Nutrition 1020

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faulkner116
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204985
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Nutrition 1020
Updated:
2013-03-04 18:52:33
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Module3
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Lipids in Heart Disease & Cancer 3.5
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  1. Heart Disease
    • #1 cause of death in America.

    • 1/3 die of atherosclerosis.

    • Myocardial infarction and stroke risk increase with atherosclerosis
  2. Atherosclerosis

    Plaques:
    • Occlude arterial vessels.

    • Form from arterial wall injury.

    • Contain cholesterol (oxidized LDL), platelets, etc.
  3. Hypertension
    Is high blood pressure.

    Is a leading cause of arterial wall injury.

    Synergizes with atherosclerosis to cause heart disease and stroke.
  4. Blood Pressure Classification of Measurements

    Picture
  5. How do you reduce blood pressure?
    • DASH Diet (The Dietary Approach to Stop Hypertension)

    • -Increase calcium, potassium and magnesium
    • -Low-fat, fiber-rich, moderate protein & carbohydrate

    • Aerobic exercise

    • Healthy Body Weight
  6. Who is Dying of Heart Disease?
    • • 25-34 years: Men at 3X rate as Women
    • • 35-44 years: Men at 2X rate as Women
    • • 45-64 years: Women catching up to men
    • • 65-75 years: Women catching up to men
    • • 75-80 years: Women = Men
  7. What are the Risk Factors?
    • • Elevated serum cholesterol
    • • Genetics
    • • Smoking tobacco & drinking alcohol
    • • Hypertension
    • • Diabetes
    • • Obesity
    • • Sedentary lifestyle
    • • Stress
    • • Male gender
    • • Consuming a low fiber & high fat diet
  8. How can heart disease be prevented?
    • • Lifestyle changes
    • - Less stress, no smoking

    • • Healthy diet
    • - Healthy fats, nutritionally adequate

    • • Regular aerobic exercise
    • - An hour a day

    • All positively affect blood lipid values and blood pressure
  9. Blood Lipids
    • Serum Triglycerides
    • • VLDL
    • • CHYLOMICRONS

    • Serum Cholesterol
    • • LDL (Bad, 77.5%)
    • • HDL (Good, 17.5%)
    • -IDL (Neutral, 5%)
  10. Serum Triglycerides
    • Elevated levels are associated with heart disease.

    • High triglyceride levels thicken the blood causing hypertriglyceridemia.

    • Triglycerides are packaged primarily in Chylomicrons and Very Low Density Lipoproteins (VLDL).

    • A fasting 12 hour blood test is needed to determine an accurate triglyceride level.

    <150mg/dl is normal.

    - 450 mg/dl is like pumping ketchup, causes arterial damage contributing to heart disease and stroke.
  11. Serum Cholesterol
    • Elevated levels are associated with atherosclerosis if 2 other risk factors exist.

    • Cholesterol is packaged as Low Density Lipoproteins (LDL) and High Density Lipoprotein(HDL). Intermediate Density Lipoprotein (IDL) is present to a minor extent.

    • HDL’s return cholesterol to the liver for synthesis of bile, hormones, and vitamins.

    • LDL’s delivers cholesterol to tissue and therefore have a higher plaque effect.
  12. Blood Cholesterol Levels & Disease Risk

    AHA

    Total Cholesterol
    < 200 mg/dl Desirable/Low Risk

    200-239 mg/dl Borderline High Risk

    ≥ 240 mg/dl High Risk
  13. Blood Cholesterol Levels & Disease Risk

    AHA

    LDL Cholesterol
    < 100 mg/dlOptimal

    100-129 mg/dl Near optimal

    130-159 mg/dl Borderline high

    160-189 mg/dl High

    ≥ 190 mg/dl Very high
  14. Blood Cholesterol Levels & Disease Risk

    AHA

    HDL Cholesterol
    < 40 Low (indicates risk)

    > 60 High
  15. Blood Cholesterol Levels & Disease Risk

    NCEP ATP III

    Metabolic Syndrome:
    If Three or More of These Factors
    • 1. Fasting Blood Triglycerides: ≥150 mg/dl
    • 2. HDL: <50 mg/dl ♀ <40 mg/dl ♂
    • 3. Blood Pressure: ≥130/85 mm Hg
    • 4. Fasting Blood Glucose: ≥110 mg/dl
    • 5. Waist Circumference: >35” ♀ >40” ♂
  16. Dietary Fat & Lipoproteins
    • SFA:Increase LDL

    • PUFA :Decrease LDL & HDL

    • MUFA:Decrease LDL

    • Cholesterol:Can Increase LDL

    • Phospholipids:Not indicated in heart disease
  17. Oxidation of Fat
    • The double bonds of polyunsaturated fatty acids are targets for oxidation(damage by oxygen species).

    • The double bond breaks with oxidation generating lipid fragments that are very sticky.(-CH2CH=CHCH2- to CH2CHO + CH2CHO).

    • The sticky fragments contribute to atherosclerotic plaque formation.
  18. Antioxidants

    Antioxidants: Prevent
    oxidation reactions, react with oxygen radical species directly, & prevent heart disease.
  19. Antioxidants

    Antioxidants vitamins include:
    vitamin E(alpha-tocopherol), vitamin C (L-ascorbic acid),beta-carotene (provitamin A)
  20. Antioxidants

    Minerals with antioxidant cofactor functions include:
    Zinc, Copper, & Iron
  21. Hydrogenation of Fat
    • Trans fatty acids levels are high in processed foods containing partially hydrogenated oils.

    • The double bonds from PUFA & MUFA are removed by hydrogenation (adding hydrogen).

    • The fatty acid becomes more saturated.

    • Is used in the process of making margarine.

    • - The softer the margarine the less trans fat.
    • - Stick margarine & shortening are highly hydrogenated and partially hydrogenated.
  22. Partial Hydrogenation of Fat
    • Is done in the food industry.

    • Many of the double bonds from PUFA & MUFA are removed and many can be chemically modified to a trans fatty acid (TFA)configuration.

    • TFAs contribute to heart disease.
  23. Cis vs. Trans Fatty Acids

    Cis:
    • The naturally occurring configuration in PUFA & MUFA.

    • Hydrogen atoms are on the same side of the double bond in the fatty acid Carbon chain.
  24. Cis vs. Trans Fatty Acids

    Trans:
    • Form during the partial hydrogenation process.

    • A chemical “Fluke”

    • Hydrogen atoms are on the opposite side of the double bond in the fatty acid Carbon chain.
  25. Trans Fatty Acids are Detrimental to Health
    • TFAs contribute to heart disease by increasing LDL & decreasing HDL cholesterol & increasing triglycerides.

    • An intake of 2-3% of energy from TFAs has greater than predicted negative effects from the marked adverse blood lipid changes. TFAs may also contribute to inflammation, endothelial cell dysfunction,and diabetes (insulin resistance).

    • Intake should be < 1% of energy to as low as possible.
  26. Consumer Keys for Avoiding Trans Fatty Acids
    • Read the nutrition facts panel. TFA free is defined as ≤0.5 gm/serving.

    • Avoid foods with partially hydrogenated oils in the ingredient list (such as cookies, chips,doughnuts) on the food label.

    • Bake with vegetable oils.

    • Use margarines that are soft. Choose margarines that are trans fatty acid free.

    • Avoid deep-fat fried foods like french fries, corn chips, doughnuts, & chicken nuggets.

    • Avoid high meat and dairy product intake as a natural TFA source from bacterial action on unsaturated fatty acids in the ruminants stomach.
  27. How Do Omega-3Fatty Acids Work?
    • They affect the synthesis of eicosanoid hormone like compounds such as prostaglandins & leukotrienes.

    • The compounds produced from omega 3 fatty acids:

    • -Decrease blood clotting (prevent plaque build-up)
    • -Decrease blood pressure (prevent atherosclerosis)
    • -Decrease blood total cholesterol, LDL cholesterol, &triglycerides & increase HDL cholesterol)
    • -Decrease inflammation (prevent arthritis, asthma)
    • -Increase immunity (prevent cancer)
  28. American Heart Association omega 3 fatty acid recommend
    • • Consume 0.5-1.8 grams of omega-3 fatty acids per day as fatty fish or supplements.
    • --- The omega-3 fatty acids in fish are called EPA & DHA.

    • • Consume 1.5-3.0 grams alpha-linolenic acid (an omega-3 fatty acid) per day.
    • --Plant sources of omega-three fatty acids flax seed, walnuts, & canola oil.
  29. Omega-3 Fatty Acids in Fish
    Best Sources:• Salmon• Herring• Mackerel• Tuna• Whitefish•


    Good Sources:• Cod• Flounder• Halibut• Mahi Mahi• Orange Roughy• Sea Bass• Clams

    To avoid mercury contamination, Scallops eat fish that live closer to the surface and have a shorter lifespan.
  30. Homocysteine in Heart Disease

    Homocysteine is an
    amino acid intermediate of cysteine & methionine metabolism.

    • Elevated levels of homocysteine cause arterial wall damage & contribute to heart disease.

    • Folic acid (folate), B6 & B12 function as cofactors for the enzymes driving the inter conversion of cysteine & methionine, thus adequate intakes prevent hyperhomocystemia.
  31. Other Factors in Heart Disease
    • High doses of Niacin: Increases HDL, decreases LDL.
    • Statin type cholesterol lowering drugs: Reduce the synthesis of cholesterol in the liver.
    • Cholesterol absorption inhibitor drugs.
    • Benecol spreads: Contain plant stanol esters that reduce the absorption of cholesterol in the digestive tract.
    • Wine: Reduces blood viscosity. Red wine and/or grape juice increases HDL.
    • Alcohol: 1 serving per day decreases risk of a cardiovascular accident. It is an anticoagulant.
    • Aerobic Activity: Increases HDL, decreases LDL.
    • Soluble Fiber: Decreases LDL.
    • Soy Protein: Increases HDL, decreases LDL.

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