Nutritional Aspects of CV Disease Flashcards
What is the main cause of mortality in Western countries?
CVD
What is the main cause of CVD?
Atherosclerosis
What is included in CVD?
- CHD
- Stroke
- Peripheral vascular disease
- Rheumatic heart disease
- Congenital heart disease
- DVT + PE
What is included in CHD?
- Stable angina
- Unstable angina
- Acute MI
- Sudden death
What is a stroke?
Sudden localised loss of brain function due to ischaemia or haemorrhage and lasting longer that 24hr.
What are ischaemic strokes a result of?
Thrombosis and emboli
What are haemorrhagic strokes a result of?
Rupture of arterial wall due to aneurysm or wall disease
What is peripheral vascular disease?
Disease of the aorta, iliac and leg arteries often coexisting with CVD
What is rheumatic heart disease?
Damage to the heart muscle and heart valves from rheumatic fever caused by streptococcal bacteria
What is congenital heart disease?
Malformations of heart structure existing at birth
What are the main risk factors for CVD?
- Diet
- Hypertension
- Obesity
- Insulin resistant diabetes
- Physical activity
- Smoking
- Alcohol
- Foetal and infant growth
- Genetic
What does excess energy intake and diet composition impact on?
Body composition and CVD risk
What parts of our diet are pro-atherogenic?
- Cholesterol
- Saturated FA
- Trans FA
- Sodium
- Alcohol
What parts of our diet are anti-atherogenic?
- PUFA
- CHO rich diet
- NSP
- MUFA
- Antioxidants
What is plasma concentration influenced by?
Fat content and quality in diet
What can hypercholesterolemia be due to?
- Poor lifestyle
- Genetic
What is HDL cholesterol associated with?
Lower risk of CHD but only when LDL cholesterol is high
What do high levels of saturated FA in the diet increase?
Blood cholesterol levels
What do saturated FA act on?
LDL receptors (inhibition and suppression)
What are the daily guidelines on the intake of saturated FA?
- Men no more than 30g/day
- Women no more than 20g/day
What do trans FA do?
Raise LDL cholesterol and plasma TAG and lower HDL cholesterol
What are the current guidelines around trans FA?
Consuming no more than 2% of total energy per day (around 5g for an adult)
What does sodium do?
Influences thrombosis by its effect on blood pressure
How is BP lowered?
- Decrease sodium intake
- Increase potassium intake
What are the current sodium intake guidelines?
< 6g NaCl per day
How many units of alcohol a week raises BP?
30 units
In relation to alcohol, what increases the risk of stroke?
Habitual heavy as well as acute consumption
What is n-6 PUFA?
Substitution of saturated FA
What does n-6 PUFA do?
Lowers LDL cholesterol but also HDL cholesterol
What are monosaturated FA?
Substitution of saturated FA by oleic acid
What do monosaturated FA do?
Reduced both total and LDL cholesterol in the plasma
What type of origin is n-3 PUFA?
Marine origin
What does n-3 PUFA do?
- Powerful reducing effects on TAG plasma levels but minimal effects on LDL and HDL levels
- Potent anti-inflammatory and anti-thrombotic properties
What are the effects of n-3 PUFA due to?
Long chain
How does a high carbohydrate diet reduce CHD risk?
Reducing fat intake
What is an increase in dietary non starch polysaccharide intake correlated with?
- A decrease risk of CVD
- Help reduce cholesterol levels
- No effect on VLDL and TAG levels
- Perhaps beneficial effects on insulin secretion
- Beneficial effects on gut health
What are antioxidants?
Essential components of the cellular defence against activated oxygen species
What is high intake of vitamin C, E and fruit and veg associated with?
Lower risk of CVD
What are included in antioxidants?
- Se
- Zn
- Mn
- Vitamin C
- Vitamin E
- Carotenoids
- Flavonoids
What evidence is there for the benefits of tea?
- Some evidence for green tea due to catechin content
- No evidence for black tea
What is the bioactive agent in garlic?
Allicin
What amount of garlic is required daily to show benefit?
7 cloves
What does garlic do?
Reduces platelet aggregation, increase fibrinolysis and decreases plasma fibrinogen
What are N-3 PUFA especially potent at?
Reducing sudden death and non-fatal MI
What effect does N-3 LCPUFA have in the heart?
Decreases arrythmias
What effect does N-3 LCPUFA have on platelets?
Decrease thrombosis
What effect does N-3 LCPUFA have on lipoprotein metabolism?
-Decreases fasting and post-prandial triglycerides
What effect does N-3 LCPUFA have on smooth muscle cells?
Decreases growth factors
What effects does N-3 LCPUFA have on immune cells?
Decreases
- Chemo-attractants
- Pro-inflammatory cytokines
- Pro-inflammatory eicosanoids
What effects does N-3 LCPUFA have on vascular endothelium?
Decreases
- Growth factors
- Chemoattractants
- Pro-inflammatory cytokines
- Pro-inflammatory eicosanoids
- Blood pressure
- Adhesion molecule expression
What does wholegrain reduce risk of?
- CAD
- IHD
- CHD
What are other dietary components that are potentially important for health?
- Vitamin D
- Carotenoids
- Phytochemicals
Why can food and nutritional components affect individuals differently?
Genetics
What can dietary components alter?
- Molecular processes such as DNA structure, gene expression and metabolism
- Disease initiation, development and progression
What can individual genetic variation influence?
-How nutrients are assimilated, metabolised, stored and exreted by the body
