Module 11: Nutrition and Its Role Flashcards
What were the Canadian Cardiovascular Society’s 4 Recommendations for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease? Describe each.
1) Adopt healthy eating habits
- Limit intake of saturated fat and trans fatty acids, simple sugars, refined carbohydrates
- Emphasize a diet rich in vegetables, fruit, whole-grain cereals, and polyunsaturated and monounsaturated oils, including omega-3 fatty acids
2) Achieve and maintain a healthy weight
- Waist circumference: <94cm males, <80cm females
3) BMI <27 as a minimum goal
- optimally <25
4) Engage in regular physical activity
- 60 min light
- 30-60 min moderate
- 20-30 min of vigorous activity
- 4-7days/week
Describe the guidelines developed by the National Cholesterol Education Program (NCEP), Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP-III) to reduce LDL-cholesterol
1) Total fat 25 - 35% of total calories
2) Saturated fats <7% of total calories
- Minimize saturated and trans fat (bad fats); encourage small amounts (2-3 Tbsp) of unsaturated fats (good fats)
- 5-70 total grams fat/day
- 11-17 grams of saturated fat/day
3) Dietary cholesterol <200 mg per day
4) Total fibre 20 - 30 g per day
5) plus LDL-lowering therapeutic options
- Plant stanols/sterols (2 g per day)
- Viscous (soluble) fiber (10–25 g per day)
6) Weight reduction
7) Increased physical activity
What are sources of saturated fat?
- solid fat that comes from animal sources, like the skin on chicken, the marbling in steak, the white part of bacon and the fat in milk, cream, and cheese, and in certain types of processed foods that contain fully hydrogenated vegetable oil
- commonly found in meat and dairy products.
commonly found in coconut and palm oils.
What is the principal dietary determinant of LDL levels?
Saturated fats
What are the 4 most common saturated fatty acids in the human diet
Lauric, myristic, palmitic, and stearic acids
Calculate the recommended total fat and saturated fat and mono poly unsaturated fatty acids for a diet of
1) 1500kcal
2) 1600kcal
3) 1800kcal
4) 2200kcal
1) 1500kcal Fat (30%) = 450kcal / 9 = 50grams Saturated fat (7%) = 105kcal / 9 = ~11 grams Mono PUFA grams = 39 - 1 tsp = 4g fat = 36kcal (1g = 9kcal)
2) 1600kcal Fat (30%) = 450kcal / 9 = 50grams Saturated fat (7%) = 105kcal / 9 = ~11 grams Mono PUFA grams = 39
3) 1800kcal Fat (30%) = 450kcal / 9 = 50grams Saturated fat (7%) = 105kcal / 9 = ~11 grams Mono PUFA grams = 39
4) 2200kcal Fat (30%) = 450kcal / 9 = 50grams Saturated fat (7%) = 105kcal / 9 = ~11 grams Mono PUFA grams = 39
How do trans fat affect the different and total cholesterol?
- raise the total and LDL cholesterol and lower HDL cholesterol.
How are trans fat produced?
- chemically produced trans-unsaturated fatty acids.
- formed when oils are partially hydrogenated and end up behaving much more like saturated fat
Examples of where to find trans fat?
some trans fatty acids occur naturally (like in milk and meat), the majority come from baked goods, fast foods, snack foods, some hard or stick margarines, and shortening
Trans fatty acids are:
- formed when ____ are converted to _____. thru a Process known as _______.
- the Down regulate ______.
- also decreases ______.
- found in processed foods such as ________.
Trans fatty acids are:
- formed when liquid oils are converted to solid fats. thru a Process known as hydrogenation.
- the Down regulate LDL receptors.
- also decreases HDL.
- found in processed foods such as baked goods, chips, cookies.
Even when calories remain the same between diets, by substituting either _____ or _____ fat for _____ fat can reduce serum LDL cholesterol
Even when calories remain the same between diets, by substituting either MONOUNSATURATED or POLYUNSATURATED fat for SATURATED fat can reduce serum LDL cholesterol
Example of foods that are high in monounsaturated fats
1) Olive oil, Canola oil
2) Avocado
3) Oleic acid - less prone to oxidation and does not decrease HDL
4) NUTS: “instead of” not in “addition to” WATCH PORTION (¼ cup)Poly
How can Polyunsaturated fats be divided?
omega-3 and omega-6
Example of 2 omega-3 fats and what food are they found in
Docosahexanoic (DHA) and eicosapentanoic (EPA) are types of omega-3 fat found in fatty fish like salmon, sardines, mackerel, and herring, and seafood – oysters
What is an omega-3 fat thats essential but the body can’t synthesize?
Alpha linolenic acid
Sources of alpha linolenic acid?
flaxseed and flaxseed oil, canola and soybean oil, and some margarine and spreads made with these oils
What is Linoleic acid? Found in what food?
- a type of omega-6 fat, is fairly common in the North American diet
- vegetable oils, like corn, safflower, or soybean oil.
How does the Canadian Cardiovascular Society recommend to lower triglycerides and/or increase HDL-C
- increase in the intake of omega-3 fatty acids
- also omega-6 intakes have been associated with cholesterol lowering
Polyunsaturated fats:
- upregulate LDL by up regulating ______
- PUFA intake relative to sat fat results in _____ ¯apo B production
- Are _____ and _____ acids
- Are _____ at room temperature
- Found in _______
Polyunsaturated fats:
- upregulate LDL by up regulating LDL RECEPTORS
- PUFA intake relative to sat fat results in DECREASED ¯apo B production
- Are LINOLEIC and LINOLENIC acids
- Are LIQUID at room temperature
- Found in SAFFLOWER, SUNFLOWER, CORN, AND SOYBEAN OILS
What are the dietary recommendations on how to inc omega-3 FAs?
Increase n-3 fatty acids:
1) Eat fish 2-3x/wk
- Salmon, mackerel, sardines and herring
- Contains eicosapentanoic acid (20:5n-3, EPA)
docosahexanoic acid (22:6n-3, DHA)
2 )Plants: (flaxseed, canola, soybeans):
- alpha-linolenic acid (18;3n-3, LNA)
- not as biologically efficient as EPA and DHA
How does omega 3 reduce cardiac risk?
modifying thrombogenesis, arrhythmia, serum lipids, endothelial function, hypertension and decrease inflammation
When is Fish oil supplements on a routine basis beneficial?
in some patients with very high triglyceride levels (7% decrease for every 1g of fish oil)
Example of foods high in cholesterol?
- shrimp
- egg
- liver
- cheese
What are the dietary recommendations for high cholesterol food?
Animal products only (< 200 mg cholesterol/day)
- Limit to 2 egg yolks/wk
- Limit to 4-6oz of meat, poultry and fish/day
Cholesterol is:
- Only found in _____ products.
- LDL but less than _____ fat.
- _____regulates LDL receptors.
- Response is _____.
- ____ content of diet.
- presence of other _____.
- ______ of an individual to dietary cholesterol.
- lipid profile and ____ status.
Cholesterol is:
- Only found in ANIMAL products.
- LDL but less than SATURATED fat.
- DOWNregulates LDL receptors.
- Response is VARIABLE.
- FA content of diet.
- presence of other STEROLS.
- SENSITIVITY of an individual to dietary cholesterol.
- lipid profile and DIABETIC status.
What are the Dietary recommendations for carbs?
1) Limit simple sugars and refined carbohydrates as follows:
355ml pop = 10 tsp of sugar (156kcal)
250ml apple juice = 7.4tsp of sugar (119kcal)
500ml Gatorade = 8 tsp of sugar (127kcal)
2tsp of sugar in 4c coffee/day =8tsp (128kcal)
Mocha frappuccino tall, no whipped cream = 10tsp (200kcal)
1tsp=4g sugar=16kcal
2) Distribute carbs evenly throughout the day
3) Eat regular meals and snacks!
Benefit of insoluble vs. soluble fiber?
Insoluble fibre increases gastrointestinal motility and reducing mechanical problems such as hemorrhoids, constipation, diverticulosis and possibly colorectal cancer vs. soluble fibre may lower blood cholesterol levels and may reduce the risk of heart disease.
Examples of soluble fibre?
atype of non-digestible carb that is found in foods like oatmeal, beans, apples, and pears
How do soluble fibre lower blood cholesterol?
binding with cholesterol in the SI and carrying it to the LI for removal
Example of insoluble fibre?
wheat bran, whole grains, peas, root vegetables and strawberry seeds
Why is fibre called soluble/insoluble?
Soluble fibre components are soluble in water
