Nutrition and CV disease Flashcards
Nutrient group that has the greatest effect on serum cholesterol levels
saturated fat
List two effects of substituting monounsaturated fats for saturated fats
- Lower LDL-C
- Raise HDL-C
List one effect of substituting polyunsaturated fats for saturated fats
- Lower LDL-C
neutral for HDL-C
What are daily intake recommendations for saturated fats? ___% of calories or ____ g per day (on a 2000 calorie diet)
7%; 16g per day
No more Culver’s sundaes :(
List some food sources high in monounsaturated fat
canola oil, olive oil, mustard oil, peanut oil, nuts, olives, avocado
List some oils high in saturated fat
coconut oil, palm oil, lard
Describe the effect of dietary cholesterol on serum cholesterol
For every additional 100mg dietary cholesterol, serum cholesterol rises about 2.4 mg/dL
Dietary cholesterol raises LDL-C by suppressing synthesis of _________
LDL receptors
Control of cholesterol intake includes using ___________ dairy products, smaller amounts of __________, and no more than _____ egg yolks per week. Organ meats like liver should be eaten no more than once per _______.
low fat; lean meat; 4; month
True or false: Now that manufacturers are starting to eliminate the use of trans fats in food, patients trying to control dietary fat can feel much more comfortable eating more processed foods.
False- trans fats are being replaced with saturated fats; whole foods are almost always a better option than processed foods
List some sources of polyunsaturated fats
corn oil, safflower oil, sunflower oil
List the cardio protective omega 3 fats in fish
- EPA, eicosopentaenoic acid
- DHA, docosahexanoic acid
- ALA may also be beneficial but is found in plants, not fish
The American Heart Association recommends that people with a diagnosis of coronary heart disease increase their consumption of omega 3 fats to about ______ per day
1 g
_______ fiber is found in wheat and has benefits for GI function. _______ fiber has been shown to lower LDL-C and blood sugar levels
insoluble; soluble
Describe how soluble fiber affects lipid levels in the body
- delays absorption of nutrients in intestine, causing a more gradual increase in blood glucose–> more gradual insulin release; less insulin–> less HMG CoA reductase activity, less cholesterol production
- in large intestine: fermented by colonic bacteria to produce short chain fatty acids that inhibit HMG CoA reductase, may encourage growth of healthy bacteria through maintenance of optimal intestinal pH
It is recommended to consume ____ g of total fiber per day, which can be attainted from ___ servings of fruit and vegetables and ____ servings of grain products, at least half of which are whole grain
20-30 g; 5 fruits/ vegetables; 6 grains
25 g soy protein per day can lower cholesterol levels by ______%
3-5%
List some foods high in total fiber
soy nuts, kidney beans, oat bran, oatmeal, barley, apple, broccoli
What is the mechanism of cholesterol reduction by fiber supplements (ex psyllium)?
Increased bile acid excretion, may reduce absorption of cholesterol, fermentation products may reduce cholesterol synthesis
What is the mechanism of cholesterol reduction by soy foods?
Stimulation of production of LDL receptors
Which is higher in soy protein, a serving of tofu or a serving of roasted soybeans?
Roasted soybeans- 30g vs 10g
What is the mechanism of cholesterol reduction by plant stanols/ sterols?
Interfering with the absorption of cholesterol from the gut
True or false: carbohydrates in the diet have a substantial impact on LDL-C levels
FALSE
Describe the effect of dietary carbohydrates on serum lipids
- increased TG levels
- decreased HDL-C levels
- excess carbons from glucose that are not immediately used by the body are converted to acetyl CoA then to fatty acids which are incorporated into TG
The effects of alcohol on production of hepatic triglycerides are more pronounced in people who:
- ingest high quantities of alcohol
- are obese
- have diabetes
- have underlying triglyceride disorder
List four categories of lipid disorder
- elevated LDL-C
- metabolic syndrome/ combined dyslipidemia
- low HDL-C
- hypertriglyceridemia (TG>500)
List some major components of the TLC diet
- lower in saturated fat and cholesterol than Step One plan
- enhanced with fiber or plant sterol/ stanol supplements
- encourages regular exercise
True or False: in high risk adults with no CVD, the Mediterranean diet results in significant reduction in risk of CV events compared to the average American diet
True
True or false: very low fat diets are likely to increase trigylcerides and reduce HDL
True
Very low fat diets have less than ____% of calories from fat.
10%
In what types of patients might very low fat diets be recommended?
Effective for weight loss, LDL-C reduction
Note- may raise TG levels because more carbohydrate available for endogenous TG production
NOT for patients with metabolic syndrome, high triglycerides, or low HDL-C
List the criteria for diagnosing metabolic syndrome
- elevated trigylcerides, greater than 150 mg/dL
- elevated blood glucose, greater than 100 mg/dL
- elevated blood pressure, greater than 130/85
- reduced HDL-C, lower than 40 for men/ 50mg/dL for women
- waist circumference greater than 40 in for men/ 35 in for women
**for all of the above, also count if on meds for the condition
How many criteria must be present to make a diagnosis of metabolic syndrome?
3
List some dietary recommendations for patients with metabolic syndrome or combined dyslipidemia
- calorie control for weight management
- total carbohydrates less than 60% of calories, avoid simple carbs
- total fat 25-40% of calories, limit saturated fat
- limit alcohol to 2 drinks/ day for men and 1 drink/ day for women
List dietary recommendations for low HDL-C
- weight management, physical activity, TLC or Mediterranean diet
List some dietary recommendations for hypertriglyceridemia
- control total fat to 10-15% of calories (different from metabolic syndrome/ combined dyslipidemia management)
- it is acceptable to have a diet higher in carbohydrates because the disorder is usually excess chylomicrons, not excess VLDL
- add medium chain triglycerides (not incorporated into chylomicrons)
List some dietary recommendations for hypertension
sodium restriction, DASH diet
List groups of people who should limit sodium to 1500 mg/ day or less
people with hypertension, anyone over 50, African Americans
