wk 7- diet and cardiovascular disease (incomplete)

kinds of cardiovascular disease

• coronary heart disease

• stroke

• peripheral vascular disease

• rheumatic heart disease

• congenital heart disease

• deep vein thrombosis and pulmonary embolism

what is coronary heart disease

• stable and unstable angina

• acute myocardial infarction

• sudden death, with or w/o history of chest pain and/or previous infarction

what is stroke

sudden localised loss of brain function due to ischemia or haemorrhage, and lasting longer than 24hrs. In the UK, 85% of the cases are due to ischemia essentially due to ischemia essentially due to thrombosis, the rest of the emboli. Haemorrhagic stokes are the consequences of the rupture of the arterial wall due to aneurysm or wall disease

what is peripheral vascualr disease

disease of the aorta, and iliac and leg arteries. Often coexist with CVD

what is the main cause of CVDs

atherosclerosis

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 is the development of atherosclerotic plaques

first satge is the fatty streak, which ocntains foam cells (everyone has this) then the development of lipid-rich plaque then the development of thrombus

what are the main risk factors of CVD

• diet- hypertension, obesity, insulin resistance diebetes

• physical activity

• smoking

• alcohol

• foetal and infant growth

• genetic

what does excess energy intake and diet consumption impact on

body composition and CVD risk

what are main prevention strategies

• tackling unhealthy life styles (e.g. poor-quality diet, physical inactivity, smoking)

• optimising risk factor

  • suppressing health risk behaviours would allow to prevent at least 80% of CVDs and even 40% of cancers

pro-atherogenic dietary components that increase risk of CVD

• cholesterol

• saturated FA

• trans FA

• sodium

• alcohol

anti-atherogenic dietary components that increase risk of CVD

• polyunsaturated fatty acids

• CHO-rich diet

• NSP

• MUFA

• antioxidant

• phytochemicals

what are other miscellaneous dietary components increasing risk of CVD

garlic and onion- allicin

green tea- cathechins

how is cholesterol a good pro-atherogenic

strong positive relationship betweeen plasma level (LDL level) and CHD. plasma concentration influenced by fat content and quality in the diet.

what does lowering raised plasma level by diet r drug do

reduces risk of CHD

1% reduction of plasma cholesterol translates to 2 to 3% lwer risk of CHD

what is hypercholesterolemia due to

poor lifestyle or genetic

saturated fatty acids as a pro-atherogenic

high level in the diet indice raise of blood cholesterol level. The magnitude of the effect depends of the nature of the fatty acid but other saturated FA with lower chain length do not modulate cholesterol level.

how much saturated fatty acids should people have

men: no more than 30g/day, women: no more than 20g/day

trans fatty acids as a pro-atherogenic

raise :D: cholesterol and plasma TAG and lower HDL cholesterol

replacing 1% of energy from trans fats with unsaturated fats reduces CHD risk by 12%

recommendation for consuming no more than 2% of total energy per day (around 5g/day for a typical adult)

sodium as a pro-atherogenic

sodium is not atherogenic but influences thrombosis by its effect on blood pressure

decreasing sodium intake and increasing potassium intake loower BP

current average salt intake 7.2g/day while the current recommendation is to not exceed Na/Cl/day (2.3g of sodium)

alcohol as a pro-atherogenic

consumption in sensibel quantity can being jor for people. However, acute consumption lead to serious health problem.

alcohol raise blood pressure

habitual heavy as well as acute consumption increaeses risk of stroke

n-6 PUFA as an anti-atherogenic

high intake of n-6 PUFA lowers LDL cholesterl, but also HDL cholesterol

mono-unsaturated FA as an anti-atherogenic

substitution of saturated fatty acid by oleic acid reduces both total and LDL cholesteril in the plasma

n-3 PUFA as an anti-atherogenic

powerful reducing effects on TAG plasma levels but minimal effects on LDL and HDL levels

they also have potent anti-inflammatory and ant-thrombotic properties

effects due to a long chain one but not alpha 18:3

carbohydrates as an anti-atherogenic

there is a reciprocal relationship between the contribution of CHO and fat to enrgy, as the variation of the proportion of energy derived from protein is very small. High CHO diet reduce risk of CHD by reducing fat intake. Should constitute around 50% of total energy intake

what is increase of dietart non starch polysaccharode inatke correlated with

a decrease risk of CVD. Help reducing cholesterol level, but no effect on VLDL and TAG levels. Perhaps beneficial effects on insulin secretion

beneficial effects on gut health

antioxidants as an anti-atherogenic

antioxidants are essential components of the cellular defence against actiavted oxygen species

they incluse Se, Zn, Mn, Vit C and E, as well as carotenoids and flavonoids, High intake of vit C, E and

tea as an anti-atherogenic

some evidence that green tea can be one, due to catechin content. no effect of black tea however

garlic as an anti-atherogenic

bioactive ingredient is allicin. Not a lot of good data availavle.

over 7 cloves daily appears to have beneficial effects

reduce platelets aggregation, increase fibrinolysis, decrease plasma fibrinogen. Potential effect on blood pressure, cholesterol and CRP

what effects does N-3 LCPUFA have

decreases arrythmias

decreases risk of thrombosis