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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
Q

What can you say about eggs?

A

They are a high-quality protein, rich in cholesterol, but one egg a day will not increase CM risk

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26
Q

What can you say about fish?

A

Lower risk of CHD, maybe stroke

n-3 could benefit the cardiovascular system and therefore lower arrhythmias

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27
Q

What can you say about plant proteins?

A

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
Q

What does protein quality mean?

A

It is based on essential AA composition and on digestibility

29
Q

What are digestible carbs?

A

Sugars: mono-disacharides; immidiate energy
Starches: polysacharides; take more time to digest, lower LDL, not body weight and BP

30
Q

What are indigestible carbs?

A

Fibres; can not be digested, so no glucose peak. They slow down gastric emptying. Lower CMDs, lower inflammation, enhance immune system

31
Q

What do fibre rich foods often also contain?

A

potassium, magnesium, vit C, beta carotene, phytochemicals: flavonoids; good for CM health

32
Q

What types of fibres are there?

A

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
Q

What is the glycaemic index?

A

The increase of BG 2h after consumption of 50gr of carbs compared to 50gr of glucose.

34
Q

What is the effect of coffee on health?

A

Short term: increase heart rate and BP
Long term: lower CHD and stroke
Only filtered coffee!

35
Q

What compounds in coffee have an effect?

A

Polyphenol: beneficial effect on the vascular system and glucose metabolism
Potassium: lowers BP
unfiltered coffee: fatty substances raise LDL

36
Q

What compound is in tea?

A

Polyphenol: flavanols

Lowers BP, lower stroke and DM

37
Q

What compound is in milk?

A

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
Q

Fermented dairy?

A

Lower DM

39
Q

SSBs

A

High in calories, and simple sugars

Increase in BMI, DM, hypertension and CVD

40
Q

Fruit juices

A

Liquid calories -> more obesity

Low fibre

41
Q

What is in salt??

A

40% sodium, 60% choride

42
Q

What is the maximum intake of salt?

A

5 gr/day, 2gr of sodium/day

43
Q

What is the average intake of salt?

A

7-12 gr/day

44
Q

How can you estimate daily salt intake?

A

24 h urine

45
Q

What happens if you eat too much salt?

A

Water retention, kidney damage, high BP

46
Q

What is the effect of potassium?

A

It makes the kidneys secrete more sodium; lowers BP

47
Q

What foods contain potassium?

A

Plants, fish and dairy

48
Q

What are the negative effects of alcohol?

A

Injuries, TB, self-harm, cancer, liver damage, psychosocial problems

49
Q

What is the French paradox?

A

Low prevalence of heart disease in France, but high wine consumption

50
Q

Is alcohol good for your heart?

A

1-2 glasses a day can lower the risk of heart failure and MI

51
Q

What is the effect of ethanol?

A

Increase HDL (not causal)
Lower markers of inflammation and blood clotting factors
Improve insulin sensitivity

52
Q

Alcohol and DM

A

J-curve for DM

53
Q

What polyphenol is in alcohol?

A

polyphenols: resveratrol in red wine

54
Q

Alcohol and stroke?

A

Unclear, but causes higher bp

55
Q

What FAs are in fish?

A

ALA, EPA and DHA, n-3

56
Q

What was the idea behind the Zutphen study?

A

Fish eating populations have lower heart attacks

Only fatal heart attacks, not non-fatal ones

57
Q

Why is the association with n-3 only with fatal heart attacks?

A

Because these are caused by severe arrhythmias

58
Q

What is the DASH diet?

A

Dietary approach to stop hypertension:
Fruit, veg, whole grains, low fat dairy
Low red meat, sweets and snacks, low salt

59
Q

What is the modified DASH diet?

A

Replace part of carbs with vegetables -> more like Mediterranean.

60
Q

What is the effect of vegetarian diets?

A

Lower CHD and DM

61
Q

What is the main mechanism of the Mediterranean diet?

A

Lower SAFA -> lower heart attacks
Lots of plant foods
High polyphenols

62
Q

What is the main type of FA in olive oil?

A

MUFA

63
Q

What substance is in olive oil?

A

Polyphenol

64
Q

What do flavonoids do?

A

Lower CVD and DM
NO production
Lower inflammation markers (TNFalpha)

65
Q

What is the advised diet for DM treatment?

A

Keto (long term is not studied yet)

Nutrition and CMD (7 decks)

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