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CAD
Coronary artery disease
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CVD
Cardiovascular Disease
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CHD
Coronary Heart Disease
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CVA
Cerebrovascular accident
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AMDR
Average Macronutrient distribution range
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SFA
Saturated Fatty Acids
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MUFA
Monounsaturated fatty acids
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PUFA
Polyunsaturated fatty acid
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EPA
Eicosapentaenoic acid
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LDL
Low-Density Lipoprotein
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HDL
High-Density lipoprotein
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What is mostly found in animal products, such as butter, meat, and cheese, as well as in coconut and palm oil?
SFA
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What is the number one cause of death among North American men and women?
CHD
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Hydrogenation of vegetable oils results in the formation of what?
trans-fatty acids
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Plant products such as vegetable oils, nuts, and seeds are the main source of?
Unsaturated FA
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What is present in shortenings, hard margarine, and baked goods, such as snack foods, crackers, cookies, and fried items?
trans-fatty acids
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What are the main constituents of dietary fats?
long-chain TG
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What are the essential fatty acids?
Linoleic and Linolenic
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What can be found in safflower, corn, soybean, cottonseed, sesame, and sunflower seeds?
Linoleic Acid
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Canola and olive oil are good sources of?
MUFA
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TG consist of FA and?
Glycerol
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What is a fat soluble component synthesized by the liver and also found in food from animal sources?
Cholesterol
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What macronutrient is most often associated with the development of obesity and CVD?
Fat
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What transports lipids and cholesterol in the blood?
lipoproteins
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Where is chol mostly stored?
liver
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What are chronic disease conditions associated with elevated bloop lipid and lipoprotein concentrations?
hyperlipidemias
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Long-term consequences of a diet high in fat, saturated and trans-fatty acids, and chol include the development of ________ plaques, which impair arterial blood flow and lead to the development of CHD?
atheroma
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What are the AMDR recommendations for fat, PRO, and CHO?
- 20-35% Fat
- 10-35% PRO
- 45-65% CHO
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What is CVD?
An abnormal condition of the heart and blood vascular system, including those associated with atherosclerosis.
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What is HD?
An abnormal condition of the heart and its vascular system such as HF and CHD.
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What is Atherosclerosis?
The chronic accumulation of chol and lipid deposits on the arterial walls, resulting in the formation of fatty streaks and hardened plaque called atheroma. With time, atheroma deposits accumulate and obstruct the lumen of arteries, reducing blood flow to important organs including the heart.
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What is HF?
Insufficiency of the heart to pump.
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What is CHD?
The accumulation of chol and lipid. causing narrowing of the arteries of the heart.
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What are lipoproteins and what is their structure?
- Micoemulsions, soluble spherical aggregates, or heterogeneous mixtures of partials that contain diverse quantities of TG, phospholipids, cholesterol, and specific PRO call apolipoproteins
- Globular structure that enables then to transport hydrophobic apolar lipids in blood from the lover and/or intestine to other tissues of the body for storage or utilization as an energy source.
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How are lipoproteins classified and differentiated?
Chemical composition, size, DENSITY.
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What are chylomicrons?
- Transport dietary TG and Chlo
- Largest lipoproteins
- Most enriched in TG
- least dense
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What is HDL?
- High-density
- small richest in PRO
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What is VLDL?
- Very-Low-Density lipoproteins
- Constituted for TG
- They transport endogenous TG originating in the liver
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What is IDL?
- Intermediate-density lipoproteins
- Contain as much TG as Chol
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What is LDL?
Low-density lipoproteins rich in Chol and represent about 70% of the total Chol in humans
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Do lipoproteins have the same metabolism and functions?
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What is the role of the liver in the metabolism of chol and lipoproteins?
Possesses some active enzymatic systems, allowing the synthesis and oxidation of FA, as well as the synthesis of TG, phospholipids, and chol. Liver can purify organism of excess chol by eliminating it in the bile as chol and bile acids.
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What is hypercholesterolemia?
The presence of abnormally high concentrations of cholesterol in the blood.
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What is hypertriglyceridemia?
The presence of abnormally high concentrations of TG in the blood.
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What is hyperlipoproteinemia?
The presence of abnormally high concentrations of lipoproteins in the blood.
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What is hypertension?
Abnormally elevated arterial blood pressure or HBP
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What is CVA?
Cerebral Stroke
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What is a stroke?
An acute brain attack due to an impairment if cerebral blood flow (caused by rupture of blood vessel or obstruction by a blood clot) and resulting in a reduction or loss of consciousness, sensations, and voluntary movement.
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What is Ischemia?
A reduction of blood supply to a localized tissue or organ, usually caused by arterial narrowing or obstruction of blood inflow to the tissue.
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What is myocardial ischemia?
A reduction of blood supply to the heart muscle so part if the heart will not be getting oxygen.
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What is Angia pectoris?
A disease characterized by the intestine, often constricting, spasmodic pain attach in the chest die to myocardial ischemia caused by a lack of oxygen supply to heart muscle.
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What is Congestive Hear Failure (CHF) ?
The inability of the heart muscle to maintain sufficient blood flow to tissues or to pump out the blood coming back to the heart by the venous circulation. Edema and congestion develop in tissues. Can't pump enough blood to organs of the body, kidneys retain water and Na.
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What is myocardial infarction (MI)?
Heart Attack or necrosis of an area of the heart muscle due to an obstruction of the coronary arterial blood flow by a thrombus or embolus.
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What is angioplasty? A surgery to repair stenosed arteries of the heart. Introduction of a catheter through the skin and inot the limen of a cardia artery that is senosed and needs to be enlarged to re-establish blood flow. Ballon tip to enlarge a narrowed area of a coronary artery.
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What is a coronary artery bypass graft (CABG)?
Major surgery to treat obstructed or almost obstructed arteries of the heart. A blood vessel is taken from another part of the body and used to replace one or more occluded heart arteries and re-establish blood circulation past the obstruction.
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What is xanthomata?
Lipid-containing yellowish plaque or nodule, especially of the skin of individuals with very high blood chol concentrations. Looks like acne on nose, ears, and elbows.
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What are the 15 risk factors of CHD?
- 1. Age > 55
- 2. Male Gender
- 3. Sedentary Lifestyle
- 4. BMI >25
- 5. Abdominal obesity
- 6. Diet high in fats, SFA, trans-fats, chol, sugars, alcohol, salt and low fiber
- 7. Smoking
- 8. HBP, esp Systolic BP
- 9. Hyperlipidemia
- 10. Family history
- 11.DM
- 12. Peripheral vascular disease or carotid atherosclerosis
- 13. Presence of lipoprotein little in blood
- 14. High blood homocysteine concentration
- 15. Presence of xanthomata
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What are the main types of hyperlipidemias?
- Elevated Blood and LDL chol concentrations
- Elevated Blood TG
- Low blood HDL
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What is Type I hyperlipoproteinema?
- Excess: Chylomicrons
- Consequence: Elevated blood TG concentrations
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What is Type IIa hyperlipoproteinema?
- Excess: LDLs
- Consequence: Elevated blood chol concentrations
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What is Type IIb hyperlipoproteinema?
- COMMON
- Excess:LDL and VLDL
- Consequence: Elevated Blood chol and TG concentration
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What is Type III hyperlipoproteinema?
- Excess: IDLs
- Consequence:Elevated chol and TG concentrations
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What is type IV hyperlipoproteinema?
- COMMON
- Excess: VLDLs
- Consequence: Elevated blood TG concentrations
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What is Type V hyperlipoproteinema?
- Excess: Chylomicrons and VLDLs
- Consequence: Elevated blood TG concentraions
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What is a blood lipid panel or a lipid profile?
- A summary of the following:
- fasting blood total
- LDL and HDL concentrations
- blood total TG concentrations
- (when possible) serum apoB and apoA concentrations
- Total HDL:Chol ratio calculated to see risk of CVD
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What is the effect of fat on on blood lipid and lipoprotein concentrations?
- Effect: Increases blood lipids esp TG, overweight, obesity
- Sources: Butter, oils, lard, milk products, eggs, fried foods
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What is the effect of SFA on blood lipid and lipoprotein concentrations?
- Effect:Increase blood TC, increase LDL, Reduce number and activity of liver LDL receptors
- Source: Butter, Lard, Milk prods, Eggs, palm and coconut oil,
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What is the effect of Trans-FA in blood lipid and lipoprotein concentrations?
- Effect: Increase TC, mostly LDL
- Sources: Hydrogenated veg oils, shortening, margarine, baked goods
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What is the effect of MUFA on blood lipid and lipoprotein concentrations?
- Effect: Reduce TC and LDL when replacing SFA
- Sources: Olive oil, canola oil, peanut oil, sesame oil
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What is the effect of PUFA from w-6 FA?
- Effect: Increase clearance of LDL particles and increase the activity of LDL receptors when substituted for SFA. Reduce TC and LDL. Also REDUCE HDL
- Sources: Salmon, sardines, trout, mackerel, herrine, anchovies
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What is the effect of PUFA from w-3 fatty acids?
- Effect: Help reduce elevated blood totoal and VLDL TG concentration, Moderately increase HDL.
- Sources: Salmon, Sardines, trout, mackeral, herring,
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What is the effect of Chol?
- Effect: Increases TC, increase LDLm
- Sources: Liver, egg yolk, organ meats, meat, poultry, milk prods.
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What is the effect of soluble fiber on lipids?
- Effect: Helps reduce high blood TC concentrations
- Sources: Beans, Lentils, dried peas, oat, apple, sweet potatoes,
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What is the effect of insoluble fiber?
- Effect: Does not modulate blood chol concentrations. Diets high in insoluble fiber tend to be low in fat, sat fat, and Chol
- Sources: Wheat, Wheat bran, rye, whole-grain pasta
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What is the effect of plant sterols?
- Effect: Plant sterols and stanols help reduce high blood TC concentrations
- Sources: Soybean, food enriched with plant sterol, veg oils, nuts, seeds, dried beans
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What is the effect of sot protein on lipids?
- Effect: Decrease high blood TC and LDL cholesterol concentrations when included in the diet in significant amounts.
- Sources: Soy beverage, tofu, textured soy pro, soybeans
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What factors can contribute to low serum HDL concentrations?
- Physical inactivity
- High-Sugar diet
- Abdominal Obesity
- Smoking
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According to AMDR recommendations what percent energy should each group get from fat: healthy adults, young children (1-3 yo), and healthy children and teenages (4-18 yo)?
- Adults: 35
- Young Children: 30-40
- Children and Teens: 25-35
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What are the 2011 recommendations about the intake of total, saturated, trans-fat, and chol?
- <70 SF
- <200 Mg Chol
- 20-30 g fiber
- stanol Esters
- TLC
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What is the purpose of the NCP for pt with hyperlipidemis/hyperlipoproteinemia?
- To help normalize their blood lipid concentration
- Reduce risk of CVD
- Precent delay CVD
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What type of diet is recommended for the management of hypercholesterolemia?
A diet low in fat, SFA, trans-fat, and chol
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What type of diet is recommended for the management of hypertriglyceridemia?
A diet low in fat, SFA, trans-FA, chol, sugars, and alcohol.
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What dietary component is used to help decrease elevated serum TG concentrations?
w-3 fatty acids from fish
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What is the optimal serum TG concentration?
<150
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What meds. could be used to manage high LDL?
Statin, resin
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What meds. could be used to manage high LDL and low HDL?
Statin, +fibrate, +niacin
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What meds could be used to manage high Chol and moderately high TG?
Statin, +fish oil, + niacin, +fibrate
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What meds. could be used to manage high blood TG?
Niacin, fibrate,
- What meds. could be used to manage LOW HDL?
- Niacin, fibrate,
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How are the target blood lipid concentrations determined for clients with hyperlipidemias?
The target blood lipid concentrations for each client with hyperlipidemias are determined according to the 10-year risk of CHD of the client.
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When you reduce your blood chol concentration by 1%, how much have you lowered your risk of CHD?
2%
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What diet is recommended for the treatment of hyperchylomicronemia?
- Diet very low in fat (or fat restricted)
- 25-50 g fat per day
- 10-20% energy from fat
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What is the Na AI & UL for adults?
- AI: 1.5g/da (3.8g salt)
- UL: 2.3g/day (5.9 salt)
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What is the optimal BP?
<120 mmHg systolic blood / <80 mmHg diastolic BP
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What BP correspond with hypertension?
>140/90
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What is the DASH diet?
Dietary Approach to Stop Hypertension, diet is low in Na and rich in fruits, veggies, whole grain prods, and low-fat dairy.
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How do you determine milliequivalents?
mEq to Mg = divide by the atomic number of Na (23g)
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How much Na is in one tsp of salt?
2325mg
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What are the treatment targets for pt with hypertension?
- <140/<90 mmHg
- DM & renal: <130/<80 mmHg
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What are the main meds used for HBP?
- Thiazide diuretics
- Beta Blockers
- ACE Inhibitors
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What factors lead to an increased risk of developing hypertension?
- Smoking
- Excessive alcohol consumption
- DM
- stress
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The lipids originating from the diet are abs and transported in the lymph to the liver by?
chylomicrons
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Is regression of atherosclerosis and CHD possible?
Yes. If they follow TLC
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What type of diet is recommend for pt with cardiac cachexia?
- Restricting Na, salt, and water
- Give some sort of oral supplement
- High PRO, low Na bars
- <1.5 water, 1 g Na
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What diet is recommend after CABG or angioplasty?
- TLC
- <2g Salt
- fluid restricted
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What dietary recommendations are given to clients on Coumadin to limit adverse effects from nutrient-drug interations?
Too much vit K, teach which foods have vit K (spinach, Brussel sprouts, cabbage)
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A deficiency in which vitamins is thought to be associated with the development of hyperhomocysteninemia, esp in elderly who have suboptimal intake of vitamins?
Folate, pyridoxine, and vit. B12
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