M103 T4 Symposia Flashcards
Where is VLDL produced?
the liver
How is IDL formed?
VLDL delivers triglycerides to muscle and adipose tissue
What two components is LDL derived from?
VLDL
IDL
Where is HDL formed?
the liver
the SI
What are the main chylomicron groups?
VLDL
HDL
IDL
LDL
What are the chylomicrons listed smallest to largest?
HDL
LDL
IDL
VDL
What are the two essential polyunsaturated FAs?
omega 3
omega 6
omega 3
long chain
What is the function of linolenic acid?
can act as a precursors for eicosapentaenoic acid
What are the health benefits of omega 3?
anti inflammatory responses
decreased expression of genes involved in inflammatory and atherogenesis-related pathways
What conditions does increased omega 3 not affect?
cardiovascular death
coronary death or events
stroke
heart irregularities
linolenic acid
18C chain length
2 double bonds
What is the main dietary source of linolenic acid?
corn oil
What does omega 6 form when metabolised?
arachidonic acid (AA)
What condition is linoleic acid positively associated with and where?
coronary artery disease
in adipose tissue
in platelets
How does aspirin work?
it blocks the synthesis of arachidonic acid
What is the metabolic pathway for omega 6?
linoleic acid
arachidonic acid
LA - AA
What is the metabolic pathway for omega 3?
a-linoleic acid
eicosapentaenoic acid
docosaheaxanoic acid
What are the two different end results of the pathways of omega 3 and omega 6?
3 - proinflammatory
6 - minimally inflammatory
Which omega-3 is minimally inflammatory?
eicosanoids
Which omega-3 is inflammatory resolving?
resolvins
protectins
How does linoleic acid reduce the risk of CVD?
reduces TC
reduces LDL
Why might linoleic acid increase the risk of CVD?
increases the susceptibility of LDL particles and other lipoproteins for oxidation
increases smaller denser LDL
reduces HDL
increases triglycerides
How might the oxidation caused by linoleic acid increase the risk of CVD?
oxidation leads to endothelial damage
How might increased amounts of smaller denser LDL caused by linoleic acid increase the risk of CVD?
the smaller the size of LDL, the greater the atherogenic risk
How might reduced amounts of HDL caused by linoleic acid increase the risk of CVD?
thought to be cardioprotective by recycling cholesterol back to the liver
What are the types of dietary carbohydrates?
non starch polysaccharides
starch polysaccharides
disaccharides
monosaccharides
Which three sugars from from dietary carbohydrates are absorbed by the body?
glucose
galactose
fructose
What is fructose associated with?
dysregulation of FA synthesis
increase the production of FAs
What is an overall effect of a low carbohydrate diet?
induce Type 2 diabetes remission
What are the short term impacts of a low carbohydrate diet?
reduce body weight
insulin resistance
HbA1c
triglyceride profile
What amounts of carbohydrate are used for a low carb diet?
21 - 70g
What is an effect of reducing the dietary intake of fat?
there will be an increased intake of carbohydrates
depending on the types of carbohydrate being consumed, it might have an impact on the total energy intake
What is an effect of a low fat diet with an increased LDL?
total LDL decreases
small dense LDL increases through atherogenesis
a down regulation of insulin response due to continued stimulation from higher carbohydrates which induces lipolysis
What does lypolysis achieve?
increases the delivery of FAs to the liver and to the circulation
increases hepatic esterification -
What is an effect of increased hepatic esterification?
over production of VLDL, particularly triglyceride-rich VLDL1
What is an effect of soluble fibre in plants?
decrease serum cholesterol
How does soluble fibre in plants decrease serum cholesterol?
inhibits cholesterol reabsorption in the GI tract
How does fruit and vegetable consumption improve the body’s antioxidant status?
by improving the plasma total antioxidant capacity and glutathione peroxidase activity in healthy young adults
What did the PREDIMED trial assess?
looked at the long-term effects of the Mediterranean diet in individuals at high risk
What did the USA DASH diet plan involve?
requires no special foods and instead provides daily and weekly nutritional goals
What is the purpose of dietary patterns?
they give indications of the sorts of foods we need to have to maximise the balance of nutrients within our diets
What type of trial was the PREDIMED trial?
a 1 year randomised control trial
How many people were in the PREDIMED trial and what did they all have in common?
235 people all at high cardiovascular risk
What were the three beneficial effects found from the PREDIMED trial?
Reduced ambulatory BP
Reduced fasting blood glucose
Reduced total cholesterol
What were the features of the DASH diet?
rich in fruit, vegetables and low-fat dairy
a higher ratio of polyunsaturated fat to saturated fat than the other diets
What were the four effects found from the DASH diet after 8 weeks?
lowered blood pressure
lowered total cholesterol
lowered LDL (“bad” cholesterol)
lowered HDL (“good” cholesterol)
Why are free FAs released from adipose tissue?
visceral adipose tissue is less responsive to insulin and so constantly secrets free FAs into circulation
What are the three effects of free FAs released from adipose tissue?
they increase the amount of reactive oxygen species
they inhibit nitric oxide
affects the RAAS
What is a source of free FAs in circuation?
adipose tissue
What is the effect of reactive oxygen species in the body?
they can potentially damage individual cells
What is nitric oxide important for in the body?
vasodilation
What two things are affected when the RAAS is affected itself?
vasodilation
apoptosis
What does the high lipolytic activity of the visceral fat contribute to?
FFAs are in circulation - more are delivered to the liver
What happens to FFAs when they are delivered to the liver?
they are converted to triglycerides
they are stored on site, in the cytosol
What is produced when FFAs are stored in the liver?
VLDL particles enriched with triglycerides
triglyceride enriched LDLs
What are features of smaller triglyceride enriched LDLs?
they are small
they are highly atherogenic
they can easily transform into oxidized LDL
What happens to the triglyceride enriched LDLs formed when FFAs are stored in the liver?
the LDL particles then become smaller and denser via CETP and hepatic lipase activity
What is the effect of exercise in skeletal muscle?
increases TG clearance
decreases hepatic VLDL synthesis
decreases levels of TCs, TGs, and LDL-C
How does exercise increase TG clearance?
by it up regulating lipoprotein lipase activity in skeletal muscle
What is an effect of decreasing VLDL synthesis?
decreases IDL production
How many hours of activity should be done by adults per week?
2.5 hours
What is an example of how adult activity can be carried out over the week?
30 minutes brisk walking on at least 5 days a week
What were the effects of exercise found by the STRRIDE1 trial?
Reduced LDL cholesterol particle number
Increase LDL cholesterol size
Increase in HDL cholesterol particle number
Increase in HDL cholesetrol size
What are the 5 As?
Ask Assess Discuss Agree Assist
What are the Stages of Change according to the Prochaska and Diclemente theory of 1983?
pre-contemplation contemplation preparation action maintenance relapse
What are the Stages of Change used for?
the process by which a patient tries to change something in their lives
