Nutrition 1020

• #1 cause of death in America.

• 1/3 die of atherosclerosis.

• Myocardial infarction and stroke risk increase with atherosclerosis

• Occlude arterial vessels.

• Form from arterial wall injury.

• Contain cholesterol (oxidized LDL), platelets, etc.

Is high blood pressure.

Is a leading cause of arterial wall injury.

Synergizes with atherosclerosis to cause heart disease and stroke.

• 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

• • 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

• • Elevated serum cholesterol
• • Genetics
• • Smoking tobacco & drinking alcohol
• • Hypertension
• • Diabetes
• • Obesity
• • Sedentary lifestyle
• • Stress
• • Male gender
• • Consuming a low fiber & high fat diet

• • 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

• Serum Triglycerides
• • VLDL
• • CHYLOMICRONS

• Serum Cholesterol
• • LDL (Bad, 77.5%)
• • HDL (Good, 17.5%)
• -IDL (Neutral, 5%)

• 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.

• 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.

< 200 mg/dl Desirable/Low Risk

200-239 mg/dl Borderline High Risk

≥ 240 mg/dl High Risk

< 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

< 40 Low (indicates risk)

> 60 High

• 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” ♂

• SFA:Increase LDL

• PUFA :Decrease LDL & HDL

• MUFA:Decrease LDL

• Cholesterol:Can Increase LDL

• Phospholipids:Not indicated in heart disease

• 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.

oxidation reactions, react with oxygen radical species directly, & prevent heart disease.

vitamin E(alpha-tocopherol), vitamin C (L-ascorbic acid),beta-carotene (provitamin A)

Zinc, Copper, & Iron

• 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.

• 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.

• The naturally occurring configuration in PUFA & MUFA.

• Hydrogen atoms are on the same side of the double bond in the fatty acid Carbon chain.

• 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.

• 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.

• 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.

• 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)

• • 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.

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.

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.

• • 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.