fruits and vegetables

Question 3

What is dietary fat?

Answer 3

Triacylglycerol makes up 95 % of dietary intake
Fat is energy dense
Fat as a source of energy – weight gain
Fat is circulated in blood as lipoproteins– arterial disease

Question 4

What does dietary advice focus on in terms of dietary fat?

Answer 4

Dietary advice focuses on reducing total fat intake and then modifying the balance of fatty acids to improve circulating lipoprotein ratio

Question 5

How is dietary fat important?

Answer 5

Source of energy for muscle
Precursor for synthesis of hormones and pro inflammatory cytokines
Insulator for cell function (neurons) and organ protection

Question 6

How can we reduce saturated fatty acid consumption?

Answer 6

Reduce visible fat intake, reduce consumption of animal meat and products
Increase consumption of vegetable products, oils, seafood nuts and seeds to increase intake of MUFA and PUFA

Question 7

What does an increase in saturated fatty acids do?

Answer 7

Consumption of saturate Fatty Acids (SFA) increases triacylglycerol (TC), HDL-C,and LDL-C even at low levels.

Question 8

What is the common advice surrounding polyunsaturated fatty acids?

Answer 8

Increase consumption vegetable oils (Omega 6) to replace SFA
Consider total fatty acid consumption
Increase consumption of Oily fish to increase supply of EPA and DHA
Flax seeds, nuts provides alpha-linolenic acid (ALA) as a precursor of EPA and DHA

Question 9

What is omega 6 polyunsaturated fatty acids and what do they do?

Answer 9

Omega 6 PUFA, Linoleic acid (LA) decreases LDL-CH

Question 10

What is the importance of omega 3?

Answer 10

Omega 3 PUFA are associated with improvements in cholesterol, TG and vascular function

Question 11

How are trans fatty acids formed?

Answer 11

Trans fatty acids (tFA) are formed by hydrogenating PUFA oils to stabilise them and to form a solid at room temperature

Question 12

Why are trans fatty acids bad?

Answer 12

tFA increases LDL-C, decreases HDL-C, and increases fasting TG

Question 13

How can trans fatty acid consumption be reduced?

Answer 13

Reduce the consumption of processed food

Question 14

List the types of dietary carbohydrate

Answer 14

Polysaccharide- starch
Monosaccharides and disaccharides
Non-starch polysaccharides

Question 15

What happens to a person’s diet when you reduce their fat intake?

Answer 15

The carbohydrate intake increases

Question 16

What can an increased carbohydrate intake cause?

Answer 16

CHO can enhance hepatic synthesis of VLDL and reduce HDL creating an adverse lipid profile
Low fat with increased CHO can lead to a reduction in total LDL but increase in small dense LDL which are more atherogenic.

Question 17

What is the maximum proportion of the energy requirement should be carbohydrate?

Answer 17

65%

Question 18

What is the maximum proportion of the energy requirement should be added sugar?

Answer 18

11%

Question 19

How much fibre should be consumed per day?

Answer 19

18g

Question 20

What is the advice given surrounding exercise?

Answer 20

Adults should aim to be active daily. Over a week, activity should add up to at least 150 minutes (2½ hours) of moderate intensity activity in bouts of 10 minutes or more – one way to approach this is to do 30 minutes brisk walking on at least 5 days a week

Question 21

What does exercise do to lipid profiles?

Answer 21

Exercise up regulates lipoprotein lipase activity in skeletal muscle increasing TG clearance
Exercise decreases hepatic VLDL synthesis
Exercise decreases levels of total cholesterol. Triglyceride and Low Density Lipoprotein (LDL-C)