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(C) Nutrition > Lecture 8: Diet and CV Disease > Flashcards

Lecture 8: Diet and CV Disease Flashcards

1
Q

What is atherosclerosis?

A

Buildup of fatty plaques in the walls of arteries, resulting in narrowing of the arteries.

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2
Q

What are the main risk factors for atherosclerosis?

A
  • DM
  • HLD/Hypercholesterolemia
  • HTN
  • Poor lifestyle habits
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3
Q

Poor lifestyle habits that inc risk of atherosclerosis

A

*Obesity
*Smoking
*Physical inactivity
*Poor diet

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4
Q

What is the #1 cause of death in the US?

A

CV disease

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5
Q

Western diet

A

increased intake of fat, red meat, and carbs with minimal fruits and vegetables

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6
Q

How do we assess ASCVD risk?

A
  • 10 year risk calculator (risk of MI or CVA)
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7
Q

When do we suggest lifestyle changes with ASCVD?

A

*LDL >/= 190.. start +/- meds

  • 10 year risk > 20% with LDL >/= 100
  • 10 year risk </= 20%…
    (with 2+ CAD risk and LDL >/= 130)
    (or with 0-1 CAD risk and LDL >/= 160)
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8
Q

What are the 7 risk factors for CAD?

A
  • DM
  • HLD/Hypercholesterolemia
  • HTN
  • Obesity
  • Smoking
  • Poor physical activity
  • Poor Diet
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9
Q

What are the general recommendations regarding fat intake for atherosclerosis?

A
  • Low sat/trans fatty acids
  • Low cholesterol
  • < 7% of calories should be saturated for those with ASCVD risk.
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10
Q

How do dietary fats contribute to atherosclerosis?

A
  • Increased saturated fats = increased LDL
  • Acute ingestion of high amts of fatty acids = cardiac stressor
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11
Q

What is the suggestion from the AHA/ACC regarding saturated fats?

A

Replace them with MUFAs and PUFAs.

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12
Q

Where do men tend to get their saturated fats from? Women? Children?

A
  • Men: Meat
  • Women: Dairy
  • Children: Milk
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13
Q

What is the effect of saturated fats on our lipids?

A

Increasing TC and LDL.

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14
Q

What are the 2 PUFAs we cannot synthesize?

A
  • Omega-3
  • Omega-6
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15
Q

Which PUFA is commonly low in the diet?

A

Omega 3

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16
Q

What has happened to the modern diet in regards to omega-3:omega-6 ratio?

A

Increased ratio of 1:20. Omega-6 is high now due to corn.

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17
Q

When might we suggest omega-3 supplementation for a patient?

A

Those with existing heart disease.

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18
Q

What is the general recommendation regarding omega-3 supplementation?

A

Reasonable, but not efficacious enough as monotherapy.

19
Q

What diet has very high MUFAs?

A

Mediterranean diet

20
Q

What is the general recommendation regarding MUFAs?

A

Regarded as healthy fats and may be promoted as part of an overall heart-healthy diet.

21
Q

Why are MUFAs good for you?

A

Promote reductions of LDL and elevations in HDL.

22
Q

What are the two major approaches to preventing heart disease in regards to dietary fats?

A
  • Limiting overall dietary fats (low fat diet)
  • Liberalizing intake of MUFAs and omega-3 PUFAs. (Medi diet)
23
Q

How much can optimal dietary intake affect LDL and TC? What about statins?

A
  • Optimal dietary fat intake: LDL down 20%, TC down 30%.
  • Statins: LDL lowered by up to 60%
24
Q

What are the general recommendations regarding carb intake for atherosclerosis?

A
  • Avoid refined carbs, grains, and added sugars.
  • High intake of fruits and veggies
  • Ketogenic diets may promote atherosclerosis.
  • Low-carb with high protein may worsen atherosclerosis.
25
Q

What are the general recommendations regarding protein intake for atherosclerosis?

A

Plant protein is best.
Poultry/fish is best among animals, processed red meat is worst.

26
Q

How do antioxidants work?

A

Inhibit LDL oxidation and nitric oxide degradation, which slows atherosclerosis.

27
Q

What falls under antioxidants? Effects?

A

Vit E, Beta-carotene, Vit C: no benefit by taking supplement versions.
Bioflavonoids: improved overall cardiac health in moderation.

28
Q

What contains bioflavonoids?

A
  • Dark choco
  • cocoa
  • tea
  • red wine
  • grape juice
29
Q

How do B vitamins help with atherosclerosis?

A

B6/12/9 help metabolize homocysteine and methionine.

Elevated homocysteine is found in 1/3 of CAD patients.
Low folate leads to elevated homocysteine.

No benefit to supplement.

30
Q

When is CoQ10 helpful?

A

Existing heart-related conditions with cardiomyopathy or HF.

31
Q

Where is CoQ10 found naturally?

A

All plant-based foods.

32
Q

How does alcohol affect atherosclerosis?

A

Low-moderate consumption = reduced ASCVD risk. (specifically red wine)

33
Q

What is resveratrol?

A

Polyphenol with high antioxidant properties, found mainly in red wine and non-alcoholic red wine.

34
Q

What nuts are best for atherosclerosis?

A

Tree nuts, mainly walnuts and then almonds.

35
Q

What additional dietary element has no effect on CVD mortality, but lowers BP?

A

Garlic

36
Q

What additional dietary element may work well with statins?

A

Plant stanols/sterols, which reduce cholesterol absorption.

Whole grains, bran, peanuts.

37
Q

How prevalent is HTN in the US?

A

29-45% of adults.

38
Q

What is stage 1 HTN?

A

SBP 130-139 OR DBP 80-89.

39
Q

What special population considerations should we consider with HTN?

A
  • Blacks
  • Non-obese patients may develop insulin resistance
40
Q

What lifestyle modifications are generally good for HTN?

A
  • Weight reduction
  • Aerobic exercise 30m/5days
  • Moderation of alcohol intake
  • General diet recommendations (Na < 2300mg, DASH diet)
41
Q

What is the DASH diet?

A
  • Dietary approaches to stop hypertension.
  • High carb, but low GI foods.
  • Na intake < 2300mg daily (but you need 1500mg minimum)
42
Q

What dietary supplement is noticeably good in younger pts for lowering BP?

A

Calcium

43
Q

What 3 things in our diet have bad effects on HTN?

A
  • SODIUM
  • Alcohol
  • Caffeine

(C) Nutrition (12 decks)

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