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Nutrition and CMD > Week 5 > Flashcards

Week 5 Flashcards

1
Q

Which study designs are combined when making FBDGs?

A

RCTs and cohorts

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2
Q

What are the downsides of the Mediterranean diet?

A

No tea, a lot of olive oil, sustainable? (a lot of protein)

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3
Q

What are the effects of salt?

A

Higher BP -> stroke, IHD, dementia
CKD
Prevents the nightly drop in BP

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4
Q

What is the recommended daily intake of carbs?

A

40-70% of energy

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5
Q

Is a ketogenic diet healthy?

A 
Depends on:
What type of carbs do you take out
Yes or no caloric restriction
What are your replacing foods?
Associated with short term weight loss
Could miss out on a lot of nutrients
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6
Q

What are the types of n-3 PUFAs and in which foods can they be found?

A

Fish: EPA, DPA and DHA
Plants: ALA

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7
Q

Is fish intake associated with heart attacks?

A

Yes, 15% reduction in fetal heart attacks

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8
Q

Describe the Alpha Omega trial

A

RCT with different margarines with n-3 PUFAs in CHD patients

No results

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9
Q

What are ways to measure vascular health?

A

Fasted BP
Endothelial function
Arterial stiffness
atherosclerosis

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10
Q

How do you measure endothelial function?

A

With biochemical markers or flow-mediated dilation (FMD) (stop blood flow and then let go and measure vasodilation

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11
Q

How do you measure arterial stiffness?

A
  • Pulse wave velocity (PWV): time the blood takes to travel, stiffer, more fast
  • Augmentation index: bounce back of pulse to periphery, more stiff, more fast
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12
Q

How do you measure atherosclerosis?

A
  • Intima-media thickness: thickness of artery wall: echo

- Coronary artery calcification (CAC): images

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13
Q

What effect does chocolate have on health?

A

Dark chocolate is rich in polyphenols: flavan-3-ols: mainly epicatechin. This can lower BP. It influences vasodilation (production of NO)and improves insulin sensitivity

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14
Q

Are foods or nutrients more associated with diseases?

A

Foods

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15
Q

Why should you be physically active?

A

Lower risk of CMD
Improve energy balance
More muscle mass -> lower DM
Lowers CVD because of lower BP and blood lipids
Strength, speed, coordination and flexibility

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16
Q

What is sedentary behaviour?

A

Low-level physical activity: sitting

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17
Q

What are MET scores?

A

Metabolic equivalent scores
How many times you use the resting energy expenditure
Doing nothing is 1
Walking is 3

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18
Q

At what MET score does the health enhancing start?

A

At 3

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19
Q

What are the dutch guidelines for physical activity?

A

30 min a day: MET 3 or higher

2x / week strength/flexibility

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20
Q

What is the amount of proteins from animals and plants in a western diet? And what should it be?

A

Western: 60/40

Should be 40/60

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21
Q

What happens if you increase protein intake and decrease carbs?

A

Lower BP, blood lipids and insulin resistance

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22
Q

What happens when you eat processed meat? And what causes it?

A

Increased risk of CMD due to SAFA, salt or other components (TMAO)
Increased risk of cancer: do not eat more than 500gr/week

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23
Q

What happens if you eat dairy?

A

Lower risk of stroke and CKD

No effect with CHD

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24
Q

What happens if you eat fermented dairy?

A

Lower risk of DM due to the effect of yoghurt bacteria on gut bacteria.

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25
What can you say about eggs?
They are a high-quality protein, rich in cholesterol, but one egg a day will not increase CM risk
26
What can you say about fish?
Lower risk of CHD, maybe stroke | n-3 could benefit the cardiovascular system and therefore lower arrhythmias
27
What can you say about plant proteins?
Protein quality is higher for animal than for plant protein | There is no evidence that it is better than animal protein on CM health
28
What does protein quality mean?
It is based on essential AA composition and on digestibility
29
What are digestible carbs?
Sugars: mono-disacharides; immidiate energy Starches: polysacharides; take more time to digest, lower LDL, not body weight and BP
30
What are indigestible carbs?
Fibres; can not be digested, so no glucose peak. They slow down gastric emptying. Lower CMDs, lower inflammation, enhance immune system
31
What do fibre rich foods often also contain?
potassium, magnesium, vit C, beta carotene, phytochemicals: flavonoids; good for CM health
32
What types of fibres are there?
Viscous fibres; fermentation of short-chain FAs-> energy. They are in fruit, nuts, oats and legumes Non-vicious fibres; less fermentable. Enhance satiety, slow down gastric emptying. NVF from whole grains lower CVD, DM and insulin resistance
33
What is the glycaemic index?
The increase of BG 2h after consumption of 50gr of carbs compared to 50gr of glucose.
34
What is the effect of coffee on health?
Short term: increase heart rate and BP Long term: lower CHD and stroke Only filtered coffee!
35
What compounds in coffee have an effect?
Polyphenol: beneficial effect on the vascular system and glucose metabolism Potassium: lowers BP unfiltered coffee: fatty substances raise LDL
36
What compound is in tea?
Polyphenol: flavanols | Lowers BP, lower stroke and DM
37
What compound is in milk?
Protein, potassium, magnesium. Potassium and magnesium: healthy BP and improve insulin resistance Calcium is only important together with vit D Milk may lower risk of hypertension, stroke, DM, no effect on MI (sat fats?)
38
Fermented dairy?
Lower DM
39
SSBs
High in calories, and simple sugars | Increase in BMI, DM, hypertension and CVD
40
Fruit juices
Liquid calories -> more obesity | Low fibre
41
What is in salt??
40% sodium, 60% choride
42
What is the maximum intake of salt?
5 gr/day, 2gr of sodium/day
43
What is the average intake of salt?
7-12 gr/day
44
How can you estimate daily salt intake?
24 h urine
45
What happens if you eat too much salt?
Water retention, kidney damage, high BP
46
What is the effect of potassium?
It makes the kidneys secrete more sodium; lowers BP
47
What foods contain potassium?
Plants, fish and dairy
48
What are the negative effects of alcohol?
Injuries, TB, self-harm, cancer, liver damage, psychosocial problems
49
What is the French paradox?
Low prevalence of heart disease in France, but high wine consumption
50
Is alcohol good for your heart?
1-2 glasses a day can lower the risk of heart failure and MI
51
What is the effect of ethanol?
Increase HDL (not causal) Lower markers of inflammation and blood clotting factors Improve insulin sensitivity
52
Alcohol and DM
J-curve for DM
53
What polyphenol is in alcohol?
polyphenols: resveratrol in red wine
54
Alcohol and stroke?
Unclear, but causes higher bp
55
What FAs are in fish?
ALA, EPA and DHA, n-3
56
What was the idea behind the Zutphen study?
Fish eating populations have lower heart attacks | Only fatal heart attacks, not non-fatal ones
57
Why is the association with n-3 only with fatal heart attacks?
Because these are caused by severe arrhythmias
58
What is the DASH diet?
Dietary approach to stop hypertension: Fruit, veg, whole grains, low fat dairy Low red meat, sweets and snacks, low salt
59
What is the modified DASH diet?
Replace part of carbs with vegetables -> more like Mediterranean.
60
What is the effect of vegetarian diets?
Lower CHD and DM
61
What is the main mechanism of the Mediterranean diet?
Lower SAFA -> lower heart attacks Lots of plant foods High polyphenols
62
What is the main type of FA in olive oil?
MUFA
63
What substance is in olive oil?
Polyphenol
64
What do flavonoids do?
Lower CVD and DM NO production Lower inflammation markers (TNFalpha)
65
What is the advised diet for DM treatment?
Keto (long term is not studied yet)

Nutrition and CMD (7 decks)

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