Studies & Sources of Nutrients

Question 1

Health Professionals Follow-Up Study

Answer 1

2 or more SSB/day (vs. <1/mo) incresased overall mortality by 21% and CVD death by 31%

Higher intake red meat = 11-15% increased risk CHD
Sub plant-protein for red meat decreased risk by 14-17%
Olive oil better than most animal fats & margarine at reducing CHD risk

Vitamin D binding protein decrease mob/mort CRCA

Question 2

DASH

Answer 2

Low fat, lots f/v, adequate mag, K+, ca2+, fewer snacks/sweets (vs. isocaloric SAD)

Pt w/ & w/o HTN, not on antihypertensives

Lower SBP & DBP after 2 weeks (-5/-3)

Those w/ HTN baseline had more pronounced improvements (-11/-5.5); age <50 did better

Results were comparable to reductions seen in monotherapy

Orig study kept Na+ stable at 3000 but everything else says low sodium (1500-2300)

Question 3

Sourcres Vitamin D

Answer 3

Calcium absorption (bone health), muscle health, glucose metabolism

Salmon
Fortified milk
Sunlight
Supplement

Question 4

NHANES

Answer 4

Ultraprocessed foods represented >50% caloric intake

Undiagnosed DM significant problem

Question 5

Good sources of soluble vs. insoluble fiber, goals, MOA

Answer 5

Goal 25g (female), 38 (male) - ideal more like 40/50
Only found in plants!!

Soluble: slowly absorbed, so slows down digestion & absorption of glucose; binds to and removes cholesterol; increases insulin sensitivity

Oats
Peas
Beans
Barley
Apples
Citrus
Carrots

Insoluble: not absorbed, so moves through gut more quickly, stool bulk - reduces CRCA risk, promotes laxation; food for bacteria -> SCFA
Whole wheat
Beans
Nuts
Potatoes
Some vegetables

Question 6

Types of fatty acids

Answer 6

Saturated - solid at room temp
-highest is coconut oil (90%)
-palm oil @ 50%
-lard ~40%
-olive oil ~15%

Trans - naturally found in red & processed meats, butter (so also in baked goods, refined grain products); now “unsafe for human consumption” due to high increase in CVD risk

Poly-unsaturated - omega 6 &3 are essential fatty acids
-Get plenty of omega 6 (corn oil, nuts, seeds)

Omega 3 (ALA, EPA, DHA - ALA can be converted into EPA & DHA; ALA source is algae; also in nuts, oils, fish

Mono-unsaturated
Canola, olive, vegetable oils

Question 7

Potsdam study

Answer 7

4 healthy lifestyle facotrs: BMI <30, healthy diet, never smoker, PA >/= 3.5 hr/week

all 4 (vs. 0):
93% decreased risk DM, 81% MI, 50% stroke, 36% cancer, 78% chornic disease overall

BMI <30 exerted the largest reduction on risk of any chronic disease

Never smoking exerted largest risk reduction on MI & cancer

Question 8

LM vital signs

Answer 8

smoking status
BMI
sleep quality/duration
perceived stress
alcohol use
dietary pattern
exercise

Question 9

Lyon

Answer 9

H/o acute MI
Med diet (w/ high alpha lineoleic acid-omega3) prevented second MI and other cardiac risks (50-70% reduction in cardiac mobiditiy/mortality), significant cost reduction

Study stopped early after 4 years b/c of sig effects

Question 10

GEMINAL

Answer 10

ITLC showed reduction in prostate cancer tumor

Question 11

Aerobics Center Longitudinal Study

Answer 11

Examined global all cause mortality

Low cardiorespiratory fitness was #1 cause of preventable death

Cardiorespiratory fitness: best reflection of whole-body health & function; inversely associated w/ all cause CVD, CA; often assoc w/ increased visceral adiposity, OB, HTN, hyperlipid, & other chronic dz

Question 12

Triacylglycerol

Answer 12

Severe caloric restriction (~600kcal) resulted in normalization of beta cell function, reduced hepatic & pancreatic triacylglycerol within weeks

Question 13

Harvard Study of Adult Development

Answer 13

Single most important predictor of happiness and longevity was having social connections

Question 14

Nurses Health Study

Answer 14

Not smoking, healthy BMI, healthy diet, exercie, low alcohol resulted in 82% lower risk CHD

Refined carbs & trans fats increased CHD risk

Impact of alcohol on breast & colon cancer risk

Vitamin D on colon cancer/polyps

As little as 1-1.9 hr MVPA/week had risk reduction 82% all cause mortality

Combined w/ Health Professionals Follow-up study:
Health plant-based: 34% less risk T2DM; 25% less CHD
Unhealthy plant-based: 16% more risk T2DM; 32% more risk CHD
Increased risk T2Dm=M w/ meat, processed meat, >/= 5 eggs/week

Question 15

Percutaneous angioplasty vs. exercise in stable CHD

Answer 15

Exercise (vs. PCI w/ stenting) showed higher EFS, less likely to experience angina, signif increased HDL, 1/2 cost, increased exercise tolerance

Question 16

Framingham

Answer 16

2 or more risk factors (vs 0) led to 69% (male) & 50% (female) lifetime arhteroslcerotic CVD risk and ~10 year less life expectancy

Systolic BP imp for CVA risk

Pre-HTN increases CVD risk

Changes in happiness level reached 3 degrees of separation

Question 17

EPIC Oxford

Answer 17

Vegetarian & vegan had 37% lower T2DM risk, 12% lower risk of cancer, 22% lower rate ischemic heart dz

Question 18

Diabetes Prevention Program

Answer 18

diet (low-fat, low-cal) + PA (150 MVPA) + lose/maintain 7% vs. metformin vs. placebo

Progression from preDM to T2DM:
lifestyle vs. placebo was ~60% lower incidence
metformin vs. placebo was ~30% lower incidence
lifestyle vs. metformin was ~39% lower incidence

Saw results even without full adherence (7% wt loss)

Question 19

Good sources of magnesium

Answer 19

Nuts
Spinach
Edamame
Dark chocolate
Whole-grain bread
Brown rice
Tofiu
Potato
Black-eyed peas
Lima beans

Question 20

Sources Vitamin K

Answer 20

Blood clotting, heart health, bone health

Green leafy vegetables
Broccoli
Cabbage
Asparagus,
Kiwi

Question 21

INTERHEART

Answer 21

Top 5 factors accounted for 80% MI risk: tobacco, lipids, HTN, DM, OB
WORLDWIDE
Examined psychosocial factors & established that they were comparable to the effect of HTN & abd OB

Question 22

Sources Vitamin C

Answer 22

Antioxidant, iron absorption, tissue growth/repair

Bok choy,
Parsley
Daikon radish
Cruciferous: Broccoli, Cauliflower, Cabbage, Brussels sprouts
Cantaloupe
Pineapple
Oranges
Mango
Kiwi
Spinach, other leafy greens
Pears
Peaches
Cherries

Question 23

CHIP

Answer 23

Diabetic cohort, workplace setting, Vanderbilt
ITLC

Less health care utilization, nearly 25% were able to cut one medication

Question 24

Portfolio

Answer 24

Impact of diet (low fat fiber, soy, plant sterols) on LDL
Showed equivalent to statin

Question 25

Sources Vitamin E

Answer 25

Antioxidant, immune fx, endothelial health

Sunflower seeds
Almonds
Sun/safflower oils
Peanut, olive, corn oils
Peanut butter

Question 26

PREDIMED

Answer 26

Pt w/ high CVD risk (had T2DM or mult risk factors)
Mediterranean (nuts vs. olive oil) vs. SAD showed 30% risk reduction of major CV event over 5 years

Question 27

Adventist

Answer 27

Reduced all cause mortality in veg versus non-vegetarian diet

Vegan lower BMI, risk of DM, HTN, met synd

Question 28

Good sources of potassium

Answer 28

Bananas
Potato
Avocado
Beans
Beet greens
Apricots
Dates
Nuts
Green vegetables

Question 29

Ornish/Lifestyle Heart Trial

Answer 29

3% regression in coronary stenosis maintained over 5 years
Regression overall (lifestyle only, no meds) vs. progression on meds and tons of progression on no meds

Reduced LDL

Question 30

Sources Vitamin A

Answer 30

Vision, growth, reproduction, skin

Requires conversion to retinol in plant foods (is preformed in animal foods)

Sweet potato
Mango
Carrots
Cantaloiupe
Butternut squash
Plant milks

Question 31

INTERSTROKE

Answer 31

Examined top factors for stroke risk; top 10 lifestyle factors were associated a/ 90% of the stroke risk