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Nutritional Physiology > Heart Disease & Nutrition and Gut microbiome > Flashcards

Heart Disease & Nutrition and Gut microbiome Flashcards

1
Q

CHD statistics

A
  • leading cause of death in Australia
  • claimed 18950 lives in 2017 (12% of all deaths)
  • kills 51 Australians each day
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2
Q

What is CHD?

A

Pathological changes in the walls of the coronary arteries that reduce blood flow to the cardiac muscle

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3
Q

How much oxygen does the heart use?

A

Rest: 8mL/min per 100g

Heavy exercise: 70mL/min per 100g

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4
Q

Insufficient O2=

A

Insufficient pumping = insufficient cardiac output

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5
Q

When is cardiac blood flow less?

A

During systole

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6
Q

Why is CBF less during systole?

A

Myocytes compress coronary arteries

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7
Q

What does CBF depend on?

A
  1. Extra vascular compression from contracting myocytes

2. Perfusion pressure in aorta

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8
Q

What is the oxygen extraction in the heart?

A

14ml/100ml

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9
Q

How can you increase oxygen supply to the heart?

A

Only way is by increasing BF

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10
Q

The heart, exercise and CBF

A
  • exercise: increased systole, decreased diastole

- disease: flow only flow during diastole

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11
Q

What are the causes of CHD?

A
  1. Vascular spasm
  2. Artherosclerosis
  3. Other complications (eg thromboembolism)
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12
Q
  1. Vascular spasm
A
  • constriction that transiently narrows coronary vessels
  • reversible and usually no long-term damage
  • triggers: cold exposure, physical exertion, anxiety
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13
Q

What are the causes of vascular spasms?

A
  • increase of noradrenaline on alpha receptors
  • heightened responses to ACh (muscarinic receptors)
  • deficient basal secretion of nitric oxide (secreted by endothelium, potent vasodilator)
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14
Q

What forms an atherosclerotic plague?

A

Cholesterol, calcium and WBC

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15
Q

What is a thromboembolism?

A

Plaque breaks through weak endothelial lining, exposing collagen to which blood platelets stick and form a blood clot

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16
Q

What is the collateral ‘safety net’ system?

A

In the event of one of the major arteries being blocked, collateral blood vessels are pushed open and blood is diverted (can increase in size)

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17
Q

There is a ………. number of collateral blood vessels

A

Finite

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18
Q

What are the uncontrollable risk factors for CHD?

A

Age
Gender
Heredity

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19
Q

What are the controllable risk factors for CHD?

A 
Hypertension
High blood cholesterol
Smoking
Obesity
Physical activity
Diabetes 
Stress
20
Q

How does hypertension cause CHD?

A

Induces endothelial dysfunction

21
Q

How do obesity and diabetes cause CHD?

A
  • both cause hypertension
  • hyperglycaemia causes glycosylation of arterial wall -> atherosclerosis
  • hyperglycaemia increases the formation of reactive oxygen species -> increases formation of oxidised cholesterol
22
Q

How does smoking cause CHD?

A
  • lowers HDL level -> atherosclerosis
  • nicotine causes vasoconstriction
  • CO reduces oxygen carrying capacity of blood
  • increases levels of circulating fibrinogen -> increases chances of clots being formed
23
Q

Smoking 1 cigarette a day increases the chances of CHD …… for men and ….. for women

A

48, 57

24
Q

What is the Mediterranean diet characterised by?

A
  • lots of fruits, vegetables, bread, grains, beans, nuts and seeds
  • olive oil as main source of fat
  • dairy products, fish and poultry
  • little red meat
  • red wine in moderation
25
Q

What is the treatment for CHD?

A

Lifestyle changes
Medication (nitroglycerin)
By-pass surgery

26
Q

Exercise and CHD risk

A
  • reduces obesity
  • lowers HDL
  • lowers LDL and total cholesterol
  • helps control diabetes and hypertension
27
Q

Why is olive oil beneficial?

A
  • high levels of monounsaturated fats (oleic-acid)
  • phenols are potent inhibitors of reactive oxygen species and protect against lipid and lipoprotein oxidation
  • associated with reduced thrombogenesis
  • anti-inflammatory and anti-hypertensive effects
28
Q

The Mediterranean diet promotes a ……… gut microbiome

A

Diverse

29
Q

What is the Mediterranean diet associated with a lower risk for?

A
  • dyslipidemia
  • hypertension
  • abnormal glucose metabolism
  • CHD
  • cerebrovascular diseases
  • Alzheimer’s
30
Q

What is a microbiota?

A

Collection of micro organisms

31
Q

What is a microbiome?

A

Collection of genomes of microbes (viruses, bacteria, funguses and bacteriophages)

32
Q

What is dysbiosis?

A

Shift in microbial composition away from what it is seen in health

33
Q

Gut microbiota weight can reach up to …….

A

1-2 kg

34
Q

….. percent of bacteria is located in the gut

A

95

35
Q

Bacteria are …… times smaller than human cells

A

10-50

36
Q

How many microbial genes are present in the microbiome?

A

2,000,000 (humans 23,000)

37
Q

What is dysbiosis linked to?

A
  • type 1 diabetes
  • food allergies
  • eczema
  • asthma
  • liver function
  • obesity
  • IBS
  • autism
  • mood disorders
38
Q

Gut microbiome stability ………. throughout life and then ………… in late age

A

Increases, decrease

39
Q

What are the benefits of fibre?

A
  • increased stool bulk
  • dilution of carcinogens in colonic lumen
  • reduces transit time (improves gut health)
  • bacterial fermentation of fibre to short chain fatty acids (different fibres are fermented in different parts of the colon)
40
Q

What is resistant starch?

A

Starch which is not digested in the SI and is broken down in the colon by bacteria

41
Q

Which foods include resistant starch?

A
  • form bananas
  • beans
  • cold potatoes
  • high amylase maize
42
Q

What is the importance of short chain fatty acids in the gut?

A

Acetate, propionate and butyrate have antineoplastic properties

43
Q

What does butyrate do in the gut?

A
  • maintains colonic mucosal health and defence
  • proffered energy source for colonocytes
  • promotes apoptosis of potential cancer cells and proliferation of healthy cells
44
Q

What are the antineoplastic properties of SCFAs?

A
  • histones deacetylase inhibitors
  • down regulate the key canonical Wnt-signalling pathway linked to colonic carcinogenesis
  • reduces the burden of carcinogens such as bile acids and red meat products
45
Q

Why is red meat carcinogenic?

A
  • haem is broken down into N-nitroso compounds (NOCs)
  • NOCs damage bowel cells, so other cells have to replicate to compensate
  • extra replication leads to more chances of errors developing in DNA

Nutritional Physiology (13 decks)

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