Nutrition and Cardiovascular Disease Flashcards
- List elements of the diet that can be reduced and their relative magnitude on lowering LDL. (5)
saturated fat <200mg (-3-5%)
adding 5-10g viscous fiber/day (-3-5%)
adding 2-3 g plant stannous or sterols (-6-15%)
adding 25g soy protein (-3-5%)
also 10lbs weight loss (-5-8%)
- What dietary component has the greatest effect on reducing LDL when reduced?
saturated fat, it is consumed by the gram, while cholesterol is consumed by the mg
Considering the variability in responses to a low fat diet, what regarding the diet has been shown to result in reduced inflammation?
increasing nutritional variety as well as decreasing fats and simple carbs has been shown to decrease LDL, increase HDL and decrease inflammation; it important to remember that feeding people the same foods, low fat diets show tremendous variability in response
- A 1% increase in calories consumed as saturated fat increases serum cholesterol by 1.8mg/dL, what types of fats can be substituted for saturated fats in reducing cholesterol?
monosaturated fats (lowers LDL-C and raises HDL-C)
substituting polyunsaturated fats (neutral for HDL-C)
** recommended only 7% of calories /day from sat. fat
- Discuss recommended dietary changes to address lowering cholesterol from food.
found only in animal products low-fat dairy small amounts of lean meat no more than 4 egg yolks/week shrimp once/week liver and organ meats once/month
- How much trans fat is recommended as part of a health diet?
as little as possible, usually found in processed foods
Name some sources of monounsaturated fats.
olive oil canola oil-rapeseed oil mustard oil peanut oil nuts olives avocado
Name some sources of omega 3 oil
fish and fish oils
soybean and canola oils
walnuts and butternuts
How much and what kind of omega -3 oil is recommended for benefits of reduced TG, decreased platelet aggregation, anti-inflammatory and anti-arrhythmic properties?
WHO recommends 0.3-0.5g/ day of EPA and DHA for general public, 3-4g /day used to reduce
top fish sources: salmon, herring and sardines
top plant sources: flax seed (oil), canola oil and soybean oil
Alpha linolenic acid in foods is converted to EPA and DHA by which enzyme?
desaturase enzymes (not omega-6 are converted from linoleum acid to arachidonic acid by the same enzyme)
Which type of fiber is most beneficial for the reduction of blood cholesterol?
soluble (viscous) fiber delays gastric emptying, slows glucose absorption (decreases blood cholesterol) and increases fecal excretion of bile acids
this is in contrast with insoluble fiber mostly beneficial for increasing fecal bulk and intestinal health
Which foods are most rich in soluble fiber?
soy nuts
legumes
oat bran
oatmeal and barley
psyllium supplements also provide a source of soluble fiber that can decrease LDL-C by increased bile acid excretion (possible reduces absorption of cholesterol)
By what mechanism do soy foods reduce cholesterol?
soy can reduce cholesterol, probably by stimulating production of LDL receptors (does not negatively affect thyroid function or breast cancer)
Name recommended sources of soy.
recommended whole soy foods include roasted soybeans, textured soy protein, soy milk, tempeh, tofu or edemame
What is the role of phytosterols in food?
the amount of photo sterols (stannous and sterols) in food is very small compared to the amount you would need to reduce LDL-C, can buy supplemented foods which can be a helpful tool given patient preference or need
What are the dietary goals regarding carbohydrates and dyslipidemia?
especially refined carbs can increase glucose that is transformed into TG, fructose having a greater effect, the goal is to have 60% or less as carbs to control TG
What is the role of alcohol in dyslipidemia?
alcohol increases hepatic TG production leading to greater VLDL production (esp if you drink a lot, are obese, have diabetes, or have a TG disorder)
Name 4 categories of lipid disorders.
elevated LDL-C
metabolic syndrome/combined dyslipidemia
low HDL-C
hypertriglyceridemia (TG>500)
- Describe the components of the Therapeutic Lifestyle Changes.
lower in sat fat and cholesterol than Step One (general public)
can be enhanced with additional fiber or plant stannous/sterols
encourages regular exercise
- Discuss dietary recommendations for the Mediterranean diet.
olive oil, tree nuts, fresh fruits, vegetables, fish, legumes, sofrito sauce and white meats
addition of evoo or nuts resulted in a reduction in 3 major CV events/1,000 person years
- Describe the elements of very low fat plans.
include diets like Pritikin, Ornish, Esselstyn
many means very low fat <10% of calories, have to intentional about increasing complex carbs instead of simple sugars
likely to increase TG and reduce HDL
Give recommendations regarding increasing HDL through diet.
effect of lifestyle on HDL is very small, although weight loss and exercise may help
include moderate amounts of unsaturated fats, and moderate amours of carbs (reducing TG usually results in HDL increase)
Give recommendations on reducing TG.
reduce the percent calories that come from fat
avoid alcohol
control weight and moderate exercise
consider medium chain triglycerides
- List categories of people for whom the lowest sodium intake (1500mg/day) is recommended.
people with HTN
people older than 40 yo
all african americans
people at greater risk for sodium sensitivity
females >40 yo abdominal obesity impaired glucose tolerance/DM african-americans HTN family Hx of hypertension
- Outline recommended dietary changes for a low sodium nutrition.
use ½ or less salt recipes call for no salt at the table limit use of high sodium processed foods eat out less often salt substitutes OK unless serum K+ is increased
- Describe the components of the DASH eating plan.
8-10 servings of fruits or vegetables
2-3 servings of low fat dairy products
1500-2400mg sodium
- Outline recommendations for diet in the management of heart failure.
manage fluid and sodium
limit or avoid alcohol
small frequent meals, esp during weight loss
calorie and protein supplements as needed
tailored aerobic exercise program
