Nutrition and CV disease Flashcards

1
Q

Nutrient group that has the greatest effect on serum cholesterol levels

A

saturated fat

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2
Q

List two effects of substituting monounsaturated fats for saturated fats

A
  • Lower LDL-C

- Raise HDL-C

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3
Q

List one effect of substituting polyunsaturated fats for saturated fats

A
  • Lower LDL-C

neutral for HDL-C

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4
Q

What are daily intake recommendations for saturated fats? ___% of calories or ____ g per day (on a 2000 calorie diet)

A

7%; 16g per day

No more Culver’s sundaes :(

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5
Q

List some food sources high in monounsaturated fat

A

canola oil, olive oil, mustard oil, peanut oil, nuts, olives, avocado

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6
Q

List some oils high in saturated fat

A

coconut oil, palm oil, lard

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7
Q

Describe the effect of dietary cholesterol on serum cholesterol

A

For every additional 100mg dietary cholesterol, serum cholesterol rises about 2.4 mg/dL

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8
Q

Dietary cholesterol raises LDL-C by suppressing synthesis of _________

A

LDL receptors

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9
Q

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 _______.

A

low fat; lean meat; 4; month

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10
Q

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.

A

False- trans fats are being replaced with saturated fats; whole foods are almost always a better option than processed foods

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11
Q

List some sources of polyunsaturated fats

A

corn oil, safflower oil, sunflower oil

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12
Q

List the cardio protective omega 3 fats in fish

A
  • EPA, eicosopentaenoic acid
  • DHA, docosahexanoic acid
  • ALA may also be beneficial but is found in plants, not fish
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13
Q

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

A

1 g

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14
Q

_______ fiber is found in wheat and has benefits for GI function. _______ fiber has been shown to lower LDL-C and blood sugar levels

A

insoluble; soluble

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15
Q

Describe how soluble fiber affects lipid levels in the body

A
  • 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
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16
Q

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

A

20-30 g; 5 fruits/ vegetables; 6 grains

17
Q

25 g soy protein per day can lower cholesterol levels by ______%

A

3-5%

18
Q

List some foods high in total fiber

A

soy nuts, kidney beans, oat bran, oatmeal, barley, apple, broccoli

19
Q

What is the mechanism of cholesterol reduction by fiber supplements (ex psyllium)?

A

Increased bile acid excretion, may reduce absorption of cholesterol, fermentation products may reduce cholesterol synthesis

20
Q

What is the mechanism of cholesterol reduction by soy foods?

A

Stimulation of production of LDL receptors

21
Q

Which is higher in soy protein, a serving of tofu or a serving of roasted soybeans?

A

Roasted soybeans- 30g vs 10g

22
Q

What is the mechanism of cholesterol reduction by plant stanols/ sterols?

A

Interfering with the absorption of cholesterol from the gut

23
Q

True or false: carbohydrates in the diet have a substantial impact on LDL-C levels

A

FALSE

24
Q

Describe the effect of dietary carbohydrates on serum lipids

A
  • 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
25
Q

The effects of alcohol on production of hepatic triglycerides are more pronounced in people who:

A
  • ingest high quantities of alcohol
  • are obese
  • have diabetes
  • have underlying triglyceride disorder
26
Q

List four categories of lipid disorder

A
  • elevated LDL-C
  • metabolic syndrome/ combined dyslipidemia
  • low HDL-C
  • hypertriglyceridemia (TG>500)
27
Q

List some major components of the TLC diet

A
  • lower in saturated fat and cholesterol than Step One plan
  • enhanced with fiber or plant sterol/ stanol supplements
  • encourages regular exercise
28
Q

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

A

True

29
Q

True or false: very low fat diets are likely to increase trigylcerides and reduce HDL

A

True

30
Q

Very low fat diets have less than ____% of calories from fat.

A

10%

31
Q

In what types of patients might very low fat diets be recommended?

A

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

32
Q

List the criteria for diagnosing metabolic syndrome

A
  • 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

33
Q

How many criteria must be present to make a diagnosis of metabolic syndrome?

A

3

34
Q

List some dietary recommendations for patients with metabolic syndrome or combined dyslipidemia

A
  • 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
35
Q

List dietary recommendations for low HDL-C

A
  • weight management, physical activity, TLC or Mediterranean diet
36
Q

List some dietary recommendations for hypertriglyceridemia

A
  • 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)
37
Q

List some dietary recommendations for hypertension

A

sodium restriction, DASH diet

38
Q

List groups of people who should limit sodium to 1500 mg/ day or less

A

people with hypertension, anyone over 50, African Americans