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HN 320 Clinical Nutrition I > Exam 3 - CVD II > Flashcards

Exam 3 - CVD II Flashcards

1
Q

What is the underlying cause of most forms of CVD?

A

Atherosclerosis

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2
Q

What can atherosclerosis lead to?

A
  • coronary arteries –> MI and angina
  • cerebral arteries –> strokes
  • peripheral circulation –> claudication and gangrene
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3
Q

What are the disease risk factors of atherosclerosis?

A
  • HTN (may initiate lesion and/or cause plaque to rupture)
  • DM
  • Metabolic syndrome
  • Impaired fasting glucose
  • Obstructive sleep apnea (symptom of obesity)
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4
Q

Describe the FRAMINGHAM HEART STUDY

A

Prospective cohort to study the prevalence/incidence of CVD and factors related to its development - found risk factors and prevention

• Major findings/links:

  • cigarette smoking
  • cholesterol level, BP, and ECG abnormalities
  • obesity
  • high BP linked to stroke
  • menopause
  • high HDL linked to decreased disease
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5
Q

Describe NCEP

A

National Cholesterol Education Program

  • Mission to reduce prevalence of hypercholesterolemia in US (Adult Treatment Panel 1 - ATP I)
  • Panel recognizes that DIET, MEDICATIONS, SERUM CHOLESTEROL, SATURATED FAT INTAKE AND PA are major factors in primary and secondary prevention of CVD
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6
Q

What is the primary therapy outlined by NCEP/ATP?

A

Lowering LDL-C levels

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7
Q

Describe C-Reactive Protein’s link to CVD

A

Synthesized in the liver, C-RP is a very general marker of acute illness/inflammation (inflammation has central role in CVD)

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8
Q

Give the risk ranges for C-Reactive Protein

A

Low Risk: <1.0mg/L
Average Risk: 1.0-3.0 mg/L
High Risk: > 3.0mg/L

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9
Q

List five modifiable risk factors for CVD

A
  • tobacco use
  • physical activity
  • poor diet
  • stress
  • alcohol consumption
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10
Q

Describe the Dietary CAGE Questions. When/how are they used?

A

C: CHEESE (and other sources of dairy fats)
A: ANIMAL FATS
G: GOT IT AWAY FROM HOME
E: EAT (EXTRA) HIGH FAT COMMERCIAL PRODUCTS (candy, pies, doughnuts, and cookies)

Used as an assessment tool to pinpoint saturated fats intake

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11
Q

Nutrition diagnosis for Atherosclerosis will focus on what?

A
  • Fat
  • Fiber
  • Weight
  • Food choices
  • Physical inactivity
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12
Q

What is the primary target of MNT for atherosclerosis?

A

Reducing saturated fat (5-7% reduction)

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13
Q

Describe monounsaturated fatty acids and their relation to CHD

A
  • One double bond in carbon chain
  • OLEIC ACID is most prevalent MUFA in American diet
  • Replacing SFA with MUFA lowers LDL and TGs to same extent as PUFAs
  • Mediterranean high-fat diets high in MUFAS are assoc with lower cholesterol and CHD incidence
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14
Q

What are some dietary MUFA sources?

A
  • Avocados
  • Canola oil
  • Olive oil
  • Olives
  • Nuts
  • Peanut oil
  • Nut butters
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15
Q

Name and describe the two categories of PUFAs. What is their link to CVD?

A
  • Omega-6: most common; primarily in vegetable oils
  • Omega-3: alpha-linolenic accounts for ~85% of omega-3 FA (EPA and DHA); anti-inflammatory (alter prostaglandin synthesis)

Replacing SFAs with PUFAs in a low-fat diet lowers LDL and HDL

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16
Q

What are the current dietary recommendations for Omega-3s?

A

Eat fish high in omega-3s at least 2x/week (salmon, tuna, mackerel, sardines)

  • Patients with CVD should have 1gm EPA and DHA/day
  • Patients with high TGs should have 2-4gms EPA and DHA/day
17
Q

Describe STANOLS and STEROLS and their role in CVD

A
  • Found in wheat, corn, rye, barley, oats, and olive oil
  • Similar in structure to cholesterol, so inhibit micelle/cholesterol absorption
  • Effective in lowering LDL-C up to 10%
18
Q

How does alcohol affect blood lipid levels?

A
  • Effects both TG and HDL levels
  • See big increases in HDL levels in people with high TAGs
  • MODERATION
19
Q

Describe the Assessment part of Atherosclerosis nutrition therapy

A
  • Use TLC as nutrient standard (dietary fat; saturated fat <6% SFA)
  • Dietary CAGE questions
  • REAP questionnaire
20
Q

Describe the Diagnosis part of Atherosclerosis nutrition therapy. What will you prioritize and focus on?

A 
• Prioritize nutrition problems
• Will focus on: 
1. saturated fat
2. fiber
3. weight
4. food choices
5. physical activity
21
Q

Describe the Intervention part of Atherosclerosis nutrition therapy. What will you focus on?

A
  • Weight loss
  • Physical activity
  • Total dietary fat
  • Saturated fat
  • Monounsaturated fat
  • Omega-3 FAs: linolenic acid
  • PUFAs
  • Cholesterol
  • Fiber
22
Q

Describe the Monitoring and Evaluation part of Atherosclerosis nutrition therapy. What will you focus on?

A
  • Dietary intake should be monitored for amount and type of fat, energy and fiber
  • Lab tests like lipid panel should be monitored if available

HN 320 Clinical Nutrition I (10 decks)

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